Tonelli L, Setti T, Falasca A, Martignoni E, Torcia E, Calcaterra F M, Merli G A, Facchinetti F
Department of Neurosurgery, University of Modena, Italy.
Appl Neurophysiol. 1988;51(6):324-32. doi: 10.1159/000099977.
The purpose of this study was to assess the biochemical mechanisms underlying spinal cord stimulation (SCS). Seventeen patients with chronic pain were investigated by measuring cerebrospinal fluid concentrations of endogenous opioids and biogenic amines before and during dorsal column stimulation. Basal cerebrospinal fluid beta-endorphin levels were below the normal range. No significant change of norepinephrine, epinephrine, dopamine, beta-endorphin, beta-lipotropin, or adrenocorticotropic hormone levels were found after SCS. A 50% increase of cerebrospinal beta-endorphin and beta-lipotropin levels occurred in 6 out of 16 patients, namely those where SCS gave the major pain relief. These data confirm the derangement of the endogenous opioid system in chronic pain conditions and suggest that the beta-endorphin response to SCS could have clinical value in predicting the success of treatment.
本研究的目的是评估脊髓刺激（SCS）背后的生化机制。通过测量17例慢性疼痛患者在背柱刺激前后脑脊液中内源性阿片类物质和生物胺的浓度来进行研究。基础脑脊液β-内啡肽水平低于正常范围。脊髓刺激后，去甲肾上腺素、肾上腺素、多巴胺、β-内啡肽、β-促脂素或促肾上腺皮质激素水平未发现显著变化。16例患者中有6例脑脊液β-内啡肽和β-促脂素水平升高了50%，即那些脊髓刺激能显著缓解疼痛的患者。这些数据证实了慢性疼痛状态下内源性阿片系统的紊乱，并表明β-内啡肽对脊髓刺激的反应可能在预测治疗成功方面具有临床价值。
