시상 뇌졸중 환자에서 신경병증 통증에 따른 체성감각의 뇌 재구성

Other Titles
Somatosensory Cortical Reorganization on Neuropathic Pain in Thalamic Post-Stroke Patients
Authors
박기영이인희이소영김영현손철호
Department
Dept. of Rehabilitation Medicine (재활의학); Dept. of Radiology (영상의학)
Issue Date
2004
Citation
Keimyung Medical Journal, Vol.23(2) : 85-95, 2004
Abstract
요 약 7명의 시상 뇌졸중 병변을 가진 환자를 대상으로 중추성 신경병증 통증의 유무에 따라 체성감각계의 뇌 재구성을 조사하였다. 이학적 감각 검사는 중추성 신경병증 통증 유무에 따라 각 검사 종류에 따른 유의한 차이는 없었다. 시상 병변은 통증 유무에 상관없이 다양하게 위치하였다. 정중신경 체성감각 유발전위 검사는 이환측 자극 시 통증이 없는 1명에서만 반응을 나타내었으나 비이환측 자극 시 모두에서 반응을 나타내었다. 기능적 뇌자기공명영상에서 통증을 가진 환자가 통증이 없는 환자보다 더욱 많은 이차체성감각피질의 활성도를 나타내었다. 기능적 뇌 자기공명영상검사는 중추성 신경병증통증을 가진 환자에서 높은 빈도의 이차 체성감각 피질의 활성을 나타내어 향후 중추성 신경병증성 통증 환자에서 통증 발생을 예측하거나 기전을 연구하는데 유용할 것으로 생각된다.
This study was performed to investigate the somatosensory recovery patterns on the neuropathic pain in seven thalamic post-stroke patients. In LANSS (leeds assessment of neuropathic symptoms and signs) pain scale using to discern peripheral and central neuropathic pain. four patients showed central neuropathic pains, while three patients had non-neuropathic pain. To evaluate the sensory function impairment, we also performed quantitative somatosensory test, median nerve somatosensory evoked potential (SEP), magnetic resonance imaging (MRI), and median nerve stimulation functional MRI. The quantitative somatosensory test did not show significant differences between central neuropathic pain group and non-neuropathic pain group. SEPs in affected side had a response in one patient central neuropathic pain group. The responses in unaffected side were normal in all patients tested, MRI-based thalamic localization data indicated that this method had a limitation in distinguishing the central neuropathic pain in thalamic post-stroke patient. the results of functional MRI showed that the central neuropathic pain group was more activated on the secondary somatosensory areas than non-neuropathic pain group. Collectively, the result of this study indicate that the functional MRI may be a helpful device in assessing central neuropathic pain and understanding the somatosensory recovery aspects.
Keywords
Functional MRINeuropathic painSomatosensory recoveryThalamic post-stroke patients
URI
http://kumel.medlib.dsmc.or.kr/handle/2015.oak/15324
Appears in Collections:
2. Keimyung Medical Journal (계명의대 학술지) > 2004
1. Journal Papers (연구논문) > 1. School of Medicine (의과대학) > Dept. of Rehabilitation Medicine (재활의학)
1. Journal Papers (연구논문) > 1. School of Medicine (의과대학) > Dept. of Radiology (영상의학)
Keimyung Author(s)
박기영; 이소영; 손철호
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