Mech-Sense, Department of Gastroenterology, Aalborg Hospital, Aarhus University Hospital, Aalborg, Denmark.
Pancreatology. 2010;10(6):742-51. doi: 10.1159/000321644. Epub 2011 Jan 26.
BACKGROUND/AIMS: In various chronic pain conditions cortical reorganisation seems to play a role in the symptomatology. The aims of this study were to investigate cortical reorganisation in patients with pain caused by chronic pancreatitis (CP) and to correlate putative cortical reorganisation to clinical pain scores.
24 patients suffering from CP and 14 healthy volunteers were included. Patients' daily experience of pain was recorded in a pain diary. The sigmoid was stimulated electrically with simultaneous recording of evoked brain potentials (EPs). The brain source localisations reflecting direct neuronal activity were fitted by a five-dipole model projected to magnetic resonance imaging of the individual brains.
Patients showed prolonged latencies of the EPs confined to the frontal region of the brain (p < 0.01). The corresponding brain sources were located in the bilateral insula, cingulate gyrus and bilateral secondary somatosensory area. The insular dipoles were localised more posterior in the patients than in healthy subjects (p < 0.01). The shift in insular dipole localisation was negatively correlated with the patients' clinical pain scores (p < 0.05).
The findings indicate that sustained pain in CP leads to functional reorganisation of the insular cortex. We suggest its physiological correlate to be an adaptive response to chronic pain. and IAP.
背景/目的：在各种慢性疼痛病症中，皮质重组似乎在症状学中起作用。本研究的目的是研究慢性胰腺炎（CP）引起疼痛患者的皮质重组，并将潜在的皮质重组与临床疼痛评分相关联。
纳入 24 名患有 CP 的患者和 14 名健康志愿者。患者的日常疼痛体验记录在疼痛日记中。用 sigmoid 进行电刺激，同时记录诱发的脑电位（EPs）。反映直接神经元活动的脑源定位通过投射到个体大脑磁共振成像的五个偶极子模型进行拟合。
患者的 EP 潜伏期延长，仅限于大脑的额叶区域（p < 0.01）。相应的脑源位于双侧脑岛、扣带回和双侧次级体感区。与健康受试者相比，患者的脑岛偶极子更靠后定位（p < 0.01）。脑岛偶极子定位的移位与患者的临床疼痛评分呈负相关（p < 0.05）。
这些发现表明，CP 中的持续性疼痛会导致脑岛皮质的功能重组。我们建议其生理相关性是对慢性疼痛的适应性反应。和 IAP。
