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Diffuse noxious inhibitory controls (DNIC) or conditioned pain modulation (CPM) refers to an endogenous pain modulatory pathway which has often been described as "pain inhibits pain". [1] It occurs when response from a painful stimulus is inhibited by another, often spatially distant, noxious stimulus.
The periaqueductal gray (PAG), also known as the central gray, is a brain region that plays a critical role in autonomic function, motivated behavior and behavioural responses to threatening stimuli. [1] [2] PAG is also the primary control center for descending pain modulation. It has enkephalin-producing cells that suppress pain.
The gate control theory of pain asserts that non-painful input closes the nerve "gates" to painful input, which prevents pain sensation from traveling to the central nervous system. In the top panel, the nonnociceptive, large-diameter sensory fiber (orange) is more active than the nociceptive small-diameter fiber (blue), therefore the net input ...
Another type of pain, known as neuropathic pain, is caused by a direct problem or disease that affects the nerves in the central nervous system. [11] The sensory pathways the WDR neurons can play a role in. A subset of this neuropathic pain, known as chronic neuropathic pain, is characterized by its long lasting and high pain intensity.
Nociplastic pain, also known as central sensitisation, is a third category of pain that is mechanistically distinct from nociceptive pain, which is due to inflammation and tissue damage, and neuropathic pain, which is due to nerve damage. [5] It may occur in combination with the other types of pain or in isolation.
Neuromodulation is the physiological process by which a given neuron uses one or more chemicals to regulate diverse populations of neurons. Neuromodulators typically bind to metabotropic, G-protein coupled receptors (GPCRs) to initiate a second messenger signaling cascade that induces a broad, long-lasting signal.
Nociceptive pain consists of an adaptive alarm system. [6] Nociceptors have a certain threshold; that is, they require a minimum intensity of stimulation before they trigger a signal. Once this threshold is reached, a signal is passed along the axon of the neuron into the spinal cord.
To help determine whether the persistent pain state was centrally or peripherally mediated, non-noxious stimuli were applied to the nerve-injured limb. In animals receiving vehicle injections into the RVM, there was an increase in c-Fos expression in the superficial and deep dorsal horn of the spinal cord, indicating activation of nociceptive ...