Mao J, Mayer D J, Price D D
Department of Anesthesiology, Medical College of Virginia, Virginia Commonwealth University, Richmond 23298.
J Neurosci. 1993 Jun;13(6):2689-702. doi: 10.1523/JNEUROSCI.13-06-02689.1993.
Regional changes in brain neural activity were examined in rats with painful peripheral mononeuropathy (chronic constrictive injury, CCI) by using the fully quantitative 14C-2-deoxyglucose (2-DG) autoradiographic technique to measure local glucose utilization rate. CCI rats used in the experiment exhibited demonstrable thermal hyperalgesia and spontaneous pain behaviors 10 d after sciatic nerve ligation when the 2-DG experiment was carried out. In the absence of overt peripheral stimulation, reliable increases in 2-DG metabolic activity were observed in CCI rats as compared to sham-operated rats within extensive brain regions that have been implicated in supraspinal nociceptive processing. These brain regions included cortical somatosensory areas, cingulate cortex, amygdala, ventral posterolateral thalamic nucleus, posterior thalamic nucleus, hypothalamic arcuate nucleus, central gray matter, deep layers of superior colliculus, pontine reticular nuclei, locus coeruleus, parabrachial nucleus, gigantocellular reticular nucleus, and paragigantocellular nucleus. The increase in 2-DG metabolic activity was bilateral in most brain regions of CCI rats. However, somatosensory regions within the thalamus and the cerebral cortex were activated in CCI rats. High levels of 2-DG metabolic activity were observed within the cortical hind limb area, ventral posterolateral thalamic nucleus, and posterior thalamic nucleus contralateral to the ligated sciatic nerve, and these levels were higher than ipsilateral corresponding regions in CCI rats. In addition, patterns of increased neural activity found in the brain of CCI rats showed some similarities and differences to those found in the brain of rats exposed to acute nociception induced by noxious heat or formalin stimulation. Thus, these CCI-induced spontaneous increases in neural activity within extensive brain regions of CCI rats previously implicated in sensory-discriminative and affective-motivational dimensions of pain as well as centrifugal modulation of pain are likely to reflect brain neural processing of spontaneous pain. Implications of increased brain neural activity in mechanisms of neuropathic pain are discussed with emphasis on correlations between spatial patterns of altered brain neural activity and pain-related behaviors in CCI rats and clinical symptoms in neuropathic pain patients.
采用全定量¹⁴C-2-脱氧葡萄糖(2-DG)放射自显影技术测量局部葡萄糖利用率,研究了患有疼痛性周围单神经病变(慢性压迫性损伤,CCI)的大鼠脑内神经活动的区域变化。在进行2-DG实验时,实验中使用的CCI大鼠在坐骨神经结扎10天后表现出明显的热痛觉过敏和自发疼痛行为。在没有明显外周刺激的情况下,与假手术大鼠相比,在参与脊髓上痛觉处理的广泛脑区中,观察到CCI大鼠的2-DG代谢活性可靠增加。这些脑区包括皮质体感区、扣带回皮质、杏仁核、腹后外侧丘脑核、丘脑后核、下丘脑弓状核、中央灰质、上丘深层、脑桥网状核、蓝斑、臂旁核、巨细胞网状核和旁巨细胞网状核。CCI大鼠大多数脑区的2-DG代谢活性增加是双侧性的。然而,丘脑和大脑皮质内的体感区在CCI大鼠中被激活。在结扎坐骨神经对侧的皮质后肢区、腹后外侧丘脑核和丘脑后核中观察到高水平的2-DG代谢活性,并且这些水平高于CCI大鼠同侧相应区域。此外,在CCI大鼠脑中发现的神经活动增加模式与暴露于有害热或福尔马林刺激诱导的急性伤害感受的大鼠脑中发现的模式有一些异同。因此,CCI诱导的CCI大鼠广泛脑区内神经活动的自发增加,这些脑区先前与疼痛的感觉辨别和情感动机维度以及疼痛的离心调节有关,很可能反映了自发疼痛的脑内神经处理过程。讨论了脑内神经活动增加在神经性疼痛机制中的意义,重点是CCI大鼠脑内神经活动改变的空间模式与疼痛相关行为以及神经性疼痛患者临床症状之间的相关性。