Articles: neuralgia.
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This article, without presuming to be comprehensive, gives a brief outline of the development of research on neuropathic pain in Germany. Current clinical research on this subject focusses on the validation of human models, patient phenotyping, mechanism-based classification and treatment as well as on molecular pathomechanisms. ⋯ In parallel, basic research achieved international top levels through the development of innovative methods. Close cooperation, building of consortia and European networking made major contributions to the success of this research.
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Curr Opin Anaesthesiol · Oct 2015
ReviewNeuropathic pain assessment: update on laboratory diagnostic tools.
The purpose of this review was to provide an update on the diagnostic tools for neuropathic pain for clinical practice. ⋯ For diagnosing neuropathic pain, confirmation of a lesion or disease affecting the somatosensory system is needed. Better clinical phenotyping will hopefully enable individualized mechanism-based treatment of neuropathic pain.
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Review Meta Analysis
Quantitative meta-analysis of grey matter anomalies in neuropathic pain.
Increasing neuroimaging studies have revealed grey matter (GM) anomalies of several brain regions by voxel-based morphometry (VBM) studies in patients with neuropathic pain. The changes have been suggested to be related to central sensitization. Our aim was to investigate concurrence across VBM studies to identify whether different subtypes of neuropathic pain share a common pathophysiological basis revealed by structural abnormalities. ⋯ This meta-analysis shows strong evidence of brain GM anomalies within the pain matrix in patients with neuropathic pain compared with healthy subjects. Further studies are needed to determine whether the reported changes are specific to neuropathic pain or whether they may be common to other chronic pain.
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Review Meta Analysis
Management of Central Poststroke Pain: Systematic Review of Randomized Controlled Trials.
Central poststroke pain is a chronic neuropathic disorder that follows a stroke. Current research on its management is limited, and no review has evaluated all therapies for central poststroke pain. ⋯ Our findings are inconsistent with major clinical practice guidelines; the available evidence suggests no beneficial effects of any therapies that researchers have evaluated in randomized controlled trials.
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Activation of noradrenergic α2 receptor in spinal dorsal horn effectively alleviates the pathological pain. However, the precise mechanisms underlying noradrenergic pain suppression are not fully understood. Convincing evidence has indicated that extracellular signal-regulated kinases 1 and 2 (ERK1/2) play a key role in spinal sensitization. The present study investigated the potential influence of noradrenergic α2 receptor agonist clonidine on ERK1/2 activity. ⋯ The analgesic action produced by noradrenergic α2 receptor agonist clonidine involved the reversal of ERK1/2 hyperactivity in spinal dorsal horn of inflamed mice.