Abstract
Pain sensation protects the organism from potential harm by triggering defensive action and by conveying signals about the noxious event to conscious awareness. Nociceptive signaling normally starts at the periphery, and the information is processed and relayed along pain pathways to the higher brain structures. The pain-processing system is complex and modulated by input from additional networks at several levels. The resulting perception of pain depends significantly on a variety of internal and external factors. Principal nodes of the pain modulation system are located in the brainstem, providing a high level of integration and intercommunication with other networks. Our current understanding of the pain-processing and pain modulation networks and their changes in chronic pain states will be reviewed here. Among these networks is a recently described brainstem area in the mesopontine tegmentum. Microinjection here of anesthetics that act on gamma-aminobutyric acid class A receptors (GABAA-Rs) produces a general anesthesia-like state permitting pain-free surgery. Connectivity of this mesopontine tegmental anesthesia area (MPTA) suggests that it has a role as an integrative node for control and modulation of the neuronal networks responsible for anesthesia's various functional endpoints.
Original language | English |
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Title of host publication | Neuronal Networks in Brain Function, CNS Disorders, and Therapeutics |
Publisher | Elsevier Inc. |
Pages | 311-326 |
Number of pages | 16 |
ISBN (Print) | 9780124158047 |
DOIs | |
State | Published - Jan 2014 |
Keywords
- Acute pain
- Anesthesia
- Barbiturate
- Chronic pain
- GABA
- Mesopontine tegmentum, MPTA
- Pain modulation
- Reticular formation