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Autonomic dysreflexia: a cardiovascular disorder following spinal cord injury

Neural Regeneration Research 2017年第9期12卷 1390-1400页

作者： Hisham Sharif Shaoping Hou Spinal cord Research center Department of Neurobiology and Anatomy Drexel University College of Medicine

Autonomic dysreflexia （AD） is a serious cardiovascular disorder in patients with spinal cord injury （ScI）. The primary underlying cause of AD is loss of supraspinal control over sympathetic preganglionic neurons （SPNs） caudal to the injury, which renders the SPNs hyper-responsive to stimulation. central maladaptive plasticity, including c-fiber sprouting and propriospinal fiber proliferation exaggerates noxious afferent transmission to the SPNs, causing them to release massive sympathetic discharges that result in severe hypertensive episodes. In parallel, upregulated peripheral vascular sensitivity following ScI exacerbates the hypertensive response by augmenting gastric and pelvic vasoconstriction. currently, the majority of clinically employed treatments for AD involve anti-hypertensive medications and Botox injections to the bladder. Although these approaches mitigate the severity of AD, they only yield transient effects and target the effector organs, rather than addressing the primary issue of central sympathetic dysregulation. As such, strategies that aim to restore supraspinal reinnervation of SPNs to improve cardiovascular sympathetic regulation are likely more effective for AD. Recent pre-clinical investigations show that cell transplantation therapy is efficacious in reestablishing spinal sympathetic connections and improving hemodynamic per- formance, which holds promise as a potential therapeutic approach.

关键词： autonomic dysreflexia hyper-reflexia sympathetic dysfunction c-fibers propriospinal axons a-adrenoceptors stem cell transplantation

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Laser evoked potential: Analysis of the methodology in post herpetic neuralgia

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World Journal of Neuroscience 2012年第1期2卷 1-6页

作者： Alessandro caminiti Amelia Zaccaro Andrea Truini William Raffaeli Domenico De Grandis Department of Neurological Science La sapienza University Rome Italy Department of Palliative care and Pain Therapy Infermi Hospital Rimini Italy Italian clinical Neurophysiology Society Rome Italy Registered Nurse Department of Palliative care and Pain Therapy lnfermi Hospital Rimini Italy

Background: selective activation and the contempo- rary recording of A delta and c fibers from Yap laser on the scalp is a new neurophysiological assessment, allowing the selective activation of the nociceptive system. Objectives: to evaluate if the damage of the nociceptive system was related to post herptic nevral-gia (PHN) development in a sample of 26 patients affected by Herpes zooster (HZ);secondly to assess if the impairment of thermal pathway and PHN development were related. Methods: Thirty-two patients were selected for the study, 26 of these were included in the study, whereas 6 were excluded because of cog- nitive impairment. All 26 study patients were sub- mitted to LEP analysis at baseline (T0) and after six months (T1), and the correlation between clinical thermal disease and the development of PHN was monitored. Results: pain duration was evidenced by the presence or absence of an instrumental signal in patients with acute HZ infection. There was total concordance between the absence of LEP signal and pain duration. The concordance between the clinical thermal disease and the pain duration was statisti- cally significant for 43% of the sample. conclusions: our results suggested a possible role of LEP for PHN prognosis estimation;indeed, most patients affected by acute HZ, with absence of instrumental LEP signal had pain > 6 months. We also noted a significant (43% of cases) clinical concordance between the thermal pathway damage, the absence of instrumental signal and PHN development. Further studies are needed to address this issue.

关键词： LEP A Delta fibers c-fibers PHN Development Pain Spino-Thalamic Pathway

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Properties of c-fiber mediated network synaptic responses in the spinal cord dorsal horn of rats:a multi-electrode array recording

Properties of C-fiber mediated network synaptic responses in...

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中国神经科学学会第四次会员代表大会暨第七届全国学术会议

作者： Zhen LI~1,Zhen-Yu ZHAO~1,Xue-Feng cHEN~1,Rui-Rui WANG~1,Jun cHEN~(1,2*) 1 Institute for Biomedical Sciences of Pain,Tangdu Hospital,Fourth Military Medical University,Xi''an 710038,china 2 Institute for Biomedical Sciences of Pain,capital Medical University,Beijing 100069,china

＜正＞The spinal cord dorsal horn is the key site for transmission and modulation of nociceptive information via synaptic connections between primary nociceptive afferent c-fibers and secondary order sensory ***, little is known about the properties of c-fiber mediated network synaptic responses in the spinal cord dorsal *** the present presentation,multi-electrode array（Med64 system,Alpha-Med Sciences co.,Ltd.） recordings were made on acute spinal cord slices attached with dorsal root obtained from adult *** stimulation at the lateral entry zone of the dorsal root via bipolar rectangular pulse（30-300 microA,100 microseconds） evoked network synaptic responses of field postsynaptic potentials（fEPSPs） which were mainly confined to the superficial layers of the dorsal *** evoked network fEPSPs were mostly with an initial positive-going fast response followed by a small and slow negative *** conduction velocity（cV） of the signal conveyed from stimulation site to the recording site was about（0.36±0.04） m/s which corresponded to the cV of primary nociceptive *** network responses were intensity-dependent and could be eliminated by perfusion with *** magnesium-low calcium and ***,but not AP5,suggesting involvement of both pre-synaptic transmitter release and postsynaptic activation of glutamate non-NMDA receptors in production of network *** further confirm whether the network synaptic responses are mediated by primary cfibers, multi-electrode array recordings were also made on spinal cord slices obtained from adult rats previously receiving subcutaneous injection of capsaicin（50 mg/kg.b.w.） on postnatal day 2 by which more than 95%of primary afferent cfibers are believed to be destructed with *** the postnatal capsaicin-treated rats,network synaptic responses in superficial layers of the spinal cord dorsal horn were significantly decreased not only in number but also in amplitude of the fEPS

关键词： multi-electrode array spinal cord field postsynaptic potentials(fEPSPs) c-fibers

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