著者
圓尾 知之 中江 文 前田 倫 高橋−成田 香代子 Morris Shayn 横江 勝 松崎 大河 柴田 政彦 齋藤 洋一
出版者
日本疼痛学会
雑誌
PAIN RESEARCH (ISSN:09158588)
巻号頁・発行日
vol.28, no.1, pp.43-53, 2013-03-10 (Released:2013-04-04)
参考文献数
15
被引用文献数
1 2

Background: The revised version of Short-Form McGill Pain Questionnaire (SF-MPQ-2) has been developed as a tool for measuring both neuropathic and non-neuropathic pain which can be used in studies of epidemiology, pathophysiologic mechanisms, and treatment response. SF-MPQ-2 was expanded and revised from the Short-Form McGill Pain Questionnaire (SF-MPQ-1) pain descriptors by adding symptoms relevant to neuropathic pain and by modifying the response format to a 0 - 10 numerical rating scale. In this study, we translated the SF-MPQ-2 into Japanese. The aim of this study was the validation of a Japanese version of the SF-MPQ-2 in patients with neuropathic pain. Materials and Methods: A total of 110 chronic pain patients from Osaka University Hospital and Nishinomiya Municipal Central Hospital were enrolled in this study, with 87 (47 males, 40 females) patients completing the study. Enrolled patients completed the SF-MPQ-2 which had been translated into Japanese. To evaluate the validity of the SF-MPQ-2 questionnaire, an exploratory factor analysis was performed. For assessment of reliability, we used internal consistency reliability coefficients (Cronbach's alpha coefficient) and the test-retest method test (Intraclass Correlation Coefficient; ICC) for the SF-MPQ-2 total and subscale scores. Validity was evaluated by examining the associations between the SF-MPQ-2 total and subscale scores and other measures. Results: The internal consistency (Cronbach's alpha coefficient; continuous pain; α=0.883, intermittent pain; α=0.856, predominantly neuropathic pain; α=0.905, affective descriptors; α=0.863, total score; α=0.906) and reproducibility coefficient (ICC; continuous pain; ρ=0.793, intermittent pain; ρ=0.750, predominantly neuropathic pain; ρ=0.819, affective descriptors; ρ=0.760, total score; ρ=0.830) were high. There were significant correlations between SF-MPQ-2 and other functional assessments. Conclusion: Our findings showed excellent reliability and validity for the Japanese version of the SF-MPQ-2 in pain patients, and the results of both exploratory and confirmatory factor analyses provided support for four readily interpretable subscales (continuous pain, intermittent pain, pre-dominantly neuropathic pain, and affective descriptors). These results provide a basis for use of the SF-MPQ-2 in future clinical research, including clinical trials of treatments for neuropathic and non-neuropathic pain conditions.
著者
岡井 恒 古江 秀昌 吉村 恵
出版者
日本疼痛学会
雑誌
PAIN RESEARCH (ISSN:09158588)
巻号頁・発行日
vol.23, no.1, pp.11-18, 2008-02-20 (Released:2013-07-04)
参考文献数
16
被引用文献数
4 4

Neurotropin®, a non protein extract from inflamed rabbit skin inoculated with vaccinia virus, is well known as an analgesic for chronic pain such as low back pain and postherpetic neuralgia, etc. In previous behavioral studies, we have shown that neurotropin activates the monoaminergic descending pain inhibitory system. In the present study, we examined the effects of neurotropin on serotonergic neurons in the nucleus raphe magnus (NRM, the origin of serotonergic descending pain inhibitory neuron) in the rostroventromedial medulla using whole-cell patch-clamp technique in brainstem slices. In some instances, recorded neurons were identified as NRM neurons with neurobiotin filled in the recording pipettes. NRM neurons had a resting membrane potential of about -60 mV. Bath application of neurotropin (1.0 NU/mL) depolarized NRM neurons, and it resulted in initiating an action potential under current-clamp conditions. Under voltage-clamp conditions at a holding potential of -70 mV, NRM neurons exhibited spontaneous excitatory postsynaptic currents (EPSCs). Neurotropin (0.2 - 1.0 NU/mL) did not change the frequency and amplitude of spontaneous EPSCs. However, neurotropin dose-dependently induced an inward current in approximately 60% of NRM neurons tested. The neurotropin-induced inward current was observed even in the presence of tetrodotoxin (1 µM). The reversal potential for the current was close to 0 mV, indicating that the neurotropin-induced current is mediated by the activation of non-selective cation channels. Neurotropin produced an inward current, in all neurons immunohistochemically stained for tryptophan hydroxylase (TPH), a marker for serotonergic neuron. These results indicate that neurotropin directly excites serotonergic NRM neurons without affecting the excitatory synaptic inputs to NRM neurons. This facilitatory action of neurotropin on serotonergic NRM neurons may have an important role for the neurotropin-induced analgesia.
著者
大住 倫弘 草場 正彦 中野 英樹 森岡 周
出版者
日本疼痛学会
雑誌
PAIN RESEARCH (ISSN:09158588)
巻号頁・発行日
vol.27, no.3, pp.165-174, 2012-08-10 (Released:2013-02-19)
参考文献数
29

Habituation to pain has been addressed in many recent studies. It is clear that patients with chronic pain do not become habituated to the pain; however, little is known about habituation to the inner experience of pain. We investigated the brain mechanisms underlying habituation to the inner experience of pain by using event-related potentials (ERPs), which provide superior temporal resolution, and low-resolution brain electromagnetic tomography (LORETA), which enables identification of regions of nervous activity. Fifteen healthy subjects participated in this study. The subjects were shown 4 sets of photographic images, with each set shown 30 times. The images included 15 images of a hand subjected to pain (painful condition). The subjects were instructed to imagine themselves in that condition and to imagine the pain they may experience in such a situation (inner experience of pain). Electroencephalography was continuously performed via 128 scalp electrodes mounted on an electrode cap. ERPs were recorded during the inner experience of pain; we also recorded N110 responses for emotional components and P3 responses for cognitive evaluation. To investigate habituation to the inner experience of pain, the mean amplitudes of P3 and N110 recordings were calculated for the first 2 (early sets) and last 2 (late sets) sets of trials for each painful condition; next, early sets were compared with late sets. We also analyzed the change in nervous activity after habituation to the inner experience of pain by LORETA analysis. The amplitude of central P3 responses was significantly lower for the late image sets than the early image sets of the painful condition. However, the mean amplitude of N110 responses did not significantly change. LORETA analysis of P3 responses showed reduced activity in the left secondary somatosensory area and left posterior insular cortex, indicating that the sensory component of the inner experience of pain was lower in the late sets than in the early sets. During habituation to the inner experience of pain, the P3 response, which is related to cognitive evaluation of this experience, changed, and brain activity, which reveals the sensory component of the inner experience of pain, reduced. Our study suggests that habituation to the inner experience of pain occurs at the point of recognition of the sensory component of pain. We hypothesize that pain recognition necessary for habituation to the inner experience of pain.
著者
柴田 政彦 寒 重之 大迫 正一 三木 健司 栁澤 琢史 助永 憲比古 恒遠 剛示 新田 一仁 岩下 成人 福井 聖 黒崎 弘倫 中野 直樹 若泉 謙太 上嶋 江利 本山 泰士 高雄 由美子 溝渕 知司
出版者
日本疼痛学会
雑誌
PAIN RESEARCH (ISSN:09158588)
巻号頁・発行日
vol.31, no.4, pp.189-196, 2016-11-26 (Released:2017-01-27)
参考文献数
37

The review was performed to investigate the functional brain alterations in patients with various kinds of chronic pain including fibromyalgia, chronic low back pain, migraine and the other chronic pain conditions. In these patients functional connectivity was different not only in the sensory–motor system but also in the affective and reward system. New technology have allowed us to identify and understand the neural mechanisms contributing to chronic pain, which provides us novel targets for future research and treatment.
著者
吉野 敦雄 岡本 泰昌 神人 蘭 森 麻子 山脇 成人
出版者
日本疼痛学会
雑誌
PAIN RESEARCH (ISSN:09158588)
巻号頁・発行日
vol.32, no.4, pp.260-266, 2017-12-20 (Released:2018-05-31)
参考文献数
17

Chronic pain affects many people and decreases their physical or emotional functioning and their quality of life, and impairs their ability to work. Psychological factors such as depression and less activities lead to chronicity of pain, and multidimensional treatments including psychotherapy for chronic pain patients are required. Cognitive behavioral therapy (CBT) is one of the psychotherapy treatments, and is required positive attitude that patients objectively monitor one’s own emotion, sensation, and social environments and that they continuously modify these maladaptive behavior and cognition, rather than negative attitude. By using acquired skills, they can learn to be able to control their symptoms by themselves. Many meta–analyses show that CBT is more useful for pain experiences, mental health, and social functioning than only drug medication. We have also developed a CBT program for patients with chronic pain since 2011 and have confirmed the improvement of subjective pain perception, depression, anxiety, and QOL after CBT. In this manuscript, we report the concrete program. Furthermore, clinical effects of our program were variable, and lastly, psychosocial or neuroscientific considerations were given to make this program more effective in the near future.

3 0 0 0 OA 痛みと情動

著者
中江 文 眞下 節
出版者
日本疼痛学会
雑誌
PAIN RESEARCH (ISSN:09158588)
巻号頁・発行日
vol.25, no.4, pp.199-209, 2010-12-10 (Released:2013-06-06)
参考文献数
38

Pain is a subjective experience comprised of physiological and affective components. Previous decades of research have placed an emphasis on pain “sensation″, which involves assessing location and intensity of noxious stimuli. However, somatosensory localization and intensity coding are not necessarily linked with emotional responses, as indicated by the IASP (International Association for the Study of Pain) definition, “Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage″. Therefore, it is important to consider that not only the sensory, but also the emotional, perspective of pain plays an important role in pain suffering. Our group previously demonstrated, for the first time, that long-term persistent pain in an animal model of neuropathic pain, resulted in anxiety and depression related behavior. The many human emotions are all capable of altering pain sensitivity, as demonstrated by experimental and clinical studies focused on the associations between pain sensation and various emotions in human imaging studies. Negative emotions, such as anger, sadness, and anxiety, result in increased pain intensity. In contrast, positive emotion can regulate various pain sensations. Patients with certain psychiatric disorders, such as schizophrenia and borderline personality disorder, are less sensitive to pain. However, one of the main symptoms of depressive patients is “pain″. Although many of the neurobiological mechanisms of these diseases remain unclear, psychiatric disorders could reflect brain mechanisms of pain processing, because patients with psychiatric disorders exhibit varying reactions to experimental and clinical pain. Certain psychiatric disorders, in particular schizophrenia, could be considered to be human diseases that exhibit symptoms completely opposite to chronic pain. As stated by Prof. Loeser, “It is not pain, but suffering, that brings patients into doctor's offices in hopes of finding relief". Doctors of modern medicine tend to believe that it is more important to remove the cause of pain through methods such as nerve blockade. However, injuries, and the diseases that cause pain, might only be the trigger. The most important problem for these patients could be the change in social environment triggered by the injuries and diseases. In other words, affective components of pain are the main problems for these patients. Although it is difficult to distinguish whether patient pain is influenced by the affective components of pain, it is recommended to attempt to simultaneously treat patients according to sensory and emotional perspectives. It is expected that studies focused on the affective components of pain will make great advancements, and drug discovery will likely aim at specifically reducing suffering from pain, with an eventual paradigm shift in pain treatment.
著者
水谷 みゆき 牛田 享宏 西原 真理
出版者
日本疼痛学会
雑誌
PAIN RESEARCH (ISSN:09158588)
巻号頁・発行日
vol.32, no.3, pp.191-202, 2017-09-15 (Released:2017-09-26)
参考文献数
30

Chronic pain is a complex state that involves unpleasant emotion, autono­mic responses, helplessness against pain and movement disorder, as well as the sensation of pain itself. These memorized responses influence the present experience and behavior of the patient. A single treatment option is not enough to treat such a complex clinical state. Thus, our facility has several treatment programs to fit individual patients’ needs. We applied an individualized hypnotic approach to 161 patients who had not shown satisfactory improvement and were considered suitable subjects for psychotherapy.A hypnosis session consisted of the introduction stage, which prepared the therapeutic contexts accommodated to the change in chronic pain as well as each patient’s history, and the induction stage, which mainly targeted non–pain body sensations. Among the patients who tried hypnosis, 71.1% experienced in–session analgesia (ISA), and 46.3% experienced out–of–session analgesia (OSA). The most of the first ISA was experienced before approximately the 10th session, and the most of the first OSA was experienced by approximate­ly the 15th session after ISA.Based on the process and degree of analgesia, the number of sessions, the leaning rate of self–hypnosis, and the patients’ characteristics and experiences in the above process, we attempted to determine the conditions under which the patients were successfully engaged in hypnosis, the stage of changes in their chronic pain, and the inhibitory factors against analgesia. Despite clinical differences among the patients and their pain situations, their responses to the hypnosis implied the importance of achieving pain cessation through their own therapeutic efforts.
著者
木口 倫一 岸岡 史郎
出版者
日本疼痛学会
雑誌
PAIN RESEARCH (ISSN:09158588)
巻号頁・発行日
vol.29, no.1, pp.9-16, 2014-03-10 (Released:2014-03-29)
参考文献数
21

Recently, the involvement of inflammatory mediators such as chemokines in neuropathic pain has been focused. Among inflammatory cells recruited into the injured peripheral nerves, macrophages play key roles in chronic neuroinflammation through cytokine–chemokine network. As epigenetic histone modifications induce long–lasting expression of inflammatory mediators, we highlight the contribution of histone modifications in the injured peripheral nerves to neuropathic pain.   After partial sciatic nerve ligation (PSL) in mice, F4⁄80+ macrophages were accumulated in the injured sciatic nerve (SCN). By microarray analysis, several inflammatory chemokine ligands and those receptors were upregulated in the injured SCN on day 7 after PSL. Indeed, the expression levels of CC–chemokine ligand (CCL) 3 and CCL8 showed the highest upregulation, and were confirmed by quantitative RT–PCR. Moreover, those receptors including CCR1, CCR2 and CCR5 were markedly upregulated after PSL. Chromatin precipitation assay revealed the acetylation in K9 residue (H3K9Ac) and trimethylation in K4 residue (H3K4me3) of histone H3, facilitating gene transcriptions associated with chromatin remodeling, on the promoter regions of CCLs in the injured SCN. By immunohistochemistry, upregulated CCL3 or CCL8 was located on the accumulated F4⁄80+ macrophages. Expressions of H3K9Ac and H3K4me3 were also increased in the injured SCN, and those were detected in the nuclei of macrophages expressing CCLs.   These findings indicate that facilitation of chemokine signaling through histone H3 modifications in macrophages largely contributes to peripheral neuroinflammation leading to neuropathic pain. Further research considering the critical components of peripheral neuroinflammation exploit novel therapeutic strategy of neuropathic pain.
著者
平川 善之 原 道也 藤原 明 花田 弘文 森岡 周
出版者
日本疼痛学会
雑誌
PAIN RESEARCH (ISSN:09158588)
巻号頁・発行日
vol.28, no.1, pp.23-32, 2013-03-10 (Released:2013-04-04)
参考文献数
29
被引用文献数
1

Total knee arthroplasty (TKA) is a surgical treatment for conditions such as knee osteoarthritis; the treatment aims to relieve knee pain and improve quality of life. Treatment outcomes are stable; however, it has been reported that postoperative pain becomes chronic in 15 - 20% of cases. The aim of this study was to examine the factors involved in the chronicity of postoperative pain by investigating the effects of cognitive and psychological factors on postoperative pain at 3 weeks, 5 weeks, and 4 months post-operation. Subjects were 50 patients who underwent TKA (8 men and 42 women, mean age: 74.8 ± 6.5 years). Cognitive factors in this study comprised an assessment of neglect-like symptoms; such symptoms included decreased “cognitive function regarding the existence of one's own limbs" or “cognitive function regarding the motion perception of one's own limbs." The severity of these symptoms was assessed using the method described by Galar et al. Psychological factors comprised assessments of anxiety and catastrophic thinking about pain. Anxiety was assessed using the state-trait anxiety inventory, while catastrophic thinking about pain was assessed using the pain catastrophizing scale (comprises categories of helplessness, magnification, and rumination). Postoperative pain was assessed using a visual analog scale (VAS). Multiple regression analysis by using VAS as the dependent variable and all other factors as independent variables showed the following factors to be significantly correlated with VAS: neglect-like symptoms at 3 weeks, 5 weeks, and 4 months post-operation and rumination at 3 weeks and 4 months post-operation. Sensory integration becomes difficult because of decreased sensory function in neglect-like symptoms; this is thought to be caused by body image becoming inaccurate. On the basis of these findings, it is considered necessary to approach for the improvement of sensory function in postoperative rehabilitation. In addition, rumination is persistent in pain, which is believed to result in a prognosis of a psychological state of severe anxiety. Therefore, methods for dealing with postoperative pain and giving patients a prognosis that is as precise as possible are thought to be necessary. These measures are thought to be factors in relieving postoperative pain and preventing it from becoming chronic.
著者
藤巻 高光 桐野 高明
出版者
日本疼痛学会
雑誌
PAIN RESEARCH (ISSN:09158588)
巻号頁・発行日
vol.15, no.2, pp.57-61, 2000-07-31 (Released:2014-06-19)
著者
池田 亮
出版者
日本疼痛学会
雑誌
PAIN RESEARCH (ISSN:09158588)
巻号頁・発行日
vol.30, no.4, pp.208-215, 2015-12-10 (Released:2016-01-06)
参考文献数
38

The sense of light touch is indispensable for environmental exploration,social interaction, and skilled tasks but the underlying mechanisms are largely unknown in mammals. Tactile dysfunction such as neuropathic pain produce allodynia which is grievous pain generated by light touch. This intra ctable phenomenon is induced by neural sensitization after the damage to nervous system. Along with the nervous system mechanisms, mechano transdcution in the tactile end organs play a crucial role to form mechanical allodynia. Thus, the elucidation of touch mystery is great expected matter to develop the effective treatment against mechanical allodynia. Merkel discs are one of the tactile special end organs thought as putative mechanoreceptors in the skins and can make sophisticated discrimination. We performed in situ patch–clamp recording from Merkel cells which compose Merkel discs in company with Aβ–afferent nerve endings. As a result, Merkel cells showed transduction of tactile stimuli via “Piezo2” channels and encode tactile signals in the form of Ca2+ action potentials. Recent advances using conditional knock out mice also show the same molecular mechanisms for Merkel cells mechanotransduction. These findings provide new insights into how to achieve delicate tactile sensation and may have clinical therapeutic implications.
著者
牛田 享宏 山口 重樹 木村 嘉之 青野 修一
出版者
日本疼痛学会
雑誌
PAIN RESEARCH (ISSN:09158588)
巻号頁・発行日
vol.33, no.4, pp.257-268, 2018-12-28 (Released:2019-03-29)
参考文献数
4

Chronic pain is a biological psychosocial pathological condition, which is caused by various elements involved in many ways. Therefore, it is necessary to analyze the disease state from various viewpoints and to treat multimodally. Since there was no standard diagnostic tool for chronic pain so far, it was difficult to develop epidemiological research and development and evaluation of treatment in accordance with specific pathological conditions. Therefore, the IASP proceeded development to add the item of Chronic Pain in ICD–11, which was officially announced from WHO in June 2018. This attempts to classify chronic pain into seven major categories (① chronic primary pain, ② chronic cancer related pain, ③ chronic postoperative and posttraumatic pain, ④ chronic secondary musculoskeletal pain, ⑤ chronic secondary visceral pain, ⑥ chronic neuropathic pain, ⑦ chronic secondary headache and/or orofacial pain) and others.By developing a more realistic method of using this new standard disease name, effective utilization not only in research but also in clinical practice is needed. In addition, this review will also introduce the versions that the Chronic Pain Research Group of the Ministry of Health, Labor and Welfare has been developing. At the same time as disease name classification, it is important to know where and how to treat chronic pain.In 2017, IASP defined the treatment by forming “Task Force on Multimodal Pain Treatment Defines Terms for Chronic Pain Care” in order to unify the names of confused treatment modes. At the same time as disease name classification, it is important to know where and how to treat chronic pain. Also, in the past, IASP has been defining treatment facilities such as Multidisciplinary Pain Center. In addition, this time we will introduce the assessment of O–P factor which is helpful for thinking about what kind of patients and where to receive medical treatment.
著者
奥野 祐次
出版者
日本疼痛学会
雑誌
PAIN RESEARCH (ISSN:09158588)
巻号頁・発行日
vol.29, no.4, pp.233-241, 2014-12-10 (Released:2014-12-29)
参考文献数
17
被引用文献数
1 1

Purpose: Neovessels and accompanying nerves are possible sources of pain. Previous work demonstrated that transcatheter arterial micro−emboliza­tion (TAME) for patients with adhesive capsulitis resulted in excellent pain relief. We hypothesized that abnormal neovessels also play an important role in nighttime shoulder pain with other conditions as well as adhesive capsulitis and that TAME can relieve pain.   Material and Methods: TAME using imipenem ⁄ cilastatin sodium as an embolic agent proceeded to seventeen shoulders in sixteen patients, including adhesive capsulitis (n=6), subacromial impingement syndrome (n=7), rotator cuff tear without surgical indication (n=2), stiff shoulder (n=1), and chronic pain post scapula fracture (n=1). All patients had nighttime shoulder pain and previous conservative therapies applied for at least three months and persisted moderate−to−severe pain (Visual Analog Scale > 50 mm) before treatments. Adverse events, changes in Visual Analog Scale scores of night pain, and changes in self reporting sleep quality scores were assessed at 1 week and at 1, 3, and 6 months after the procedure.   Results: Abnormal neovessels were identified in all cases. No major adverse events were related to the procedures. Transcatheter arterial micro− embolization rapidly decreased nighttime pain visual analog scale scores from 72 ± 7 mm to 42 ± 26 mm at 1 week after the procedure, with further improvement at 1, 3 and 6 months (28 ± 22 mm, 19 ± 24 mm, and 16 ± 23 mm respectively). Self reporting sleep quality scores and nighttime pain frequency improved and maintained for 6 months.   Conclusion: Abnormal neovessels were observed in all patients. TAME of this lesion was feasible, effectively relieved unrelenting chronic night shoulder pain.
著者
松平 浩 藤井 朋子
出版者
日本疼痛学会
雑誌
PAIN RESEARCH (ISSN:09158588)
巻号頁・発行日
vol.32, no.4, pp.252-259, 2017-12-20 (Released:2018-05-31)
参考文献数
22

A stratified approach for low back pain (LBP) involves targeted treatment for subgroups of patients classified according to their key characteristics such as prognostic psychological factors. This approach tailors therapeutic decisions in ways that maximize treatment benefit and reduce medical care costs. A stratified approach was known as the “Holy Grail” in back pain research over a decade ago.Psychological factors strongly influence the chronicity of LBP. Evidence suggests that fear avoidance beliefs are prognostic for poor outcomes in subacute LBP. Thus, early treatment, including interventions aimed to reduce fear avoidance beliefs, may prevent delayed recovery and chronicity.A recent development in the stratified approach is to use brief risk prediction tools such as the short–form Örebro Musculoskeletal Pain Screening Questionnaire (ÖMPSQ) and the Keele STarT Back Screening Tool (SBST). These tools identify patients with an increased likelihood of delayed recovery, and facilitate intervention for these patients from day 1, rather than waiting for failure of the first–line care. These tools can also help clinicians to better understand the reasons for a potentially poor prognosis and to choose interventions accordingly. Both of these screening tools focus on assessment of key psychological factors such as fear avoidance beliefs.Somatic symptom burden is used to evaluate the severity and course of illness. Co–existence of various somatic symptoms including multisite pain may be the core feature of central dysfunctional pain. The 8–item Somatic Symptom Scale (SSS–8) was recently developed as a brief, patient–reported measure of somatic symptom burden. We believe this tool to be useful for screening for functional somatic syndrome including chronic widespread pain.
著者
林 聖子 岡田 薫 川喜田 健司
出版者
日本疼痛学会
雑誌
PAIN RESEARCH (ISSN:09158588)
巻号頁・発行日
vol.25, no.1, pp.45-53, 2010-03-15 (Released:2013-06-26)
参考文献数
24

To investigate underlying mechanism of subjective pain ⁄ numbness sensation following ischemia-reperfusion of upper arm, we examined the changes in skin blood flow (SBF) and current perception threshold (CPT). Eighteen healthy volunteers with informed consents were used. A 140 mm wide tourniquet cuff was inflated to 200 mmHg and maintained for 15 min at non-dominant upper arm. SBF was measured by Laser Doppler flow meter before, during and after ischemia at the index finger. Magnitude of the evoked pain ⁄ numbness sensation after ischemia-reperfusion was recorded by VAS with an electric device continuously. CPT was measured by 5, 250, 2000 Hz of sine-waves randomly applied to the index finger. SBF was increased immediately after reperfusion in all the subjects. Pain ⁄ numbness sensation was also evoked after reperfusion in all subjects.But baseline SBF, increased SBF and magnitude of subjective sensation after reperfusion were different among individuals. Correlation between changes of SBF and magnitude of subjective sensation measured by VAS did not show statistical significance. After ischemia-reperfusion, significant increases of CPT were observed in 250 and 2000 Hz (baseline vs. after reperfusion, p<0.01). The sine-wave stimulation of 5, 250 and 2000 Hz were assumed to activate C, A-delta and A-beta fibers, respectively. The production of pain ⁄ numbness sensation was accompanied with the significant increases of CPT at 250 and 2000 Hz after reperfusion. These results suggest the participation of A fibers in the production of pain ⁄ numbness sensation evoked by ischemia-reperfusion.
著者
植田 弘師
出版者
日本疼痛学会
雑誌
PAIN RESEARCH (ISSN:09158588)
巻号頁・発行日
vol.32, no.4, pp.239-245, 2017-12-20 (Released:2018-05-31)
参考文献数
30

We have firstly demonstrated that LPA1 receptor signaling initiates the neuropathic pain and underlying mechanisms including dorsal root (DR) demyelination and up–regulation of Cavα2δ1 in dorsal root ganglion (DRG), which are supposedly related to allodynia and hyperalgesia, respectively. Since this report, we have accumulated the findings supporting this discovery. They are the findings that LPA is produced in the spinal dorsal root upon the partial ligation of sciatic nerves of mice, the LPA production is self–amplified through activations of LPA1 ⁄ 3 receptors and microglia. Thus produced LPA may go back to DR and DRG and cause abnormal pain behavior. All these mechanisms may develop the feed–forward amplification of abnormal pain mechanisms, or pain memory. On the analogy of this neuropathic pain, we tested the involvement of LPA1 receptor signaling in experimental fibromyalgia–like mouse models, such as intermittent psychological stress (IPS)–, intermittent cold stress– and repeated intramuscular injection of acid saline–induced models. The deficiency of LPA1 receptor completely lost the hyperalgesia in all these models. The repeated treatments with LPA1 antagonist AM966 completely cured the established pain in the IPS model. All these findings demonstrate that LPA1 signaling plays key roles in the development and maintenance of chronic pain.
著者
上田 豊
出版者
日本疼痛学会
雑誌
PAIN RESEARCH (ISSN:09158588)
巻号頁・発行日
vol.32, no.4, pp.272-279, 2017-12-20 (Released:2018-05-31)
参考文献数
11

In Japan, cervical cancer tends to develop at a younger age. Cervical cancer screening rate in Japanese females is extremely low among developed countries. Therefore, HPV vaccine was expected to prevent cervical cancer effectively in Japan. An urgent promotion project for HPV vaccination was initiated by the Ministry of Health, Labour and Welfare (MHLW) in 2010. From April 2013, periodical vaccination of 12 to 16–year–old was initiated. However, so–called serious adverse events upon HPV vaccinations was repeated­ly reported in the media and the MHLW announced suspension of the recommendation of HPV vaccination in June 2013. Consequently, the inoculation rate has sharply declined, and a unprotected group against HPV will result in higher incidences of HPV infection and cervical cancer. It is necessary for us to face the increased risk of HPV infection and cervical cancer for girls who have refrained from HPV vaccination.
著者
水谷 みゆき 鈴木 千春 大道 裕介 櫻井 博紀 森元 温子 西原 真理 牛田 亨宏 新井 健一 佐藤 純
出版者
日本疼痛学会
雑誌
PAIN RESEARCH (ISSN:09158588)
巻号頁・発行日
vol.27, no.3, pp.175-188, 2012-08-10 (Released:2013-02-19)
参考文献数
44

The effect of hypnotic intervention for the refractory chronic pain patients was examined along with the process of patients' selection and their psychological characteristics. The total 596 visit patients in the first year were statistically examined concerning duration of pain, scores of psychological distress (Hospital Anxiety and Depression Scale) and disability (Pain Disability Assessment Scale) at the initial visit and the treatment outcome at the end of the first year. The duration of chronic pain was significantly related to disability but not to psychological distress at the initial visit. At the end of the first year of multidisciplinary pain treatment, 44% of total patients were under treatment, 19% finished treatment (10% evidently improved and 9% accepted their pain), 12% were referred and 25% dropped out. The group of patients who were evidently improved was not different concerning the duration of pain, but significantly less anxious, less depressed and less disabled at the initial visit than the other groups. Among the 261 patients under treatment, 33 patients (5.6% of total patients) were introduced into individual psychological interventions in consideration of 1) poor outcome in pharmacological and physical treatments, 2) unstable treatment relationship and marked pain behaviors, 3) obvious psychological distress, 4) event-related fluctuations in pain. They were significantly more anxious and depressed at the initial visit, than those who were not introduced to psychological intervention. Multiple bio-psycho-social factors were identified; tender points in 21 patients (by physiotherapist), stressful life events around the onset of pain in 26, serious daily conflicts at present in 30, catastrophizing thinking in 21, repressive thinking in 12, avoidance in 2 and perseverative coping in 6. Many of them did not or partly perceive their somatic tension / discomfort. Multiple factors were considered to inhibit the effect of treatment in those patients. In individual hypnosis, therapeutic conversation, permissive induction and indirect suggestions were employed. Direct suggestions for analgesia were not applied. Among 33 patients, 25 patients experienced hypnotic analgesia during sessions, 14 of whom finished their sessions with the decreased daily pain level or the enhanced effect of medication until the end of the 3rd year. Among them, 5 patients evidently improved (one phantom limb pain and 4 other chronic pain). Hypnosis successfully helped 42% of the patients who had failed to respond to multi disciplinary treatment. The psychosomatic resources in patients need to be more attended and utilized in chronic pain treatment.
著者
歌 大介 田口 徹
出版者
日本疼痛学会
雑誌
PAIN RESEARCH (ISSN:09158588)
巻号頁・発行日
vol.32, no.4, pp.280-287, 2017-12-20 (Released:2018-05-31)
参考文献数
23

Fibromyalgia (FM) is characterized by chronic widespread pain with mecha­nical allodynia and hyperalgesia. However, the neural mechanisms of nociception and pain are largely unknown. The aim of this study was to examine the responsiveness of peripheral nociceptive afferents and super­ficial dorsal horn (SDH) neurons by using a manifest rat model of FM, that was induced by reserpine (RES) injection. Repeated administration of RES (1 mg/kg, s.c., once daily for three consecutive days) caused a significant decrease in the mechanical withdrawal threshold of the plantar skin. Single–fiber electrophysiological recordings in vitro revealed that mechanical responses of mechano–responsive C–fibers were increased, although the proportion of mechano–responsive C–nociceptors was paradoxically de­creased. Next, we performed in vivo extracellular recordings of the SDH neurons. Although the SDH neurons showed mechanical stimulus intensity–dependent increases in the discharge rate both in the vehicle (VEH) and the RES–injected group, the response magnitude was significantly greater in the RES–injected group. Some SDH neurons in the RES–injected rats exhibited spontaneous firing with low frequencies, although those in the VEH–injected rats did not. These results suggest that increased mechanical sensitivity of the mechano–responsive C–fibers and the SDH neurons are involved in mechanical allodynia and hyperalgesia in a rat model of RES–induced pain. Similar mechanisms may underlie in patients with FM.
著者
河野 崇 横山 正尚
出版者
日本疼痛学会
雑誌
PAIN RESEARCH (ISSN:09158588)
巻号頁・発行日
vol.28, no.3, pp.177-181, 2013-08-30 (Released:2013-10-03)
参考文献数
8
被引用文献数
1 1

Some validated methods for assessing pain in laboratory animals are currently available. However, it remains to be determined whether these methods are also applicable for aged animals. Recently, grimace scale (GS) was developed for pain assessment based on facial expressions, and can effective­ly evaluate animal spontaneous pain. In the present study, we investigat­ed that accuracy and reliability of the rat grimace scale (RGS) in aged rats. Six coders were trained with the RGS training manual. Unlabeled 80 facial images of which half were with no pain (baseline), the other half were with pain (2 - 4 h after laparotomy) were randomly assigned and then scored by the coders. A high degree of the reliability was found with an overall intra-class correlation coefficient value of 0.92. The average ac­curacy of pain detection assessed by coders’ dichotomous judgment of “global pain” or “no pain” was sufficiently high with a correct classification rate of 84.6%. Furthermore, a single subcutaneous administration with morphine (1.0 mg/kg) resulted in decrease of RGS at 4 h after laparotomy. These results suggested that RGS is a useful method for assessing spontaneous pain after laparotomy in aged rats.