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The Journal of Neuroscience, June 15, 2002, 22(12):5129-5136
Time-Dependent Descending Facilitation from the Rostral
Ventromedial Medulla Maintains, But Does Not Initiate,
Neuropathic Pain
Shannon E.
Burgess,
Luis R.
Gardell,
Michael H.
Ossipov,
T.
Philip
Malan Jr,
Todd W.
Vanderah,
Josephine
Lai, and
Frank
Porreca
Departments of Pharmacology and Anesthesiology, University of
Arizona, Tucson, Arizona 85724
Although injury-induced afferent discharge declines significantly
over time, experimental neuropathic pain persists unchanged for long
periods. These observations suggest that processes that initiate
experimental neuropathic pain may differ from those that maintain such
pain. Here, the role of descending facilitation arising from developing
plasticity in the rostral ventromedial medulla (RVM) in the initiation
and maintenance of experimental neuropathic pain was explored.
Tactile and thermal hypersensitivity were induced in rats
by spinal nerve ligation (SNL). RVM lidocaine blocked SNL-induced
tactile and thermal hypersensitivity on post-SNL days 6-12 but not on
post-SNL day 3. Lesion of RVM cells expressing µ-opioid receptors
with dermorphin-saporin did not prevent the onset of SNL-induced
tactile and thermal hypersensitivity, but these signs reversed to
baseline levels beginning on post-SNL day 4. Similarly, lesions of the
dorsolateral funiculus (DLF) did not prevent the onset of SNL-induced
tactile and thermal hypersensitivity, but these signs reversed to
baseline levels beginning on post-SNL day 4. Lesions of the DLF also
blocked the SNL-induced increase in spinal dynorphin content, which has
been suggested to promote neuropathic pain. These data distinguish
mechanisms that initiate the neuropathic state as independent of
descending supraspinal influences and additional mechanism(s) that
require supraspinal facilitation to maintain such pain. In addition,
the data indicate that these time-dependent descending influences can
underlie some of the SNL-induced plasticity at the spinal level. Such
time-dependent descending influences driving associated spinal changes,
such as the upregulation of dynorphin, are key elements in the
maintenance, but not initiation, of neuropathic states.
Key words:
descending facilitation; neuropathic pain; RVM; lidocaine; tactile hypersensitivity; thermal hyperalgesia; dermorphin-saporin
Copyright © 2002 Society for Neuroscience 0270-6474/02/22125129-08$05.00/0
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