Which statement best captures central sensitization?

Which statement best captures central sensitization?

• A. Increased CNS excitability leading to amplified pain.
• B. Decreased CNS excitability.
• C. Pain is solely due to peripheral signals.
• D. Opioid-mediated inhibition is the sole mechanism.

Answer: (A)

Central sensitization involves neurons in the central nervous system becoming more responsive to input from the periphery, so normal or subthreshold signals can produce amplified pain. This heightened CNS excitability leads to phenomena like allodynia (pain from non-painful stimuli) and hyperalgesia (increased pain from painful stimuli), as well as neuroplastic changes in dorsal horn neurons, wind-up from repeated C-fiber activity, and ongoing glial/immune signaling that sustains the heightened state. Because of this amplification process, the statement that best captures central sensitization is that increased CNS excitability leads to amplified pain. The other ideas don’t fit: decreased CNS excitability would reduce pain, pain cannot be explained by peripheral signals alone given CNS involvement, and opioid inhibition is not the sole mechanism driving central sensitization.

Central sensitization involves neurons in the central nervous system becoming more responsive to input from the periphery, so normal or subthreshold signals can produce amplified pain. This heightened CNS excitability leads to phenomena like allodynia (pain from non-painful stimuli) and hyperalgesia (increased pain from painful stimuli), as well as neuroplastic changes in dorsal horn neurons, wind-up from repeated C-fiber activity, and ongoing glial/immune signaling that sustains the heightened state. Because of this amplification process, the statement that best captures central sensitization is that increased CNS excitability leads to amplified pain. The other ideas don’t fit: decreased CNS excitability would reduce pain, pain cannot be explained by peripheral signals alone given CNS involvement, and opioid inhibition is not the sole mechanism driving central sensitization.