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. Author manuscript; available in PMC: 2010 Sep 1.
Published in final edited form as: J Pain. 2009 Sep;10(9):895–926. doi: 10.1016/j.jpain.2009.06.012

Figure 4.

Figure 4

Central sensitization triggers: Schematic representation of key synaptic triggers of central sensitization. (A), Model of the synapse between the central terminal of a nociceptor and a lamina I neuron under control, basal conditions. mGluR receptors sit at the extremities of the synapse and are linked to the endoplasmic reticulum (ER). Note that NMDAR channels are blocked by Mg2+ in the pore (black dot). After a barrage of activity in the nociceptor (B), the primary afferent presynaptic terminal releases glutamate that binds to AMPAR, NMDAR (now without Mg2+), and mGluR, as well as substance P, CGRP, and BDNF, which bind to NK1, CGRP1, and TrkB receptors, respectively. B2 receptors are also activated by spinally produced bradykinin. NO is produced by several cell types in the spinal cord and can act presynaptically and postsynaptically.