Kayser Valérie, Christensen Dennis
Unité de Recherches de Physiopharmacologie du Système Nerveux, INSERM U-161, 2 rue d'Alésia, 75014 Paris, France.
Pain. 2000 Oct;88(1):53-60. doi: 10.1016/S0304-3959(00)00307-9.
The anticonvulsant gabapentin is effective against neuropathic pain, but the primary site(s) and mechanism(s) of action are unknown. In order to explore the relative contribution of spinal versus supra-spinal mechanisms to the antinociceptive effect of gabapentin, this study used two differentially integrated nociceptive tests. We systematically compared the effects of various doses of gabapentin on the paw withdrawal to pressure (PWTP), a spinally coordinated reflex and the vocalization threshold to paw pressure (VTPP), a supra-spinal integrated test in the sciatic nerve constriction rat model of neuropathic pain. In addition, we evaluated the effect of gabapentin on the struggle latency to paw immersion into a non-noxious cold (10 degrees C) water bath. Similar lower doses (1-30 mg/kg) of gabapentin produced potent antinociception in the VTPP test but were devoid of effects on the PWTP. The effect was observed not only on the nerve-injured side, but also, although less pronounced, on the contralateral side. Only the highest dose (100 mg/kg) of the anticonvulsant was able to induce an increase in the nerve-injured paw threshold in both tests. In the thermal test, gabapentin (3, 10 and 30 mg/kg i.p.) dose-dependently increased the response time to the 10 degrees C stimulus. Gabapentin at 100 mg/kg but not at 30 mg/kg produced motor deficits in animals using the rotarod test. Taken together, our findings suggest that low doses of gabapentin have a preferential action on the more integrated pain-related behaviour in neuropathic rats. The present results confirm that gabapentin may be a useful approach for the clinical management of several aspects of neuropathic pain.
抗惊厥药物加巴喷丁对神经性疼痛有效,但其主要作用部位和作用机制尚不清楚。为了探究脊髓机制与脊髓上机制对加巴喷丁抗伤害感受作用的相对贡献,本研究采用了两种不同整合程度的伤害感受测试。我们系统地比较了不同剂量加巴喷丁对坐骨神经缩窄大鼠模型神经性疼痛中爪对压力的缩足反应(PWTP,一种脊髓协调反射)和爪对压力的发声阈值(VTPP,一种脊髓上整合测试)的影响。此外,我们评估了加巴喷丁对爪浸入非伤害性冷水(10摄氏度)水浴的挣扎潜伏期的影响。相似的低剂量(1 - 30毫克/千克)加巴喷丁在VTPP测试中产生了有效的抗伤害感受作用,但对PWTP没有影响。不仅在神经损伤侧观察到了这种作用,在对侧虽然作用较弱但也观察到了。只有最高剂量(100毫克/千克)的抗惊厥药物能够在两项测试中使神经损伤爪的阈值升高。在热测试中,加巴喷丁(腹腔注射3、10和30毫克/千克)剂量依赖性地增加了对10摄氏度刺激的反应时间。100毫克/千克的加巴喷丁而非30毫克/千克的加巴喷丁在使用转棒试验的动物中产生了运动缺陷。综上所述,我们的研究结果表明低剂量加巴喷丁对神经性大鼠中更整合的疼痛相关行为具有优先作用。目前的结果证实加巴喷丁可能是临床管理神经性疼痛多个方面的一种有用方法。