• Title/Summary/Keyword: Pain: neuropathic pain syndrome

Search Result 51, Processing Time 0.029 seconds

Tumor Necrosis Factor-alpha and Apoptosis Following Spinal Nerve Ligation Injury in Rats

  • Kim, Sung-Hoon;Nam, Jae-Sik;Choi, Dae-Kee;Koh, Won-Wook;Suh, Jeong-Hun;Song, Jun-Gol;Shin, Jin-Woo;Leem, Jeong-Gil
    • The Korean Journal of Pain
    • /
    • v.24 no.4
    • /
    • pp.185-190
    • /
    • 2011
  • Background: Spinal nerve ligation (SNL) injury in rats produces a pain syndrome that includes mechanical and thermal allodynia. Previous studies have indicated that proinflammatory cytokines such as tumor necrosis factor-${\alpha}$ (TNF-${\alpha}$) play an important role in peripheral mediation of neuropathic pain, and that altered dorsal root ganglion (DRG) function and degree of DRG neuronal apoptosis are associated with spinal nerve injury. The present study was conducted to evaluate the expression of TNF-${\alpha}$ and the extent of apoptosis in the dorsal root ganglion after SNL in rats. Methods: Sprague-Dawley rats were subjected to SNL of the left L5 and L6 spinal nerves distal to the DRG and proximal to the formation of the sciatic nerve. At postoperative day 8, TNF-${\alpha}$ protein levels in the L5.6 DRG were compared between SNL and naive groups using ELISA. In addition, we compared the percentage of neurons injured in the DRG using immunostaining for apoptosis and localization of activated caspase-3. Results: SNL injury produced significant mechanical and cold allodynia throughout the 7-day experimental period. TNF-${\alpha}$ protein levels were increased in the DRG in rats that had undergone SNL ($12.7{\pm}3.2$ pg/100 ${\mu}g$, P < 0.001) when compared with naive rats ($4.1{\pm}1.4$ pg/100 ${\mu}g$). The percentage of neurons or satellite cells co-localized with activated caspase-3 were also significantly higher in rats with SNL than in naive rats (P < 0.001, P < 0.05, respectively). Conclusions: SNL injury produces mechanical and cold allodynia, as well as TNF-${\alpha}$ elevation and apoptosis in the DRG.

A Review of Burning Mouth Disorders (구강작열감질환에 관한 고찰 및 의료분쟁 증례보고)

  • Hur, Yun-Kyung;Jung, Jae-Kwang;Choi, Jae-Kap
    • The Journal of the Korean dental association
    • /
    • v.48 no.9
    • /
    • pp.688-695
    • /
    • 2010
  • Burning mouth disorders (sometimes referred to as burning mouth syndrome) are characterized by a burning sensation in the tongue or other oral sites, usually in the absence of clinical and laboratory findings. Affected patients often present with multiple oral complaints, including burning, dryness and taste alterations. Burning mouth complaints are reported more often in women, especially after menopause. Typically, patients awaken without pain, but report increasing symptoms through the day and into the evening. Conditions that have been reported in association with burning mouth syndrome include chronic anxiety or depression, various nutritional deficiencies, diabetes and changes in salivary function. However, these conditions have not been consistently linked with the syndrome, and their treatment has had little impact on burning mouth symptoms. Recent studies have pointed to dysfunction of several cranial nerves associated with taste sensation as a possible cause of burning mouth disorders. The most common central mechanism that likely explains burning mouth disorders is a centrally mediated continuous neuropathic pain. Given in low dosages, benzodiazepine, tricyclic antidepressants or anticonvulsants may be effective in patients with burning mouth disorders.

Review about effects of sleep disturbances on Burning mouth syndrome (수면장애가 구강작열감 증후군에 미치는 영향에 대한 고찰)

  • Lim, Hyun-Dae;Lee, You-Mee
    • Journal of Oral Medicine and Pain
    • /
    • v.38 no.4
    • /
    • pp.313-318
    • /
    • 2013
  • The aim of this study was to the relationship between sleep disturbances and Burning mouth syndrome(BMS). BMS presents as a chronic burning sensation in the oral mucous membrane that is frequently associated with sleep disturbances. BMS is considered neuropathic pain condition with dysfunction of small diameter afferent sensory fiber. A review of the studies reveals, BMS suggested peripheral and cental nervous system changes. Sleep disruption or Rem sleep deprivation cause an inhibition of opioid protein synthesis and a reduced affinity of ${\mu}$ and ${\delta}$ opioid receptors. Let me say that sleep disturbances suggest a risk factor For BMS and support to evaluate as a part of BMS treatment. Further study will be required to ascertain the relationship between distruption of sleep continuity or Rem sleep deprivation and BMS and the evidence of altered neurochemical degeneration of BMS.

Superoxide and Nitric Oxide Involvement in Enhancing of N-methyl-D-aspartate Receptor-Mediated Central Sensitization in the Chronic Post-ischemia Pain Model

  • Ryu, Tae-Ha;Jung, Kyung-Young;Ha, Mi-Jin;Kwak, Kyung-Hwa;Lim, Dong-Gun;Hong, Jung-Gil
    • The Korean Journal of Pain
    • /
    • v.23 no.1
    • /
    • pp.1-10
    • /
    • 2010
  • Background: Recent studies indicate that reactive oxygen species (ROS) are involved in persistent pain, including neuropathic and inflammatory pain. Since the data suggest that ROS are involved in central sensitization, the present study examines the levels of activated N-methyl-D-aspartate (NMDA) receptors in the dorsal horn after an exogenous supply of three antioxidants in rats with chronic post-ischemia pain (CPIP). This serves as an animal model of complex regional pain syndrome type-I induced by hindpaw ischemia/reperfusion injury. Methods: The application of tight-fitting O-rings for a period of three hours produced CPIP in male Sprague-Dawley rats. Allopurinol 4 mg/kg, allopurinol 40 mg/kg, superoxide dismutase (SOD) 4,000 U/kg, N-nitro-L-arginine methyl ester (L-NAME) 10 mg/kg and SOD 4,000 U/kg plus L-NAME 10 mg/kg were administered intraperitoneally just after O-ring application and on the first and second days after reperfusion. Mechanical allodynia was measured, and activation of the NMDA receptor subunit 1 (pNR1) of the lumbar spinal cord (L4-L6) was analyzed by the Western blot three days after reperfusion. Results: Allopurinol reduced mechanical allodynia and attenuated the enhancement of spinal pNR1 expression in CPIP rats. SOD and L-NAME also blocked spinal pNR1 in accordance with the reduced mechanical allodynia in rats with CPIP. Conclusions: The present data suggest the contribution of superoxide, produced via xanthine oxidase, and the participation of superoxide and nitric oxide as a precursor of peroxynitrite in NMDA mediated central sensitization. Finally, the findings support a therapeutic potential for the manipulation of superoxide and nitric oxide in ischemia/reperfusion related pain conditions.

Spinal cord stimulation in chronic pain: technical advances

  • Isagulyan, Emil;Slavin, Konstantin;Konovalov, Nikolay;Dorochov, Eugeny;Tomsky, Alexey;Dekopov, Andrey;Makashova, Elizaveta;Isagulyan, David;Genov, Pavel
    • The Korean Journal of Pain
    • /
    • v.33 no.2
    • /
    • pp.99-107
    • /
    • 2020
  • Chronic severe pain results in a detrimental effect on the patient's quality of life. Such patients have to take a large number of medications, including opioids, often without satisfactory effect, sometimes leading to medication abuse and the pain worsening. Spinal cord stimulation (SCS) is one of the most effective technologies that, unlike other interventional pain treatment methods, achieves long-term results in patients suffering from chronic neuropathic pain. The first described mode of SCS was a conventional tonic stimulation, but now the novel modalities (high-frequency and burst), techniques (dorsal root ganglia stimulations), and technical development (wireless and implantable pulse generator-free systems) of SCS are becoming more popular. The improvement of SCS systems, their miniaturization, and the appearance of new mechanisms for anchoring electrodes results in a significant reduction in the rate of complications and revision surgeries, and the appearance of new waves of stimulation allows not only to avoid the phenomenon of addiction, but also to improve the long-term results of chronic SCS. The purpose of this review is to describe the current condition of SCS and up-to-date technical advances.

Descending Controls: The Self-Regulation of Chronic Pain (하행성 조절계 : 만성 통증에 대한 제어 작용)

  • Kim, Min-Jae;Kang, Soo-Kyung;Chun, Yang-Hyun;Hong, Jung-Pyo;Auh, Q-Schick
    • Journal of Oral Medicine and Pain
    • /
    • v.38 no.2
    • /
    • pp.215-219
    • /
    • 2013
  • The descending control system is composed of a group of structures in the midbrain, medulla oblongata and pons that form a network of descending inhibitory projections. In the clinical setting, it has been shown that the application of a electrical counterirritant to these structures and diminishes the pain in patients. Thus, depression and anxiety have been shown to predict the development of chronic neuropathic pain state. These factors could influence pain might also involve descending controls. Interestingly, reduced descending controls are seen in patients with irritable bowel syndrome and theses patients had greater anxiety, depression compared to controls. And, the influence of anxiety on the chronicity of pain and on the descending control pathways should be tested in animal models, using modern techniques. Given this Knowledge, it is no wonder that pain is a highly personal experience that is susceptible to a variety of biologic, pharmacologic, and environmental influences.

Case Report : Treatment of Burning mouth Syndrome Using a Removable Anti-Nociceptive Appliance (가철성 유해자극차단장치를 이용한 구강작열감증후군의 치료 증례)

  • Roh, Byung-Yoon;Ahn, Jong-Mo;Yoon, Chang-Lyuk;Ryu, Ji-Won
    • Journal of Oral Medicine and Pain
    • /
    • v.37 no.1
    • /
    • pp.1-7
    • /
    • 2012
  • Burning mouth syndrome(BMS) refers to a chronic orofacial pain disorder usually unaccompanied by mucosal lesions or other clinical signs. Tongue(anterior and lateral border) is found to be the most common site for the burning sensations in the oral cavity, and various oral sites may be affected including hard palate and lips. The etiology of this disorder remains poorly understood, but the various factors might be related with the pathogenesis of the BMS. These factors have been devided into local, systemic and psychological. Recently, there have been increasing reports that the pain of BMS may be neuropathic in origin. The complex and multifactorial etiology of BMS necessitates multidisciplinary approach for the management of these patients. Recently, several studies have reported that oral parafunctional habits could be related the pathogenesis of BMS, and tried to control the symptom of BMS with various methods. We reported the cases who had the symptom of burning mouth syndrome with removable anti-nociceptive appliance in the lower dentition.

A Review of Etiopathogenesis of Burning Mouth Syndrome (구강작열감증후군의 병인론과 병태생리에 대한 고찰)

  • Lim, Hyun-Dae;Kang, Jin-Kyu;Lee, You-Mee
    • Journal of Oral Medicine and Pain
    • /
    • v.35 no.1
    • /
    • pp.41-47
    • /
    • 2010
  • Burning mouth syndrome(BMS) is a chronic oral pain and a symptom complex disorder usually unaccomplished by mucosal lesion or other clinical and laboratory signs of organic disease. BMS is characterized by a spontaneous burning sensation that mainly affects middle-aged and postmenopausal women. The etiology of BMS is poorly understood even though evidence for a possible neuropathic pathogenesis. BMS cause from various local or systemic factor, including nutritional deficiencies, hormonal change, local infection, dental procedure, dry mouth, medication and systemic disease including diabetes mellitus. Many studies suggest peripheral alteration in sensory of trigeminal nerve system. BMS patients with supertaster indicates pathologies of central and peripheral nerve system induced by an alteration in the taste system at the level of chorda tympani and glossopharyngeal nerve. The author discuss our current understanding of etiology and pathogenesis of BMS that refered chronic oral pain.

The analysis of present condition and the method of medical treatment studies on Scolopendrid Herbal Acupuncture (오공약침(蜈蚣藥鍼)에 대한 연구현황분석(硏究現況分析)과 치료법(治療法)에 관한 연구(硏究))

  • Kim, Sung-Chul
    • Journal of Pharmacopuncture
    • /
    • v.9 no.2
    • /
    • pp.113-127
    • /
    • 2006
  • Objectives : We review a result of studies until the present and suggest the method of medical treatment for the clinical treatment of Scolopendrid Herbalacupuncture. Methods : We analysis the paper of the bibliographic studies, the experiment studies and the clinical studies from 2001 developed Scolopendrid Herbalacupuncture and grope for the course of studies. Results : 1. Scolopendrid Herbalacupuncture is proved the clinical safety by the aninmal and human tests. 2. The pharmacological action of Scolopendra subspinipes mutilans L. Koch is anti-convulsive action, analgesic action, lowering blood pressure, anti-inflammatory action, anti-tumor action and microbe inhibition 3. Scolopendrid Herbalacupuncture has been a fine effect to the entrapment neuropathy and inflammatory. 4. Scolopendrid Herbalacupuncture was thought effective on a acute phase and to the excessive symptoms. The Sub-chronic toxicity experiment observing the response after hypodermic medication over 90 days, The Genetic-mutagenic toxity experiment and the clinical effect studies are necessary.

Miniscalpel Needle Therapy with Integrative Korean Medical Treatment for Carpal Tunnel or Tarsal Tunnel Syndrome: Case Series of Three Patients

  • Kim, Jae Ik;Kim, Hye Su;Park, Gi Nam;Jeon, Ju Hyon;Kim, Jung Ho;Kim, Young Il
    • Journal of Acupuncture Research
    • /
    • v.34 no.3
    • /
    • pp.139-152
    • /
    • 2017
  • Objectives : This study reports the clinical effects of miniscalpel needle therapy in patients with carpal tunnel or tarsal tunnel syndrome. Methods : Three patients with carpal tunnel syndrome (CTS) or tarsal tunnel syndrome (TTS) (first case, patient with CTS and TTS; second case, patient with CTS; and third case, patient with TTS) were treated with miniscalpel needle (MSN) therapy and integrative Korean medical treatment. The Numeric Rating Scale (NRS), Neuropathic Pain Scale (NPS), Boston scale score, and AOFAS (American Orthopaedic Foot and Ankle Society) ankle-hindfoot score were measured. Results : In general, outcome measures after treatment showed improvement in all cases. In the first case (CTS and TTS), scores on the NRS, NPS, and Boston scale decreased, and AOFAS ankle-hind foot scores increased. In addition, Tinel's sign showed improvement. In the second case (CTS), scores on the NRS, NPS, and Boston scale, and Tinel's sign, were decreased. In the third case (TTS), scores on the NRS and NPS, and Tinel's sign, showed improvement, and AOFAS ankle-hind foot scores were increased. Conclusion : These results suggest that MSN therapy has a meaningful clinical effect in CTS and TTS.