Menétrey Daniel, Besson Jean Marie
Unité de Recherches de Neurophysiologie Pharmacologique, I.N.S.E.R.M. (U. 161), 2, rue d'Alésia, 75014 Paris, France.
Pain. 1982 Aug;13(4):343-364. doi: 10.1016/0304-3959(82)90003-3.
(1) Electrophysiological properties of dorsal horn neurones have been investigated in decerebrate, immobilized spinal rats rendered polyarthritic by intradermal injection of Freund's adjuvant. Since arthritis is associated with pronounced erythema and oedema of the foot sole and ankle areas, this particular study was devoted to the induced modifications of responses of units driven by cutaneous inputs. It allowed comparison with previous studies performed in healthy animals. (2) Superficial dorsal horn cells could be separated in: those driven from non-oedematous skin and which had properties similar to those observed in healthy animals; and those driven from oedematous skin and which characterized by unclassical electrophysiological properties such as: (a) a relatively high level of background activity, frequently with bursting pattern and sometimes exhibiting dramatic increases; these neurones are normally silent in healthy animals; (b) a high degree of responsivity to light mechanical stimuli associated with a clear decrease in threshold. It is possible that units which initially only responded to high intensity or frankly noxious stimuli shifted to become highly or maximally responsive to gentle stimuli. (3) Similar modifications were also observed for some of the neurones located in deeper areas of the spinal cord where it is suggested that some units initially responding to both non-noxious and noxious stimuli (class 2 cells) in healthy rats shifted their characteristics to resemble units maximally driven by non-noxious stimuli (class 1 cells) in arthritic animals. (4) The numerous structural alterations reported in cutaneous tissues compared to the relatively normal structure of peripheral nerves and central nervous systems suggest that these observations can be related to peripheral sensitization of the sensory endings of thin peripheral fibres induced by the release of chemalgogens in inflammatory exudates. (5) For both superficial and deeper dorsal horn neurones, arthritis also affected the late responses of neurones to transcutaneous electrical stimulation and their responses to radiant heat. Responses to radiant heat showed an increase in threshold, sometimes associated with a very high degree of adaptation. (6) Another group of neurones displayed fading responses to repetitive mechanical stimuli. All were located in the deeper two-thirds of the dorsal horn. (7) These data indicate that chronic pathological conditions related to articular and/or cutaneous diseases strongly modify the responses of dorsal horn neurones, some being at the origin of ascending tracts. This model seems to be a promising approach to study the fundamental mechanisms involved in chronic pain in order to approach these problems in human beings.
(1) 对通过皮内注射弗氏佐剂致使多关节发炎的去大脑、固定脊髓的大鼠的背角神经元的电生理特性进行了研究。由于关节炎与足底和踝关节区域明显的红斑和水肿相关,这项特定研究致力于观察由皮肤输入驱动的神经元反应的诱导性改变。这使得能够与先前在健康动物身上进行的研究进行比较。(2) 浅背角细胞可分为两类:一类由非水肿皮肤驱动,其特性与在健康动物身上观察到的相似;另一类由水肿皮肤驱动,其具有非经典的电生理特性,例如:(a) 相对较高水平的背景活动,常呈爆发模式,有时会急剧增加;这些神经元在健康动物中通常是沉默的;(b) 对轻度机械刺激的高度反应性,同时阈值明显降低。最初仅对高强度或明显有害刺激有反应的神经元有可能转变为对轻柔刺激有高度或最大反应。(3) 在脊髓更深区域的一些神经元也观察到了类似的改变,提示在健康大鼠中一些最初对非有害和有害刺激都有反应的神经元(2类细胞)在关节炎动物中其特性转变为类似于主要由非有害刺激驱动的神经元(1类细胞)。(4) 与相对正常的外周神经和中枢神经系统结构相比,皮肤组织中报道的众多结构改变表明,这些观察结果可能与炎症渗出物中化学致痛物质释放所诱导的细外周纤维感觉末梢的外周敏化有关。(5) 对于浅背角和深背角神经元,关节炎还影响了神经元对经皮电刺激的晚期反应及其对辐射热的反应。对辐射热的反应表现为阈值升高,有时伴有高度适应性。(6) 另一组神经元对重复性机械刺激表现出衰减反应。所有这些神经元都位于背角的下三分之二区域。(7) 这些数据表明,与关节和/或皮肤疾病相关的慢性病理状况强烈改变了背角神经元的反应,其中一些是上行传导束的起源。这个模型似乎是研究慢性疼痛所涉及的基本机制以便解决人类这些问题的一个有前景的方法。