Comprehensive Pain Program, Toronto Western Hospital, Canada.
Curr Opin Anaesthesiol. 2010 Oct;23(5):593-7. doi: 10.1097/ACO.0b013e32833dd01c.
To review the literature and our current understanding of nondermatomal somatosensory deficits (NDSDs) associated with chronic pain in regards to their prevalence, assessment and clinical presentation, cause and pathophysiology, relationship with conversion disorder and psychological factors, as well as their treatment and prognosis.
NDSDs are negative sensory deficits consisting of partial or total loss of sensation to pinprick, light touch or other cutaneous modalities. Although they had been noted more than a century ago and appear prevalent in chronic pain populations, they are poorly studied. They may be very mild or very dense, may occupy large body areas, are often highly dynamic and changeable or, to the contrary, very stable and long lasting. NDSDs may occur in the absence of biomedical pathology or coexist with structural musculoskeletal or nervous system abnormalities. They appear to be associated with psychological factors and a poor prognosis for response to treatment and return to work. Recent brain imaging studies provide a basis for understanding NDSD pathophysiology.
NDSDs represent prevalent phenomena associated with chronic pain. Further, research is needed to elucidate their origin, response to treatment, and prevalence in the general population, primary care settings, and nonpain patients.
回顾有关慢性疼痛相关非皮节躯体感觉缺失（NDSD）的文献和我们目前的认识，包括其患病率、评估和临床表现、原因和病理生理学、与转换障碍和心理因素的关系，以及它们的治疗和预后。
NDSD 是一种负性感觉缺失，表现为刺痛、轻触或其他皮肤感觉模式的部分或完全丧失。尽管它们在一个多世纪前就已被注意到，并在慢性疼痛人群中似乎很常见，但它们的研究却很少。它们可能非常轻微或非常密集，可能占据大面积，通常高度动态和多变，或者相反，非常稳定和持久。NDSD 可能在没有生物医学病理学的情况下发生，也可能与结构肌肉骨骼或神经系统异常共存。它们似乎与心理因素以及对治疗和重返工作的反应不佳有关。最近的脑成像研究为理解 NDSD 病理生理学提供了基础。
NDSD 是与慢性疼痛相关的普遍现象。此外，需要进一步研究以阐明其起源、对治疗的反应以及在普通人群、初级保健环境和非疼痛患者中的患病率。
