Department of Anesthesiology, Jinling Hospital, Nanjing, China.
Eur J Anaesthesiol. 2010 Feb;27(2):162-8. doi: 10.1097/EJA.0b013e328331a3d5.
Clinical studies have revealed that patients with chronic pain are more likely to have anxiety and depression, which are often associated with cognitive dysfunction. However, whether neuropathic pain can induce cognition dysfunction remains uncertain. Antidepressants and nonsteroidal anti-inflammatory drugs can treat neuropathic pain, but whether they can prevent cognition dysfunction is unknown. The present study was designed to investigate the effects and possible mechanisms of neuropathic pain on learning and memory, and the effects of amitriptyline and lornoxicam on cognitive function.
Sixty male Sprague-Dawley rats were randomly subjected to L5 spinal nerve transection and sham operation, then given saline, amitriptyline and lornoxicam, respectively, during the postoperative days (7-28). Pain-related behaviours, depression-related behaviours, spatial learning and memory abilities, and expression of brain-derived neurotrophic factor were measured at different times after surgery.
L5 spinal nerve transection induced mechanical allodynia and depression, and decreased the function of learning and memory as well as the expression of brain-derived neurotrophic factor. Amitriptyline ameliorated mechanical allodynia and depression-related behaviour, improved the impaired cognition, and increased the expression of brain-derived neurotrophic factor, whereas lornoxicam only inhibited the mechanical allodynia.
We found that neuropathic pain may impair cognitive function via downregulation of the expression of brain-derived neurotrophic factor of the hippocampus, and amitriptyline rather than lornoxicam can ameliorate cognitive dysfunction via upregulation of brain-derived neurotrophic factor of the hippocampus.
临床研究表明,慢性疼痛患者更容易出现焦虑和抑郁,而焦虑和抑郁通常与认知功能障碍有关。然而,神经病理性疼痛是否会导致认知功能障碍尚不确定。抗抑郁药和非甾体抗炎药可治疗神经病理性疼痛,但它们是否能预防认知功能障碍尚不清楚。本研究旨在探讨神经病理性疼痛对学习记忆的影响及其可能机制,以及阿米替林和氯诺昔康对认知功能的影响。
60 只雄性 Sprague-Dawley 大鼠随机接受 L5 脊神经横断术和假手术,然后分别在术后第 7-28 天给予生理盐水、阿米替林和氯诺昔康。术后不同时间测量疼痛相关行为、抑郁相关行为、空间学习记忆能力和脑源性神经营养因子表达。
L5 脊神经横断术导致机械性痛觉过敏和抑郁,并降低学习记忆功能和脑源性神经营养因子的表达。阿米替林改善机械性痛觉过敏和抑郁相关行为,改善受损认知功能,并增加脑源性神经营养因子的表达,而氯诺昔康仅抑制机械性痛觉过敏。
我们发现神经病理性疼痛可能通过下调海马脑源性神经营养因子的表达损害认知功能,而阿米替林而非氯诺昔康通过上调海马脑源性神经营养因子改善认知功能障碍。