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Chronic Pain Explained

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Brain and Mind

Abstract

Pains that persist long after damaged tissue hasrecovered remain a perplexing phenomenon. Theseso-called chronic pains serve no useful function foran organism and, given its disabling effects, mighteven be considered maladaptive. However, a remarkablesimilarity exists between the neural bases thatunderlie the hallmark symptoms of chronic pain andthose that subserve learning and memory. Bothphenomena, wind-up in the pain literature andlong-term potentiation (LTP) in the learning andmemory literature, are forms of neuroplasticity inwhich increased neural activity leads to a longlasting increase in the excitability of neuronsthrough structural modifications at pre- andpost-synaptic sites. Moreover, the synapticmodifications of wind-up and LTP share a commonmechanism: a glutamate N-methyl-D-aspartate(NMDA) receptor interaction that initiates a calciummediated biochemical cascade that ultimately enhancessignal processing at theα-amino-3-hydroxy-5-methyl-4-isoxazoleproprionic acid (AMPA) receptor. This paper arguesthat chronic pain, which has no adaptive value, canbe accounted for in terms of the highly adaptivephenomenon of activity-dependent neural plasticity;hence, some cases of chronic pain can beconceptualized as a memory trace in spinal neurons.

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References

  • Arnstein, P., Caudill, M., Mandle, C. L., Norris, A. and Beasley, R., 1999: Self efficacy as a mediator of the relationship between pain intensity, disability and depression in chronic pain patients, Pain 80, 483–491.

    PubMed  Google Scholar 

  • Anwyl, R., 1999: Metabotropic glutamate receptors: electrophysiological properties and role in plasticity, Brain Res. Rev. 29, 83–120.

    PubMed  Google Scholar 

  • Barber, J., 1996: Hypnosis and Suggestion in the Management of Pain: A Clinical Guide, Norton, New York.

    Google Scholar 

  • Barbieri, M., Colnaghi, E., Tommasino, C., Zangrillo, A., Galli, L. and Torri, G., 1997: Efficacy of NMDA antagonist ketamine in preemptive analgesia, in T. S. Jensen, J. A. Turner and Z. Wiesenfeld-Hallin (eds), Proceedings of the 8th World Congress on Pain. Progress in Pain Research and Management, Vol. 8, pp. 343–349.

  • Barnes, C. A., Erickson, C. A., Davis, S. and McNaughton, B. L., 1995: Hippocampal synaptic enhancement as a basis for learning and memory: a selected review of current evidence from behaving animals, in J. L. McGaugh, N. M. Weinberger and G. Lynch (eds), Brain and Memory. Modulation and Mediation of Neuroplasticity, Oxford University Press, New York, pp. 259–276.

    Google Scholar 

  • Basbaum, A. I., 1999: Distinct neurochemical features of acute and persistent pain, Proceedings of the National Academy of Sciences USA 96, 7739–7743.

    Google Scholar 

  • Baudry, M. and Davis, J. L. (eds.), 1994: Long-Term Potentiation, Vol. 2, MIT Press, Cambridge, MA.

    Google Scholar 

  • Baudry, M. and Davis, J. L. (eds.), 1997: Long-Term potentiation, Vol. 3, MIT Press, Cambridge, MA.

    Google Scholar 

  • Bennett, M. R., 2000: The concept of long term potentiation of transmission at synapses, Progress in Neurobiology 60, 109–137.

    PubMed  Google Scholar 

  • Bennett, G. J. and Xie, Y., 1988: A peripheral mono-neuropathy in rat that produces disorders of pain sensation like those seen in man, Pain 33, 87–107.

    PubMed  Google Scholar 

  • Bliss, T. V. P. and Lømo, T., 1973: Long-lasting potentiation of synaptic transmission in the dentate area of the anesthetized rabbit following stimulation of the perforant path, J. Physiol. (London) 232, 331–356.

    Google Scholar 

  • Bliss, T. V. P. and Gardner-Medwin, A. R., 1973: Long-lasting potentiation of synaptic transmission in the dentate area of the anesthetized rabbit following stimulation of the perforant path, J. Physiol. (London) 232, 357–374.

    Google Scholar 

  • Bonica, J. J., 1992: Clinical importance of hyperalgesia, in W. D. Willis, Jr. (ed.), Hyperalgesia and Allodynia, Raven Press, New York, pp. 17–43.

    Google Scholar 

  • Carli, G. and Zimmerman, M., 1996: Progress in Brain Research, Vol. 110. Towards the Neurobiology of Chronic Pain. Elsevier, Amsterdam.

    Google Scholar 

  • Carstens, E., 1996: Quantitative experimental assessment of pain and hyperalgesia in animals and underlying neural mechanisms, in G. Carli and M. Zimmermann (eds), Progress in Brain Research, Vol. 110. Towards the Neurobiology of Chronic Pain, Elsevier, Amsterdam, pp. 17–31.

    Google Scholar 

  • Colpaert, F. C., 1987: Evidence that adjuvant arthritis in the rat is associated with chronic pain, Pain 48, 73–81.

    Google Scholar 

  • Crawford, C. B. and Krebs, D. (eds), 1998: Handbook of Evolutionary Psychology. Ideas, Issues, and Applications, Lawrence Erlbaum, Mahwah, NJ.

    Google Scholar 

  • Cummins, D. D. and Allen, C. (eds), 1998: The Evolution of Mind, Oxford University Press, New York.

    Google Scholar 

  • De Castro Costa, M. C., De Sutter, P., Gybels, J. and Van Haas, J., 1981: Adjuvant-induced arthritis in rats: a possible model for chronic pain, Pain 10, 173–185.

    PubMed  Google Scholar 

  • Dickenson, A. H., 1996: Balances between excitatory and inhibitory events in the spinal cord and chronic pain, in G. Carli and M. Zimmermann (eds), Progress in Brain Research, Vol. 110. Towards the Neurobiology of Chronic Pain, Elsevier, Amsterdam, pp. 225–231.

    Google Scholar 

  • Dray, A., 1997: Mechanisms of central hypersensitivity: excitatory amino acid mechanisms and their control, in A. Dickenson and J.-M Besson (eds), Handbook of Experimental Pharmacology, Vol. 130. The Pharmacology of Pain, Springer, Berlin, pp. 167–210.

    Google Scholar 

  • Dubner, R., 1997: Neural basis of persistent pain: sensory specialization, sensory modulation, and neuronal plasticity, in T. S. Jensen, J. A. Turner and Z. Wiesenfeld-Hallin (eds), Proceedings of the 8th World Congress on Pain. Progress in Pain Research and Management, Vol. 8, IASP Press, Seattle, pp. 243–257.

    Google Scholar 

  • Dubner, R. and Basbaum, A. I., 1994: Spinal dorsal horn plasticity following tissue or nerve injury, in P. D. Wall and R. Melzack (eds), Textbook of Pain, Churchill Livingstone, Edinburgh, NY, pp. 225–241.

    Google Scholar 

  • Dudai, Y., 1995: On the relevance of long-term potentiation to learning and memory, in J. L. McGaugh, N. M. Weinberger and G. Lynch (eds), Brain and Memory. Modulation and Mediation of Neuroplasticity, Oxford University Press, New York, pp. 319–327.

    Google Scholar 

  • Dudek, S. M. and Bear, M. F.: 1992, Homosynaptic long-term depression in area CA1 of the hippocampus and effects of IN-methyl-D-aspartate receptor blockade, Proceedings of the National Academy of Sciences (USA) 89, 4363–4367.

    Google Scholar 

  • Forrest, D. M., 1996: Spinal cord stimulator therapy, J. Perianesthesia Nursing 11, 349–352.

    Google Scholar 

  • Fregnac, Y. and Shulz, D., 1994: Models of synaptic plasticity and cellular analogs of learning in the developing and adult vertebrate visual cortex, in V. A. Casagrande and P. G. Shinkman (eds), Advances in Neural and Behavioral Development, Vol. 4, Ablex Publishing Corp, Norwood, NJ, pp. 149–235.

    Google Scholar 

  • Gilbert, C. D. and Darian-Smith, C., 1995: The dynamic nature of adult visual cortex, in J. L. McGaugh, N. M. Weinberger and G. Lynch (eds), Brain and Memory. Modulation and Mediation of Neuroplasticity, Oxford University Press, New York, pp. 193–205.

    Google Scholar 

  • Gallistel, C. R., 1995: Is long-term potentiation a plausible basis for memory? In J. L. McGaugh, N. M. Weinberger and G. Lynch (eds), Brain and Memory; Modulation and Mediation of Neuroplasticity, Oxford University Press, New York, pp. 328–337.

    Google Scholar 

  • Garraghty, P. E., Kaas, J. H. and Florence, S. L., 1994: Plasticity of sensory and motor maps in adult and developing mammals, in V. A. Casagrande and P. G. Shinkman (eds), Advances in Neural and Behavioral Development, Vol. 4, Ablex Publishing Corporation, Norwood, NJ, pp. 1–36.

    Google Scholar 

  • Hardcastle, V. G., 1999: The Myth of Pain, MIT Press, Cambridge, MA.

    Google Scholar 

  • Hargreaves, K., Dubner, R., Brown, F., Flores, C. and Joris, J., 1987: A new and sensitive method for measuring thermal nociception in cutaneous hyperalgesia, Pain 32, 77–88.

    Google Scholar 

  • Hebb, D. O., 1949: The Organization of Behavior, Wiley, New York.

    Google Scholar 

  • Herrero, J. F., Laird, J. M. A. and Lopez-Garcia, J. A., 2000: Wind-up of spinal neurones and pain sensation: much ado about something? Progress in Neurobiology 61, 169–203.

    PubMed  Google Scholar 

  • Hill, A., 1999: Phantom limb pain: a review of the literature on attributes and potential mechanisms, J. Pain Symptom Manag. 17, 125–142.

    Google Scholar 

  • Holroyd, J., 1996: Hypnosis treatment of clinical pain: Understanding why hypnosis is useful, Int. J. Clinical Experimental Hypnosis 44, 33–51.

    Google Scholar 

  • Ishimaru, K., Kawakita, K. and Sakita, M., 1995: Analgesic effects induced by TENS and electroacupuncture with different types of stimulating electrodes on deep tissue in human subjects, Pain 63, 181–187.

    PubMed  Google Scholar 

  • Izquierdo, I., 1995: Role of the hippocampus, amygdala, and entorhinal cortex in memory storage and expression, in J. L. McGaugh, F. Bermúdez-Rattoni and R. A. Prado-Alcalá (eds), Plasticity in the Central Nervous System. Learning and Memory, Mahwah, NJ, Lawrence Erlbaum, pp. 41–56.

    Google Scholar 

  • Jensen, M. P., Turner, J. A., Romano, J. M. and Lawler, B. K., 1994: Relationship of pain-specific beliefs to chronic pain adjustment, Pain 57, 361–369.

    PubMed  Google Scholar 

  • Jones, A. K. P., 1997, May/June: Pain, its perception, and pain imaging, International Association for the Study of Pain Newsletter, pp. 3–5.

  • Katz, J., Kavanagh, B. P., Sandler, A. N., Nierenberg, H., Boylan, J. F., Friedlander, M. and Shaw, B. F., 1992: Preemptive analgesia: clinical evidence of neuroplasticity contributing to postoperative pain, Anesthesiology 77, 439–446.

    PubMed  Google Scholar 

  • Keogh, E., Hatton, K. and Ellery, D., 2000: Avoidance versus focused attention and the perception of pain: differential effects for men and women, Pain 85, 225–230.

    PubMed  Google Scholar 

  • Khalsa, D. S., 1999: Long deep breathing, J. Back Musculoskeletal Rehabilitation 11, 153–156.

    Google Scholar 

  • Kim, S. H. and Chung, J. M., 1991: Sympathectomy alleviates mechanical allodynia in an experimental model for neuropathy in rats, Neurosci. Lett. 134, 131–134.

    PubMed  Google Scholar 

  • Koltzenberg, M., 1995: Stability and plasticity of nociceptor function and their relationship to provoked and ongoing pain, Semi. Neurosci. 7, 199–210.

    Google Scholar 

  • Laroche, S., Doyère, V., Rédini-Del Négro, C. and Burette, F., 1995: Neural mechanisms of associative memory: role of long-term potentiation, in J. L. McGaugh, N. M. Weinberger and G. Lynch (eds), Brain and Memory. Modulation and Mediation of Neuroplasticity, Oxford University Press, New York, pp. 277–302.

    Google Scholar 

  • Lewis, A. J., Carlson, R. P. and Chang, J., 1985: ExperimentalModels of Inflammation, in I. L. Bonta, M. A. Bray and M. J. Parham (eds), Handbook of Inflammation, Vol. 5. The Pharmacology of Inflammation, Elsevier, New York, pp. 371–397.

    Google Scholar 

  • Lorento de Nó, R., 1934: Studies on the structure of the cerebral cortex: continuation of the study of the ammonic system, J. für Psychologie und Neurologie 46, 113–177.

    Google Scholar 

  • Lotze, M., Grodd, W., Birbaumer, N., Erb, M., Huse, E. and Flor, H., 1999: Does use of a myoelectric prosthesis prevent cortical reorganization and phantom limb pain? Nature Neurosci. 2, 501–502.

    PubMed  Google Scholar 

  • Malenka, R. C., 1997: Mechanisms of homosynaptic LTD in the hippocampus, in M. Baudry and J. L. Davis (eds), Long-Term Potentiation, Vol. 3, MIT Press, Cambridge, MA, pp. 105–116.

    Google Scholar 

  • Mao, J., 1999: NMDA and opioid receptors: their interactions in antinociception, tolerance, and neuroplasticity, Brain Res. Rev. 30, 289–304.

    PubMed  Google Scholar 

  • McGaugh, J. L., Bermúdez-Rattoni, F. and Prado-Alcalá, R. A. (eds), 1995: Plasticity in the Central Nervous System. Learning and Memory, Lawrence Earlbaum Associates, Mahwah, NJ.

    Google Scholar 

  • McGaugh, J. L., Weinberger, N. M. and Lynch, G. (eds), 1995: Brain and Memory. Modulation and Mediation of Neuroplasticity, Oxford University Press, New York.

    Google Scholar 

  • McQuay, H. J., 1992: Preemptive analgesia, British J. Anaesthesiol. 69, 1–3.

    Google Scholar 

  • Melzack, R. and Wall, P. D., 1983: The Challenge of Pain, Basic Books, New York.

    Google Scholar 

  • Mendell, L. M., 1966: Physiological properties of unmyelinated fibre projections to the spinal cord, Experimental Neurol. 16, 316–332.

    Google Scholar 

  • Merskey, H., 1986: Pain terms: a current list with definitions and notes on usage, Pain (Suppl. 3), S217.

    Google Scholar 

  • Merskey H. and Bogduk, N., 1994: Classification of Chronic Pain. Descriptions and Chronic Pain Syndromes and Definitions of Pain Terms, 2nd edn, IASP Press, Seattle, pp. 207–213.

    Google Scholar 

  • Millan, M. J., 1999: The induction of pain: an integrative review, Progress in Neurobiol. 57, 1–164.

    Google Scholar 

  • Miron, D., Duncan, G. H. and Bushnell, M. C., 1989: Effects of attention on the intensity and unpleasantness of thermal pain, Pain 39, 345–352.

    PubMed  Google Scholar 

  • Morley, S., Eccleston, C. and Williams, A., 1999: Systematic review and meta-analysis of randomized controlled trials of cognitive behaviour therapy and behaviour therapy for chronic pain in adults, excluding headache, Pain 80, 1–13.

    PubMed  Google Scholar 

  • Mulkey, R. M. and Malenka, R. C., 1992: Mechanisms underlying induction of homosynaptic longterm depression in area CA1 of the hippocampus, Neuron 9, 967–975.

    Article  PubMed  Google Scholar 

  • Nichols, M. L., Allen, B. J., Rogers, S. D., Ghilardi, J. R., Honore, P., Lugar, N. M., Finke, M. P., Li, J., Lappi, D. A., Simone, D. A. and Mantyh, P. W., 1999: Transmission of chronic nociception by spinal neurons expressing the Substance P receptor, Science 286, 1558–1561.

    PubMed  Google Scholar 

  • Nowak, G., Trullas, R., Layer, R. T., Skolnick, P. and Paul, I. A., 1993: Adaptive changes in the N-methyl-D-aspartate receptor complex after chronic treatment with imipramine and 1-aminocyclopropanecarboxylic acid, J. Pharmacol. Experimental Therapeutics 265, 1380–1386.

    Google Scholar 

  • Orbach, J., 1998: The Neuropsychological Theories of Lashley and Hebb. Contemporary Perspectives Fifty Years after Hebb's The Organization of Behavior. Vanuxem Lectures and Selected Theoretical Papers of Lashley, University Press of America, Lanham, MD.

    Google Scholar 

  • Paice, J. A., Shott, S., Oldenburg, F. P., Zeller, J. and Swanson, B., 2000: Efficacy of a vibratory stimulus for the relief of HIV-associated neuropathic pain, Pain 84, 291–296.

    PubMed  Google Scholar 

  • Paul, I. A., Nowack, G., Layer, R. T., Popik, P. and Skolnick, P., 1994: Adaptation of the Nmethyl-D-aspartate receptor complex following chronic antidepressant treatments, J. Pharmacol. Experimental Therapeutics 269, 95–102.

    Google Scholar 

  • Petrovic, P., Petersson, K. M., Ghatan, P. H., Stone-Elander, S. and Ingvar, M., 2000: Pain-related cerebral activation is altered by a distracting cognitive task, Pain 85, 19–30.

    PubMed  Google Scholar 

  • Plotkin, H. C., 1998: Evolution in Mind: An Introduction to Evolutionary Psychology, Harvard University Press, Cambridge, MA.

    Google Scholar 

  • Price, D. D., 2000: Psychological and neural mechanisms of the affective dimension of pain, Science 288, 1769–1772.

    Google Scholar 

  • Rainville, P., Duncan, G. H., Price, D. D., Carrier, B. and Bushnell, M. C., 1997: Pain affect encoded in human anterior cingulate but not somatosensory cortex, Science 277, 968–971.

    Google Scholar 

  • Rainville, P., Carrier, B., Hofbauer, R. K., Bushnell, M. C. and Duncan, G. H., 1999: Dissociation of sensory and affective dimensions of pain using hypnotic modulation, Pain 82, 159–171.

    PubMed  Google Scholar 

  • Ramachandran, V. S. and Herstein, W., 1998: The perception of phantom limbs: the D. O. Hebb lecture, Brain 121, 1603–1630.

    PubMed  Google Scholar 

  • Randall, L. O. and Sellitto, J. J., 1957: A new method for measurement of analgesic activity on inflamed tissue, Archives Int. Pharmacodyn. 111, 409–419.

    Google Scholar 

  • Richmond, C. E., Bromley, L. M. and Woolf, C. J., 1992: Preoperative morphine re-empts postoperative pain, Lancet 342, 73–75.

    Google Scholar 

  • Sandkühler, J. and Randic, M., 1997: Long-term depression of primary afferent neurotransmission induced by low-frequency stimulation of afferent Aδ fibers, in T. S. Jensen, J. A. Turner and Z. Wiesenfeld-Hallin (eds), Proceedings of the 8th World Congress on pain. Progress in Pain Research and Management, Vol. 8, IASP Press, Seattle, pp. 827–837.

    Google Scholar 

  • Sanes, J. R. and Lichtman, J. W., 1999: Can molecules explain long-term potentiation? Nature Neurosci. 2, 597–604.

    PubMed  Google Scholar 

  • Scoville, W. B. and Milner, B., 1957: Loss of recent memory after bilateral hippocampus lesions, J. Neurol., Neurosurg., & Psych. 20, 11–21.

    Google Scholar 

  • Seltzer, Z., Dubner, R. and Shir, Y. A., 1990: A novel model of neuropathic pain disorders produced in rats by partial sciatic nerve injury, Pain 43, 205–208.

    PubMed  Google Scholar 

  • Sherman, R. A., 1997: Phantom Pain, Plenum Press, New York.

    Google Scholar 

  • Skolnick, P., Layer, R. T., Popik, P., Nowak, G., Paul, I. A. and Trullas, R., 1996: Adaptation of Nmethyl-D-aspartate (NMDA) receptors following antidepressant treatment: implications for the pharmacotherapy of depression, Pharmacopsych. 29, 23–26.

    Google Scholar 

  • Spear, N. E., Spear, L. P. and Woodruff, M. L. (eds), 1995: Neurobehavioral Plasticity. Learning Development, and Responses to Brain Insults, Lawrence Earlbaum Associates, Hillsdale, NJ.

    Google Scholar 

  • Stein, C., Millan, M. J. and Herz, A., 1988: Unilateral inflammation of the hindpaw in rats as a model of prolonged noxious stimulation: alterations in behavior and nociceptive thresholds, Pharmacol. Biochem. Behavior 31, 445–451.

    Google Scholar 

  • Svendsen, F., Tjølsen, A., Rygh, L. and Hole, K., 1999: Expression of long-term potentiation in single wide dynamic range neurons in the rat is sensitive to blockade of glutamate receptors, Neurosci. Lett. 259, 25–28.

    PubMed  Google Scholar 

  • Stubhaug, A., Breivik, H., Eide, P. K., Kreunen, M. and Foss, A.: 1997, Ketamine reduces postoperative hyperalgesia, in T. S. Jensen, J. A. Turner and Z. Wiesenfeld-Hallin (eds), Proceedings of the 8th World Congress on Pain. Progress in Pain Research and Management, Vol. 8, pp. 333–342.

  • Sufka, K. J., Brockel, B. J., Liou, J.-R. and Fowler, S. C., 1996: Functional deficits following bilateral forelimb adjuvant inflammation assessed by operant methodology: effects of indomethacin and morphine on recovery of function, Experim. Clinical Psychopharmacol. 4, 336–343.

    Google Scholar 

  • Talbot, J. D., Marrett, S., Evans, A. C., Meyer, E., Bushnell, M. C. and Duncan, G. H., 1991: Multiple representations of pain in human cerebral cortex, Science 251, 1355–1358.

    PubMed  Google Scholar 

  • Tjølson, A. and Hole, K., 1997: Animal models of analgesia, in A. Dickenson and J.-M. Besson (eds), The Pharmacology of Pain, Springer-Verlag, New York, pp. 1–20.

    Google Scholar 

  • Turner, J. A., Loeser, J. D. and Bell, K. G., 1995: Spinal cord stimulation for chronic low back pain: a systematic literature synthesis, Neurosurgery 37, 1088–1096.

    PubMed  Google Scholar 

  • Vincent, C. A. and Richardson, P. H., 1986: The evaluation of therapeutic acupuncture: concepts and methods, Pain 24, 1–14.

    PubMed  Google Scholar 

  • Vogt, B. A., Derbyshire, S. and Jones, A. K. P.: 1996, Pain processing in four regions of the human cingulate cortex localised with coregistered PET and MR imaging, Europ. J. Neurosci. 8, 1461–1473.

    Google Scholar 

  • Wall, P. D. and Melzack, R. (eds), 1994: Textbook of Pain, Churchill Livingstone, Edinburgh, NY.

    Google Scholar 

  • Willis, W. D., 1992: Hyperalgesia and Allodynia, Raven Press, New York.

    Google Scholar 

  • Willis, W. D. and Westlund, K. N., 1997: Neuroanatomy of the pain system and of the pathways that modulate pain, J. Clinical Neurophysiol. 14, 2–31.

    Google Scholar 

  • Willner, P., 1991: Behavioural models in psychopharmacology, in P. Willner (ed), Behavioural Models in Psychopharmacology. Theoretical, Industrial and Clinical Perspectives, Cambridge University Press, Cambridge, MA, pp. 3–18.

    Google Scholar 

  • Woolf, C. J., 1989: Recent advances in the pathophysiology of acute pain, British J. Anaesthesiol. 63, 139–146.

    Google Scholar 

  • Woolf, C. J. and Chong, M. S., 1993: Preemptive analgesia-treating postoperative pain by preventing the establishment of central sensitization, Anesthesia and Analgesia 77, 362–379.

    PubMed  Google Scholar 

  • Woolf, C. J. and Salter, M. W., 2000: Neuronal plasticity: increasing the gain in pain, Science 288, 1765–1768.

    PubMed  Google Scholar 

  • Woolf, C. J. and Thompson, J. W., 1994: Stimulation fibre-induced analgesia: transcutaneous electrical nerve stimulation (TENS) and vibration, in P. D. Wall and R. Melzack (eds), Textbook of Pain, Churchill Livingstone, Edinburgh, NY, pp. 1191–1208.

    Google Scholar 

  • Yaksh, T. L., 1999: Spinal systems and pain processing: development of novel analgesic drugs with mechanistically designed models, Trends in Pharmacological Sciences 20, 329–337.

    PubMed  Google Scholar 

  • Zimmermann, M. and Herdegen, T., 1996: Plasticity of the nervous system at the systemic, cellular and molecular levels: a mechanism of chronic pain and hyperalgesia, in G. Carli and M. Zimmermann (eds), Progress in Pain Research, Vol. 10. Towards a Neurobiology of Chronic Pain, Elsevier, Amsterdam, pp. 233–259.

    Google Scholar 

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  1. Departments of Psychology and Pharmacology, University of Mississippi, Oxford, MS, 38677, U.S.A.

    Kenneth Sufka

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Sufka, K. Chronic Pain Explained. Brain and Mind 1, 155–179 (2000). https://doi.org/10.1023/A:1010032508495

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