Section of Neurosurgery, Department of Surgery, Regina General Hospital, University of Saskatchewan, Regina, SK, S4P 0W5, Canada,
Curr Pain Headache Rep. 2014 Jan;18(1):387. doi: 10.1007/s11916-013-0387-y.
Neuromodulation is based on the revolutionary concept that paresthesia-inducing electrical stimulation could be analgesic. Its historical basis emanates from Melzack and Wall's gate control theory of pain proposed in 1965. Neuromodulation has given us ready access to the systems of pain modulation and helped mature the understanding of the pathophysiology of pain. Physiologic studies highlight the complex ascending influence of neurostimulation on sensory processing. However, the present understanding of pain is rudimentary and evidence that neuromodulation works is modest. This paper emphasizes the historical antecedents, present state, and emerging future of 3 commonly applied neuromodulatory techniques--spinal cord stimulation, peripheral nerve and field stimulation, and deep brain stimulation--for chronic pain. It is hoped this article will enhance the understanding of neuromodulation and its role in pain management.
神经调节基于一个革命性的概念，即诱发电位的电刺激可能具有镇痛作用。其历史基础源自梅尔扎克和沃尔于 1965 年提出的门控疼痛理论。神经调节使我们能够轻易地接触到疼痛调节系统，并帮助我们深入了解疼痛的病理生理学。生理学研究强调了神经刺激对感觉处理的复杂上行影响。然而，目前对疼痛的理解还很初步，神经调节有效的证据也有限。本文重点介绍了三种常用的神经调节技术——脊髓刺激、周围神经和电场刺激以及深部脑刺激——在慢性疼痛治疗中的历史背景、现状和未来发展。希望本文能够增强对神经调节及其在疼痛管理中的作用的理解。
