Microglia-neuron interactions are leading to altered neural network excitability, the pathogenetic base of neuropathic pain. Modern research demonstrates that one of the key factors driving neurons nuts in neuropathic pain is the inflammatory compound ‘Brain-derived neurotrophic factor (BDNF)’, released by microglia. 
Microglial BDNF plays a key role in controlling neuronal excitability by causing disinhibition. This results in a neuronal network hyperactivity appears to explain several features of the associated pathologies such as in neuropathic pain. Targeting the molecular players involved in this signaling pathway may lead to novel therapeutic approach for ameliorating a wide array of neural dysfunctions.
Since some years neuropathic pain is also referred to as gliopathic pain. Step by step pain physicians start to realize the importance of this new inroad in treating pain. Glia plays a much bigger role as we always thought. One each neuron there are 10 glia cells. So we have been a bit short sighted not considering the impact of glia cells in neuropathic pain!
In our clinic we have much experience with the natural compound palmitoylethanolamide (PEA), a food supplement. PEA is available since 2008 for clinicians and can be seen as a glia-modulator and much of its painkilling and anti-inflammatory properties might be explained via its influence on the microglia hyperactivity.
Oktober 2013, prof. dr. Jan M. Keppel Hesselink, MD, PhD