引用

确定neuro-anatomic中枢神经性疼痛的原因(CNP)在多发性硬化(MS)患者。、并行临床和neuro-anatomical进行研究。连续获得了MS患者的临床研究,没有CNP(即冷触诱发痛或深感觉过敏)女士在一个中心。多元逻辑回归模型被用来评估之间的关系上胸部中央脊髓中枢疼痛投诉焦点。识别与双边递减预测假设自主中间神经元,腰骶的感觉神经元,逆行单-和双标记实验与施和荧光示踪剂进行了三个动物物种(如老鼠、猫和猴)。、临床数据可以在MS患者(n = 32;F: 23;平均年龄:34.6岁(四分位范围(差):27.4 - -45.5))和没有(n = 30;F: 22;平均年龄:36.6岁CNP (IQR: 31.6 - -47.1))。焦点T1-T6之间的价值关系CNP证明96.9%的敏感性(95%可信区间[CI]: 83.8 - -99.9)和特异性为83.3%(95%置信区间:65.3—-94.4)。CNP之间的重大关系和中央集中在脊柱胸也观察到(优势比[或]:155.0(95%可信区间下限:16.0); P < 0.0001, two-tailed Fisher exact test). In all animal models, neurons with bilateral descending projections to the lumbosacral superficial dorsal horn were concentrated in the autonomic intermediomedial nucleus surrounding the mid-thoracic central canal.,Our observations provide the first evidence for the etiology of CNP. These data may assist with the development of refined symptomatic therapies and allow for insights into unique pain syndromes observed in other demyelinating subtypes.