Neuroscience 2004 Abstract
| Presentation Number: | 863.9 |
|---|---|
| Abstract Title: | Temporal analysis of opiate-induced intrathecal granulomatus mass progression and regression using MRI. |
| Authors: |
Allen, J. W.*1
; Horais, K. A.1
; Tozier, N. A.1
; Corbeil, J. A.2
; Mattrey, R. F.2
; Yaksh, T. L.1
1Anesthesiol., UCSD, La Jolla, CA 2Radiology, UCSD, La Jolla, CA |
| Primary Theme and Topics |
Sensory Systems - Pain -- Treatments for persistent pain |
| Secondary Theme and Topics | Neurological and Psychiatric Conditions<br />- Neurotoxicity<br />-- Toxic metabolic effects and disorders |
| Session: |
863. Treatments for Persistent Pain Poster |
| Presentation Time: | Wednesday, October 27, 2004 8:00 AM-9:00 AM |
| Location: | San Diego Convention Center - Hall A-H, Board # T9 |
| Keywords: | INTRATHECAL, OPIATE, MRI, INFLAMMATION |
Continuous intrathecal (IT) delivery of morphine sulfate (MS) for 28 days can produce aseptic subdural inflammatory masses (granulomas) localized at the catheter tip. The rate at which these IT masses develop, and if they regress after MS infusions are terminated are unknown. To assess this, we performed serial MRI scans with gadolinium (Gd) enhancement in dogs. Beagle dogs were implanted with chronic IT lumbar catheters and were infused at 0.96 ml/day for 28 days. Dogs received a 100% granuloma inducing concentration of MS (12.5 mg/ml), the maximum tolerable concentration of fentanyl HCl (2 mg/ml) or the mu specific peptide DAMGO (2 mg/ml). Before MS infusions, MRI scans were obtained with a Siemens Symphony 1.5 Tesla system while dogs were anesthetized with propofol. Dogs had repeated MRI scans at intervals ranging from 3 to 14 days, for up to 45 days, with IV Gd (Optimark, 0.2 mmol/kg). One group of dogs had saline substituted for MS at the first appearance of a mass by MRI. A second group of dogs continued to receive MS for 28-days, when saline was substituted for MS. On the day of the final scan, 1 ml of Gd (Magnevist) 1:400 in saline was injected IT. With MRI, masses in some MS dogs were apparent as early as 3 days and in all by 14 days. Termination of MS resulted in a rapid regression of the masses. This was greater in dogs receiving MS for 14 days vs. 28 days. DAMGO produced a small mass apparent only at the later time points (28 days). Fentanyl did not produce IT granulomas. Repeat MRI scans with propofol anesthesia and IV Gd were well tolerated in dogs with no lasting negative effects noted. Morphine-induced IT masses form and regress quickly. Histology of the masses correlated well with MRI images. Mass size and behavioral were not well correlated but faster growing masses produced greater behavioral signs. IT fentanyl and possibly DAMGO may be therapeutic alternatives to MS. Supported in part by DA-15353.
Sample Citation:
[Authors]. [Abstract Title]. Program No. XXX.XX. 2004 Neuroscience Meeting Planner. San Diego, CA: Society for Neuroscience, 2004. Online.
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