Central neuronal plasticity, low back pain and spinal manipulative therapy
Central neuronal plasticity, low back pain and spinal manipulative therapy
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DOI：
10.1016/j.jmpt.2004.04.005
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发表时间：
2004-06-01
影响因子：
1.3
通讯作者：
Gillette, RG
中科院分区：
文献类型：
--
作者：
Boal, RW;Gillette, RG
目的：最近的实验证据表明，神经元/突触可塑性，特别是长时程增强（LTP）和长时程抑制（LTD）在脊髓神经元的审查。这些研究可能的机制解释腰痛及其补救脊柱推拿疗法（SMT）的影响进行了探讨。LTP和LTD的简要描述和钙，谷氨酸和谷氨酸受体在LTP/LTD中的关键作用的阐述作为单独的appendics.Data Sources提供：关于LTP/LTD在脊髓神经元和神经元可塑性的参考文章，一般来说，从神经科学文献的累积审查确定。从脊椎按摩疗法来源引用的与中枢神经元可塑性和LTP/LTD相关的出版物使用脊椎按摩疗法文献索引和非正式综述进行识别。研究选择：包括检查脊髓神经元中LTP/LTD机制的实验研究和更一般的参考文献，这些参考文献可作为中枢神经元可塑性和LTP/LTD的介绍。在这篇综述中提出的实验证据以前已经发表，并说明了神经元可塑性的动物模型腰痛。资料综合：在体外和体内的证据，鉴定LTP和LTD在背角伤害性神经元进行审查。特别感兴趣的是研究显示LTP在强烈的伤害性刺激和报告，Adelta-mechanosensitive传入激活可以扭转现有的LTP条件在背角neurons.Conclusions：潜在的参与LTP在腰痛进行了讨论，并提出了一个作用LTD在脊柱推拿治疗。未来研究的需要是确定在空间和时间变化的领域，SMT后的下背部;组合，测序，并比较几种治疗方法;并证明LTD在脊髓神经元后SMT样刺激。
Objective: Recent experimental evidence demonstrating neuronal/synaptic plasticity and, in particular, long-term potentiation (LTP) and long-term depression (LTD) in spinal neurons is reviewed. The implications of these studies for possible mechanistic explanations of low back pain and its remediation by spinal manipulative therapy (SMT) are explored. Brief descriptions of LTP and LTD and elaboration of the key roles of calcium, glutamate, and glutamate receptors in LTP/LTD are provided as separate appendices.Data Sources: The referenced articles regarding LTP/LTD in spinal cord neurons and neuronal plasticity, in general, were identified from accumulated review of the neuroscience literature. Publications cited from chiropractic sources relevant to central neuronal plasticity and LTP/LTD were identified using the Index to Chiropractic Literature and informal review.Study Selection: Experimental studies examining LTP/LTD mechanisms in spinal neurons and more general references useful as an introduction to central neuronal plasticity and LTP/LTD are included.Data Extraction: Experimental evidence presented in this review has been previously published and illustrates neuronal plasticity from an animal model for low back pain. Data Synthesis: Both in vitro and in vivo evidence identifying LTP and LTD in dorsal horn nociceptive neurons is reviewed. Of special interest are studies showing LTP in response to intense noxious stimulation and reports that Adelta-mechanosensitive afferent activation can reverse an existing LTP condition in dorsal horn neurons.Conclusions: The potential involvement of LTP in low back pain is discussed and a role for LTD in spinal manipulative therapy is proposed. The need for future studies is identified in the areas of spatial and temporal changes in symptomatology post-SMT of the low back; combining, sequencing, and comparing several therapeutic approaches; and demonstrating LTD in spinal cord neurons post-SMT-like stimulation.