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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 ascending pain and temperature fibers of the spinothalamic tract send information to the PAG via the spinomesencephalic pathway (so-named because the fibers originate in the spine and terminate in the PAG, in the mesencephalon or midbrain). This region has been used as the target for brain-stimulating implants in patients with chronic pain.
The pathway crosses over at the level of the spinal cord, rather than in the brainstem like the dorsal column-medial lemniscus pathway and lateral corticospinal tract. It is one of the three tracts which make up the anterolateral system : anterior and lateral spinothalamic tract, spinotectal tract , spinoreticular tract .
The tract transmits slow nociceptive/pain information (but thermal, and crude touch information as well) from the spinal cord to reticular formation which in turn relays the information to the thalamus via reticulothalamic fibers as well as to other parts of the brain (as opposed to the spinothalamic tract - the direct pathway of the ...
It thus complements the classical serotonergic-opioid peptide descending pain-inhibiting system: whereas the serotonergic-opioid peptide pathway ultimately pre-synaptically inhibits first-order nociceptive group C neurons, the DLPRF inhibits - by way of presumably GABAergic inhibitory interneurons - the second-order neurons of the ascending ...
Descartes' pain pathway: "Particles of heat" (A) activate a spot of skin (B) attached by a fine thread (cc) to a valve in the brain (de) where this activity opens the valve, allowing the animal spirits to flow from a cavity (F) into the muscles causing them to flinch from the stimulus, turn the head and eyes toward the affected body part, and ...
Pain arising from structures supplied by the phrenic nerve is often "referred" to other somatic regions served by spinal nerves C3-C5. For example, a subphrenic abscess beneath the right diaphragm might cause a patient to feel pain in the right shoulder. Irritation of the phrenic nerve (or the tissues it supplies) leads to the hiccup reflex.
Chronic hyperstimulation of opioid receptors results in altered homeostasis of pain signalling pathways in the body with several mechanisms of action involved. One major pathway being through stimulation of the nociceptin receptor, [8] [9] [10] and blocking this receptor may therefore be a means of preventing the development of hyperalgesia. [11]