Meperidine Suppresses the Excitability of Spinal Dorsal Horn Neurons

Background: In addition to local anesthetics, meperidine has been successfully used for local anesthesia. When applied intrathecally, the dorsal horn neurons of the superficial laminae are exposed to high concentrations of meperidine. These cells represent an important point for the transmission of pain information. This study investigated the blocking effects of meperidine on different ionic currents of spinal dorsal horn neurons and, in particular, its impact on the generation of action potentials.

Methods: Using a combination of the patch clamp technique and the entire soma isolation method, the action of meperidine on voltage-gated Na+ and K+ currents in spinal dorsal horn neurons of rats was described. Current clamp recordings from intact neurons showed the functional relevance of the ion current blockade for the generation of action potentials.

Results: Externally applied meperidine reversibly blocked voltage-gated Na+ currents with a half-maximum inhibiting concentration (IC50) of 112 [mu]m. During repetitive stimulation, a slight phasic block occurred. In addition, A-type K+ currents and delayed-rectifier K+ currents were affected in a dose-dependent manner, with IC50 values of 102 and 52 [mu]m, respectively. In the current clamp mode, single action potentials were suppressed by meperidine. The firing frequency was lowered to 54% at concentrations (100 [mu]m) insufficient for the suppression of a single action potential.     

初级感觉神经元钾通道与慢性疼痛

外周神经损伤后初级感觉神经元过度兴奋能够引起与疼痛有关的异常激活,同时初级感觉神经元中钾通道的结构与功能发生变化,钾通道在疼痛的病理生理中起了重要的作用。     

Differential Block of Fast and Slow Inactivating Tetrodotoxin-sensitive Sodium Channels by Droperidol in Spinal Dorsal Horn Neurons

Background: Dorsal horn neurons of the spinal cord participate in neuronal pain transmission. During spinal and epidural anesthesia, dorsal horn neurons are exposed to local anesthetics and opioids. Droperidol is usually given with opioids to avoid nausea and vomiting. A recently developed method of "entire soma isolation" has made it possible to study directly the action of droperidol on different components of Na+ current in dorsal horn neurons.

Methods: Using a combination of the whole-cell patch-clamp recording from spinal cord slices and the entire soma isolation method, we studied the direct action of droperidol on two types of Na+ currents in dorsal horn neurons of young rats.

Results: The tetrodotoxin-sensitive Na+ current in isolated somata consisted of a fast inactivating ([tau]F, 0.5-2 ms; 80-90% of the total amplitude) and a slow inactivating ([tau]S, 6-20 ms; 10-20% of the total amplitude) component. Droperidol, at concentrations relevant for spinal and epidural anesthesia, selectively and reversibly suppressed the fast component with a half-maximum inhibiting concentration (IC50) of 8.3 [mu]m. The slow inactivating component was much less sensitive to droperidol; the estimated IC50 value was 809 [mu]m.     

Suppression of Spinal Cord Motoneuron Excitability Correlates with Surgical Immobility during Isoflurane Anesthesia

Background: Recent evidence suggests that the spinal cord is an important site of anesthetic action that produces surgical immobility. Inhalation anesthetics depress the Hoffmann's reflex (H reflex) and F wave, indicating spinal motoneuron suppression. The aim of this study was to assess the correlation between isoflurane-induced immobility and H- and F-wave suppression.

Methods: The baseline H reflex and F wave were measured before anesthesia in 15 adult patients. After induction, 1% end-tidal isoflurane was maintained for 20 min before the H and F waves were reelicited. Using an electric stimulus applied to the forearm and grading the response as movement or no movement, the authors increased or decreased the isoflurane concentration in 0.1% steps, depending on the movement responses. The H and F waves were recorded 20 min after each change of isoflurane concentration. The correlation between H- and F-wave suppression and surgical immobility was analyzed using a paired t test with Bonferroni correction.

Results: H-reflex amplitude (2.74 +/- 1.63 mV) and F-wave persistence (70.69 +/- 26.19%) at the highest isoflurane concentration that allowed movement response to a stimulus are different (P < 0.01) from these (1.97 +/- 1.46 mV; 43.16 +/- 22.91%) at the lowest isoflurane concentration that suppressed response. At 0.8% isoflurane, the H-reflex amplitude was 3.69 +/- 1.83 mV with movement and 1.01 +/- 1.14 mV without movement (P < 0.01); F-wave amplitude was 0.29 +/- 0.15 mV with movement and 0.11 +/- 0.06 mV without movement (P < 0.01); F-wave persistence was 80 +/- 22.36% with movement and 34.9 +/- 25.75% without movement (P < 0.01).     

Local Inflammation in Rat Dorsal Root Ganglion Alters Excitability and Ion Currents in Small-diameter Sensory Neurons

Background: Chronic pain conditions may result from peripheral nerve injury, chronic peripheral inflammation, or sensory ganglia inflammation. However, inflammatory processes may also contribute to peripheral nerve injury responses. To isolate the contribution of local inflammation of sensory ganglia to chronic pain states, the authors previously developed a rat model in which long-lasting pain is induced by inflaming sensory ganglia without injuring the neurons. This results in prolonged mechanical pain, local increases in proinflammatory cytokines, increased neuronal hyperexcitability, and abnormal spontaneous activity.

Methods: The authors used whole cell patch clamp in acutely isolated small-diameter neurons to determine how localized inflammation (3-5 days) of L4 and L5 ganglia altered voltage-gated K+ and Na+ currents.

Results: Tetrodotoxin-sensitive Na+ currents increased twofold to threefold in neurons from inflamed ganglia. Tetrodotoxin-resistant Na+ currents increased more than twofold, but only in cells that bound isolectin B4. These increases occurred without shifts in voltage dependence of activation and inactivation. Similar results are seen in models of peripheral inflammation, except for the large magnitudes. Unlike most pain models, localized inflammation increased rather than decreased voltage-gated K+ currents, due to increased amplitudes of the sustained (delayed rectifier) and fast-inactivating transient components. The overall effect in current clamp experiments was an increase in excitability as indicated by decreased rheobase and lower action potential threshold.     

Isoflurane Reduces Excitability of Drosophila Larval Motoneurons by Activating a Hyperpolarizing Leak Conductance

Background: Mechanisms of anesthetic-mediated presynaptic inhibition are incompletely understood. Isoflurane reduces presynaptic excitability at the larval Drosophila neuromuscular junction, slowing conduction velocity and depressing glutamate release. Mutations in the Para voltage-gated Na+ channel enhance anesthetic sensitivity of adult flies. Here, the author examines the role of para in anesthetic sensitivity and seeks to identify the conductance underlying presynaptic inhibition at this synapse.

Methods: Neuromuscular transmission was studied using a two-electrode voltage clamp, with isoflurane applied in physiologic saline. The relation between ionic conductances and presynaptic function was modeled in the Neuron Simulation Environment. Motoneuron ionic currents were monitored via whole cell recordings.

Results: Presynaptic inhibition by isoflurane was enhanced significantly in para mutants. Computer simulations of presynaptic actions of anesthetics indicated that each candidate target conductance would have diagnostic effects on the relation between latency and amplitude of synaptic currents. The experimental latency-amplitude relation for isoflurane most closely resembled activation of a simulated hyperpolarizing leak. Simulations indicated that increased isoflurane potency in para axons resulted from reduced excitability of mutant axons. In whole cell recordings, isoflurane activated a hyperpolarizing leak current. The effects of isoflurane at the neuromuscular junction were insensitive to low pH.     

褪黑素对大鼠脊髓损伤后神经细胞凋亡的影响

目的 观察褪黑素(melatonin,MT)对大鼠脊髓损伤(spinal cord injury,SCI)后脊髓组织细胞凋亡的影响,探讨其对脊髓损伤的保护作用.方法 成年Wister大鼠66只,随机分为三组Sham组(假手术组)、A组(单纯SCI组)及B组(MT治疗组).Sham组仅切除椎板未损伤脊髓;A、B两组采用改良Allen法制成大鼠SCI模型,术后立即分别腹腔注射等体积无水乙醇、褪黑素(100 mg/kg);Sham组于术后48 h、A和B组于术后8、24、48、72 h和7 d分别进行神经功能评分和测定伤段脊髓组织凋亡细胞数.结果 A组凋亡细胞百分率伤后24 h开始升高,48 h达到高峰,72 h开始下降;B组凋亡细胞百分率伤后24 h、48 h及72 h与A组相比明显减少,差异具有显著性(P＜0.05或P＜0.01);B组神经功能比A组有明显提高(P＜0.05).结论 SCI后应用MT可以抑制脊髓组织神经细胞凋亡,从而对脊髓损伤起保护作用.     

Sensitization of Spinal Neurons by Non-noxious Stimuli in the Awake but Not Anesthetized State

Background: The observation that peripheral trauma causes enhanced spinal neuronal excitability has provided the scientific rationale for the concept of "preemptive analgesia." The premise has been that only noxious stimuli cause sensitization in sensory pathways, but this premise has not been tested in the conscious state.

Methods: Responses of single spinal neurons were recorded in instrumented sheep that were untrained and free from drugs or recent surgery, in either fully conscious or halothane-anesthetized states. Receptive field (RF) size was measured before and after non-noxious mechanical conditioning stimulation.

Results: Noxious conditioning stimuli in anesthetized sheep caused enlargement of RF areas, as expected. Conditioning with nonpainful scratching or other stimuli was without effect in anesthetized animals; in marked contrast, it caused enlargement of RF size in conscious animals, in which 29 of 33 wide dynamic range units but only 1 of 12 low-threshold mechanoreceptive neurons were affected.     

X线照射对脊髓神经元及少突胶质细胞效应的实验研究

目的：通过Ｘ照射新生（生后３天）Ｗｉｓｔａｒ大鼠部分脊髓，研究Ｘ线照射对脊髓神经元及少突胶质细胞的效应。方法：实验动物分为实验组、对照组。实验组分别给予一次２５、３５、４５和５５Ｇｙ的Ｘ线照射剂量，观察照射后动物一般状态及运动功能情况。取生后１３天大鼠的已照射脊髓标本进行组织学评价，用图像分析仪对其定量；用航向电镜观察超微结构的变化。结果：对照组与实验组少突胶质细胞数量间差异，以及各实验组间的差异     

Action of 5-Hydroxytryptamine,Substance P,Thyrotropin Releasing Hormone and Clonidine on Spinal Neuron Excitability

Abstract

We investigated the influence of four substances on the excitability of lumbar motoneurons. These substances, three of which coexist in the same bulbospinal descending pathways that end, for the most part, around motoneurons (MNS), are: 5-hydroxytryptamine (5-HT), substance P (SP) and thyrotropin-releasing hormone (TRH). We also studied the effects of Clonidine, an alpha 2 noradrenergic (NA) agonist. This study was carried out in rats spinalized at T5 and treated three weeks earlier with 5–7 dihydroxytryptamine (5–7 DHT). Under these conditions, the following responses were observed: 5-HTP (5-HT precursor) intraperitoneally (I.P.), 5-HT intrathecally (I.T.), TRH (I.P. or I.T.) and substance P (I.T.) all elicited strong excitation of MNS as measured by integrated EMG of the hindlimb muscles; substance P reduced by almost half the response to 5-HTP given one hour and 24 hours later; TRH given acutely did not modify the response to 5-HTP, but given chronically for 21 days markedly increased the response to this substance. Clonidine by itself decreased the excitability of MNS and antagonized the excitatory effects of 5-HTP and TRH. In two separate pilot trials, cyproheptadine, a 5-HTP antagonist, decreased the manifestations of spasticity in a patient with a partial spinal lesion. It would appear that Clonidine may have potential use in the management of spasticity. (J Spinal Cord Med; 18:42–46)     

Action of Isoflurane on the Substantia Gelatinosa Neurons of the Adult Rat Spinal Cord

Background: Although isoflurane, a volatile anesthetic, can block the motor response to noxious stimulation (immobility and analgesia) and suppress autonomic responsiveness, how it exerts these effects at the neuronal level in the spinal cord is not fully understood.

Methods: The effects of a clinically relevant concentration (1 rat minimum alveolar concentration [MAC]) of isoflurane on electrically evoked and spontaneous excitatory/inhibitory transmission and on the response to exogenous administration of the [gamma]-aminobutyric acid type A receptor agonist muscimol were examined in lamina II neurons of adult rat spinal cord slices using the whole cell patch clamp technique. The effect of isoflurane on the action potential-generating membrane property was also examined.

Results: Bath-applied isoflurane (1.5%, 1 rat MAC) diminished dorsal root-evoked polysynaptic but not monosynaptic excitatory postsynaptic currents. Glutamatergic miniature excitatory postsynaptic currents were also unaffected by isoflurane. In contrast, isoflurane prolonged the decay phase of evoked and miniature [gamma]-aminobutyric acid type A receptor-mediated inhibitory postsynaptic currents and increased the amplitude of the muscimol-induced current. Isoflurane had little effect on action potential discharge activity.     

GDNF对脊髓前角运动神经元的保护作用

目的：证实胶质源性神经营养因子（glial cell line-derived neurotrophic factor,GDNF)对脊髓前角运动神经元有保护作用。方法：切断SD大鼠一侧坐骨神经建立脊髓前角运动神经元损伤模型。借助单盲端硅胶管系统在损伤神经局部给予GDNF，术后不同时间分别取L5脊髓切片，利用酶组织化学染色方法显示胆碱酯酶（CHE）和酸性磷酸酶（ACP）活性并进行图像分析。结果：坐骨神经切断可导致腰段脊髓前角运动神经元明显损害，表现为CHE活性降低。ACP活性升高；应用GDNF可显著改善上述酶学变化。结论：GDNF对损伤的脊髓前角运动神经元有保护作用。     

Quantitative Assessment of Differential Sensory Nerve Block after Lidocaine Spinal Anesthesia

Background: Recent technology allows for quantitative and selective measurement of A beta, A delta, and C fiber nerve transmission. To gain further insight into the physiology of differential block after lidocaine spinal anesthesia, the function of these different fibers was quantitatively measured over time, and these measurements were correlated with regression of anesthesia to pinprick, touch, cold, and tolerance of tetanic electrical current (equivalent to surgical incision).

Methods: Six volunteers received lidocaine spinal anesthesia with 50 mg lidocaine (5% in dextrose). Cutaneous current perception thresholds at 2,000, 250, and 5 Hz, which stimulate A beta, A delta, and C fibers, respectively, were determined at L2-L3 (medial aspect above knee) before and every 10 min after spinal anesthesia. Dermatomal levels to pinprick, touch, and cold were assessed every 5 min after spinal anesthesia. Tolerance to tetanic electrical stimulus was assessed at L2-L3 every 10 min after spinal anesthesia.

Results: Differential block was demonstrated by the sequential return of sensation to touch, pinprick, and cold at L2-L3. Recovery of function of A beta, A delta, and C fibers correlated with return of sensation to touch (R2 = 0.7, p = 0.03), pinprick (R2 = 0.75, p = 0.02), and cold (R2 = 0.67, p = 0.04) respectively. Loss of tolerance of surgical anesthesia corresponded to return of A beta current perception thresholds to baseline, whereas current perception thresholds for A delta and C fibers were still increased to greater than baseline (p = 0.025).     

Role of the Spinal Monoaminergic Systems in Suppression of Ejaculation by α-Methyldopa

Alpha-methyldopa causes inhibition of ejaculation by suppressing the dopaminergic system in the brain. The spinal mechanism which works together with this brain inhibitory mechanism was persued by determining the changes of spinal monoamines in dogs. As a result, it was found that suppression of the dopaminergic system by alpha-methyldopa is caused also in the spinal cord just as in the brain and that this suppression can be a direct origin of the inhibition of ejaculation.     

Loss of T-type Calcium Current in Sensory Neurons of Rats with Neuropathic Pain

Background: Pathophysiology in the primary sensory neuron may contribute to chronic neuropathic pain. Ca channels play a central role in neuronal processes, and sensory neurons are rich in low-voltage-activated calcium channels (LVACCs). However, the physiologic function of these channels is unknown. Their possible role in rebound burst firing makes them a candidate for increased excitability after neuropathic injury.

Methods: This study uses pharmacological methods to isolate LVACC in cells from the dorsal root ganglia of neuropathic and sham-operated rats, including the blockade of high-voltage-activated Ca channels with fluoride and selective toxins. LVACCs were examined with conventional whole cell patch clamp electrophysiology techniques.

Results: After chronic constriction injury of the peripheral axon, LVACC was significantly reduced compared to sham rats as shown by a 60% reduction in peak current density and an 80% reduction in total calcium influx. A depolarizing shift in the voltage dependence of activation and an increase in the rate of deactivation and inactivation appear to cause this reduction of LVACC. Either Ni2+ or mibefradil, blockers of LVACC, applied in the bath to normal dorsal root ganglion cells during current clamp significantly and reversibly increased excitability.     

Painful Nerve Injury Decreases Resting Cytosolic Calcium Concentrations in Sensory Neurons of Rats

Background: Neuropathic pain is difficult to treat and poorly understood at the cellular level. Although cytoplasmic calcium ([Ca2+]c) critically regulates neuronal function, the effects of peripheral nerve injury on resting sensory neuronal [Ca2+]c are unknown.

Methods: Resting [Ca2+]c was determined by microfluorometry in Fura-2 AM-loaded neurons dissociated from dorsal root ganglia of animals with hyperalgesia to mechanical stimulation after spinal nerve ligation and section (SNL) at the fifth and sixth lumbar (L5 and L6) levels and from animals after skin incision alone (control group). Axotomized neurons from the L5 dorsal root ganglia were examined separately from adjacent L4 neurons that share the sciatic nerve with degenerating L5 fibers.

Results: After SNL, large (34 [mu]m or larger) neurons from the L4 ganglion showed a 29% decrease in resting [Ca2+]c, whereas those from the L5 ganglion showed a 54% decrease. Small neurons only showed an effect of injury in the axotomized L5 neurons, in which resting [Ca2+]c decreased by 30%. A decrease in resting [Ca2+]c was not seen in neurons isolated from rats in which hyperalgesia did not develop after SNL. In separate experiments, SNL reduced resting [Ca2+]c in capsaicin-insensitive neurons of the L5 ganglion by 60%, but there was no change in neurons from L4. Resting [Ca2+]c of capsaicin-sensitive neurons was not affected by injury in either ganglion. SNL injury decreased the proportion of neurons sensitive to capsaicin in the L5 group but increased the proportion in the L4 group.     

损伤区上下神经根吻合对大鼠损伤脊髓神经元的影响

目的：探讨损伤区上下神经根吻合对防止成鼠脊髓轴突损伤后引起神经元萎缩和凋亡的作用。方法：采用改良的Ａｌｌｅｎ‘ｓ打击法致伤大鼠脊髓,将实验动物分为单损伤组（Ａ组）,损伤＋上下神经根吻合组（Ｂ组）。手术后应用这和电生理检查,观察大鼠功能恢复情况;应用尼氏染色方法观察神经元的大小,采用计算机图像分析技术,进行定量分析。结果：损伤区上下神经根吻合,可以防止成鼠脊髓轴突损伤后引起的神经元萎缩,图像分析发现     

Actions of Midazolam on Excitatory Transmission in Dorsal Horn Neurons of Adult Rat Spinal Cord

Background: Although intrathecal administration of midazolam, a water-soluble imidazobenzodiazepine derivative, has been found to produce analgesia, how it exerts this effect at the neuronal level in the spinal cord is not fully understood.

Methods: The effects of midazolam on electrically evoked and spontaneous excitatory transmission were examined in lamina II neurons of adult rat spinal cord slices using the whole cell patch clamp technique.

Results: Bath-applied midazolam (1 [mu]m) diminished A[delta]- and C-fiber evoked polysynaptic excitatory postsynaptic currents in both amplitude and integrated area. However, it affected neither A[delta]- and C-fiber evoked monosynaptic excitatory postsynaptic currents in amplitude nor miniature excitatory postsynaptic currents in amplitude, frequency, and decay time constant. In the presence of a benzodiazepine receptor antagonist, flumazenil (5 [mu]m), midazolam (1 [mu]m) did not diminish A[delta]-fiber evoked polysynaptic excitatory postsynaptic currents, suggesting that midazolam modulate the [gamma]-aminobutyric acid interneurons in the dorsal horn.