Study of mechanisms of motor-related pain relief

2022 Fiscal Year Final Research Report

• Project/Area Number: 19K19867
• Research Category: Grant-in-Aid for Early-Career Scientists
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 59010:Rehabilitation science-related
• Research Institution: Osaka University
• Principal Investigator: Mori Nobuhiko 大阪大学, 大学院医学系研究科, 特任研究員(常勤) (20833924)
• Project Period (FY): 2019-04-01 – 2023-03-31
• Keywords: 神経障害性疼痛 / 多面的評価 / 経頭蓋磁気刺激 / リハビリテーション

Outline of Final Research Achievements

We evaluated patients with neuropathic pain by multifaceted assessments, including pain intensity and psychosocial aspects, as well as physical activities such as ADL and QOL and examined factors related to ADL and QOL. In multifaceted assessments of patients with central post-stroke pain, it was found that ADL were related to stroke-related motor disturbance and pain intensity, with the impact of motor disturbance being particularly. Then, QOL was found to be related to a combination of factors, including pain intensity, degree of motor and sensory disturbance, and depression.
An electrophysiological approach was used to measure sensory and motor cortical activity in the central nervous system quantitatively and noninvasively (motor cortex mapping with transcranial magnetic stimulation). The results suggested that motor disturbances were milder in patients with higher pain intensity and that cortical excitability tended to differ less between hemispheres.

Free Research Field

神経障害性疼痛、ニューロモデュレーション、リハビリテーション

Academic Significance and Societal Importance of the Research Achievements

昨今の慢性疼痛の治療目標として、痛みそのものよりも、ADLやQOLの改善に重点が置かれるようになってきているが、それらの評価やその知見は十分ではなかった。神経障害性疼痛には、ADL・QOL、社会心理面などが複合的に関連しており、さらに皮質興奮性の半球間の機序についての一部が明らかとなった。神経障害性疼痛に関連する要因ついての理解が深まることで、適切に評価され、治療抵抗性の神経障害性疼痛患者に応じたリハビリテーションを提供することにより、治療が奏功することが期待される。