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PubMed1992

Relationship between autotomy behaviour and spinal cord monoaminergic levels in rats.

In the rat, unilateral neurectomy of the sciatic and saphenous nerves causes autotomy, a self-mutilation behaviour, against the denervated limb that is variable in both its onset and severity. To study some of the possible neurochemical sources of this variability, spinal cord levels of norepinephrine (NE), dopamine (DA), serotonin (5-HT0 and 5-hydroxyindoleacetic acid (5-HIAA) were analysed ipsi- and contralateral to the lesioned side by high performance liquid chromatography at C5-T1 and L1-S1. According to the early or late onset and to the slight or intense autotomy behaviour, the animals were assigned to four different groups: early autotomy, early no autotomy, late autotomy, and late no autotomy. Two sham-operated groups were sacrificed at an early or late stage in the postoperative period. The spinal cord NE content remained unchanged throughout the different experimental situations. The more conspicuous changes observed were: (1) a generalized increase in spinal 5-HT metabolism in all deafferented groups; (2) a significant and selective increase in lumbosacral 5-HT and 5-HIAA levels of the rats that did not self-lesion for 8 weeks after deafferentation and (3) a significant fall (30-45%) in DA levels at denervated spinal segments of the rats that actively self-attacked late in the postoperative period. The data suggests that spinal cord serotonergic and dopaminergic influences play an important role in determining the susceptibility to autotomy (and perhaps chronic pain) after peripheral deafferentation.

Animals↗
PubMed1992

Intracerebroventricular salmon calcitonin reduces autotomy behavior in rats after dorsal rhizotomy.

We studied the effects of intracerebroventricularly (ICV) administered salmon calcitonin (sCT) on the self-mutilation behavior (autotomy) of rats after dorsal rhizotomy. sCT was given 2 micrograms/rat ICV, on alternate days) from day 15 to day 40 after surgery and autotomy was scored until day 60. Autotomy scores were significantly reduced during treatment but once the ICV sCT was stopped mean values for the treated group gradually returned to control levels. These data support the concept that autotomy is a useful model of chronic pain, sensitive to centrally acting antinociceptive agents. In addition, these findings extend the knowledge of the antinociceptive profile of sCT and are in agreement with recent clinical observations.

Animals↗
PubMed1993

Naltrexone-induced pruritus in a dog with tail-chasing behavior.

Naltrexone, an opioid antagonist recently advocated for the control of stereotypic behavioral patterns in horses and dogs, induced an intense dose-related pruritic reaction in a dog with tail-chasing and self-mutilating behavior. Used in human beings primarily as an adjunct in the treatment of opioid abusers, naltrexone's adverse effects include dermatologic signs, such as alopecia and pruritus, observed in < 1% of human patients. In contrast to previously reported findings, naltrexone treatment was of limited benefit to the dog of this report. During administration of the drug, stereotypic patterns were reduced but did not disappear. Although naltrexone may be effective in controlling certain obsessive-compulsive disorders, its inconsistent therapeutic value, prohibitive cost to pet owners, and side effects such as the pruritus observed in the dog of this report may restrict use of this drug.

Animals↗
PubMed1985

"Your feet's too big": an inquiry into psychological and symbolic meanings of the foot.

The foot is a highly cathected appendage that is commonly singled out as the brunt of humorous or derisive remarks, as if it embodies repugnance and disgust. Attitudes toward the foot are overdetermined, bearing the imprint of man's early linguistic patterns and individual dynamics. This article suggests that feet are symbolic because they bear the feelings derived from earlier separations, good and bad object representations, collective memories, and genital representations. The foot's role as symbol of both the male and female genitals, repository of badness, symbol of passivity, initiator of movement, and site of self-mutilation have been briefly reviewed. As Fats Waller rhapsodizes that the "feet's too big," he finds a convenient way to displace his symbiotic and erotic anxieties vis-à-vis women. Similarly, patients who come for psychiatric treatment and psychotherapy frequently make references to their feet or use them in specific ways. An understanding of this type of communication can often provide insight into individual dynamics and enhance treatment. The weight placed on these communications depends, of course, on the vicissitudes of the previous therapeutic work as well as on the particular problems of the patient.

Adult↗
PubMedDate not supplied

Possible role of sympathetic activity in abnormal behavior of rats induced by lesion of the sciatic nerve.

The role of genetic differences and environmental stress in the form of continuous exposure to cold in the production of abnormal behavior in rats was examined by subjecting the animals to unilateral sciatic nerve section. Some nerve-lesioned Sprague-Dawley (SD) rats responded to the cold by developing a state we termed stress-related pain behavior (SRPB). These animals also self-mutilated the denervated limb (autotomized) more often than cold-exposed rats that did not develop SRPB. The role of genetic differences was studied by also subjecting Wistar-Kyoto (WK) and spontaneously hypertensive (SHR) rats to sciatic nerve section and cold. Both WK and SHR rats, which have a higher level of circulating catecholamines than SD rats, autotomized significantly less than SDs, and did not exhibit SRPB. The results suggest that differences in susceptibility to stress and genetic variability may be important factors in the development of abnormal and/or pain behaviors following peripheral nerve trauma.

Animals↗
PubMed1983

Continuous naloxone administration via osmotic minipump decreases autotomy but has no effect on nociceptive threshold in the rat.

Rats with unilaterally sectioned sciatic nerves were continuously administered naloxone HCl (80 or 800 micrograms/h) or equivalent volumes of saline (1 or 10 microliters/h) subcutaneously via osmotic minipumps over a 2 or 5 week period. Rats receiving 80 micrograms/h naloxone for 5 weeks exhibited significantly less self-mutilation (autotomy) of the denervated foot than saline controls or rats receiving 80 micrograms/h naloxone for 2 weeks. The nociceptive threshold of intact rats infused with the same dose of naloxone was tested on a hot plate. In these animals there was no influence on the nociceptive threshold during naloxone administration for 1 week. Autotomy was also reduced in rats infused with 800 micrograms/h naloxone. The nociceptive threshold of intact rats infused with this dose of naloxone or an equivalent volume of saline (10 microliters/h) was increased, suggesting that the presence of the larger osmotic pump caused analgesia.

Animals↗
PubMed2004

The borderline syndrome in psychosomatic dermatology. Overview and case report.

The borderline syndrome is one of the most severe disturbances of psychosomatic dermatology. Patients with borderline syndrome are situated 'on the border' of psychosis, neurosis and personality disorders. The skin as a borderline organ carries a symbolic role. The clinical picture includes artefactual skin diseases due to self-mutilation by conscious or unconscious cutting, and rubbing, scratching or para-artefactual manipulations of pre-existing dermatoses. Leading symptoms of the borderline syndrome are poor impulse control, emotional instability and poor ego strength with low frustration tolerance and unstable personal relationships. We present the case of a 38-year-old female patient with borderline syndrome suffering from para-artefactual skin diseases of the face and a massive hyperhidrosis of the hands and feet. Within 9 months she was treated in four acute psychiatric hospitals and by 12 psychiatrists and psychotherapists. Early and accurate diagnosis and high-quality, sophisticated long-term therapy are necessary.

Adult↗
PubMed1974

Stereotactic amygdaloidotomy for aggressive behaviour.

Amygdaloidotomy was performed bilaterally on 15 and unilaterally on three patients exhibiting severe aggressive or self-mutilating behaviour. Nine subjects (50%) were improved a year after operation; improvement was maintained in seven (39%) for periods ranging from 27 months to nearly six years. Four non-epileptic cases had convulsions during the period of review; one of them has a persistent mild hemiparesis dating from the postoperative period. There was a tendency for epileptics to respond better than non-epileptics and for mentally retarded patients to respond poorly, but none of the differences was statistically significant.

Adolescent↗
PubMed2006

Focal seizures originating from the left temporal lobe in a case with chorea-acanthocytosis.

Neuroacanthocytosis is a group of disorders, clinically characterized with movement disorders, self-mutilation and seizures. There is little information in the literature regarding the clinical and EEG findings of the accompanying seizures in this neurodegenerative disorder. A 46-year-old man who was diagnosed as chorea-acanthocytosis, a subgroup of neuroacanthocytosis, was investigated for severe drug resistant seizures. Continuous video-EEG monitoring revealed an active left temporal epileptogenic focus with left temporal rhythmic discharges detected during his complex partial seizures. T2-weighted cranial MRI indicated hyperintensity of the left amygdala as well as hyperintensity and atrophy of bilateral basal ganglia. We discuss the development of focal seizures in a patient who has a neurodegenerative disease, namely neuroacanthocytosis.

Adult↗
PubMed1978

Reactions of schizophrenics to life-threatening disease.

This contribution reports a study of chronic schizophrenics hospitalized in state hospitals who suffer from serious and life-threatening medical and surgical illnesses. Four primary findings are described and discussed: lack of verbalization of pain and discomfort; bodily self-mutilation; toleration and exhibition of loathsome lesions; and inability or unwillingness to tolerate medical care. Some examples of exceptions to these four findings are also presented. Possible explanations for the findings are discussed in terms of their biological, social, and psychological components, recognizing that no single factor can explain the findings in this complex and varied population. It is concluded that treatment staffs in the hospital or community must be alert to changes in patient state, must utilize compromise methods of care and must anticipate or deduce a patient's needs while the patient is physically ill.

Adult↗
PubMed1976

The use of 5-hydroxytryptophan in a child with Lesch-Nyhan syndrome.

The effects of 5-hydroxytryptophan (5-HTP), a serotonin precursor, were studied in a boy with the Lesch-Nyhan syndrome. During the course of drug treatment, self-mutilation, crying, sleep state architecture, serum dopamine B-hydroxylase (DBH), and cerebrospinal fluid levels of 5-hydroxyindolylacetic acid and homovanillic acid were studied. Treatment with 5-HTP failed to affect this child's biting behavior. However, the drug significantly reduced irritability as measured by crying time. Moreover, 5-HTP may have affected sleep state architecture, making it more normal in character. Serum DBH levels were normal throughout the study. Neither the patient's mother nor his maternal grandmother showed a hypertensive response on the cold pressor test.

5-Hydroxytryptophan↗
PubMed2006

Multisite integumentary squamous cell carcinoma in an African grey parrot (Psittacus erithacus erithacus).

A 22-year-old male African grey parrot (Psittacus erithacus erithacus) had had episodes of chronic feather picking and self-mutilation for 10 years; it had a 5 cm diameter right axillary wound and a 2 cm left dorsal patagial wound. Initial treatment with azithromycin and wound management was unsuccessful. Biopsies of both masses indicated squamous cell carcinoma. The left patagial tumour was removed completely by electrocautery. Cisplatin was administered weekly into multiple sites on the right axillary tumour and it initially appeared to regress; however, the bird's condition deteriorated after a month of treatment, and it was euthanased. The tumour was confirmed postmortem to be squamous cell carcinoma, which had invaded local tissues. The aetiology of the carcinoma may have been secondary to chronic focal trauma.

Animals↗
PubMed1993

Self-inflicted orbital and intracranial injury with a retained foreign body, associated with psychotic depression: case report and review.

Reports of intracranial self-mutilation by psychotic individuals are associated with severe mental disorders, criminality, or both. We describe a psychotically depressed male who drove a ballpoint pen through his right medial canthus and into his intracranial compartment. The patient developed a cavernous sinus syndrome and a traumatic dissection of the cavernous portion of the carotid artery. The pen was removed intraoperatively. Postoperatively, the patient was placed on a course of broad-spectrum antibiotics, antidepressants, and antipsychotic medications, and he has received long-term psychiatric follow-up. The literature related to these unusual cases is reviewed, and relevant surgical, medical, and psychiatric aspects of treatment are discussed.

Adult↗
PubMed1987

Cutaneous hyperalgesia: contributions of the peripheral and central nervous systems to the increase in pain sensitivity after injury.

This study assesses the contributions of the peripheral and central nervous systems in the development of hyperalgesia (increased pain sensitivity) after an injury. Experiments were carried out to examine the role of C-fiber afferents, the spinal cord and sympathetic efferents on inflammation, primary hyperalgesia and referred hyperalgesia produced in rats by a heat injury. A peripheral mechanism was indicated since both primary hyperalgesia and inflammation after a heat injury were significantly attenuated by blocking C-fiber afferents with local capsaicin. In addition, a central mechanism was indicated since the spread of hyperalgesia to the paw contralateral to a heat injury was prevented by either spinal anesthesia or the blocking of sympathetic efferents by guanethidine. A further role for central mechanisms was indicated since referred hyperalgesia--the enhancement of self-mutilation (autotomy) of a denervated limb which had previously sustained a heat injury--was reduced by spinal anesthesia or a combined blocking of C-fiber afferents and sympathetic efferents with intrathecal capsaicin + guanethidine. The results strongly suggest that referred hyperalgesia after a heat injury is dependent on increased spinal cord activity. However, autotomy in rats that did not undergo a previous injury was unaffected by either spinal anesthesia or intrathecal capsaicin. This suggests that spinal cord hyperactivity, although it plays a role in hyperalgesia following a heat injury, is not a crucial factor in producing pain and hyperalgesia after a nerve injury.

Animals↗
PubMed1989

Chronic amitriptyline decreases autotomy following dorsal rhizotomy in rats.

In the rat, unilateral dorsal cervicothoracic rhizotomy (C5-T1), a proposed model of chronic pain, resulted in autotomy of the ipsilateral limb. The self-mutilation lesions were evaluated daily by means of an autotomy score from the 1st to the 80th postoperatory day. The onset of lesions was variable and attained the maximum degree 8-9 weeks after the dorsal roots section. Chronic administration of amitriptyline (5 and 10 mg/kg/day, i.p., over 30 days), started on the 10th day after rhizotomy, decreased autotomy behavior, an effect which persisted 20 days after treatment withdrawal, and lengthened almost two-fold the lag time between rhizotomy and appearance of lesions. A more pronounced effect was observed with the lowest dose of amitriptyline suggesting the existence of a therapeutic window. Possible mechanisms for the antinociceptive effect of amitriptyline in this model are discussed.

Amitriptyline↗
PubMed1986

Deafferentation and chronic pain in animals: an evaluation of evidence suggesting autotomy is related to pain.

This paper examines evidence which suggests that the self-mutilation of deafferented limbs exhibited by laboratory animals is a response to pain or dysesthesia and is therefore an adequate model of chronic pain. Evidence from studies using physiological, pharmacological and behavioral methods provides strong support that autotomy reflects chronic pain. New evidence presented in this paper demonstrates that specific treatments can be used to manipulate the extent of autotomy, causing increases or decreases, as well as restricting it to specific parts of a denervated foot. This evidence argues that autotomy scores are an appropriate measure of the degree of pain or dysesthesia which results from the deafferentation of a limb.

Afferent Pathways↗
PubMed2003

The deafferented nonhuman primate is not a reliable model of intractable pain.

Before extending the application of motor cortex stimulation it is important to investigate the intimate mechanisms by which it alleviates intractable pain and to consider possible side effects. Self-mutilation in animals following extensive neurectomy or posterior rhizotomy of a limb is thought to reveal severe dysesthesias in the deafferented zone suggesting its usefulness as an animal model of chronic pain in humans. We here show in deafferented nonhuman primates that the autotomy behavior immediately follows the surgery and disappears after 28 days. In keeping with the experience of Y. Lamarre, the simple but careful care of all wounds is sufficient to abolish this behavior. Our results do not exclude the possibility that the deafferentiation is still painful for the monkeys, but they definitely rule out that autotomy is a consistent response to deafferentation.

Animals↗
PubMed2002

Pre-degenerated peripheral nerve extracts applied to the proximal stump of transected sciatic nerve enhance both regeneration and autotomic behavior in rats.

BACKGROUND: Peripheral nerve regeneration after traumatic injury and standard repair with a nerve autograft is often incomplete and results in neuropathic pain. Peripheral nerve extracts applied to the proximal nerve stump by means of autologous, dead-ended connective tissue chambers (deCTC) are known to accelerate the rate of axon regeneration. This study tested if such extracts would influence autotomy, which is a behavioral measure of neuropathic pain in animal models. MATERIAL/METHODS: The study was performed on Wistar rats. DeCTCs, filled with postmicrosomal fraction obtained from 7-day-predegenerated nerves (7D group) or fibrin (F group), were implanted into transected sciatic nerve. In the control group (C), sciatic nerve was transected and its distal part was removed. The self-mutilation behavior in rats was assessed daily for seven weeks after sciatic nerve transection. The onset as well as intensity of autotomy was measured. The progress of regeneration was assessed under light microscopy and histochemistry. RESULTS: The earliest onset and greatest severity of autotomy were found in the 7D group. Regeneration progress was also highest in this group. In the F group, we found weaker regeneration and less autotomy. The control group showed no regeneration, but more autotomy than the F group. CONCLUSIONS: Intensified autotomy may be the price paid for enhanced peripheral nerve regeneration after application of growth-promoting substances.

Animals↗