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加巴喷丁和普瑞巴林在神经病变模型中可抑制触觉异常性疼痛并增强脊髓刺激。

Gabapentin and pregabalin suppress tactile allodynia and potentiate spinal cord stimulation in a model of neuropathy.

作者信息

Wallin Johan, Cui Jian-Guo, Yakhnitsa Vadim, Schechtmann Gastón, Meyerson Björn A, Linderoth Bengt

机构信息

Department of Clinical Neuroscience, Section of Neurosurgery, Karolinska Institutet, S-171 76 Stockholm, Sweden.

出版信息

Eur J Pain. 2002;6(4):261-72. doi: 10.1053/eujp.2002.0329.


DOI:10.1053/eujp.2002.0329
PMID:12161092
Abstract

Spinal cord stimulation (SCS) is an effective tool in alleviating neuropathic pain. However, a number of well-selected patients fail to obtain satisfactory pain relief. Previous studies have demonstrated that i.t. baclofen and/or adenosine can enhance the SCS effect, but this combined therapy has been shown to be useful in less than half of the cases and more effective substances are therefore needed. The aim of this experimental study in rats was to examine whether gabapentin or pregabalin attenuates tactile allodynia following partial sciatic nerve injury and whether subeffective doses of these drugs can potentiate the effects of SCS in rats which do not respond to SCS. Mononeuropathy was produced by a photochemically induced ischaemic lesion of the sciatic nerve. Tactile withdrawal thresholds were assessed with von Frey filaments. Effects of increasing doses of gabapentin and pregabalin (i.t. and i.v.) on the withdrawal thresholds were analysed. These drugs were found to reduce tactile allodynia in a dose-dependent manner. In SCS non-responding rats, i.e. where stimulation per se failed to suppress allodynia, a combination of SCS and subeffective doses of the drugs markedly attenuated allodynia. In subsequent acute experiments, extracellular recordings from wide dynamic range neurones in the dorsal horn showed prominent hyperexcitability. The combination of SCS and gabapentin, at the same subeffective dose, clearly enhanced suppression of this hyperexcitability. In conclusion, electrical therapy and pharmacological therapy in neuropathic pain can, when they are inefficient individually, become effective when combined.

摘要

脊髓刺激(SCS)是缓解神经性疼痛的一种有效手段。然而,一些精心挑选的患者未能获得满意的疼痛缓解效果。先前的研究表明,鞘内注射巴氯芬和/或腺苷可增强脊髓刺激的效果,但这种联合疗法在不到一半的病例中显示有效,因此需要更有效的药物。本大鼠实验研究的目的是检验加巴喷丁或普瑞巴林是否能减轻坐骨神经部分损伤后的触觉异常性疼痛,以及这些药物的亚有效剂量是否能增强对脊髓刺激无反应的大鼠的脊髓刺激效果。通过光化学诱导的坐骨神经缺血性损伤造成单神经病。用von Frey细丝评估触觉撤防阈值。分析了加巴喷丁和普瑞巴林(鞘内注射和静脉注射)剂量增加对撤防阈值的影响。发现这些药物以剂量依赖的方式减轻触觉异常性疼痛。在对脊髓刺激无反应的大鼠中,即刺激本身未能抑制异常性疼痛的大鼠中,脊髓刺激与药物亚有效剂量的联合明显减轻了异常性疼痛。在随后的急性实验中,对背角广动力范围神经元的细胞外记录显示出明显的兴奋性过高。脊髓刺激与加巴喷丁以相同的亚有效剂量联合使用时,明显增强了对这种兴奋性过高的抑制作用。总之,神经性疼痛的电疗法和药物疗法单独使用无效时,联合使用可能会变得有效。

相似文献

[1]
Gabapentin and pregabalin suppress tactile allodynia and potentiate spinal cord stimulation in a model of neuropathy.

Eur J Pain. 2002

[2]
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Neurosci Lett. 2008-5-2

[3]
A nitric oxide (NO)-releasing derivative of gabapentin, NCX 8001, alleviates neuropathic pain-like behavior after spinal cord and peripheral nerve injury.

Br J Pharmacol. 2004-1

[4]
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[5]
The efficacy of morphine, pregabalin, gabapentin, and duloxetine on mechanical allodynia is different from that on neuroma pain in the rat neuropathic pain model.

Anesth Analg. 2012-3-13

[6]
Successful pain relief in non-responders to spinal cord stimulation: the combined use of ketamine and spinal cord stimulation.

Eur J Pain. 2011-5-11

[7]
A combination of gabapentin and morphine mediates enhanced inhibitory effects on dorsal horn neuronal responses in a rat model of neuropathy.

Anesthesiology. 2002-3

[8]
Release of gamma-aminobutyric acid in the dorsal horn and suppression of tactile allodynia by spinal cord stimulation in mononeuropathic rats.

Neurosurgery. 1996-8

[9]
Injury type-specific calcium channel alpha 2 delta-1 subunit up-regulation in rat neuropathic pain models correlates with antiallodynic effects of gabapentin.

J Pharmacol Exp Ther. 2002-12

[10]
Differential pharmacological modulation of the spontaneous stimulus-independent activity in the rat spinal cord following peripheral nerve injury.

Exp Neurol. 2006-3

引用本文的文献

[1]
Characterization of preclinical models to investigate spinal cord stimulation for neuropathic pain: a systematic review and meta-analysis.

Pain Rep. 2025-1-13

[2]
Comparing the effectiveness of pregabalin and gabapentin in patients with lumbar radiculopathy: A systematic review and meta-analysis.

Pain Pract. 2024-10-11

[3]
Enhancing spinal cord stimulation-induced pain inhibition by augmenting endogenous adenosine signalling after nerve injury in rats.

Br J Anaesth. 2024-4

[4]
Combination Drug Therapy for the Management of Chronic Neuropathic Pain.

Biomolecules. 2023-12-16

[5]
Gabapentinoids Associated With Lower Explantation Rate in 203 Patients With Spinal Cord Stimulation for Failed Back Surgery Syndrome.

Neurosurgery. 2021-9-15

[6]
Anti-allodynic effect induced by curcumin in neuropathic rat is mediated through the NO-cyclic-GMP-ATP sensitive K channels pathway.

BMC Complement Med Ther. 2020-3-14

[7]
Neuropathic Pain Medication Use Does Not Alter Outcomes of Spinal Cord Stimulation for Lower Extremity Pain.

Neuromodulation. 2018-1

[8]
A bacosides containing Bacopa monnieri extract alleviates allodynia and hyperalgesia in the chronic constriction injury model of neuropathic pain in rats.

BMC Complement Altern Med. 2017-6-5

[9]
The antiallodynic action of pregabalin in neuropathic pain is independent from the opioid system.

Mol Pain. 2016-3-29

[10]
Spinal cord transection-induced allodynia in rats--behavioral, physiopathological and pharmacological characterization.

PLoS One. 2014-7-14

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