Laboratory of Ion Channel Research, VIB-KU Leuven Center for Brain & Disease Research, Leuven, Belgium. Department of Cellular and Molecular Medicine, KU Leuven, Belgium; Neuroscience in Physiotherapy (NiP), independent research group, Elche, Spain.
International Doctorate School, Faculty of Health Sciences, University of Málaga, Málaga 29071, Spain.
Neurosci Biobehav Rev. 2024 Dec;167:105886. doi: 10.1016/j.neubiorev.2024.105886. Epub 2024 Sep 13.
Chronic pain causes disability and loss of health worldwide. Yet, a mechanistic explanation for it is still missing. Frequently, neural phenomena, and among them, Central Sensitization (CS), is presented as causing chronic pain. This narrative review explores the evidence substantiating the relationship between CS and chronic pain: four expert researchers were divided in two independent teams that reviewed the available evidence. Three criteria were established for a study to demonstrate a causal relationship: (1) confirm presence of CS, (2) study chronic pain, and (3) test sufficiency or necessity of CS over chronic pain symptoms. No study met those criteria, failing to demonstrate that CS can cause chronic pain. Also, no evidence reporting the occurrence of CS in humans was found. Worryingly, pain assessments are often confounded with CS measures in the literature, omitting that the latter is a neurophysiological and not a perceptual phenomenon. Future research should avoid this misconception to directly interrogate what is the causal contribution of CS to chronic pain to better comprehend this problematic condition.
慢性疼痛在全球范围内导致残疾和健康丧失。然而，其发病机制仍不清楚。神经现象，尤其是中枢敏化（CS），常被认为是导致慢性疼痛的原因。本综述探讨了 CS 与慢性疼痛之间关系的证据：四位专家研究人员分为两个独立的小组，对现有证据进行了审查。为了证明研究具有因果关系，确立了三项标准：（1）证实 CS 的存在，（2）研究慢性疼痛，（3）测试 CS 对慢性疼痛症状的充分性或必要性。没有一项研究符合这些标准，未能证明 CS 可以引起慢性疼痛。此外，也没有发现报告人类 CS 发生的证据。令人担忧的是，文献中的疼痛评估常常与 CS 测量混淆，忽略了后者是一种神经生理学现象，而不是知觉现象。未来的研究应避免这种误解，直接探究 CS 对慢性疼痛的因果贡献，以更好地理解这种复杂的疾病。
