Central and Genetic Modifiers of Pain Lateralization in the Breast Cancer Context
Abstract
Breast cancer treatment results in chronic pain in approximately 50% of survivors. There is an association between the side of the body treated and the subsequent development of chronic mechanosensory pain: this lateralization may be related to central and /or genetic influence. The ACC processes and modulates negative and positive valence emotions in a lateralized, genetically-influenced opioid and biochemical system. TRPV1 is facilitated or inhibited by these systems. Genetic influence is reflected by COMT (norepinephrine, dopamine, epinephrine); by GCH1 (BH4 pathway) and by the opioid system (CYP2D6, CYP3A4, ABCB1, OPRM1). The continued sensitization of TRPV1 receptors may explain the failure of the descending inhibitory system in chronic, movement-related (mechanosensory) pain.
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DOI: http://dx.doi.org/10.18103/imr.v3i1.306
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