Jutzeler C R, Curt A, Kramer J L K
Spinal Cord Injury Center, University Hospital Balgrist, University of Zurich, Zurich, Switzerland.
Spinal Cord Injury Center, University Hospital Balgrist, University of Zurich, Zurich, Switzerland; ICORD, School of Kinesiology, University of British Columbia, Vancouver, BC, Canada.
Neuroimage Clin. 2015 Oct 3;9:599-606. doi: 10.1016/j.nicl.2015.09.018. eCollection 2015.
Mechanisms underlying the development of phantom limb pain and neuropathic pain after limb amputation and spinal cord injury, respectively, are poorly understood. The goal of this systematic review was to assess the robustness of evidence in support of "maladaptive plasticity" emerging from applications of advanced functional magnetic resonance imaging (MRI).
Using MeSH heading search terms in PubMed and SCOPUS, a systematic review was performed querying published manuscripts.
From 146 candidate publications, 10 were identified as meeting the inclusion criteria. Results from fMRI investigations provided some level of support for maladaptive cortical plasticity, including longitudinal studies that demonstrated a change in functional organization related to decreases in pain. However, a number of studies have reported no relationship between reorganization, pain and deafferentation, and emerging evidence has also suggested the opposite - that is, chronic pain is associated with preserved cortical function.
Based solely on advanced functional neuroimaging results, there is only limited evidence for a relationship between chronic pain intensity and reorganization after deafferentation. The review demonstrates the need for additional neuroimaging studies to clarify the relationship between chronic pain and reorganization.
分别导致截肢后幻肢痛和脊髓损伤后神经性疼痛的机制仍知之甚少。本系统评价的目的是评估支持高级功能磁共振成像（MRI）应用中出现的“适应性不良可塑性”的证据的稳健性。
在PubMed和SCOPUS中使用医学主题词（MeSH）检索词进行系统评价，查询已发表的手稿。
从146篇候选出版物中，确定了10篇符合纳入标准。功能磁共振成像（fMRI）研究结果为适应性不良的皮质可塑性提供了一定程度的支持，包括纵向研究表明功能组织的变化与疼痛减轻有关。然而，许多研究报告重组、疼痛和传入神经阻滞之间没有关系，新出现的证据也表明情况相反——即慢性疼痛与保留的皮质功能有关。
仅基于高级功能神经影像学结果，去传入后慢性疼痛强度与重组之间关系的证据有限。该评价表明需要更多的神经影像学研究来阐明慢性疼痛与重组之间的关系。
