神经源性痛觉过敏:脊髓丘脑束神经元反应中的中枢神经关联
Neurogenic hyperalgesia: central neural correlates in responses of spinothalamic tract neurons.
作者信息
Simone D A, Sorkin L S, Oh U, Chung J M, Owens C, LaMotte R H, Willis W D
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):228-46. doi: 10.1152/jn.1991.66.1.228.
PMID:1919669
Abstract
- The contribution of activity in spinothalamic tract (STT) neurons to the pain and neurogenic hyperalgesia produced by an intradermal injection of 100 micrograms of capsaicin was investigated. Electrophysiological responses of identified STT neurons recorded in anesthetized monkeys were compared with psychophysical measurements of pain and hyperalgesia obtained in humans using identical stimuli. 2. Magnitude estimates of pain in humans were obtained after an injection of capsaicin or the vehicle. Capsaicin produced immediate burning pain that was most intense within 15 s after injection and then declined over the next 10-30 min. The vehicle produced no pain. 3. Cutaneous hyperalgesia to gentle stroking (allodynia) and also hyperalgesia to punctate stimulation developed in a wide area surrounding the capsaicin injection. Within this area, magnitude estimates of pain produced by a punctate stimulus (von Frey type with force of 225 mN) increased over preinjection values by an average of sixfold at test sites, 1, 2, and 3 cm away from the injection site. At the capsaicin injection site, magnitude estimates of pain in response to punctate simulation typically remained the same or were decreased. 4. After capsaicin, but not vehicle, the mean heat pain thresholds were lowered from approximately 45 degrees C before injection to 34 degrees C after, but only in the immediate vicinity of the injection site. At a site located 2 cm away, the thresholds were not significantly altered. Similarly, magnitude estimates of pain produced by suprathreshold heat stimuli were increased after capsaicin only at the injection site. 5. STT neurons were classified as high-threshold (HT) or wide-dynamic-range (WDR) cells according to responses evoked by graded cutaneous mechanical stimulation. An intradermal injection of capsaicin excited 4 of 7 HT cells and 10 of 12 WDR cells. The discharge rates of STT neurons correlated in time course with the magnitude estimates of pain in humans. The correlation was considerably better for WDR than for HT neurons, suggesting a predominant contribution of WDR neurons to the pain from capsaicin. 6. Capsaicin significantly increased the responses of HT neurons (9-fold) and the responses of WDR neurons (2-fold) to stroking the skin within the receptive field. Similar increases in responses to a standard punctate stimulus were observed at test sites, 1, 2, and 3 cm away from the injection site. After injection of vehicle, the responses to punctate stimulation increased by a mean of only 1.2- and 1.4-fold for HT and WDR neurons, respectively.(ABSTRACT TRUNCATED AT 400 WORDS)
摘要
- 研究了脊髓丘脑束(STT)神经元活动对皮内注射100微克辣椒素所产生的疼痛和神经源性痛觉过敏的作用。将在麻醉猴身上记录的已鉴定STT神经元的电生理反应与使用相同刺激在人类身上获得的疼痛和痛觉过敏的心理物理学测量结果进行比较。2. 在注射辣椒素或赋形剂后获得人类疼痛的强度估计值。辣椒素产生即刻灼痛,注射后15秒内最为强烈,随后在接下来的10 - 30分钟内逐渐减轻。赋形剂未产生疼痛。3. 在辣椒素注射部位周围的广泛区域出现了对轻触的皮肤痛觉过敏(异常性疼痛)以及对点状刺激的痛觉过敏。在该区域内,距离注射部位1、2和3厘米的测试部位,由点状刺激(225毫牛顿力的von Frey型)产生的疼痛强度估计值比注射前的值平均增加了六倍。在辣椒素注射部位,对点状刺激的疼痛强度估计值通常保持不变或降低。4. 注射辣椒素后,但注射赋形剂后未出现这种情况,平均热痛阈值从注射前的约45摄氏度降至注射后的34摄氏度,但仅在注射部位附近。在距离2厘米处的部位,阈值没有明显改变。同样,仅在注射部位,超阈值热刺激产生的疼痛强度估计值在注射辣椒素后增加。5. 根据分级皮肤机械刺激诱发的反应,将STT神经元分为高阈值(HT)或广动力范围(WDR)细胞。皮内注射辣椒素使7个HT细胞中的4个和12个WDR细胞中的10个兴奋。STT神经元的放电率在时间进程上与人类疼痛的强度估计值相关。WDR神经元的相关性比HT神经元好得多,表明WDR神经元对辣椒素引起的疼痛起主要作用。6. 辣椒素显著增加了HT神经元(9倍)和WDR神经元(2倍)对感受野内皮肤轻触的反应。在距离注射部位1、2和3厘米的测试部位,对标准点状刺激的反应也有类似增加。注射赋形剂后,HT和WDR神经元对点状刺激的反应分别仅平均增加1.2倍和1.4倍。(摘要截断于400字)