Schattschneider J, Wasner G, Binder A, Siebrecht D, Baron R
Klinik für Neurologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel.
Schmerz. 2003 Oct;17(5):317-24. doi: 10.1007/s00482-003-0229-7.
Sympathetically maintained pain is a symptom which occurs in neuropathic pain syndromes of different etiologies. From animal experiments it is known that nociceptive afferents after partial nerve lesions develop adrenergic sensitivity at the site of the injury. In addition, a sympathetic-afferent coupling takes place in the dorsal root ganglia. It is still controversial if these pathophysiological mechanisms are responsible for the developing of SMP in humans. Clinical studies support the idea that also in humans the application of adrenergic substances in pharmacological doses is capable to influence nociception, but a direct interaction between the sympathetic system and the nociceptive system had not been demonstrated so far. By using a thermal suit for whole body cooling and warming, which produces low and high activity of sympathetic vasoconstrictor neurons, it was possible for the first time to demonstrate an interaction between physiological changes in sympathetic activity and nociception.
交感神经维持性疼痛是一种出现在不同病因的神经病理性疼痛综合征中的症状。从动物实验可知，部分神经损伤后的伤害性传入神经在损伤部位会产生肾上腺素能敏感性。此外，在背根神经节中会发生交感神经与传入神经的耦合。这些病理生理机制是否导致人类交感神经维持性疼痛的发生仍存在争议。临床研究支持这样一种观点，即对人类而言，给予药理剂量的肾上腺素能物质也能够影响痛觉，但到目前为止，尚未证实交感神经系统与痛觉系统之间存在直接相互作用。通过使用一种用于全身冷却和加热的热服，这种热服可产生交感缩血管神经元的低活性和高活性，首次证明了交感神经活动的生理变化与痛觉之间存在相互作用。
