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 language | English (US) |
|---|---|
| Article number | 13 |
| Journal | Current rheumatology reports |
| Volume | 21 |
| Issue number | 5 |
| DOIs | |
| State | Published - May 1 2019 |
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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 journal › Review article
}
TY - JOUR
T1 - Descending Control Mechanisms and Chronic Pain
AU - Chen, Qi Liang
AU - Heinricher, Mary
PY - 2019/5/1
Y1 - 2019/5/1
N2 - 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.
AB - 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.
KW - Brainstem
KW - Hypersensitivity
KW - Inflammation
KW - Pain modulation
KW - Persistent pain
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UR - http://www.scopus.com/inward/citedby.url?scp=85062404684&partnerID=8YFLogxK
U2 - 10.1007/s11926-019-0813-1
DO - 10.1007/s11926-019-0813-1
M3 - Review article
C2 - 30830471
AN - SCOPUS:85062404684
VL - 21
JO - Current Rheumatology Reports
JF - Current Rheumatology Reports
SN - 1523-3774
IS - 5
M1 - 13
ER -