💤 Central Sensitization Mechanism Simulator

The Wind-Up Protocol — A Stable Baseline in Healthy Nervous Systems

Short placeholder: identical repeated pinpricks, flat pain rating in healthy controls.

• Pinprick / von Frey: Stimulus type (placeholder caption)
• 1 Hz: Repetition rate (placeholder caption)
• ±0.3 / 10: Healthy rating drift (placeholder caption)
• ~10 sec: Test duration (placeholder caption)

What the test measures

Placeholder: same stimulus, repeated, tracks perceived pain over time.

Why healthy responses stay flat

Placeholder: normal dorsal horn gain control prevents amplification.

Stimulus One in Fibromyalgia — Indistinguishable From Healthy

Short placeholder: the first hit looks identical between groups, that is the trap.

• ~2.8 / 10: FM rating, stimulus 1 (placeholder caption)
• ~2.6 / 10: Healthy rating, stimulus 1 (placeholder caption)
• ~12%: NMDA activation (placeholder caption)
• 100% baseline: Threshold (placeholder caption)

Why single stimuli mislead

Placeholder: one pinprick cannot reveal sensitization, repetition can.

Setting up the comparison

Placeholder: same applicator, same force, same rate, both groups.

Temporal Summation — Repeats Two and Three Amplify the Signal

Short placeholder: NMDA receptors unblock, each repeat feels bigger.

• ~4.4 / 10: FM rating, stimulus 3 (placeholder caption)
• ~31%: NMDA activation (placeholder caption)
• Relieved: Mg2+ block (placeholder caption)
• ~13%: Threshold drop (placeholder caption)

NMDA receptor unblocking

Placeholder: depolarization removes magnesium block, calcium floods in.

Wide-dynamic-range neuron output

Placeholder: neuron firing rate climbs with each identical input.

Later Repeats — Pain Rating Outpaces Stimulus Intensity

Short placeholder: by repeat seven, rating is far above what force alone predicts.

• ~8.5 / 10: FM rating, stimulus 7 (placeholder caption)
• ~69%: NMDA activation (placeholder caption)
• ~61%: Pain threshold (placeholder caption)
• ~2.7 / 10: Healthy rating, stimulus 7 (placeholder caption)

Threshold lowering

Placeholder: less input now needed to trigger the same pain.

Clinical relevance

Placeholder: mirrors widespread spontaneous pain reported in fibromyalgia.

Flat vs Escalating — Objective Evidence of Central Sensitization

Short placeholder: two curves, one test, a measurable diagnostic signature.

• ~10 / 10: FM rating, stimulus 10 (placeholder caption)
• ~2.6 / 10: Healthy rating, stimulus 10 (placeholder caption)
• ~7.4 pts: Curve separation (placeholder caption)
• ~41%: Threshold, stimulus 10 (placeholder caption)

Reading the dual-line chart

Placeholder: flat line healthy, rising line fibromyalgia wind-up.

Bedside diagnostic value

Placeholder: simple, low-cost, objective marker of sensitization.