NETTER - Neuroscience Flash Cards

Descending Control of Pain Processing
1. Enkephalin-containing neuron in periaqueductal gray matter
2. Locus coeruleus
3. Lateral reticular formation
4. Brain stem tegmental noradrenergic cell groups
5. Descending norepinephrine pathway
6. Corticonuclear fiber
7. Descending serotonin pathway
8. Spinoreticular pathway
9. Posterolateral funiculus
10. Anterolateral funiculus
11. Enkephalin-containing neuron
12. Afferent pain neuron of dorsal root ganglion
Comment: Nociceptive information processing in the dorsal horn
of the spinal cord, associated with the spinoreticular system, can
be modulated by descending connections from the cerebral cortex
(corticonuclear), limbic forebrain structures, the hypothalamus (such
as the paraventricular nucleus and the periarcuate beta-endorphin
neurons), the periaqueductal gray, the brain stem reticular formation,
central noradrenergic neurons (locus coeruleus, brain stem tegmental
groups), central serotonergic neurons (especially nucleus raphe
magnus), and primary afferent collaterals from the dorsal column
system. The central descending noradrenergic and serotonergic
pathways, modulated by the periaqueductal gray and other higher
centers, are particularly important for endogenous and exogenous
opioid modulation of pain. Synthetic opiates may activate neurons of
the periarcuate region of the hypothalamus and periaqueductal gray,
enhancing analgesia. These descending pathways also can modulate
trigeminal pain through the descending nucleus of V.
Systemic Neuroscience See book 14.8