Deafferentation pain and stimulation of the thalamic sensory relay nucleus: clinical and experimental study

This report summarizes our clinical experience in which the effects of both thalamic sensory relay nucleus (TSRN) and periaqueductal gray (PAG) stimulation were tested in the same series of patients with various forms of pain. The clinical data indicated that neurogenic pain due to deafferentation at the level of the peripheral nerves or the spinal cord was often controlled by TSRN stimulation but not by PAG stimulation. We also review the results of our experimental investigations in cats which were undertaken in an attempt to clarify the neurophysiologic basis of such differential clinical effects of TSRN and PAG stimulation. It appeared that abnormal hyperactivity within the trigeminal medullary dorsal horn following retrogasserian rhizotomy was far more frequently inhibited by TSRN stimulation than by PAG stimulation.     

电刺激猫中脑导水管周围灰质和中缝大核对脊髓背角神经元伤害性感受反应的抑制

1.在氯醛糖麻醉的猫上,观察了电刺激中脑导水管周围灰质(PAG)和中缝大核(NRM)对脊髓腰段背角神经元传入活动的影响。2.按照对刺激的反应型式,在背角记录到非伤害性低阈值传入、广动力范围、伤害性热敏以及高阈值传入诱发的自发放电抑制等四类神经元。3.刺激 PAG和 NRM对记录到的多数背角神经元皮肤传入反应有明显抑制效应,而对自发放电抑制性神经元产生去抑制。4.比较刺激两脑区的抑制效应:NRM 作用较PAG 强;PAG 活动对背角伤害性反应抑制的选择性较 NRM强;阿片肽拮抗剂-纳洛酮拮抗NRM刺激的抑制。5.这些结果提示PAG和NRM对脊髓的下行抑制,可能有一部分是通过不同神经机制实现的。     

刺激大鼠中脑导水管周围灰质诱发的脊髓背根电位...

When periaqueductal gray (PAG) was stimulated with concentric electrodes, a steady negative potential called PAG-DRP was recorded from L5 dorsal root. PAG-DRP with properties of spatial and temporal summation propagates decrementally along the dorsal root and is inhibited by picrotoxin. Lesions of NRM had no effect on the PAG-DRP evoked by stimulation of dorsal PAG, but showed obvious reduction up to about 40% on the PAG-DRP evoked by stimulation of ventral PAG. It is suggested that the descending inhibition of PAG includes some presynaptic inhibition and that the ventral PAG-DRP is relayed partly via NRM while the dorsal PAG-DRP is not associated with NRM.     

Nociceptive afferent blockade by percutaneous peripheral stimulation in the cat]

Experiments have been performed in order to study the effects of percutaneous peripheral stimulation (PCPS) both on the transmission of messages elicited by recruiting sensory units of the tooth pulp at the thalamic Centrum Medianum Level and on the jaw opening reflex (JOR). Both evoked potentials and JOR were inhibited by stimuli applied to the limbs by means of percutaneous (needle) electrodes. Observed inhibitory effects were not immediate: there was a latency period and progressive induction of these phenomena. The site of the inhibition is still unknown, nevertheless, the demonstration that PCPS was able to inhibit both evoked potentials in Centrum Medianum and JOR support the hypothesis that the analgesic effects may be due to descending inhibition blocking transmission of nociceptive information through the spinal cord.     

Modulation of neuron activity of the midbrain periaqueductal gray matter influenced by monoaminergic brainstem structures

A study was done on base activity and changes in base activity (BA) of neurons in periaqueductal gray matter (PAG) during stimulation of monoaminergic structures of the brainstem: the nucleus raphe magnus (NRM), the locus coeruleus (LC), and the substantia nigra (SN), in rats anesthetized with hexenal (200 mg/kg). Three types of PAG neurons that differed in BA structure were identified. NRM, LC and SN stimulation changed BA only in type III neurons. Stimulation of these structures evoked an increase in BA frequency in 11.0–14.5%, and inhibition in 31.0–47.5% of type III neurons. Simultaneous stimulation of two structures led to a marked drop in intensity of effects. A depressing effect on BA was always detected if stimulation of one of the structures suppressed BA. Stimulation of two structures, with one being the NRM, was most effective. The role of PAG in the organization of the brain-stem component of the antinociceptive mechanism is discussed.A. A. Bogomolets Institute of Physiology, Ukrainian Academy of Sciences, Kiev. Translated from Neirofiziologiya, Vol. 24, No. 1, pp. 52–60, January–February, 1992.     

刺激大鼠中脑导水管周围灰质诱发的脊髓背根电位及其传出途径的分析

电刺激大鼠中脑导水管周围灰质(PAG),在腰5(L_5)背根可记录到—稳定的负性背根电位(DRP),简称 PAG-DRP。PAG-DRP 具有空间和时间总和性质,沿背根作电紧张性扩布,且能被 GABA 能拮抗剂印防己毒素(Picrotoxin)所抑制。电解损毁中缝大核(NRM)对刺激背侧 PAG 诱发的 PAG-DRP 无明显影响,而可使刺激腹侧 PAG 诱发的 PAG-DRP电位幅值降低40%左右。结果表明,PAG 下行抑制作用中有突触前抑制参与;NRM 参与腹侧 PAG-DRP 的产生,背侧 PAG-DRP 则可能由 NRM 以外的其他核团中继。     

兴奋黑质对中缝大核神经元的抑制作用及其机制

本工作观察到在清醒、麻痹大鼠,电刺激黑质致密部(SN_C)或网状部(SN_R)均明显抑制中缝大核(NRM)神经元的自发放电;电针刺激双侧“足三里-三阴交”的同时,电刺激SN_C或SN_R可完全翻转电针对NRM神经元的兴奋效应,NRM神经元放电受抑制。将谷氨酸钠微量注入黑质,对中缝大核神经元亦具有抑制作用,电解损毁双侧中脑导水管周围灰质(PAG)腹外侧部或将多巴胺受体阻断剂氟哌啶醇注入该处,均可阻断此抑制效应。提示黑质对抗电针镇痛机制之一是通过其DA能投射纤维作用于PAG内的DA受体,进而抑制PAG-NRM系统而实现的。     

Descending influences from nucleus raphe magnus on fusimotor neurone activity in rats

1. 1.Single fusimotor fibres were isolated in the ventral roots of lumbosacral segments of urethane-anaesthetized rats, and effects of electrical stimulation of the nucleus raphe magnus (NRM) on their spontaneous activity were investigated. The experiments were carried out in rats whose bilateral preoptic and anterior hypothalamic regions (PO/AH) were electrolytically destroyed to eliminate the influences of these regions to fusimotor activity.

2. 2.Of 44 fusimotor fibres studied, 38 (86%) were found to be affected by NRM stimulation. The effects of NRM stimulation were classified according to their response pattern: primary depression (D-type, n = 24), facilitation followed by depression (F-D-type, n = 5) and primary facilitation (F-type, n = 8). The most predominant effect of NRM stimulation upon fusimotor activity was characterized by a strong depression followed by a complete cessation of firing lasting either for a short period or for more than 30 min (D- and F-D-type).

3. 3.In three fusimotor fibres studied in the different preparations, it was observed that a NRM-evoked depression response was blocked by an intraperitoneal administration of a serotonin antagonist, p-chlorophenylalamine (p-CPA) (10 mg/kg).

4. 4.The results indicate that the NRM exerts descending inhibitory or facilitatory influences on fusimotor neurones, and suggest that cold shivering is controlled by modulating fusimotor neurone activity via the serotonergic raphe-signal pathways.

Relationship of glutamate and aspartate to the periaqueductal gray-raphe magnus projection: analysis using immunocytochemistry and microdialysis.

This study tested the hypothesis that the excitatory amino acid transmitters glutamate and/or aspartate are associated with the periaqueductal gray (PAG)-raphe magnus (NRM) projection. Retrograde neuroanatomical tracing procedures utilizing the tracers WGA-HRP or D-[3H]-aspartate were combined with immunocytochemical localization of glutamate or aspartate to determine if glutamate and/or aspartate immunostained neurons projected to the NRM. Both glutamate- and aspartate-immunoreactive cells in the PAG were found to project to the NRM. Double labeling immunocytochemichemical procedures indicated that glutamate and aspartate are co-localized in many PAG neurons, suggesting the following possibilities: (a) one of these two amino acids may serve as a precursor to the other; (b) both amino acids may be co-released from the same PAG neuron; or (c) both amino acids are present in high levels in the perikarya for metabolic purposes. At the EM level, both glutamate- and aspartate-immunoreactive terminals were identified in the NRM, strengthening the concept that both amino acids participate in synaptic transmission in this medullary nucleus. To determine if glutamate and aspartate are in fact released from PAG-NRM axons, the PAG was stimulated chemically with homocysteic acid (HCA) and amino acids were collected from the NRM using a microdialysis probe. Microinjection of HCA, but not vehicle, into the PAG resulted in the release of both glutamate and aspartate in the nucleus raphe magnus. These data suggest that both glutamate and aspartate are released from PAG fibers terminating in the NRM and provide strong support for the hypothesis that excitatory amino acids play a neurotransmitter role in the PAG-NRM pathway.     

内源性下行抑制/易化系统与5-羟色胺对脊髓伤害感受性信息的调制

内源性下行抑制系统在痛传递与调制中具有重要作用。近年来,与这一系统相对的下行易化系统开始引起人们的关注。中枢神经系统通过下行抑制易化系统对外周伤害性信息进行双向调制。５－羟色胺（５－ＨＴ）是痛上行调制系统的主要神经递质,电刺激或微量注射兴奋性氨基酸于中缝大核（ＮＭＲ）或巨细胞网状核（ＮＧＣ）内,既可兴奋也可抑制脊髓伤害性反应。这种相互矛盾遥效应可能与脊髓内的多种５－ＨＴ受体亚型有关。     

蓝斑核、中缝大核和迷走神经背核在胃运动调节中的关系

目的：探讨蓝斑（LC）、中缝大核（NRM）和迷走神经背核（DMV）,及其相关递质和受体对胃运动的调节途径及机制,阐明它们在调节胃运动中的相互关系。方法：实验采用了核团定位电刺激、损毁和核团微量注射等实验方法,以记录胃内压,统计胃收缩幅度作为胃运动变化的指标。结果：①刺激LC显著降低胃收缩幅度（P〈0.01）,损毁DMV可以减弱此效应,而阻断DMV上的肾上腺素能α受体,可以反转此抑胃效应。②刺激NRM显著降低胃收缩幅度（P〈0.01）,损毁DMV后此效应被消除;阻断DMV上的5-HT2A受体使胃收缩幅度大幅度降低（P〈0.01）,此时再刺激NRM不能进一步的抑制胃运动;而损毁LC后刺激NRM,可消除NRM的抑胃效应,在LC注射5-HT2A受体阻断剂也可以消除该效应。结论：①LC可能通过DMV的5-HT2A受体和α受体对生理条件下正常胃的运动起着重要的双向调节作用;②NRM通过LC上的5-HT2A受体而发挥其对胃运动的抑制效应。     

Brain circuits for mating behavior in cats and brain activations and de-activations during sexual stimulation and ejaculation and orgasm in humans

In cats, there exists a descending system that controls the posture necessary for mating behavior. A key role is played by the mesencephalic periaqueductal gray (PAG), which maintains strong specific projections to the nucleus retroambiguus located laterally in the most caudal medulla. The NRA, in turn, has direct access to motoneurons in the lumbosacral cord that produce the mating posture. This pathway is slightly different in males and females, but in females its strength fluctuates strongly depending on whether or not the cat is in heat. This way the PAG determines whether or not mating can take place. Via the PAG many other regions in the limbic system as well as in the prefrontal cortex and insula can influence mating behavior.In humans, the brain also controls responses to sexual stimulation as well as ejaculation in men and orgasm in women. Neuroimaging techniques show activations and de-activations but are not able to verify whether the PAG has a similar effect as in cats. PET-scanning results revealed that there is activation in the upper brainstem and cerebellum, as well as insula in men and in the somatomotor and somatosensory cortex in women. During sexual stimulation, but especially during ejaculation and orgasm there was strong de-activation mainly on the left side in the temporal lobe and ventral prefrontal cortex. These neuroimaging results show the importance of lowering the level of alertness regarding your immediate environment (left hemisphere) to have proper sexual behavior.     

电刺激大鼠尾核头部镇痛的中枢效应—[^3H]—2脱氧...

Sokoloff's 2-deoxyglucose (2-DG) autoradiographic technique was used to identify changes of glucose metabolic rate in the rat brain following unilateral stimulation of the head of the caudate nucleus. The results were as follows. The local glucose metabolic rate after noxious stimulation was increased in the somatosensory cortex, cingulate cortex, ventroposterior and parafascicular nucleus of the thalamus, septal area, habenular nucleus, head of caudate nucleus, periaqueductal gray (PAG) and dorsal raphe nucleus (P < 0.05). After stimulating the head of the caudate nucleus, the local glucose metabolic rate of nucleus raphe magnus (rm) and nucleus paragigantocellularis (pgcl) was increased significantly and that of the PAG and dorsal raphe nucleus had a tendency to increase, while stimulation of the head of caudate nucleus could partially abolish the increased glucose metabolic rate in the somatosensory cortex, cingulate cortex, ventroposterior and parafascicular nucleus of the thalamus, septal area and habenular nucleus as induced by noxious stimulation. These results suggest that caudate stimulation is able to depress the activation of some brain structures related to nociception and to activate those related to antinociception. The pgcl, rm, PAG and dorsal raphe nucleus might be the key structures participating in the caudate stimulation produced analgesia.     

Responses of raphe-spinal neurons to stimulation of the pontine parabrachial region producing behavioral nociceptive suppression in the cat

Cholinergic stimulation of the pontine parabrachial region (PBR) produces behavioral nociceptive suppression in the awake cat. This report shows that electrical stimulation of both PBR sites (verified to be associated with behavioral nociceptive suppression on cholinergic stimulation) and the periaqueductal gray (PAG) excites raphe-spinal neurons which have been implicated in descending nociceptive suppression. Although several lines of evidence have strongly indicated that pathways from the PBR and PAG for nociceptive suppression are anatomically as well as neurochemically distinct, the results of the present study appear to suggest that certain components of the pathways from the PBR may be synergic in function with those from the PAG with regard to the activity of raphe-spinal neurons.     

Central administration of neuronostatin induces antinociception in mice

Neuronostatin, a recently discovered endogenous bioactive peptide, was encoded by pro-mRNA of somatostatin that contributes to modulation of nociception. However, nociceptive effect of neuronostatin is still not fully known. The aim of this study was to evaluate effect of neuronostatin on nociception and elucidate its possible mechanism of action. Intracerebroventricular (i.c.v.) administration of neuronostatin (0.3, 3, 6, 12 nmol/mouse) produced a dose- and time-related antinociceptive effect in the tail immersion assay in mice, an acute pain model. The antinociceptive effect of neuronostatin was significantly antagonized by naloxone, and was strongly inhibited by co-injection with β-funaltrexamine or nor-binaltorphimine, but not by naltrindole. Also, melanocortin 3/4 receptor antagonist, SHU9119, completely blocked the effect of neuronostatin. These data indicated the involvement of both μ- and κ-opioid receptors and central melanocortin system in the analgesic response induced by neuronostatin. In addition, neuronostatin (6 nmol, i.c.v.) increased c-Fos protein expression in the periaqueductal gray (PAG) and the nucleus raphe magnus (NRM) that have a pivotal role in regulating descending pain pathways. Taken together, this study is the first to reveal that neuronostatin produces antinociceptive effect via opioid and central melanocortin systems, which is associated with an increase in neuronal activity the PAG and NRM.     

电刺激大鼠巨细胞网状核对小脑浦肯野细胞自发和诱发电活动的影响

本研究在麻醉并制动的大鼠上观察了电刺激巨细胞网状核(Gi)对小脑浦肯野细胞(PC)自发及诱发简单锋电位的影响。结果如下:(1)刺激Gi可使PC的简单锋电位出现潜伏期小于20ms的抑制性或兴奋性反应,并以抑制性反应为主。抑制性反应持续40-100ms,而兴奋性反应的时程可达200ms以上;(2)注射5-HT_2型受体阻断剂methysergide可以减弱或阻断电刺激Gi对PC自发简单锋电位的抑制作用;(3)条件性Gi刺激可以显著压抑或加强由刺激对侧大脑皮层感觉运动区引起的PC诱发简单锋电位反应。以上结果说明:在大鼠存在Gi-小脑通路,这一通路中的部分纤维是5-HT能的。Gi-小脑纤维可能通过突触和/或非经典突触的化学传递方式对PC的电活动产生某种调制性的影响。推测Gi-小脑传入纤维投射可能在某些小脑功能活动,如肌紧张及姿势的调节等方面发挥重要作用。     

中缝核与阻塞性睡眠呼吸暂停关系的实验研究

本实验在６４只氨基甲酸乙酯麻醉、断双侧迷走神经、自主呼吸的健康家兔上进行,观察电、化学刺激中缝背核（ＮＲＤ）、中缝大核（ＮＲＭ）对颏舌肌和膈肌肌电、以及窒息增幅反应（ＡＡＲＡ）的作用。结果如下：１．长串电脉冲刺激ＮＲＤ,颏舌肌和膈肌肌电幅度明显升高,在刺激过程中呈持续性吸气相放电。长串电脉冲刺激ＮＲＭ,颏舌肌和膈肌肌电幅度显著抑制,呼吸节律减弱或消失;２．于ＮＲＤ微量注入谷氨酸钠,颏舌肌和膈肌肌电幅度升高,频率加快。在ＮＲＭ微量注射谷氨酸钠,ＡＡＲＡ降低。上述结果与电刺激ＮＲＤ、ＮＲＭ的效应基本一致;３．ＮＲＭ内微量注入吗啡,颏舌肌和膈肌的ＡＡＲＡ峰值被抑制,潜伏期延长,恢复期缩短。若注射吗啡后５ｍｉｎ再微量注入纳络酮,则吗啡的抑制效应减弱。结果提示：中缝核和阿片肽类物质对颏舌肌有重要的调制作用,可能与阻塞性睡眠呼吸暂停的发生有关     

刺激中缝背核对大鼠脊髓背角神经元伤害性反应的影响及其传出途径的分析

大量资料表明,中缝背核(DR)在痛觉调节中具有重要作用。本实验用电生理学方法研究DR在痛觉调制中的下行性抑制作用,主要观察刺激DR对清醒制动大鼠脊髓背角神经元伤害性放电的影响。其主要结果是:①刺激DR或电针可以抑制脊髓背角神经元的伤害性反应,吗啡可加强这种抑制效应;②损毁中缝大核(NRM)、纳洛酮、麦角酰二乙胺(LSD)、赛庚啶及对氯苯丙氨酸(PCPA)均能部分阻断DR对脊髓背角神经元伤害性反应的抑制,实验结果表明:刺激DR抑制脊髓背角神经元的伤害性反应,部分是通过NRM间接控制背角神经元的伤害性传入;还有一部分是不通过NRM,可能是DR直接对脊髓背角伤害性信息的调制。在这种下行性抑制通路中有5-HT和阿片样物质的参与。     

A Comparative Study of Excitatory and Inhibitory Amino Acids in Three Different Brainstem Nuclei

This study was designed to shed more light onto the three different brainstem regions which are implicated in the pain pathway for the level of various excitatory and inhibitory neurotransmitters before and following neuronal stimulation. The in vivo microdialysis technique was used in awake, freely moving adult Sprague-Dawley rats. The neurotransmitters studied included aspartate, glutamate, GABA, glycine, and taurine. The three brainstem regions examined included the mid-brain periaqueductal gray (PAG), the medullary nucleus raphe magnus (NRM), and the spinal trigeminal nucleus (STN). Neuronal stimulation was achieved following the administration of the sodium channel activator veratridine. The highest baseline levels of glutamate (P < 0.0001), aspartate (P < 0.0001), GABA (P < 0.01), taurine (P < 0.0001), and glycine (P < 0.001) were seen in the NRM. On the other hand, the lowest baseline levels of glutamate, GABA, glycine, and taurine were found in the PAG, while that of aspartate was found in the STN. Following the administration of veratridine, the highest release of the above neurotransmitters except for the aspartate and glycine was found in the PAG where the level of glutamate increased by 1,310 ± 293% (P < 0.001), taurine by 1,008 ± 143% (P < 0.01), and GABA by 10,358 ± 1,920% (P < 0.0001) when comparison was performed among the three brainstem regions and in relation to the baseline levels. The highest release of aspartate was seen in the STN (2,357 ± 1,060%, P < 0.001), while no significant difference was associated with glycine. On the other hand, the lowest release of GABA and taurine was found in the STN (696 ± 91 and 305 ± 25%, respectively), and glutamate and aspartate in the NRM (558 ± 200 and 874 ± 315%, respectively). Our results indicate, and for the first time, that although some differences are seen in the baseline levels of the above neurotransmitters in the three regions studied, there are quite striking variations in the level of release of these neurotransmitters following neuronal stimulation in these regions. In our opinion this is the first study to describe the pain activation/modulation related changes of the excitatory and inhibitory amino acids profile of the three different brainstem areas.     

大鼠下丘脑-缰核系统对中缝大核痛反应神经元放电的影响

在大鼠尾部给以伤害性刺激后,外侧缰核和中缝大核的单位按其反应型式可分为四种类型,即痛兴奋单位、广动力型单位、痛抑制单位和无反应单位。电刺激下丘脑外侧区对外侧缰核中各种单位的自发放电主要产生抑制作用,对其中痛兴奋单位和痛抑制单位的自发放电尤为明显。刺激下丘脑外侧区对中缝大核中痛兴奋单位的自发放电有明显兴奋作用,刺激外侧缰核则有抑制作用,损毁外侧缰核后,下丘脑外侧区的兴奋作用消失。分别刺激下丘脑外侧区和外侧缰核对中缝大核中痛抑制单位的自发放电都有明显的抑制作用;损毁外侧缰核后下丘脑外侧区的抑制作用仍存在。以上结果提示,下丘脑外侧区影响中缝大核活动的途径有二。其一可能是通过去除外侧缰核对中缝大核中痛兴奋单位的紧张性抑制作用;另外还可能通过外侧缰核以外的途径抑制中缝大核中痛抑制单位的活动。