Author's Response Controversies in Neuroscience V: Persistent pain
What exactly is central to the role of central neuroplasticity in persistent pain?
Terence J. Coderre a1a2a3andJoel Katz a4a5 a1 Pain Mechanisms Laboratory, Clinical Research Institute of Montreal a2 Centre de recherche en sciences neurologiques et departement demédecine, Université de Montréal a3 Department of Psychology, McGill University, Montreal, Quebec H2W 1R7, Canada
coderrt@ircm.umontreal.cawww.ircm.umontreal.ca/ a4 Department of Psychology and Acute Pain Research Unit, The Toronto Hospital a5 Departments of Behavioral Science and Anaesthesia, University of Toronto, Toronto, Ontario M5S 2C4 Canada
j.katz@utoronto.cawww.utoronto.ca/
Abstract
The commentaries on our target article have raised important
issues about central neuroplasticity and its role in persistent pain
states. Some suggest that central neuroplasticity plays nothing
more than a minor role in persistent pain, while others argue that
persistent pain depends critically on peripheral inputs for its
maintenance. Some stress that persistent pain relies to a large
extent on changes in the brain and on centrifugal inputs from brain
to spinal cord, whereas others argue that it depends on alterations
in inhibitory as well as excitatory systems. We attempt to address
each of the commentators' points, while defending our position
that central neuroplasticity is critical to pathological persistent
pain states.
