Neuroplasticity+and+Pain

Perception of pain is a subjective experience that includes both sensory and emotional components. This emotional component of pain is capable of significantly altering the pain sensation but its processing remains distinct from the sensation of a noxious stimulus. The processing of the sensory component of pain primarily occurs in the somatosensory cortex, while the processing of the emotional component occurs in amygdale and anterior cingulate cortex. The conscious experience of a noxious stimulus induces glutamatergic synaptic plasticity in amygdale and anterior cingulate cortex, which parallels the aversive behavior of the organism apart from the sensation of the stimuli. In particular, this pain induced synaptic plasticity involves mechanisms such as the enhancement of glutamate release, enhancement of glutamate receptor-mediated responses, synaptic trafficking of AMPA receptors, and structural changes in the synapses. Modifications of the synapses in the areas responsible for emotional component of pain as well as motor cortex have been proposed to have significant clinical applications in chronic pain treatments. In particular, neuropathic pain, a type of chronic pain caused by damaged or dysfunctional nervous tissue, is not effectively treated with current systemic medication. Recent research suggests that the noninvasive pain management procedures such as transcranial direct current stimulation (tDCS) and repeated transcranial magnetic stimulation (rTMS) can produce long lasting analgesic effects in patients suffering from phantom pain.

 **Pain-induced glutamatergic synaptic plasticity in anterior cingulate cortex (H. Park)**  a. Enhancement of presynaptic glutamate release  b. Enhancement of postsynaptic glutamate receptor-mediated responses  c. Synaptic trafficking of AMPA receptors d. structural changes in the synapses

 1. Causes  2. Mechanisms > 2.1 Peripheral sensitization > 2.2 Central >> 2.2a Central sensitization >> 2.2b Deafferentation hypersensitivity > 2.3 Mechanisms based symptoms 3. Noninvasive pain treatment approach > 3.1 Transcranial direct current stimulation > 3.2 Repeated transcrnaial magnetic stimulation
 * N europathic pain and treatment (S. Park) **

 **References**