[libribook.com] Traumatic Scar Tissue Management 1st Edition

heightened nociceptive responses and/or lower thresholds; i.e. a lower intensity
stimuli results in increased responsiveness. Clinically, sensitization may only be
inferred indirectly from presenting phenomena, such as hyperalgesia or
allodynia, and may include dysfunction of endogenous pain control systems.
• Central sensitization: increased responsiveness of nociceptive neurons in the
CNS.
• Peripheral sensitization: increased responsiveness of nociceptive neurons in the
periphery.
Neuroplasticity
As noted, neurons communicate with each other via electrical signals and
synapses. Our brains learn and form memories by strengthening synapses that
are frequently used and weakens those that are used less often.
Neuroplasticity, an intrinsic adaptation trait of the NS, enables modification of
function and structure in response to demands via the strengthening, weakening,
pruning, or adding of synaptic connections and by promoting neurogenesis.
Contrary to common belief, neurogenesis in the adult brain can persist into the
elder years (Rakic 2002); therefore, the brain does not remain static but instead,
throughout life, continues to change its physical structure and functional
organization in response to each sensory input, motor act, association, reward
signal, action plan and awareness (Pascual-Leone et al. 2005). So, not only can
an ‘old dog learn new tricks’, new cells and streamlined synaptic connections
will support the ability to expertly master said-tricks well into the elder years.
Neuroplasticity occurs on a variety of levels, ranging from cellular changes in
response to learning, to large-scale changes involved in cortical remapping in
response to injury.
Neuroplastic adaptation can occur as positive or negative: recovery post-stroke
to normal levels of performance is a case of positive plasticity. For example
when a region of tissue or body part is immobilized, brain regions devoted to
sensing, initiating and controlling movement will change as a result of lack of
neuronal activity or stimulation. In turn this results in re-allocation of these
nerves to other functions (e.g. nociception) and/or actual shrinkage of gray
matter within the associated brain region – denoting negative plasticity. Other