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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.
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.
[1] [2] PAG is also the primary control center for descending pain modulation. It has enkephalin-producing cells that suppress pain. The periaqueductal gray is the gray matter located around the cerebral aqueduct within the tegmentum of the midbrain. It projects to the nucleus raphe magnus, and also contains descending autonomic tracts.
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 ...
Electrical stimulation using implantable devices came into modern usage in the 1980s and its techniques and applications have continued to develop and expand. [16] Recent reviews highlight how neuromodulation is increasingly utilized across multiple medical subspecialties, providing clinicians with novel therapeutic options for both painful and non-painful complex disorders. [17]
The most common use of SCS is failed back surgery syndrome (FBSS) in the United States and peripheral ischemic pain in Europe. [4] [5]As of 2014 the FDA had approved SCS as a treatment for FBSS, chronic pain, complex regional pain syndrome, intractable angina, as well as visceral abdominal and perineal pain [1] and pain in the extremities from nerve damage.
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 ...
The ventrobasal complex (VB) is a relay nucleus of the thalamus for nociceptive stimuli received from nociceptive nerves.The VB consists of the ventral posteromedial nucleus (VPM) and the ventral posterolateral nucleus (VPL).