基础医学与临床 ›› 2008, Vol. 28 ›› Issue (4): 305-314.

• 专题综述 •    下一篇

脊髓下丘脑和脊髓丘脑束神经元在内脏痛传导中的作用

Zhang Xijing Glenn J Giesler, Jr   

  1. University of Minnesota University of Minnesota
  • 收稿日期:2008-05-08 修回日期:1900-01-01 出版日期:2008-04-25 发布日期:2008-04-25
  • 通讯作者: Glenn J Giesler, Jr

Spinohypothalamic and spinothalamic tract neurons contribute to visceral pain transmission

Xi-jing ZHANG,   

  1. University of Minnesota University of Minnesota
  • Received:2008-05-08 Revised:1900-01-01 Online:2008-04-25 Published:2008-04-25

摘要: 脊髓下丘脑束在脊髓至间脑和脑干的信息传递过程中起着重要作用。我们以往的研究检测了脊髓下丘脑束是否参与了大鼠内脏痛的信号传导。结果表明,随着对结肠、直肠和(或)阴道的强制性扩张刺激强度的增加,三分之一以上的腰段和骶段的脊髓下丘脑束和脊髓丘脑束神经元的放电频率增加。检测的低胸段脊髓中,有接近一半的下丘脑束神经元可通过逐级扩张胆管被激活。这些反应曲线高度符合加速函数,提示在应对内脏器官伤害性扩张的微小变化时,这些神经元的放电频率明显增加。我们的结果表明脊髓下丘脑束在从脊髓到大脑广泛区域伤害性内脏感觉信息的直接传递过程中起重要作用。

Abstract: Vulvodynia, or chronic vulvar pain, affects 16% of women in the general population and has negative effects on numerous aspects of a woman's life. The purpose of this paper is to review the literature on the etiology and treatment of vulvodynia. Since relatively little research has been carried out on unprovoked generalized vulvodynia (UGVD), this review focuses on provoked vestibulodynia (PVD), a subtype of vulvodynia characterized by a severe, burning/sharp pain that occurs in response to pressure localized to the vestibule. Research examining the pathophysiology of PVD provides evidence that both peripheral (e.g., vestibular tissue abnormalities, pelvic floor hypertonicity) and central (e.g., increased neural activation) factors are involved in the development and maintenance of PVD. Additionally, psychological reactions to the pain may vary and influence the expression and course of the pain. Despite the multitude of factors involved in PVD, most treatment studies to date are unimodal in nature, retrospective, and uncontrolled. A review of treatment studies targeting peripheral (e.g., topical applications, vestibulectomy) and central (e.g., antidepressants, pain management therapy) components of PVD is provided, and the need for multimodal treatment plans which target both levels of pain processing is discussed. Given the complexity of PVD, a biopsychosocial approach is recommended for future research endeavors and treatment plans.