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Pain Control pp 79-102 | Cite as

Central Sensitization in Humans: Assessment and Pharmacology

  • Lars Arendt-NielsenEmail author
Part of the Handbook of Experimental Pharmacology book series (HEP, volume 227)

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.

Keywords

Pain assessment Quantitative sensory testing Spreading sensitization 

Notes

Conflict of Interest

No conflict of interest can be reported.

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© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  1. 1.Center for Sensory-Motor Interaction (SMI), Department of Health Science and TechnologySchool of Medicine, Aalborg UniversityAalborgDenmark

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