Rewiring of Developing Spinal Nociceptive Circuits by Neonatal Injury and Its Implications for Pediatric Chronic Pain

Significant evidence now suggests that neonatal tissue damage can evoke long-lasting changes in pain sensitivity, but the underlying cellular and molecular mechanisms remain unclear. This review highlights recent advances in our understanding of how injuries during a critical period of early life modulate the functional organization of synaptic networks in the superficial dorsal horn (SDH) of the spinal cord in a manner that favors the excessive amplification of ascending nociceptive signaling to the brain, which likely contributes to the generation and/or maintenance of pediatric chronic pain. These persistent alterations in synaptic function within the SDH may also contribute to the well-documented "priming" of developing pain pathways by neonatal tissue injury.