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Thus, central nervous system neurons encoding painful inputs must receive some decisive input from the nerve fibres of the hyperalgesic region during the early phases of exposure to the stimulus.
Functional and effective connectivity in terms of synchronization and information transfer were able to reveal differences in visual reactivity between migraine patients and controls, so these methods may presumably outline a different way to process nociceptive laser stimuli in migraine, giving further knowledge on how the cortex changes its inter-connections under painful inputs.
The first sensory synapse at the spinal cord between DRG and dorsal horn (DH) neurons functions as a gain controller for painful inputs from the periphery.
Alongside this, the persistent input into the limbic brain areas such as the amygdala are likely to be causal in the comorbidities that patients often report due to ongoing painful inputs disrupting normal function and generating fear, depression, and sleep problems (Fig. 2).
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This may be due to insufficient inhibition of incoming painful stimuli or a consequence of frequent painful input from the pericranial musculoskeletal tissue (central sensitisation) [24].
In TTH, several lines of evidence indicate that the development of sensitization at the level of the spinal dorsal horn/trigeminal nucleus is the result of prolonged continuous painful input from pericranial myofascial tissues [8].
First proposed in the 1960s, this theory suggests that pain is like an open gate that can be "closed" by non-painful input.
However, increasing evidence points towards peripheral tissues as relevant contributors of painful impulse input that might either initiate or maintain central sensitization, or both.
Other factors, such as preoperative pain and additional painful noxious intraoperative inputs such as retraction, as well as postoperative inflammatory processes, can all result in the development of an altered central processing of afferent input, which, in turn, is capable of amplifying subsequent postoperative nociceptive input [ 3].
Please see: Hummel T, Springborn M, Croy I, Lötsch J (2011) High pain sensitivity is distinct from high susceptibility to non-painful sensory input at threshold level.
Input stimulus functions were defined for each visual cue type (pain, safety and control), for the painful heat stimulation, for the pleasant and neutral written scenarios as well as for the tasks of rating.
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