刺激大鼠尾核对丘脑束旁核躯体-内脏会聚神经元放电的影响

实验记录大鼠丘脑束旁核躯体-内脏会聚(PfSV)神经元伤害性放电。观察刺激尾核(Cd)对 PfSV 神经元放电的影响。(1)Cd 对刺激内脏大神经诱发 PfSV 神经元伤害性放电有抑制作用(n=19)。(2)Cd 对刺激腓浅神经和内脏大神经诱发同一 PfSV 神经元伤害性放电均有抑制作用(n=11)。结果提示,躯体和内脏痛觉信息可会聚到丘脑束旁核同一神经元,Cd 可能不仅能抑制躯体痛也能抑制内脏痛。     

Brainstem discharge sites: therapeutic targets for chronic pain

Optimum mesothalamic targets for therapeutic electrode implants are characterized by (1) spontaneously occurring focal discharges, (2) attenuation of the discharges by electrical stimulation, and (3) stimulation-induced pain relief.     

A brainstem "mini-discharge" syndrome (anesthesia dolorosa)

Chronic pain consisting of anesthesia dolorosa secondary to bilateral interruption of the trigeminal nerves is presented as a brain stem reticular denervation syndrome. Electrothalamograms revealed fast frequency discharges in the mesothalamic prerubral and centermedian reticular formation. Mesothalamic electrical stimulation attenuated the discharges. Pain and other symptoms presumably of brainstem origin also were attenuated or abolished by therapeutic electrical stimulation twice daily. It is postulated that brain stem-represented behavioral generators are implicated by the reticular discharges in order to produce the complex symptomatology. Consequently the symptom complex is collectively identified as a brainstem "mini-discharge" syndrome. A theoretical discussion is presented to defend the thesis that reticular denervation-induced low threshold discharge system accounts for the episodic states of pain, dyskinesia, mood, and memory disturbances.     

刺激交感神经对大鼠多觉型伤害性感受器诱发和自发放电的不同作用

多觉型伤害性感受器是皮肤内专一性较强的痛觉感受器。本实验用剥制神经细束的技术,引导大鼠尾神经C类纤维的传入放电反映多觉型伤害性感受器的活动,以判定刺激交感神经对外周痛觉感受过程的调制作用。测试了57个该类感受器的单位放电,发现下述两个主要事实:(1)刺激腰骶部交感干外周端,可以显著抑制伤害性刺激(包括机械压力,直流电-钾离子,热烫等)诱发的多觉型伤害性感受器的单位放电,其作用出现较快,可使放电数减少1/3左右,后作用延续十多分钟。局部动脉注射去甲肾上腺素也产生类似的抑制效应。从而证实交感神经具有抑制痛觉感受器的作用。(2)交感神经对部分多觉型伤害性感受器活动的调制具有双重作用的特点,即对同一单位因外加刺激引起的诱发放电有抑制作用,对其自发放电则有易化作用。讨论了交感神经这一双重作用的临床意义以及针刺通过交感神经调制外周痛觉感受过程的设想。     

Chronic pain syndromes

Brainstem-scalp discharge propagation was evaluated in 20 patients with chronic pain, of which 10 were ranked according to the frequency of involved systems making up the chronic pain syndrome. It is concluded that brainstem discharges alone were sufficient to generate the chronic pain syndrome.     

大鼠杏仁核簇与痛觉调制的关系

目的：研究伤害性刺激对大鼠杏仁核簇中各亚核痛反应神经元电活动的影响。方法：用串电脉冲刺激坐骨神经作为伤害性刺激,用玻璃微电极引导神经元放电。结果：杏仁核簇中多个亚核均存在痛反应神经元。伤害性刺激使痛兴奋神经元(PEN)诱发放电频率增加;使痛抑制神经元(PIN)诱发放电频率降低,并出现放电频率极低现象;两类神经元电活动相互配合。腹腔注射吗啡(10mg／kg)可以对抗伤害性刺激对痛反应神经元的作用。结论：杏仁核簇中的部分亚核在感受、整合和传递痛觉信息方面起一定作用,是中枢神经系统控制和处理痛觉信息的一个组成部分。     

视前区微量注射吗啡对大鼠丘脑束旁核痛反应神经元电活动的影响

本实验观察了视前区(POA)内微量注入阿片样物质对丘脑束旁核(Pf)痛反应神经元电活动影响。结果如下:(1)POA 内微量注射高浓度吗啡(10μg/μl)能显著抑制 Pf 内大部分(20/26)痛兴奋神经元(PEN)的痛诱发放电,其中3个神经元注药后对伤害性刺激转变成抑制反应;POA 内微量注射低浓度吗啡(1μg/μl)也显著抑制 Pf 内大部分(19/23)PEN 的痛诱发放电。(2) POA 内微量注射两种浓度的吗啡,均使大多数痛抑制神经元(PIN,共27/33)的完全抑制时程缩短。上述结果提示,POA 内阿片样物质对 Pf 内痛反应神经元的电活动可能具有抑制作用。     

Possible mechanism of bursting suppression in nociceptive neurons

The use of the mathematical model of rat nociceptive neuron membrane allowed us to predict a new mechanism of suppression of ectopic bursting discharges, which arise in neurons of dorsal root ganglia and are one of the causes of neuropathic pain. The treatment with comenic acid leads to switching off the ectopic bursting discharges due to a decrease in the effective charge transferring via the activation gating structure of the slow sodium channels (Na _V1.8a). Comenic acid is a drug substance of a new non-opioid analgesic [1] Thus, this analgesic not only reduces the frequency of rhythmic discharges of nociceptive neuron membrane [2] but also it suppresses its ectopic bursting discharges.     

Effects of verapamil on the development of pain syndrome in rats after section of the sciatic nerve]

The effect of daily verapamil administration (5 mg/kg) on pain sensitivity, bioelectric activity of cerebral cortex and microcirculation was studied in rats with cut sciatic nerve. Verapamil untreated rats showed hyperalgesia, autotomies and hypersynchronic discharges in contralateral hemisphere, increased range of evoked potentials and disorders in microcirculatory system which evidence developing pain syndrome. Early introduction of verapamil after the nerve cut prevented the emergence of pain syndrome.     

微电泳GABA和5－HT对大鼠丘脑束旁核单位痛放电的影响

本实验用多管微电极细胞外记录和离子微电泳方法,在水含氯醛麻醉的ＳＤ大鼠上观察了γ－氨基丁酸（ＧＡＢＡ）和５－羟色胺（５－ＨＴ）以及它们的受体阻断剂（印防已毒素和赛庚啶）对丘脑束旁核（Ｐｆ）单位痛放电的影响。结果表明：（１）电泳ＧＡＢＡ可抑制Ｐｆ神经元的痛放电,这作用可被电泳印防已毒素所阻断,而单独电泳印防己毒素可加强Ｐｆ的痛放电。（２）电泳５－ＨＴ对Ｐｆ单位痛放电在有些单位表现加强作用,另一些单位表现抑制作用,仅前者可被电泳赛庚啶所阻断。上述结果提示：在Ｐｆ神经元的痛放电活动中,ＧＡＢＡ可能起抑制性作用,而５－ＨＴ可能通过不同的受体亚型既发挥其兴奋作用,也可有抑制作用。     

HCN2阳离子通道:缓解疼痛的新靶点

疼痛长期困扰人类健康,其发病机制纷繁复杂,究竟谁在其中扮演了重要的作用是目前亟待解决的重大问题。随着对疼痛研究的不断深入,超极化激活的环核苷酸门控通道逐渐引起广泛关注。在炎性痛和神经病理性痛过程中,它都扮演了至关重要的作用,其数目改变和开放频率增加都参与介导了疼痛部位的异常放电,成为诱发疼痛的开关。在给与阻断剂或敲除通道2亚型后,能明显缓解炎性痛和神经病理性痛的不良反应,成为可以缓解疼痛发生的新靶点。超极化激活的环核苷酸门控通道在机体分布广泛,参与多种重要生理功能的调节,但目前还没有针对该门控通道某种亚型的特异性阻断剂。在今后,也许超极化激活的环核苷酸门控通道会成为临床治疗疼痛的新靶点,该通道的特异性药物也将为广大患者带来新的福音。     

脑室注射5-羟色胺对大鼠丘脑束旁核痛兴奋和痛抑制神经元电活动的调制作用

本实验利用两根微电极同时记录大鼠丘脑束旁核两个痛兴奋、两个痛抑制或一个痛兴奋和一个痛抑制神经元的放电,观察脑室注射5-羟色胺后对两个神经元同时电活动的影响。结果表明,当脑内5-羟色胺含量增加时,丘脑束旁核两个神经元同时电活动的变化主要有如下三个方面:1.两个痛兴奋神经元的电活动均受抑制,诱发放电频率减少,潜伏期延长。2.两个痛抑制神经元抑制均解除,诱发抑制时程均缩短。3.一个痛兴奋神经元电活动受抑制的同时,另一个痛抑制神经元的电活动加强。以上结果提示,在痛和镇痛过程中,痛兴奋和痛抑制神经元的作用是协同进行的。     

Ciliary neurotrophic factor (CNTF) affects the excitable and contractile properties of innervated skeletal muscles

The well-established trophic role of CNTF upon neurons led to performing clinical trials in patients of neurodegenerative diseases. However, trials were suspended due to side effects such as severe weight loss, hyperalgesia, coughing, muscle cramps and pain. So far it is not known how CNTF triggers the problems related to skeletal muscle cramps and pain. CNTF has also been described as a myotrophic factor for denervated skeletal muscles, but the possibility that it affects innervated muscles has also been considered. Since a myotrophic factor could be a valuable tool for treatment of several muscle diseases, we studied the effects of low doses of CNTF delivered systemically by an osmotic pump, over the electrical and mechanical properties of innervated and denervated fast and slow muscles. CNTF induced spontaneous electrical discharges and slowed twitches in innervated muscles, but did not prevent the changes induced by denervation. We postulate that the spontaneous discharges induced by CNTF in innervated muscles may be the cause of the cramps, coughing, and muscle ache reported by patients. At low doses, CNTF does not exert its myotrophic role over denervated muscles but clearly affects the excitable and contractile properties of innervated muscles.     

刺激下丘脑弓状核或垂体前叶对丘脑束旁核神经元伤害性反应的抑制

采用电生理学方法,观察电刺激大鼠下丘脑弓状核（ＡＲＣ）或垂体前叶（ＡＬ）,对丘脑束旁核（Ｐｆ）神经元伤害性反应的影响。实验结果表明,电刺激ＡＲＣ能抑制Ｐｆ神经元的伤害性放电,这种抑制很快出现,也很快恢复,称为即时抑制。电刺激Ａ辄能抑制Ｐｆ神经元的伤害性放电,这种抑制的出现有一定的潜伏期,并持续较长时间,称为延迟抑制。摘除垂体减弱刺激ＡＲＣ的即时抑制,而损毁ＡＲＣ则减弱刺激ＡＬ的延迟抑制。地塞米松预     

伤害性刺激和非伤害性刺激对大鼠丘脑后核神经元电活动的影响

用微电极细胞外记录的方法,观察内脏痛、躯体痛和触觉刺激对大鼠丘脑后核(PO)中770个神经元电活动的影响,其中305(38.3％)个对伤害性刺激起反应,103(13.4％)个对触觉刺激起反应。对伤害性刺激反应的神经元中多数对躯体痛和内脏痛刺激均起反应且反应形式相同,少数反应不同或相反,对触觉刺激反应的神经元中多数也对两种伤害性刺激均起反应,只对触觉刺激反应的神经元很少。     

Dopamine Affects the Change of Pain-Related Electrical Activity Induced by Morphine Dependence

Morphine is among the most effective analgesics. However, many evidences suggest that, besides the well-know analgesic activity, repeated opioids treatment can induce some side effects such as dependence, hyperalgesia and tolerance. The mechanism of noxious information transmission in the central nervous system after dependence is not clear. An important neurotransmitter, dopamine (DA) participates not only in the process of opioid dependence but also in pain modulation in the central nervous system. In the present study we observed changes of electrical activities of pain-excitation neurons (PENs) and pain-inhibition neurons (PINs) in the caudate nucleus (Cd) following the development of morphine dependence. We also observed the role of DA on these changes. Our results revealed that both the latency of PEN discharges and the inhibitory duration of PIN discharges decreased, and the net increased values of PEN and PIN discharges increased in the Cd of morphine dependent rats. Those demonstrated that electrical activities of both PENs and PINs increased in morphine dependent rats. DA inhibited the electrical activities of PENs and enhanced those of PINs in morphine dependent rats.     

Features of changes in bioelectric reactions of the cerebral cortex in rats with deafferentation pain syndrome]

In rats with pain syndrome after sciatic nerve section the authors studied spontaneous and evoked bioelectric activity in sensomotor cerebral cortex of both hemispheres. Electrocorticogram showed the presence of hyper-synchronic discharges and paroxysmal peak-wave (700-800 mV) activity in contralateral hemisphere. While stimulating the injured limb the threshold of evoked potentials (EP) was observed to decrease, its amplitude to increase and focus maximum EP activity to extend.     

躯体和内脏传入冲动在大鼠束旁核内的会聚

在麻痹的大鼠上,分别刺激迷走神经、内脏大神经、坐骨神经、腓肠神经、睾丸和副睾,在对侧丘脑束旁核记录到了45个细胞的单位放电。根据诱发反应的潜伏期、时程和放电频谱分布的不同,可将他们分为五种类型,并且认为这些类型和刺激引起的感觉性质有关。在观察到的45单位中,29个的反应具有痛放电的特性,而且对躯体及内脏的传入冲动呈聚合性反应。其中2个单位只对内脏传入冲动产生反应。这项研究的结果表明,束旁核不仅是接受内脏传入的丘脑结构,而且也是一个整合内脏与躯体传入信息的中枢。     

Influence of the State of TTX-Resistant Sodium Channels on Electrical Activity of a Nociceptive Sensory Fiber: A Model Study

On a model of a thin (C-type) primary afferent fiber, we examined one of the hypotheses related to the phenomenon of initiation of long-lasting tonic discharges in nociceptive afferents. In the membrane of a region corresponding to the free peripheral terminal of the modeled nociceptive C fiber, there were sodium channels of three types (channels of rapidly inactivating TTX-sensitive current and TTX-resistant channels of two types, Na_V1.8/SNS/PN3 and Na_V1.9/NaN/SNS2). As is known, TTX-resistant sodium currents promote the development of long-lasting trains of action potentials, APs, where the duration of tonic discharges exceeds by orders of magnitude the duration of short stimuli inducing such discharges. Such trains, when transmitted to the spinal cord, are interpreted as pain signals. Using the model, we obtained the time course of changes in the membrane potential in the distal and proximal segments of the nerve fiber and values of the densities of inward and outward TTX-resistant sodium currents through channels Na_V1.9/NaN/SNS2 and Na_V1.8/SNS/PN3 in the norm and in a state mimicking the action of inflammation factors. Results of modeling demonstrated that TTX-resistant sodium currents provide intensification of slow components in the generated APs (plateau afterdepolarization). Having a higher inactivation threshold, these currents are inactivated more slowly and recover more rapidly after inactivation, as compared with the currents through TTX-sensitive sodium channels. Such behavior presupposes a considerable role of the TTX-resistant currents in facilitation of transmission of nociceptive signals under conditions of neuropathic pain characterized by excessive “upregulation” of the respective channels. It can be concluded that expression of TTX-resistant sodium channels in nociceptive sensory neurons possessing primary afferent C fibers, the presence of these channels in the membranes of peripheral terminals of the above fibers, and modification of biophysical properties of such channels under conditions of action of inflammation mediators, when taken together, create substantial prerequisites for initiation of anomalous long-lasting AP trains in the above peripheral terminals and, therefore, for transmission of such signals to the CNS. Such a situation appears to be a key electrophysiological phenomenon responsible for generation of neuropathic and inflammation-related pain.     

Recent evidence for activity-dependent initiation of sympathetic sprouting and neuropathic pain

Traumatic injury or inflammatory irritation of the peripheral nervous system often leads to persistent pathophysiological pain states. It has been well-documented that, after peripheral nerve injury or inflammation, functional and anatomical alterations sweep over the entire peripheral nervous system including the peripheral nerve endings, the injured or inflamed afferent fibers, the dorsal root ganglion (DRG), and the central afferent terminals in the spinal cord. Among all the changes, ectopic discharge or spontaneous activity of primary sensory neurons is of great clinical interest, as such discharges doubtless contribute to the develop-ment of pathological pain states such as neuropathic pain. Two key sources of abnormal spontaneous activity have been identified following peripheral nerve injury: the injured afferent fibers (neuroma) leading to the DRG, and the DRG somata. The purpose of this review is to provide a global account of the abnormal spontaneous activity in various animal models of pain. Particular attention is focused on the consequence of peripheral nerve injury and localized inflammation. Further, mechanisms involved in the generation of spontaneous activity are also reviewed; evidence of spontaneous activity in contributing to abnormal sympathetic sprouting in the axotomized DRG and to the initiation of neuropathic pain based on new findings from our research group are discussed. An improved understanding of the causes of spontaneous activity and the origins of neuropathic pain should facilitate the development of novel strategies for effective treatment of pathological pain.