Skip to main content
SpringerLink
Log in
Book cover

Neuroscience in the 21st Century pp 3439–3464Cite as

Central Mechanisms of Pain Suppression: Central Mechanisms of Pain Modulation

  • Reference work entry
  • First Online:

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.

This is a preview of subscription content, log in via an institution.

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   2,999.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

Abbreviations

5HT:

5-hydroxytryptamine (serotonin)

AS ODN:

Antisense oligodeoxynucleotide

CCK:

Cholecystokinin

CPM:

Conditioned pain modulation

CRF:

Corticotropin releasing factor

DAMGO:

[D-Ala2, NMe-Phe4, Gly-ol5]-enkephalin

DNIC:

Diffuse noxious inhibitory controls

DOPAC:

3,4-Dihydroxyphenylacetic acid, a dopamine metabolite

DPDPE:

[D-Pen2,D-Pen5]Enkephalin

HPA:

Hypothalamo-pituitary axis

M6G:

Morphine-6-glucuronide

MPO:

Medial preoptic area

norBNI:

Nor-binaltorphimine

PAG:

Periaqueductal gray

PGE2 :

Prostaglandin E2

RVM:

Rostral ventromedial medulla

SRD:

Subnucleus reticularis dorsalis

vlPAG:

Ventrolateral periaqueductal gray

αMSH:

Alpha-melanocyte stimulating hormone

β-FNA:

β-funaltrexamine

References

  • Bingel U, Tracey I (2008) Imaging CNS modulation of pain in humans. Physiology (Bethesda) 23:371–380

    Article  Google Scholar 

  • Bodnar RJ, Kest B (2010) Sex differences in opioid analgesia, hyperalgesia, tolerance and withdrawal: central mechanisms of action and roles of gonadal hormones. Horm Behav 58:72–81

    Article  CAS  PubMed  Google Scholar 

  • Fields HL, Basbaum AI (1978) Brainstem control of spinal pain-transmission neurons. Annu Rev Physiol 40:217–248, Classic paper that helped define the field

    Article  CAS  PubMed  Google Scholar 

  • Heinricher MM, Fields HL (2012) Central nervous system mechanisms of pain modulation. In: McMahon S, Koltzenburg M (eds) Wall and Melzack’s textbook of pain, 6th edn. Elsevier, London

    Google Scholar 

  • Heinricher MM, Tavares I, Leith JL, Lumb BM (2009) Descending control of nociception: specificity, recruitment and plasticity. Brain Res Rev 60:214–225

    Article  CAS  PubMed  Google Scholar 

  • Le Bars D (2002) The whole body receptive field of dorsal horn multireceptive neurones. Brain Res Rev 40:29–44

    Article  PubMed  Google Scholar 

  • Lovick TA (1997) The medullary raphe nuclei: a system for integration and gain control in autonomic and somatomotor responsiveness? Exp Physiol 82:31–41

    Article  CAS  PubMed  Google Scholar 

  • Melzack R, Wall PD (1965) Pain mechanisms: a new theory. Science 150:971–979, Classic paper that helped define the field

    Article  CAS  PubMed  Google Scholar 

  • Yaksh TL, Rudy TA (1978) Narcotic analgestics: CNS sites and mechanisms of action as revealed by intracerebral injection techniques. Pain 4:299–359, Classic paper that helped define the field

    Article  CAS  PubMed  Google Scholar 

  • Yarnitsky D (2010) Conditioned pain modulation (the diffuse noxious inhibitory control-like effect): its relevance for acute and chronic pain states. Curr Opin Anaesthesiol 23:611–615

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Psychology and Neuropsychology, Queens College City University of New York, 65-30 Kissena Blvd, Flushing, NY, 11367, USA

    Richard Bodnar

  2. Department of Neurological Surgery, Oregon Health and Science University, Portland, OR, 97239, USA

    Mary M. Heinricher

Authors
  1. Richard Bodnar
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Mary M. Heinricher
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Richard Bodnar .

Editor information

Editors and Affiliations

  1. Laboratory of Neurobiology and Behavior, The Rockefeller University, New York, New York, USA

    Donald W. Pfaff

  2. National Institute on Drug Abuse (NIDA), National Institutes of Health (NIH), Rockville, Maryland, USA

    Nora D. Volkow

Rights and permissions

Reprints and permissions

Copyright information

© 2016 Springer Science+Business Media New York

About this entry

Cite this entry

Bodnar, R., Heinricher, M.M. (2016). Central Mechanisms of Pain Suppression: Central Mechanisms of Pain Modulation. In: Pfaff, D., Volkow, N. (eds) Neuroscience in the 21st Century. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-3474-4_102

Download citation

Publish with us

Policies and ethics

Search

Navigation