Contemporary management of sarcoidosis.

Chronic pain neuroscience has advanced significantly in recent years, identifying central nervous system (CNS) mechanisms that contribute to pain chronification. Chronic pain is prevalent, heterogeneous, and disabling with variable trajectories and treatment responses. Current evidence highlights maladaptive reorganization across ascending and descending neural pathways, including the dorsal horn, anterior cingulate cortex, nucleus accumbens, and somatosensory cortex. Key contributors include altered neurotransmitter systems including endocannabinoid, reward and addiction circuits, and CNS structures that mediate pain perception and modulation. This review focuses exclusively on CNS mechanisms and does not address broader biopsychosocial contributors to chronic pain. The intended audience includes clinicians seeking neuroscience-based insights into adult chronic pain. The purpose of this scoping review is to synthesize recent evidence on CNS mechanisms associated with chronic pain. The central question is: What CNS mechanisms underlie chronic pain perception, modulation, and chronification in adults; and how do they differ from acute and pain-free states? Describe spinal, ascending, and dorsal horn mechanisms that contribute to chronic pain sensitization.