Showing posts with label Deep. Show all posts
Showing posts with label Deep. Show all posts

Monday, August 21, 2017

New Drugs To Be Targeted At Pain Receptors Deep In The Nerve Cell


Today's post from sciencedaily.com (see link below) may at first sight seem a little difficult to understand but basically, when the body experiences pain, there are pain receptors on the surface of nerve cells that identify it and transmit the information further and let you feel that pain. If the pain is extreme, sometimes these pain receptors retreat to the nucleus of the cell, as if it's 'safer' there. Pain relieving drugs are designed to block the pain signals in the receptors at the surface of the cell but if the receptors have migrated to the nucleus then the drugs don't have any effect. This knowledge enables researchers to design pain-relieving drugs that can penetrate the nerve cell to the nucleus and thus block the signals from reaching the receptors. They can then 'safely' return to the surface of the cell. At least that's the theory and although it may seem like double-dutch to most of us, sometimes it's interesting to know in which direction the scientists are going.
 


Location may be key to effectively controlling pain
Date:February 3, 2016 Source:McGill University
 
In real estate, location is key. It now seems the same concept holds true when it comes to stopping pain. New research published in Nature Communications indicates that the location of receptors that transmit pain signals is important in how big or small a pain signal will be -- and therefore how effectively drugs can block those signals.

Blocking pain receptors in the nucleus of spinal nerve cells could more effectively control pain than interfering with the same type of receptors located on cell surfaces. The scientists also found that when spinal nerve cells encounter a painful stimulus, some of the receptors will migrate from the cell surface into the nucleus.

A team of researchers led by McGill University's Director of Anesthesia Research Terence Coderre and Karen O'Malley at Washington University in St. Louis, found that rats treated with investigational drugs to block the activity of the receptors in the nucleus soon began behaving in ways that led them to believe the animals had gotten relief from neuropathic pain. According to Prof. Coderre, "drugs that penetrate the spinal nerve cells to block receptors at the nucleus were effective at relieving pain, while those that don't penetrate the nerve cells were not. Rats with nerve injuries had less spontaneous pain and less pain hypersensitivity after blocking receptors at the nucleus, while the pain sensitivity of normal rats was not affected."

Location is key
Scientists have been studying glutamate receptors in the pain pathway for decades. What's new, Coderre explained, is that these most recent experiments -- in cell cultures and rats -- demonstrate that the location of the receptor in the cell has a major effect on the cell's ability to transmit pain signals.

The researchers focused mainly on nerve cells in the spinal cord, an important area for transmitting pain signals coming from all parts of the body.

"We'll now focus our research at determining what events cause the glutamate receptors to migrate to the nucleus, and how to produce drugs that more specifically block glutamate receptors only at the nucleus," added Coderre.

Story Source:

The above post is reprinted from materials provided by McGill University. The original item was written by Cynthia Lee. Note: Materials may be edited for content and length.

Journal Reference:
Kathleen Vincent, Virginia M. Cornea, Yuh-Jiin I. Jong, André Laferrière, Naresh Kumar, Aiste Mickeviciute, Jollee S. T. Fung, Pouya Bandegi, Alfredo Ribeiro-da-Silva, Karen L. O’Malley, Terence J. Coderre. Intracellular mGluR5 plays a critical role in neuropathic pain. Nature Communications, 2016; 7: 10604 DOI: 10.1038/NCOMMS10604


http://www.sciencedaily.com/releases/2016/02/160203111018.htm

Thursday, August 17, 2017

Deep Brain Stimulation Helps Neuropathic Pain


Today's post from newswise.com (see link below) talks about one of the latest stories concerning neuropathic pain treatment and that is deep brain stimulation. This is where a small electrode is inserted into the brain and activated to produce an electrical signal designed to interrupt abnormal activity. It's precisely this sort of research which gives us hope that it won't be too long before pain can be controlled without resorting to powerful drugs. However, it will probably never be cheap, or available to all, even if it is proved to be of benefit to all people living with chronic pain. That said, it looks as though it may well be an effective option for some patients and that must be a good thing.




For Some, Deep Brain Stimulation Brings Lasting Improvement in Neuropathic Pain
Released: 2/13/2013 10:00 AM EST
Source Newsroom: Wolters Kluwer Health: Lippincott Williams & Wilkins



Large Study Shows Continued Improvement with Longer Follow-up, Reports Neurosurgery

Newswise — Philadelphia, Pa. (February 13, 2013) – For many patients with difficult-to-treat neuropathic pain, deep brain stimulation (DBS) can lead to long-term improvement in pain scores and other outcomes, according to a study in the February issue of Neurosurgery, official journal of theCongress of Neurological Surgeons. The journal is published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health.

About two-thirds of eligible patients who undergo DBS achieve significant and lasting benefits in terms of pain, quality of life, and overall health, according to the report by Sandra G.J. Boccard, PhD, and colleagues of University of Oxford, led by Tipu Aziz FMedSci and Alex Green, MD. Some outcomes show continued improvement after the first year, according to the new report, which is one of the largest studies of DBS for neuropathic pain performed to date.

Most Patients Benefit from DBS for Neuropathic Pain
The authors reviewed their 12-year experience with DBS for neuropathic pain. Neuropathic pain is a common and difficult-to-treat type of pain caused by nerve damage, seen in patients with trauma, diabetes, and other conditions. Phantom limb pain after amputation is an example of neuropathic pain.

In DBS, a small electrode is surgically placed in a precise location in the brain. A mild electrical current is delivered to stimulate that area of the brain, with the goal of interrupting abnormal activity. Deep brain stimulation has become a standard and effective treatment for movement disorders such as Parkinson's disease. Although DBS has also been used to treat various types of chronic pain, its role in patients with neuropathic pain remains unclear.

Between 1999 and 2011, that authors' program evaluated 197 patients with chronic neuropathic pain for eligibility for DBS. Of these, 85 patients proceeded to DBS treatment. The remaining patients did not receive DBS—most commonly because they were unable to secure funding from the U.K. National Health Service or decided not to undergo electrode placement surgery.

The patients who underwent DBS were 60 men and 25 women, average age 52 years. Stroke was the most common cause of neuropathic pain, followed by head and face pain, spinal disease, amputation, and injury to nerves from the upper spinal cord (brachial plexus).

In 74 patients, a trial of DBS produced sufficient pain relief to proceed with implantation of an electrical pulse generator. Of 59 patients with sufficient follow-up data, 39 had significant improvement in their overall health status up to four years later. Thus, 66 percent of patients "gained benefit and efficacy" by undergoing DBS.

Benefits Vary by Cause; Some Outcomes Improve with Time
The benefits of DBS varied for patients with different causes of neuropathic pain. Treatment was beneficial for 89 percent for patients with amputation and 70 percent of those with stroke, compared to 50 percent of those with brachial plexus injury.

On average, scores on a 10-point pain scale (with 10 indicating the most severe pain) decreased from about 8 to 4 within the first three months, remaining about the same with longer follow-up. Continued follow-up in a small number of patients suggested further improvement in other outcomes, including quality-of-life scores.

Deep brain stimulation has long been regarded as potentially useful for patients with severe neuropathic pain that is not relieved by other treatments. However, because of the difficulties of performing studies of this highly specialized treatment, there has been relatively little research to confirm its benefits; only about 1,500 patients have been treated worldwide. The new study—accounting for about five percent of all reported patients—used up-to-date DBS technologies, imaging, and surgical techniques.

Dr. Boccard and coauthors acknowledge some important limitations of their study—especially the lack of complete patient follow-up. However, they believe their experience is sufficiently encouraging to warrant additional studies, especially with continued advances in stimulation approaches and technology. The researchers conclude, "Clinical trials retaining patients in long-term follow-up are desirable to confirm findings from prospectively assessed case series."

About Neurosurgery
Neurosurgery, the Official Journal of the Congress of Neurological Surgeons, is your most complete window to the contemporary field of neurosurgery. Members of the Congress and non-member subscribers receive 3,000 pages per year packed with the very latest science, technology, and medicine, not to mention full-text online access to the world's most complete, up-to-the-minute neurosurgery resource. For professionals aware of the rapid pace of developments in the field, Neurosurgery is nothing short of indispensable.

About Lippincott Williams & Wilkins
Lippincott Williams & Wilkins (LWW) is a leading international publisher of trusted content delivered in innovative ways to practitioners, professionals and students to learn new skills, stay current on their practice, and make important decisions to improve patient care and clinical outcomes.

LWW is part of Wolters Kluwer Health, a leading global provider of information, business intelligence and point-of-care solutions for the healthcare industry. Wolters Kluwer Health is part of Wolters Kluwer, a market-leading global information services company with 2011 annual revenues of €3.4 billion ($4.7 billion).


http://www.newswise.com/articles/for-some-deep-brain-stimulation-brings-lasting-improvement-in-neuropathic-pain?ret=/articles/list&category=medicine&page=1&search[status]=3&search[sort]=date+desc&search[section]=10&search[has_multimedia]=