Neuroanatomical substrates of nociception in the spinal cord

Ultrastructure of pacinian corpuscle primary afferent terminals in the cat spinal cord

The glabrous skin of the hindlimb of the cat contains 3 types of low-threshold mechanoreceptors: Pacinian corpuscles (PC), and slowly and rapidly adapting receptors. In the present study, 12 primary afferent fibers transmitting impulses from PC were injected intra-axonally with horseradish peroxidase (HRP) in the spinal cord to examine the morphology of their terminals in the dorsal horn. At the light microscopic level, terminal arborizations were observed in laminae II-VI of the dorsal horn, extending up to 7 mm rostrocaudally in and near the seventh lumbar segment. Bouton-like swellings, predominantly (67%) of the en passant type, were distributed in two discrete clusters, one concentrated rostrally in Rexed's laminae III-IV, and the other concentrated caudally in lamina V. At the electron microscopic level, a combination of morphometric and serial reconstructive analyses with 3 fibers revealed the following. Boutons labelled with HRP invariably contained clear round vesicles, approximately 40 nm in diameter. Labelled bouton sections had longest dimensions of 1.84 +/- 0.63 micron. Their shapes varied from rounded to elongated forms with occasional scalloped appearances. A majority (73%) of the contacts associated with HRP-filled boutons were made with dendritic spines and shafts. Thick postsynaptic densities were usually associated with these synapses, although thinner densities were also observed. 24% of the contacts made by labelled boutons were synapse-like contacts with unlabelled vesicle-containing structures. The vesicles in the unlabelled structures were usually pleomorphic, but sometimes round. These contacts were identified as 'synapse-like' because labelling obscured possible landmarks necessary for definitive identification of synapses. However, in most of these contacts, there was an accumulation of vesicles near the cleft on the unlabelled side, suggesting that the labelled boutons were postsynaptic. Only 3% of the contacts made by labelled boutons were axosomatic. The lengths of contacts with dendritic spines (0.49 +/- 0.23 micron) or with dendrites proper (0.45 +/- 0.20 micron) were significantly longer than those with vesicle-containing unlabelled structures (0.31 +/- 0.18 micron). The portions of cross-sectional bouton contours devoted to synaptic or synapse-like contacts accounted for 9-13% of the perimeters. The larger the bouton, the longer the summed lengths of contacts. Serial reconstruction of selected labelled boutons revealed both simple and quite complex synaptic organizations, including glomeruli with labelled boutons as the central component.(ABSTRACT TRUNCATED AT 400 WORDS)

A spino-reticulo-thalamic pathway in the rat: an anatomical study with reference to pain transmission

The axonal tract tracing technique using the transport in both the retrograde and orthograde directions of wheat-germ agglutinin conjugated to horseradish peroxidase permitted the observation of both retrogradely labelled spinal neurons and anterogradely labelled thalamic fiber terminals in the same animal after injections of the compound in the nucleus reticularis gigantocellularis, thus allowing the definition of the spino-reticulo-thalamic pathway which relays in this nucleus in the rat. Results of the present study are in favor of the existence of a pathway originating mostly in the spinal ventral horn and ending in the intralaminar nuclei of the thalamus, in particular in the nucleus center median, after a relay in the nucleus reticularis gigantocellularis. Origin and termination of this pathway seem to be well differentiated from those of the direct spino-thalamic tract. The results are discussed with reference to the possible involvement of this pathway in some aspects of pain transmission. It is suggested, in particular, that the direct spino-thalamic system which relays in the thalamic ventrobasal complex, presents the features required of a structure playing a role in the sensory-discriminative aspects of pain transmission; in contrast, the spino-reticulo thalamic system defined here could be involved in some motor and/or behavioral responses related to pain.

An electron microscopic study of primary afferent terminals from slowly adapting type I receptors in the cat

Primary afferent fibers transmitting impulses from slowly adapting (SA) Type I receptors in the glabrous skin of the hind paw of the cat were injected intraaxonally in the spinal cord with horseradish peroxidase (HRP). At the light microscopic level, terminal arborizations were observed in the medial dorsal horn extending up to 6 mm rostrocaudally in and near the seventh lumbar segment. Boutonlike swellings labelled with HRP were distributed in clusters in Rexed's laminae III-VI. There was a tendency for the most dorsal clusters from an individual fiber to be located rostrally and for the most ventral clusters to be located caudally. At the electron microscopic level, a combination of morphometric analysis and serial reconstruction revealed the following: (1) All the boutons labelled with HRP contained predominantly clear, round synaptic vesicles, 40-50 nm in diameter. (2) Labelled boutons (n = 75) had cross-sectional longest dimensions of 1.72 +/- 0.53 micron (Mean +/- S.D.), perimeters of 4.95 +/- 1.52 micron, and areas of 1.18 +/- 0.59 micron 2. Their shapes in section varied from rounded to elongated forms. (3) The sizes of labelled boutons decreased significantly and linearly with depth from lamina IV to VI. The shapes of the bouton cross sections also became rounder with depth in the dorsal horn. (4) About 72% of synaptic contacts associated with HRP-filled boutons were with dendritic spines and shafts; most of these synapses were of the asymmetric type. (5) The remainder (28%) of the appositions were synapselike contacts between labelled boutons and unlabelled structures containing flattened or pleomorphic vesicles, and occasional dense-cored vesicles. (6) We observed no unequivocal axosomatic contacts made by labelled boutons. (7) The lengths of synaptic appositions with dendritic spines (0.46 +/- 0.20 micron) or with dendritic shafts (0.51 +/- 0.18 micron) were significantly greater than the synapselike contacts with vesicle-containing unlabelled structures (0.29 +/- 0.09 micron). (8) Complex neuropilar organization was occasionally seen with labelled boutons as central elements, although simpler organizations were much more common. In summary, HRP-labelled fibers ended predominantly in boutons containing clear, round vesicles forming axospinous and axodendritic synapses.(ABSTRACT TRUNCATED AT 400 WORDS)

Intraventricular morphine for control of pain in terminal cancer patients

Satisfactory control of intractable pain has been achieved in 17 terminal cancer patients by injecting small doses of morphine into the lateral cerebral ventricle via an Ommaya reservoir. Pain relief together with a favorable behavioral response was obtained without interference with other sensory modalities, noticeable physical changes, or side effects annoying or severe enough for the patient to discontinue therapy. Eleven patients developed tolerance, but this phenomenon does not require withdrawal of treatment. Chronic intraventricular morphine administration can be safely performed on an outpatient basis, and results in control of midline, bilateral, and diffuse pain associated with orofacial and disseminated cancer. However, this experience is preliminary and further clinical trials are needed to determine the place of this method of therapy in the management of chronic pain.

Morphological properties of physiologically characterized lamina III neurones in the cat spinal cord

Six lamina III interneurones of the cat spinal cord were impaled and stained with intracellular injections of horseradish peroxidase. The responses of these neurones varied considerably: 1 neurone responded to light brushing of its receptive field, whilst 4 cells were excited by strong pressure. Morphologically, they were also a heterogeneous population. Two neurones had rostro-caudally orientated dendritic arbors that were confined to the lamina, while four of the cells were vertically orientated and possessed dendrites that crossed lamina boundaries. There was no correlation between the physiological characteristics of a neurone and its morphology. Three of the vertically orientated neurones were examined ultrastructurally. The first of these cells received several types of synaptic terminal which were distributed in an organised pattern over the entire dendritic tree. This neurone possessed recurrent dendrites which participated in a variety of complex synaptic arrangements. The second neurone also participated in a variety of synaptic arrangements, including glomeruli in lamina II, and received contacts from vesicle-containing dendrites. It gave rise to collateral axons which arborized in lamina II and formed boutons which formed synapses with dendrites. The third cell possessed varicose dendrites which were probably artifactual. It is concluded that lamina III interneurones are a heterogeneous population by electrophysiological, morphological and ultrastructural criteria. They differ in many respects from lamina II neurones and from the cells of origin of ascending systems. The diversity of their inputs and their variation in morphology suggests that they receive input from a variety of primary afferent fibres and dorsal horn neurones and hence may integrate information from these sources.

Do convergent neurones in the spinal dorsal horn discriminate nociceptive from non-nociceptive information?

Thirty convergent neurones responding to both noxious and non-noxious cutaneous stimuli were recorded at the lumbar level in either anaesthetized 'intact' rats or unanaesthetized 'spinal' rats. Their responses to radiant heat application and to repetitive innocuous mechanical stimulation of the centre of their receptive fields were analysed, both in terms of the maximal and the mean firing rates. These neurones increased their discharge rates in relation to the temperature applied to their receptive fields with the highest levels being produced by noxious intensities. This finding confirms earlier reports suggesting the capacity of these neurones to encode nociceptive information of thermal origin. However, a very high level of firing could also be evoked by repetitively applied innocuous mechanical stimuli. This was a consistent finding, observed both in intact and spinal animals, which was true for the two subgroups into which we divided the convergent neurones (warming/noxious heat units and noxious heat units). These results are discussed in terms of the role of convergent neurones in nociception. It is suggested that a single channelled signal emanating from these neurones could not be the basis of a clear nociceptive message to the brain; two alternative hypotheses involving multichannelled organizations of impulses are proposed for discussion.

The bilaterally symmetrical deafferentation syndrome in macaques after bilateral spinal lesions: evidence for dysesthesias resulting from brain foci and considerations of spinal pain pathways

Six macaques had been subjected to chronic left thoracic anterolateral cordotomy, which released persistent self-attacks of the hypoalgesic right hind limb. One to 4 weeks later, lesions were placed in the right thoracic spinal cord, 2-5 segments apart from the left lesion. None of these second-stage spinal lesions, including spinal hemisection, affected the continued self-attacks of the right leg. Therefore, the chronic deafferentation syndrome of contralateral anterolateral cordotomy is not dependent upon the rostral conduction, via long spinal sensory tracts, of neural activity from ipsilateral lumbosacral spinal segments. Furthermore, second-stage right thoracic spinal lesions, which damaged the anterolateral tracts in 4 macaques, caused the release of the deafferentation syndrome in the left hind limb, despite extensive prior destruction of the left anterolateral tracts. Therefore, the release of the deafferentation syndrome by contralateral cordotomy is independent of the functional activity of the ipsilateral anterolateral tracts. The bilateral symmetry of this syndrome after extensive bilateral spinal lesions suggests pathophysiological foci at the level of the brain rather than the spinal cord. This syndrome is considered to be an objective index of disturbing subjective sensations.

Mapping of CRF-immunoreactive nerve fibers in the medulla oblongata and spinal cord of the rat

By use of an antiserum raised against Corticotropin Releasing Factor (CRF 1-41), nerve fibers can be stained in the medulla oblongata and spinal cord of rats. A dense plexus of CRF-immunoreactive (CRFi) nerve fibers is present in the nucleus tractus spinalis nervi trigemini from which fiber bundles enter the tractus spinalis nervi trigemini. Large numbers of CRFi fibers are present in the substantia gelatinosa of the spinal cord, while the tractus solitarius, the nucleus tractus solitarius and the nucleus ambiguus contain a low number of CRFi fibers. In rats treated with colchicine, CRFi cell bodies are found in the hypothalamus and occasionally in the nucleus tractus solitarius and the nucleus olivaris inferior. Posterolateral deafferentation of the hypothalamus did not result in a disappearance of the CRFi fibers in the medulla oblongata and spinal cord 7 days after surgery. These results indicate that CRFi fibers present in the spinal cord and medulla oblongata are part of a novel peptidergic neuronal system, which is different from the hypothalamo-infundibular CRF system.

A system of rat spinal cord lamina 1 cells projecting through the contralateral dorsolateral funiculus

The aim of these experiments was to sample the properties of lamina I neurones with long ascending projections. Recordings have been made from 136 units at the L4/5 level, with ascending axons reaching C2. More than 80% of the units projected via the contralateral dorsolateral white matter and only 10% via the contralateral ventral quadrant. None projected via the dorsal columns. Receptive fields were typically 1-2 cm2 and although a substantial number of units responded to a limited range of intense stimuli, a greater number of units were fired by both low- and high-threshold stimulation. In contrast to cells of deeper laminae, the majority of units were excited following activation of descending pathways in the dorsolateral funiculus. The functional role of these units is not obvious, but the location of the ascending projection and the influence of descending pathways does not support the notion that the output of lamina 1 constitutes a simple "pain pathway."

Immunocytochemical localization of substance P in the spinal trigeminal nucleus of the rat: a light and electron microscopic study

The neuropeptide substance P is a transmitter candidate for certain primary afferent fibers which terminate in the substantia gelatinosa. In this study the light and electron microscopic localization of substance P in the substantia gelatinosa of the spinal trigeminal nucleus of the rat has been studied using immunocytochemical procedures. Substance P immunoreactive fibers were observed mainly in lamina I and outer lamina II. Ultrastructural analysis revealed immunoreactivity in unmyelinated fibers and in axon terminals which contained agranular spherical vesicles and large dense-cored vesicles and which made predominantly simple asymmetric axodendritic synaptic contacts. Immunoreactive terminals only rarely formed the central terminal of synaptic glomeruli and in only one example was a stained terminal possibly postsynaptic to an unstained terminal. The majority of synapses were onto small dendrites in outer lamina II and in some cases these dendrites were themselves presynaptic to other dendrites. Immunoreactive terminals also synapsed with the soma and proximal dendrites of large neurons on the border of laminae I and II. The results show that there are at least two distinct targets for substance P immunoreactive terminals in the substantia gelatinosa, namely the large lamina I neurons and lamina II probable interneurons. Some of the former may be projection neurons while some of the latter may correspond to the inhibitory islet cells described by Gobel and colleagues in the cat. In addition the results indicate that few substance P immunoreactive terminals receive axoaxonic synapses and emphasize instead the role of postsynaptic interactions. In particular the results suggest several sites at which substance P might interact postsynaptically with the neuropeptide enkephalin.

Ultrastructure of normal and degenerating glomerular terminals of dorsal root axons in the substantia gelatinosa of the rhesus monkey

The fine structure of primary sensory terminals within glomerular complexes of lamina II of Rexed (substantia gelatinosa Rolandi) in the spinal cord was investigated in normal adult rhesus monkeys and in monkeys subjected to thoracic or lumbosacral dorsal root transection. Three types of "scalloped" primary sensory terminals were distinguished on the basis of their ultrastructural characteristics, size, and distribution of synaptic vesicle population: (1) dense sinusoid axon (DSA) terminals contain medium-sized (42--46 nm and 58--62 nm) and large (80 nm) clear synaptic vesicles; (2) large dense-core vesicles (LDCV) terminals are equipped with empty synaptic vesicles ranging from 30 to 106 nm, large, (80 nm) and very large, (100 nm) dense-core vesicles; and (3) regular synaptic vesicles (RSV) terminals contain a homogeneous population of 45--50 nm clear synaptic vesicles. Following transection of the dorsal roots, all three types of primary afferents degenerate and become engulfed and phagocytosed by glial cells. However, each type of terminal displays a different mode and tempo of degeneration as seen in monkeys sacrificed 36, 48, and 72 hours following rhizotomy. DSAs follow the osmiophilic degeneration pattern; LDCVs are characterized by a gradual increase in the number of "electron-dense bodies" and, less frequently, by a progressive osmiophilic process; RSVs exhibit signs of a filamentous degeneration, accompanied by clusters of synaptic vesicles. The three types of terminals are distributed in an overlapping but distinct pattern within the posterior horn. Thus DSAs are present in highest numbers in lamina II where they constitute the most frequent terminal type. LDCVs also occur in lamina II in its outer half but are most concentrated in lamina I. RSVs predominate in the deeper layers of the dorsal horn (lamina III) but are also found in the internal half of lamina II. On the basis of these ultrastructural data and a comparison with afferent profiles impregnated according to the Golgi method, it appears that DSAs and LDCVs correspond respectively to superficial and marginal collaterals of small, thin dorsal root fibers whereas RSVs represent terminals of deep collaterals from large, thick dorsal root axons.

Dorsal root projections in the clawed toad (Xenopus laevis) as demonstrated by anterograde labeling with horseradish peroxidase

Horseradish peroxidase was applied to the proximal stumps of severed cervical, thoracic and lumbar dorsal roots in the clawed toad, Xenopus laevis, in order to study the course, distribution and site of termination of dorsal root fibers in the spinal cord and brain stem. The anterograde transport of horseradish peroxidase as applied in the present study proved to be a useful and reliable technique. Results show that on entering the spinal cord, dorsal root fibers segregate into a medially placed component entering the dorsal funiculus and a more laterally situated bundle in the dorsal part of the lateral funiculus. As regards its position the latter bundle presumably represents the anuran homologue of the mammalian tract of Lissauer. Moreover, a small intermediate bundle of fibers directly enters the spinal gray matter. The labeled fibers entering the dorsal funiculus and the tract of Lissauer ascend and descend in the spinal cord, displaying a longitudinal arrangement resembling that of higher vertebrates. In the spinal gray, dorsal root fibers terminate in the dorsal, central and lateral fields of Ebbesson, with the last field being a major terminus for dorsal root fibers originating in the limb-innervating segments. No dorsal root fibers were found to project to the motoneuron fields. A dorsal column nucleus, which is divisible into medial and lateral compartments, is present in the obex region and extends from the level of the second spinal nerve to that of the entrance of the vagus and glossopharyngeal nerves. Dorsal root fibers from the lumbar and all thoracic segments project to the medial compartment of the dorsal column nucleus, whereas those of the cervical enlargement project to the lateral compartment. Although the anuran dorsal column nucleus appears to be less differentiated than that of higher vertebrates, its medial and lateral compartments can be considered to be the forerunners of the mammalian nucleus gracilis and nucleus cuneatus, respectively.

Ultrastructure of hair follicle afferent fibre terminations in the spinal cord of the cat

In acute electrophysiological experiments on anaesthetized cats, single identified hair follicle afferent fibres were injected with horseradish peroxidase (HRP). The HRP was injected from an intra-axonal microelectrode in the lumbosacral spinal cord. One to six hours after injection the animals were perfused and the tissue prepared for light and electron microscopy (EM). Axon collateral arborizations containing HRP reaction product were identified in thick sections under the light microscope and the same tissue then cut on the ultramicrotome for EM study. The terminal branches of the collaterals kept their myelin sheaths until they were 0.45-1.0 micron in diameter, just before they formed synaptic boutons. Synaptic boutons (1.0-4.0 microns in diameter) were usually of the en passant variety and made contact with dendrites. The contacts were asymmetrical (Type I) and contained round, clear synaptic vesicles of 35-60 nm diameter. Both the non-myelinated portion of the terminal axon and the synaptic boutons received axo-axonic contacts. These axo-axonic boutons contained clear (agranular) vesicles irregular in profile.

Synaptic complexes formed by functionally defined primary afferent units with fine myelinated fibers

The individual fine myelinated fibers of cutaneous mechanical nociceptors and "D-hair" receptors were identified by electrophysiological recording with micropipette electrodes in cats and monkeys. Their intraspinal terminations were labeled by iontophoresing horseradish peroxidase intracellularly and subsequent diaminobenzidine histochemistry. These terminations were examined with light and electron microscopy to determine the nature and organization of their synaptic contacts. Myelinated fibers of the mechanical nociceptors became unmyelinated before exhibiting many enlargements that made multiple synaptic contacts in the marginal zone (lamina I) and lamina V. Pre- or postsynaptic contacts were found only on enlargements. In the marginal zone of the cat, enlargements made simple axodendritic contacts or were scalloped, central terminals in glomeruli. In glomeruli, myelinated mechanical nociceptor enlargements were presynaptic to several dendritic appendages and postsynaptic to two different types of profiles. One type was interpreted as a presynaptic axon terminal, the other as a presynaptic, vesicle-containing, dendritic appendage. In lamina V of the cat the nociceptor synaptic complexes were similar, but simpler, and only axonal profiles were found to be presynaptic to them. In the monkey marginal zone and deep nucleus proprius, myelinated nociceptor terminations formed the central element of glomeruli, which consisted of postsynaptic dendritic appendages and presynaptic axon terminals. D-hair axons terminated in large numbers of enlargements in the nucleus proprius (laminae III and IV) and inner substantia gelatinosa (lamina IIi). Their large rounded enlargements formed the central terminals in glomeruli and were presynaptic to both ordinary and vesicle-containing dendritic appendages; the presynaptic dendritic profiles also often contacted each other. Profiles interpreted as axonal in origin were the only terminals presynaptic to the primary ending within the D-hair glomeruli. The results suggest that transfer of primary afferent information occurs only at enlargements of the primary fiber and that each primary fiber enters into more than one kind of synaptic arrangement. They also point out that synaptic glomeruli are common to functionally different types of primary afferent fibers and that the internal organization of glomeruli varies with the kind of primary fiber and the locus of the complex.

Light microscopic and ultrastructural localization of immunoreactive substance P in the dorsal horn of monkey spinal cord

Light- and electron-microscopic localization of substance P in the monkey spinal cord was studied by the peroxidase anti-peroxidase technique with the particular aim of examining types of interactions made by substance P-positive boutons with other neuronal elements in the dorsal horn. By light-microscopy dense labeling for immunoreactive substance P was found in laminae I, II (outer zone) and V (lateral region), consistent with findings in other mammalian species. By electron-microscopy, substance P-positive staining was mostly in unmyelinated and in some thinly myelinated small diameter fibers. Substance P-positive terminals contained both large granular vesicles (80-120 nm diameter), which were filled with reaction product, and clear round vesicles (40-60 nm). Substance P-positive large granular vesicles were sometimes observed near presynaptic sites and in contact with dense projection there. Immunoreactive substance P boutons were small to large in size (1-4 micron), formed synapses with somata and large dendrites and were the central axons of synaptic glomeruli where they were in synaptic contact with numerous small dendrites and spines. Substance P-labeled axons frequently formed synapses with dorsal horn neurons which were also postsynaptic to other types of axons. Substance P-positive profiles participated in numerous puncta adhaerentia with unlabeled cell bodies, dendrites and axons. Only rarely, some suggestive evidence was obtained indicating that axons might synapse onto substance P-containing boutons. Biochemical analysis of monkey spinal cord tissue extracts, undertaken to characterize more precisely the immunoreactive substances, indicated that only substance P and its oxide derivative were detected with the antiserum used in the immunocytochemistry. These morphological findings show that substance P is contained within a class of axon terminals, many of which have been shown previously in the monkey to originate from the dorsal root. The results suggest that modulation of substance P primary afferents terminating in the outer dorsal laminae of the monkey spinal cord occurs in part via axonal inputs onto dorsal horn neurons postsynaptic to the primary afferent.

The cytoarchitecture of GABAergic neurons in rat spinal cord

Glutamic acid decarboxylase (GAD), the enzyme that synthesizes the transmitter gamma-aminobutyric acid (GABA), has previously been localized within synaptic terminals in rat spinal cord by immunocytochemistry. In the present study, GAD was localized within the somata and dendrites of GABA neurons following colchicine injections into rat lumbar spinal cord. All regions of the spinal gray matter contained GAD-positive somata except the motoneuron pools (lamina IX). GAD-positive somata also were observed in the ependymal layer and in the dorsolateral funiculus. Small GAD-positive somata, averaging 9 X 13 micrometer in size, were located in laminae I-III, and the size of GAD-positive somata increased for cells located in progressively more ventral laminae, reaching a maximum in lamina VII where somal size averaged 12 X 19 micrometer. Lamina I contained two classes of GAD-positive cell bodies; lenticular shaped, intermediate size neurons that were reminiscent of stalked cells, and a smaller cell type that was elongated in the sagittal plane. GAD-positive somata in laminae II and III had the size and position of islet cells. In laminae IV-VI, GAD-positive somal profiles averaged 12 X 17 micrometer in size. Lamina IV neurons were concentrated along laminar edges, while those in laminae V and VI were distributed more homogeneously. In lamina VIII, GAD-positive cell bodies appeared in groups of 3 or 4 and were smaller than those in lamina VII. Lamina X contained GAD-positive somal profiles averaging 12 X 16 micrometer in size. In the ependymal layer, there were two types of cerebrospinal fluid (CSF)-contacting neurons that contained GAD; one spherical and the other elongated. Both types sent extensions into the central canal where these processes expanded into 4-5 micrometer-wide end bulbs. CSF-contacting cells with sizes and shapes similar to the GAD-positive ones were seen to receive synapses in electron micrographs. The widespread distribution of GABA neurons in spinal cord was suggestive of diverse functions for these cells, encompassing conventional synaptic roles and, perhaps, an involvement in hormonally modulated communication via GABAergic, CSF-contacting neurons.

Multiple afferent innervation of primate facial hairs--Henry Head and Max von Frey revisited

Large guard hairs as well as small vellus hairs are multiple innervated having lanceolate terminals of variable number. Ruffini corpuscles consisting of fine axonal ramifications are arranged circularly and located external to the lanceolate terminals. Free nerve endings (FNE's) can also be identified on some hairs distinct from Ruffini terminals. Ruffini terminals and FNE's are usually innervated by axons from the superficial dermal nerve net whereas lanceolate terminals are innervated by axons from the deeper portions of the dermal nerve net. All guard hairs have both types of terminals (lanceolate and Ruffini) confirming Hoggan and Hoggan, Retzius and Symonowicz, and most guard hairs have presumptive FNE's. Many vellus hairs have only small Ruffini endings or FNE's. The diameter of axons supplying Ruffini terminals is 1-2 micrometer and those to lanceolate terminals is 2-4 micrometers. Axons innervating lanceolate and Ruffini terminals branch rarely as correlated with small punctate receptive fields. FNE's branch widely and are correlated with large receptive fields of known nociceptors. The multiplicity of anatomically defined terminals is consistent with the known diversity of physiologically defined hair mechanoreceptive afferents as well as perceptual complexity of human hairy skin. The concept of multiple innervation of hairs confirms Head's prediction and could provide the anatomical basis of Head's basic thesis of altered sensibilities in nerve regeneration (i.e. epicritic and protopathic responses). Head's concept of two separate nervous systems, however, is an over-simplification in the light of current knowledge.

Neurotensin immunoreactivity in the superficial laminae of the dorsal horn of the rat: I. Light microscopic studies of cell bodies and proximal dendrites

Although neurotensin perikarya have been identified in the superficial laminae of the dorsal horn, little is known regarding the cytoarchitecture of these neurotensin-containing neurons. Immunohistochemical staining of 75-microns sections in several planes through colchicine-treated rat spinal cords revealed morphologic features of neurotensinlike immunoreactive (NLI) perikarya and proximal dendrites. Populations of NLI neurons were identified in the outer one-third of lamina II, the inner one-third of lamina II, and outer lamina III. The NLI neurons in lamina II had elongated perikarya and the dendrites emerged from the rostral and caudal poles of the cell body. The proximal dendrites of NLI cells in inner laminae II were shorter and contained more spines than outer lamina II NLI cells. The NLI cells in outer lamina III did not exhibit polarity and the proximal dendrites were generally shorter than those of NLI cells in lamina II. The lamina II cells appear similar to islet cells (Gobel, '75), while the lamina III cells have many of the characteristics of the II/III border cell described by Gobel ('78). Interestingly, the inner lamina II NLI cells occurred in clusters with NLI cells in outer lamina III. The periodicity of these clusters suggests a neurochemical dimension for the organization of the superficial laminae of the dorsal horn.

Dorsal root entry zone lesions to control central pain in paraplegics

✓ Thirteen patients with intractable long-term pain following spinal cord injury and paraplegia were treated with dorsal root entry zone lesions placed at the level just above the transection. Pain relief of 50% or more was achieved in 11 of the 13 patients, with follow-up periods ranging from 5 to 38 months. A previous report showed that central pain from brachial plexus avulsion could be relieved by dorsal root entry zone lesions, and this technique has been extended to the central pain phenomena associated with spinal trauma and paraplegia.

Aminophylline differentiates between the depressant effects of morphine on the spinal nociceptive reflex and on the spinal ascending activity evoked from afferent C fibres

The action of aminophylline on anti-nociceptive effects of morphine in rats was tested on the tail-flick response to noxious heat and on the activity evoked in ascending axons of the spinal cord by stimulation of nociceptive afferents. The depression of the tail-flick response produced by an intraperitoneal (i.p.) injection of morphine 2 mg/kg in intact and spinal rats was abolished by an i.p. injection of aminophylline 25 mg/kg. The activity evoked in ascending axons of spinal rats by electrical stimulation of afferent C fibres of the sural nerve was depressed by an intravenous (i.v.) injection of morphine 2 mg/kg. Aminophylline 25 mg/kg injected i.v. after morphine produced a slight and transient increase in the ascending activity immediately after its administration but did not abolish the depressant effect of morphine. Naloxone 0.2 mg/kg administered after aminophylline antagonized the depressant effect of morphine on the ascending activity. It is suggested that morphine exerts its depressant effect on the two nociceptive responses (the motor and the sensory response) by different mechanisms, one being sensitive to aminophylline, the other being relatively resistant to the action of the purine derivative.

The deafferentation syndrome in monkeys: dysesthesias of spinal origin

Chronic thoracic spinal lesions were surgically placed in 35 monkeys of 6 different species. In a very large percent of the cases, a bizarre behavioral pattern was released, which persisted for many months of observation. This syndrome was one in which the monkey severely attacked an hypoalgesic area of the body, namely, the leg. The syndrome resulted from contralateral anterolateral cordotomy or hemisection. It was very similar to the deafferentation syndrome which results from extensive dorsal rhizotomies. Bilateral spinal lesions indicated that the release of the syndrome was dependent upon the integrity of a widespread bilateral spinal pathway for peripheral nociception, but was independent of the integrity of specific sensory tracts. The deafferentation syndrome is considered to be a behavioral response to abnormal subjective sensations of central neural origin, and appears not to be relieved by morphine therapy. The incidence of this syndrome in the primate was subject to genetic variation.

Selective neurotoxic action of capsaicin on glomerular C-type terminals in rat substantia gelatinosa

This study demonstrates that capsaicin exerts a selective neurotoxic action to induce degeneration of glomerular C-type nerve terminals in adult rats. Since the C terminals may be essential components of the circuitry for modulation of pain, it is suggested that capsaicin induced analgesia is the result of this neurotoxic action.

Substance P immunoreactive neurons following neonatal administration of capsaicin

Neonatal administration of capsaicin on the days 2, 10 or 20 leads to a long-lasting loss of substance P immunoreactive material in fibers of primary sensory neurons in the spinal cord and medulla oblongata. The degree of depletion examined 6 months after treatment was related to the day of injection. Injections on the second day produced dramatic losses of substance P in fibers of the substantia gelatinosa and the marginal layer of the spinal cord and the spinal nucleus of the trigeminal nerve, although these losses were never complete. The observed depletion of substance P immunoreactive material was homogenous throughout the superficial layers of the dorsal horn and the spinal nucleus of the trigeminal nerve. No changes were observed for the immunoreactivity of Leu-enkephalin in the substantia gelatinosa and the marginal layer of the spinal cord in consecutive sections from the same treated animals. In the medulla oblongata a reduction of substance P immunofluorescent fibers was found in the nucleus tractus solitarii and the spinal nucleus of the trigeminal nerve. Other areas of the central nervous system with a rich innervation of substance P immunoreactive fibers were not affected by capsaicin treatment.

Excitation and inhibition of marginal layer and interstitial interneurons in cat nucleus caudalis by mechanical stimuli

In cats anesthetized with urethane, the caudal medulla was stabilized in preparation for intracellular recording from interstitial neurons in the descending tract of the trigeminal nerve and from neurons in lamina I of nucleus caudalis. Glass micropipets (10-50 M ohms) were advanced from the surface to a maximum depth of 350 micrometer. When DC potential shifts occurred, it was found that mechanical stimuli to the face generated bursts of positive-going spikes, followed in some cases by inhibitory postsynaptic potentials (IPSPs). Subdermal electrical stimulation of the face in each receptive field almost always enabled the same neuron to be driven electrically. Recordings were classified as from primary afferent fibers or from interneurons. Primary fibers had a purely positive spike, with a latency varying by no more than 0.05 msec, and could follow stimulation at 500 Hz. The mean latency for the fibers was 1.87 +/- 0.06 msec (n=75), and their absolute refractory period was 0.42 +/- 0.02 msec (n=36). Recordings were classed as from interneurons if there was an IPSP or the latency was at least 4 msec, with a variation of latency of at lest 0.5 msec. Responses thought to be monosynaptically driven had a mean latency of 2.09 +/0 0.07 msec (n=32) and could follow pairs of stimuli at a mean minimum interval of 0.70 +/- 0.06 msec (n=20). Responses thought to be polysynaptically driven had a mean latency of 7.9 +/- 1.08 msec (n=49) and a mean interstimulus interval of 2.96 +/- 0.84 (n=20). Most responses were generated by brushing the face (n=87), some by pressure on the face (n=25), and a few by pinching the skin of the face (n=6). Interneuron responses were most commonly recorded in the first 200 micrometer of the descending tract, and this position was confirmed by the injection of pontamine sky blue and the examination of frozen sections. The recordings were thought to be from dendrites of marginal and interstitial cells or the somas of interstitial cells. The IPSPs which followed spike potentials could only follow stimuli at 10 Hz or less. The failure appeared to be at a primary afferent synapse upon an inhibitory interneuron. Collision tests between mechanically evoked and electrically evoked responses showed long-lasting inhibition of the response to electrical stimulation after collision. Presynaptic inhibition exerted on the primary afferent excitation was suggested as the explanation.

Epidural opiate and perioperative analgesia

Epidural injections of 5 mg nicomorphine in 20 ml 5% glucose wee given to 10 gynaecological patients to provide intra-operative and post-operative analgesia. Signs of changed nociception appeared within 5 min. The maximum change occurred within 20 min. Effectiveness was at least 3 1/2 h. After an observation period of 30 min, light general anaesthesia is supplemented to give excellent operating conditions. It is suggested that opiates produce these effects by a direct action on the endorphin "pain" modulatory system of human beings at spinal level.

Depressant and excitant effects of intraspinal microinjections of morphine and methionine-enkephalin in the cat

The effects of intraspinal microinjectins of morphine (10 microgram) and methionine-enkephalin (Met-enkephalin) (5 microgram) on the C-fiber and polysynaptic reflexes in the acute decerebrate low spinal cat were investigated. Microinjected into the dorsal horn, morphine and Met-enkephalin depressed the nociceptive C-fiber reflex (CFR) without altering the short latency polysynaptic reflex. Microinjected into the ventral horn, morphine and Met-enkephalin facilitated the C-fiber and polysynaptic reflexes. Pretreatment of the cats with intravenous naltrexone (2 mg/kg) antagonized the depressant effects produced by dorsal horn intraspinal microinjections of morphine and Met-enkephalin. The excitant effects of ventral horn microinjections of morphine were not antagonized by naltrexone (2 mg/kg). These results support a hypothesis that the analgesic effects of morphine at the spinal cord level are due to interactions with opiate receptors in the dorsal horn.

Morphine does not antagonize the substance P mediated excitation of dorsal horn neurons

Multibarrelled microelectrodes were used to test the effects of iontophoretically released substance P (SP), morphine, glutamate, and naloxone on spinal cord dorsal horn neurons. Cells excited by SP were also excited by noxious stimuli, a finding consistent with the hypothesis that SP is the neurotransmitter released by primary nociceptor afferents to excite dorsal horn neurons. Iontophoretic morphine failed to depress the SP-induced discharges. Indeed, iontophoretic morphine frequently potentiated the SP responses. In addition to potentiating SP-induced discharges, iontophoretic morphine frequently increased both the spontaneous activity of dorsal horn neurons and the activity evoked in these cells by noxious cutaneous heat and iontophoretic glutamate. Naloxone did not antagonize these excitatory effects. Intravenous morphine only depressed spontaneous discharges. Nevertheless, iontophoretic morphine still produced excitatory effects in spinal animals pretreated with analgesic doses of intravenous morphine. It is concluded that such excitatory effects are toxic actions indicative of supratherapeutic morphine concentrations in the vicinity of the neuron being studied. Intravenously administered morphine depressed the spontaneous activity of dorsal horn neurons of spinal cats, but failed to depress their responses to SP. Morphine also failed to antagonize SP's biological effects in peripheral systems (contraction of isolated guinea pig ileum, rabbit hypotensive effect, rat sialogogic response). It is concluded that morphine is not a substance P receptor antagonist. The results are discussed with respect to the hypotheses that (1) the spinal analgesic effects of systemically administered morphine occur on presynaptic terminals of sensory neurons, and (2) an SP antagonist might be a unique analgesic agent.

The cells of origin of the primate spinothalamic tract

Spinothalamic tract cells in the lumbar, sacral and caudal segments of the primate spinal cord were labelled by the retrograde transport of horseradish peroxidase (HRP) injected into the thalamus. The laminar distribution of stained spinothalamic cells in the lumbosacral enlargement differed according to whether the HRP was injected into the lateral or the medial thalamus. Lateral injections labelled cells in most laminae, but the largest numbers of cells were in laminae I and V. The highest concentrations of cells labelled from the medial thalamus were in laminae VI-VIII. Ninety percent or more of the stained spinothalamic cells in the lumbosacral enlargement were contralateral to the injection site. In the conus medullaris stained spinothalamic cells were most numerous in laminae I, V and VI following lateral thalamic injections of HRP. Many of the cells of the conus were in Stilling's nucleus. Twenty-three percent of the cells in the conus were ipsilateral to the injection site in the lateral thalamus. Only a few cells in the conus were labelled by medial thalamic injections. The total number of spinothalamic cells from L5 caudally was estimated to be at least 1,200-2,500. An injection of HRP into the midbrain resulted in laminar distribution of labelled cells much like that produced by a lateral thalamic injection. The types of spinothalamic tract cells and the sizes of their somata were determined for different laminae. The cell types resemble those already described from Golgi and other studies of the spinal cord gray matter. The spinothalamic tract cells in lamina I included Waldeyer cells and numerous small fusiform, pyriform or triangular cells. Those in lamina II included limitrophe and central cells. Spinothalamic cells in lamina III were central cells. Most of the labelled cells in laminae IV-X were polygonal, although there were also flattened cells in these layers. The smallest spinothalamic cells were in laminae I-III, while the largest were in laminae V and VII-IX. Spinothalamic cells in the conus medullaris included cells like those in the lumbosacral enlargement, but also a special cell type in Stilling's nucleus. Some cells in the conus had dendrites that crossed the midline. Spinothalamic axons could sometimes be traced to the ventral white commissure within one or a few sections. In longitudinal sections, most labelled axons were in the ventral part of the lateral funiculus on the side of the injection, although a few were in the ventral funiculus or on the contralateral side. The axons were widely dispersed, and a few were located adjacent to the pia-glial membrane.

Indirect evidence for presynaptic location of opiate receptors on chemosensitive primary sensory neurones

1. Rats were pretreated with 50 mg/kg s.c. capsaicin or solvent on the second day of life; 5 months later 3H-diprenorphine binding to homogenates of the whole spinal cord or of the upper dorsal horn of the spinal cord was investigated. 2. Capsaicin pretreatment resulted in a 17% decrease of opiate binding sites in the whole spinal cord and a 37% decrease in the upper dorsal horn with no change in their affinity. 3. Since neonatal capsaicin pretreatment causes degeneration of chemosensitive primary sensory neurones it is concluded that some opiate receptors are located presynaptically on the central terminals of these neurones.

Inhibition of spinal cord interneurons by narcotic microinjection and focal electrical stimulation in the periaqueductal central gray matter

Single cell evoked activity was recorded from spinal cord interneurons in rats prepared with microinjection cannulae or stimulating electrodes in the periaqueductal central gray matter (PAG). Morphine microinjections (4-16 microgram) inhibited the response evoked by a noxious stimulus in 55% of the wide dynamic range neurons tested. Microinjections of etorphine (0.25-0.5 microgram) inhibited 82% of the nociceptive neurons tested. Neither drug inhibited neurons which responded only to innocuous mechanical stimulation. The inhibition of wide dynamic range neurons produced by narcotic microinjection was antagonized by naloxone (1 mg/kg, i.p.) in 7 of 11 cases. Control experiments indicated that the effects obtained with microinjections could not be attributed to the drugs' diffusion to the spinal cord. Focal electrical stimulation of the PAG inhibited the responses to noxious stimuli of 60% of wide dynamic range neurons but was without effect on the responses of neurons that were activated only by innocuous stimuli. These experiments directly demonstrate that narcotic analgesics restricted to an intracerebral site of action activate a neural system which preferentially inhibits the responses of spinal cord wide dynamic range neurons to noxious stimuli. The system has a specificity for nociceptive input since non-nociceptive neurons were unaffected. Directly comparable results were produced by electrical stimulation of the PAG, supporting the concept that stimulation and narcotics modulate the transmission of nociceptive information by similar mechanisms.

Morphological features of functionally defined neurons in the marginal zone and substantia gelatinosa of the spinal dorsal horn

Functional characteristics of spinal neurons located in the marginal zone (lamina I) and substantia gelatinosa (lamina II) were compared to their structural features by intrcellularly staining the source of unitary potentials with horseradish peroxidase (HRP) in unanesthetized, spinal cats. The responses of postsynaptic units to graded electrical volleys in intact dorsal roots and to physiological stimulation revealed that the peripheral excitatory input to neurons of the region is dominated by slowly conducting afferent fibers; often, the input to a given element is largely from a particular class of receptors. One type commonly seen received its principal peripheral excitation from low threshold mechanoreceptors with A delta or C afferent fibers. Mechanoreceptive elements often exhibited a marked, prolonged habituation and many were not excited by afferent volleys. Other units were predominantly excited by nociceptors with myelinated or unmyelinated fibers, or by thermoreceptors with unmyelinated fibers. A few units (principally the thermoreceptive) showed substantial ongoing activity which was modulated by sensory stimulation, but most had little or none. The HRP staining revealed neuronal morphology in fine detail. No relationship between neuronal configuration and physiological response was discerned. Soma location was not always linked to afferent input, although the cell bodies of nociceptive and thermoreceptive neurons tended to be in lamina I or outer lamina II (SGo) while those of the innocuous mechanoreceptive meurons tended to be in inner lamina II (SGi). The locus of a neuron's major dendritic arborization was more closely related to the source(s) of peripheral excitation. Cells excited by nociceptors with myelinated fibers had major dendritic projections in the marginal zone. Cells excited by nociceptors or thermoreceptors with unmyelinated fibers had important dendritic branching in the SGo. Innocuous mechanoreceptive neurons had primary dendritic arborization in the SGi when the input derived from unmyelinated fibers, or in the SGi and extending into the outer nucleus proprius (lamina III) when the afferent drive came from A delta fibers. These findings support the concept that laminae I and II constitute a major termination region for thin primary afferent fibers, myelinated fibers from nociceptors ending principally in lamina I and unmyelinated fibers from nociceptors, thermoreceptors, and mechanoreceptros terminating predominantly in lamina II. Substantial integrative and distributive functions can be expected of such an afferent termination zone.

Reexamination of the dorsal root projection to the spinal dorsal horn including observations on the differential termination of coarse and fine fibers

Primary afferent fibers in the lumbar, sacral, and caudal spinal segments of several mammals (rat, cat, monkey) were stained by applying horseradish peroxidase to the proximal part of cut dorsal rootlets and reacting the tissue histochemically after several hours of survival. The stained fibers' pattern of termination in the dorsal horn was similar in all three species, with many bouton-like enlargements in the ipsilateral marginal zone, substantia gelatinosa, and nucleus proprius, as well as a few projections at each level to the dorsal commissure and contralaterally to the ventral border of the nucleus proprius. Partial lesions of dorsal rootlets in monkey revealed that the thin fibers comprising the lateral division end principally in the marginal zone and substantial gelatinosa, while the thick fibers of the medial division terminate in the nucleus proprius and deeper regions, contributing little to the substantia gelatinosa and marginal zone. On the basis of the termination patterns observed for whole and partly sectioned rootlets, the superficial dorsal horn can be divided into at least four regions. (1) The marginal zone (lamina I of cat) appears to receive terminations from intermediate (smaller myelinated) fibers; (2) the outer substantia gelatinosa (outer lamina II) receives many terminations from the very finest afferent fibers; (3) the inner substantia gelatinosa (inner lamina II) receives endings from some of the finest fibers and also from intermediate (smaller myelinated) fibers; and (4) the superficial part of the nucleus proprius (lamina III) receives endings from intermediate and large diameter dorsal root fibers.

Distribution of primary afferent fibers within the sacrococcygeal dorsal horn: an autoradiographic study

The spinal segmental distribution and intersegmental course of primary afferent fibers were studied by injecting (by pressure or iontophoresis) tritiated amino acids (L-proline or L-leucine) into spinal ganglia of coccygeal and sacral segments and autoradiographically analyzing histological sections of the spinal cord, particularly those regions lying dorsal to the central canal. The results from eight cats and three monkeys are described. A heavy projection of primary afferent fibers to the marginal zone (lamina I), the substantia gelatinosa Rolandi (lamina II), and throughout the nucleus proprius (laminae III-IV) was demonstrated. The projections to these three areas appeared to be substantially independent. Primary afferent fibers were found to course rostrally and caudally within the marginal zone, in the midline dorsal to the central canal, in Lissauer's tract, and in the dorsal columns. A crossed projection passed by way of the dorsal commissure to the contralateral marginal zone and to a region ventrolateral to the contralateral nucleus proprius. There was a distinct medial-to-lateral shift in the termination of primary afferent fibers in the substantia gelatinosa and in the dorsal portion of the nucleus proprius. The most medial distribution occurred immediately caudal to the entry zone of the primary afferent fibers, and the most lateral at the cephalad end of the segment immediately rostral to the entry level. Small (iontophoretic) injections revealed circumscribed fields of termination, approximately 40 micrometers by 70 micrometers (dorsoventrally) by 400 micrometers or more (rostrocaudally) in the substantia gelatinosa.