Descending control of pain.
TLDR
The periaqueductal grey, the raphe nuclei and the locus coeruleus are all key brainstem sites for the control of nociceptive transmission in the spinal cord and it is clear from more recent work that NA has an equally important part to play.Abstract:
Thanks largely to the study of the brainstem nuclei that mediate stimulation analgesia, the involvement of the monoamines in the descending control of pain is now well established. The periaqueductal grey, the raphe nuclei (NRM and DRN) and the locus coeruleus are all key brainstem sites for the control of nociceptive transmission in the spinal cord. Although the initial emphasis was on 5-HT as the transmitter mediating this control at spinal levels, it is clear from more recent work that NA has an equally important part to play. How (or even if) the two amines differ in their roles and actions in analgesia is, however, still an open question. The small size and complexity of the brainstem areas from which analgesia may be elicited by electrical stimulation complicates the interpretation of the data. Stimulating currents may spread to surrounding regions mediating opposite effects to that of the main region stimulated. Opiates and GABA are clearly involved in descending control at both brainstem and spinal levels, although the relative roles of the different types of amino-acid and opiate receptors is still hotly debated. Despite the fact that the first report on stimulation analgesia appeared more than a quarter of a century ago in 1969, the precise connections and cord synaptology are still the basis of ongoing research. It is perhaps ironic, in an issue dedicated to new molecules and mechanisms, that those transmitters most involved in descending inhibition should be such old and familiar friends.read more
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Journal ArticleDOI
Descending control of pain.
TL;DR: The present review focuses on the organisation of descending pathways and their pathophysiological significance, the role of individual transmitters and specific receptor types in the modulation and expression of mechanisms of descending inhibition and facilitation and the advantages and limitations of established and innovative analgesic strategies which act by manipulation of descending controls.
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The induction of pain: an integrative review
TL;DR: A global account of mechanisms involved in the induction of pain is provided, including neuronal pathways for the transmission of nociceptive information from peripheral nerve terminals to the dorsal horn, and therefrom to higher centres.
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Pathological and protective roles of glia in chronic pain
TL;DR: The current understanding of the contribution of glia to pathological pain and neuroprotection is reviewed, and how the protective, anti-inflammatory actions ofglia are being harnessed to develop new drug targets for neuropathic pain control is reviewed.
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Peter J. Goadsby,Philip R. Holland,Margarida Martins-Oliveira,Jan Hoffmann,Christoph J. Schankin,Simon Akerman +5 more
TL;DR: Investment in understanding migraine leaves us at a new dawn, able to transform its impact on a global scale, as well as understand fundamental aspects of human biology.
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Models and Mechanisms of Hyperalgesia and Allodynia
TL;DR: This review focuses on highly topical spinal mechanisms of hyperalgesia and allodynia including intrinsic and synaptic plasticity, the modulation of inhibitory control, and neuroimmune interactions.
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Daniel Hoyer,David E. Clarke,John R. Fozard,Paul R. Hartig,Graeme R. Martin,Ewan J. Mylecharane,Pramod R. Saxena,Patrick P.A. Humphrey +7 more
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