Mechanismen neuropathischer Schmerzen am Beispiel des Phantomschmerzes

K. Wiech; R.-T. Kiefer

doi:10.1055/s-0038-1626377

Nervenheilkunde, Table of Contents

Nervenheilkunde 2004; 23(05): 274-278
DOI: 10.1055/s-0038-1626377

Original- und Übersichtsarbeiten - Original and Review Articles

Schattauer GmbH

Mechanismen neuropathischer Schmerzen am Beispiel des Phantomschmerzes

Übertragbarkeit tierexperimenteller Daten auf den MenschenMechanisms of neuropathic pain: Comparison of data from experimental models of neuropathic pain and patients with phantom limb pain

K. Wiech

¹Wellcome Department of Imaging Neuroscience, Institute of Neurology, London

,

R.-T. Kiefer

²Abteilung für Anästhesiologie und Intensivmedizin, Universitätsklinikum Tübingen

› Author Affiliations

Abstract

Zusammenfassung

Die aktuellen Vorstellungen über pathophysiologische Mechanismen neuropathischer Schmerzen basieren wesentlich auf experimentellen Untersuchungen am Tier. Am Beispiel des Phantomschmerzes wird dargestellt, welche tierexperimentellen Befunde zur Erklärung neuropathischer Schmerzen beim Menschen herangezogen werden können. Neben pathologischen Prozessen im Stumpfbereich (z.B. Neurombildungen) und Fehlregulationen im sympathischen Nervensystem wurden vornehmlich schmerzassoziierte Auffälligkeiten in supraspinalen Strukturen untersucht. Untersuchungen mit Verfahren funktioneller Bildgebung zeigen, dass Phantomschmerzen mit Veränderungen der funktionellen Organisation im primären sensorischen und motorischen Kortex in Zusammenhang stehen, die den tierexperimentellen Befunden entsprechen.

Summary

Today, most insights into the pathophysiology underlying neuropathic pain come from animal studies. Based on the example of phantom limb pain, analogies between experimental evidence from animal studies and pain research in humans are discussed. In addition to pathological processes in the residual limb (e.g. formation of neuroma), and dysregulation in the sympathetic nervous system, pain associated alterations in supraspinal structures have been investigated. Studies using functional neuroimaging techniques showed that phantom limb pain is related to changes in the functional organization of the primary somatosensory and motor cortex reflecting cortical reorganization observed in animals.

Schlüsselwörter

Phantomschmerz - chronischer Schmerz - funktionelle Bildgebung

Keywords

Phantom limb pain - chronic pain - functional neuroimaging

Full Text

References

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