title: From electrical wiring to plastic neurons: evolving approaches to the study of pain.
abstract: Clinical and animal experimental evidences accumulated during the past four decades indicate an evolving change, championed by Patrick D. Wall, from the old concept of a specific pain pathway and hard-wired nervous system to a dynamic concept of plastic neural mechanisms underlying nociceptive processing like other sensory neural functions. These include: (1) the reciprocal sharing and interaction of various somatic sensory modalities between the ascending pathways; (2) the activation of spinal gating mechanisms through a dorsal column brainstem spinal loop; (3) the role of plastic changes in the nervous system in the production and maintenance of chronic pain; (4) the evidence showing that processing of nociception involves the activation of a diffuse network of transmitting fiber tracts and brain centers that are not exclusively devoted to pain; and (5) the consideration of chronic pain, at least in part, as a sign or reflection of a dysfunction in neuroimmune-endocrine regulations.
authors.affiliation: Department of Physiology, Faculty of Medicine, American University of Beirut, Beirut, Lebanon Department of Human Morphology, Faculty of Medicine, American University of Beirut, Beirut, Lebanon.
authors.forename: Suhayl J
authors.initials: SJ
authors.lastname: Jabbur
authors.forename: Nayef E
authors.initials: NE
authors.lastname: Saadé
mesh_terms: D000818:Animals; D004594:Electrophysiology; D006801:Humans; D009434:Neural Pathways / Q000166:cytology / Q000502:physiology*; D009473:Neuronal Plasticity / Q000502:physiology*; D009474:Neurons / Q000502:physiology*; D010146:Pain / Q000473:pathology* / Q000503:physiopathology