Effects of Therapeutic Ultrasound on Paraesthesia and Cold Allodynia Caused by Oxaliplatin-induced Peripheral Neuropathy

• Main Authors: Ching-Hsiang Yang, 楊景翔
• Other Authors: 謝悅齡
• Format: Others
• Language: zh-TW
• Published: 2016
• Online Access: http://ndltd.ncl.edu.tw/handle/3m9ea7

碩士 === 中國醫藥大學 === 物理治療學系復健科學碩士班 === 104 === Introduction/Background Oxaliplatin-induced peripheral neuropathy (OIPN) is a common complication of chemotherapy including symptoms of paraesthesia, cold allodynia and pain..Therapeutic ultrasound is a physical modality that is usually used on managements of neuropathic pain. The aim of this study was to evaluate the effects of therapeutic ultrasound on paraethesia and cold allodinia induced by OIPN from bench (Part I) to bedside (part II). Material and Methods Part I. Fifteen animals were randomly divided into three groups: (1) oxaliplatin and ultrasound treatment (n=5); (2) oxaliplatin and sham ultrasound (n=5); and (3) normal controls (n=5). Each animal received a total of eight injections with oxaliplatin (4mg/kg, i.p.) at 3-days intervals. Ultrasound (50% of pulsed mode, 0.5W/cm2, 5 mins) was started after the five doses of oxaliplatin administration and continued for 12 consecutive days. Behavioral assessments were performed on the days before oxaliplatin injection, before and after ultrasound treatments and then followed by immunohistochemistry for SP proteins. Part II. 11 Patients with OIPN were recruited for a 54-day study with single-group of ABA design. On the 12th day after recruitment, therapeutic ultrasound stimulation (1.0-1.5 W/cm2) at acupoints of Neiguan (PC6), Daling (PC7), Kunlun (BL60), Yongquan (KI1) were conducted and induced deqi sensation for 3 minutes/point and 12 sessions Measurements using von Frey filament test, cold-water immersion test, Pain Quality Assessment Scale (PQAS), Chemotherapy induced neuropathy questionnaire (CINQ), EORTC QLQ-C30, and Oxaliplatin-Specific Neurotoxicity Scale (OSNS) were performed on Days 0, 12, 24 and 54.   Results Part I. Therapeutic ultrasound relieved both cold, mechanical allodynia and capsaicin/menthol evoked-nociceptive behaviors induced by oxaliplatin in rats. Oxaliplatin-related increases in protein levels of SP in the dorsal horn were also reduced after ultrasound. Part II. Significant improvements were found on mechanical pain threshold, cold withdrawal latency, as well as the scores of PQAS, QLQ-C30 and CINQ after 12-session ultrasound at acupoints in patients with OIPN. Conclusion This study conducted the beneficial effects of therapeutic ultrasound on paraesthesia and cold allodynia induced by OIPN from bench to bedside. We found that ultraound stimulation have benefits on alleviation of sesory impairments in animals and patients with OIPN, moreover, to improve life quality of patients with cancers.