Descending Control Mechanisms and Chronic Pain

Qi Liang Chen, Mary Heinricher

Research output: Contribution to journalReview article

2 Citations (Scopus)

Abstract

Purpose of Review: The goal of the review was to highlight recent advances in our understanding of descending pain-modulating systems and how these contribute to persistent pain states, with an emphasis on the current state of knowledge around “bottom-up” (sensory) and “top-down” (higher structures mediating cognitive and emotional processing) influences on pain-modulating circuits. Recent Findings: The connectivity, physiology, and function of these systems have been characterized extensively over the last 30 years. The field is now beginning to ask how and when these systems are engaged to modulate pain. A recent focus is on the parabrachial complex, now recognized as the major relay of nociceptive information to pain-modulating circuits, and plasticity in this circuit and its connections to the RVM is marked in persistent inflammatory pain. Top-down influences from higher structures, including hypothalamus, amygdala, and medial prefrontal areas, are also considered. Summary: The challenge will be to tease out mechanisms through which a particular behavioral context engages distinct circuits to enhance or suppress pain, and to understand how these mechanisms contribute to chronic pain.

Original languageEnglish (US)
Article number13
JournalCurrent rheumatology reports
Volume21
Issue number5
DOIs
StatePublished - May 1 2019

Fingerprint

Chronic Pain
Pain
Middle Hypothalamus
Amygdala

Keywords

  • Brainstem
  • Hypersensitivity
  • Inflammation
  • Pain modulation
  • Persistent pain

ASJC Scopus subject areas

  • Rheumatology

Cite this

Descending Control Mechanisms and Chronic Pain. / Chen, Qi Liang; Heinricher, Mary.

In: Current rheumatology reports, Vol. 21, No. 5, 13, 01.05.2019.

Research output: Contribution to journalReview article

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