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Pathophysiological and Neuroplastic Changes in Postamputation and Neuropathic Pain: Review of the Literature

Despite advancements in surgical and rehabilitation strategies, extremity amputations are frequently associated with disability, phantom limb sensations, and chronic pain. Investigation into potential treatment modalities has focused on the pathophysiological changes in both the peripheral and centr...

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Autores principales: Issa, Christopher J., Svientek, Shelby R., Dehdashtian, Amir, Cederna, Paul S., Kemp, Stephen W. P.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9521753/
https://www.ncbi.nlm.nih.gov/pubmed/36187278
http://dx.doi.org/10.1097/GOX.0000000000004549
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author Issa, Christopher J.
Svientek, Shelby R.
Dehdashtian, Amir
Cederna, Paul S.
Kemp, Stephen W. P.
author_facet Issa, Christopher J.
Svientek, Shelby R.
Dehdashtian, Amir
Cederna, Paul S.
Kemp, Stephen W. P.
author_sort Issa, Christopher J.
collection PubMed
description Despite advancements in surgical and rehabilitation strategies, extremity amputations are frequently associated with disability, phantom limb sensations, and chronic pain. Investigation into potential treatment modalities has focused on the pathophysiological changes in both the peripheral and central nervous systems to better understand the underlying mechanism in the development of chronic pain in persons with amputations. METHODS: Presented in this article is a discussion outlining the physiological changes that occur in the peripheral and central nervous systems following amputation. In this review, the authors examine the molecular and neuroplastic changes occurring in the nervous system, as well as the state-of-the-art treatment to help reduce the development of postamputation pain. RESULTS: This review summarizes the current literature regarding neurological changes following amputation. Development of both central sensitization and neuronal remodeling in the spinal cord and cerebral cortex allows for the development of neuropathic and phantom limb pain postamputation. Recently developed treatments targeting these pathophysiological changes have enabled a reduction in the severity of pain; however, complete resolution remains elusive. CONCLUSIONS: Changes in the peripheral and central nervous systems following amputation should not be viewed as separate pathologies, but rather two interdependent mechanisms that underlie the development of pathological pain. A better understanding of the physiological changes following amputation will allow for improvements in therapeutic treatments to minimize pathological pain caused by amputation.
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spelling pubmed-95217532022-09-30 Pathophysiological and Neuroplastic Changes in Postamputation and Neuropathic Pain: Review of the Literature Issa, Christopher J. Svientek, Shelby R. Dehdashtian, Amir Cederna, Paul S. Kemp, Stephen W. P. Plast Reconstr Surg Glob Open Peripheral Nerve Despite advancements in surgical and rehabilitation strategies, extremity amputations are frequently associated with disability, phantom limb sensations, and chronic pain. Investigation into potential treatment modalities has focused on the pathophysiological changes in both the peripheral and central nervous systems to better understand the underlying mechanism in the development of chronic pain in persons with amputations. METHODS: Presented in this article is a discussion outlining the physiological changes that occur in the peripheral and central nervous systems following amputation. In this review, the authors examine the molecular and neuroplastic changes occurring in the nervous system, as well as the state-of-the-art treatment to help reduce the development of postamputation pain. RESULTS: This review summarizes the current literature regarding neurological changes following amputation. Development of both central sensitization and neuronal remodeling in the spinal cord and cerebral cortex allows for the development of neuropathic and phantom limb pain postamputation. Recently developed treatments targeting these pathophysiological changes have enabled a reduction in the severity of pain; however, complete resolution remains elusive. CONCLUSIONS: Changes in the peripheral and central nervous systems following amputation should not be viewed as separate pathologies, but rather two interdependent mechanisms that underlie the development of pathological pain. A better understanding of the physiological changes following amputation will allow for improvements in therapeutic treatments to minimize pathological pain caused by amputation. Lippincott Williams & Wilkins 2022-09-28 /pmc/articles/PMC9521753/ /pubmed/36187278 http://dx.doi.org/10.1097/GOX.0000000000004549 Text en Copyright © 2022 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) (https://creativecommons.org/licenses/by-nc-nd/4.0/) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
spellingShingle Peripheral Nerve
Issa, Christopher J.
Svientek, Shelby R.
Dehdashtian, Amir
Cederna, Paul S.
Kemp, Stephen W. P.
Pathophysiological and Neuroplastic Changes in Postamputation and Neuropathic Pain: Review of the Literature
title Pathophysiological and Neuroplastic Changes in Postamputation and Neuropathic Pain: Review of the Literature
title_full Pathophysiological and Neuroplastic Changes in Postamputation and Neuropathic Pain: Review of the Literature
title_fullStr Pathophysiological and Neuroplastic Changes in Postamputation and Neuropathic Pain: Review of the Literature
title_full_unstemmed Pathophysiological and Neuroplastic Changes in Postamputation and Neuropathic Pain: Review of the Literature
title_short Pathophysiological and Neuroplastic Changes in Postamputation and Neuropathic Pain: Review of the Literature
title_sort pathophysiological and neuroplastic changes in postamputation and neuropathic pain: review of the literature
topic Peripheral Nerve
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9521753/
https://www.ncbi.nlm.nih.gov/pubmed/36187278
http://dx.doi.org/10.1097/GOX.0000000000004549
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