Impact of deafferentation on descending pain control systems
Changes within the sensory system following spinal cord injury not only affect the individual specific sensory modalities (proprio-, noci-, mechano-, enteroception) but also physiological sensori-sensory interactions across the spinal and supra-spinal system.
PAIN – from phenotypes to mechanisms
Independent of the diverse clinical presentations of chronic pain conditions, a common underlying pathophysiological mechanism is sensitization along the nociceptive neuraxis. By dissecting the impact of peripheral, spinal and supra-spinal processes a common framework for mechanistically oriented therapies across disease entities can be provided. Understanding peripheral and central sensitization may promote not only better profiling and diagnosis of pain patients, but also the development of new mechanism-based therapies.
Examination of the different modalities of nociception is recommended for a comprehensive assessment of spinothalamic integrity. Moreover, residual sparing of specific modalities in discomplete spinal cord lesions has been related to the development of central neuropathic pain.