GENERAL CLINICAL RESEARCH CENTER

本研究旨在阐明生物化学和生理 与脑室周围、导水管周围灰质刺激相关的效应 用于治疗严重的，顽固性的，慢性疼痛继发于 转移性癌症，不直接累及中枢神经系统。 内源性阿片系统与单胺能神经元相互作用的意义 已经提出脑干中的通路作为 在实验动物和人类中，这种方式的有效性。 本研究的最终长期目标是评估 中脑导水管周围灰质刺激对慢性疼痛、CSF和血浆变化的影响 B-内啡肽、蛋氨酸脑啡肽和亮氨酸脑啡肽的水平 放射免疫分析在我们的实验室开发;可能的关联， 内源性阿片分泌的昼夜节律和24小时睡眠节律; 人生长激素24小时分泌模式的变化， 生长抑素、催乳素、促卵泡激素、促黄体激素 和促肾上腺皮质激素;睡眠模式本身和可逆性或封锁这些 特异性阿片拮抗剂纳洛酮的变化。

This study is directed at elucidating the biochemical and physiologic effects associated with peri-ventricular, peri-aqueductal gray stimulation utilized in the therapy of severe, intractable, chronic pain secondary to metastatic cancer without direct central nervous system involvement. Implication of an endogenous opiate system interacting with monoaminergic pathways in the brain stem has been proposed as the substrate for the efficacy of this modality both in experimental animals and in man. The ultimate long range objectives of this study are to evaluate the effect of peri-aqueductal gray stimulation upon chronic pain, CSF and plasma change in levels of B-endorphin, and Met- and Leu-enkephalin utilizing specific radioimmunoassays developed in our laboratory; possible association in diurnal and 24 hour sleep related rhythms in endogenous opiate secretion; changes in 24 hour secretory patterns of human growth hormone, somatostatin, prolactin, follicle stimulating hormone, luteinizing hormone and ACTH; sleep patterns per se and reversibility or blockade of these changes by the specific opiate antagonist, naloxone.