• Title/Summary/Keyword: Central pain

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Central Pain from Excitotoxic Spinal Cord Injury Induced by Intraspinal NMDA Injection: A Pilot Study

  • Leem, Yeon-Ju;Joh, Jung-Wha;Joeng, Kyoung-Woon;Suh, Jeong-Hun;Shin, Jin-Woo;Leem, Jeong-Gill
    • The Korean Journal of Pain
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    • v.23 no.2
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    • pp.109-115
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    • 2010
  • Background: The pathophysiological and neurochemical changes following spinal injury are not yet elucidated. This study was designed to evaluate the morphological changes of the dorsal horn of the spinal cord and profiles of pain behaviors following intraspinal injection of NMDA in rats. Methods: Rats were randomized into three groups: a sham-operated control group and groups where the rats received 10 mM or 100 mM N-methyl-D-aspatate (NMDA) injected into their spinal dorsal horn. Following injection, hypersensitivity to cold and mechanical stimuli and excessive grooming behaviors were assessed serially for four weeks. Morphological changes of the spinal cord were evaluated four weeks after intraspinal injection. Results: Few animals in the NMDA groups developed hypersensitivity to cold and mechanical stimuli. The number of groomers and the severity of excessive grooming were significantly higher in the 100 mM NMDA group than those values of the control and 10 mM NMDA groups. The size of the neck region (lamina III-IV) was significantly smaller in the 100 mM NMDA group than in the control and 10 mM NMDA groups. Conclusions: In conclusion, intraspinal injection of NMDA in rats leads to the pathological sequela in the spinal cord and to excessive grooming behavior. These results support the use of NMDA and excessive grooming behavior after excitotoxic SCI as a model to study chronic pain after SCI.

Antinociceptive Effects of Prim-O-Glucosylcimifugin in Inflammatory Nociception via Reducing Spinal COX-2

  • Wu, Liu-Qing;Li, Yu;Li, Yuan-Yan;Xu, Shi-hao;Yang, Zong-Yong;Lin, Zheng;Li, Jun
    • Biomolecules & Therapeutics
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    • v.24 no.4
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    • pp.418-425
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    • 2016
  • We measured anti-nociceptive activity of prim-o-glucosylcimifugin (POG), a molecule from Saposhnikovia divaricate (Turcz) Schischk. Anti-nociceptive or anti-inflammatory effects of POG on a formalin-induced tonic nociceptive response and a complete Freund's adjuvant (CFA) inoculation-induced rat arthritis pain model were studied. Single subcutaneous injections of POG produced potent anti-nociception in both models that was comparable to indomethacin analgesia. Anti-nociceptive activity of POG was dose-dependent, maximally reducing pain 56.6% with an $ED_{50}$ of 1.6 mg. Rats given POG over time did not develop tolerance. POG also time-dependently reduced serum TNF${\alpha}$, IL-$1{\beta}$ and IL-6 in arthritic rats and both POG and indomethacin reduced spinal prostaglandin E2 ($PGE_2$). Like indomethacin which inhibits cyclooxygenase-2 (COX-2) activity, POG dose-dependently decreased spinal COX-2 content in arthritic rats. Additionally, POG, and its metabolite cimifugin, downregulated COX-2 expression in vitro. Thus, POG produced potent anti-nociception by downregulating spinal COX-2 expression.

Accidental Vertebral Artery Cannulation as a Complication of the Central Venous Catherization (우발적인 척추동맥으로의 중심정맥 카테터의 삽관)

  • Jeong, Ju Ho
    • Journal of Trauma and Injury
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    • v.27 no.2
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    • pp.33-37
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    • 2014
  • Central venous catheterization through a subclavian approach is indicated for some special purposes but it may cause many complications such as infection, bleeding, pneumothorax, thrombosis, air embolization, arrhythmia, myocardial perforation, and nerve injury. A case involving a mistaken central venous catheterization into the right vertebral artery through the subclavian artery is presented. A 33-year-old man who had deteriorated mentality after head injury underwent an emergency craniotomy for acute epidural hematomas on the right frontal and temporal convexities. His mentality improved rapidly, but he complained of continuous severe pain in the right posterior neck even though he had no previous symptom or past medical history of such pain. Three-dimensional cervical spine computed tomography (3D-CT) was performed first to rule out unconfirmed cervical injuries and it revealed a linear radiopaque material intrathoracically from the level of the 1st rib up to the level of C6 in the right vertebral foramen. An additional neck CT was performed, and the subclavian catheter was indwelling in the right vertebral artery through right subclavian artery. For the purpose of proper fluid infusion and central venous pressure monitoring, the subclavian vein catheterization had been performed in the operation room after general anesthesia induction before the craniotomy. Sufficient anatomical consideration and prudence is essential because inadvertent arterial cannulation at a non-compressible site is a highly risky iatrogenic complication of central venous line placement.

Exploring the role and mechanisms of diallyl trisulfide and diallyl disulfide in chronic constriction-induced neuropathic pain in rats

  • Wang, Gang;Yang, Yan;Wang, Chunfeng;Huang, Jianzhong;Wang, Xiao;Liu, Ying;Wang, Hao
    • The Korean Journal of Pain
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    • v.33 no.3
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    • pp.216-225
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    • 2020
  • Background: Garlic oil is a rich source of organosulfur compounds including diallyl disulfide and diallyl trisulfide. There have been studies showing the neuroprotective actions of these organosulfur compounds. However, the potential of these organosulfur compounds in neuropathic pain has not been explored. The present study was aimed at investigating the pain attenuating potential of diallyl disulfide and diallyl trisulfide in chronic constriction injury (CCI)-induced neuropathic pain in rats. The study also explored their pain-attenuating mechanisms through modulation of H2S, brain-derived neurotrophin factor (BDNF) and nuclear factor erythroid 2-related factor 2 (Nrf2). Methods: The rats were subjected to CCI injury by ligating the sciatic nerve in four places. The development of neuropathic pain was measured by assessing mechanical hyperalgesia (Randall-Selittotest), mechanical allodynia (Von Frey test), and cold allodynia (acetone drop test) on 14th day after surgery. Results: Administration of diallyl disulfide (25 and 50 mg/kg) and diallyl trisulfide (20 and 40 mg/kg) for 14 days led to a significant reduction in pain in CCI-subjected rats. Moreover, treatment with these organosulfur compounds led to the restoration of H2S, BDNF and Nrf2 levels in the sciatic nerve and dorsal root ganglia. Co-administration of ANA-12 (BDNF blocker) abolished pain attenuating actions as well as BDNF and the Nrf2 restorative actions of diallyl disulfide and diallyl trisulfide, without modulating H2S levels. Conclusions: Diallyl disulfide and diallyl trisulfide have the potential to attenuate neuropathic pain in CCI-subjected rats possibly through activation of H2S-BDNF-Nrf2 signaling pathway.

Prevalence and risk factors of low back and pelvic pain in women with rectus abdominis diastasis: a multicenter retrospective cohort study

  • Yuan, Sue;Wang, Honghong;Zhou, Jie
    • The Korean Journal of Pain
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    • v.35 no.1
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    • pp.86-96
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    • 2022
  • Background: To explore the association between low back pain (LBP) and pelvic pain (PP) and rectus abdominis diastasis (RAD) in postpartum women and identify the characteristics and risk factors. Methods: Women diagnosed with RAD and a history of labor and delivery, between 2009 and 2018, were identified from six hospitals within the Partners Healthcare System. Univariate and multivariable binary logistic regression analyses were used to identify the risk factors associated with pain. Results: Age at onset of RAD in the non-cesarean delivery group was earlier than those in cesarean delivery (CD) group (P = 0.017). Women who underwent CD demonstrated 4.5 times greater risk of RAD than those who had no CD exposure. The cumulative composition ratio of LBP at every age stage of the period from 8 years pre-first delivery to 8 years post-first delivery was significantly higher than the other five conditions (RAD, umbilical hernia, PP, depressive disorder [DD], and strain of muscle, fascia, and tendon [SMFT]) (P for trend < 0.001). Women with DD, SMFT, and PP were more likely to have LBP (odds ratio [OR] = 1.91, 95% confidence interval [CI] 1.06 to 3.47, P = 0.032; OR = 4.50, 95% CI 1.64 to 12.36, P = 0.003; OR = 2.14, 95% CI 1.17 to 3.89, P = 0.013; respectively). Conclusions: In postpartum women with RAD, DD, SMFT, and PP were found to be risk factors contributing to the development of LBP. Race and LBP also played roles in the development of PP.

The Clinical Evaluation of East-West Medical Management for Central Poststroke Pain (뇌졸중후 중추성 통증에 대한 동서협진의 임상적 효율성 평가)

  • Cheong, Byung-Shik;Kim, Keon-Sik;Lee, Doo-Ik;Choi, Do-Young
    • Journal of Pharmacopuncture
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    • v.4 no.2
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    • pp.95-103
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    • 2001
  • Background : Central poststroke pain(CPSP) can occur as a result of lesion or dysfunction of the brain from stroke and may cause many difficulty in the social activities and daily life. In this study, we evaluate the clinical effectiveness of east-west medical management for CPSP through VAS(visual analogue scale), infrared themography, MBI(Moderfied Barthel Index) and Rankin scale. Methods : We treated thirty patients with oriental medical treatment method and western & oriental medical treatment method. Each group has fifteen patients of the CPSP. We evaluated their pain(characterizes tingling and burning sensation, aching, hyperalgesia, and allodynia) through VAS(visual analog scale) pain score, the skin temperature of pain site by infrared thermography and assessed their mobility & rehabilitation ability through MBI(Moderfied Barthel Index), Rankin scale before and after pain treatment. Results : The skin temperature of pain site was lower than non-pain site. The difference of skin temperature improved from $0.65{\pm}0.45^{\circ}C$ to $0.39{\pm}0.25^{\circ}C$ after oriental medical treatment and $0.68{\pm}0.54^{\circ}C$ to $0.27{\pm}0.24^{\circ}C$ after western & oriental medical treatment VAS scores improved from $7.9{\pm}1.4$ to $4.7{\pm}1.6$ after oriental medical treatment and $8.1{\pm}1.3$ to $4.6{\pm}1.2$ after western & oriental medical treatment. MBI scores improved from $61.40{\pm}13.58$ to $85.00{\pm}13.85$ after oriental medical treatment and $52.26{\pm}13.52$ to $77.13{\pm}12.04$ after western & oriental medical treatment. And Rankin scale scores improved from $3.33{\pm}0.72$ to $2.46{\pm}0.74$ after oriental medical treatment and $3.60{\pm}0.82$ to $2.66{\pm}0.81$ after western & oriental medical treatment Conclusion : The difference of skin temperature and Rankin scale scores more significantly improved after western & oriental medical treatment than oriental medical treatment. According to the results, we thought east-west medical management is very useful treatment for CPSP and rehabilitation of the patients with stroke.

Influence of Joint Mobilization on Formalin Induced Pain Prevention of Rats (관절가동술이 흰쥐의 포르말린 유도 통증 예방에 미치는 영향)

  • Kang, Jong-Ho;Kim, Eun-Kyung;Ro, Hyo-Lyun
    • Journal of the Korean Society of Physical Medicine
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    • v.6 no.2
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    • pp.207-213
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    • 2011
  • Purpose: The purpose of this study was to determine the preventive effect of joint mobilization on biphasic pain response induced formalin test. Methods: Sprague-dawley rats(n=30) were ramdomly divided into the control group without intervention, sham control group with application of hand contact without mobilization, joint mobilization group with application of hand contact with mobilization. Joint mobilization of knee procedure involved an grade III extension mobilization basically with anterior-posterior gliding of the tibia on the femur. Formalin injection caused biphasic pain response which is lated for 60 minute. The first phase result from primary afferent sensory fiber, wheareas the second phase has been proposed to central sensitization in the central nervous system. Behavioral analysis was performed by digital camera after 5% formalin subcutaneous injection into the dorsal foot. Results: Pain response of joint mobilization group show significant lower than control gorup and sham control group. Conclusion: This result suggest that pre-application of joint mobilization may be effective intervention to prevent the formalin induced pain.

A Synaptic Model for Pain: Long-Term Potentiation in the Anterior Cingulate Cortex

  • Zhuo, Min
    • Molecules and Cells
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    • v.23 no.3
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    • pp.259-271
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    • 2007
  • Investigation of molecular and cellular mechanisms of synaptic plasticity is the major focus of many neuroscientists. There are two major reasons for searching new genes and molecules contributing to central plasticity: first, it provides basic neural mechanism for learning and memory, a key function of the brain; second, it provides new targets for treating brain-related disease. Long-term potentiation (LTP), mostly intensely studies in the hippocampus and amygdala, is proposed to be a cellular model for learning and memory. Although it remains difficult to understand the roles of LTP in hippocampus-related memory, a role of LTP in fear, a simplified form of memory, has been established. Here, I will review recent cellular studies of LTP in the anterior cingulate cortex (ACC) and then compare studies in vivo and in vitro LTP by genetic/pharmacological approaches. I propose that ACC LTP may serve as a cellular model for studying central sensitization that related to chronic pain, as well as pain-related cognitive emotional disorders. Understanding signaling pathways related to ACC LTP may help us to identify novel drug target for various mental disorders.

Low-Level Laser Therapy including Laser Acupuncture for Non-Specific Chronic Low Back Pain : Protocol for a Systematic Review

  • Yeum, Hyewon;Nam, Dongwoo
    • Journal of Acupuncture Research
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    • v.36 no.4
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    • pp.251-255
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    • 2019
  • Background: Low-level laser therapy (LLLT) including laser acupuncture (LA) has been widely used to treat chronic low back pain (CLBP), but there is no critically appraised evidence of the potential benefits. The purpose of this protocol for a systematic review was to enable the evaluation of the effectiveness of LLLT including LA for non-specific CLBP to identify the potential benefits. Methods: The electronic databases MEDLINE (PubMed), Embase (Ovid), the Cochrane Central Register of Controlled Trials (CENTRAL), Korean medical databases (KoreaMed, KMBASE, KISS, NDSL, KISTI, OASIS), the Chinese database (CNKI), and Japanese databases (CiNII, J-STAGE) are recommended. Results: Randomized controlled trials in LLLT including LA should be included in the searches. All data synthesis and subgroup analyses should be conducted using a Review Manager software. The Cochrane risk of bias tool can be used to evaluate methodological quality of the studies. A risk ratio or mean difference with a 95% confidence interval will show the effects of LLLT including LA. Conclusion: The primary outcome would be pain intensity and functional status/disability due to low back pain. The secondary outcome would be a global measurement of recovery or improvement, quality of life and adverse event.

The Classification and Diagnosis of Neuropathic orofacial pain (구강안면 신경병성 통증의 진단 및 분류)

  • Ahn, Jong-Mo
    • The Journal of the Korean dental association
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    • v.49 no.6
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    • pp.316-320
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    • 2011
  • Neuropathic orofacial pain (NOP) is initiated or caused by a priomary lesion or dysfunction in the peripheral nervous system or the central nervous system. NOP is divided into paroxysmal and continuous by duration of pain. NOP is important for dentists, because they can occur after dental procedures, such as extractions, endodontic treatment, and dental implant insertion. Dentists should have concern about NOP, because it is difficult to diagnose and treat.