GENERAL CLINICAL RESEARCH CENTER

本研究旨在阐明生物化学和生理效应 与脑室周围、导水管周围灰质刺激相关， 转移性癌症继发的严重、顽固性、慢性疼痛的治疗 而不直接累及中枢神经系统。 一个内源性 阿片系统与脑干中的单胺能通路相互作用， 提出作为基板的这种方式的功效，无论是在实验 本研究的最终长期目标是 评价中脑导水管周围灰质刺激对慢性疼痛、CSF的影响 B-内啡肽、甲硫氨酸和亮氨酸脑啡肽水平的血浆变化 利用我们实验室开发的特定放射免疫测定;可能 内源性阿片类物质与昼夜和24小时睡眠相关节律的关系 分泌;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 睡眠模式本身和可逆性或阻断这些变化， 特异性阿片拮抗剂纳洛酮

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.