Central mechanisms of pain suppression: Central mechanisms of pain modulation

Richard Bodnar, Mary Heinricher

Research output: Chapter in Book/Report/Conference proceedingChapter

1 Scopus citations

Abstract

In contrast to a classic view that the brain was a passive receiver of the pain message, Melzack and Wall proposed in 1965 that the brain exerted descending control upon spinal nociceptive transmission. This chapter reviews the substrates mediating endogenous pain-modulation. The respective roles of the ventrolateral periaqueductal gray (vlPAG) and rostroventromedial medualla (RVM) in the mediation of not only pain-inhibitory, but also pain-facilitatory responses are described behaviorally, neuroanatomically, neurochemically and neurophysiologically. How this intrinsic pain-modulatory system is activated by other brain nuclei (limbic system and cortex) and by exogeneous environmental factors is described. The emergence of sex differences and neurohormonal factors in mediating pain modulation is also considered. The neurophysiological underpinnings of RVM “ON-" and “OFF-cells” and their respective roles in endogenous pain-facilitatory and pain-inhibitory responses are discussed in detail. Finally, how these pain-modulatory responses relate to other neurobehavioral adapatations are considered, including how animal studies can inform human pain conditions and their detection through functional imaging.

Original languageEnglish (US)
Title of host publicationNeuroscience in the 21st Century
Subtitle of host publicationFrom Basic to Clinical, Second Edition
PublisherSpringer New York
Pages3439-3464
Number of pages26
ISBN (Electronic)9781493934744
ISBN (Print)9781493934737
DOIs
StatePublished - Jan 1 2016

Keywords

  • Allodynia
  • Analgesia
  • Anti-hyperalgesia
  • Antinociception
  • Diffuse noxious inhibitory controls (DNIC)
  • Hyperalgesia
  • Hypoalgesia
  • Intrinsic pain-modulatory system
  • Intrinsic painmodulatory system. see also PAG-RVM system
  • Opioid tolerance
  • PAG
  • PAG-RVM system
  • Pronociception
  • Ventrolateral periaqueductal gray (vlPAG)

ASJC Scopus subject areas

  • Medicine(all)
  • Neuroscience(all)
  • Agricultural and Biological Sciences(all)

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  • Cite this

    Bodnar, R., & Heinricher, M. (2016). Central mechanisms of pain suppression: Central mechanisms of pain modulation. In Neuroscience in the 21st Century: From Basic to Clinical, Second Edition (pp. 3439-3464). Springer New York. https://doi.org/10.1007/978-1-4939-3474-4_102