目的:观察不同强度不同层次针灸刺激承山穴对腓肠肌炎性痛的镇痛作用,分析热灸样刺激(Mox)、电针(EA)和经皮穴位电刺激(TEAS)的镇痛特征及其和感觉传入的关系。方法:以双足承重差值为疼痛行为指标,在肌肉炎性痛模型上,分别观察Mox、不...目的:观察不同强度不同层次针灸刺激承山穴对腓肠肌炎性痛的镇痛作用,分析热灸样刺激(Mox)、电针(EA)和经皮穴位电刺激(TEAS)的镇痛特征及其和感觉传入的关系。方法:以双足承重差值为疼痛行为指标,在肌肉炎性痛模型上,分别观察Mox、不同强度不同层次EA、不同强度TEAS的镇痛效果;免疫荧光染色观察皮下SP/CGRP+C-纤维的表达;透射电镜观察胫神经中髓鞘的结构;切断皮神经或用蛇毒破坏A-纤维髓鞘,分析参与镇痛的外周传入类型。结果:Mox、1 mA EA深刺肌肉和5 mA TEAS能显著改善大鼠痛行为(P<0.01)。Mox和TEAS均可激活皮下肽能C-纤维;去皮神经后这种效应消失。切断皮神经后Mox的镇痛作用消失,TEAS的镇痛效应减弱,但EA的镇痛不受影响。阻断肌肉A-纤维传入后,EA和TEAS的镇痛作用消失。结论:Mox与EA镇痛作用分别通过激活皮肤C-纤维、肌肉A-纤维来实现,介导TEAS镇痛的感觉传入主要是肌肉A-纤维。这可能是3种针灸刺激镇痛作用的神经传入特征。展开更多
Autonomic dysreflexia （AD） is a serious cardiovascular disorder in patients with spinal cord injury （SCI）. The primary underlying cause of AD is loss of supraspinal control over sympathetic preganglionic neurons ...Autonomic dysreflexia （AD） is a serious cardiovascular disorder in patients with spinal cord injury （SCI）. The primary underlying cause of AD is loss of supraspinal control over sympathetic preganglionic neurons （SPNs） caudal to the injury, which renders the SPNs hyper-responsive to stimulation. Central maladaptive plasticity, including C-fiber sprouting and propriospinal fiber proliferation exaggerates noxious afferent transmission to the SPNs, causing them to release massive sympathetic discharges that result in severe hypertensive episodes. In parallel, upregulated peripheral vascular sensitivity following SCI exacerbates the hypertensive response by augmenting gastric and pelvic vasoconstriction. Currently, the majority of clinically employed treatments for AD involve anti-hypertensive medications and Botox injections to the bladder. Although these approaches mitigate the severity of AD, they only yield transient effects and target the effector organs, rather than addressing the primary issue of central sympathetic dysregulation. As such, strategies that aim to restore supraspinal reinnervation of SPNs to improve cardiovascular sympathetic regulation are likely more effective for AD. Recent pre-clinical investigations show that cell transplantation therapy is efficacious in reestablishing spinal sympathetic connections and improving hemodynamic per- formance, which holds promise as a potential therapeutic approach.展开更多
Background: selective activation and the contempo- rary recording of A delta and C fibers from Yap laser on the scalp is a new neurophysiological assessment, allowing the selective activation of the nociceptive system...Background: selective activation and the contempo- rary recording of A delta and C fibers from Yap laser on the scalp is a new neurophysiological assessment, allowing the selective activation of the nociceptive system. Objectives: to evaluate if the damage of the nociceptive system was related to post herptic nevral-gia (PHN) development in a sample of 26 patients affected by Herpes zooster (HZ);secondly to assess if the impairment of thermal pathway and PHN development were related. Methods: Thirty-two patients were selected for the study, 26 of these were included in the study, whereas 6 were excluded because of cog- nitive impairment. All 26 study patients were sub- mitted to LEP analysis at baseline (T0) and after six months (T1), and the correlation between clinical thermal disease and the development of PHN was monitored. Results: pain duration was evidenced by the presence or absence of an instrumental signal in patients with acute HZ infection. There was total concordance between the absence of LEP signal and pain duration. The concordance between the clinical thermal disease and the pain duration was statisti- cally significant for 43% of the sample. Conclusions: our results suggested a possible role of LEP for PHN prognosis estimation;indeed, most patients affected by acute HZ, with absence of instrumental LEP signal had pain > 6 months. We also noted a significant (43% of cases) clinical concordance between the thermal pathway damage, the absence of instrumental signal and PHN development. Further studies are needed to address this issue.展开更多
文摘目的:观察不同强度不同层次针灸刺激承山穴对腓肠肌炎性痛的镇痛作用,分析热灸样刺激(Mox)、电针(EA)和经皮穴位电刺激(TEAS)的镇痛特征及其和感觉传入的关系。方法:以双足承重差值为疼痛行为指标,在肌肉炎性痛模型上,分别观察Mox、不同强度不同层次EA、不同强度TEAS的镇痛效果;免疫荧光染色观察皮下SP/CGRP+C-纤维的表达;透射电镜观察胫神经中髓鞘的结构;切断皮神经或用蛇毒破坏A-纤维髓鞘,分析参与镇痛的外周传入类型。结果:Mox、1 mA EA深刺肌肉和5 mA TEAS能显著改善大鼠痛行为(P<0.01)。Mox和TEAS均可激活皮下肽能C-纤维;去皮神经后这种效应消失。切断皮神经后Mox的镇痛作用消失,TEAS的镇痛效应减弱,但EA的镇痛不受影响。阻断肌肉A-纤维传入后,EA和TEAS的镇痛作用消失。结论:Mox与EA镇痛作用分别通过激活皮肤C-纤维、肌肉A-纤维来实现,介导TEAS镇痛的感觉传入主要是肌肉A-纤维。这可能是3种针灸刺激镇痛作用的神经传入特征。
基金supported by NIH NINDS R01NS099076,Morton Cure Paralysis Funds(MCPF)
文摘Autonomic dysreflexia （AD） is a serious cardiovascular disorder in patients with spinal cord injury （SCI）. The primary underlying cause of AD is loss of supraspinal control over sympathetic preganglionic neurons （SPNs） caudal to the injury, which renders the SPNs hyper-responsive to stimulation. Central maladaptive plasticity, including C-fiber sprouting and propriospinal fiber proliferation exaggerates noxious afferent transmission to the SPNs, causing them to release massive sympathetic discharges that result in severe hypertensive episodes. In parallel, upregulated peripheral vascular sensitivity following SCI exacerbates the hypertensive response by augmenting gastric and pelvic vasoconstriction. Currently, the majority of clinically employed treatments for AD involve anti-hypertensive medications and Botox injections to the bladder. Although these approaches mitigate the severity of AD, they only yield transient effects and target the effector organs, rather than addressing the primary issue of central sympathetic dysregulation. As such, strategies that aim to restore supraspinal reinnervation of SPNs to improve cardiovascular sympathetic regulation are likely more effective for AD. Recent pre-clinical investigations show that cell transplantation therapy is efficacious in reestablishing spinal sympathetic connections and improving hemodynamic per- formance, which holds promise as a potential therapeutic approach.
文摘Background: selective activation and the contempo- rary recording of A delta and C fibers from Yap laser on the scalp is a new neurophysiological assessment, allowing the selective activation of the nociceptive system. Objectives: to evaluate if the damage of the nociceptive system was related to post herptic nevral-gia (PHN) development in a sample of 26 patients affected by Herpes zooster (HZ);secondly to assess if the impairment of thermal pathway and PHN development were related. Methods: Thirty-two patients were selected for the study, 26 of these were included in the study, whereas 6 were excluded because of cog- nitive impairment. All 26 study patients were sub- mitted to LEP analysis at baseline (T0) and after six months (T1), and the correlation between clinical thermal disease and the development of PHN was monitored. Results: pain duration was evidenced by the presence or absence of an instrumental signal in patients with acute HZ infection. There was total concordance between the absence of LEP signal and pain duration. The concordance between the clinical thermal disease and the pain duration was statisti- cally significant for 43% of the sample. Conclusions: our results suggested a possible role of LEP for PHN prognosis estimation;indeed, most patients affected by acute HZ, with absence of instrumental LEP signal had pain > 6 months. We also noted a significant (43% of cases) clinical concordance between the thermal pathway damage, the absence of instrumental signal and PHN development. Further studies are needed to address this issue.
基金This work was supported by the National Natural Science Foundation of China (No. 30070256 and No.30200076) CMB-SUMSScholarship (No.98-766) and a grant from Health department of Guangdong Province.
