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PloS One 2022This study aimed to identify potential lateralization of bladder function. Electrical stimulation of spinal roots or the pelvic nerve's anterior vesical branch was...
This study aimed to identify potential lateralization of bladder function. Electrical stimulation of spinal roots or the pelvic nerve's anterior vesical branch was performed bilaterally in female dogs. The percent difference between the left and right stimulation-induced increased detrusor pressure was determined. Bladders were considered left or right-sided if differences were greater or less than 25% or 10%. Based on differences of 25%, upon stimulation of spinal roots, bladders were left-sided in 17/44 (38.6%), right-sided in 12/44 (27.2%) and bilateral in 15/44 (34.2%). Using ± 10%, 48% had left side dominance (n = 21/44), 39% had right side dominance (n = 17/44), and 14% were bilateral (n = 6/44). With stimulation of the pelvic nerve's anterior vesical branch in 19 dogs, bladders were left-sided in 8 (42.1%), right-sided in 6 (31.6%) and bilateral in 5 (26.3%) using 25% differences and left side dominance in 8 (43%), right sided in 7 (37%) and bilateral in 4 (21%) using 10% differences. These data suggest lateralization of innervation of the female dog bladder with left- and right-sided lateralization occurring at similar rates. Lateralization often varied at different spinal cord levels within the same animal.
Topics: Animals; Dogs; Electric Stimulation; Female; Spinal Nerve Roots; Spinal Nerves; Urinary Bladder; Urinary Tract Physiological Phenomena
PubMed: 35231045
DOI: 10.1371/journal.pone.0264382 -
Neurotherapeutics : the Journal of the... Apr 2018As reliable biomarkers of disease activity are lacking, monitoring of therapeutic response in chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) remains a...
As reliable biomarkers of disease activity are lacking, monitoring of therapeutic response in chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) remains a challenge. We sought to determine whether nerve ultrasound and electrophysiology scoring could close this gap. In CIDP patients (fulfilling EFNS/PNS criteria), we performed high-resolution nerve ultrasound to determine ultrasound pattern sum scores (UPSS) and predominant echotexture nerve conduction study scores (NCSS) as well as Medical Research Council sum scores (MRCSS) and inflammatory neuropathy cause and treatment disability scores (INCAT) at baseline and after 12 months of standard treatment. We retrospectively correlated ultrasound morphology with nerve histology when available. 72/80 CIDP patients featured multifocal nerve enlargement, and 35/80 were therapy-naïve. At baseline, clinical scores correlated with NCSS (r = 0.397 and r = 0.443, p < 0.01), but not or hardly with UPSS (Medical Research Council sum scores MRCSS r = 0.013, p = 0.332; inflammatory neuropathy cause and treatment disability scores INCAT r = 0.053, p = 0.048). Longitudinal changes in clinical scores, however, correlated significantly with changes in both UPSS and NCSS (r = 0.272-0.414, p < 0.0001). Combining nerve/fascicle size with echointensity and histology at baseline, we noted 3 distinct classes: 1) hypoechoic enlargement, reflecting active inflammation and onion bulbs; 2) nerve enlargement with additional hyperechogenic fascicles/perifascicular tissue in > 50% of measured segments, possibly reflecting axonal degeneration; and 3) almost no enlargement, reflecting "burned-out" or "cured" disease without active inflammation. Clinical improvement after 12 months was best in patients with pattern 1 (up to 75% vs up to 43% in pattern 2/3, Fisher's exact test p < 0.05). Nerve ultrasound has additional value not only for diagnosis, but also for classification of disease state and may predict treatment response.
Topics: Aged; Biomarkers; Female; Follow-Up Studies; Humans; Male; Middle Aged; Neural Conduction; Polyradiculoneuropathy, Chronic Inflammatory Demyelinating; Prospective Studies; Spinal Nerves; Treatment Outcome; Ultrasonography
PubMed: 29435815
DOI: 10.1007/s13311-018-0609-4 -
Current Pain and Headache Reports Sep 2014Cervicogenic headache (CGH) is defined as referred pain from various cervical structures innervated by the upper three cervical spinal nerves. Such structures are... (Review)
Review
Cervicogenic headache (CGH) is defined as referred pain from various cervical structures innervated by the upper three cervical spinal nerves. Such structures are potential pain generators, and include the atlanto-occipital joint, atlantoaxial joint, C2-3 zygapophysial joint, C2-3 intervertebral disc, cervical myofascial trigger points, as well as the cervical spinal nerves. Various interventional techniques, including cervical epidural steroid injection (CESI), have been proposed to treat this disorder. And while steroids administered by cervical epidural injection have been used in clinical practice to provide anti-inflammatory and analgesic effects that may alleviate pain in patients with CGH, the use of CESI in the diagnosis and treatment of CGH remains controversial. This article describes the neuroanatomy, neurophysiology, and classification of CGH as well as a review of the available literature describing CESI as treatment for this debilitating condition.
Topics: Anesthetics, Local; Cervical Vertebrae; Diagnosis, Differential; Humans; Injections, Epidural; Neck Injuries; Nerve Block; Pain Measurement; Patient Selection; Post-Traumatic Headache; Quality of Life; Spinal Nerves; Steroids; Treatment Outcome
PubMed: 25091129
DOI: 10.1007/s11916-014-0442-3 -
Asian Journal of Surgery Dec 2022Neuropathic pain can cause significant physical and economic burden, and there are no effective long-term treatments. We conducted a bioinformatics analysis to identify...
BACKGROUND
Neuropathic pain can cause significant physical and economic burden, and there are no effective long-term treatments. We conducted a bioinformatics analysis to identify mechanisms to determine strategies for more effective treatments of neuropathic pain.
METHOD
GSE24982 and GSE63442 microarray datasets were extracted from the Gene Expression Omnibus database to analyze transcriptome differences of neuropathic pain in the dorsal root ganglions (DRGs). We filtered the differentially expressed genes (DEGs) in the two datasets and conducted Gene Ontology (GO) functional analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis of the shared DEGs. The Protein-Protein Interaction network was used to determine the hub genes, which were verified in the GSE30691 dataset. miRDB and miRWalk Databases were used to predict potential miRNA of the selected DEGs. We made the spinal nerve ligation (SNL) rat model and qPCR was used to verify the differential expression of hub genes.
RESULTS
A total of 182 overlapped DEGs were found between GSE24982 and GSE63442 datasets. The GO and KEGG analysis showed that the selected DEGs were enriched in infection, transmembrane transport of ion channels, and synaptic transmission. We identified seven hub genes (Atf3, Aif1, Ctss, Gfap, Scg2, Jun, and Vgf). qPCR verified the expression differences of the hub genes in the DRGs after SNL model. Predicted miRNA targeting each selected hub genes were identified.
CONCLUSIONS
Seven hub genes related to the pathogenesis of neuropathic pain and potential targeting miRNA were identified, expanding understanding of the mechanism of neuropathic pain and facilitating treatment development.
Topics: Rats; Animals; Gene Expression Profiling; MicroRNAs; Neuralgia; Spinal Nerves; Gene Expression
PubMed: 35184964
DOI: 10.1016/j.asjsur.2021.12.021 -
British Journal of Anaesthesia Aug 1998
Review
Topics: Analgesia; Anesthetics, Local; Contraindications; Humans; Nerve Block; Spinal Nerves
PubMed: 9813528
DOI: 10.1093/bja/81.2.230 -
International Journal of Molecular... May 2020Activation of CX3CR1 in microglia plays an important role in the development of neuropathic pain. Here, we investigated whether neuropathic pain could be attenuated in...
Activation of CX3CR1 in microglia plays an important role in the development of neuropathic pain. Here, we investigated whether neuropathic pain could be attenuated in spinal nerve ligation (SNL)-induced rats by reducing microglial activation through the use of poly(D,L-lactic-co-glycolic acid) (PLGA)-encapsulated CX3CR1 small-interfering RNA (siRNA) nanoparticles. After confirming the efficacy and specificity of CX3CR1 siRNA, as evidenced by its anti-inflammatory effects in lipopolysaccharide-stimulated BV2 cells in vitro, PLGA-encapsulated CX3CR1 siRNA nanoparticles were synthesized by sonication using the conventional double emulsion (W/O/W) method and administered intrathecally into SNL rats. CX3CR1 siRNA-treated rats exhibited significant reductions in the activation of microglia in the spinal dorsal horn and a downregulation of proinflammatory mediators, as well as a significant attenuation of mechanical allodynia. These data indicate that the PLGA-encapsulated CX3CR1 siRNA nanoparticles effectively reduce neuropathic pain in SNL-induced rats by reducing microglial activity and the expression of proinflammatory mediators. Therefore, we believe that PLGA-encapsulated CX3CR1 siRNA nanoparticles represent a valuable new treatment option for neuropathic pain.
Topics: Animals; Behavior, Animal; CX3C Chemokine Receptor 1; Humans; Ligation; Lipopolysaccharides; Macrophage Activation; Microglia; Nanoparticles; Neuralgia; Pain Management; Pain Measurement; Polylactic Acid-Polyglycolic Acid Copolymer; RNA, Small Interfering; Rats; Spinal Cord; Spinal Cord Dorsal Horn; Spinal Nerves
PubMed: 32423102
DOI: 10.3390/ijms21103469 -
ENeuro 2017Peripheral nerves can regenerate and, when injured, may cause neuropathic pain. We propose that the active regeneration process plays a pivotal role in the maintenance...
Peripheral nerves can regenerate and, when injured, may cause neuropathic pain. We propose that the active regeneration process plays a pivotal role in the maintenance of neuropathic pain. In one commonly used rodent neuropathic pain model, pronounced pain behaviors follow ligation and cutting of the L5 spinal nerve. We found that the injured nerve regenerates into the sciatic nerve and functionally reinnervates target tissues: the regenerated nerve conducts electrical signals, mechanical responses, and tracers between the leg/hindpaw and axotomized sensory ganglion. The regenerating nerve is the primary source of abnormal spontaneous activity detected . Disrupting the regeneration inhibited pain. First, semaphorin 3A, an inhibitory axonal guidance molecule, reduced functional regeneration, spontaneous activity, and pain behaviors when applied to the injury site . Second, knockdown of the upregulated growth-associated protein 43 (GAP43) with siRNA injected into the axotomized sensory ganglion reduced pain behaviors. We next examined the spared nerve injury model, in which pain behaviors are essentially permanent. The regeneration resulted in tangled GAP43-positive neuromas at the nerve injury site without target reinnervation. Perfusing the nerve stump with semaphorin 3A, but not removing the tangled fibers, prevented or reversed pain behaviors. This effect far outlasted the semaphorin 3A perfusion. Hence, in this model the long-lasting chronic pain may reflect the anatomical inability of regenerating nerves to successfully reinnervate target tissues, resulting in an ongoing futile regeneration process. We propose that specifically targeting the regeneration process may provide effective long-lasting pain relief in patients when functional reinnervation becomes impossible.
Topics: Action Potentials; Animals; Chronic Pain; Disease Models, Animal; Female; GAP-43 Protein; Ganglia, Spinal; Male; Nerve Regeneration; Neuralgia; Random Allocation; Rats, Sprague-Dawley; Semaphorin-3A; Spinal Nerves
PubMed: 28197545
DOI: 10.1523/ENEURO.0008-17.2017 -
Clinical Gastroenterology and... Oct 2023
Topics: Humans; Gastroparesis; Spinal Nerves; Gastric Emptying; Diabetes Mellitus
PubMed: 36152902
DOI: 10.1016/j.cgh.2022.09.012 -
Orthopaedic Surgery Feb 2009To evaluate the clinical results of, and surgical techniques for, microendoscopic (METRx) decompression of extraforaminal entrapment of the L5 spinal nerve at the... (Comparative Study)
Comparative Study
OBJECTIVE
To evaluate the clinical results of, and surgical techniques for, microendoscopic (METRx) decompression of extraforaminal entrapment of the L5 spinal nerve at the lumbosacral tunnel.
METHODS
Five patients with extraforaminal entrapment of the L5 spinal nerve in the lumbosacral tunnel were treated in our department, including three men and two women. The average age was 65.6 years. All patients suffered severe leg pain and neurological deficits compatible with L5 radiculopathy. Minimally invasive decompression of the L5 spinal nerve was performed under METRx intertransverse decompression.
RESULTS
With an average follow-up of 17.8 months, clinical results were assessed based on Nakai criteria and Visual Analogue scale (VAS). All patients experienced immediate pain relief postoperatively. Clinical outcomes were excellent in three patients and good in two. The average intraoperative blood loss was 59 ml, with an average operative time of 103 min. Average post-operative stay in bed was 7 days, and average cost was $1860.
CONCLUSION
Extraforaminal entrapment of the L5 spinal nerve in the lumbosacral tunnel can cause L5 radiculopathy. METRx partial resection of the L5 transverse processes, sacral ala and osteophytes of L5-S1 vertebral bodies to relieve extraforaminal entrapment of the L5 spinal nerve is a very effective and minimally invasive surgical option.
Topics: Aged; Decompression, Surgical; Female; Follow-Up Studies; Humans; Lumbar Vertebrae; Male; Middle Aged; Nerve Compression Syndromes; Pain Measurement; Retrospective Studies; Spinal Nerves; Spinal Stenosis; Treatment Outcome
PubMed: 22009785
DOI: 10.1111/j.2757-7861.2008.00013.x -
Drug Research Jan 2023Gabapentinoids are specific ligands for the αδ-1 subunit of voltage-gated calcium channels. This class of drugs, including gabapentin and pregabalin, exert various...
The Novel Gabapentinoid Mirogabalin Prevents Upregulation of α2δ-1 Subunit of Voltage-Gated Calcium Channels in Spinal Dorsal Horn in a Rat Model of Spinal Nerve Ligation.
Gabapentinoids are specific ligands for the αδ-1 subunit of voltage-gated calcium channels. This class of drugs, including gabapentin and pregabalin, exert various pharmacological effects and are widely used for the treatment of epilepsy, anxiety, and chronic pain. The mechanism of action of gabapentinoids involves both direct modulation of calcium channel kinetics and inhibition of channel trafficking and expression, which contribute to the above pharmacological effects. In the present study, we investigated the effects of mirogabalin, a novel potent gabapentinoid, on expression levels of the αδ-1 subunit in the spinal dorsal horn in a rat model of spinal nerve ligation (SNL) as an experimental animal model for peripheral neuropathic pain. The neuropathic pain state was induced by SNL in male Sprague - Dawley rats. After the development of mechanical hypersensitivity, the animals received 10 mg/kg mirogabalin or vehicle orally for 5 consecutive days and were subjected to immunohistochemical analysis of αδ-1 subunit expression in the spinal cord. In the SNL model rats, expression of the αδ-1 subunit significantly increased in the spinal dorsal horn at the ipsilateral side of nerve injury, while mirogabalin inhibited this increase. In conclusion, the αδ-1 subunit was upregulated in the spinal dorsal horn of SNL model rats, and repeated administration of mirogabalin inhibited this upregulation. The inhibitory effect of mirogabalin on upregulation of the αδ-1 subunit after nerve injury is considered to contribute to its analgesic effects in peripheral neuropathic pain.
Topics: Rats; Male; Animals; Up-Regulation; Calcium Channels, L-Type; Rats, Sprague-Dawley; Neuralgia; Spinal Nerves; Spinal Cord Dorsal Horn
PubMed: 36216339
DOI: 10.1055/a-1941-8907