Flor Herta
Department of Clinical & Cognitive Neuroscience, University of Heidelberg, Central Institute of Mental Health, J5, D-68159 Mannheim, Germany.
Expert Rev Neurother. 2008 May;8(5):809-18. doi: 10.1586/14737175.8.5.809.
A number of studies have shown that phantom limb pain is associated with plastic changes along the neuraxis, with a close correlation between changes in the cortical representation of the affected limb and phantom limb pain. Mechanisms underlying these maladaptive plastic changes are related to a loss of GABAergic inhibition, glutamate-mediated long-term potentiation-like changes and structural alterations such as axonal sprouting. These plastic changes and phantom limb pain seem to be more extensive when chronic pain precedes the amputation. Behavioral interventions, stimulation, feedback and pharmacological interventions that are designed to reverse these maladaptive memory traces and enhance extinction may be beneficial for the treatment and prevention of phantom limb pain.
多项研究表明，幻肢痛与沿神经轴的可塑性变化有关，受影响肢体的皮质表征变化与幻肢痛之间存在密切关联。这些适应不良的可塑性变化背后的机制与GABA能抑制的丧失、谷氨酸介导的类似长时程增强的变化以及轴突发芽等结构改变有关。当慢性疼痛先于截肢出现时，这些可塑性变化和幻肢痛似乎更为广泛。旨在逆转这些适应不良记忆痕迹并增强消退的行为干预、刺激、反馈和药物干预可能对幻肢痛的治疗和预防有益。
