Pain, depression, and poor quality of life in chronic pancreatitis: Relationship with altered brain metabolites

To evaluate if altered brain metabolites are connected to pain, depression and affective responses in CP. In this prospective study we evaluated pain characteristics, QOL (EORTC QLQc30+PAN28), depression (Beck depression inventory [BDI] II) in 558 patients with CP and 67 healthy controls. Brain metabolites were evaluated using magnetic resonance spectroscopy (MRS) in 49 patients and 5 healthy controls. We measured plasma metabolites using gas chromatography-mass spectrometry (GC-MS/MS). Relationship between metabolomic alterations, pain, depression and QOL components were assessed using statistical/bioinformatics methods. Benjamini-Hochberg FDR correction was applied for multiple testing. 261 (46.8%) patients had depression compared to 5 (7.5%) among healthy controls [n = 67](p