Central neuronal mechanisms in cancer-induced bone pain.
Central neuronal mechanisms in cancer-induced bone pain.
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DOI：
10.1097/spc.0b013e328133f5e9
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发表时间：
2007-04-01
影响因子：
2.1
通讯作者：
Dickenson, Anthony H
中科院分区：
文献类型：
--
作者：
Gordon-Williams, Richard M;Dickenson, Anthony H
回顾的目的：考虑不同的神经药理学的基础，从外周神经系统到中枢神经系统在癌症疼痛的冲动传递。最新发现：研究进展表明，可塑性，即神经系统响应外部事件而改变的能力，会导致整个与疼痛感知相关的通路发生变化。利用药理学、功能学、分子学和基因组学技术，为深入了解病理生理学导致疼痛的分子和细胞机制奠定了基础。各种原因引起的慢性或持续性疼痛的特征性变化包括感受野扩大、异常性疼痛和缺乏外部刺激时的自发性疼痛。此外，还有情感和情绪反应，必须与疼痛的这些感官方面一起考虑。总结：很明显，尽管疼痛的感觉和心理方面是可分离的，但导致这些方面疼痛的神经通路是相互联系的。此外，在外周和中枢部位，存在放大和延长疼痛刺激的机制——这可能导致在相对较小的外周病理存在的情况下严重疼痛。这篇综述考虑了这些信号系统及其变化在癌症疼痛的背景下。
PURPOSE OF REVIEW: To consider distinct neuropharmacological substrates that underlie transmission of impulses from the periphery to the central nervous system in cancer pain.RECENT FINDINGS: Advances reveal that plasticity, the ability of the nervous system to alter in response to external events, leads to changes throughout the pathways involved in the perception of pain. Exploitation of pharmacological, functional, molecular and genomic techniques is a basis for new insights into the molecular and cellular mechanisms that contribute to the pain that follows pathophysiology. Characteristic changes experienced with chronic or persistent pain from various causes include expanded receptive fields, allodynia and spontaneous pain in the absence of external stimuli. In addition there are the affective and emotional responses that have to be considered along with these sensory aspects of pain.SUMMARY: It is clear that although the sensory and psychological aspects of pain are separable, the neural pathways that contribute to these aspects of pain are interlinked. Furthermore, at both peripheral and central sites, there are mechanisms that amplify and prolong the painful stimulus--this can result in severe pain in the presence of relatively minor peripheral pathology. This review considers these signalling systems and changes therein in the context of pain in cancer.