Pathophysiology of Neuropathic Pain

Abstract

Cerebral responses to pain are complex and dynamic in nature and in the case of chronic pain, especially neuropathic pain, changes involved are more profound and they are characterized by the involvement of entire pain-related peripheral and central nervous system. Functional magnetic resonance imaging studies identified a number of cerebral, cortical, and subcortical structures that are activated during pain stimuli. Many of those structures are also active in patient with neuropathic pain. While no specific functional magnetic resonance imaging studies were done with patients with diabetic neuropathy, result of the studies with various neuropathic pain disorders that share fundamental characteristics with painful diabetic neuropathy and are through earlier observations expected to apply to patients with painful diabetic neuropathy. Translational pain research is a new field with a few obstacles. Pain research has to rise and they include lack of clinical and pain translational research standards, lack of clear communication among basic scientists and among clinicians as well as between scientists and clinicians, and lack of standard in measurement tools that cross from bench to bedside and vice versa. However there are strong efforts to advance communication and to develop methods relevant to translational neuropathic pain research.