GENERAL CLINICAL RESEARCH CENTER

这项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的应用 转移性癌症继发严重、顽固性慢性疼痛的治疗 没有直接的中枢神经系统参与。内生性的隐含 阿片系统与脑干中的单胺能通路相互作用 被认为是这种模式的有效性的底物，在实验中 动物和人类。这项研究的最终长期目标是 评价导水管周围灰质刺激对慢性疼痛的疗效 以及血浆B-内啡肽、蛋氨酸和亮氨酸脑啡肽水平的变化 利用我们实验室开发的特定放射免疫分析方法；可能 内源性阿片类药物与昼夜和24小时睡眠相关节律的相关性 人类生长激素24小时分泌模式的变化， 生长抑素、催乳素、卵泡刺激素、黄体生成素和 ACTH；睡眠模式本身以及这些变化的可逆性或阻滞性 特定的阿片类拮抗剂，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.