Yamanaka Hiroki, Noguchi Koichi
Department of Anatomy and Neuroscience, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan.
Brain Nerve. 2012 Nov;64(11):1255-65.
Neuropathic pain syndromes are clinically characterized by spontaneous pain and evoked pain (hyperalgesia and allodynia). The optimal treatment approach for neuropathic pain is still under development because of the complex pathological mechanisms underlying this type of pain. The spinal cord is an important gateway thorough which peripheral pain signals are transmitted to the brain, and sensitization of the spinal neurons is one of the important mechanisms underlying neuropathic pain. Central sensitization represents enhancement of the function of neuronal circuits in nociceptive pathways and is a manifestation of the remarkable plasticity of the somatosensory nervous system after nerve injury. This review highlights the pathological features of central sensitization, which develops because of (1) injury-induced abnormal inputs from primary afferents, (2) increase in the excitability of dorsal horn neurons, and (3) activated glial cell-derived signals.
神经病理性疼痛综合征的临床特征为自发痛和诱发性疼痛(痛觉过敏和感觉异常)。由于这类疼痛背后的病理机制复杂,神经病理性疼痛的最佳治疗方法仍在研究中。脊髓是外周疼痛信号传递至大脑的重要通道,脊髓神经元的敏化是神经病理性疼痛的重要机制之一。中枢敏化表现为伤害性感受通路中神经回路功能增强,是神经损伤后体感神经系统显著可塑性的一种表现。本综述重点介绍了中枢敏化的病理特征,其形成原因包括:(1)损伤诱导的初级传入神经异常输入;(2)背角神经元兴奋性增加;(3)胶质细胞衍生信号激活。
Neuroscientist. 2011-2-28