Cited by 125Pain Mechanisms and TreatmentsPain Management and TreatmentMusculoskeletal pain and rehabilitation

Central sensitization in humans: assessment and pharmacology

Arendt-Nielsen, Lars·2015·Handbook of Experimental Pharmacology

Abstract

It is evident that chronic pain can modify the excitability of central nervous system which imposes a specific challenge for the management and for the development of new analgesics. The central manifestations can be difficult to quantify using standard clinical examination procedures, but quantitative sensory testing (QST) may help to quantify the degree and extend of the central reorganization and effect of pharmacological interventions. Furthermore, QST may help in optimizing the development programs for new drugs.Specific translational mechanistic QST tools have been developed to quantify different aspects of central sensitization in pain patients such as threshold ratios, provoked hyperalgesia/allodynia, temporal summation (wind-up like pain), after sensation, spatial summation, reflex receptive fields, descending pain modulation, offset analgesia, and referred pain areas. As most of the drug development programs in the area of pain management have not been very successful, the pharmaceutical industry has started to utilize the complementary knowledge obtained from QST profiling. Linking patients QST profile with drug efficacy profile may provide the fundamentals for developing individualized, targeted pain management programs in the future. Linking QST-assessed pain mechanisms with treatment outcome provides new valuable information in drug development and for optimizing the management regimes for chronic pain.

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Crossref · 10.1007/978-3-662-46450-2_5

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163 of 163 references verified0 citation errors · 0 not checkable

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  • Depression, anxiety, general emotional distress, and negative affect are probably the most commonly assessed psychological factors in persistent pain patients.

    “Depression, anxiety, and general indices of emotional distress along with a cluster of negative emotions, thoughts, and behaviors termed, “negative affect,” are probably the most commonly-assessed psychological factors in patients with persistent pain 11, 32, 33.”
  • Depression and anxiety are linked to chronic pain and increased pain sensitivity.

    “An abundance of evidence links depression and anxiety to chronic pain and increased pain sensitivity 11, 13, 32, 41.”
  • Recent reviews identify catastrophizing as a key phenotypic factor to assess in trials of analgesic treatments for chronic pain.

    “Recent reviews have identified catastrophizing as a key phenotypic factor to assess in trials of analgesic treatments in patients with chronic pain 11.”

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Authors
Arendt-Nielsen, L.
Venue
Handbook of Experimental Pharmacology
Published
2015
Volume
227
Pages
79-102
ISSN
  • 0171-2004 (ISSN-L)
  • 1865-0325
OpenAlex
W213693423
Cited by
125
References
163
Citations by year
2026: 5 · 2025: 11 · 2024: 7 · 2023: 13 · 2022: 14 · 2021: 17 · 2020: 14 · 2019: 8 · 2018: 13 · 2017: 11 · 2016: 10 · 2015: 2
FWCI
39.56
Type
book chapter
Language
en
Open access
closed
Locations
  • Handbook of experimental pharmacology (publishedVersion)
  • PubMed (publishedVersion)
  • VBN Forskningsportal (Aalborg Universitet) (submittedVersion)
Topics
  • Health Sciences › Medicine › Physiology › Pain Mechanisms and Treatments
  • Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
  • Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
Keywords
central sensitization, chronic pain, quantitative sensory testing, pharmacological evaluation, drug development, temporal summation, spatial summation, descending pain modulation, referred pain, allodynia, hyperalgesia, personalized pain management
MeSH terms
Humans, Central Nervous System Sensitization, Chronic Pain, Pain Management

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