• The Journal of Internal Korean Medicine
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• v.21 no.5
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• pp.765-771
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• 2000

Objectives : To evaluate the pain control effect of combination treatment of Oriental Medicine on patients who suffered from thalamic pain syndrome caused by thalamic stroke. Methods : We reviewed the medical records and brain imaging data of all patients with thalamic stroke from September 1998 to August 2000 who visited to Department of Oriental Internal Medicine, National Medical Center. We evaluated clinical features of thalamic pain syndrome, including incidence, onset interval from stroke, nature, pain distribution, and assessed the pain control effect of combination treatment by Visual Analog Scale(VAS). Results : 64 cases were selected under the inclusion criteria, and 17 patients(26.5%) with thalamic pain syndrome were identified from 64 thalamic strokes. VAS proved combination treatment effective to control pain of thalamic pain syndrome. In 12 cases(70.5%), pain onset was within the first week poststroke. The patients with allodynia were 6(35.3%). In 12 cases(70.5%), the lesion was mainly located in the posterolateral areas of thalamus. Conclusion : We conclude that combination treatment of the Oriental Medicine modalities have pain control effectiveness on thalamic pain syndrome.(t=-5.47, p=0.0001)

• The Korean Journal of Pain
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• v.29 no.2
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• pp.119-122
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• 2016

Thalamic pain is a primary cause of central post-stroke pain (CPSP). Clinical symptoms vary depending on the location of the infarction and frequently accompany several pain symptoms. Therefore, correct diagnosis and proper examination are not easy. We report a case of CPSP due to a left acute thalamic infarction with central disc protrusion at C5-6. A 45-year-old-male patient experiencing a tingling sensation in his right arm was referred to our pain clinic under the diagnosis of cervical disc herniation. This patient also complained of right cramp-like abdominal pain. After further evaluations, he was diagnosed with an acute thalamic infarction. Therefore detailed history taking should be performed and examiners should always be aware of other symptoms that could suggest a more dangerous disease.

• The Journal of Internal Korean Medicine
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• v.40 no.3
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• pp.295-311
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• 2019

Objectives: This research aimed to investigate Chinese clinical studies on the treatment of central post-stroke pain (CPSP) and thalamic syndrome after stroke with traditional herbal medicine (THM). Methods: Randomized controlled trials verifying the effects of herbal medicine on treating CPSP and thalamic syndrome after stroke were included in the study. Electrical and hand search were conducted in the China National Knowledge Infrastructure (CNKI), National Discovery for Science Leaders (NDSL), Research Information Sharing Service (RISS), Oriental Medicine Advanced Searching Integrated System (Oasis) for CPSP and thalamic syndrome after stroke. A literature search was performed in the Chinese and Korean databases for papers published from January 1, 2010 to October 1, 2018. The selected literature was assessed by Cochrane's risk of bias. Results: Twelve reports on randomized controlled trials met the inclusion criteria from the 227 identified reports. Effective rate, comparison of visual analogy scale, present pain intensity, pain grading index, recurrence rate, follow-up, and a 36-item short form survey instrument were used to evaluate the treatments. The effective rate of the treatment group was significantly higher than that of the control group in all papers. Side effects occurred less frequently in the treatment group than in the western medicine control group. Conclusions: The treatment of CPSP and thalamic syndrome after stroke with THM was shown to be highly effective. Additional well-designed clinical trials are needed. This study can be used as a basis for further research on the treatment of CPSP and thalamic syndrome after stroke.

• The Journal of the Society of Stroke on Korean Medicine
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• v.14 no.1
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• pp.115-121
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• 2013

A 67 year-old Taeeumin(太陰人) female patient with Thalamic pain Syndrome(Dejerine-Roussy Syndrome) was treated. She was suffering from rt. side numbness, pain and weakness, rt. facial palsy, dizziness, dysarthria and lassitude. She was diagnosed as Cerebral lacunar infarction(Lt. thalamus) by Brain MRI(Magnetic Resonance Imaging) and adminstered Yeoldahanso-tang(熱多寒少湯). After taking Yeoldahanso-tang(熱多寒少湯), her symptoms had improved. Result suggest that Yeoldahanso-tang(熱多寒少湯) is an effective for Taeeumin Thalamic pain Syndrome. Though, results support a role for oriental medical treatment for Cerebrovascular Accident(CVA) connected Sasang Constitution, further research into the effectiveness of oriental medical treatments for CVA connected Sasang Constitution is needed.

• The Korean Journal of Nuclear Medicine
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• v.26 no.1
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• pp.33-39
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• 1992

Spontaneous pain and painful overreaction to external stimuli resulting from lesion confined central nervous system (CNS) were named as thalamic syndrome. Thalamic lesion and decreased regional cortical perfusion thought to the pathogenesis of thalamic syndrome due to decreased function of thalamocortical tract. We performed $^{99m}Tc-HMPAO$ regional cerebral perfusion in 10 patients with clinical diagnosis of thalamic syndrome due to thalamic lesion or near the thalamic lesion at Yonsei University Hospital, from January 1989 to August 1991. In contrast to five patients with lesions near the thalamus who did not show secondarily decreased perfusion at cerebral cortex, four among the five patients with thalamic lesions revealed decreased cortical perfusion in the ipsilateral cerebral cortex on brain SPECT. These phenomena may suggest the loss of afferent activating stimuli from the thalamus led to decreased neuronal activity and the followitng hypoperfusion of cerebral cortex, and might be one of the indirect signs for suggesting presence of the thalamocortical tract. A causal relationship between cortical hypoperfusion and neuropsychological deficit is strongly suggested.

• 대한약리학회:학술대회논문집
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• 2006.10a
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• pp.82.2-82.2
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• 2006

• The Journal of Korean Medicine
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• v.20 no.3 s.39
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• pp.36-44
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• 1999

Objectives: It has been well known that electroacupuncture(EA) has an analgesic effect and there is a pain control system in the central nervous system(CNS). The pain control system is composed of three major nuclei, which are periaqueductal gray(PAG), raphe nuclei, and the pain inhibitory complex located in the spinal cord. It has been suggested that the analgesic effect of EA might be the result of activation of the pain control system in the CNS. However, there may be a possibility that other nuclei are also involved in this pain modulation. Thus, we investigated whether the posterior intralaminar thalamic nuclei (PTIN) are involved in the pain modulation. Methods: To measure the level of pain, the jaw opening reflex (JOR) was used as a pain index. The magnitude of JOR is estimated by averaging the area of 10 successive responses. JOR was evoked by tooth-pulp stimulation with bipolar electrode carrying stimulus with the following parameters: intensity ranging from 420uA to 680ulA, 0.3ms duration of square pulse, and 0.5 Hz. Hapkog($LI_4$) and Taechung ($LR_3$) were the chosen acupoints. The Hapkog point was stimulated ipsilaterally at 5V, 3 Hz, for 15min in total, and the Taechung was stimulated at 2-3 V, 3 Hz, and for a total of 15 or 30 minutes. Different intensities of stimulation were given the PITN; one was given at $300{\mu}A$ and the other was at 500uA. The position stimulated in these nuclei by Paxinos Atlas was AP; from bregma $-4.0{\sim}-4.3mm,\;L; 0.5{\sim}1.8mm,\;D;\;4.8{\sim}6.3mm$. Results: The Hapkog point had a significant analgesic effect (P<0.05). However, the Taechung point had no effect. Both types of stimulation in the PITN did not reveal any analgesic effects. Conclusions: From these results, it was suggested that the posterior intralaminar thalamic nuclei are not involved in the modulation of pain.

• Korean Journal of Oriental Medicine
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• v.2 no.1
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• pp.514-550
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• 1996

There are many theory in acupuncture mechanism, so we must know the detail contents. and then we can use the acupuncture as we know. the follow article will be helpful in this part. 1. Spinal cord are role in intermediate part in somatosensorypathway also in acupuncture stumulating tract 2. Acute pain pathway started in laminae I, V of gray colmn, next are the spinothalamic tract(trigeminal spinothalamic tract in above neck part) and then go to the specific thalamic nucleus. but chronic pain in laminae II, III, VI, VII, next are spinoreticular tract(trigeminal spinoreticular tract in the neck part) and finally to the nonspecific thalamic nucleus. 3. Thalamus is very important area in somatosensory stimuation including acupuncture stumulating sensory also as a pain control center. but except this, there are Hypothalamus, Limbic system Cerebral cortex and Cerebellum as intermediator. as we Know hypothalamus is related to the emotional analgesic system with a limbic system. 4. A ${\delta$ fiber has relationship in Acute, sharp and initial pain, contrary this C fiber is related with Chronic, dull and last pain. 5. In Acupuncture mechanism of pain analgesia, there are two theory, one is gate control theory as large fiber another is stimuation produced analgesia as small diameter fier. 6. In DNIC, the stimulation sources are mechanical, thermal, heating, pain and acupuncture stimulation etc. we call these as a Heterotopic Noxious Stimulation. 7. In DNIC, SRD(Subnucleus reticularis dorsalis)is core nucleus in pain imtermediated analgesic mechanism. 8. Takeshige insisted nonacupuncture point dependent analgesic mechanism and acupuncture point dependent analgesic mechanism. and protested that Stimulation acupuncture piing evoke blocking nomacupuncture point analgesic pathway.

• Journal of Acupuncture Research
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• v.23 no.1
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• pp.145-154
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• 2006

Objectives : To research the recent trends of study related to pain modulation of acupuncture. Methods : We searched the resent study related to pain modulation of acupuncture. Results & Conclusion : 1) Early studies demonstrated that the analgesic effects of acupuncture are mediated by opioid peptides in the periaqueductal gray. Recent evidences show that nitric oxide plays an important role in mediating the cardiovascular responses to acupuncture stimulation through gracile nucleus-thalamic pathway. 2) Recent evidences show that acupuncture stimulate gene expression related to pain. 3) By using functional magnetic resonance and positron emission tomography, recent study suggest that acupuncture has regionally specific, quantifiable effects on pain-relevant brain structures.

• Journal of Physiology & Pathology in Korean Medicine
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• v.21 no.6
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• pp.1483-1490
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• 2007

This study was carried out to investigate the effects of GCP treatment on the expression of NOS, c-fos, serotonin and substance P in central nerve system of monosodium iodoacetate(MIA)-induced osteoarthritic pain model. Arthritis was induced by injection of MIA(0.5 mg) into knee joint cavities of rats. Arthritic rats were divided into control(n=8) and treated(n=8) group. Control group was taken distilled water for 20 days. Treated group was taken extracts of GCP by oraly for same duration. Normal group(n=8) was infected with normal saline and was taken distilled water for 20 days. The numbers of NADPH-d positive cells in superficial dorsal horn of spinal cord of treated group($21{\pm}5$) was significantly (p<0.01) decreased compared with control($33{\pm}5$). The numbers of NADPH-d positive cell in dorsolateral periaqueductal gray matter of treated group($111{\pm}16$) was significantly(p<0.01) decreased compared with control($143{\pm}14$). The numbers of c-fos positive cells in dorsal periaqueductal gray matter of treated group($57{\pm}16$) was significantly(p<0.01) decreased compared with control($78{\pm}13$). The numbers of c-fos positive cells in paraventricular thalamic nucleus of treated group($60{\pm}15$) was significantly decreased compared with control($88{\pm}27$). The numbers of serotonin positive cells in median raphe nucleus of treated group($171{\pm}31$) was significantly(p<0.05) decreased compared with control($217{\pm}48$). On the basis of these results, we concluded that GCP treatment has inhibiting effects on the pain transmission in monosodium iodoacetate-induced osteoarthritic pain model in rat.