• Title/Summary/Keyword: Central pain

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Differential Role of Central GABA Receptors in Nociception of Orofacial Area in Rats

  • Lee, Ah-Ram;Lim, Nak-hyung;Kim, Hye-Jin;Kim, Min-Ji;Ju, Jin-Sook;Park, Min-Kyoung;Lee, Min-Kyung;Yang, Kui-Ye;Ahn, Dong-Kuk
    • International Journal of Oral Biology
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    • v.40 no.3
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    • pp.117-125
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    • 2015
  • The present study investigated the role of central $GABA_A$ and $GABA_B$ receptors in orofacial pain in rats. Experiments were conducted on Sprague-Dawley rats weighing between 230 and 280 g. Intracisternal catheterization was performed for intracisternal injection, under ketamine anesthesia. Complete Freund's Adjuvant (CFA)-induced thermal hyperalgesia and inferior alveolar nerve injury-induced mechanical allodynia were employed as orofacial pain models. Intracisternal administration of bicuculline, a $GABA_A$ receptor antagonist, produced mechanical allodynia in naive rats, but not thermal hyperalgesia. However, CGP35348, a $GABA_B$ receptor antagonist, did not show any pain behavior in naive rats. Intracisternal administration of muscimol, a $GABA_A$ receptor agonist, attenuated the thermal hyperalgesia and mechanical allodynia in rats with CFA treatment and inferior alveolar nerve injury, respectively. On the contrary, intracisternal administration of bicuculline also attenuated the mechanical allodynia in rats with inferior alveolar nerve injury. Intracisternal administration of baclofen, a $GABA_B$ receptor agonist, attenuated the thermal hyperalgesia and mechanical allodynia in rats with CFA treatment and inferior alveolar nerve injury, respectively. In contrast to $GABA_A$ receptor antagonist, intracisternal administration of CGP35348 did not affect either the thermal hyperalgesia or mechanical allodynia. Our current findings suggest that the $GABA_A$ receptor, but not the $GABA_B$ receptor, participates in pain processing under normal conditions. Intracisternal administration of $GABA_A$ receptor antagonist, but not $GABA_B$ receptor antagonist, produces paradoxical antinociception under pain conditions. These results suggest that central GABA has differential roles in the processing of orofacial pain, and the blockade of $GABA_A$ receptor provides new therapeutic targets for the treatment of chronic pain.

Effects of Acupuncture, Electro-acupuncture, Low Level He-Ne Laser Therapy at Oe-gwan($TE_5$) ${\cdot}$ Chogimup ($GB_{41}$) on L5 Spinal Nerve Ligation Model in Rats (건측(健測) 취혈(取穴) 다종(多種) 침자법(鍼刺法)이 백서(白鼠)의 신경병리성(神經病理性) 동통(疼痛)에 미치는 영향)

  • Jung, Jung-Hee;Cho, Myung-Rae;Wei, Tung-Sheun;Ryu, Chung-Ryeol
    • Journal of Acupuncture Research
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    • v.24 no.5
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    • pp.137-150
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    • 2007
  • Objectives : To find effects of acupuncture, electro-acupuncture, low level He-Ne laser therapy(LLLT) at $TE_5$, $GB_{41}$ in the neuropathic pain. We made experiment on rats ligated L5 spinal nerve like general herniation of nucleus pulposus(HNP). Methods : A model of neuropathic pain was made by isolating Left 5th lumbar spinal nerve of rats. Three days after the neuropathic surgery, acupuncture and LLLT, electro-acupuncture was injected at $TE_5$, $GB_{41}$ one time a day for a week. Each group was divided two. one is opposite side performed the surgery which is right, another is left side performed the surgery. After that, the author examined the withdrawal response of neuropathic rats' legs by van Frey filament and acetone stimulation. And also the author examined c-Fos, Nociceptin and KOR-3 in the midbrain central gray of neuropathic rats. Results : As we have observed the effect of mechanical allodynia, LT-R group were diminished on 6th day compared with control group, EA-L group, EA-R group and LT-L group were diminished on 7th day compared with control group. As we have observed the effect of cold allodynia, EA-R group were diminished on 6th day, 7th day compared with control group. As we have observed the effect of activity of c-Fos in the central gray part, EA-R group and LT-R group were diminished compared with control group. As we have observed the effect of activity of Nociceptin in the central gray part, EA-R group were a little increased compared with control group but it is not reliability. As we have observed the effect of activity of KOR-3 in the central gray part, EA-R group were significantly increased compared with control group. Conclusions : We have noticed that effect of acupuncture at opposite side of sickness and powerful stimulation could be more effective, because of EA-R group have more controllable effect all test we have done on the other hand EA-L group have only effect on mechanical allodynia. This study can be used in clinical therapy for neuropathic pain. But it is not reliability that Nociceptin have effectively to control pain. Therefore We have to follow up about that.

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Changes in Cross-sectional Area of Lumbar Muscle in Patients with Chronic Back Pain (만성요통환자의 요부근육 단면적의 변화)

  • Kim, Seong-Yeol
    • The Journal of Korean Physical Therapy
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    • v.22 no.5
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    • pp.39-47
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    • 2010
  • Purpose: The purpose of this study was to characterize changes in back muscles in patients with chronic back pain. Accordingly, we studied 154 patients with chronic low back pain with regard to area, aspect and triggering position of the pain. We also determined muscle atrophy in painful areas. Methods: Subjects were questioned about pain and a pain provoking test was done. On Magnetic Resonance Imaging (MRI), we measured cross sections of the multifidus, erector spinae, iliopsoas and quadratus lumborum muscles at each spinal level. Results: Muscles in painful regions (multifidus and erector spinae muscles) decreased in area significantly more than nonpainful regions, and showed a significant difference (p<0.05) at levels L3, L4, and L5. Painful regions of the iliopsoas and quadratus lumborum did not change significantly more than non-painful regionsexcept at L5 (p<0.05). The group that had unilateral low back pain showed a significant decrease in cross section compared to the group that had central or bilateral pain (p<0.05). Conclusion: Chronic low back pain causes variable decreases in cross-sectional areas of some but not all back muscles, and at some but not all spinal levels.

Low Level Laser Therapy for Two Patients with Herniated Nucleus Pulposus (척추 추간판 탈출증의 저출력 레이저에 의한 치험 2예)

  • Kim, Young-Choo;Kim, Hae-Gyu;Baik, Seong-Wan;Kim, Inn-Se;Jung, Kyoo-Sub
    • The Korean Journal of Pain
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    • v.4 no.1
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    • pp.51-55
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    • 1991
  • There is a variety of therapeutic modality for herniated nucleus pulposus. Recently the low level laser has come into use for treatment for it. We treated two patients suffered from herniated nucleus pulposus of the central type of $L_{3,4}$ level, with He-Ne, $CO_2$ and Ga Al As laser simultaneously daily under hospitalization. In order to determine the efficacy of treatment, we used the "visual analogue scale" and its improvement rate. The results were as follows; Case I complained of gait disturbance, and hypoesthesia on the lateral side of the left lower leg, as and as low back pain. At the 15th day after treatment, VAS improvement rate was 40%, and the gait disturbance and hypoesthesia were markedly improved. 35th days after tratement, VAS improvement rate was 80%. Case II complained only of low back pain. At the 15th day after treatment, the VAS improvement rate was 68%, and at 20 days after treatment it was 84%. We sugsest that, using the low level laser for treatment of herniated nucleus pulposus increased the cartilage entrophism, and inhibitory effects of the inflammatory materials such as acid glycosaminoglycan by its anti-inflammatory and analgesic effects.

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Glia as a Link between Neuroinflammation and Neuropathic Pain

  • Jha, Mithilesh Kumar;Jeon, Sang-Min;Suk, Kyoung-Ho
    • IMMUNE NETWORK
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    • v.12 no.2
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    • pp.41-47
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    • 2012
  • Contemporary studies illustrate that peripheral injuries activate glial components of the peripheral and central cellular circuitry. The subsequent release of glial stressors or activating signals contributes to neuropathic pain and neuroinflammation. Recent studies document the importance of glia in the development and persistence of neuropathic pain and neuroinflammation as a connecting link, thereby focusing attention on the glial pathology as the general underlying factor in essentially all age-related neurodegenerative diseases. There is wide agreement that excessive glial activation is a key process in nervous system disorders involving the release of strong pro-inflammatory cytokines, which can trigger worsening of multiple disease states. This review will briefly discuss the recent findings that have shed light on the molecular and cellular mechanisms of glia as a connecting link between neuropathic pain and neuroinflammation.

Effect of warming local anesthesia solutions before intraoral administration in dentistry: a systematic review

  • Tirupathi, Sunny Priyatham;Rajasekhar, Srinitya
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.20 no.4
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    • pp.187-194
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    • 2020
  • Background: The aim of the present systematic review was to evaluate and compare the efficacy of warmed and unwarmed local anesthesia solutions in reduction of pain during intraoral injection administration. Methods: PubMed, Ovid SP, and Cochrane Central Register of Controlled Trials were searched from publication years 1990 to 2020 with relevant MeSH terms. Studies were screened by titles and abstracts, followed by full-texts evaluation of the included studies. Results: A total of four studies were included in the systematic review. Outcomes evaluated were subjective and objective pain during administration of the warmed local anesthesia solution in comparison with the unwarmed local anesthesia solution. Among the four studies that evaluated the self-reported pain score, three studies showed significantly lower pain scores associated with warmed local anesthesia. Only two studies evaluated the observed pain score, and both of them reported a significantly lower pain reaction with the warmed local anesthesia solution. Conclusion: Within the limits of this systematic review, warming the local anesthesia solution to body temperature (37℃) before administration seemed to reduce the discomfort during intraoral local anaesthesia administration, and more high-quality studies should be carried out to validate the same.

Serotonin syndrome in a patient with chronic pain taking analgesic drugs mistaken for psychogenic nonepileptic seizure: a case report

  • Boudier-Reveret, Mathieu;Chang, Min Cheol
    • Journal of Yeungnam Medical Science
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    • v.38 no.4
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    • pp.371-373
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    • 2021
  • Serotonin syndrome (SS) is a potentially life-threatening condition that is caused by the administration of drugs that increase serotonergic activity in the central nervous system. We report a case of serotonin syndrome in a patient with chronic pain who was taking analgesic drugs. A 36-year-old female with chronic pain in the lower back and right buttock area had been taking tramadol hydrochloride 187.5 mg, acetaminophen 325 mg, pregabalin 150 mg, duloxetine 60 mg, and triazolam 0.25 mg daily for several months. After amitriptyline 10 mg was added to achieve better pain control, the patient developed SS, which was mistaken for psychogenic nonepileptic seizure. However, her symptoms completely disappeared after discontinuation of the drugs that were thought to trigger SS and subsequent hydration with normal saline. Various drugs that can increase serotonergic activity are being widely prescribed for patients with chronic pain. Clinicians should be aware of the potential for the occurrence of SS when prescribing pain medications to patients with chronic pain.

Effectiveness of graded motor imagery in subjects with frozen shoulder: a pilot randomized controlled trial

  • Gurudut, Peeyoosha;Godse, Apurva Nitin
    • The Korean Journal of Pain
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    • v.35 no.2
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    • pp.152-159
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    • 2022
  • Background: Subjects with frozen shoulder (FS) might not be comfortable with vigorous physical therapy. Clinical trials assessing the effect of graded motor imagery (GMI) in FS are lacking. The aim of this study was to determine the effect of GMI as an adjunct to conventional physiotherapy in individuals with painful FS. Methods: Twenty subjects aged 40-65 years having stage I and II of FS were randomly divided into two study groups. The conventional physiotherapy group (n = 10) received electrotherapy and exercises while the GMI group (n = 10) received GMI along with the conventional physiotherapy thrice a week for 3 weeks. Pre- (Session 1) and post- (Session 9) intervention analysis for flexion, abduction, and external rotation range of motion (ROM) using a universal goniometer, fear of movement using the fear avoidance belief questionnaire (FABQ), pain with the visual analogue scale, and functional disability using the shoulder pain and disability index (SPADI) was done by a blinded assessor. Results: Statistically significant difference was seen within both the groups for all the outcomes. In terms of increasing abduction ROM as well as reducing fear of movement, pain, and functional disability, the GMI group was significantly better than control group. However, both groups were equally effective for improving flexion and external rotation ROM. Conclusions: Addition of GMI to the conventional physiotherapy proved to be superior to conventional physiotherapy alone in terms of reducing pain, kinesiophobia, and improving shoulder function for stage I and II of FS.

An experimental study of Yangsymtang's effects on the activities of Central Nervous System (중추신경계(中樞神經系)에 작용(作用)하는 양심탕(養心湯)의 실험중적(實驗中的) 연구(硏究))

  • Joa Seung-Ho;Lee Jin-Yong;Kim Deok-Gon;Jeong Gyu-Man
    • The Journal of Pediatrics of Korean Medicine
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    • v.10 no.1
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    • pp.245-263
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    • 1996
  • In order to investigate the effects of Yangsymtang on the activities of central nervous system, we observed the effects on convulsions induced by pentylenetetrazole, strychnine and picrotoxin. The sedative those on spontaneous motor activity and by rota rod method, the those on sleeping time induced by barbiturate and the alleviative those on pain induced by acetic acid and hind limb pressure also were analyzed. The results were as follows: 1. The solid extracts of Yangsymtang showed no anticonvulsive effects on convulsions induced by pentylenetetrazole, strychnine and picrotoxin. 2. As to the sedative effects by rota rod method, th solid extracts of Yangsymtang were recognized as significance(P<0.01). 3. The sleeping time induced by thiopental sodium was not prolonged by the oral administration of the solid extracts of Yangsymtang. 4. The oral administration of Yangsymtang did not influenced the sleeping induced by pentobarbital sodium significantly. 5. As to the effects on spontaneous motor activity, the oral administration of Yangsymtang made spontaneous motor activity decrease significantly(P<0.05). 6. The oral administration of Yangsymtang was significant on pain induced by acetic acid(P<0.001). 7. As to alleviative effects on pain induced by hind limb pressure. The solid extracts of Yangsymtang were not significant.

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Anti-nociceptive and Anti-inflammatory Effect of an Ethanol Extract of The Leaf and Stem of Aralia cordata

  • Jang, Ji Yeon;Seong, Yeon Hee
    • Natural Product Sciences
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    • v.20 no.4
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    • pp.301-305
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    • 2014
  • The aim of our study is to investigate the anti-nociceptive and anti-inflammatory properties of an ethanol extract of the leaf and stem of Aralia cordata. Writhing responses induced by acetic acid, tail immersion test, and formalin-induced paw pain response for nociception and formalin-induced paw edema for inflammation were evaluated in mice. A. cordata (50 - 200 mg/kg, p.o.) and ibuprofen (100 mg/kg, p.o.), a positive non-steroidal anti-inflammatory drugs (NSAIDs), inhibited the acetic acid-induced writhing response, but they did not protect the thermal nociception in tail immersion test. However, morphine (5 mg/kg, s.c.) used as positive opioid control alleviated both the acetic acid-induced writhing response and thermal nociception in tail immersion test. In the formalin test, A. cordata (50 - 200mg/kg) and ibuprofen (200mg/kg) inhibited the second phase response (peripheral inflammatory response), but not the first phase response (central response), whereas morphine inhibited both phase pain responses. Both A. cordata (100 mg/kg) and ibuprofen (200 mg/kg) significantly alleviated the formalin-induced increase of paw thickness, the index of inflammation. These results show for the first time that the leaf and stem of A. cordata has a significant anti-nociceptive effect that seems to be peripheral, but not central. A. cordata also displays an anti-inflammatory activity in an acute inflammation model. The present study supports a possible use of the leaf and stem of A. cordata to treat pain and inflammation.