• Paolo Pedersini, Massimiliano Gobbo, Mark D Bishop, Lars Arendt-Nielsen, and Jorge H Villafañe.
• IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy.
• Pain Med. 2022 Mar 2; 23 (3): 488-498.

ObjectiveSeveral reports in literature have identified sensitization as a possible basis for the enhanced pain reactions associated with osteoarthritis (OA). The aim of this current systematic review is to summarize functional and structural brain changes associated with surrogate sensitization parameters assessed in patients with OA-related pain.DesignSystematic review.SubjectsPatients with OA related pain.MethodsA literature search was conducted systematically in MEDLINE, CINAHL, EMBASE databases for human studies up to December 2019. Articles were included if they assessed brain imaging and sensitization parameters (quantitative sensory testing and questionnaires) in adults with OA-related pain. Methodological quality was assessed using the Methodological Index for Non-Randomized Studies (MINORS) score.ResultsFive studies reporting on 138 patients were included in this review. The MINORS scale yielded mean scores of 8.5/16 and 12.3/24, for the cohort and case-control studies respectively. Four low-quality studies suggest a greater pain matrix activation associated with clinical measures of sensitization in patients with OA, while another study underlined the presence of structural changes (reduced gray matter volume) in the cortical areas involved in the nociceptive processing possible also related to sensitization.ConclusionsThis review shows conflicting evidence for structural and functional neuroplastic brain changes related to sensitization proxies in patients with OA.© The Author(s) 2021. Published by Oxford University Press on behalf of the American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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