Qu Ning, Tian HaoChun, De Martino Enrico, Zhang Bin
Department of Orthopedic Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, China.
Center for Neuroplasticity and Pain (CNAP), Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark.
Front Comput Neurosci. 2022 Jul 15;16:946514. doi: 10.3389/fncom.2022.946514. eCollection 2022.
Neck pain is a worldwide health problem. Clarifying the etiology and providing effective interventions are challenging for the multifactorial nature of neck pain. As an essential component of cervical spine function, the sensorimotor control system has been extensively studied in both healthy and pathological conditions. Proprioceptive signals generated from cervical structures are crucial to normal cervical functions, and abnormal proprioception caused by neck pain leads to alterations in neural plasticity, cervical muscle recruitment and cervical kinematics. The long-term sensorimotor disturbance and maladaptive neural plasticity are supposed to contribute to the recurrence and chronicity of neck pain. Therefore, multiple clinical evaluations and treatments aiming at restoring the sensorimotor control system and neural plasticity have been proposed. This paper provides a short review on neck pain from perspectives of proprioception, sensorimotor control system, neural plasticity and potential interventions. Future research may need to clarify the molecular mechanism underlying proprioception and pain. The existing assessment methods of cervical proprioceptive impairment and corresponding treatments may need to be systematically reevaluated and standardized. Additionally, new precise motor parameters reflecting sensorimotor deficit and more effective interventions targeting the sensorimotor control system or neural plasticity are encouraged to be proposed.
颈部疼痛是一个全球性的健康问题。由于颈部疼痛的多因素性质,明确其病因并提供有效的干预措施具有挑战性。作为颈椎功能的重要组成部分,感觉运动控制系统在健康和病理状态下都得到了广泛研究。由颈椎结构产生的本体感觉信号对正常的颈椎功能至关重要,而颈部疼痛引起的异常本体感觉会导致神经可塑性、颈部肌肉募集和颈椎运动学的改变。长期的感觉运动障碍和适应性不良的神经可塑性被认为是导致颈部疼痛复发和慢性化的原因。因此,已经提出了多种旨在恢复感觉运动控制系统和神经可塑性的临床评估和治疗方法。本文从本体感觉、感觉运动控制系统、神经可塑性和潜在干预措施等方面对颈部疼痛进行了简要综述。未来的研究可能需要阐明本体感觉和疼痛背后的分子机制。现有的颈椎本体感觉障碍评估方法和相应的治疗方法可能需要进行系统的重新评估和标准化。此外,鼓励提出反映感觉运动缺陷的新的精确运动参数,以及针对感觉运动控制系统或神经可塑性的更有效干预措施。