Special Issue "Botulinum Toxin for Neuropathic Pain Treatment"
Deadline for manuscript submissions: closed (30 June 2019).
Interests: functional urology; female urology; neuro-urology; oncological urology
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Botulinum neurotoxin (BoNT), derived from Clostridium botulinum, has been used worldwide for the treatment of neurologic disorders, such as dystonia or spasticity, and for cosmetic purposes. The neurotoxin has eight antigenically different serotypes, and its main mechanism of action is the inhibition of acetylcholine release at presynaptic nerve terminals, with a resulting reduction of muscle fiber activity.
In recent times, the therapeutic use of BoNT, and particularly of BoNT/A, has expanded to cover different clinical conditions characterized by neuropathic pain (NP), such as chronic migraine, lower back pain, myofascial pain, trigeminal neuropathy, temporo-mandibular joint disorders, osteoarthritis, pelvic pain, and bladder painful syndrome.
NP, which is pain caused by a lesion or a disease of the somatosensory system, affects 6–8% of the general population and exerts a great impact on patients’ quality of life. Despite its high prevalence, NP is still difficult to diagnose and treat, as it is not a unique disease but a syndrome covering a wide spectrum of different pathologies with complex clinical presentations and multiple signs and symptoms. The pathophysiology of NP involves both the peripheral and the central nervous systems and includes changes in the excitability of peripheral nerves and dorsal root ganglions (peripheral sensitization), changes in spinal cord neurons, the descending pain-controlling systems, and abnormal brain plasticity (central sensitization).
Although BoNT/A action on NP is still mainly considered to be of peripheral origin, recent findings showed that the neurotoxin is axonally transported to central sensory regions and suggested that its antinociceptive action is centrally mediated. Yet, the process by which BoNT/A is able to induce pain relief is not clear, and many additional questions remain to be answered on the mechanism of BoNT/A antinociceptive action at both peripheral and central levels and on the effectiveness of the neurotoxin in the treatment of different pain syndromes. Studies addressing these questions are welcomed.
Prof. Dr. Antonella Giannantoni
Manuscript Submission Information
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- Botulinum toxin
- neuropathic pain
- chronic pain syndromes
- substance P
- calcitonin gene-related peptide