Demasles S, Peyron R, Garcia Larrea L, Laurent B
Centre stéphanois de la douleur et service de neurologie, hôpital de Bellevue, 42055 Saint-Etienne cedex 02, France.
Rev Neurol (Paris). 2008 Oct;164(10):825-31. doi: 10.1016/j.neurol.2008.07.016. Epub 2008 Sep 6.
Central post-stroke pain (CPSP) is known since the famous Dejerine-Roussy syndrome and its description has not improved. The subject has however been revived over the last decade thanks to advances in central nervous system imaging with magnetic resonance imaging (MRI), the description of allodynia functional phenomena with fMRI, the study of opioid receptors, and above all, the analysis of pain pathways by laser-evoked potentials. Progress has also occurred in CPSP treatment with motor cortex stimulation, which probably opens a period of neuromodulation of the cortical areas controlling pain. The thalamus plays a prominent role in this disorder of central control of pain.
自从著名的德热里纳 - 罗西综合征被发现以来,中枢性卒中后疼痛(CPSP)就已为人所知,但其描述并无改进。然而,在过去十年中,由于磁共振成像(MRI)在中枢神经系统成像方面的进展、功能磁共振成像(fMRI)对痛觉过敏功能现象的描述、阿片受体的研究,尤其是通过激光诱发电位对疼痛通路的分析,这个主题又重新受到关注。CPSP的治疗也取得了进展,运动皮层刺激疗法可能开启了对控制疼痛的皮层区域进行神经调节的时期。丘脑在这种疼痛中枢控制障碍中起着重要作用。