正子射影斷層掃描影像研究神經痛和癌症痛之大腦活性改變區域

Abstract

疼痛警告人類和動物避免受到危險和傷害，疼痛也會保護我們，直到受傷的組織癒合。然而，疼痛是一種令人不快的感覺和情緒體驗。儘管之前許多研究已使用功能性腦部影像來解釋疼痛的腦部模型，在疼痛感知的大腦特徵中，存在一些不一致的結果，仍然沒有解答。 本論文的目的是提供腦部處理的疼痛感知和止痛線索。第一部分是觀察大鼠在不同的神經性疼痛行為和治療的反應。在第二部分研究中，我們使用正子射影斷層掃描影像，鑑定了神經性疼痛大鼠在兩種不同的神經性疼痛行為中的腦部活化區域。此外，我們測試了pregabalin 的治療在腦部中之反應。在第三部分的研究中，我們確定了癌症疼痛小鼠和嗎啡止痛的腦部活化區域。最後，我們利用回顧性研究分析了癌症疼痛患者的正子射影斷層掃描影像中大腦部分。在這些人類和囓齒動物的研究中，我們發現一個持續活動的大腦區域－腦島皮質。我們提出，腦島皮質可能是人類和大鼠最重要的疼痛相關的區域。

Pain alerts humans and animals from danger and injury, also it protects us until the injured tissue heal. However, pain is an unpleasant sensory and emotional experience. Although numerous studies have been performed to delineate pain mechanism using functional brain imaging, there were still some discrepant results in the brain signature for pain has not been solved. The purpose of this dissertation is to provide the clue of brain processing in pain perception and analgesia using FDG-PET imaging. The first part is observing different neuropathic pain behaviors and treatment response in rats. In the second series of studies, we used FDG-PET to identify the activated brain areas of neuropathic pain rats in different neuropathic pain behaviors. Furthermore, we tested the treatment response of these brain areas to pregabalin. In the third study, we identified the activated brain area in cancer pain mice and morphine analgesia. Finally, we retrospectively analyzed brain FDG-PET in cancer pain patients. In these human and rodent studies, we found one consistently activated brain area－i.e., the insular cortex. We propose that insular cortex maybe one of the most important pain related areas in both human and rodents.