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Hyperbaric oxygen therapy attenuates neuropathic hyperalgesia in rats and idiopathic trigeminal neuralgia in patients
Author(s) -
Gu N.,
Niu J.Y.,
Liu W.T.,
Sun Y.Y.,
Liu S.,
Lv Y.,
Dong H.L.,
Song X.J.,
Xiong L.Z.
Publication year - 2012
Publication title -
european journal of pain
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.305
H-Index - 109
eISSN - 1532-2149
pISSN - 1090-3801
DOI - 10.1002/j.1532-2149.2012.00113.x
Subject(s) - neuropathic pain , medicine , anesthesia , allodynia , neuralgia , hyperalgesia , trigeminal neuralgia , analgesic , neurochemical , nerve injury , carbamazepine , nociception , epilepsy , receptor , psychiatry
Background: Neuropathic pain after nerve injury is severe and intractable, and current drug and non‐drug therapies offer very limited pain relief. Hyperbaric oxygen ( HBO 2 ) has been clinically used for protection of the nervous system after acute injury. We investigated whether HBO 2 treatment could prevent and/or attenuate neuropathic pain in animals and in patients. Methods: Mechanical allodynia and thermal hyperalgesia and neurochemical alterations of neuropathic pain were analysed in male, adult, S prague‐ D awley rats with sciatic nerve injury. Clinical trials were conducted in patients with idiopathic trigeminal neuralgia. Results: Repetitive HBO 2 treatment [a combination of pressure at 3 atmosphere absolute ( ATA ) and pure oxygen] greatly inhibited behavioural signs of neuropathic pain manifested as thermal hyperalgesia and mechanical allodynia. Such an HBO 2 treatment also inhibited nerve injury‐induced induction of c‐ F os and activation of astrocytes and increased phosphorylation of NR2B receptor and the subsequent Ca 2+ ‐dependent signals in rats. Neither high pressure (up to 3 ATA ) nor pure oxygen alone resulted in analgesic effect. In clinical trials, one course of HBO 2 therapy (10 consecutive days) produced a rapid‐onset, dose‐dependent and long‐lasting analgesic effects evidenced by the decreased doses of carbamazepine required for keeping patient pain at a minimum and decreased scores of visual analogue scales, which was used for patient's self‐evaluation. Conclusions: These findings support that HBO 2 therapy is an effective approach for treating neuropathic pain in both animals and human beings and suggest that neural protection, anti‐inflammation and inhibition of nerve injury‐induced altered neural activity may contribute to the analgesic effect of HBO 2 therapy.