Neuroscience Research, AbbVie, Inc., North Chicago, IL 60064, USA.
Pain. 2013 Jul;154(7):1092-102. doi: 10.1016/j.pain.2013.03.019. Epub 2013 Mar 15.
Preclinical assessment of pain has typically relied on measuring animal responses to evoked stimulation. Because of inherent limitations of these assays, there is a need to develop measures of animal pain/discomfort that are objective, not experimentally evoked, and mimic the human condition. Patients with chronic pain manifest a variety of co-morbidities, one of which is disturbances in sleep. We used electroencephalography to objectively assess 4 rat models of pain (inflammatory/complete Freund's adjuvant [CFA], neuropathic/chronic constriction injury [CCI], postoperative/skin incision, osteoarthritis/monosodium iodoacetate [MIA]) for the occurrence of sleep disturbances. Four different measures of slow-wave sleep (SWS) were examined: amplitude of 1- to 4-Hz waves, total time spent in SWS, time spent in SWS-1, and time spent in SWS-2. Bilateral injuries were more likely to induce a sleep disturbance than unilateral injuries in the CFA, CCI, and skin incision assays. Sleep disturbances occurred in the deeper stage of SWS, as the amplitude of 1- to 4-Hz waves and time spent in SWS-2 were significantly decreased in all models except the osteoarthritis model. Sleep disturbances lasted for approximately 3 to 14days, depending on the model, and were resolved despite continued hypersensitivity to evoked stimulation. Morphine, gabapentin, diclofenac, and ABT-102 (TRPV1 antagonist) all improved sleep in the bilateral CFA assay at doses that did not significantly alter SWS in uninjured rats. Preclinical assessment of compounds should follow the path of clinical studies and take into account diverse aspects of the "pain condition." This would include evaluating nociceptive thresholds as well as other endpoints, such as cognition and sleep, that may be affected by the pathological state.
临床前疼痛评估通常依赖于测量动物对诱发刺激的反应。由于这些测定方法存在固有局限性,因此需要开发客观的、非实验诱发的动物疼痛/不适测量方法,以模拟人类的状况。慢性疼痛患者表现出多种合并症,其中之一是睡眠障碍。我们使用脑电图客观评估了 4 种疼痛大鼠模型(炎症/完全弗氏佐剂[CFA]、神经病理性/慢性缩窄性损伤[CCI]、术后/皮肤切口、骨关节炎/单碘乙酸盐[MIA])是否存在睡眠障碍。检查了慢波睡眠(SWS)的 4 种不同测量方法:1-4Hz 波的幅度、SWS 总时间、SWS-1 时间和 SWS-2 时间。与 CFA、CCI 和皮肤切口测定相比,双侧损伤比单侧损伤更有可能引起睡眠障碍。在所有模型中,除骨关节炎模型外,1-4Hz 波的幅度和 SWS-2 时间均显著降低,表明睡眠障碍发生在 SWS 的更深阶段。睡眠障碍持续约 3 至 14 天,具体取决于模型,尽管对诱发刺激的敏感性持续增加,但睡眠障碍仍得到解决。吗啡、加巴喷丁、双氯芬酸和 ABT-102(TRPV1 拮抗剂)均在双侧 CFA 测定中以不显著改变未受伤大鼠 SWS 的剂量改善了睡眠。化合物的临床前评估应遵循临床研究的路径,并考虑到“疼痛状况”的各个方面。这将包括评估伤害感受阈值以及认知和睡眠等可能受病理状态影响的其他终点。