Kakigi R
Department of Integrative Physiology, National Institute for Physiological Sciences.
Rinsho Shinkeigaku. 1994 Dec;34(12):1255-7.
Recent advances of evoked potentials, mainly pain-related somatosensory evoked potentials following CO2 laser stimulation (pain SEPs), were summarized. A small negative and a large positive potential, the N240-P340 and the N300-P400 following the hand and the foot stimulation, were identified in normal subjects. Conduction velocity of the A delta fibers and the spinothalamic tract was approximately 10 m/sec. Pain SEPs were significantly decreased in amplitude and the marked pain relief was induced by vibration applied to the area where laser stimulation was applied. This finding was compatible with the gate control theory. Active and passive movements of the limbs remote from and adjacent to the stimulated area significantly decreased pain SEPs in amplitude. This indicated the particular interactions between pain perception and movement-related cortical activities taken place in some areas of the brain. The theory, diffuse noxious inhibitory controls (DNIC) proposed by Le Bars et al., was also confirmed by pain SEPs. Pain SEPs were useful in clinical testing. Pain SEP findings showed a significant correlation with the clinical impairment of pain sensation, and the subclinical lesions of the ascending pathways of the painful sensation were detected by pain SEPs.
本文总结了诱发电位的最新进展,主要是二氧化碳激光刺激后与疼痛相关的体感诱发电位(疼痛SEP)。在正常受试者中,分别在手和足部刺激后识别出一个小的负电位和一个大的正电位,即N240-P340和N300-P400。Aδ纤维和脊髓丘脑束的传导速度约为10米/秒。疼痛SEP的幅度显著降低,并且通过对激光刺激部位施加振动可诱导明显的疼痛缓解。这一发现与闸门控制理论相符。远离和邻近刺激区域的肢体的主动和被动运动显著降低了疼痛SEP的幅度。这表明在大脑的某些区域发生了疼痛感知与运动相关皮质活动之间的特定相互作用。Le Bars等人提出的弥漫性伤害性抑制控制(DNIC)理论也得到了疼痛SEP的证实。疼痛SEP在临床测试中很有用。疼痛SEP的结果与疼痛感觉的临床损害显著相关,并且通过疼痛SEP检测到了痛觉上行通路的亚临床病变。