Establishment of a therapeutic strategy based on axonal ionic pathophysiology in patients with neuropathic pain

• Project/Area Number: 22790812
• Research Category: Grant-in-Aid for Young Scientists (B)
• Allocation Type: Single-year Grants
• Research Field: Neurology
• Research Institution: Clinical research Center, Chiba-East National Hospital, National Hospital Organization (2011); Chiba University (2010)
• Principal Investigator: ISOSE Sagiri 独立行政法人国立病院機構(千葉東病院臨床研究センター), 神経内科, 医師 (80466698)
• Project Period (FY): 2010 – 2011
• Project Status: Completed (Fiscal Year 2011)
• Budget Amount: ¥3,900,000 (Direct Cost: ¥3,000,000、Indirect Cost: ¥900,000); Fiscal Year 2011: ¥1,560,000 (Direct Cost: ¥1,200,000、Indirect Cost: ¥360,000); Fiscal Year 2010: ¥2,340,000 (Direct Cost: ¥1,800,000、Indirect Cost: ¥540,000)
• Keywords: 脳神経疾患 / 生理学 / 神経障害性疼痛 / 末梢神経障害 / 軸索機能検査法 / 軸索Na電流

Research Abstract

We investigated changes in nodal persistent Na^+currents in sensory axons of patients with neuropathic pain before and after mexiletine(Na^+channel blocker) administration, using computerized threshold tracking system. Mexiletine substantially suppressed the degree of pain associated with decreased Na^+currents. In addition, we established a recording of pain-related evoked potentials using intra-epidermal needle electrode which can selectively stimulate Aδand C fiber. The combination of evaluating peripheral ionic mechanism and studying central pathophysiology underlying neurpathic pain patients would contribute to establishment of an efficient therapeutic strategy in the future.

Research Products

• [Journal Article] Differences in excitability between median and superficial radial sensory axons (2012)
  • Author(s): Fujimaki Y, Kanai K, Misawa S, Shibuya K, Isose S, Nasu S, Sekiguchi Y, Ohmori S, Noto YI, Kugio Y, Shimizu T, Matsubara S, Lin CS, Kuwabara S.
  • Journal Title: Clin Neurophysiol Volume: 123(7) Pages: 1440-5
  • URL: http://www.ncbi.nlm.nih.gov/pubmed/22204921
  • Peer Reviewed
• [Journal Article] Altered axonal excitability properties in juvenile muscular atrophy of distal upper extremity(Hirayama disease) (2011)
  • Author(s): Sawai S, Misawa S, Kanai K, Isose S, Shibuya K, Noto Y, Fujimaki Y, Sekiguchi Y, Nasu S, Nomura F, Kuwabara S.
  • Journal Title: Clin Neurophysiol Volume: 122 Pages: 205-9
  • URL: http://www.ncbi.nlm.nih.gov/pubmed/20624687
  • Peer Reviewed
• [Journal Article] POEMS syndrome with Guillan-Barre syndrome-like acute onset : A case report and review of neurological progression in 30 cases (2011)
  • Author(s): Isose S, Misawa S, Kanai K, Shibuya K, Sekiguchi Y, Nasu S, Fujimaki Y, Noto Y, Nakaseko C, Kuwabara S.
  • Journal Title: Journal of Neurology, Neurosurgery, and Psychiatry Volume: 82 Pages: 678-80
  • URL: http://www.ncbi.nlm.nih.gov/pubmed/20562460
  • Peer Reviewed
• [Journal Article] Differences in excitability between median and superficial radial sensory (2011)
  • Author(s): Fujimaki Y, Isose S, et al
  • Journal Title: Clinical Neurophyisiology Volume: (inprinted)
  • Peer Reviewed
• [Journal Article] Altered axonal excitability properties in juvenile muscular atrophy of distal upper extremity (Hirayama disease). (2011)
  • Author(s): Sawai S, Isose S, et al.
  • Journal Title: Clin Neurophyisiol Volume: 122 Pages: 205-209
  • Peer Reviewed
• [Journal Article] Distal motor axonal dysfunction in amyotrophic lateral sclerosis. (2011)
  • Author(s): Noto Y, Isose S, et al
  • Journal Title: J Neurol Sci Volume: 15 Pages: 58-62
  • Peer Reviewed
• [Journal Article] Long-term regular plasmapheresis as a maintenance treatment for chronic inflammatory demyelinating polyneuropathy (2010)
  • Author(s): Isose S, Mori M, Misawa S, Shibuya S, Kuwabara S.
  • Journal Title: J Peripher Nerv Syst Volume: 15 Pages: 147-9
  • URL: http://www.ncbi.nlm.nih.gov/pubmed/20626778
  • Peer Reviewed
• [Journal Article] Mexiletine suppresses nodal persistent sodium currents in sensory axons of patients with neuropathic pain (2010)
  • Author(s): Isose S, Misawa S, Sakurai K, Kanai K, Shibuya K, Sekiguchi Y, Nasu S, Noto Y, Fujimaki Y, Yokote K, Kuwabara S.
  • Journal Title: Clinical Neurophysiology Volume: 121(5) Pages: 719-24
  • URL: http://www.ncbi.nlm.nih.gov/pubmed/20097124
  • Peer Reviewed
• [Journal Article] Mexiletine suppresses nodal persistent sodium currents in sensory axons of patients with neuropathic pain (2010)
  • Author(s): Isose S, et al.
  • Journal Title: Clin Neurophyisiol Volume: 121 Pages: 719-724
  • Peer Reviewed
• [Journal Article] Long-term regular plasmapheresis as a maintenance treatment for chronic inflammatory demyelinating polyneuropathy. (2010)
  • Author(s): Isose S, et al
  • Journal Title: J Peripher Nerv Syst Volume: 15 Pages: 147-149
  • Peer Reviewed
• [Presentation] CIDPの電気診断における遠位CMAP持続時間のピット・フォール (2011)
  • Author(s): 磯瀬沙希里
  • Organizer: 第52回日本神経学会学術大会
  • Place of Presentation: 名古屋国際会議場
  • Year and Date: 2011-05-20
• [Presentation] 慢性炎症性脱髄性多発神経炎の臨床病型分類からみた治療反応性 (2011)
  • Author(s): 磯瀬沙希里
  • Organizer: 第23回日本末梢神経学会学術集会
  • Place of Presentation: 沖縄コンベンションセンター
• [Presentation] CIDPの電気診断における遠位CMAP持続時間のピット・フォール:低周波フィルターの影響 (2011)
  • Author(s): 磯瀬沙希里
  • Organizer: 第52回日本神経学会学術大会
  • Place of Presentation: 名古屋国際会議場
• [Presentation] Mexiletine suppresses nodal persistent sodium currents in sensory axons of patients with neuropathic pain (2010)
  • Author(s): 磯瀬沙希里
  • Organizer: 29th International Congress of Clinical Neurophysiology
  • Place of Presentation: 神戸国際会議場(神戸)
  • Year and Date: 2010-11-01
• [Presentation] Mexiletine suppresses nodal persistent sodium currents in sensory axons of patients with neuropathic pain (2010)
  • Author(s): Sagiri Isose, Sonoko Misawa, Kenichi Sakurai, et al.(11名)
  • Organizer: The 29th International Congress of Clinical Neurophysiology
  • Place of Presentation: 神戸国際会議場
• [Presentation] 再発性CIDPの長期寛解維持に間欠的血液浄化療法は有用である (2010)
  • Author(s): 磯瀬沙希里
  • Organizer: 第28回日本神経治療学会総会
  • Place of Presentation: パシフィコ横浜
• [Presentation] Crow-Fukase症候群における発症様式の多様性 (2010)
  • Author(s): 磯瀬沙希里
  • Organizer: 第51回日本神経学会学術大会
  • Place of Presentation: 東京国際フォーラム