Effect of levodopa on pain threshold in Parkinson's disease: A clinical and positron emission tomography study
Effect of levodopa on pain threshold in Parkinson's disease: A clinical and positron emission tomography study
复制标题
DOI：
10.1002/mds.20629
复制
发表时间：
2005-12-01
影响因子：
8.6
通讯作者：
Rascol, O
中科院分区：
文献类型：
--
作者：
Brefel-Courbon, C;Payoux, P;Rascol, O
帕金森氏症（PD）患者经常经历痛苦的感觉，部分原因可能是中枢伤害感觉的改变。我们比较了PD患者和对照组左旋多巴给药前后的痛觉阈值，并利用正电子发射断层扫描（PET）研究了实验性伤害刺激时的大脑活动。在两种随机条件下：关闭和打开时，使用热刺激来确定痛阈。当受试者在关闭和打开的情况下接受随机的有害和无害刺激时，我们对他们进行了H-2 -15 PET区域脑血流分析。在关闭状态下，9例PD患者的疼痛阈值明显低于9例对照组。左旋多巴显著提高PD患者的疼痛阈值，而对照组没有。在关闭状态下，PD大鼠脑岛、前额叶和左前扣带皮层的疼痛诱导激活明显增加。左旋多巴显著降低PD患者这些区域的疼痛诱导激活。本研究表明，PD患者的痛阈值较低，但左旋多巴给药后恢复正常范围。此外，PD患者在痛觉通路中具有较高的疼痛诱导激活，而左旋多巴可以降低这种激活。(c) 2005年运动障碍协会。
Patients suffering from Parkinson's disease (PD) frequently experienced painful sensations that could be in part due to central modification of nociception. We compared pain threshold before and after administration of levodopa in PD patients and in controls, and investigated cerebral activity with positron emission tomography (PET) during experimental nociceptive stimulation. Pain threshold was determined using thermal stimulation during two randomized conditions: off and on. We performed H-2 O-15 PET analysis of regional cerebral blood flow on subjects while they received alternate randomized noxious and innocuous stimuli during off and on conditions. In off condition, pain threshold in nine PD patients was significantly lower than in nine controls. Administration of levodopa significantly raised pain threshold in PD patients but not in controls. During off condition, there was a significant increase in pain-induced activation in fight insula and prefrontal and left anterior cingulate cortices in PD compared to control group. Levodopa significantly reduced pain-induced activation in these areas in PD. This study shows that pain threshold is lower in PD patients but returns to normal ranges after levodopa administration. Moreover, PD patients have higher pain-induced activation in nociceptive pathways, which can be reduced by levodopa. (c) 2005 Movement Disorder Society.