Rosner, Jan; de Andrade, Daniel C; Davis, Karen D; Gustin, Sylvia M; Kramer, John L K; Seal, Rebecca P; Finnerup, Nanna B (2023). Central neuropathic pain. Nature reviews. Disease Primers, 9(1), p. 73. Nature Publishing Group 10.1038/s41572-023-00484-9
Full text not available from this repository. (Request a copy)Central neuropathic pain arises from a lesion or disease of the central somatosensory nervous system such as brain injury, spinal cord injury, stroke, multiple sclerosis or related neuroinflammatory conditions. The incidence of central neuropathic pain differs based on its underlying cause. Individuals with spinal cord injury are at the highest risk; however, central post-stroke pain is the most prevalent form of central neuropathic pain worldwide. The mechanisms that underlie central neuropathic pain are not fully understood, but the pathophysiology likely involves intricate interactions and maladaptive plasticity within spinal circuits and brain circuits associated with nociception and antinociception coupled with neuronal hyperexcitability. Modulation of neuronal activity, neuron-glia and neuro-immune interactions and targeting pain-related alterations in brain connectivity, represent potential therapeutic approaches. Current evidence-based pharmacological treatments include antidepressants and gabapentinoids as first-line options. Non-pharmacological pain management options include self-management strategies, exercise and neuromodulation. A comprehensive pain history and clinical examination form the foundation of central neuropathic pain classification, identification of potential risk factors and stratification of patients for clinical trials. Advanced neurophysiological and neuroimaging techniques hold promise to improve the understanding of mechanisms that underlie central neuropathic pain and as predictive biomarkers of treatment outcome.
Item Type: |
Journal Article (Review Article) |
|---|---|
Division/Institute: |
04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology |
UniBE Contributor: |
Rosner, Jan |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
2056-676X |
Publisher: |
Nature Publishing Group |
Language: |
English |
Submitter: |
Pubmed Import |
Date Deposited: |
28 Dec 2023 14:36 |
Last Modified: |
28 Dec 2023 14:36 |
Publisher DOI: |
10.1038/s41572-023-00484-9 |
PubMed ID: |
38129427 |
URI: |
https://boris.unibe.ch/id/eprint/190675 |
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