Nerve lesions and the generation of pain

Research output: Contribution to journalArticle

Abstract

This review addresses the issue of how axotomy of peripheral nerve fibers leads to pain and hyperalgesia. The point of axotomy (the nerve injury site), the dorsal root ganglia, and the dorsal horn of the spinal cord are candidate sites for generation of the pain signal that is likely to be critical for maintaining the neuropathic pain state. This review considers neuropathic pain from a "systems" perspective, tracing concepts of neuropathic pain from the work of Henry Head to the present. Surprisingly, the nerve injury site and the dorsal root ganglion belonging to a transected spinal nerve do not give rise to spontaneous activity in putative C-fiber nociceptors. The intact nociceptor belonging to adjacent uninjured spinal nerves, however, does acquire abnormal spontaneous activity and a chemical sensitivity to catechols. It is suggested that partially denervated tissues in the nerve, skin, and other locations may release substances that, in turn, sensitize the intact nociceptors. These abnormalities in the intact nociceptor, which arise in the context of Wallerian degeneration, probably play a role in creating or maintaining the abnormal pain state. These considerations probably also apply to the understanding of pain arising in other neuropathies. The findings relative to the "intact" nociceptor provide a rationale by which to understand how therapies distal to the nerve injury site may diminish pain.

Original languageEnglish (US)
Pages (from-to)1261-1273
Number of pages13
JournalMuscle and Nerve
Volume24
Issue number10
DOIs
StatePublished - 2001

Fingerprint

Nociceptors
Neuralgia
Pain
Axotomy
Spinal Nerves
Spinal Ganglia
Wounds and Injuries
Catechols
Wallerian Degeneration
Nerve Tissue
Unmyelinated Nerve Fibers
Hyperalgesia
Peripheral Nerves
Nerve Fibers
Head
Skin

Keywords

  • Complex regional pain syndrome
  • Neuropathic pain
  • Nociceptors
  • Peripheral neuropathies
  • Sympathetic nervous system
  • Wallerian degeneration

ASJC Scopus subject areas

  • Clinical Neurology
  • Neuroscience(all)

Cite this

Nerve lesions and the generation of pain. / Campbell, James N.

In: Muscle and Nerve, Vol. 24, No. 10, 2001, p. 1261-1273.

Research output: Contribution to journalArticle

Campbell, James N. / Nerve lesions and the generation of pain. In: Muscle and Nerve. 2001 ; Vol. 24, No. 10. pp. 1261-1273.
@article{87fa694d41f84528a41d4f7860fe8b1a,
title = "Nerve lesions and the generation of pain",
abstract = "This review addresses the issue of how axotomy of peripheral nerve fibers leads to pain and hyperalgesia. The point of axotomy (the nerve injury site), the dorsal root ganglia, and the dorsal horn of the spinal cord are candidate sites for generation of the pain signal that is likely to be critical for maintaining the neuropathic pain state. This review considers neuropathic pain from a {"}systems{"} perspective, tracing concepts of neuropathic pain from the work of Henry Head to the present. Surprisingly, the nerve injury site and the dorsal root ganglion belonging to a transected spinal nerve do not give rise to spontaneous activity in putative C-fiber nociceptors. The intact nociceptor belonging to adjacent uninjured spinal nerves, however, does acquire abnormal spontaneous activity and a chemical sensitivity to catechols. It is suggested that partially denervated tissues in the nerve, skin, and other locations may release substances that, in turn, sensitize the intact nociceptors. These abnormalities in the intact nociceptor, which arise in the context of Wallerian degeneration, probably play a role in creating or maintaining the abnormal pain state. These considerations probably also apply to the understanding of pain arising in other neuropathies. The findings relative to the {"}intact{"} nociceptor provide a rationale by which to understand how therapies distal to the nerve injury site may diminish pain.",
keywords = "Complex regional pain syndrome, Neuropathic pain, Nociceptors, Peripheral neuropathies, Sympathetic nervous system, Wallerian degeneration",
author = "Campbell, {James N}",
year = "2001",
doi = "10.1002/mus.1143",
language = "English (US)",
volume = "24",
pages = "1261--1273",
journal = "Muscle and Nerve",
issn = "0148-639X",
publisher = "John Wiley and Sons Inc.",
number = "10",

}

TY - JOUR

T1 - Nerve lesions and the generation of pain

AU - Campbell, James N

PY - 2001

Y1 - 2001

N2 - This review addresses the issue of how axotomy of peripheral nerve fibers leads to pain and hyperalgesia. The point of axotomy (the nerve injury site), the dorsal root ganglia, and the dorsal horn of the spinal cord are candidate sites for generation of the pain signal that is likely to be critical for maintaining the neuropathic pain state. This review considers neuropathic pain from a "systems" perspective, tracing concepts of neuropathic pain from the work of Henry Head to the present. Surprisingly, the nerve injury site and the dorsal root ganglion belonging to a transected spinal nerve do not give rise to spontaneous activity in putative C-fiber nociceptors. The intact nociceptor belonging to adjacent uninjured spinal nerves, however, does acquire abnormal spontaneous activity and a chemical sensitivity to catechols. It is suggested that partially denervated tissues in the nerve, skin, and other locations may release substances that, in turn, sensitize the intact nociceptors. These abnormalities in the intact nociceptor, which arise in the context of Wallerian degeneration, probably play a role in creating or maintaining the abnormal pain state. These considerations probably also apply to the understanding of pain arising in other neuropathies. The findings relative to the "intact" nociceptor provide a rationale by which to understand how therapies distal to the nerve injury site may diminish pain.

AB - This review addresses the issue of how axotomy of peripheral nerve fibers leads to pain and hyperalgesia. The point of axotomy (the nerve injury site), the dorsal root ganglia, and the dorsal horn of the spinal cord are candidate sites for generation of the pain signal that is likely to be critical for maintaining the neuropathic pain state. This review considers neuropathic pain from a "systems" perspective, tracing concepts of neuropathic pain from the work of Henry Head to the present. Surprisingly, the nerve injury site and the dorsal root ganglion belonging to a transected spinal nerve do not give rise to spontaneous activity in putative C-fiber nociceptors. The intact nociceptor belonging to adjacent uninjured spinal nerves, however, does acquire abnormal spontaneous activity and a chemical sensitivity to catechols. It is suggested that partially denervated tissues in the nerve, skin, and other locations may release substances that, in turn, sensitize the intact nociceptors. These abnormalities in the intact nociceptor, which arise in the context of Wallerian degeneration, probably play a role in creating or maintaining the abnormal pain state. These considerations probably also apply to the understanding of pain arising in other neuropathies. The findings relative to the "intact" nociceptor provide a rationale by which to understand how therapies distal to the nerve injury site may diminish pain.

KW - Complex regional pain syndrome

KW - Neuropathic pain

KW - Nociceptors

KW - Peripheral neuropathies

KW - Sympathetic nervous system

KW - Wallerian degeneration

UR - http://www.scopus.com/inward/record.url?scp=0034814183&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0034814183&partnerID=8YFLogxK

U2 - 10.1002/mus.1143

DO - 10.1002/mus.1143

M3 - Article

C2 - 11562904

AN - SCOPUS:0034814183

VL - 24

SP - 1261

EP - 1273

JO - Muscle and Nerve

JF - Muscle and Nerve

SN - 0148-639X

IS - 10

ER -