PMID- 25519921 OWN - NLM STAT- MEDLINE DCOM- 20151123 LR - 20150311 IS - 1744-7631 (Electronic) IS - 1472-8222 (Linking) VI - 19 IP - 4 DP - 2015 Apr TI - Brain-derived neurotrophic factor as a driving force behind neuroplasticity in neuropathic and central sensitization pain: a new therapeutic target? PG - 565-76 LID - 10.1517/14728222.2014.994506 [doi] AB - INTRODUCTION: Central sensitization is a form of maladaptive neuroplasticity underlying many chronic pain disorders, including neuropathic pain, fibromyalgia, whiplash, headache, chronic pelvic pain syndrome and some forms of osteoarthritis, low back pain, epicondylitis, shoulder pain and cancer pain. Brain-derived neurotrophic factor (BDNF) is a driving force behind neuroplasticity, and it is therefore crucial for neural maintenance and repair. However, BDNF also contributes to sensitization of pain pathways, making it an interesting novel therapeutic target. AREAS COVERED: An overview of BDNF's sensitizing capacity at every level of the pain pathways is presented, including the peripheral nociceptors, dorsal root ganglia, spinal dorsal horn neurons, and brain descending inhibitory and facilitatory pathways. This is followed by the presentation of several potential therapeutic options, ranging from indirect influencing of BDNF levels (using exercise therapy, anti-inflammatory drugs, melatonin, repetitive transcranial magnetic stimulation) to more specific targeting of BDNF's receptors and signaling pathways (blocking the proteinase-activated receptors 2-NK-kappabeta signaling pathway, administration of phencyclidine for antagonizing NMDA receptors, or blockade of the adenosine A2A receptor). EXPERT OPINION: This section focuses on combining pharmacotherapy with multimodal rehabilitation for balancing the deleterious and therapeutic effects of BNDF treatment in chronic pain patients, as well as accounting for the complex and biopsychosocial nature of chronic pain. FAU - Nijs, Jo AU - Nijs J AD - Pain in Motion international research group. FAU - Meeus, Mira AU - Meeus M FAU - Versijpt, Jan AU - Versijpt J FAU - Moens, Maarten AU - Moens M FAU - Bos, Inge AU - Bos I FAU - Knaepen, Kristel AU - Knaepen K FAU - Meeusen, Romain AU - Meeusen R LA - eng PT - Journal Article PT - Review DEP - 20141218 PL - England TA - Expert Opin Ther Targets JT - Expert opinion on therapeutic targets JID - 101127833 RN - 0 (Brain-Derived Neurotrophic Factor) SB - IM MH - Animals MH - Brain-Derived Neurotrophic Factor/*metabolism MH - Central Nervous System Sensitization/physiology MH - Chronic Pain/physiopathology/*therapy MH - Combined Modality Therapy MH - Humans MH - Molecular Targeted Therapy MH - Neuralgia/physiopathology/therapy MH - Neuronal Plasticity/*physiology MH - Signal Transduction/physiology OTO - NOTNLM OT - chronic pain OT - descending inhibition OT - exercise OT - long-term potentiation OT - neuropathic OT - pharmacotherapy EDAT- 2014/12/19 06:00 MHDA- 2015/12/15 06:00 CRDT- 2014/12/19 06:00 PHST- 2014/12/19 06:00 [entrez] PHST- 2014/12/19 06:00 [pubmed] PHST- 2015/12/15 06:00 [medline] AID - 10.1517/14728222.2014.994506 [doi] PST - ppublish SO - Expert Opin Ther Targets. 2015 Apr;19(4):565-76. doi: 10.1517/14728222.2014.994506. Epub 2014 Dec 18.