痛觉超敏疼痛矩阵失衡及其针刺镇痛的再平衡机制研究

项目名称： 痛觉超敏疼痛矩阵失衡及其针刺镇痛的再平衡机制研究

项目编号： No.81473769

项目类型： 面上项目

立项/批准年度： 2015

项目学科： 医药、卫生

项目作者： 吴文

作者单位： 南方医科大学

项目金额： 66万元

中文摘要： 痛觉超敏是神经性疼痛的主要特征，针刺是治疗痛觉超敏的重要手段。然而，痛觉超敏及其针刺镇痛的脑机制尚不完全清楚。前期伤害性疼痛fMRI研究表明疼痛刺激同时激活了感觉、情绪及认知等脑区组成的神经网络- - -疼痛矩阵,伤害刺激与疼痛矩阵维持平衡，针刺镇痛引起疼痛矩阵发生变化。但是，因伤害性疼痛与神经性疼痛具有不同病理基础及临床表现，后者对非伤害刺激有痛觉超敏特征，两者应有不同的发生机制及脑加工模式。由此，我们提出痛觉超敏是由于疼痛矩阵失衡所致，针刺通过神经调节引起疼痛矩阵再平衡实现镇痛。本项目拟以触压诱发神经性疼痛痛觉超敏，以rfMRI、ERP及DTI为研究手段，动态观察痛觉超敏及针刺对疼痛矩阵脑加工部位、脑区激活顺序及连接性的影响特征，以揭示痛觉超敏疼痛矩阵失衡及其针刺镇痛的再平衡机制。为研究痛觉超敏及其针刺镇痛机制提供新的思路和切入点，为针灸在神经性疼痛镇痛领域的应用提供新的理论依据。

中文关键词： 痛觉超敏；针刺镇痛；疼痛矩阵；静息态功能性磁共振；事件相关电位

英文摘要： Allodynia is an essential characteristic of neuropathic pain and acupuncture treatment is an important means of allodynia. However, brain mechanisms of allodynia and acupuncture analgesia remain unclear. Previous brain imaging studies of nociceptive pain indicate that pain activates the pain matrix which is composed of sensory, cognitive and affective brain regions. The nociceptive stimulation and pain matrix should maintain in balance, and stimulation of acupuncture in acupoints may result in change of the activated brain regions. However, due to differing pathological basis and clinical manifestations between nociceptive pain and neuropathic pain, the latter being allodynia for non-nociceptive stimuli, they may have different mechanisms and brain processing modes. Thus, we put forward the brain mechanism of pain hypersensitivity is pain matrix loss of balance, as well as the effectiveness of acupuncture to rebalance the pain matrix to achieve analgesia through neuromodulation. The purpose of this study is to obtain the characteristics of allodynia and acupuncture intervention on the pain processing regions, activated volume, the order, and their functional relations and anatomical connections in the pain matrix network. In addition, this study will reveal the mechanisms of unbalance in the pain matrix and the mechanisms of rebalance through acupuncture analgesia using ERP, fMRI and DTI for patients with allodynia of neuropathic pain induced by touch. This study seeks to provide a new way of thinking and advancement in exploring the brain mechanisms of allodynia and acupuncture analgesia. Its purpose is to provide a new theoretical basis in the application of analgesia to treat neuropathic pain with acupuncture.

英文关键词： allodynia;Acupuncture analgesia;pain matrix;resting-state fMRI(rfMRI);event related potential(ERP)