Gainfully employing descending controls in acute and chronic pain management

White, Kate; Targett, Mike; Harris, John

Abstract

Specific primary afferent fibres termed nociceptors are responsible for transmitting nociceptive information. Centrally the axonal terminals of these fibres synapse with secondary projection neurones in the spinal dorsal horn to transmit nociceptive information to the higher centres in the brain. Irrespective of the presence or absence of nociceptive inflow the activity of dorsal horn neurones is modulated by, amongst other things, local interneurones and descending midbrain and brainstem networks which can inhibit or facilitate dorsal horn transmission. These pathways therefore set the threshold for information inflow to the CNS. This review article summarises the anatomy, physiology and pharmacology particularly of these descending inhibitory and facilitatory pathways and explains why the study of descending modulation is essential if we are to develop more efficacious interventions for treating pain and relieving suffering.

Citation

White, K., Targett, M., & Harris, J. (2018). Gainfully employing descending controls in acute and chronic pain management. Veterinary Journal, 237, 16-25. https://doi.org/10.1016/j.tvjl.2018.05.005

• Journal Article Type: Article
• Acceptance Date: May 19, 2018
• Online Publication Date: May 19, 2018
• Publication Date: Jul 30, 2018
• Deposit Date: May 23, 2018
• Publicly Available Date: May 20, 2019
• Journal: Veterinary Journal
• Print ISSN: 1090-0233
• Electronic ISSN: 1532-2971
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• Volume: 237
• Pages: 16-25
• DOI: https://doi.org/10.1016/j.tvjl.2018.05.005
• Keywords: Analgesia; DNIC; Nociception; Pain modulation
• Public URL: https://nottingham-repository.worktribe.com/output/948588
• Publisher URL: https://www.sciencedirect.com/science/article/pii/S1090023318301801
• Contract Date: May 23, 2018