| Co-Investigator(Kenkyū-buntansha) |
MASHIMO Takashi Osaka University, Graduate School of Medicine, Professor, 医学研究科, 教授 (60157188)
INOUE Takaya Osaka University, Graduate School of Medicine, Assistant Professor, 医学研究科, 助手 (00335358)
HAYASHI Yukio Osaka University, Graduate School of Medicine, Associate Professor, 医学研究科, 助教授 (60294063)
HAGIHIRA Satoshi Osaka University, Graduate School of Medicine, Assistant Professor, 医学研究科, 助手 (90243229)
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| Budget Amount *help |
¥3,600,000 (Direct Cost: ¥3,600,000)
Fiscal Year 2005: ¥1,300,000 (Direct Cost: ¥1,300,000)
Fiscal Year 2004: ¥2,300,000 (Direct Cost: ¥2,300,000)
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| Research Abstract |
Post nerve-injury pain (so-called neuropathic pain) is often treated in clinical situations, however, almost all of the pain are refractory. Among patients with neuropathic pain, there are some patients who suffer from the pain a few months after cerebral stroke. Since there have been a lot of studies using functional magnetic resonance imaging (fMRI) on underlying mechanisms of neuropathic pain in central nervous system but there is none of reports which evaluates the relationships between neuropathic pain and the white matter pain pathway. In the present grant, we now have been evaluating the white matter pain pathway by using a MR-diffusion tensor tractgraphy. The diffusion-weighted data were acquired using echo planar imaging (thick slices 4mm/gapless ; FOV 24cm ; matrix 128^*128;2 NEX, TR/TE 15000/87.8ms ; MPG 6 axis ; b=1000s/mm2) implemented on a General Electric 1.5 T scanner with a standard quadrature head-coil in 3 patient with post-stroke pain patients, 3 patients with cereb
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ral stroke who did not suffer from central deafferentation pain, 5 non-post-stroke pain patients (post-brachial plexus avulsion pain, l;shoulder-hand syndrome, 2;trigeminal neuralgia 1;and migraine 1), and 8 normal subjects. Using free software [Volume-One (provided by the VOLUME-ONE developer group and available on the internet http://www.volume-one.org) and dTV (developed by Image Computing and Analysis Laboratory, Department of Radiology, The University of Tokyo Hospital, Japan and available on the internet http://www.ut-radiology.umin.jp/people/matutani/dtv.htm)], 3-dimensional visualization and tractgraphy are obtained. We have continued to work on this study in detail. Further, we also evaluate the thalamic function because blood flow in thalamus was reported to relate to neuropathic pain (Lancet 1999;354p1790-1). Thalamus plays important parts of brain function and we especially evaluated the spatial perception of patients with complex regional pain syndrome (CRPS) and normal subjects. Using visual subjective body-midline judgment task (vSMJ-task), in which subjects directed the moving red dot to a position where it crossed their subjective body-midline (SM). As a result, each SM matched objective body-midline approximately under the light, whereas under the dark CRPS patients shifted the SM toward the affected side. To investigate more thoroughly, we applied deafferentation induced by nerve blockade and then evaluate the same task. Subsequently, deafferentation caused acute shift of SM toward the contra-lateral side of the exposed limb in both CRPS patients and normal subjects, and thereafter the shift reverted in the affected side when deafferentation became inoperative. Our these findings validate that egocentric reference results from the position of equilibrium between multimodal information arising from both sides of space. Further, we proposed that CRPS is not only accompanied by peripheral and somatosensory abnormalities but also cognitive and multimodal disturbance and hence we should pay more attention to higher brain function associated with space perception and sensorimotor processing in future treatment strategies for neuropathic pain (manuscript in preparation). Less
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