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[PMID]:29465567
[Au] Autor:Zhao X; Zhao J; Guan J; Zeng J; Han C; He Y; Zhou T; Chen C; Xie Y
[Ad] Endereço:Shanghai Key Laboratory of Orthopedic Implant, Department of Orthopaedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, PR of China.
[Ti] Título:Measurement of the nerve root of the lower lumbar region using digital images.
[So] Source:Medicine (Baltimore);97(8):e9848, 2018 Feb.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The purpose of this study was to evaluate the relationship between the nerve root of lower lumbar and the surrounding structures using three-dimensional computed tomography (3D CT).Twenty-three consecutive patients with thoracolumbar fractures without obvious radiological degeneration were retrospectively studied at the spinal surgery department of the hospital. The parameters of the relationship between the nerve root of the lower lumbar and the surrounding structures were measured using 3D CT in the work station of the picture archiving and communication system.The size of the dorsal root ganglion (DRG) of the L4 was 5.5 ±â€Š0.4 mm on the right side and 5.8 ±â€Š0.3 mm on the left side. The size of the DRG of the L5 was 6.1 ±â€Š0.5 mm on the right side and 5.7 ±â€Š0.4 mm on the left side. The value of the preganglionic nerve root of the L4 was 11.2 ±â€Š0.6 mm on the right side and 12.3 ±â€Š0.8 mm on the left side, and the value of the preganglionic nerve root of the L5 was 15.1 ±â€Š1.1 mm on the right side and 14.9 ±â€Š0.9 mm on the left side.Using 3D CT imaging constructed in the picture archiving and communication system is a practical and convenient method for evaluating the relationship between the nerve root and the surrounding structures in the routine clinical work of a spinal surgeon. The data obtained through 3D CT imaging will be helpful for surgeons, allowing them to become more familiar with correlating anatomical knowledge of individual patient.
[Mh] Termos MeSH primário: Imagem Tridimensional
Região Lombossacral/diagnóstico por imagem
Raízes Nervosas Espinhais/diagnóstico por imagem
Tomografia Computadorizada por Raios X/métodos
[Mh] Termos MeSH secundário: Adulto
Feminino
Seres Humanos
Região Lombossacral/anatomia & histologia
Masculino
Meia-Idade
Estudos Retrospectivos
Raízes Nervosas Espinhais/anatomia & histologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180227
[Lr] Data última revisão:
180227
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180222
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009848


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[PMID]:29269693
[Au] Autor:Yasuda K; Murase N; Ohtani R; Oka N; Nakamura M
[Ad] Endereço:Department of Neurology, National Hospital Organization Kyoto Medical Center.
[Ti] Título:[A case of chronic inflammatory demyelinating polyradiculoneuropathy, showing radicular pain due to tuberous hypertrophy of the spinal roots and plexuses after 20 years interval without relapsing sensorimotor symptoms].
[So] Source:Rinsho Shinkeigaku;58(1):21-24, 2018 Jan 26.
[Is] ISSN:1882-0654
[Cp] País de publicação:Japan
[La] Idioma:jpn
[Ab] Resumo:A 40-year-old man visited our department because of chest and back pain. He had a history of diagnosis of chronic inflammatory demyelinating polyneuropathy (CIDP) 20 years ago. He received immunosuppressive therapy and had no relapses after that. On Admission, MRI showed tuberous hypertrophy of the spinal roots, intercostal nerves, and brachial and lumbar plexuses. The genetic analysis showed no mutations in any of Charcot-Marie-Tooth related genes. He was finally diagnosed with CIDP and administration of high dose intravenous methylprednisolone relieved his chest and back pain within a few days. We present a rare case of CIDP in which showed marked enlarged spinal roots in long clinical course and have a relapse with radicular pain without sensorimotor symptoms.
[Mh] Termos MeSH primário: Dor nas Costas/etiologia
Plexo Braquial/patologia
Dor no Peito/etiologia
Polirradiculoneuropatia Desmielinizante Inflamatória Crônica/complicações
Raízes Nervosas Espinhais/patologia
[Mh] Termos MeSH secundário: Adulto
Dor nas Costas/tratamento farmacológico
Plexo Braquial/diagnóstico por imagem
Dor no Peito/tratamento farmacológico
Seres Humanos
Hipertrofia
Infusões Intravenosas
Imagem por Ressonância Magnética
Masculino
Metilprednisolona/administração & dosagem
Polirradiculoneuropatia Desmielinizante Inflamatória Crônica/diagnóstico por imagem
Polirradiculoneuropatia Desmielinizante Inflamatória Crônica/tratamento farmacológico
Polirradiculoneuropatia Desmielinizante Inflamatória Crônica/patologia
Pulsoterapia
Raízes Nervosas Espinhais/diagnóstico por imagem
Fatores de Tempo
Resultado do Tratamento
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
X4W7ZR7023 (Methylprednisolone)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180227
[Lr] Data última revisão:
180227
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171223
[St] Status:MEDLINE
[do] DOI:10.5692/clinicalneurol.cn-001073


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Barraviera, Benedito
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[PMID]:28450050
[Au] Autor:Araújo MR; Kyrylenko S; Spejo AB; Castro MV; Ferreira Junior RS; Barraviera B; Oliveira ALR
[Ad] Endereço:Department of Structural and Functional Biology, Institute of Biology, University of Campinas, Campinas, Sao Paulo, Brazil.
[Ti] Título:Transgenic human embryonic stem cells overexpressing FGF2 stimulate neuroprotection following spinal cord ventral root avulsion.
[So] Source:Exp Neurol;294:45-57, 2017 08.
[Is] ISSN:1090-2430
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Ventral root avulsion (VRA) triggers a strong glial reaction which contributes to neuronal loss, as well as to synaptic detachment. To overcome the degenerative effects of VRA, treatments with neurotrophic factors and stem cells have been proposed. Thus, we investigated neuroprotection elicited by human embryonic stem cells (hESC), modified to overexpress a human fibroblast growth factor 2 (FGF-2), on motoneurons subjected to VRA. Lewis rats were submitted to VRA (L4-L6) and hESC/FGF-2 were applied to the injury site using a fibrin scaffold. The spinal cords were processed to evaluate neuronal survival, synaptic stability, and glial reactivity two weeks post lesion. Then, qRT-PCR was used to assess gene expression of ß2-microglobulin (ß2m), TNFα, IL1ß, IL6 and IL10 in the spinal cord in vivo and FGF2 mRNA levels in hESC in vitro. The results indicate that hESC overexpressing FGF2 significantly rescued avulsed motoneurons, preserving synaptic covering and reducing astroglial reactivity. The cells were also shown to express BDNF and GDNF at the site of injury. Additionally, engraftment of hESC led to a significant reduction in mRNA levels of TNFα at the spinal cord ventral horn, indicating their immunomodulatory properties. Overall, the present data suggest that hESC overexpressing FGF2 are neuroprotective and can shift gene expression towards an anti-inflammatory environment.
[Mh] Termos MeSH primário: Células-Tronco Embrionárias Humanas/transplante
Radiculopatia/cirurgia
Raízes Nervosas Espinhais/patologia
[Mh] Termos MeSH secundário: Animais
Movimento Celular
Sobrevivência Celular/efeitos dos fármacos
Sobrevivência Celular/genética
Modelos Animais de Doenças
Doxiciclina/uso terapêutico
Feminino
Adesivo Tecidual de Fibrina/toxicidade
Fator 2 de Crescimento de Fibroblastos/genética
Fator 2 de Crescimento de Fibroblastos/metabolismo
Regulação da Expressão Gênica/efeitos dos fármacos
Regulação da Expressão Gênica/genética
Vetores Genéticos/fisiologia
Células-Tronco Embrionárias Humanas/metabolismo
Seres Humanos
Neurônios Motores/metabolismo
Neurônios Motores/patologia
Proteínas do Tecido Nervoso/metabolismo
Neuroglia/efeitos dos fármacos
Neuroglia/metabolismo
Radiculopatia/induzido quimicamente
Ratos
Ratos Endogâmicos Lew
Adesivos Teciduais/toxicidade
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Fibrin Tissue Adhesive); 0 (Nerve Tissue Proteins); 0 (Tissue Adhesives); 103107-01-3 (Fibroblast Growth Factor 2); N12000U13O (Doxycycline)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:180218
[Lr] Data última revisão:
180218
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE


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[PMID]:29049245
[Au] Autor:Chang MC
[Ad] Endereço:Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Namku, Daegu, Republic of Korea.
[Ti] Título:Sacral root injury during trans-sacral epiduroscopic laser decompression: A case report.
[So] Source:Medicine (Baltimore);96(42):e8326, 2017 Oct.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Trans-sacral epiduroscopic laser decompression (SELD) is reported to have strong positive short-term effects in controlling lower back pain (LBP) or radicular leg pain following herniated lumbar disc (HLD). However, little is known about the possible complications following SELD. PATIENT CONCERNS: A 36-year-old man received SELD with YAG laser for controlling LBP and radicular pain due to HLD on L5-S1. However, after SELD, voiding and defecation difficulties and sensory deficits on the S3-5 dermatome were presented. DIAGNOSES: An areflexic neurogenic bladder was demonstrated by a urodynamic study four days after onset of sacral nerve root injury symptoms. In the electromyogram study, latency of electrically induced bulbocavernosus reflex (BCR) was delayed on both sides at four days after symptom onset. Based on the patient's symptoms and the results of the clinical evaluation, we diagnosed the patient as having an injury in the sacral nerve roots. INTERVENTIONS: The patient was observed without any specific medication. OUTCOMES: Three months after symptom onset, the patient's voiding and defecation difficulties were nearly completely recovered. LESSONS: In this study, we described a patient who showed neurogenic bladder and bowel and sensory deficits in the S3 to S5 dermatome due to sacral nerve root injury after SELD. During SELD, clinicians should be mindful of the possibility of injury to sacral nerve roots.
[Mh] Termos MeSH primário: Descompressão Cirúrgica/efeitos adversos
Sacro/inervação
Raízes Nervosas Espinhais/lesões
[Mh] Termos MeSH secundário: Adulto
Seres Humanos
Lasers de Estado Sólido/uso terapêutico
Masculino
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171122
[Lr] Data última revisão:
171122
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171020
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008326


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[PMID]:29044418
[Au] Autor:Koeppen AH; Becker AB; Qian J; Gelman BB; Mazurkiewicz JE
[Ad] Endereço:Research Service, Veterans Affairs Medical Center, Albany, New York; Department of Pathology, Albany Medical College, Albany, New York; Department of Pathology and Laboratory Medicine, University of Texas Medical Branch, Galveston, Texas; Department of Neuroscience and Experimental Therapeutics, Alb
[Ti] Título:Friedreich Ataxia: Developmental Failure of the Dorsal Root Entry Zone.
[So] Source:J Neuropathol Exp Neurol;76(11):969-977, 2017 Nov 01.
[Is] ISSN:1554-6578
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Dorsal root ganglia, dorsal roots (DR), and dorsal root entry zones (DREZ) are vulnerable to frataxin deficiency in Friedreich ataxia (FA). A previously unrecognized abnormality is the intrusion of astroglial tissue into DR. Segments of formalin-fixed upper lumbar spinal cord of 13 homozygous and 2 compound heterozygous FA patients were sectioned longitudinally to represent DREZ and stained for glial fibrillary acidic protein (GFAP), S100, vimentin, the central nervous system (CNS)-specific myelin protein proteolipid protein, the peripheral nervous system (PNS) myelin proteins PMP-22 and P0, and the Schwann cell proteins laminin, alpha-dystroglycan, and periaxin. Normal DREZ showed short, sharply demarcated, dome-like extensions of CNS tissue into DR. The Schwann cell-related proteins formed tight caps around these domes. In FA, GFAP-, S100-, and vimentin-reactive CNS tissue extended across DREZ and into DR over much longer distances by breaching the CNS-PNS barrier. The transition between PNS and CNS myelin proteins was disorganized. During development, neural-crest derived boundary cap cells provide guidance to dorsal root ganglia axons growing into the dorsal spinal cord and at the same time block the inappropriate intrusion of CNS glia into DR. It is likely that frataxin is required during a critical period of permissive (axons) and nonpermissive (astroglia) border-control.
[Mh] Termos MeSH primário: Ataxia de Friedreich/patologia
Gânglios Espinais/crescimento & desenvolvimento
Gânglios Espinais/patologia
Raízes Nervosas Espinhais/crescimento & desenvolvimento
Raízes Nervosas Espinhais/patologia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Criança
Feminino
Seres Humanos
Masculino
Meia-Idade
Medula Espinal/crescimento & desenvolvimento
Medula Espinal/patologia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171027
[Lr] Data última revisão:
171027
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171019
[St] Status:MEDLINE
[do] DOI:10.1093/jnen/nlx087


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[PMID]:28877025
[Au] Autor:Rush RP; Saltman AP; Prica AA; Breiner A; Detsky AS
[Ad] Endereço:From the Department of Medicine (R.P.R., A.P.S., A.A.P., A.B., A.S.D.) and Institute for Health Policy Management and Evaluation (A.S.D.), University of Toronto, and the Department of Medicine, University Health Network and Mount Sinai Hospital (A.A.P., A.B., A.S.D.), Toronto, and the Department of
[Ti] Título:Connecting the Dots.
[So] Source:N Engl J Med;377(10):978-984, 2017 Sep 07.
[Is] ISSN:1533-4406
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Linfoma Difuso de Grandes Células B/diagnóstico
Debilidade Muscular/etiologia
Polirradiculoneuropatia Desmielinizante Inflamatória Crônica/diagnóstico
[Mh] Termos MeSH secundário: Animais
Dor nas Costas/etiologia
Diagnóstico Diferencial
Evolução Fatal
Feminino
Seres Humanos
Linfoma Difuso de Grandes Células B/complicações
Linfoma Difuso de Grandes Células B/patologia
Imagem por Ressonância Magnética
Meia-Idade
Ovário/diagnóstico por imagem
Ovário/patologia
Polirradiculoneuropatia Desmielinizante Inflamatória Crônica/etiologia
Polirradiculoneuropatia Desmielinizante Inflamatória Crônica/patologia
Tomografia por Emissão de Pósitrons
Raízes Nervosas Espinhais/patologia
Coluna Vertebral/diagnóstico por imagem
Ultrassonografia
Útero/diagnóstico por imagem
Útero/patologia
Perda de Peso
[Pt] Tipo de publicação:CASE REPORTS; CLINICAL CONFERENCE; JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170918
[Lr] Data última revisão:
170918
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170907
[St] Status:MEDLINE
[do] DOI:10.1056/NEJMcps1613804


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[PMID]:28786493
[Au] Autor:Munger ME; Aldahondo N; Krach LE; Novacheck TF; Schwartz MH
[Ad] Endereço:Center for Gait and Motion Analysis, Gillette Children's Specialty Healthcare, Saint Paul, MN, USA.
[Ti] Título:Long-term outcomes after selective dorsal rhizotomy: a retrospective matched cohort study.
[So] Source:Dev Med Child Neurol;59(11):1196-1203, 2017 Nov.
[Is] ISSN:1469-8749
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:AIM: To examine long-term outcomes of selective dorsal rhizotomy (SDR) 10 to 17 years after surgery. METHOD: Participants who underwent SDR had spastic diplegic cerebral palsy (CP), completed baseline gait analysis, and were 16 to 25 years old at follow-up. Non-SDR participants (i.e. controls) were matched on important clinical parameters at baseline but did not undergo SDR. All study participants completed six surveys assessing pain, quality of life, participation, function, and mobility. Treatment history for lower extremity surgery and antispasticity injections was tabulated. A subset of each study group returned for three-dimensional gait analysis, including kinematics, metabolic energy cost, and physical examination. Gait Deviation Index (GDI) was calculated to measure gait quality. RESULTS: The study cohort had 24 participants with SDR and 11 without SDR. Of these, 13 patients with SDR (five males, eight females; median [IQR] age 17y 2mo [16y 8mo-17y 9mo]) and eight without SDR (three males, five females; median [IQR] age 19y 2mo [17y 3mo-21y 11mo]) completed baseline and follow-up gait analysis. Spasticity significantly decreased in those with SDR (p<0.05). Gait Deviation Index improved more in participants without SDR than those with SDR (Δ =12.8 vs Δ =9.1; p=0.01). Compared with the SDR group, participants without SDR underwent significantly more subsequent interventions (p<0.05). INTERPRETATION: Patients in both the SDR and non-SDR groups showed improved gait quality more than 10 years after surgery. Participants without SDR had a larger improvement in gait pathology but underwent significantly more intervention. There were no differences between groups in survey measures. These results suggest differing treatment courses provide similar outcomes into early adulthood. WHAT THIS PAPER ADDS: Selective dorsal rhizotomy (SDR) and non-SDR groups had significant improvement in gait pathology over time. The non-SDR group had significantly better gait compared with the SDR group at follow-up. The groups had similar levels of energy cost, pain, and quality of life. Non-SDR participants underwent significantly more orthopaedic surgery and antispasticity injections than SDR participants. Use of a clinically similar control group highlights that different treatment courses may result in similar outcomes into young adulthood.
[Mh] Termos MeSH primário: Paralisia Cerebral/cirurgia
Rizotomia/métodos
Raízes Nervosas Espinhais/cirurgia
[Mh] Termos MeSH secundário: Adolescente
Estudos de Casos e Controles
Paralisia Cerebral/psicologia
Criança
Estudos de Coortes
Feminino
Marcha/fisiologia
Seres Humanos
Masculino
Qualidade de Vida/psicologia
Amplitude de Movimento Articular/fisiologia
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171030
[Lr] Data última revisão:
171030
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170809
[St] Status:MEDLINE
[do] DOI:10.1111/dmcn.13500


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[PMID]:28636859
[Au] Autor:David WS; Bowley MP; Mehan WA; Shin JH; Gerstner ER; DeWitt JC
[Ad] Endereço:From the Departments of Neurology (W.S.D., M.P.B., E.R.G.), Radiology (W.A.M.), Neurosurgery (J.H.S.), and Pathology (J.C.D.), Massachusetts General Hospital, and the Departments of Neurology (W.S.D., M.P.B., E.R.G.), Radiology (W.A.M.), Neurosurgery (J.H.S.), and Pathology (J.C.D.), Harvard Medical
[Ti] Título:Case 19-2017 - A 53-Year-Old Woman with Leg Numbness and Weakness.
[So] Source:N Engl J Med;376(25):2471-2481, 2017 Jun 22.
[Is] ISSN:1533-4406
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Linfoma Difuso de Grandes Células B/patologia
Raízes Nervosas Espinhais/patologia
[Mh] Termos MeSH secundário: Encéfalo/diagnóstico por imagem
Encéfalo/patologia
Líquido Cefalorraquidiano/química
Líquido Cefalorraquidiano/citologia
Diagnóstico Diferencial
Feminino
Seres Humanos
Hipestesia/etiologia
Vértebras Lombares/diagnóstico por imagem
Linfoma Difuso de Grandes Células B/complicações
Linfoma Difuso de Grandes Células B/diagnóstico por imagem
Imagem por Ressonância Magnética
Meia-Idade
Debilidade Muscular/etiologia
Sistema Nervoso Periférico/anatomia & histologia
Sistema Nervoso Periférico/fisiologia
Sarcoidose/diagnóstico
Tuberculose/diagnóstico
[Pt] Tipo de publicação:CASE REPORTS; CLINICAL CONFERENCE; JOURNAL ARTICLE
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170629
[Lr] Data última revisão:
170629
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170622
[St] Status:MEDLINE
[do] DOI:10.1056/NEJMcpc1701762


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[PMID]:28576935
[Au] Autor:Dickie AC; McCormick B; Lukito V; Wilson KL; Torsney C
[Ad] Endereço:Centre for Integrative Physiology, Edinburgh Medical School: Biomedical Sciences, The University of Edinburgh, Edinburgh EH8 9XD, United Kingdom.
[Ti] Título:Inflammatory Pain Reduces C Fiber Activity-Dependent Slowing in a Sex-Dependent Manner, Amplifying Nociceptive Input to the Spinal Cord.
[So] Source:J Neurosci;37(27):6488-6502, 2017 Jul 05.
[Is] ISSN:1529-2401
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:C fibers display activity-dependent slowing (ADS), whereby repetitive stimulation (≥1 Hz) results in a progressive slowing of action potential conduction velocity, which manifests as a progressive increase in response latency. However, the impact of ADS on spinal pain processing has not been explored, nor whether ADS is altered in inflammatory pain conditions. To investigate, compound action potentials were made, from dorsal roots isolated from rats with or without complete Freund's adjuvant (CFA) hindpaw inflammation, in response to electrical stimulus trains. CFA inflammation significantly reduced C fiber ADS at 1 and 2 Hz stimulation rates. Whole-cell patch-clamp recordings in the spinal cord slice preparation with attached dorsal roots also demonstrated that CFA inflammation reduced ADS in the monosynaptic C fiber input to lamina I neurokinin 1 receptor-expressing neurons (1-10 Hz stimulus trains) without altering the incidence of synaptic response failures. When analyzed by sex, it was revealed that females display a more pronounced ADS that is reduced by CFA inflammation to a level comparable with males. Cumulative ventral root potentials evoked by long and short dorsal root stimulation lengths, to maximize and minimize the impact of ADS, respectively, demonstrated that reducing ADS facilitates spinal summation, and this was also sex dependent. This finding correlated with the behavioral observation of increased noxious thermal thresholds and enhanced inflammatory thermal hypersensitivity in females. We propose that sex/inflammation-dependent regulation of C fiber ADS can, by controlling the temporal relay of nociceptive inputs, influence the spinal summation of nociceptive signals contributing to sex/inflammation-dependent differences in pain sensitivity. The intensity of a noxious stimulus is encoded by the frequency of action potentials relayed by nociceptive C fibers to the spinal cord. C fibers conduct successive action potentials at progressively slower speeds, but the impact of this activity-dependent slowing (ADS) is unknown. Here we demonstrate that ADS is more prevalent in females than males and is reduced in an inflammatory pain model in females only. We also demonstrate a progressive delay of C fiber monosynaptic transmission to the spinal cord that is similarly sex and inflammation dependent. Experimentally manipulating ADS strongly influences spinal summation consistent with sex differences in behavioral pain thresholds. This suggests that ADS provides a peripheral mechanism that can regulate spinal nociceptive processing and pain sensation.
[Mh] Termos MeSH primário: Fibras Nervosas Amielínicas
Condução Nervosa
Neuralgia/fisiopatologia
Nociceptividade
Medula Espinal/fisiopatologia
Raízes Nervosas Espinhais/fisiopatologia
[Mh] Termos MeSH secundário: Vias Aferentes/fisiopatologia
Animais
Feminino
Masculino
Ratos
Ratos Sprague-Dawley
Fatores Sexuais
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170818
[Lr] Data última revisão:
170818
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170604
[St] Status:MEDLINE
[do] DOI:10.1523/JNEUROSCI.3816-16.2017


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[PMID]:28574334
[Au] Autor:Takai K; Taniguchi M
[Ad] Endereço:Department of Neurosurgery, Tokyo Metropolitan Neurological Hospital, Tokyo, Japan.
[Ti] Título:Modified dorsal root entry zone lesioning for intractable pain relief in patients with root avulsion injury.
[So] Source:J Neurosurg Spine;27(2):178-184, 2017 Aug.
[Is] ISSN:1547-5646
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE Dorsal root entry zone (DREZ) lesioning has been the most effective surgical treatment for the relief of intractable pain due to root avulsion injury, but residual pain and a decrease in pain relief in the follow-up period have been reported in 23%-70% of patients. Based on pain topography in the most recent studies on neuropathic pain, the authors modified the conventional DREZ lesioning procedure to improve clinical outcomes. The presumed rationale for this procedure is to eliminate the spontaneous discharges of neurons in the superficial spinal dorsal horn as well as wide dynamic range neurons in the deep spinal dorsal horn. METHODS Ten patients with avulsion-related pain underwent surgery between 2011 and 2015. The surgical procedure was described and postoperative pain relief was assessed as follows: excellent (residual pain never exceeded 3 on the visual analog scale [VAS] without medication), good (residual pain never exceeded 5 on the VAS with medication), and poor (residual pain was greater than 5 with medication). Specific perioperative complications were assessed. RESULTS The aim of this surgical procedure was to destroy the deeper layers of the posterior horn of spinal gray matter, which was in contrast to the procedures of Nashold and Sindou, which were to destroy the superficial layers. All patients achieved excellent (n = 7, pain relief without medication) or good (n = 3, pain relief with medication) pain relief postoperatively, and the recurrence of pain was not reported in any patients (median 29 months after surgery, range 12-64 months). Nine patients (90%) achieved complete pain relief (a score of 0 or 1 on the VAS) with or without medication. No surgical site complications such as infection or CSF leakage were noted. No motor deficit was observed in any patient. A sensory deficit was observed in 2 patients and disappeared within 1 month in 1 patient. New pain at the adjacent level of DREZ lesioning was observed in 3 patients and disappeared within 1 month in 2 patients. In the other patient, new pain persisted and required analgesics. CONCLUSIONS These preliminary results demonstrated that total and persistent global pain relief was achieved with the modified DREZ lesioning procedure in 90% of patients without major neurological deficits. The clinical improvements achieved by this modified surgical procedure support the hypothesis that not only the superficial layers, but also deeper layers of the spinal dorsal horn are associated with intractable pain due to root avulsion injury.
[Mh] Termos MeSH primário: Procedimentos Neurocirúrgicos
Dor Intratável/etiologia
Dor Intratável/cirurgia
Raízes Nervosas Espinhais/lesões
Raízes Nervosas Espinhais/cirurgia
[Mh] Termos MeSH secundário: Acidentes por Quedas
Acidentes de Trânsito
Adulto
Idoso
Analgésicos/uso terapêutico
Feminino
Seguimentos
Seres Humanos
Masculino
Meia-Idade
Medição da Dor
Dor Intratável/diagnóstico por imagem
Dor Intratável/tratamento farmacológico
Células do Corno Posterior
Recidiva
Estudos Retrospectivos
Raízes Nervosas Espinhais/diagnóstico por imagem
Resultado do Tratamento
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Analgesics)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170807
[Lr] Data última revisão:
170807
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170603
[St] Status:MEDLINE
[do] DOI:10.3171/2017.1.SPINE16234



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