Mechanisms of neuropathic pain |
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| Authors: | Florian T. Nickel Frank Seifert Stefan Lanz Christian Maihöfner |
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| Affiliation: | 1. Danish Pain Research Center, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark;2. INSERM U-987, Centre d''Evaluation et de Traitement de la Douleur, Hôpital Ambroise Paré, Assistance Publique Hôpitaux de Paris, Boulogne-Billancourt, France;3. Université Versailles Saint-Quentin, France;4. Division of Clinical and Translational Research, Department of Anesthesiology, Washington University School of Medicine, St Louis, MO, USA;5. Departments of Anesthesiology and Pharmacy, Tufts Medical Center, Boston, MA, USA;6. Division of Neurological Pain Research and Therapy, Department of Neurology, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Kiel, Germany;7. Department of Anesthesiology and Department of Neurology, Center for Human Experimental Therapeutics, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA;8. Department of Anesthesiology and Perioperative Medicine and Biomedical and Molecular Sciences, Queen''s University, Kingston, ON, Canada;9. Department of Neurosurgery, Helsinki University Central Hospital, Helsinki, Finland;10. Mutual Insurance Company Etera, Helsinki, Finland;11. Department of Pain Management and Research, Oslo University Hospital, Oslo, Norway;12. Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden;13. Department of Neurology, Aarhus University Hospital, Aarhus, Denmark;14. Brain Function Research Group, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, South Africa;15. Nuffield Division of Anaesthetics, Nuffield Department of Clinical Neurosciences, Pain Research, Churchill Hospital, Oxford, UK;p. Johns Hopkins School of Medicine, Division of Pain Medicine, Department of Anesthesiology and Critical Care Medicine, Baltimore, MD, USA;q. Pain Research, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, UK;r. Pain Medicine, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK;s. California Pacific Medical Center Research Institute and UCSF Pain Management Center, San Francisco, CA, USA;t. Division of Clinical Neurosciences, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK;u. Florey Institute of Neuroscience and Mental Health, Melbourne, VIC, Australia;v. Department of Pain Management, Greenwich Hospital, HammondCare, Sydney, NSW, Australia;w. Kolling Institute, Sydney Medical School-Northern, University of Sydney, Sydney, NSW, Australia;x. Division of Population Health Sciences, University of Dundee, Ninewells Hospital and Medical School, Dundee, Scotland;y. Division of Pain Medicine, Department of Anesthesiology, UCSD, San Diego, CA, USA;1. Sektion Neurologische Schmerzforschung und Therapie, Klinik für Neurologie, Universitätsklinikum Schleswig-Holstein, Kiel, Germany;1. Department of Anesthesiology, Weill Cornell Medical College, New York, NY, USA;2. Department of Medicine, Weill Cornell Medical College, New York, NY, USA;1. Institut des Neurosciences Cellulaires et Intégratives, Centre National de la Recherche Scientifique, Strasbourg, France;2. Université de Strasbourg, Strasbourg, France;3. Centre d’Etude et de Traitement de la Douleur, Hôpitaux Universitaires de Strasbourg, Strasbourg, France |
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| Abstract: | Neuropathic pain is a disease of global burden. Its symptoms include spontaneous and stimulus-evoked painful sensations. Several maladaptive mechanisms underlying these symptoms have been elucidated in recent years: peripheral sensitization of nociception, abnormal excitability of afferent neurons, central sensitization comprising pronociceptive facilitation, disinhibition of nociception and central reorganization processes, and sympathetically maintained pain. This review aims to illustrate these pathophysiological principles, focussing on molecular and neurophysiological findings. Finally therapeutic options based on these findings are discussed. |
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