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Nervenheilkunde 2012; 31(03): 132-139
DOI: 10.1055/s-0038-1628271
DOI: 10.1055/s-0038-1628271
Schmerz
Funktionelle Bildgebung bei neuropathischen Schmerzen
Functional imaging of neuropathic painWeitere Informationen
Publikationsverlauf
Eingegangen am:
20. März 2011
angenommen am:
30. März 2011
Publikationsdatum:
23. Januar 2018 (online)
Zusammenfassung
Patienten mit neuropathischen Schmerzen zeigen eine heterogene klinische Manifestation mit spontanen und stimulusevozierbaren Schmerzen. In den vergangenen Jahren ge-lang es, detaillierte Einblicke in die Verarbeitung von neuropathischen Schmerzen im menschlichen Gehirn zu gewinnen. Mittels funktionell-bildgebenden Methoden konnten veränderte Aktivitätsmuster in zentralen schmerzverarbeitenden Netzwerken detektiert werden. Des Weiteren fanden sich kortikale Reorganisationsphänomene mit Verschiebungen im Bereich somatotopisch gegliederter Hirnareale des somatosensorischen und motorischen Systems. Der Nachweis neuroplastischer Veränderungen gelang nicht nur auf funktioneller Ebene, auch die strukturelle und neuronal-chemische Konstitution des Gehirns scheint bei chronischen Schmerzen beeinflusst zu sein. Im Zuge einer erfolgreichen Therapie zeigten sich die zentralen reorganisatorischen Vorgänge rückläufig. Eine Implementierung dieser Erkenntnisse in zukünftige neurorehabilitative Strategien erscheint denkbar.
Summary
Patients suffering from neuropathic pain frequently present with a puzzling clinical picture including spontaneous and evoked pain. During the last years detailed insights were gained into the processing of neuropathic pain in the human brain. Studies using functional neuroimaging techniques provided evidence for activity changes in central nociceptive networks and additional central reorganization phenomena in the central somatosensory and motor system. Moreover, it has been shown that chronic neuropathic pain influences the structural and neurochemical configuration of the brain. Future neurorehabilitation strategies may benefit from these findings.
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