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      Neuropathic pain as a process: reversal of chronification in an animal model

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          Abstract

          Peripheral neuropathic pain arises from trauma to sensory nerves. Other types of acute neurotrauma such as stroke and spinal cord injury are treated immediately, largely to prevent secondary damage. To pursue the possibility that neuropathic pain may also be amenable to early treatment, a rat model of neuropathic pain was induced using a 2-mm polyethylene cuff implanted around one sciatic nerve. Within 24 hours, hypersensitivity to von Frey hair stimulation appeared, as indicated by decreased paw withdrawal thresholds. When the cuff was removed 24 hours after implantation, readings returned to pre-implantation levels starting as early as day 18. When the cuff was removed after 4 days, there was a period of initial hypersensitivity, and then an increase toward baseline at two time points near the end of the study; therefore, only a partial recovery toward pre-implantation values occurred. Having established that a temporal reversal can occur, the next step examined possible pharmacological reversal. The tachykinin NK 1 receptor antagonist, CP-96,345, produced a minor increase in withdrawal thresholds in animals with the cuff left permanently implanted. To determine the effect of early and repeated administration of CP-96,345, it was given daily on days 1–4. The cuff was removed on day 4. Six days later, readings showed reversal of tactile hypersensitivity. We suggest that persistent neuropathic pain occurs from processes that develop over several hours and days, and that some of these processes may be prevented by early medical intervention. Thus, nerve injury in the context of chronic neuropathic pain should be treated in a similar manner to nerve injury resulting from stroke, spinal cord injury, and other types of neurotrauma. We suggest that effective medical intervention within the first few hours after nerve injury may spare a patient from a chronic debilitating pain that may be refractory to later therapies.

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          Author and article information

          Journal
          J Pain Res
          Journal of Pain Research
          Dove Medical Press
          1178-7090
          2011
          29 September 2011
          : 4
          : 315-323
          Affiliations
          [1 ]Department of Physiology and Pharmacology, University of Western Ontario, London, ON, Canada
          [2 ]Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
          Author notes
          Correspondence: James L Henry, Health Sciences Centre, McMaster, University, 1200 Main Street West, Hamilton, ON, Canada, L8N 3Z5, Tel +1 905 525 9140 ext 27751, Fax +1 905 522 8844, Email jhenry@ 123456mcmaster.ca
          Article
          jpr-4-315
          10.2147/JPR.S17882
          3191931
          22003305
          © 2011 Dableh et al, publisher and licensee Dove Medical Press Ltd.

          This is an Open Access article which permits unrestricted noncommercial use, provided the original work is properly cited.

          Categories
          Original Research

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