Retrograde sensory ganglionectomy for control of intractable pain
| Project/Area Number |
63870063
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| Research Category |
Grant-in-Aid for Developmental Scientific Research
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| Allocation Type | Single-year Grants |
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| Research Field |
麻酔学
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| Research Institution | Fukushima Medical College (1989)
Tohoku University (1988) |
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Principal Investigator |
YAMAMOTO Teiji Fukushima Medical College, Dept, Neurol. Professor, 教授 (10106487)
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| Co-Investigator(Kenkyū-buntansha) |
OTSUKI Taisuke Miyagi Cational Hospital, Dept. Neurosurg. Head, 臨床研究部, 医長
KANEKO Tadanobu Tohoku Univ. Sch. Med. Dept. Anesth. Ass. Prof., 医学部, 講師
IWASAKI Yuzo Tohoku Univ. Sch. Med. Dept. Neurol Sci. Prof., 医学部, 教授 (00142927)
兼子 忠延 東北大学, 医学部, 講師 (10091670)
岩崎 裕三 東北大学, 医学部, 教授
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| Project Period (FY) |
1988 – 1989
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| Project Status |
Completed (Fiscal Year 1989)
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| Budget Amount *help |
¥9,700,000 (Direct Cost: ¥9,700,000)
Fiscal Year 1989: ¥1,900,000 (Direct Cost: ¥1,900,000)
Fiscal Year 1988: ¥7,800,000 (Direct Cost: ¥7,800,000)
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| Keywords | pain / neuralgia / axoplasmic transport / doxorubicin / sensory evoked potentials / trigeminal nerve / ganglionectomy |
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| Research Abstract |
Our earlier studies indicated that several neurotoxins could be retrogradely transported to their parental sensory neurons when intraneurally injected into the peripheral nerve. Consequently, sensory neurons having taken up the toxin underwent degeneration. Utilizing this phenomenon, we initiated a study in which suitable neurotoxins when injected into the nerve may selectively gangliotomize the particular groups of sensory cells in the dorsal root ganglia or trigeminal ganglia and thus serve as a way of controlling pain.
Among more than several neurotoxins studied, we found doxorubicin(Adriamycin, ADM) is in particular useful for this purpose since ADM has its proper autofluorescence which enabled us to localize the route and destination of ADM when injected. Within 12 hrs after intraneural injection of ADM into the cat's trigeminal nerve branches, ADM was demonstrated in the trigeminal ganglion cells in a topographically organized manner. Within several days, these neurons having take
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n up ADM underwent selective degeneration. The primary afferents entering into the brainstem trigeminal complex could be traced upt to the spinal trigeminal nucleus by the Fink-Helmer method. The short latency sensory evoked potential (SSEP) of the trigeminal nerve disclosed the abolishment of the entire waveforms 24-48 hrs after the injection of ADM into the corresponding nerve. The SSEP never recovered when once lost.
Following these basic data, we initiated the ADM ganglionectomy to three selected patients with intractable neuralgic pain syndrome. Two with postherpetic neuralgia and the third with failed trigeminal neuralgia to a variety of attempts. These patients responded favorably to ADM ganglionectomy. One, complete abolishment of pain, the second, 50 % and the third 70 % relief. Some remaining pain after ADM ganglionectomy in two patients was in part explained by the wider extent of pain which was not totally denervaied by a single injection. This novel method of pain control may be utilized for neuralgic pain syndromes of deafferentation in nature such as postherpetic neuralgia, phantom limb pain, and pain due to cancer invasion into the nerves. Less
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Report
(3 results)
Research Products
(13 results)
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[Publications] Kato, S., Yamamoto, T., Iwasaki, Y., Niizuma, H., Nakamura, T., Suzuki, J.: "Experimental retrograde sensory ganglionectomy." J Neurosurg. 69:760-765, 1988.
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