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Effect of drug-induced convulsive tgherapy for intractable chronic pain

Research Project

Project/Area Number 10671420
Research Category

Grant-in-Aid for Scientific Research (C)

Allocation TypeSingle-year Grants
Section一般
Research Field Anesthesiology/Resuscitation studies
Research InstitutionSaga Medical School

Principal Investigator

TAKASAKI Mitsuhiro (2000-2001)  SAGA MEDICAL SCHOOL, ASSISTANT PROFESSOR, 医学部, 講師 (70236206)

原野 清 (1998-1999)  佐賀医科大学, 医学部, 助教授 (30038848)

Co-Investigator(Kenkyū-buntansha) TOTOKI Tadahide  SAGA MEDICAL SCHOOL, PROFESSOR, 医学部, 教授 (20038722)
能塚 博史  佐賀医科大学, 医学部, 助手 (00274598)
高崎 光浩  佐賀医科大学, 医学部, 助手 (70236206)
Project Period (FY) 1998 – 2001
Project Status Completed (Fiscal Year 2001)
Budget Amount *help
¥3,800,000 (Direct Cost: ¥3,800,000)
Fiscal Year 2001: ¥1,000,000 (Direct Cost: ¥1,000,000)
Fiscal Year 2000: ¥900,000 (Direct Cost: ¥900,000)
Fiscal Year 1999: ¥900,000 (Direct Cost: ¥900,000)
Fiscal Year 1998: ¥1,000,000 (Direct Cost: ¥1,000,000)
KeywordsConvulsion induced by medication / Instractable chronic pain / SPECT / Sodium methylprednisolone succinate / Electroencephalogram / 慢性痛 / 痙攣脳波 / 記憶 / 急性局麻薬中毒 / くも膜下注入 / メチルプレドニゾロン
Research Abstract

Aimms of this study: We have been being obtained good outcome of successful pain relief for the thalamic pain syndrome(TPS) and variety of intractable chronic pain(ICP) using our unique treatment method, or "modified Drug-induced Convulsive Therapy ; DICT". The mechanism of this treatment is, however, still unknown. Periodically occurring irregular waves are found in the trend electroencephalogram(EEG) in all patients treated with modified DICT. Antegrade- and/or retrograde- amnesia is also observed. It might be brought up the interesting problem concerning the pain and memory relationship.
In this study, qualitative and quantitative analysis of EEG wave during the treatment were performed to clarify the pain-relief mechanism of the modified DICT.
Results:
(1) Animal study ; About 10-20 min after the injection, irregular wave which lasts for 1-2 min every 20-25 min were observed for 2-3 hrs. Amplitude and duration of the convulsive EEG wave were correlated with the concentration of sodium … More methylprednisolone succinate. Pain related behavior, licking and/or claudication was disappeared after the treatment.
(2) Analysis of human EEG wave. ; About 10-20 min after the injection, irregular wave which is characterized typically by spike & wave complex, and which lasts for 1-2 min every 20-25 min were observed for 2-3 hrs. Amplitude and duration of the convulsive EEG wave were correlated with the concentration of sodium methylprednisolone succinate. Patient was disoriented after the first convulsion, and complained no pain at all. Depression accompanied with chronic pain was disappeared in many cases. The complete disuse of pentazocine was also obtained in two cases of its addiction.
Antegrade- or retrograde amnesia which recovered within 1-4 weeks was occurred in most cases and the pain-relief was superior in the patients with amnesia than without amnesia.
Discussion : No pain at falling nor memory during seizure were found in poorly controlled epilepsy patient. The cerebral stimuli by MP injection seemed similar to epileptic status. It is known that repeated application of electroconvulsive therapy(ECT) for the patient with episode of depression makes effective pain relief. Multiple intermittent spike and wave complex in the EEG at one treatment so that obtained successful pain relief with single treatment. Comparative EEG irregularity and amnesia after the treatment was observed in the patient who obtained good pain relief.
It is strongly suspected that transient cerebral stimuli as much as irregularity is appeared in EEG and occurred amnesia is essential for the emergence from vicious spiral of chronic pain. Less

Report

(5 results)
  • 2001 Annual Research Report   Final Research Report Summary
  • 2000 Annual Research Report
  • 1999 Annual Research Report
  • 1998 Annual Research Report
  • Research Products

    (12 results)

All Other

All Publications (12 results)

  • [Publications] 原野 清 他: "Drug Induced Convulsive Therapy"日本臨床麻酔学会誌. 20・5. 275-283 (2000)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2001 Final Research Report Summary
  • [Publications] 原野 清: "大槽内ステロイド"ペインクリニック. 20・6. 827-835 (2000)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2001 Final Research Report Summary
  • [Publications] 原野 清 他: "非経口投与法における薬物療法の特徴と使用法 硬膜外・くも膜下投与、ペインクリニックにおける薬物療法の実際"ペインクリニック. 21・別冊. 68-75 (2000)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2001 Final Research Report Summary
  • [Publications] Harano, K, et al.: "Drug-induced convulsive therapy(DICT) fot central and intractable chronic pain"Anesthesiology. A981 (1999)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2001 Final Research Report Summary
  • [Publications] Harano K, et al: "Drug-induced convulsive therapy (Japanese)"J. Jpn. Soc Cln Anesth. 20(5). 275-283 (2000)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      2001 Final Research Report Summary
  • [Publications] Harano, K: "Interacisternal steroid injection (Japanese)"Pain Clinic. 20(6). 827-835 (2000)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      2001 Final Research Report Summary
  • [Publications] Harano, K, et al: "Practice in pain clinic : treatment of intractable chronic pain patient with epidural/intrathecal injectiion (Japanese)"Pain Clinic. 20(supl). 68-75 (2000)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      2001 Final Research Report Summary
  • [Publications] Harano, K, et al: "Drug-induced convulsive therapy (DICT) for cedntral and interactable pain"Anesthesiology. A981. (1999)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      2001 Final Research Report Summary
  • [Publications] 原野 清: "難治性慢性疼痛に対する大槽内メチルプレドニゾロン注入法(Drug induced convulsive therapy: DICT)"第25回日本医学会総会会誌. [II]. 366 (1999)

    • Related Report
      1999 Annual Research Report
  • [Publications] 原野 清: "大槽内ステロイド"ペインクリニック. 20(6). 827-835 (1999)

    • Related Report
      1999 Annual Research Report
  • [Publications] 原野 清: "硬膜外・くも膜下投与"ペインクリニック. 21(Suppl)(5/10発行予定). (2000)

    • Related Report
      1999 Annual Research Report
  • [Publications] 原野 清: "Drug induced convulsive therapy"日本臨床麻酔学会誌. 20(3)(印刷中). (2000)

    • Related Report
      1999 Annual Research Report

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Published: 1998-04-01   Modified: 2016-04-21  

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