Wiech K, Preissl H, Birbaumer N
Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Germany.
Scand J Rheumatol Suppl. 2000;113:13-8. doi: 10.1080/030097400446571.
New developments in brain imaging lead to a better understanding of cortical and subcortical processes involved in pain perception and the establishment of chronic pain. For different forms of chronic pain long-term changes in cortical structures have been described. In patients with phantom limb pain and back pain alterations in the somatotopic organization of the primary somatosensory (SI) could be observed. The amount of this reorganization is correlated with the subjective pain rating. These changes, which are based on processes of neuronal plasticity, can partially be reversed by analgesic interventions. For the investigation of cortical processes concerning reorganization, EEG and MEG methods are most suitable because of their high temporal and spatial resolution. In conclusion, these findings open a new way for therapeutic interventions to prevent the development of chronic pain.
脑成像技术的新进展使人们对疼痛感知和慢性疼痛形成过程中涉及的皮质及皮质下过程有了更好的理解。对于不同形式的慢性疼痛，已有关于皮质结构长期变化的描述。在幻肢痛和背痛患者中，可以观察到初级躯体感觉皮层（SI）躯体定位组织的改变。这种重组的程度与主观疼痛评分相关。这些基于神经元可塑性过程的变化，部分可通过镇痛干预得以逆转。对于研究与重组相关的皮质过程，脑电图（EEG）和脑磁图（MEG）方法因其高时间和空间分辨率而最为适用。总之，这些发现为预防慢性疼痛发展的治疗干预开辟了一条新途径。
