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神经源性痛觉过敏:潜在机制的心理物理学研究

Neurogenic hyperalgesia: psychophysical studies of underlying mechanisms.

作者信息

LaMotte R H, Shain C N, Simone D A, Tsai E F

机构信息

Department of Anesthesiology, Yale University School of Medicine, New Haven, Connecticut 06510.

出版信息

J Neurophysiol. 1991 Jul;66(1):190-211. doi: 10.1152/jn.1991.66.1.190.


DOI:10.1152/jn.1991.66.1.190
PMID:1919666
Abstract
  1. Psychophysical studies were made, in humans, of the sensory characteristics and underlying mechanisms of the hyperalgesia (often termed "secondary hyperalgesia") that occurs in uninjured skin surrounding a local cutaneous injury. The hyperalgesia was characterized by lowered pain thresholds and enhanced magnitude of pain to normally painful stimuli. The "injury" was produced by a single intradermal injection of 10 microliters of 100 micrograms of capsaicin, the algesic substance in hot chili peppers. 2. On injection of capsaicin into the volar forearm, the subjects experienced intense burning pain, accompanied immediately by the formation of three areas of hyperalgesia surrounding the injection site. The largest mean area (55 cm2) was hyperalgesic to a normally painful punctate stimulation of the skin. Nested within this was an area of tenderness to gentle stroking (38 cm2) and a much smaller area of hyperalgesia to heat (2 cm2). An area of analgesia to pinprick, approximately 4 mm in diameter and centered on the injection site, developed within minutes and typically disappeared within 24 h. The hyperalgesia to heat and to stroking disappeared within 1-2 h, whereas the hyperalgesia to punctate stimuli, although gradually decreasing in area, lasted from 13 to 24 h. 3. The radial spread of the mechanical hyperalgesia (to punctate and stroking stimuli) away from the injury was dependent on neural activity and not produced, for example, by algesic substances transported away from the injury. The injection of capsaicin into a small area of anesthetized skin did not produce hyperalgesia in the surrounding, unanesthetized skin. Also, the hyperalgesia in normal skin readily crossed a tight arm band that blocked the circulation of blood and lymph. 4. The spread of mechanical hyperalgesia away from the injury was peripherally mediated via cutaneous nerve fibers because it was blocked by a thin mediolateral strip of cutaneous anesthesia placed 1 cm away from the capsaicin injection site. Hyperalgesia developed normally on the capsaicin side of the strip but not on the other side. 5. Heat stimulation of the skin that produced pain that was equivalent in magnitude and time course to that produced by an injection of capsaicin (10 micrograms) resulted in much smaller areas of mechanical hyperalgesia. It was postulated that there exist special chemosensitive primary afferent nerve fibers that are more effective in producing mechanical hyperalgesia than are the known thermo- and mechanosensitive nociceptive nerve fibers. 6. Once developed, the mechanical hyperalgesia became only partially dependent on peripheral neural activity originating at the site of injury.(ABSTRACT TRUNCATED AT 400 WORDS)
摘要
  1. 针对人类进行了心理物理学研究,以探究局部皮肤损伤周围未受伤皮肤中发生的痛觉过敏(常称为“继发性痛觉过敏”)的感觉特征及潜在机制。这种痛觉过敏的特点是疼痛阈值降低,对正常疼痛刺激的疼痛强度增强。“损伤”通过皮内注射10微升含100微克辣椒素(辣椒中的致痛物质)产生。2. 将辣椒素注射到掌侧前臂后,受试者会经历强烈的灼痛,并立即在注射部位周围形成三个痛觉过敏区域。最大的平均区域(55平方厘米)对皮肤的正常疼痛点状刺激表现为痛觉过敏。在这个区域内嵌套着一个对轻触敏感的压痛区域(38平方厘米)和一个对热敏感的小得多的痛觉过敏区域(2平方厘米)。一个直径约4毫米、以注射部位为中心的针刺镇痛区域在数分钟内形成,通常在24小时内消失。对热和轻触的痛觉过敏在1 - 2小时内消失,而对点状刺激的痛觉过敏尽管面积逐渐减小,但持续13至24小时。3. 机械性痛觉过敏(对点状和轻触刺激)从损伤部位的径向扩散依赖于神经活动,而非例如从损伤部位运走的致痛物质所产生。将辣椒素注射到局部麻醉皮肤的小区域内,不会在周围未麻醉的皮肤中产生痛觉过敏。此外,正常皮肤中的痛觉过敏很容易穿过阻断血液和淋巴循环的紧束臂带。4. 机械性痛觉过敏从损伤部位的扩散是通过皮肤神经纤维在周围介导的,因为它会被置于距辣椒素注射部位1厘米处的一条薄的中外侧皮肤麻醉带阻断。在麻醉带辣椒素一侧痛觉过敏正常发展,而另一侧则不然。5. 对皮肤进行热刺激产生的疼痛在强度和时间进程上与注射10微克辣椒素产生的疼痛相当,但导致的机械性痛觉过敏区域要小得多。据推测,存在特殊的化学敏感初级传入神经纤维,它们在产生机械性痛觉过敏方面比已知的热和机械敏感伤害性神经纤维更有效。6. 一旦形成,机械性痛觉过敏仅部分依赖于源自损伤部位的周围神经活动。(摘要截断于400字)

相似文献

[1]
Neurogenic hyperalgesia: psychophysical studies of underlying mechanisms.

J Neurophysiol. 1991-7

[2]
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[3]
Neurogenic hyperalgesia: central neural correlates in responses of spinothalamic tract neurons.

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[4]
Pain, hyperalgesia and activity in nociceptive C units in humans after intradermal injection of capsaicin.

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[5]
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[6]
Central changes in processing of mechanoreceptive input in capsaicin-induced secondary hyperalgesia in humans.

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[7]
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[8]
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[9]
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[10]
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Brain Res Bull. 1997

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