实验医学中的内脏痛读数。

Visceral pain readouts in experimental medicine.

机构信息

Wingate Institute for Neurogastroenterology, Centre for Digestive Diseases, Institute of Cell and Molecular Science, Barts, and The London School of Medicine and Dentistry, Queen Mary University of London, UK.

出版信息

Neurogastroenterol Motil. 2012 Oct;24(10):891-4. doi: 10.1111/nmo.12014.

Abstract

Visceral pain is studied at the level of the primary afferent fiber, spinal cord, subcortical, and cortical levels electrophysiologically and using brain imaging, which provides an objective measure of excitation at each level. However, correlation of these with actual perception of pain in conscious animal models has been problematic, and we rely on indirect measures in most preclinical research. The main method is electromyographic recording of abdominal muscle contractions in response to colorectal distension (CRD), which may reflect reflexes set up at several levels of the above pathway. Several experimental treatments for visceral pain have failed in clinical trials, possibly because of failure to translate from preclinical observations on CRD responses in animals to perception of spontaneous events in patients. Therefore, we need more objective outcomes. In this NGM issue, Hultin et al. show feasibility of routine recordings of cortical evoked electrical potentials (CEP) using implanted cranial electrodes in response to graded CRD in rats. CEP comprised three temporal components with latencies of approximately 20-50 ms, 90-180 ms, and 300 ms, which were reproducible and graded in intensity and latency with distension pressure. From this basic study it is clear that colorectal evoked potentials can be recorded reliably in awake rats and may serve as an objective marker for centrally projecting visceral sensory signals in rodents. It remains to be seen how these responses are affected by drugs under development for clinical management of visceral pain, and if there is improved translation.

摘要

内脏痛在初级传入纤维、脊髓、皮质下和皮质水平上进行电生理学研究,并使用脑成像来提供每个水平兴奋的客观测量。然而,这些与有意识动物模型中实际疼痛感知的相关性一直存在问题,我们在大多数临床前研究中依赖间接测量。主要方法是记录腹部肌肉对结直肠扩张(CRD)的肌电图反应,这可能反映了上述途径中几个水平上建立的反射。几种内脏痛的实验性治疗在临床试验中失败了,可能是因为未能将动物对 CRD 反应的临床前观察转化为患者自发事件的感知。因此,我们需要更客观的结果。在本期 NGM 中,Hultin 等人展示了使用植入的颅电极对大鼠进行分级 CRD 时记录皮质诱发电位(CEP)的常规记录的可行性。CEP 包括三个时间成分,潜伏期约为 20-50ms、90-180ms 和 300ms,这些成分具有可重复性,并且随着扩张压力的增加而在强度和潜伏期上分级。从这项基础研究中可以清楚地看出,结直肠诱发的电位可以在清醒的大鼠中可靠地记录下来,并且可以作为啮齿动物内脏感觉信号向中枢投射的客观标志物。这些反应如何受到正在开发用于内脏痛临床管理的药物的影响,以及是否有更好的转化,还有待观察。

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