Department of Neurology, Rambam Health Care Campus, Laboratory of Clinical Neurophysiology, Faculty of Medicine, Technion, P.O. Box 9602, Haifa, Israel.
Curr Pain Headache Rep. 2013 Sep;17(9):361. doi: 10.1007/s11916-013-0361-8.
Psychophysical evaluation of endogenous pain inhibition via conditioned pain modulation (CPM) represents a new generation of laboratory tests for pain assessment. In this review we discuss recent findings on CPM in neuropathic pain and refer to psychophysical, neurophysiological, and methodological aspects of its clinical implications. Typically, chronic neuropathic pain patients express less efficient CPM, to the extent that incidence of acquiring neuropathic pain (e.g. post-surgery) and its intensity can be predicted by a pre-surgery CPM assessment. Moreover, pre-treatment CPM evaluation may assist in the correct choice of serotonin-noradrenalin reuptake inhibitor analgesic agents for individual patients. Evaluation of pain modulation capabilities can serve as a step forward in individualizing pain medicine.
内源性疼痛抑制的心理物理学评估，通过条件性疼痛调制（CPM），代表了疼痛评估的新一代实验室测试。在这篇综述中，我们讨论了 CPM 在神经病理性疼痛中的最新发现，并提到了其临床意义的心理物理学、神经生理学和方法学方面。通常情况下，慢性神经病理性疼痛患者的 CPM 效率较低，以至于获得神经病理性疼痛（例如手术后）的发生率及其强度可以通过手术前的 CPM 评估来预测。此外，治疗前 CPM 评估可能有助于为个体患者正确选择 5-羟色胺-去甲肾上腺素再摄取抑制剂类镇痛剂。疼痛调制能力的评估可以作为疼痛医学个体化的一个进步。
