疼痛基础研究方法.ppt

Diabetic neuropathy (DN) and post-herpetic neuralgia (PHN) are the most prevalent neuropathic pain disorders Majority of randomized controlled trials datais in DN/PHN PHN has been the most commonly used model for treating neuropathic pain in clinical trials * Neuroscience Research Institute, Peking University * Clinical studies of chronic pain use paper and pencil measures such as the Minnesota Multiphasic Personality Inventory (MMPI) to quantify these changes. More often, clinical studies rely on the patient’s verbal report of the intensity of his chronic pain. * Neuroscience Research Institute, Peking University * Pain intensity and measures 0 1 2 3 4 5 6 7 8 9 10 Visual analogue scale (VAS) No pain (unpleasantness) Intolerable pain (unpleasantness) Numeric Rating Scale (NRS) Verbal Rating Scale (VR) Example No pain Mild pain Moderate pain Severe pain Very severe pain Picture scale * Neuroscience Research Institute, Peking University * Thank you for your attention ! * Neuroscience Research Institute, Peking University * * Work done in Waxman’s lab has identified subsets of Na channels that are upregulated after nerve injury in DRG cells * NMDA receptor: possible role in central sensitiz, but also in tolerance to opioids. * Figure 1 Induction of long-term potentiation of C-fiber-evoked potentials in the spinal dorsal horn of neuropathic pain rats compared with sham-operated rats A, Neuropathic pain rats (n = 6). a: Before conditioning stimulation; b: After conditioning stimulation. B: Sham-operated rats (n = 5). a1: Before conditioning stimulation; b1: After HF-LI-CS; c1: after HF-HI-CS. SNL: spinal nerve ligation; HF-LI-CS: high frequency-low intensity conditioning stimulation; HF-HI-CS: high frequency-high intensity conditioning stimulation. * Donald D. Price. Psychological and neural mechanisms of the affective dimension of pain. Science 2000; 288: 1769-1772 * PHN is often used for investigating neuropathic pain because it is a readily distinguis