Brain and nerve = Shinkei kenkyū no shinpo
-
Review
[Pharmacological treatment strategy and mirror visual feedback treatment for neuropathic pain].
Neuropathic pain is a debilitating condition, and pharmacotherapy is the most established treatment strategy. A variety of pharmacotherapies is used for neuropathic pain management: however, pharmacotherapies with evidence for analgesic potency are less common. ⋯ We have treated pharmacotherapy-resistant neuropathic pain with neurorehabilitation techniques such as mirror visual feedback (MVF) treatment. Further to our clinical experience using MVF, we discuss the cerebral mechanism associated with neuropathic pain in this study.
-
Neuropathic pain is often a consequence of nerve injury due to surgery, cancer, bone compression, diabetes, or infection. This type of pain can be so severe that even the slightest touch can cause intense pain in the affected area. ⋯ In this review, we summarize the roles of the microglia in the functioning of ATP receptors and of the astrocytes in neuropathic pain. Understanding the key functions of the microglia and astrocytes may lead to the development of new strategies for the management of intractable chronic pain.
-
Review
[Pathophysiology of neuropathic pain: Na⁺ channel and hyperexcitability of primary afferents].
Neuropathic pain occurs as a result of peripheral neuropathy or peripheral nerve injury. Voltage-gated Na⁺ channels are assumed to play a major role in the pathophysiology of neuropathic pain and have become important therapeutic targets, because they are critical determinants of the excitability of sensory neurons. Nerve injury or disease could induce changes in trafficking, gene expression, and kinetics of Na⁺ channels, resulting in ectopic discharge and increased neuronal excitability. ⋯ Na⁺ channels are attractive targets for studying the pathophysiology of neuropathic pain and for drug development. However, recent advances have been mostly based on basic research. Overcoming the challenges in directly approaching patients with neuropathic pain might advance our understanding of the pathophysiology of pain and aid the development of therapeutic strategies.
-
We reported a case of ischemic stroke induced by a left atrial myxoma. A 76-year-old man was found unconscious and transferred to the emergency ward in our hospital. He experienced consciousness disturbance, motor dominant aphasia, and severe right hemiparesis. ⋯ Neither his neurological symptom nor intracerebral hemorrhage was not deteriorated after the operation. Thrombolytic treatment seemed a safe option for ischemic stroke caused by left atrial myxoma. However, we should carefully monitor the extent of anticoagulation therapy because hemorrhagic transformation might alter the timing of surgery for tumor resection.
-
Review
[Neuroimaging using ultrahigh-field magnetic resonance imaging at 7 tesla: current concepts].
The introduction of ultrahigh-field MRI at 7 tesla (7T) has increased the interest in the use of neuroimaging techniques in clinical research. The high signal-to-noise ratio and profound susceptibility effect at 7T can remarkably improve the spatial resolution and image contrast of structural imaging, susceptibility imaging, and functional imaging techniques, whereas the heating effects of the radio frequency and the inhomogeneities of the local magnetic field can have substantial negative effects on parameter setting, acquisition time, and image quality. T1 prolongation at 7T can improve the enhancement effects of gadolinium agents and the inflow effects on MR angiography and arterial spin labeling. Ultrahigh-field MRI is expected to have a high clinical impact in the near future; however, further technological advances tailored to ultrahigh-field systems as well as the accumulation of scientific evidence will be needed to establish its clinical significance.