Bharadwaj Vimala N, Sahbaie Peyman, Shi Xiaoyou, Irvine Karen-Amanda, Yeomans David C, Clark J David
Department of Anesthesia, Perioperative and Pain Medicine, Stanford University, School of Medicine, Stanford, California.
Department of Anesthesia, Perioperative and Pain Medicine, Stanford University, School of Medicine, Stanford, California; Anesthesiology Service, Veterans Affairs Palo Alto Health Care System, Palo Alto, California.
J Pain. 2023 Oct;24(10):1859-1874. doi: 10.1016/j.jpain.2023.05.015. Epub 2023 Jun 2.
Traumatic brain injury (TBI) can cause acute and chronic pain along with motor, cognitive, and emotional problems. Although the mechanisms are poorly understood, previous studies suggest disruptions in endogenous pain modulation may be involved. Voluntary exercise after a TBI has been shown to reduce some consequences of injury including cognitive impairment. We hypothesized, therefore, that voluntary exercise could augment endogenous pain control systems in a rodent model of TBI. For these studies, we used a closed-head impact procedure in male mice modeling mild TBI. We investigated the effect of voluntary exercise on TBI-induced hindpaw nociceptive sensitization, diffuse noxious inhibitory control failure, and periorbital sensitization after bright light stress, a model of post-traumatic headache. Furthermore, we investigated the effects of exercise on memory, circulating markers of brain injury, neuroinflammation, and spinal cord gene expression. We observed that exercise significantly reduced TBI-induced hindpaw allodynia and periorbital allodynia in the first week following TBI. We also showed that exercise improved the deficits associated with diffuse noxious inhibitory control and reduced bright light stress-induced allodynia up to 2 months after TBI. In addition, exercise preserved memory and reduced TBI-induced increases in spinal BDNF, CXCL1, CXCL2, and prodynorphin expression, all genes previously linked to TBI-induced nociceptive sensitization. Taken together, our observations suggest that voluntary exercise may reduce pain after TBI by reducing TBI-induced changes in nociceptive signaling and preserving endogenous pain control systems. PERSPECTIVE: This article evaluates the effects of exercise on pain-related behaviors in a preclinical model of traumatic brain injury (TBI). The findings show that exercise reduces nociceptive sensitization, loss of diffuse noxious inhibitory control, memory deficits, and spinal nociception-related gene expression after TBI. Exercise may reduce or prevent pain after TBI.
创伤性脑损伤(TBI)可导致急性和慢性疼痛,以及运动、认知和情绪问题。尽管其机制尚不清楚,但先前的研究表明,内源性疼痛调节的破坏可能与之有关。TBI后的自愿运动已被证明可以减轻损伤的一些后果,包括认知障碍。因此,我们推测,在TBI的啮齿动物模型中,自愿运动可能会增强内源性疼痛控制系统。在这些研究中,我们对雄性小鼠采用闭合性颅脑撞击程序来模拟轻度TBI。我们研究了自愿运动对TBI诱导的后爪伤害性感受过敏、弥漫性有害抑制控制失效以及强光应激后眶周敏化(一种创伤后头痛模型)的影响。此外,我们还研究了运动对记忆、脑损伤循环标志物、神经炎症和脊髓基因表达的影响。我们观察到,运动在TBI后的第一周显著减轻了TBI诱导的后爪痛觉过敏和眶周痛觉过敏。我们还表明,运动改善了与弥漫性有害抑制控制相关的缺陷,并在TBI后长达2个月内减轻了强光应激诱导的痛觉过敏。此外,运动保留了记忆,并减少了TBI诱导的脊髓BDNF、CXCL1、CXCL2和前强啡肽表达的增加,所有这些基因之前都与TBI诱导的伤害性感受过敏有关。综上所述,我们的观察结果表明,自愿运动可能通过减少TBI诱导的伤害性信号变化和保留内源性疼痛控制系统来减轻TBI后的疼痛。观点:本文评估了运动对创伤性脑损伤(TBI)临床前模型中疼痛相关行为的影响。研究结果表明,运动可减轻TBI后的伤害性感受过敏、弥漫性有害抑制控制丧失、记忆缺陷和脊髓伤害性感受相关基因表达。运动可能会减轻或预防TBI后的疼痛。