Clinical psychologic analysis for the pain in patients suffering from pulpal pathosis and responsiveness changes in the tooth pulp-driven neurons in the central nervous system

牙髓病患者疼痛及中枢神经系统牙髓驱动神经元反应性变化的临床心理分析

• 批准号: 12470403
• 负责人: SUNAKAWA Mitsuhiro
• 金额: $ 9.15万
• 依托单位: Tokyo Medical and Dental University
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (B)
• 财政年份: 2000
• 资助国家: 日本
• 起止时间: 2000 至 2001
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/en/grant/KAKENHI-PROJECT-12470403/
• 关键词: pulpitis; apical periodontitis; Japanese McGill Pain questionnaire; Visual Analog Scale; mustard oil; trigeminal spinal cord nuclues subnucleus caudalis; brain stem reticular formation; ventral posteromedial thalamic nucleus; 視床後内側腹側核; マギル質問表; 三

This study was aimed to elucidate the physiological mechanisms of pain observed in the patients with dental pulp pathosis. We have tried to perform the combined study of the clinical psychological analysis for the pain in patients suffering from pulpal pathosis and the basic neurophysiological investigation for the responsiveness changes in tooth pulp-driven neurons.Using the Japanese McGill Pain Questionnaire, the pain description terms were examined in patients suffering from the broad pulpal pathosis. The pain intensity was detected by the visual analog scale (VAS) method. It was difficult to generalize the pain terms specific with pulpitis because of the absence of the cases. It was demonstrated that there were some differences describing the pain caused by the acute and the chronic conditions. Especially, the patients with acute inflammation frequently selected the terms in affective subclass and evaluative subclass. There was no significant differences of the VAS values between i … More n the acute phase patients and in the chronic, eventhough the mean VAS value of the former was larger than the one of the latter.The neurophysiologic investigation for responsiveness changes in the tooth pulp-driven neurons in the central nervous system (CNS) revealed that different types of central sensitization were elicited in neurons in the trigeminal spinal cord nucleus (subnucleus caudalis ), brain stem reticular formation, or ventral posteromedial thalamic nucleus. These nuclei contain relay neurons which transfer the trigeminal information including the pulp one projecting to the higher brain area, and have close relations in processing the sensory-descriminative aspects of pain and the emotional-affective aspects. These neurons would modify their responsiveness with the ascending oan/or descending control system in the brain. These results suggest that the central sensitization phenomena or some neuroplastic changes have occurred in the CNS in patients suffering from severe pain of tooth origin. Less

本研究旨在阐明牙髓病患者疼痛的生理机制。本研究尝试将牙髓病患者疼痛的临床心理学分析与牙髓驱动神经元反应性变化的神经生理学基础研究相结合，采用日本麦吉尔疼痛问卷，对广泛性牙髓病患者的疼痛描述词进行了研究。采用视觉模拟评分法（VAS）测定疼痛强度。由于缺乏病例，很难概括牙髓炎的疼痛术语。结果表明，急性和慢性疾病引起的疼痛有一些差异。尤其是急性炎症患者，情感亚类和评价亚类术语的选择频率较高。两组VAS值无显著性差异， ...更多信息 急性期患者和慢性期患者的VAS平均值均大于慢性期患者。对中枢神经系统（CNS）牙髓驱动神经元反应性变化的神经生理学研究表明，三叉神经脊髓核内的神经元可引起不同类型的中枢敏化（尾侧亚核）、脑干网状结构或丘脑腹后内侧核。这些核团中含有传递三叉神经信息的中继神经元，这些中继神经元在疼痛的感觉描述方面和情绪情感方面的加工中有着密切的联系。这些神经元会改变它们对大脑中上行和/或下行控制系统的反应。这些结果表明，在严重的牙齿疼痛患者的中枢神经系统中发生了中枢敏化现象或某些神经可塑性改变。少

项目成果

Sunakawa, M. et al: "Responsiveness changes in VPM tooth pulp-driven neurons"J. Dent. Res.. 81(S)(in press).

Sunakawa, M. 等人：“VPM 牙髓驱动神经元的反应性变化”J.

深山治久: "表面麻酔薬の効果をあげる試み"日本歯科医学会雑誌. 20. 80-85 (2001)

Haruhisa Miyama：“增加表面麻醉剂效果的尝试”日本牙科协会杂志 20. 80-85 (2001)。

Araki, K. et al.: "A fact-finding of incurable endodontic cases and analysis of their inducers"Jap. J. Conserv. Dent.. 43(Autumn). 124 (2000)

Araki, K. 等：“无法治愈的牙髓病病例的事实调查及其诱发因素的分析”Jap。

Sunakawa, M. et al: "Responsiveness changes in Vc and RF tooth pulp-driven neurons"J. Dent. Res.. 80(S). 773 (2001)

Sunakawa, M. 等人：“Vc 和 RF 牙髓驱动神经元的反应性变化”J.

Sunakawa et al.: "Pulsed Nd : YAG laser irradiation of the tooth pulp. II. Effect of scanning lasing."Lasers Surg Med. 26(5). 477-484 (2000)

Sunakawa 等人：“脉冲 Nd：YAG 激光照射牙髓。II.扫描激光的效果。”Lasers Surg Med。