Recent findings have implications for how we conceptualise, assess and treat pain
The concept of neuroplasticity — the ability of the nervous system to change its structure and function — has captured the imagination of clinicians, researchers and the general public.1 The ability of the brain to reorganise itself is remarkable. For example, people who are visually impaired engage their visual cortex for fine sensory discrimination when using their hands. In these situations, neuroplasticity appears to be a positive adaptation to loss of function.
- 1. Doidge N. The brain that changes itself: stories of personal triumph from the frontiers of brain science. London: Penguin Books, 2007.
- 2. Seifert F, Maihofner C. Functional and structural imaging of pain-induced neuroplasticity. Curr Opin Anaesthesiol 2011; 24: 515-523.
- 3. Latremoliere A, Woolf CJ. Central sensitization: a generator of pain hypersensitivity by central neural plasticity. J Pain 2009; 10: 895-926.
- 4. Flor H, Elbert T, Knecht S, et al. Phantom-limb pain as a perceptual correlate of cortical reorganization following arm amputation. Nature 1995; 375: 482-484.
- 5. Wrigley PJ, Press SR, Gustin SM, et al. Neuropathic pain and primary somatosensory cortex reorganization following spinal cord injury. Pain 2009; 141: 52-59.
- 6. Melzack R, Coderre TJ, Katz J, Vaccarino AL. Central neuroplasticity and pathological pain. Ann N Y Acad Sci 2001; 933: 157-174.
- 7. Price DD, Verne GN, Schwartz JM. Plasticity in brain processing and modulation of pain. Prog Brain Res 2006; 157: 333-352.
- 8. Sandkühler J. Learning and memory in pain pathways. Pain 2000; 88: 113-118.
- 9. Knecht S, Henningsen H, Hohling C, et al. Plasticity of plasticity — changes in the pattern of perceptual correlates of reorganization after amputation. Brain 1998; 121: 717-724.
- 10. Gwilym SE, Filippini N, Douaud G, et al. Thalamic atrophy associated with painful osteoarthritis of the hip is reversible after arthroplasty: a longitudinal voxel-based morphometric study. Arthritis Rheum 2010; 62: 2930-2940.
Publication of your online response is subject to the Medical Journal of Australia's editorial discretion. You will be notified by email within five working days should your response be accepted.