A Placebo-Controlled Randomized Crossover Trial of the N-Methyl-D-Aspartic Acid Receptor Antagonist, Memantine, in Patients with Chronic Phantom Limb Pain
| Autor: | Ralph Thomas Kiefer, Christoph Braun, Niels Birbaumer, Stephanie Töpfner, Klaus Unertl, Herta Flor, Hubert Preissl, Katja Wiech |
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| Předmět: |
Adult
Male medicine.drug_class Phantom limb N-Methyl-D-aspartic acid Placebo Receptors N-Methyl-D-Aspartate Amputation Surgical Functional Laterality chemistry.chemical_compound Double-Blind Method Memantine medicine Humans Pain Measurement Cross-Over Studies business.industry Antagonist Magnetoencephalography Middle Aged medicine.disease Receptor antagonist Crossover study Treatment Outcome Anesthesiology and Pain Medicine Phantom Limb chemistry Anesthesia Chronic Disease NMDA receptor Female business Excitatory Amino Acid Antagonists medicine.drug |
| Zdroj: | Scopus-Elsevier |
| Popis: | In the present study we investigated the effect of the N-methyl-D-aspartic acid (NMDA) receptor antagonist memantine (30 mg/d) on the intensity of chronic phantom limb pain (PLP) and cortical reorganization. In 8 patients with chronic PLP, memantine was tested in a placebo-controlled double-blinded crossover trial of 4 wk duration per trial. The intensity of PLP was rated hourly by the patients on a visual analog scale during baseline and both treatment periods. At the same time points, the functional organization of the primary somatosensory cortex (SI) was determined by neuromagnetic source imaging. In comparison to baseline and placebo, the NMDA receptor antagonist had no effect on the intensity of chronic PLP. In none of the periods were significant changes in the functional organization of SI observed. Although the conclusions regarding the clinical effect are limited because of the small sample size, the data indicate that in the studied dosage the NMDA receptor antagonist memantine is ineffective in the treatment of chronic PLP and is also ineffective for the reduction of associated neural plasticity in the primary SI.NMDA receptors play a substantial role in central nervous system changes underlying neuropathic pain. In a placebo-controlled double-blinded study we tested the effect of 30 mg memantine on chronic phantom limb pain and pain-associated cortical reorganization. |
| Databáze: | OpenAIRE |
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