Establishment of a therapeutic strategy based on axonal ionic pathophysiology in patients with neuropathic pain

我们用计算机阈值跟踪系统研究了神经病理性疼痛患者使用钠通道阻滞剂美西律（mexilectin）前后感觉轴突上的持续性钠电流的变化。美西律显著抑制了与Na^+电流减少相关的疼痛程度。此外，我们还建立了选择性刺激Aδ和C纤维的表皮内针电极记录痛相关诱发电位的方法。评价外周离子机制和研究中枢神经病理生理基础的结合将有助于建立一个有效的治疗策略，在未来的神经病理性疼痛患者。

We investigated changes in nodal persistent Na^+currents in sensory axons of patients with neuropathic pain before and after mexiletine(Na^+channel blocker) administration, using computerized threshold tracking system. Mexiletine substantially suppressed the degree of pain associated with decreased Na^+currents. In addition, we established a recording of pain-related evoked potentials using intra-epidermal needle electrode which can selectively stimulate Aδand C fiber. The combination of evaluating peripheral ionic mechanism and studying central pathophysiology underlying neurpathic pain patients would contribute to establishment of an efficient therapeutic strategy in the future.