Mechanisms of Central Hypersensitivity: Excitatory Amino Acid Mechanisms and Their Control

  • A. Dickenson
Part of the Handbook of Experimental Pharmacology book series (HEP, volume 130)


There has been much evidence from clinical studies to support the idea that there are mechanisms for enhancing the transmission of pain. These events, underlying hyperalgesia — where the sensation of pain is greater than expected for a given stimulus, where the relationship between the stimulus and the response no longer holds — could be due to either peripheral or central mechanisms or indeed both. It is now clear that peripheral mechanisms are of great importance in this respect, and the primary hyperalgesia seen in damaged tissue is therefore explicable in terms of local mechanisms (see Dray 1995). However, the secondary hyperalgesia around the damaged area is likely to involve central events, so-called central hypersensitivity. Arising from this is the idea that the ascending pain messages from the dorsal horn of the spinal cord are not the same under all circumstances but can be altered over short and long time courses. In addition, it is becoming clear that this plasticity, the ability of pain transmission and modulation systems to change, varies in different pain states (McQuay and Dickenson 1990). Thus there may be both common and unique alterations in different pain states.


NMDA Receptor Dorsal Horn Excitatory Amino Acid NMDA Receptor Antagonist NMDA Antagonist 
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© Springer-Verlag Berlin Heidelberg 1997

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  • A. Dickenson

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