ABSTRACT
OBJECTIVE: To investigate the emotional and neurobehavioural status of patients suffering from chronic pain. METHODS: Fifteen male patients with chronic lower back pain and 15 healthy control subjects were studied for approximately six months. Pain was measured using a visual analogue scale. The WHO Neurobehavioral Core Test Battery (NCTB) was used to assess neurobehavioural effects of environmental and occupational exposures. RESULTS: Visual analogue scale results demonstrated a modest range of reported pain (mean [± SD] 62.0 ± 10.8) in chronic pain patients, whereas control subjects reported no measurable pain. With the NCTB, it was found that scores of negative mood state, including anger-hostility, depression-dejection, fatigue-inertia and tension-anxiety in pain patients were significantly higher than scores in the control subjects. By contrast, scores of positive mood state (vigour-activity) in chronic pain patients were lower than those in the control group. The NCTB scores of the Santa Ana Dexterity and Pursuit Aiming II tests in chronic lower back pain patients were lower than those of the control group. Scores for other NCTB subtests, including the Digit Span, Benton Visual Retention and Digit Symbol tests, were not significantly different compared with controls. Subject(s) Emotions , Motor Skills Disorders/etiology , Pain/complications , Pain/psychology , Reaction Time/physiology , Adult , Chronic Disease , Female , Humans , Male , Middle Aged , Neuropsychological Tests , Pain/diagnosis , Pain Measurement , Photic Stimulation , Retention, Psychology/physiology , Surveys and Questionnaires
ABSTRACT
Radiofrequency thermocoagulation (RFT) of the gasserian ganglion is a routine and effective technique for the treatment of classical trigeminal neuralgia (CTN). In this study we compared its efficacy in patients with CTN and atypically symptomatic or mixed trigeminal neuralgia (MTN). Fifty-seven patients were treated with RFT for trigeminal neuralgia from June 2006 to February 2009. Thirty patients had CTN, and 27 had MTN. Outcomes were measured by using the visual analog pain scale (VAS) and patients' reports of quality of life (QOL), medication usage, and complications over a follow-up period of up to 3 years. Our results showed that the patients with MTN were younger, tended to have bilaterial involvement of the first division, and were unresponsive to treatment. All surgeries were completed smoothly. About 86.7% CTN patients and 48.1% MTN patients responded immediately to RFT. The VAS scores were significantly higher in the CTN group than in MTN group (P<0.05). Kaplan-Meier curves showed that 1-year, 2-year, and 3-year pain relief rates were 76.7%, 73.3%, and 73.3% in the CTN group and 46.6%, 41.4%, and 41.4% in the MTN group, respectively. The rates of pain relief for both groups leveled off at 2 years. Complications included numbness, dysesthesia, and anesthesia dolorosa. RFT did not cause any deaths and complications were low. The treatment was very effective for CTN and, to some degrees, effective for MTN. If numbness, dysesthesia, and anesthesia dolorosa are limited to the trigger area, QOL will be greatly improved.
ABSTRACT
PURPOSE: High brain levels of aluminum (Al) can be neurotoxic and cause learning and memory deficits. Gastrodia elata (GE) is a Chinese herb widely used for improving mental function in traditional Chinese medicine. We measured changes in Al-induced neurotransmitter alteration and performance on a learning and memory task to elucidate the mechanism of Al toxicity and to assess whether these alterations could be attenuated by GE. METHODS: Thirty-six adult, male rats were randomly divided into six groups. Four Al-exposed groups were given aluminum chloride at 5 mg/kg/day or 10 mg/kg/day (i.p.) for two months, with two of these groups (one for each dose of Al) receiving GE (0.4 g/kg, via oral intubation, with the GE powder mixed in the drinking water) while the other two groups received vehicle. A GE control group was given injections of saline plus GE and a saline control group was given injections of saline and with 3 injection days and one day off. A step-down test was used to measure learning and memory ability. Al concentrations in the neocortex were assayed with a graphite furnace atomic absorption spectrophotometer. Amino acid neurotransmitter levels in the neocortex were determined by high performance liquid chromatogram-fluorescence. RESULTS: Al-exposed rats showed impaired learning and memory ability as indicated by shorter step down latency and more retention errors. Cortical concentrations (mean +/- SEM) of Al were: 56.22 +/- 34.10 ng/g (wet weight) in the Saline control group; 172.87 +/- 111.06 in the 5 mg/kg/dayAl group; 289.15 +/- 102.55 in the 10 mg Al group; 74.98 +/- 19.00 in the GE control group; 232.55 +/- 35.74 in 5 mg Al+GE group; and 291.35 98.38 in 10 mg Al+GE group respectively. Al exposure produced a significant increase in cortical GABA levels. Gastrodia elata reduced learning and memory deficits without affecting brain Al levels. CONCLUSIONS: Rats exposed to AlCl_{3} suffer from deficits in learning and memory, accompanied by increases in GABA levels in the neocortex. Gastrodia elata is effective in improving memory functions and normalizing GABA levels.
