Single-unit analysis of the spinal dorsal horn in patients with neuropathic pain

被引:43
作者
Guenot, M
Bullier, J
Rospars, JP
Lansky, P
Mertens, P
Sindou, M
机构
[1] P Wertheimer Hosp, Dept Funct Neurosurg, F-69003 Lyon, France
[2] INSERM, U 371, Natl Inst Hlth & Med Res, F-69500 Bron, France
[3] Inst Fed Neurosci, Lyon, France
[4] Univ Toulouse 3, Ctr Rech Cerveau & Cognit, F-31062 Toulouse, France
[5] INRA, Unite Phytopharm & Mediateurs Chim, F-78026 Versailles, France
[6] Acad Sci Czech Republ, Prague, Czech Republic
关键词
spinal dorsal horn; unitary recordings; neurosurgery; microelectrode; neuropathic pain;
D O I
10.1097/00004691-200304000-00009
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Despite the key role played by the dorsal horn of the spinal cord in pain modulation, single-unit recordings have only been performed very rarely in this structure in humans. The authors report the results of a statistical analysis of 64 unit recordings from the human dorsal horn. The recordings were done in three groups of patients: patients with deafferentation pain resulting from brachial plexus avulsion, patients with neuropathic pain resulting from peripheral nerve injury, and patients with pain resulting from disabling spasticity. The patterns of neuronal activities were compared among these three groups. Nineteen neurons were recorded in the dorsal horns of five patients undergoing DREZotomy for a persistent pain syndrome resulting from peripheral nerve injury (i.e., nondeafferented dorsal horns), 31 dorsal horn neurons were recorded in nine patients undergoing DREZotomy for a persistent pain syndrome resulting from brachial plexus avulsion (i.e., deafferented dorsal horns), and 14 neurons were recorded in eight patients undergoing DREZotomy for disabling spasticity. These groups were compared in terms of mean frequency, coefficient of variation of the discharge, other properties of the neuronal discharge studied by the nonparametric test of Wald-Wolfowitz, and the possible presence of bursts. The coefficient of variation tended to be higher in the deafferented dorsal horn group than in the other two groups. Two neurons displaying burst activity could be recorded, both of which belonged to the deafferented dorsal horn group. A significant difference was found in term of neuronal behavior between the peripheral nerve trauma group and the other groups: The brachial plexus avulsion and disabling spasticity groups were very similar, including various types of neuronal behavior, whereas the peripheral nerve lesion group included mostly neurons with "nonrandom" patterns of discharge (i.e., with serial dependency of interspike intervals).
引用
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页码:143 / 150
页数:8
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