Neuropathic pain: Frommechanisms to treatment

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Finnerup NB, Kuner R, Jensen TS. Neuropathic Pain: From Mechanisms to Treatment. Physiol Rev 101: 259-301, 2021. First published June 25, 2020; doi:10.1152/physrev. 00045.2019.-Neuropathic pain caused by a lesion or disease of the somatosensory nervous system is a common chronic pain condition with major impact on quality of life. Examples include trigeminal neuralgia, painful polyneuropathy, postherpetic neuralgia, and central poststroke pain. Most patients complain of an ongoing or intermittent spontaneous pain of, for example, burning, pricking, squeezing quality, which may be accompanied by evoked pain, particular to light touch and cold. Ectopic activity in, for example, nerve-end neuroma, compressed nerves or nerve roots, dorsal root ganglia, and the thalamus may in different conditions underlie the spontaneous pain. Evoked pain may spread to neighboring areas, and the underlying pathophysiology involves peripheral and central sensitization. Maladaptive structural changes and a number of cell-cell interactions and molecular signaling underlie the sensitization of nociceptive pathways. These include alteration in ion channels, activation of immune cells, glial-derived mediators, and epigenetic regulation. The major classes of therapeutics include drugs acting on α2δ subunits of calcium channels, sodium channels, and descending modulatory inhibitory pathways.

Original languageEnglish
JournalPhysiological Reviews
Volume101
Issue1
Pages (from-to)259-301
Number of pages43
ISSN0031-9333
DOIs
Publication statusPublished - Jan 2021

    Research areas

  • Allodynia, Immune cells, Ion channels, Neuropathic pain, Pharmacology, Primary neuron, Spinal cord circuits

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