WHAT EXACTLY IS CENTRAL TO THE ROLE OF CENTRAL NEUROPLASTICITY IN PERSISTENT PAIN

The commentaries on our target article have raised important issues ab out central neuroplasticity and its role in persistent pain states. So me suggest that central neuroplasticity plays nothing more than a mino r role in persistent pain, while others argue that persistent pain dep ends critically on peripheral inputs for its maintenance. Some stress that persistent pain relies to a large extent on changes in the brain and on centrifugal inputs from brain to spinal cord, whereas others ar gue that it depends on alterations in inhibitory as well as excitatory systems. We attempt to address each of the commentators' points, whil e defending our position that central neuroplasticity is critical to p athological persistent pain states.