Møller A R
Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pennsylvania, USA.
Am J Otol. 1997 Sep;18(5):577-85.
The aim of this study is to review hypotheses about the mechanisms of chronic pain and to compare them with that of tinnitus. Hypotheses about the pathophysiology of severe tinnitus and chronic pain have been of mainly two kinds: one of which claims that pathology located in the periphery (the ear for tinnitus, and peripheral nerves for pain) can explain the symptoms, while the other claims that the symptoms are caused by changes in the function of nuclei of the central nervous system.
A search of the literature from the past 35 years was used.
There is considerable evidence that both chronic pain and some forms of tinnitus are caused by changes in the central nervous system and that the anatomic location of the physiologic abnormality causing the symptoms of chronic pain and some forms of tinnitus is not the same location to which the symptoms are referred, i.e., the ear for tinnitus and the location of injury for pain. Such changes in the central nervous system may have been induced by peripheral processes such as tissue damage, but the changes can persist a long time after complete healing of a peripheral lesion. Different forms of tinnitus may respond to different treatments as is the case for chronic pain. If the different forms of tinnitus cannot be separated, then the results of studies of the efficacy of different kinds of drugs may be misleading.
本研究旨在回顾关于慢性疼痛机制的假说，并将其与耳鸣的机制进行比较。关于重度耳鸣和慢性疼痛病理生理学的假说主要有两类：一类认为位于外周的病变（耳鸣为耳部，疼痛为外周神经）可解释症状，而另一类则认为症状是由中枢神经系统核团功能变化所致。
使用了对过去35年文献的检索。
有大量证据表明，慢性疼痛和某些形式的耳鸣均由中枢神经系统变化引起，且导致慢性疼痛和某些形式耳鸣症状的生理异常的解剖位置与症状所涉及的位置不同，即耳鸣的耳部和疼痛的损伤部位。中枢神经系统的此类变化可能由诸如组织损伤等外周过程诱发，但在外周病变完全愈合后，这些变化仍可能长期存在。与慢性疼痛一样，不同形式的耳鸣可能对不同治疗有反应。如果不能区分不同形式的耳鸣，那么不同种类药物疗效研究的结果可能会产生误导。
