Neuroplasticity, Sensitization, and Pain

Abstract

In this chapter, we discuss the concept of neuroplasticity as the operating system of our nervous system computer. Without judgment, neuroplasticity can be of extreme usefulness, or it can produce, via sensitization, an "altered computer program" with devastating life effects of pain and suffering. We look at the normal neuroplastic pain system for eudynia and what can go awry to result in maldynia, a disease. We see how neuroplasticity and sensitization can account for the good, the bad, and the ugly for pain transmission. Although the mechanisms involved with neuroplastic sensitization of peripheral and central nervous components have been studied and continue to be researched, we still do not know which is the chicken or the egg. Exactly why this sensitization occurs, and who are the vulnerable people, is still a mystery. We do know that the brain can undergo neuroplastic reorganization from lower level (peripheral and spinal) changes or from higher level (mind) inputs. The system remains plastic throughout time and is responsive to inputs from any level. However, successful treatment approaches all seem to be explained in terms of their effect on the neuroplastic changes. Successful treatments either seem to cause long-term depression (LTD) of pain-related cerebral activation involving sensory, affective, cognitive, and attentional processes, dampen the sensitized transmission of the disordered system, or results in positive change rather than negative change. Ultimately, however, the most significant changes appear to be related to those that occur in the brain. (PsycINFO Database Record (c) 2015 APA, all rights reserved). (chapter)