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首页> 美国卫生研究院文献>Journal of Pain Research >Peripherally Induced Reconditioning of the Central Nervous System: A Proposed Mechanistic Theory for Sustained Relief of Chronic Pain with Percutaneous Peripheral Nerve Stimulation
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Peripherally Induced Reconditioning of the Central Nervous System: A Proposed Mechanistic Theory for Sustained Relief of Chronic Pain with Percutaneous Peripheral Nerve Stimulation

机译：周边诱导的中枢神经系统的修复：一种提出的机制理论用于持续缓解慢性疼痛与经皮外周神经刺激

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摘要

Peripheral nerve stimulation (PNS) is an effective tool for the treatment of chronic pain, although its efficacy and utilization have previously been significantly limited by technology. In recent years, purpose-built percutaneous PNS devices have been developed to overcome the limitations of conventional permanently implanted neurostimulation devices. Recent clinical evidence suggests clinically significant and sustained reductions in pain can persist well beyond the PNS treatment period, outcomes that have not previously been observed with conventional permanently implanted neurostimulation devices. This narrative review summarizes mechanistic processes that contribute to chronic pain, and the potential mechanisms by which selective large diameter afferent fiber activation may reverse these changes to induce a prolonged reduction in pain. The interplay of these mechanisms, supported by data in chronic pain states that have been effectively treated with percutaneous PNS, will also be discussed in support of a new theory of pain management in neuromodulation: Peripherally Induced Reconditioning of the Central Nervous System (CNS).
机译：周围神经刺激（PNS）是治疗慢性疼痛的有效工具，尽管其疗效和利用率以前通过技术显着限制。近年来，已经开发出专用经皮PNS器件以克服常规永久植入的神经刺激装置的局限性。最近的临床证据表明临床显着且持续减少疼痛可以持续超越PNS治疗期，以前用常规的永久性植入的神经刺激装置观察到的结果。这种叙事审查总结了有助于慢性疼痛的机制过程，以及选择性大直径传入纤维活化的潜在机制可能逆转这些变化，以诱导疼痛的长期降低。这些机制的相互作用，通过经皮PNS有效治疗的慢性疼痛状态支持，其还将讨论在神经调节中的新疼痛管理理论：外周诱导的中枢神经系统（CNS）的修复。

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