Conditioned Pain Modulation: A Predictor for Development and Treatment of Neuropathic Pain

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作者
Yelena Granovsky
机构
[1] Technion,Department of Neurology, Rambam Health Care Campus, Laboratory of Clinical Neurophysiology, Faculty of Medicine
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关键词
Central sensitization; Chronic pain; Conditioned pain modulation (CPM); Personalized pain medicine; Neuropathic pain; Pain facilitation; Pain inhibition; Psychophysics;
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摘要
Psychophysical evaluation of endogenous pain inhibition via conditioned pain modulation (CPM) represents a new generation of laboratory tests for pain assessment. In this review we discuss recent findings on CPM in neuropathic pain and refer to psychophysical, neurophysiological, and methodological aspects of its clinical implications. Typically, chronic neuropathic pain patients express less efficient CPM, to the extent that incidence of acquiring neuropathic pain (e.g. post-surgery) and its intensity can be predicted by a pre-surgery CPM assessment. Moreover, pre-treatment CPM evaluation may assist in the correct choice of serotonin-noradrenalin reuptake inhibitor analgesic agents for individual patients. Evaluation of pain modulation capabilities can serve as a step forward in individualizing pain medicine.
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