Burning mouth syndrome is a rare disorder of a complex nature that significantly impairs the life quality of those affected. Its clinical features are characterized by oral burning sensation as well as xerostomia, dysgeusia, and halitosis. While various etiological factors have been proposed over the last few decades, recent studies have focused on understanding its pathophysiology as a neuropathic disorder that involves both peripheral and central neuropathy. In addition, other explanations of BMS pathology have also been proposed, including hormonal disturbances during and after menopause, immunological challenges, and psychological distress. Despite these research efforts, the etiology of BMS remains elusive, awaiting further investigations. The scope of this review includes the current understanding of BMS pathology and animal models developed for deciphering molecular mechanisms underlying the development and progression of BMS. The overview of recent research efforts and our knowledge of BMS pathology will provide an opportunity to evaluate the status of our understanding of BMS and its future perspective in improving the life quality of those affected by this rather intractable disorder.
국제통증연구학회(IASP)에 따르면, 신경병증성 통증은 정상 조건에서 중추신경계에 유해한 정보를 전달하는 신경계 기능 장애로 특징 지워진다. 이런 통증은 말초 혹은 중추 신경계에 확인 가능한 병변이 있는 질환과 어떠한 신경에도 병변이 없는 상태에서 발생하는 상황으로 나누어 볼 수 있다. 두 가지 상황 모두 장기적이고 만성적인 변화과정을 겪게 되며, 결과적으로 신경계가 부적절하게 적응하여 치유되기 어려운 만성통증 증후군으로 발전할 수 있다. 그러나 이러한 통증 치료는 진단에서부터 치료까지의 과정이 어려운 탓에 현재까지도 특별한 해결방안이 부족한 실정이다. 최근 자기공명영상(fMRI), 양전자방출단층촬영법(PET), 광영상(optical imaging) 등 영상분석기술이 발달함에 따라 통증을 유발할 수 있는 유해 자극에 대한 중추신경계의 반응을 영상화하는 연구가 증가하고 있다. 이러한 영상 기법들을 통해 통증을 해석하고 처리하는 뇌 영역에서 시냅스 간 가소성 변화가 일어나고 있음을 확인하였으며, 신경병증성 통증을 비롯한 만성통증과 학습과의 상호 작용을 이해하는 데 많은 도움을 주고 있다. 본 연구는 병리적 통증의 기전과 통증 자극에 따른 뇌의 구조적, 기능적 변화에 대해 최근까지 밝혀진 연구들을 소개하고자 한다. 만성적 통증의 정의와 발생기전을 되짚고 새로운 연구 동향을 살펴보는 것은 통증을 완화할 수 있는 방안을 강구하는 데 도움이 될 것으로 사료된다.
The purpose of this study was to determine whether high voltage pulsed current stimulation (HVPCS) would enhance wound healing in neuropathic rabbits. Ten rabbits were assigned to either an experimental or a control group. The wounded part around the peripheral neuropathy of the experimental rabbits was stimulated for two hours twice a day for six days under the following conditions: pulse frequency 80 pps, pulse duration , and stimulation intensity 30~40 V. The results indicated that there was no difference in the wound closure between the experimental and control groups. The two groups showed similar aspects in collagen and reticulum, which were observed by colored Masson's trichome. While the rabbits in the control group had more or less thick fibers, the rabbits in the experimental group had thin and branched-shape fibers. The rabbits in the experimental group showed both strong responses in the shaping of elastic fibers and the increased aspects in fibroblast when compared with the control group.
The purposes of this study were to determine the effect of different degrees of severity of diabetic neuropathy on balance function, and to evaluate dynamic balance and functional performance in diabetes patients. Twenty-four subjects with diabetes mellitus were divided into three groups according to results of sensory nerve conduction study. All subjects were evaluated for dynamic balance which was measured using computerized dynamic posturography, and functional performance which was measured using the Berg balance scale. One-way analysis of variance was used to determine whether there were any statistically differences of dynamic balance function and functional performance among the three groups. The Spearrnan's rank correlation was used to determine statistical significance between dynamic balance and age. The results were as follows: 1. Dynamic balance measured using computerized dynamic posturography was significantly lower in the no response group than in the normal amplitude group (p<0.05). 2. Functional performance tested by the Berg balance scale was not statistically different among the three groups (p>0.05). 3. an inverse relationship was found between dynamic balance measured using computerized dynamic posturography and age (r=-0.68, p<0.05). These results suggest that patients with severe diabetic neuropathy have loss of dynamic balance function. Therefore, patients with severe diabetic neuropathy need to have their balance evaluated and receive appropriate education.
Focal myositis is a rare disease associated with inflammatory changes invading the skeletal muscles and may be triggered by nerve lesion. We describe a case of 33-year-old woman who was diagnosed focal denervation myositis of piriformis and gluteal muscles associated with sciatic neuropathy because of severe uterine enlargement due to twin pregnancy misdiagnosed as lumbar herniated nucleus pulposus. MRI is one of the key diagnostic tools in the assessment of focal denervation myositis for differential diagnosis. Nonsteroidal anti-inflammatory drugs are commonly used for treatment of focal myositis. Spontaneous regression is obtained in numerous cases.
Nerve injury can lead to neuropathic pain, which is often resistant to current analgesics and interventional therapeutic methods. Extracellular signal-regulated kinase (ERK) plays important role in the induction of neuropathic pain. We explored the antinociceptive effect of curcumin and its effect on ERK in the spinal cord in the neuropathic pain model of rats induced by chronic constriction injury (CCI) of the sciatic nerve. In injured rats, mechanical allodynia, which is one of characteristics of neuropathic pain developed and the activation of ERK in spinal cord significantly increased compared with control group. However, administration of curcumin (50 mg/kg/day p.o) for 7 days started from one day before the injury prevented the development of mechanical allodynia and increase of ERK phosphorylation. These results indicate that curcumin can be a new therapeutic agent in the treatment of neuropathic pain.