RECENT ADVANCES IN THE PATHOPHYSIOLOGY OF ACUTE PAIN
1989; Elsevier BV; Volume: 63; Issue: 2 Linguagem: Inglês
10.1093/bja/63.2.139
ISSN1471-6771
Autores Tópico(s)Nicotinic Acetylcholine Receptors Study
ResumoThe peripheral receptors of the sensory systems have transduction mechanisms that ensure maximal sensitivity to only a small spectrum of the wide range of stimuli that impinge upon them. Because there is a minimal overlap in sensitivity between the receptors of the different sensory systems, each is specialized and possesses its own or adequate stimulus. Maintaining this receptor-generated specificity, sensory pathways in the central nervous system are, to a considerable extent, arranged so that inputs from similar classes of receptor run through neural networks that are closely aligned anatomically. This enables functionally discrete systems such as the visual, auditory and tactile sensory systems to be seen to be structurally distinct. At each level of the neuraxis where sensory information is relayed, complex processing and modulation occurs to assist in denning the location, onset, duration, intensity and dynamic properties of a stimulus. Ultimately, activation of the highest levels of the nervous system may produce a conscious awareness of the stimulus, either as a relatively pure sensation or as a complex hybrid one resulting from parallel sensory inputs. In this way photons falling upon the retina are unambiguously perceived as light, movement of hair cells in the cochlea as sound and deformation of mechanoreceptor terminals in the skin as touch. Is pain the perceptual consequence of the activation of a specialized sensory system that resembles in its neural organization the visual, auditory or tactile sensory systems ? This is not an abstruse academic issue, but the key to understanding the pathophysiology of pain. The current view of many basic scientists and clinicians is that there is a sensory system specific for pain, which
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