1.Role of different peripheral components in the expression of neuropathic pain syndrome.
Ran WON ; Bae Hwan LEE ; Sehun PARK ; Se Hyuck KIM ; Yong Gou PARK ; Sang Sup CHUNG
Yonsei Medical Journal 2000;41(3):354-361
Peripheral nerve injury frequently leads to neuropathic pain like hyperalgesia, spontaneous pain, mechanical allodynia, thermal allodynia. It is uncertain where the neuropathic pain originates and how it is transmitted to the central nervous system. This study was performed in order to determine which peripheral component may lead to the symptoms of neuropathic pain. Under halothane anesthesia, male Sprague-Dawley rats were subjected to neuropathic surgery by tightly ligating and cutting the tibial and sural nerves and leaving the common peroneal nerve intact. Behavioral tests for mechanical allodynia, thermal allodynia, and spontaneous pain were performed for 2 weeks postoperatively. Subsequently, second operation was performed as follows: in experiment 1, the neuroma was removed; in experiment 2, the dorsal roots of the L4-L6 spinal segments were cut; in experiment 3, the dorsal roots of the L2-L6 spinal segments were cut. Behavioral tests were performed for 4 weeks after the second operation. Following the removal of the neuroma, neuropathic pain remained in experiment 1. After the cutting of the L4-L6 or L2-L6 dorsal roots, neuropathic pain was reduced in experiments 2 and 3. The most remarkable relief was seen after the cutting of the L2-L6 dorsal roots in experiment 3. According to the fact that the sciatic nerve is composed of the L4-L6 spinal nerves and the femoral nerve is composed of the L2-L4 spinal nerves, neuropathic pain is transmitted to the central nervous system via not only the injured nerves but also adjacent intact nerves. These results also suggest that the dorsal root ganglion is very important in the development of neuropathic pain syndrome.
Animal
;
Ganglia, Spinal/physiopathology
;
Male
;
Nervous System Diseases/physiopathology*
;
Nervous System Diseases/complications
;
Pain/physiopathology*
;
Pain/etiology
;
Rats
;
Rats, Sprague-Dawley
;
Spinal Nerve Roots/physiopathology
;
Spinal Nerves/physiopathology
2.Antiallodynic Effects of Acupuncture in Neuropathic Rats.
Myeoung Hoon CHA ; Ji Soo CHOI ; Sun Joon BAI ; Insop SHIM ; Hye Jung LEE ; Sun Mi CHOI ; Bae Hwan LEE
Yonsei Medical Journal 2006;47(3):359-366
Peripheral nerve injury often results in abnormal neuropathic pain such as allodynia or hyperalgesia. Acupuncture, a traditional Oriental medicine, has been used to relieve pain and related symptoms. However, the efficiency of acupuncture in relieving neuropathic pain is not clear. The aim of this study was to investigate the anti-allodynic effects of acupuncture through behavioral and electrophysiological examinations. Male Sprague-Dawley rats were subjected to neuropathic surgery consisting of a tight ligation and transection of the left tibial and sural nerves, under pentobarbital anesthesia. The acupuncture experiment consisted of four different groups, one treated at each of three different acupoints (Zusanli (ST36), Yinlingquan (SP9), and a sham-acupoint) and a control group. Behavioral tests for mechanical allodynia and cold allodynia were performed for up to two weeks postoperatively. Extracellular electrophysiological recordings were made from the dorsal roots using platinum wire electrodes. Mechanical and cold allodynia were significantly reduced after acupuncture treatment at the Zusanli and Yinlingquan acupoints, respectively. Electrophysiological neural responses to von Frey and acetone tests were also reduced after acupuncture at the same two acupoints. These results suggest that acupuncture may be beneficial in relieving neuropathic pain.
Spinal Nerve Roots/*physiology
;
Rats, Sprague-Dawley
;
Rats
;
Neuralgia/physiopathology/*therapy
;
Male
;
Electrophysiology
;
Animals
;
*Acupuncture Analgesia
3.Antiallodynic Effects of Acupuncture in Neuropathic Rats.
Myeoung Hoon CHA ; Ji Soo CHOI ; Sun Joon BAI ; Insop SHIM ; Hye Jung LEE ; Sun Mi CHOI ; Bae Hwan LEE
Yonsei Medical Journal 2006;47(3):359-366
Peripheral nerve injury often results in abnormal neuropathic pain such as allodynia or hyperalgesia. Acupuncture, a traditional Oriental medicine, has been used to relieve pain and related symptoms. However, the efficiency of acupuncture in relieving neuropathic pain is not clear. The aim of this study was to investigate the anti-allodynic effects of acupuncture through behavioral and electrophysiological examinations. Male Sprague-Dawley rats were subjected to neuropathic surgery consisting of a tight ligation and transection of the left tibial and sural nerves, under pentobarbital anesthesia. The acupuncture experiment consisted of four different groups, one treated at each of three different acupoints (Zusanli (ST36), Yinlingquan (SP9), and a sham-acupoint) and a control group. Behavioral tests for mechanical allodynia and cold allodynia were performed for up to two weeks postoperatively. Extracellular electrophysiological recordings were made from the dorsal roots using platinum wire electrodes. Mechanical and cold allodynia were significantly reduced after acupuncture treatment at the Zusanli and Yinlingquan acupoints, respectively. Electrophysiological neural responses to von Frey and acetone tests were also reduced after acupuncture at the same two acupoints. These results suggest that acupuncture may be beneficial in relieving neuropathic pain.
Spinal Nerve Roots/*physiology
;
Rats, Sprague-Dawley
;
Rats
;
Neuralgia/physiopathology/*therapy
;
Male
;
Electrophysiology
;
Animals
;
*Acupuncture Analgesia
4.Study of the morphology and biomechanics of sacral fracture.
Ren-fu QUAN ; Di-sheng YANG ; Yi-jin WANG
Chinese Journal of Traumatology 2006;9(5):259-265
OBJECTIVETo observe the morphological characteristics of sacral fracture under different impact loads.
METHODTen fresh pelvic specimens were loaded in dynamic or static state. A series of mechanical parameters including the pressure strain and velocity were recorded. Morphological characteristics were observed under scanning electron microscope.
RESULTSThe form of sacral fracture was related to the impact energy. Under low energy impact loads, ilium fracture, acetabulum fracture and crista iliaca fracture were found. Under high energy impact loads, three types of sacral fracture occurred according to the classification of Denis: sacral ala fracture, Type I fracture; sacral foramen cataclasm fracture, Type II fracture; central vertebral canal fracture, Type III fracture. Nerve injury of one or two sides was involved in all three types of sacral fracture. The fracture mechanism of sacrum between the dynamic impact and static compression was significantly different. When the impact energy was above 25 J, sacral foramen cataclasm fracture occurred, involving nerve root injury. When it was below 20 J, ilium and sacral fracture was most likely to occur. When it was 20 approximately 25 J, Type I fracture would occur. While in the static test, most of the fracture belonged to ilium or acetabulum fracture. The cross section of sacrum was crackly and the bone board of Haversian system was brittle, which could lead to separation of bone boards and malposition of a few of cross bone boards.
CONCLUSIONSIn dynamic state, sacrum fracture mostly belongs to Type I and Type II, and usually involves the nerve roots. Sacrum fracture is relevant to the microstructures, the distribution of the bone trabecula, the osseous lacuna and the Haversian system of sacrum. The fracture of ilium and acetabulum more frequently appears in static state, with slight wound of peripheral tissues.
Biomechanical Phenomena ; Humans ; Male ; Microscopy, Electron, Scanning ; Sacrum ; injuries ; pathology ; Spinal Fractures ; pathology ; physiopathology ; surgery ; Spinal Nerve Roots ; injuries
5.Long term depression of the recurrent inhibition of monosynaptic spinal reflexes after sciatic nerve crush in adult rats.
Liang SHU ; You-Rong DONG ; Wei-Hong YAN ; Yu ZHAI ; Yun WANG ; Wei LI
Acta Physiologica Sinica 2011;63(4):291-299
Sciatic nerve injury is a common disease of peripheral nerve in clinic. After nerve injury, there are many dysfunctions in motoneurons and muscles following regeneration. Previous studies mostly investigated the aspects related to the injured nerve, and the effect on the recurrent inhibition (RI) pathway of spine following regeneration was not fully understood. Following reinnervation after temporary sciatic nerve crush, the functional alteration of RI was studied. In adult rats, RI between lateral gastrocnemius-soleus (LG-S) and medial gastrocnemius (MG) motor pools was assessed by conditioning monosynaptic reflexes (MSRs) elicited from the cut dorsal roots and recorded from either the LG-S or MG nerves by antidromic stimulation of the synergist muscle nerve. The following results were obtained. (1) The RI of MSRs in rats was almost lost (<5 weeks) after sciatic nerve crush. Although the RI partially recovered following reinnervation (6 weeks), it remained permanently depressed (up to 14 weeks). (2) Sciatic nerve crush on one side did not affect the contralateral RI. (3) Sciatic nerve crush did not induce any motoneuron loss revealed by immunohistochemistry. Peripheral nerve temporary disconnection causes long term alterations in RI pathway which make up motoneuron's function enhance for the alteration of muscle power and suggests that peripheral nerve injury induces long term plastic changes in the spinal motoneuron circuitry.
Animals
;
Long-Term Synaptic Depression
;
physiology
;
Male
;
Motor Neurons
;
physiology
;
Nerve Crush
;
Nerve Regeneration
;
physiology
;
Neuronal Plasticity
;
physiology
;
Neurons, Afferent
;
physiology
;
Rats
;
Rats, Wistar
;
Reflex, Monosynaptic
;
physiology
;
Sciatic Nerve
;
injuries
;
physiopathology
;
Spinal Cord
;
physiopathology
;
Spinal Nerve Roots
;
physiopathology
6.The expression of c-fos and transmitter calcitonin gene-related peptide in the chronic compressive injury of the nerve root.
Da-zhi YANG ; Kun-zheng WANG ; Jun-chang CHEN ; Duo WANG ; Hong-tao LIU ; Liang XU ; Xian-bin DUAN
Chinese Journal of Surgery 2004;42(20):1236-1239
OBJECTIVESTo investigate the significance of c-fos oncogene morphogenetic protein's locational expression, and the correlativity between nerve transmitters calcitonin gene-related peptide (CGRP) expression and nerve root's functional change using the animal model of the chronic compressive injury in the nerve root.
METHODSThe animal model of chronic compressive injury of the nerve root was established by transplanting autogenous cancellous bone into the intervertebral foramen. During different injury phase (1, 2, 4, 8, 12, 24 weeks after operation), the functional status of the nerve root was determined under the monitoring of evoked potential, and the expression changes of c-fos oncogene morphogenetic protein and nerve transmitter CGRP were detected using in situ hybridization technique and their expression intensity was determined using automatic image analytic instrument respectively.
RESULTSOne week after operation, the c-fos expression strengthened in both anterior and posterior root fiber obviously. Two to four weeks after operation, the expression of the posterior root fiber weakened than the anterior root fiber. After 12 weeks, the anterior root fiber expression turned down obviously, however the posterior root fiber expression backed up slightly compared with that of the 8 weeks. By the time of 24 weeks after operation, the expression enhancement in all roots disappeared. CGRP expression increased obviously at the site of compressive axon of both anterior and posterior root. The expression of the posterior root axon and ganglion cell was higher than that of the anterior root axon. CGRP expression was diminished in the second week than the first week, and that was especially obvious in the posterior root and ganglion cell. But 4 weeks after operation, the expression enhanced once more, and that was more obvious inside the anterior root axon. Eight weeks after operation, the expression intensity attained the high peak. Twelve weeks after operation, the expression started the slow-moving descent.
CONCLUSIONSThe expression of c-fos gene protein is beneficial to localize the damaged part of certain nerve. During chronic injury, the degeneration of posterior root sensory fiber is earlier than the anterior root motor fiber. The expression of CGRP strengthened when the nerve fiber degenerated by the harmful stimulation, and the expression intensity is positively related with pain. That suggests when the nervous tissue is hurt, the information of warning and regulation should be sent out to our body.
Animals ; Calcitonin Gene-Related Peptide ; metabolism ; Cats ; Disease Models, Animal ; Female ; In Situ Hybridization ; Male ; Proto-Oncogene Proteins c-fos ; metabolism ; Radiculopathy ; metabolism ; physiopathology ; Spinal Nerve Roots ; physiopathology
7.Clinical observation on ankle-three-needle for treatment of nerve root pain of prolapse of lumbar intervertebral disc.
You-Long ZHOU ; Shi-Qing ZHANG ; Guo-Sheng SUN ; Jian-Hui CHEN ; Ping LIU ; Yi-Jun LIU ; Guo-Ping LIN ; Bin HU
Chinese Acupuncture & Moxibustion 2006;26(12):847-850
OBJECTIVETo observe the analgesic effect of ankle-three-needle on nerve root pain of prolapse of lumbar intervertebral disc.
METHODSThree hundred and eighty cases were randomly divided into an ankle-three-needle group, a routine acupuncture group and a medication group. The ankle-three-needle group were treated with ankle-three-needle therapy, i. e. according to different prolapse segments, points Gentong No. 1, 2 and 3 were selected with lifting-kneading needle insertion method used and the needle was inserted along the skin; the routine acupuncture group were treated with acupuncture at Shenshu (BL 23), Qihaishu (BL 24) and Jiaji (EX-B 2) of the prolapse corresponding segment, and Ciliao (BL 32), etc. with uniform reinforcing-reducing manipulation; the medication group were treated with routine buttock intramuscular injection of aspirin-DL-lysine plus saline.
RESULTSThe time inducing analgesia was 6 min in the ankle-three-needle group, 27 min in the routine acupuncture group and 18 min in the medication group. The effect-lasting time was 24.48 h in the ankle-three-needle group, 8.93 h in the routine acupuncture group and 6.36 h in the medication group, with a significant difference as the ankle-three-needle group compared with both the routine acupuncture group and the medication group, but with no significant difference between the routine acupuncture group and the medication group. After treatment, there were very significant differences in change tendency of the analgesic score among the three groups at all the time points (P < 0.01). And there was very significant differences in the changing tendency of straight-leg raising test among the three groups at 0.5 h, 1 h, 24 h and 48 h (P < 0.001).
CONCLUSIONAnkle-three-needle has obvious therapeutic effect on nerve root pain induced by prolapse of lumbar intervertebral disc.
Acupuncture Analgesia ; methods ; Adult ; Aged ; Ankle ; Female ; Humans ; Intervertebral Disc Displacement ; physiopathology ; therapy ; Lumbar Vertebrae ; Male ; Middle Aged ; Neuralgia ; therapy ; Spinal Nerve Roots ; physiopathology
8.Acupuncture combined with moxibustion plaster for nerve-root type cervical spondylosis.
Li-an LIU ; Shu ZHANG ; Hajying WANG ; Tang LIXIN
Chinese Acupuncture & Moxibustion 2016;36(2):139-143
OBJECTIVETo compare the clinical efficacy differences between acupuncture combined with moxi-bustion plaster and electroacupuncture (EA) for nerve-root type cervical spondylosis.
METHODSA total of 60 casesof nerve-root type cervical spondylosis were randomly divided into a plaster group and an EA group, 30 cases ineach one. Patients in the plaster group were treated with regular acupuncture at Jiaji(EX-B 2) points and ashipoints, combined with moxibustion plaster at Gaohuang (BL 43); patients in the EA group were treated with EAat identical acupoints as plaster group. The treatment was given once a day, and 5 days were taken as one course;there was an interval of 2 days between courses and totally 2 courses were performed. The pain questionnaires andquantitative score of signs and symptoms were observed before and after treatment in the two groups. The clinicalefficacy of the two groups was compared.
RESULTSThe total effective rate was 96. 7% (29/30) in the plastergroup, which was not significantly different from 93. 3% (28/30) in the EA group (P>0. 05). After treatment,PRI, VAS and PPI were all reduced in the two groups (all P CONCLUSIONAcupuncture combinedwith moxibustion plaster and EA both have superior clinical efficacy for nerve-root type cervical spondylosis; EA issuperior to acupuncture combined with moxibustion plaster on relieving pain, while acupuncture combined withmoxibustion plaster is superior to EA on improving life quality, muscle strength and feeling.
Acupuncture Points
;
Acupuncture Therapy
;
Adult
;
Female
;
Humans
;
Male
;
Middle Aged
;
Moxibustion
;
Quality of Life
;
Spinal Nerve Roots
;
physiopathology
;
Spondylosis
;
physiopathology
;
therapy
;
Treatment Outcome
9.Otopoint-penetrative needling and aligned needling therapy for 61 cases of cervical spondylosis of nerve-root type.
Xian-Bing HOU ; Ying-Li LIU ; Mei-Ying WANG
Chinese Acupuncture & Moxibustion 2014;34(7):651-652
Acupuncture Points
;
Acupuncture, Ear
;
instrumentation
;
Adult
;
Aged
;
Female
;
Humans
;
Male
;
Middle Aged
;
Spinal Nerve Roots
;
physiopathology
;
Spondylosis
;
physiopathology
;
therapy
;
Young Adult
10.Clinical observations of the effects on the lower limb function after lumbar or sacral nerve root transferring to reconstruct urination function.
Zhen XU ; Chun-Lin HOU ; Wei ZHANG ; Ai-Min CHEN ; Xian-You ZHENG ; Jian-Huo WANG
Chinese Journal of Surgery 2008;46(3):221-223
OBJECTIVETo observe the effects on the lower limbs function after lumbar or sacral nerve root transferring to reconstruct urination function.
METHODSNine patients with bladder dysfunction and normal lower limb function after spinal cord injury were treated with anastomosis the S2 or S3 nerve root with the normal lumbar or sacral nerve root to reconstruct a new bladder artificial reflex arc. Then the alterations on the sensation and motor function of the lower limb after the surgery were observed.
RESULTSMyodynamia of the legs decreased slightly, and the decreasing about half grade of the myodynamia in the plantar flexion of the ankles were detected in 4 of 9 patients with S1 transferring. And the myodynamia recovered 3 months postoperatively. No obvious decreasing of the myodynamia appeared in the other cases.
CONCLUSIONNo obvious effects on the motor function can be found after the single lumbar or sacral nerve root transferring to reconstruct urination function.
Adult ; Exercise ; Female ; Follow-Up Studies ; Humans ; Lower Extremity ; innervation ; physiopathology ; Lumbosacral Region ; Male ; Middle Aged ; Reflex ; Rhizotomy ; Spinal Cord Injuries ; complications ; physiopathology ; Spinal Nerve Roots ; surgery ; Treatment Outcome ; Urinary Bladder ; innervation ; physiopathology ; Urinary Bladder, Neurogenic ; etiology ; physiopathology ; surgery