title: Contribution of central neuroplasticity to pathological pain: review of clinical and experimental evidence.
abstract: Peripheral tissue damage or nerve injury often leads to pathological pain processes, such as spontaneous pain, hyperalgesia and allodynia, that persist for years or decades after all possible tissue healing has occurred. Although peripheral neural mechanisms, such as nociceptor sensitization and neuroma formation, contribute to these pathological pain processes, recent evidence indicates that changes in central neural function may also play a significant role. In this review, we examine the clinical and experimental evidence which points to a contribution of central neural plasticity to the development of pathological pain. We also assess the physiological, biochemical, cellular and molecular mechanisms that underlie plasticity induced in the central nervous system (CNS) in response to noxious peripheral stimulation. Finally, we examine theories which have been proposed to explain how injury or noxious stimulation lead to alterations in CNS function which influence subsequent pain experience.
authors.affiliation: Pain Mechanisms Laboratory, Clinical Research Institute of Montreal, MontrealCanada Département de Médecine, Université de Montréal, MontrealCanada Department of Psychology, McGill University, MontrealCanada Department of Psychology, Toronto General Hospital, TorontoCanada Departments of Behavioral Science and Anaesthesia, University of Toronto, TorontoCanada.
authors.forename: Terence J
authors.initials: TJ
authors.lastname: Coderre
authors.forename: Joel
authors.initials: J
authors.lastname: Katz
authors.forename: Anthony L
authors.initials: AL
authors.lastname: Vaccarino
authors.forename: Ronald
authors.initials: R
authors.lastname: Melzack
mesh_terms: D000208:Acute Disease; D000818:Animals; D002490:Central Nervous System / Q000378:metabolism / Q000503:physiopathology*; D002908:Chronic Disease; D006801:Humans; D008959:Models, Neurological; D009473:Neuronal Plasticity / Q000502:physiology*; D010146:Pain / Q000503:physiopathology*; D059408:Pain Management; D010166:Palliative Care