Modulating neuroplasticity for chronic pain relief: noninvasive neuromodulation as a promising approach, 2025, Jayathilake et al.

[Chandelier]

Modulating neuroplasticity for chronic pain relief: noninvasive neuromodulation as a promising approach

Spoiler: Authors

Jayathilake, Nishani Jayanika; Phan, Tien Thuy; Kim, Jeongsook; Lee, Kyu Pil; Park, Joo Min

Abstract
Abstract Chronic neuropathic pain is a debilitating neuroplastic disorder that notably impacts the quality of life of millions of people worldwide.
This complex condition, encompassing various manifestations, such as sciatica, diabetic neuropathy and postherpetic neuralgia, arises from nerve damage or malfunctions in pain processing pathways and involves various biological, physiological and psychological processes.
Maladaptive neuroplasticity, known as central sensitization, plays a critical role in the persistence of chronic neuropathic pain.
Current treatments for neuropathic pain include pharmacological interventions (for example, antidepressants and anticonvulsants), invasive procedures (for example, deep brain stimulation) and physical therapies.
However, these approaches often have limitations and potential side effects.
In light of these challenges, interest in noninvasive neuromodulation techniques as alternatives or complementary treatments for neuropathic pain is increasing.
These methods aim to induce analgesia while reversing maladaptive plastic changes, offering potential advantages over conventional pharmacological practices and invasive methods.
Recent technological advancements have spurred the exploration of noninvasive neuromodulation therapies, such as repetitive transcranial magnetic stimulation, transcranial direct current stimulation and transcranial ultrasound stimulation, as well as innovative transformations of invasive techniques into noninvasive methods at both the preclinical and clinical levels.
Here this review aims to critically examine the mechanisms of maladaptive neuroplasticity in chronic neuropathic pain and evaluate the efficacy of noninvasive neuromodulation techniques in pain relief.
By focusing on optimizing these techniques, we can better assess their short-term and long-term effects, refine treatment variables and ultimately improve the quality of neuropathic pain management.

Web | DOI | PMC | PDF | Experimental & Molecular Medicine

 

[rvallee]

Chronic neuropathic pain is a debilitating neuroplastic disorder

There is no evidence of that. This is a purely speculative model lacking any credible evidence. Wikipedia usually has higher standards than this, although given that stuff like this gets through academic papers, it probably just follows the downgraded lack of standards here, but there is no mention of neuroplasticity on its neuropathic page, so there's that.

Now, what they do they mean by neuroplastic disorder?

Maladaptive neuroplasticity, known as central sensitization, plays a critical role in the persistence of chronic neuropathic pain

Ah, another turtle. What a surprise. The evidence?

Chronic neuropathic pain is increasingly recognized as a neuroplasticity disorder caused by excitatory and inhibitory imbalances in pain processing pathways

Some people have been asserting it, more people are asserting it. What's beneath the turtle-support-turtle?

A key aspect of neuropathic pain is central sensitization, a form of maladaptive neuroplasticity that amplifies pain signaling in the central nervous system (CNS)

Another turtle, you say? Oh my that's a lot of turtles all the way down there.

Importantly, modulating this unhelpful neuroplasticity can potentially alleviate persistent pain symptoms and restore normal functioning, promoting adaptive changes

Routinely used in standard care, something that can at best, really at very best, be described with "can potentially" do the thing they claim it must do, because the model says so. This is like pulling yourself by your own bootstraps, and it works because the bootstraps have their own bootstraps. How do they justify this?

Central to this understanding is the concept of maladaptive neural plasticity: the nervous system’s ability to reorganize its structure, function and connections in response to persistent pain signals, often in ways that perpetuate rather than alleviate the pain state17,18. The development and persistence of chronic pain states are thus tightly linked to this neuroplasticity.

Well, the model says so. So, the model is correct because the model says so.

While neural plasticity is essential for normal function and adaptation, in chronic pain, it can become maladaptive, amplifying and sustaining pain signals. This maladaptive plasticity plays crucial roles in both the development and maintenance of chronic pain conditions.

It's conceivable that it could do that, therefore it must do that. Do you have a better explanation? Oh, you do? Well, I disagree with it so up yours.

I don't think it can be overstated that the development of AI, a potential threat to humanity, is also a critical requirement for the possible continuation of this civilization because humans have over-reached the limits of our ability to deal with the remaining problems relating to health, regressing back down to narratives popular in Antiquity, even if they used slightly different wording for it.