Jääskeläinen Satu K, Rinne Juha O, Forssell Heli, Tenovuo Olli, Kaasinen Valtteri, Sonninen Pirkko, Bergman Jörgen
Department of Clinical Neurophysiology, Turku University Central Hospital, PL 52, FI-20 521 Turku, Finland Turku PET Centre, Turku University Central Hospital, Turku, Finland Department of Oral Diseases, Turku University Central Hospital, Turku, Finland Department of Neurology, Turku University Central Hospital, Turku, Finland Department of Radiology, Turku University Central Hospital, Turku, Finland Turku PET Centre, Radiopharmaceutical Chemistry Laboratory, MediCity PET and Accelerator Laboratory, Turku, Finland.
Pain. 2001 Feb 15;90(3):257-260. doi: 10.1016/S0304-3959(00)00409-7.
Recent data from animal experiments suggest an important role for the basal ganglia in the processing and sensorimotor gating of nociceptive information. However, very little is known about their possible participation in human pain. Because of our previous finding of increased excitability of the blink reflex (a brainstem reflex under dopaminergic inhibitory control) in some burning mouth syndrome (BMS) patients, we have studied the dopaminergic function of the striatum (putamen and caudatus) of BMS patients with positron emission tomography (PET). 6-[(18)F]fluorodopa (FDOPA) PET scans were done on ten BMS patients and 14 healthy control subjects. The presynaptic dopaminergic function was significantly decreased in the right putamen (20%, P=0.04) of the BMS patients compared to control subjects. On the left side, the FDOPA uptake was decreased by 17% (P=0.08). The mean FDOPA uptake was not significantly changed in the caudate nucleus of the patients. The finding of decreased striatal FDOPA uptake in the putamen supports our previous neurophysiological observations indicating decreased dopaminergic inhibition in BMS patients. The present result provides direct evidence of the involvement of the nigrostriatal dopaminergic system in pain for the first time in a clinical pain condition.
近期动物实验数据表明，基底神经节在伤害性信息的处理及感觉运动门控中发挥重要作用。然而，对于它们在人类疼痛中的可能参与情况却知之甚少。鉴于我们之前发现一些灼口综合征（BMS）患者的眨眼反射（一种受多巴胺能抑制控制的脑干反射）兴奋性增加，我们利用正电子发射断层扫描（PET）研究了BMS患者纹状体（壳核和尾状核）的多巴胺能功能。对10名BMS患者和14名健康对照者进行了6-[(18)F]氟多巴（FDOPA）PET扫描。与对照者相比，BMS患者右侧壳核的突触前多巴胺能功能显著降低（20%，P = 0.04）。在左侧，FDOPA摄取量降低了17%（P = 0.08）。患者尾状核的平均FDOPA摄取量无显著变化。壳核中纹状体FDOPA摄取量降低的这一发现支持了我们之前的神经生理学观察结果，即表明BMS患者多巴胺能抑制作用减弱。本研究结果首次在临床疼痛病症中提供了黑质纹状体多巴胺能系统参与疼痛的直接证据。
