• Title/Summary/Keyword: Neuropathic

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Combined Effects of Different Wavelength Laser Stimulations and Electroacupuncture on Neuropathic Pain (파장별 레이저 자극과 전침 결합 시술이 신경병리성 동통에 미치는 영향)

  • Cho, Myoung-rae;Kim, Myeong-hun;Moon, Youngmin;Jeong, Sungho;Na, Chang-su
    • Korean Journal of Acupuncture
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    • v.38 no.3
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    • pp.151-161
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    • 2021
  • Objectives : The effects of a combined stimulation of 658 nm, 830 nm, 904 nm, and 1064 nm laser acupuncture treatment (LAT) and electroacupuncture treatment (EAT) on GB39 and GB34 on neuropathic pain in rats induced by tibial and sural nerve transection were studied in this paper. Methods : To express a neuropathic pain model, surgery was performed to transection rats' tibial and sural nerves. The rats were divided into normal group, control group, and experimental groups. In addition, the experimental groups were divided into 658 nm laser and electroacupuncture (LAT658+EAT), 830 nm laser and electroacupuncture (LAT830+EAT), 904 nm laser and electroacupuncture (LAT904+EAT), and 1064 nm laser and electroacupuncture (LAT830+EAT). For the treatment of the experimental groups, electroacupuncture and different laser wavelengths were alternately applied to GB34 and GB39 twice a week for 3 weeks for 1 minute 30 seconds. The withdrawal response of neuropathic rats' legs by acetone stimulation was observed, as well as the c-Fos in the central gray region in the midbrain of neuropathic rats together with Bax, Bcl2, and mGluR5 expressions associated with apoptosis. Results : Compared with the control group, a significant decrease in the frequency of paw withdrawal in response to acetone allodynia was observed in LAT658+EAT and LAT830+EAT groups in 6th times, LAT904+EAT group in 2nd, 3rd, and 6th times, and LAT1064+EAT group in 2nd and 6th times, respectively. For c-fos positive cells in the central gray region, a significant decrease was observed in LAT830+EAT, LAT904+EAT, and LAT1064+EAT groups in comparison with the control group. In Bax expression, LAT1064+EAT group showed a significant decrease compared to the control group. In Bcl-2 expression, the LAT658+EAT,the LAT904+EAT, and the LAT1064+EAT groups increased significantly compared to the control group. LAT830+EAT, LAT904+EAT, and LAT1064+EAT groups showed significantly increased mGlu5 expression compared to the control group. Conclusions : The combination of laser for each wavelength and electroacupuncture alternately performed in this study is thought to be effective in improving neuropathic pain and apoptosis.

The effect of perineural injection therapy on neuropathic pain: a retrospective study

  • Haekyu Kim;Hyae Jin Kim;Young-Hoon Jung;Wangseok Do;Eun-Jung Kim
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.24 no.1
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    • pp.47-56
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    • 2024
  • Background: Among the various pain-related diseases that can be encountered at the clinic, there is a neuropathic pain that is difficult to treat. Numerous methods have been proposed to treat neuropathic pain, such as taking medication, nerve block with lidocaine, or neurolysis with alcohol or phenol. Recently, a method of perineural injection using dextrose instead of lidocaine was proposed. This study was designed to compare the effects of perineural injection therapy (PIT) with buffered 5% dextrose or 0.5% lidocaine on neuropathic pain. Methods: The data were collected from the database of pain clinic from August 1st, 2019 to December 31st, 2022 without any personal information. The inclusion criteria were patients diagnosed with postherpetic neuralgia (PHN), trigeminal neuralgia (TN), complex regional pain syndrome (CRPS), or peripheral neuropathy (PN), and patients who had undergone PIT with buffered 5% dextrose (Dextrose group) or 0.5% lidocaine (Lidocaine group) for pain control. The data of patients, namely sex, age, and pain score (numerical rating scale, NRS) were collected before PIT. The data of NRS, side effects, and satisfaction grade (excellent, good, fair, or poor) were collected one week after each of the four PIT, and two weeks after the last PIT. Results: Overall, 112 subjects were enrolled. The Dextrose group included 89 and Lidocaine group included 23 patients. Because the number of patients in the Lidocaine group was too small to allow statistical analysis, the trend in Lidocaine group was just observed in each disease. There were no significant side effects except for a few bruise cases on the site of injection in all groups. The NRS in most Dextrose groups except CRPS were reduced significantly; however, the Lidocaine group showed a trend of pain reduction only in PHN. The Dextrose group except CRPS showed increased satisfaction two weeks after the final PIT. Conclusion: From the results, it is suggested that PIT with buffered 5% dextrose may have a good effect for neuropathic pain without any side effect except for patients with CRPS. This may offer a window into a new tool that practitioners can employ in their quest to help patients with neuropathic pain.

Identification of Differentially Expressed Genes by Gabapentin in Cultured Dorsal Root Ganglion in a Rat Neuropathic Pain Model

  • Heo, Ji Hye;Lee, Seung Ha;Chang, Kyung Ha;Han, Eun Hye;Lee, Seung Gwan;Choi, Dal Woong;Kim, Suhng Wook
    • Biomolecules & Therapeutics
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    • v.21 no.2
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    • pp.126-131
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    • 2013
  • Neuropathic pain is a chronic pain disorder caused by nervous system lesions as a direct consequence of a lesion or by disease of the portions of the nervous system that normally signal pain. The spinal nerve ligation (SNL) model in rats that reflect some components of clinical pain have played a crucial role in the understanding of neuropathic pain. To investigate the direct effects of gabapentin on differential gene expression in cultured dorsal root ganglion (DRG) cells of SNL model rats, we performed a differential display reverse transcription-polymerase chain reaction analysis with random priming approach using annealing control primer. Genes encoding metallothionein 1a, transforming growth factor-${\beta}1$ and palmitoyl-protein thioesterase-2 were up-regulated in gabapentin-treated DRG cells of SNL model rats. The functional roles of these differentially expressed genes were previously suggested as neuroprotective genes. Further study of these genes is expected to reveal potential targets of gabapentin.

Effect of Anorexia and Neuropathic Pain Induced by Cisplatin on Hindlimb Muscles of Rat (시스플라틴 항암제에 의해 유발되는 식욕부진과 신경병증성 통증이 쥐의 뒷다리근에 미치는 영향)

  • Yang, Gee Su;Choe, Myoung-Ae
    • Journal of Korean Academy of Nursing
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    • v.43 no.3
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    • pp.361-369
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    • 2013
  • Purpose: The purpose of this study was to examine the effect of anorexia and neuropathic pain induced by cisplatin on hindlimb muscles of rats. Methods: Adult male Sprague-Dawley rats were divided into two groups, a cisplatin-treated group (n=10) and a control group (n=10). In the cisplatin-treated group, cisplatin at a dose of 2 mg/kg was injected intraperitoneally two times a week up to a cumulative dose of 20 mg/kg over 5 weeks, and in the control group saline (0.9% NaCl) was injected intraperitoneally at the same dose and duration as the cisplatin-treated group. At 34 days all rats were anesthetized, after which the soleus and plantaris muscles were dissected. Withdrawal threshold, body weight, food intake, activity, muscle weight, Type I and II fiber cross-sectional areas and myofibrillar protein content of the dissected muscles were determined. Results: Compared with the control group, the cisplatin-treated group showed significant decreases (p<.05) in withdrawal threshold, activity, food intake, body weight, Type I and II fiber cross-sectional areas, myofibrillar protein content and weight of the soleus and plantaris muscles. Conclusion: Muscular atrophy in hindlimb occurs due to anorexia and neuropathic pain induced by the cisplatin treatment.

Effect of the Combination of CI-988 and Morphine on Neuropathic Pain after Spinal Cord Injury in Rats

  • Kim, Junesun;Kim, Youngkyung;Hahm, Suk-Chan;Yoon, Young Wook
    • The Korean Journal of Physiology and Pharmacology
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    • v.19 no.2
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    • pp.125-130
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    • 2015
  • Cholecystokinin is known to be involved in the modulation of nociception and to reduce the efficacy of morphine analgesia. This study investigated the effects of intrathecal administration of morphine and the cholecystokinin type B antagonist CI-988 on below-level neuropathic pain after spinal cord injury in rats. We also examined the interaction of morphine and CI-988 in the antinociceptive effect. Both morphine and CI-988 given individually increased the paw withdrawal threshold to mechanical stimulation in a dose-dependent manner. The combination of ineffective doses of intrathecally administered CI-988 and morphine produced significant analgesic effects and the combination of effective doses resulted in analgesic effects that were greater than the sum of the individual effects of each drug. Thus, morphine showed a synergistic interaction with CI-988 for analgesia of central neuropathic pain.

Effects of Nitric Oxide Synthase Inhibitor on Hindlimb Muscles in Rats with Neuropathic Pain Induced by Unilateral Peripheral Nerve Injury (산화질소 합성효소 억제제가 일측성 말초신경 손상에 의해 유발된 신경병증성 통증 쥐의 뒷다리근에 미치는 영향)

  • Choe, Myoung-Ae;An, Gyeong-Ju
    • Journal of Korean Academy of Nursing
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    • v.41 no.4
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    • pp.520-527
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    • 2011
  • Purpose: The purpose of this study was to examine effects of nitric oxide synthase (NOS) inhibitor on muscle weight and myofibrillar protein content of affected and unaffected hindlimb muscles in rats with neuropathic pain induced by unilateral peripheral nerve injury. Methods: Neuropathic pain was induced by ligation and cutting of the left L5 spinal nerve. Adult male Sprague-Dawley rats were randomly assigned to one of two groups: The NOSI group (n=19) had NOS inhibitor (L-NAME) injections daily for 14 days, and the Vehicle group (n=20) had vehicle injections daily for 14 days. Withdrawal threshold, body weight, food intake and activity were measured every day. At 15 days all rats were anesthetized and soleus, plantaris and gastrocnemius muscles were dissected from hindlimbs. Muscle weight and myofibrillar protein content of the dissected muscles were determined. Results: The NOSI group showed significant increases as compared to the Vehicle group for body weight at 15 days, muscle weight and myofibrillar protein content of the unaffected soleus and gastrocnemius. The NOSI group demonstrated a higher pain threshold than the vehicle group. Conclusion: NOSI for 14 days attenuates unaffected soleus and gastrocnemius muscle atrophy in neuropathic pain model.

The classification of neuropathic and thyroid function of the diabetic using amplitude-spectrum-density analysis in peripheral blood vessels (말초혈관 혈류에서 진폭-스펙트럼-밀도 분석에 의한 당뇨병에서의 신경병증 및 갑상선 기능 유무 분류)

  • 남상희;최준영
    • Progress in Medical Physics
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    • v.9 no.1
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    • pp.23-28
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    • 1998
  • We measured the flow at peripheral blood vessel of finger dorsum surface using noninvasive LDF(Laser Doppler Flowmeter). We investigated the flow properties between the normal and the diabetic with the Amplitude Spectral Densities of FFT analysis. We classified the diabetic as four groups of negative neuropathy, positive neuropathy, hyperthyroid and hypothyroid. And tested the neuropathic and thyroid effects of peripheral blood flow. As the results, the diabetic, the positive neuropathic and the hypothyroid respectively showed the abnormal blood flow properties on the contrary of the normal flow of negative neuropathic and hyperthyroid.

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Involvement of Selective Alpha-2 Adrenoreceptor in Sympathetically Maintained Pain

  • Park, Chan-Hong;Yong, An;Lee, Sang-Ho
    • Journal of Korean Neurosurgical Society
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    • v.47 no.6
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    • pp.420-423
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    • 2010
  • Objective : Peripheral nerve injury often leads to neuropathic pain, which is characterized by burning pain, allodynia, and hyperalgesia. The role of the sympathetic nervous system in neuropathic pain is a complex and controversial issue. It is generally accepted that the alpha adrenoreceptor (AR) in sympathetic nerve system plays a significant role in the maintenance of pain. Among alpha adrenoreceptor, alpha-1 receptors play a major role in the sympathetic mediated pain. The primary goal of this study is to test the hypothesis that sympathetically maintained pain involves peripheral alpha-2 receptors in human. Methods : The study was a randomized, prospective, double-blinded, crossover study involving twenty patients. The treatments were : Yohimbine (30 mg mixed in 500 mL normal saline), and Phentolamine (1 mg/kg in 500 mL normal saline) in 500 mL normal saline at 70 mL/hr initially then titrated. The patients underwent infusions on three different appointments, at least one month apart. Thus, all patients received all 2 treatments. Pain measurement was by visual analogue scale, neuropathic pain questionnaire, and McGill pain questionnaire. Results : There were significant decreases in the visual analogue scale, neuropathic score, McGill pain score of yohimnine, and phentolamine. Conclusion : We conclude that alpha-2 adrenoreceptor, along with alpha-2 adrenoreceptor, may be play role in sympathetically maintained pain in human.

Rediscovery of Nefopam for the Treatment of Neuropathic Pain

  • Kim, Kyung Hoon;Abdi, Salahadin
    • The Korean Journal of Pain
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    • v.27 no.2
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    • pp.103-111
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    • 2014
  • Nefopam (NFP) is a non-opioid, non-steroidal, centrally acting analgesic drug that is derivative of the nonsedative benzoxazocine, developed and known in 1960s as fenazocine. Although the mechanisms of analgesic action of NFP are not well understood, they are similar to those of triple neurotransmitter (serotonin, norepinephrine, and dopamine) reuptake inhibitors and anticonvulsants. It has been used mainly as an analgesic drug for nociceptive pain, as well as a treatment for the prevention of postoperative shivering and hiccups. Based on NFP's mechanisms of analgesic action, it is more suitable for the treatment of neuropathic pain. Intravenous administration of NFP should be given in single doses of 20 mg slowly over 15-20 min or with continuous infusion of 60-120 mg/d to minimize adverse effects, such as nausea, cold sweating, dizziness, tachycardia, or drowsiness. The usual dose of oral administration is three to six times per day totaling 90-180 mg. The ceiling effect of its analgesia is uncertain depending on the mechanism of pain relief. In conclusion, the recently discovered dual analgesic mechanisms of action, namely, a) descending pain modulation by triple neurotransmitter reuptake inhibition similar to antidepressants, and b) inhibition of long-term potentiation mediated by NMDA from the inhibition of calcium influx like gabapentinoid anticonvulsants or blockade of voltage-sensitive sodium channels like carbamazepine, enable NFP to be used as a therapeutic agent to treat neuropathic pain.

Acupuncture analgesia in a rat model of neuropathic pain (Neuropathic pain을 일으킨 쥐에 있어서 침의 진통작용)

  • Lim, Kyu-sang
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.12 no.1
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    • pp.143-153
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    • 1999
  • Background: The vasoreactivity of cerebral artery is currently the subject of increasing interest Transcranial Doppler The purpose of this study was to investigate the analgesic effect of acupuncture in a model of neuropathic pain produced by segmental spinal nerve injury (SSI) in rats. The left L5 and L6 spinal nerves of Sprague-Dawley rats were tightly ligated, and one week later, manual or electro-acupuncture was applied for 30 minutes to the contralateral hindlimb (right side) while the animal was lightly anesthetized with halothane. The mechanical threshold of the paw for ipsilateral (left side) hind limb flinching was determined prior to and 0.5, 1, 2, 4, and 24 hours after termination of acupuncture. The mechanical threshold for flinching was significantly elevated for about 4 hours after manual acupuncture applied to the BL. 60 (Kunlun) point or electro-acupuncture to the BL. 60 and BL. 40 (Weizhong) points. However, manual acupuncture applied to the ST. 36 (Zusanli) point was not effective. Furthermore, systemic naloxone pretreatment had no effect on the acupuncture induced threshold elevation. These data suggests that acupuncture produces a point specific, naloxone independent analgesia in a rat neuropathic pain model. ※ This paper is supported by a grant from the '1996 Jusan Foundation of Wonkwang university.)

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