中枢神经病痛中心神经病痛
Jan Rosner1,2,3, Daniel C de Andrade4, Karen D Davis5,6
1Danish Pain Research Center, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
Nature reviews. Disease primers
|December 21, 2023
概括
中枢神经病痛,通常是脑或脊髓损伤后,涉及复杂的神经系统变化. 了解这些机制是开发超越当前药物和治疗方法的更好的治疗方法的关键.
科学领域:
- 神经学 神经学
- 疼痛医学 医学 疼痛医学
- 神经科学是一个神经科学.
背景情况:
- 中枢神经病痛 (CNP) 源于中枢神经系统 (CNS) 的损伤,包括脑损伤,脊髓损伤,中风和多发性硬化症.
- 虽然发病率各不相同,但中枢中风后疼痛是全球最常见的形式,脊髓损伤患者面临的风险最高.
- 病理生理学是复杂的,涉及不适应性可塑性,神经元过度刺激性和疼痛通路内的神经免疫相互作用.
研究的目的:
- 审查目前对中枢神经病痛机制的理解.
- 概述当前和潜在的治疗策略来管理CNP.
- 强调临床评估和先进技术在CNP研究和患者护理中的作用.
主要方法:
- 对CNP现有研究的文献综述.
- 分析当前的药物和非药物治疗选择.
- 讨论神经生理学和神经成像技术的作用.
主要成果:
- CNP机制涉及脊髓和大脑电路内的复杂相互作用,导致神经元过度兴奋.
- 抗抑郁药和 gabapentinoids 是一线的药理疗法.
- 非药物治疗方法包括自我管理,运动和神经调节.
结论:
- 调节神经元活动,神经免疫相互作用和大脑连接是有希望的治疗途径.
- 综合性临床评估对于CNP分类和患者分层至关重要.
- 神经成像和神经生理学为治疗反应提供了机械洞察力和预测生物标志物的潜力.
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