RESUMO
Reorganization of primary somatosensory cortex subsequent to either reduced or enhanced peripheral input is well established. Recently, plastic changes following arm amputation in humans were shown to correlate with phantom limb pain. This raised the question whether spatial attention and pain may cause cortical reorganization in the absence of deafferentation. Using non-invasive neuroelectric imaging to study the digit representation in the human primary somatosensory cortex, we report a delayed shift of the representation of digits 2-3 due to pain on the digits 4-5, which outlasted the pain by several minutes. In contrast, reorganization during spatial attention was less pronounced, was seen almost immediately and only during the condition. These data indicate that spatial attention and pain without peripheral deafferentation cause cortical reorganization by different mechanisms. The differential time course of reorganizational effects observed at the cortex may be due to modulation of the lemniscal pathways by nociceptive input from the spinal cord dorsal horn.
Assuntos
Atenção/fisiologia , Dedos/fisiologia , Dor/fisiopatologia , Córtex Somatossensorial/fisiologia , Percepção Espacial/fisiologia , Adulto , Mapeamento Encefálico , Tronco Encefálico/fisiologia , Temperatura Baixa , Estimulação Elétrica , Potenciais Somatossensoriais Evocados/fisiologia , Feminino , Dedos/inervação , Humanos , Imageamento por Ressonância Magnética , Masculino , Plasticidade Neuronal/fisiologia , Estimulação Física , Tempo de Reação/fisiologia , Córtex Somatossensorial/anatomia & histologia , Tato/fisiologiaRESUMO
Two patients with complicated acute pancreatitis are demonstrated. Sonographic factors are compared to laboratory and clinical findings. Ultrasound can add relevant information for classification and thereby supply an indication for surgery in patients with acute pancreatitis. This is especially true since laboratory classification of the grade of the disease is as yet not generally accepted.
