뇌기능 영상장치를 이용한 통증의 평가
New Trend of Pain Evaluation by Brain Imaging Devices
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초록
통증은 다른 일반 감각과는 달리 감각적인 면과 정서적인 면이 있어, 인격, 기대, 암시, 과거 통증경험과 같은 개인의 심리적 특성이나 사회문화적 환경 등 여러 요인에 의해 크게 영향을 받는다. 이러한 환자의 주관적인 통증의 호소를 객관화하려는 노력은 여러 통증 치료 의사들한테 많이 시도되어 왔으나 아직도 정확한 객관적인 진단방법이 나타나고 있지 않다. 최근에 PET이나 fMRI의 등장은 이러한 면에서 통증에 관한 연구를 하는 학자들에게 커다란 도움을 주고 있고 현재에도 이러한 뇌 기능적 자기공명영상을 이용한 많은 연구결과들이 보고되고 있다. 뇌는 어떠한 기능을 수행하기 위하여 특정부위의 뇌 신경활동이 항진되면 이와 함께 그 부위의 국소적 뇌 혈류 및 대사가 증가하는 것으로 알려져 있다. 이러한 생리적 변화를 이용하여 뇌에 국소적 신경활성화가 생기는 위치를 mapping 할 수 있다. mapping 대상 뇌기능은 지각, 운동, 기억, 언어 등의 기능에서 출발하여 최근 감정, 정서, 사회적 인식, 도덕적 판단, 의식, 마음까지 조사대상이 넓어지고 있다. 본 발표에서는 이러한 뇌기능 영상기법에 대한 내용과 뇌기능 영상 기법을 이용하여 통증의 평가를 어떻게 할 수 있는지를 알아보고자 한다.
Abstract
Pain has at least two dimensions such as somatosensory qualities and affect and patients are frequently asked to score the intensity of their pain on a numerical pain rating scale. However, the use of a undimensional scale is questionable in view of the belief, overwhelmingly supported by clinical experience as well as by empirical evidence from multidimensional scaling and other sources, that pain has multidimen- sions such as sensory-discrimitive, motivational-affective and cognitive-evaluative. The study of pain has recently received much attention, especially in understanding its neurophysiology by using new brain imaging techniques, such as positron emission tomography(PET) and functiolnal magnetic resonance imaging (fMRI), both of which allow us to visualize brain function in vivo. Also the new brainimaging devices allow us to evaluate the patients pain status and plan to treat patients objectively. Based on our findings we presented what are the new brain imaging devices and the results of study by using brain imaging devices.
참고문헌 (25)
- "Thalamocortical connections of the cingulate and insula in relation to nociceptive inputs to the cortex. : Pain Mechanisms and Management, Series.", pp.212~20 (1997), IOS Press
- "Imaging how attention modulates pain in humans using functional", 125, pp.310~319 (2002)
- "Human brain activation under controlled thermal stimulation and habituation to noxious heat: an fMRI study.", 41, pp.1044~1057 (1999)
- "Cognitive and emotional influences in anterior cingulate cortex", 4, pp.215~222 (2000)
- ". Positron emission tomographic analysis of cerebral structures activated specifically by repetitive noxious heat stimuli. J. Neurophysiol. 71. 802-7.", mi(shima) (1994)
- "New findings of the correlation between acupoints and corresponding brain cortices using functional MRI", 95, pp.2670~2673 (1998)
- "Effects of the acoustic noise of the gradient systems on fmri : a study on auditory, motor, and visual cortices", 39, pp.331~335 (1998)
- "Functional magnetic resonance imaging of the brain in the investiga- tion of acupuncture" (2000)
- "The search for biologic evidence with functional magnetic resonance imaging and positron emission tomography techniques", 8, pp.399~401 (2002)
- "fMRI Neurophysiological Evidence of Acupuncture Mechanisms", 14, pp.16~22 (2002)
- "Pain Dynamics Observed by fMRI: Differential Regression Analysis Technique", 18, pp.273~283 (2003)
- "Undimensional pain rating scales: a multidimensional affect and pain survey (MAPS) analysis of what they really measure", 98, pp.241~247 (2002)
- "Evaluation of yhe patient in pain" (2001)
- "Does glutamate image your thought?", 25, pp.359~364 (2002)
- "What does fMRI tell us about neuronal activity?", 3, pp.142~151 (2002)
- ". Cortical and subcortical localization of response to pain in man using positron emission tomography. Proc. R. Soc. Lond.", pp.~44 (1991)
- "Event-related fMRI", 5, pp.243~248 (1997)
- "Evaluation of the Pain Patient : Rajpp. Pain Medicine: a compre- hensive review." (1996)
- "Cellular mechanisms of brain energy metabolism and their relevance to functional brain imaging", 354, pp.1155~1163 (1999)
- "functional brain mapping with magnetic resonance imaging. Proc. Natl. Acad. Sci. 89. 5951-5." (1992), . Intrinsic signal changes accompanying sensory stimulation
- "Placebo and opioid analgesia : Imaging a shared neuronal network", 295, pp.1737~1740 (2002)
- "The neuroimaging of human brain function", 95, pp.763~764 (1998)
- "Attention, self-regulation and consciousness", 353, pp.1915~1927 (1998)
- "Introduction to Pain : Textbook of pain, 4th ed Series." (1999), Churchill Livingstone. pp 1-8.
- "Regional mu opioid receptor regulation of sensory and affective dimensions of pain", 293, pp.311~315 (2001)