Interactions between the painful disorders and the autonomic nervous system

Arslan, Doruk; UNAL-CEVIK, ISIN

doi:10.14744/agri.2021.43078

Interactions between the painful disorders and the autonomic nervous system

Doruk ARSLAN, (Nöroloji Anabilim Dalı, Hacettepe Üniversitesi Tıp Fakültesi, Ankara, Türkiye)

ISIN UNAL-CEVIK (Hacettepe Üniversitesi Tıp Fakültesi Nöroloji Anabilim Dalı, Ağrı ve Baş Ağrısı Ünitesi, Ankara, Türkiye)

Ağrı

5 1

Yıl: 2022 Cilt: 34 Sayı: 3 Sayfa Aralığı: 155 - 165 Metin Dili: İngilizce DOI: 10.14744/agri.2021.43078 İndeks Tarihi: 02-10-2022

Interactions between the painful disorders and the autonomic nervous system

Öz:

The autonomic nervous system (ANS) controls the heart rate, blood pressure, digestion, respiration, pupillary reactivity, sweating, urination, sexual arousal, and regulates the functions of internal organs. This system provides the homeostasis of the cells, tissues, and organs throughout the body and protects against the disturbances imposed by the external and internal stressors. The ANS has three main divisions: The sympathetic nervous system (SNS), the parasympathetic nervous system (PNS), and the enteric nervous system. In general, the SNS and PNS have opposing effects. Each region belonging to the “pain matrix” interacts with ANS. The descending system regulates pain and creates a regulatory effect by the contri- bution of aminergic neurotransmitters. Hypothalamus, amygdala, and periaqueductal gray are the main structures of this regulatory system. Dysfunction of the ANS is frequently observed in pain patients. The SNS induce, facilitate, or potentiate chronic pain. Increased responsiveness of injured sensory nerves to catecholamines, increased expression of α-1 adrenore- ceptors on the primary afferent nociceptors and hyperalgesic skin, central sensitization rendering Aβ mechanoreceptors, enhanced discharge and sympathetic sprouting in dorsal root ganglia, central sensitization, and dysfunction of the pain modulation is proposed mechanisms. In this review, the anatomical, physiological and pathological aspects of ANS and pain, and laboratory tests to evaluate autonomic functions will be discussed. Pathophysiological role of ANS in migraine, trigeminal autonomic cephalgias, trigeminal neuralgia, peripheral nerve injuries, small fiber neuropathies, myofascial pain syndrome, fibromyalgia, painful joint diseases, visceral pain, phantom limb pain, complex regional pain syndrome, and spinal cord injury will be discussed.

Anahtar Kelime:

Otonom sinir sistemi ve ağrılı bozukluklar arasındaki etkileşimler Doruk ARSLAN,1 Işın ÜNAL ÇEVİK2

Öz:

Otonom sinir sistemi, iç organların fonksiyonlarını düzenler, kalp atım hızını, kan basıncını, sindirimi, solunumu, pupiller reak- tiviteyi, terlemeyi, idrara çıkmayı ve cinsel uyarılmayı da kontrol eder. Otonom sinir sistemi vücuttaki hücrelerin, dokuların ve organların homeostazını sağlamaya ve iç/dış zorlayıcı etmenlerin sebep olduğu hasara karşı koymaya çalışır. Otonom sinir sis- teminin üç ana dalı vardır: sempatik sinir sistemi, parasempatik sinir sistemi ve enterik sinir sistemi. Genel olarak, sempatik sinir sistemi ve parasempatik sinir sisteminin birbirine zıt etkileri bulunmaktadır. Ağrı matrisine ait her bölge otonom sinir sistemi ile etkileşim içerisindedir. İnen yolakları ağrıyı düzenler, aminerjik nörotransmitterlerin katkısıyla sistem üzerine regülatör bir etki yaratır. Hipotalamus, amigdala ve periakuaduktal gri cevher bu düzenleyici sistemin ana yapılarıdır. Otonom sinir sisteminin işlev bozukluğu ağrılı hastalarında gözlenebilmektedir. Sempatik sinir sistemi, kronik ağrıyı indükleyebilir, kolaylaştırabilir veya güçlendirebilir. Hasarlı duyu sinirlerinin katekolaminlere karşı artmış hassasiyeti, primer aferent nosiseptörler ve hiperaljezik cilt üzerinde alfa-1 adrenoreseptörlerinin ekspresyonunda artış, Aβ mekanoreseptörleri aracılı merkezi sensitizasyon, dorsal kök ganglionlarında artmış deşarj ve sempatik filizlenme, santral sensitizasyon ve ağrı modülasyonunun disfonksiyonu bu sürece katkı sağlayan mekanizmalar olarak sayılabilir. Bu derlemede otonom sinir sistemi ve ağrının, anatomik, fizyolojik, pa- tolojik yönleri ve otonomik fonksiyonları değerlendirmek için kullanılabilecek laboratuvar testleri tartışılacaktır. Otonom sinir sisteminin migren, trigeminal otonomik sefaljiler, trigeminal nevralji, periferik sinir yaralanmaları, ince lif nöropatisi, miyofasi- yal ağrı sendromu, fibromiyalji, inflamatuvar eklem hastalıkları, viseral ağrı, fantom ağrısı, kompleks bölgesel ağrı sendromu ve spinal kord hasarındaki patofizyolojik rolü tartışılacaktır.

Anahtar Kelime:

Belge Türü: Makale Makale Türü: Diğer Erişim Türü: Erişime Açık

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APA	Arslan D, UNAL-CEVIK I (2022). Interactions between the painful disorders and the autonomic nervous system. , 155 - 165. 10.14744/agri.2021.43078
Chicago	Arslan Doruk,UNAL-CEVIK ISIN Interactions between the painful disorders and the autonomic nervous system. (2022): 155 - 165. 10.14744/agri.2021.43078
MLA	Arslan Doruk,UNAL-CEVIK ISIN Interactions between the painful disorders and the autonomic nervous system. , 2022, ss.155 - 165. 10.14744/agri.2021.43078
AMA	Arslan D,UNAL-CEVIK I Interactions between the painful disorders and the autonomic nervous system. . 2022; 155 - 165. 10.14744/agri.2021.43078
Vancouver	Arslan D,UNAL-CEVIK I Interactions between the painful disorders and the autonomic nervous system. . 2022; 155 - 165. 10.14744/agri.2021.43078
IEEE	Arslan D,UNAL-CEVIK I "Interactions between the painful disorders and the autonomic nervous system." , ss.155 - 165, 2022. 10.14744/agri.2021.43078
ISNAD	Arslan, Doruk - UNAL-CEVIK, ISIN. "Interactions between the painful disorders and the autonomic nervous system". (2022), 155-165. https://doi.org/10.14744/agri.2021.43078

APA	Arslan D, UNAL-CEVIK I (2022). Interactions between the painful disorders and the autonomic nervous system. Ağrı, 34(3), 155 - 165. 10.14744/agri.2021.43078
Chicago	Arslan Doruk,UNAL-CEVIK ISIN Interactions between the painful disorders and the autonomic nervous system. Ağrı 34, no.3 (2022): 155 - 165. 10.14744/agri.2021.43078
MLA	Arslan Doruk,UNAL-CEVIK ISIN Interactions between the painful disorders and the autonomic nervous system. Ağrı, vol.34, no.3, 2022, ss.155 - 165. 10.14744/agri.2021.43078
AMA	Arslan D,UNAL-CEVIK I Interactions between the painful disorders and the autonomic nervous system. Ağrı. 2022; 34(3): 155 - 165. 10.14744/agri.2021.43078
Vancouver	Arslan D,UNAL-CEVIK I Interactions between the painful disorders and the autonomic nervous system. Ağrı. 2022; 34(3): 155 - 165. 10.14744/agri.2021.43078
IEEE	Arslan D,UNAL-CEVIK I "Interactions between the painful disorders and the autonomic nervous system." Ağrı, 34, ss.155 - 165, 2022. 10.14744/agri.2021.43078
ISNAD	Arslan, Doruk - UNAL-CEVIK, ISIN. "Interactions between the painful disorders and the autonomic nervous system". Ağrı 34/3 (2022), 155-165. https://doi.org/10.14744/agri.2021.43078