PERSISTENT EXCITATORY SYNAPTIC PLASTICITY IN THE DORSAL HORN OF THE SPINAL CORD AS A NEUROPHYSIOLOGICAL BASIS OF CHRONIC PAIN
DOI:
https://doi.org/10.36557/2674-8169.2026v8n1p672-683Keywords:
Dor crônica, Sensibilização central, Plasticidade sináptica, Corno dorsal, Modulação descendente da dorAbstract
Introduction: Chronic pain represents a major public health problem and constitutes a complex clinical condition sustained by central mechanisms that extend beyond peripheral nociception. Increasing evidence indicates that persistent excitatory synaptic plasticity in the dorsal horn of the spinal cord plays a central role in the amplification and maintenance of pain, configuring a state of central sensitization associated with dysfunction of descending pain modulation systems. Objectives: To systematically analyze neurophysiological, molecular, and functional evidence related to persistent excitatory synaptic plasticity in the dorsal horn of the spinal cord as a mechanistic basis of chronic pain, integrating spinal, suprasegmental, and clinical findings. Methods: This study is a systematic review conducted according to the PRISMA guidelines. Searches were performed in PubMed/MEDLINE, Scopus, SciELO, and the Virtual Health Library, including articles published within the last five years in English, Portuguese, and Spanish. Original studies and reviews addressing mechanisms of central sensitization, spinal synaptic plasticity, and descending pain modulation were included, provided that full texts were available. Duplicate studies, grey literature, and articles not directly related to the topic were excluded. Conclusion: The analyzed evidence demonstrates that chronic pain is sustained by na integrated process of neurophysiological reorganization characterized by persistent spinal hyperexcitability, dependent on specific molecular mechanisms and microcircuit remodeling. The involvement of suprasegmental networks and dysfunction of descending modulatory systems amplifies and stabilizes this state, consolidating pain as na emergent property of reorganized neural circuits. These findings highlight the need for diagnostic and therapeutic approaches that directly address the central mechanisms underlying chronic pain.
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Copyright (c) 2026 Jorge Eberson de Oliveira Santana, Emanuel Levi Da Silva , Emanuel Vitor Ferreira dos Santos , Islandia Maria Rodrigues Silva , Iverton Rameri Carvalho Alencar , João Gabriel Pereira Luna , José Ferreira Lima Júnior , Lanna Louise Costa Campos Luz , Maria Alice Santos Nardini , Maria Gabriella Cavalcante de Lima , Maria Júlia Ribeiro Sales , Pedro Gustavo Tavares Souza
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors are copyright holders under a CCBY 4.0 license.
