Skip to main content
Top
Gepubliceerd in:

05-07-2017 | Artikel

Chronische pijn: een doorbraak?

Auteurs: Onno G. Meijer, Maarten R. Prins, Robert Dantzer

Gepubliceerd in: Neuropraxis | Uitgave 4/2017

Log in om toegang te krijgen
share
DELEN

Deel dit onderdeel of sectie (kopieer de link)

  • Optie A:
    Klik op de rechtermuisknop op de link en selecteer de optie “linkadres kopiëren”
  • Optie B:
    Deel de link per e-mail

Samenvatting

Recentelijk is gerapporteerd dat verschillende delen van het brein ontstoken zijn bij chronische pijn. Deze ‘neuro-inflammatie’ werd het meest gevonden in de thalamus. Langdurig is er weerstand geweest tegen de suggestie dat het immuunsysteem ook zonder een primair centrale ontsteking (zoals infectie) actief kan zijn in het brein. Inmiddels is de gedachte dat chronische pijn ontstaat bij (1) sterke vervanging van synapsen in de thalamus met (2) verstoring van de corticale kaarten van het lichaam, onder (3) aanwezigheid van pro-inflammatoire signalen. Wat betreft de behandeling denken wij vooral aan het weer normaliseren van de kaarten (discriminatietraining) in combinatie met omgevingsverrijking (waardoor groeifactoren worden geproduceerd).
Literatuur
1.
go back to reference Veldhuizen R. Twee miljoen Nederlanders lijden dagelijks ernstige pijn. de Volkskrant 2015; 14 december, V1. Veldhuizen R. Twee miljoen Nederlanders lijden dagelijks ernstige pijn. de Volkskrant 2015; 14 december, V1.
3.
go back to reference Woolf CJ. Neurobiology of disease. Pain. 2000;7:504–10. Woolf CJ. Neurobiology of disease. Pain. 2000;7:504–10.
4.
go back to reference McMahon S, Koltzenburg M, Tracey I. et al. Wall & Melzack’s textbook of pain. Amsterdam: Elsevier; 2013. McMahon S, Koltzenburg M, Tracey I. et al. Wall & Melzack’s textbook of pain. Amsterdam: Elsevier; 2013.
6.
go back to reference Wall P. Introduction to the edition after this one. In: Wall P, Melzack R (redactie). The textbook of pain. Edinburgh: Churchill Livingstone; 1994. pp. 1–7. Wall P. Introduction to the edition after this one. In: Wall P, Melzack R (redactie). The textbook of pain. Edinburgh: Churchill Livingstone; 1994. pp. 1–7.
7.
go back to reference Vinkers CH, Tijdink JK, Otte WM. Use of positive and negative words in scientific PubMed abstracts between 1974 and 2014: retrospective analysis. BMJ. 2015;351(1):h6467.CrossRefPubMedPubMedCentral Vinkers CH, Tijdink JK, Otte WM. Use of positive and negative words in scientific PubMed abstracts between 1974 and 2014: retrospective analysis. BMJ. 2015;351(1):h6467.CrossRefPubMedPubMedCentral
9.
go back to reference Watkins LR, Maier SF, Goehler LE. Immune activation: the role of pro-inflammatory cytokines in inflammation, illness responses and pathological pain states. Pain. 1995;63:289–302.CrossRefPubMed Watkins LR, Maier SF, Goehler LE. Immune activation: the role of pro-inflammatory cytokines in inflammation, illness responses and pathological pain states. Pain. 1995;63:289–302.CrossRefPubMed
10.
go back to reference Tsuda M, Shigemoto-Mogami Y, Koizumi S, et al. P2X4 receptors induced in spinal microglia gate tactile allodynia after nerve injury. Nature. 2003;424:778–83.CrossRefPubMed Tsuda M, Shigemoto-Mogami Y, Koizumi S, et al. P2X4 receptors induced in spinal microglia gate tactile allodynia after nerve injury. Nature. 2003;424:778–83.CrossRefPubMed
11.
go back to reference Miller TR, Wetter JB, Jarvis MF, Bitner RS. Spinal microglial activation in rat models of neuropathic and osteoarthritic pain: an autoradiographic study using [3H]PK11195. Eur J Pain. 2013;17:692–703.CrossRefPubMed Miller TR, Wetter JB, Jarvis MF, Bitner RS. Spinal microglial activation in rat models of neuropathic and osteoarthritic pain: an autoradiographic study using [3H]PK11195. Eur J Pain. 2013;17:692–703.CrossRefPubMed
12.
go back to reference Eikelenboom P, Stam FC. Immunoglobulins and complement factors in senile plaques. Acta Neuropathol. 1982;57:239–42.CrossRefPubMed Eikelenboom P, Stam FC. Immunoglobulins and complement factors in senile plaques. Acta Neuropathol. 1982;57:239–42.CrossRefPubMed
13.
go back to reference Eikelenboom P, Exel E van, Hoozemans JJ, et al. Neuroinflammation: An early event in both the history and pathogenesis of Alzheimer’s disease. Neurodegener Dis. 2010;7:38–41.CrossRefPubMed Eikelenboom P, Exel E van, Hoozemans JJ, et al. Neuroinflammation: An early event in both the history and pathogenesis of Alzheimer’s disease. Neurodegener Dis. 2010;7:38–41.CrossRefPubMed
14.
go back to reference Sherrington CS. Man on his nature. Cambridge: Cambridge University Press; 1942. Sherrington CS. Man on his nature. Cambridge: Cambridge University Press; 1942.
15.
16.
go back to reference Damasio AR. De vergissing van Descartes: gevoel, verstand en het menselijk brein. Amsterdam: Wereldbibliotheek; 1998. Damasio AR. De vergissing van Descartes: gevoel, verstand en het menselijk brein. Amsterdam: Wereldbibliotheek; 1998.
17.
go back to reference Eikelenboom P, Veerhuis R, Scheper W, et al. The significance of neuroinflammation in understanding Alzheimer’s disease. J Neural Transm. 2006;113:1685–95.CrossRefPubMed Eikelenboom P, Veerhuis R, Scheper W, et al. The significance of neuroinflammation in understanding Alzheimer’s disease. J Neural Transm. 2006;113:1685–95.CrossRefPubMed
18.
go back to reference Schnabel J. Forever joung: science and the search for immortality. London: Bloomsburry; 1998. Schnabel J. Forever joung: science and the search for immortality. London: Bloomsburry; 1998.
19.
go back to reference Niederkorn JY. See no evil, hear no evil, do no evil: the lessons of immune privilege. Nat Immunol. 2006;7:354–9.CrossRefPubMed Niederkorn JY. See no evil, hear no evil, do no evil: the lessons of immune privilege. Nat Immunol. 2006;7:354–9.CrossRefPubMed
21.
22.
go back to reference Trembley M‑È, Lecours C, Samson L, et al. From the Cajal alumni Achúcarro and Río-Hortega to the rediscovery of never-resting microglia. Front Neuroanat. 2015;9:45. doi:10.3389/fnana.2015.00045. Trembley M‑È, Lecours C, Samson L, et al. From the Cajal alumni Achúcarro and Río-Hortega to the rediscovery of never-resting microglia. Front Neuroanat. 2015;9:45. doi:10.​3389/​fnana.​2015.​00045.
23.
26.
go back to reference Benjumeda I, Molano-Mazón M, Martinez LM. Flowers and weeds: cell-type specific pruning in the developing visual thalamus. BMC Biol. 2014;123:1–4. Benjumeda I, Molano-Mazón M, Martinez LM. Flowers and weeds: cell-type specific pruning in the developing visual thalamus. BMC Biol. 2014;123:1–4.
27.
go back to reference Roberts TF, Tschida KA, Klein ME, Mooney R. Rapid spine stabilization and synaptic enhancement at the onset of behavioural learning. Nature. 2010;463:948952.CrossRef Roberts TF, Tschida KA, Klein ME, Mooney R. Rapid spine stabilization and synaptic enhancement at the onset of behavioural learning. Nature. 2010;463:948952.CrossRef
28.
30.
31.
go back to reference Walker AK, Kavelaars CJ, Heijnen CJ, Dantzer R. Neuroinflammation and comorbidity of pain and depression. Pharmacol Rev. 2014;66:80101. Walker AK, Kavelaars CJ, Heijnen CJ, Dantzer R. Neuroinflammation and comorbidity of pain and depression. Pharmacol Rev. 2014;66:80101.
32.
go back to reference Scherder E, Bouma A, Borkent M, Rahman O. Alzheimer patients report less pain intensity and pain effect than non-demented elderly. Psychiatry. 1999;62:265–72.CrossRefPubMed Scherder E, Bouma A, Borkent M, Rahman O. Alzheimer patients report less pain intensity and pain effect than non-demented elderly. Psychiatry. 1999;62:265–72.CrossRefPubMed
33.
go back to reference Dantzer R. Cytokine-induced sickness behavior: mechanisms and implications. Sciences (New York). 2001;933:222–34. Dantzer R. Cytokine-induced sickness behavior: mechanisms and implications. Sciences (New York). 2001;933:222–34.
34.
go back to reference Exel E van, Eikelenboom P, Comijs H, et al. Vascular factors and markers of inflammation in offspring with a parental history of late-onset Alzheimer disease. Arch Gen Psychiatry. 2009;66:1263–70.CrossRefPubMed Exel E van, Eikelenboom P, Comijs H, et al. Vascular factors and markers of inflammation in offspring with a parental history of late-onset Alzheimer disease. Arch Gen Psychiatry. 2009;66:1263–70.CrossRefPubMed
35.
go back to reference Queiroz BZ, Pereira DS, Lopes RA, et al. Association between plasma levels of mediators of inflammation with pain and disability in the elderly with acute low back pain: data from the Back Complaints in the Elders (BACE)-Brazil study. Spine. 1976;41(3):197–203.CrossRef Queiroz BZ, Pereira DS, Lopes RA, et al. Association between plasma levels of mediators of inflammation with pain and disability in the elderly with acute low back pain: data from the Back Complaints in the Elders (BACE)-Brazil study. Spine. 1976;41(3):197–203.CrossRef
36.
go back to reference Hao S, Dey A, Yu X, Stranaham AM. Dietary obesity reversibly induces synaptic stripping by microglia and impairs hippocampal plasticity. Brain Behav Immun. 2016;51:230–9.CrossRefPubMed Hao S, Dey A, Yu X, Stranaham AM. Dietary obesity reversibly induces synaptic stripping by microglia and impairs hippocampal plasticity. Brain Behav Immun. 2016;51:230–9.CrossRefPubMed
37.
go back to reference Hotamisligil GS. Inflammation and endoplasmatic reticulum stress in obesity and diabetes. Int J Obes. 2008;32:S52–S4.CrossRef Hotamisligil GS. Inflammation and endoplasmatic reticulum stress in obesity and diabetes. Int J Obes. 2008;32:S52–S4.CrossRef
38.
go back to reference Maguire E, Woollett K, Spiers HJ. London taxi drivers and bus drivers: a structural MRI and neuropsychological analysis. Hippocampus. 2006;16:1091–2006.CrossRefPubMed Maguire E, Woollett K, Spiers HJ. London taxi drivers and bus drivers: a structural MRI and neuropsychological analysis. Hippocampus. 2006;16:1091–2006.CrossRefPubMed
39.
go back to reference Saab CY, Hains BC. Remote neuroimmune signaling: a long range mechanism of nociceptive network plasticity. Trends Neurosci. 2008;32:110–7.CrossRef Saab CY, Hains BC. Remote neuroimmune signaling: a long range mechanism of nociceptive network plasticity. Trends Neurosci. 2008;32:110–7.CrossRef
40.
go back to reference Banati RB. Brain plasticity and microglia: Is transsynaptic glial activation in the thalamus after limb denervation linked to cortical plasticity and central sensitisation? J Physiol Paris. 2002;96:289–99.CrossRefPubMed Banati RB. Brain plasticity and microglia: Is transsynaptic glial activation in the thalamus after limb denervation linked to cortical plasticity and central sensitisation? J Physiol Paris. 2002;96:289–99.CrossRefPubMed
43.
go back to reference Ramachandran VS, MeGeoch PD, Williams L. Can vestibular caloric stimulation be used to treat Dejerine-Roussy syndrome? Med Hypotheses. 2007;69:486–8.CrossRefPubMed Ramachandran VS, MeGeoch PD, Williams L. Can vestibular caloric stimulation be used to treat Dejerine-Roussy syndrome? Med Hypotheses. 2007;69:486–8.CrossRefPubMed
44.
45.
go back to reference Mumford D. On the computational architecture of the neocortex: 1. The role of the thalamo-cortical loop. Biol Cybern. 1991;65:135–45.CrossRefPubMed Mumford D. On the computational architecture of the neocortex: 1. The role of the thalamo-cortical loop. Biol Cybern. 1991;65:135–45.CrossRefPubMed
46.
go back to reference Kumar V, Mang S, Grodd W. Direct diffusion-based parcellation of the human thalamus. Brain Struct Funct. 2015;220:1619–35.CrossRefPubMed Kumar V, Mang S, Grodd W. Direct diffusion-based parcellation of the human thalamus. Brain Struct Funct. 2015;220:1619–35.CrossRefPubMed
47.
go back to reference Llinás R, Ribary U. Consciousness and the brain: the thalamocortical dialogue in health and disease. Ann N Y Acad Sci. 2001;929:166–75.CrossRefPubMed Llinás R, Ribary U. Consciousness and the brain: the thalamocortical dialogue in health and disease. Ann N Y Acad Sci. 2001;929:166–75.CrossRefPubMed
48.
go back to reference Eagleman D. The brain. New York: Pantheon; 2015. Eagleman D. The brain. New York: Pantheon; 2015.
49.
go back to reference Mumford D. On the computational architecture of the neocortex: 2. The role of cortico-cortical loops. Biol Cybern. 1992;66:241–51.CrossRefPubMed Mumford D. On the computational architecture of the neocortex: 2. The role of cortico-cortical loops. Biol Cybern. 1992;66:241–51.CrossRefPubMed
50.
go back to reference Llinás R, Urbano FJ, Leznik E, et al. Rhythmic and dysrhythmic thalamocortical dynamics. GABA systems and the edge effect. Trends Neurosci. 2005;28:325–33.CrossRefPubMed Llinás R, Urbano FJ, Leznik E, et al. Rhythmic and dysrhythmic thalamocortical dynamics. GABA systems and the edge effect. Trends Neurosci. 2005;28:325–33.CrossRefPubMed
51.
go back to reference Benninghoff A, Goerttler K. Nervensystem, Haut und Sinnesorgane. Lehrbuch der Anatomie des Menschen. band 3. München: Urban & Schwarzenberg; 1964. Benninghoff A, Goerttler K. Nervensystem, Haut und Sinnesorgane. Lehrbuch der Anatomie des Menschen. band 3. München: Urban & Schwarzenberg; 1964.
Metagegevens
Titel
Chronische pijn: een doorbraak?
Auteurs
Onno G. Meijer
Maarten R. Prins
Robert Dantzer
Publicatiedatum
05-07-2017
Uitgeverij
Bohn Stafleu van Loghum
Gepubliceerd in
Neuropraxis / Uitgave 4/2017
Print ISSN: 1387-5817
Elektronisch ISSN: 1876-5785
DOI
https://doi.org/10.1007/s12474-017-0156-5

Andere artikelen Uitgave 4/2017

Neuropraxis 4/2017 Naar de uitgave

EditorialNotes

Woorden vooraf