2012年11月6日 讯 /生物谷BIOON/ --治疗很多疾病的止痛药物或许对病人来说还有别的用途，近日，刊登在国际杂志Journal of Neuroscience上的研究报告中，来自弗里德里希-席勒大学等处的研究者揭示了局部麻醉可以明显改善中风病人的运动技能。
研究者Thomas表示，许多中风病人表现出慢性的手部损伤或者手臂的完全损伤。在“约束诱导运动疗法”（CIMT）中，患者健康的手臂处于限制状态，而其受中风所影响的手臂处于紧密的训练中来恢复运动机能。研究者表示其很高兴进行这项疗法，疗法中，病人需要进行堆积小玩具或者把小针插进一个穿孔板等任务和训练，每一位患者都可以从这种新型疗法中受益。
当受影响手臂的敏感性随着麻醉程度而降低的时候，病人运动疗法的作用就会明显增强，在研究中，研究者对36位病人进行了检测，其中一半的病人使用局部麻醉膏涂于其前臂上，于此同时，其余的病人仅仅接受安慰剂治疗。随后所有的病人都开始进行每日的运动疗法。
通过研究，所有病人的运动表现都明显地增强了，而且病人接受麻醉剂所得到的效用明显优于接受安慰剂。
未来的研究中，研究者试图去揭示是否局部麻醉药和运动性疗法的结合可以改善长期改善中风病人的运动能力。如果研究成功，无疑可以更有效的改善病人的生活质量。（生物谷Bioon.com）
编译自：Therapy for Stroke Patients Improved: More Mobility Due to Deafferentation
doi:10.1523/JNEUROSCI.5912-11.2012
PMC:
PMID:
Effects of Temporary Functional Deafferentation on the Brain, Sensation, and Behavior of Stroke Patients
Elisabeth Sens1, Ulrike Teschner1,2, Winfried Meissner3, Christoph Preul2, Ralph Huonker2, Otto W. Witte2, Wolfgang H. R. Miltner1, and Thomas Weiss1
Following stroke, many patients suffer from chronic motor impairment and reduced somatosensation in the stroke-affected body parts. Recent experimental studies suggest that temporary functional deafferentation (TFD) of parts of the stroke-affected upper limb or of the less-affected contralateral limb might improve the sensorimotor capacity of the stroke-affected hand. The present study sought evidence of cortical reorganization and related sensory and motor improvements following pharmacologically induced TFD of the stroke-affected forearm. Examination was performed during 2 d of Constraint-Induced Movement Therapy. Thirty-six human patients were deafferented on the stroke-affected forearm by an anesthetic cream (containing lidocaine and prilocaine) on one of the 2 d, and a placebo cream was applied on the other. The order of TFD and placebo treatment was counterbalanced across patients. Somatosensory and motor performance were assessed using a Grating orienting task and a Shape-sorter-drum task, and with somatosensory-evoked magnetic fields. Evoked magnetic fields showed significant pre- to postevaluation magnitude increases in response to tactile stimulation of the thumb of the stroke-affected hand during TFD but not following placebo treatment. We also observed a rapid extension of the distance between cortical representations of the stroke-affected thumb and little finger following TFD but not following placebo treatment. Moreover, somatosensory and motor performance of the stroke-affected hand was significantly enhanced during TFD but not during placebo treatment. Thus, pharmacologically induced TFD of a stroke-affected forearm might improve the somatosensory and motor functions of the stroke-affected upper limb, accompanied by cortical plasticity.
