Publicado may 24, 2012


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Juan Carlos Acevedo González



El conocimiento del dolor ha tenido momentos cruciales en los que el curso evolutivo se modificó y que cambiaron los conceptos aceptados y abrieron nuevos horizontes de investigación, entendimiento y tratamiento. Cuando Melzack y Wall desarrollaron la teoría de la compuerta aclararon fenómenos básicos del entendimiento del dolor y sustentaron múltiples tratamientos, que son la base de procedimientos actuales. Son cincuenta años que se cumplen de la publicación de aquel artículo en la revista Science (“Pain Mechanism: A New Theory. A Gate Control System Modulates Sensory Input from the Skin before it Evoques Pain Perception and Response”). Este se escribió en un contexto científico particular y a la luz de dos vidas diferentes que ilustran un proceso ejemplar de desarrollo de la ciencia. El análisis, aquí presentado, es no solo científico, sino humano de lo que ha sido este artículo para el entendimiento de las ciencias del dolor.


dolor, neuralgia, dolor crónico, inflamación neurogénica, dolor intratable, Pain, neuralgia, chronic pain, inflammation neurogenic, intractable pain,

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38. Devor M, Wall PD. The effect of peripheral nerve injury on receptive fields of cells in the cat spinal cord. J Comp Neurol. 1981;199:277-91.
39. Devor M, Wall PD. Plasticity in the spinal cord sensory map following peripheral nerve injury in rats. J Neurosci. 1981;1(7):679-84.
40. Dostrovsky J, Millar J, Wall PD. The inmediate shift afferent drive of dorsal column nucleus cells following deafferentation: A comparison of acute and chronic deafferentation in gracile nucleus and spinal cord. Exp Neurol. 1976;52:480-95.
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42. McMahon SB, Wall PD. Receptive fields of rat lamina 1 projection cells move to incorporate a nearby region of injury. Pain. 1984;19:235-47.
43. McMahon SB, Wall PD. Descending excitation and inhibition of spinal cord lamina 1 projection neurons. J Neurophysiol. 1988;59:1204-19.
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45. Lidierth M, Wall PD. Superficial dorsal horn cells connected to the Lissauer tract and their relation to the dorsal root potential. J Neurophysiol. 1997;80:667-79.
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51. Wall PD, Yaksh TL. Effect of Lissauer tract stimulation on activity in dorsal roots and in ventral roots. Exp Neurol. 1978;60:570-83.
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55. Wall PD, Devor M, Inbal R, Scadding JW, Schonfeld D, Seltzer Z, Tomkiewicz MM. Autotomy following peripheral nerve lesions; Experimental anaesthesia dolorosa. Pain. 1979;7:103-13.
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57. Egger MD, Wall PD. The plantar cushion reflex circuit: An oligosynaptic reflex. J Physiol. 1971;216:483-501.
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59. Fitzgerald M, Wall PD, Geodert M, Emson PC. Nerve growth factor counteracts the neurophysiological and neurochemical effects of chronic sciatic nerve injury. Brain Res. 1985;332:131-41.
60. McMahon SB, Wall PD. A system of rat spinal cord lamina 1 cells projecting through the contralateral dorsolateral funiculus. J Comp Neurol. 1983;214:217-23.
61. Nussbaumer JC, Wall PD. Expansion of receptive fields in the mouse cortical barrelfield after administration of capsaicin to neonates or local application on the infraorbital nerve in adults. Brain Res. 1985;360:1-9.
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63. Thompson SWN, Wall PD. The effect of GABA and 5-HT antagonists on rat dorsal root potentials. Neurosci Lett. 1996;217:153-6.
64. Wall PD. The presence of ineffective synapses and the circumstances which unmask them. Philos Trans R Soc London B. 1977;278:361-72.
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66. Wall PD, Gutnick M. Ongoing activity in peripheral nerves: 11. The physiology and pharmacology of impulses originating in a neuroma. Exp Neurol. 1947;43:580-93.
67. Wall PD, Mills R, Fitzgerald M, Gibson SJ. Chronic blockade of sciatic nerve transmission by tetrodotoxin does not produce central changes in the dorsal horn of the spinal cord of the rat. Neurosci Lett. 1982;30:315-20.
68. Wall PD, Lidierth M, Hillman P. Brief and prolonged effects of Lissauer tract stimulation on dorsal horn cells. Pain. 1999;83:579-89.
69. Woolf CJ, Wall PD. The relative effectiveness of C-primary afferents of different origins in evoking a prolonged facilitation on the flexor reflex in the rat. J Neurosci. 1986;6:1433-42.
Cómo citar
Acevedo González, J. C. (2012). Teoría de la compuerta (Ronald Melzack y Patrick D. Wall, 1965). Universitas Medica, 53(4), 395–419.
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