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The analgesic effect of local heat is similar to the electrical cutaneous stimulation of nerves, which is explained by the gate-control theory of pain or by central alteration of the pain threshold [ 16, 17].
In our own study using healthy volunteers, we have shown that the perception of pain/discomfort in relation to cuff occlusion for RIPC reduces with subsequent cuff inflations [ 28], possibly either due to some desensitisation of nerve signal at the site of occlusion with repeated exposure or due to central alteration in pain perception.
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3. Tuka, B., Helyes, Z., Markovics, A., Bagoly, T., Nemeth, J., Mark, L., Brubel, R., Reglodi, D., Pardutz, A., Szolcsanyi, J., Vecsei, L., Tajti, J. Peripheral and central alterations of pituitary adenylate cyclase activating polypeptide-like immunoreactivity in the rat in response to activation of the trigeminovascular system.
In this context, it is hardly surprising that enteric neurons can mirror central alterations in neurodegenerative disorders.
Moreover, our group have shown central alterations in diabetic patients and reorganization of the cingulate-operculum network (11).
So the question arises whether muscle alterations with respect to metabolics and algesics are present in chronic myalgia and contribute to maintenance of the central alterations mentioned above.
In particular, CFS patients have increased levels of catecholamines [ 40, 41] and a sympathetic predominance of cardiovascular autonomic control possibly due to central alterations [ 9, 11, 42].
This suggests that a probable mechanism for positive effects on pain as a consequence of exercise was central alterations and not peripheral improvements in the muscles.
It has previously been shown that peripheral impairments are generally more pronounced after shorter high-intensity tasks, whereas central alterations increase with task duration (Amann 2011; Nybo 2008).
However, there are several indications that central alterations in nociceptive processing can be driven by peripheral tissue alterations [ 76] and peripheral nociceptive input [ 80, 81] also in the chronic stage of a pain condition.
Aberrant promoter hypermethylation of TSGs and differentiation factors is a central epigenetic alteration in cancer [26], [27].
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