Tooth pulp input to the spinal trigeminal nucleus: a comparison of inhibitions following segmental and raphe magnus stimulation

Descending projections from the insular cortex to the trigeminal spinal subnucleus caudalis facilitate excitatory outputs to the parabrachial nucleus in rats

ABSTRACT

Nociceptive information from the orofacial area projects to the trigeminal spinal subnucleus caudalis (Sp5C) and is then conveyed to several nuclei, including the parabrachial nucleus (PBN). The insular cortex (IC) receives orofacial nociceptive information and sends corticofugal projections to the Sp5C. The Sp5C consists of glutamatergic and GABAergic/glycinergic interneurons that induce excitatory postsynaptic currents and inhibitory postsynaptic currents, respectively, in projection neurons. Therefore, quantification of glutamatergic IC inputs in combination with identifying postsynaptic neuronal subtypes is critical to elucidate IC roles in the regulation of Sp5C activities. We investigated features of synaptic transmission from the IC to glutamatergic and GABAergic/glycinergic Sp5C neurons of laminae I/II using vesicular GABA transporter-Venus transgenic rats that received an injection of adeno-associated virus-channelrhodopsin-2-mCherry into the IC. Selective stimulation of IC axon terminals in Sp5C slice preparations induced monosynaptic excitatory postsynaptic currents in both excitatory glutamatergic and inhibitory GABAergic/glycinergic Sp5C neurons with a comparable amplitude. Paired whole-cell patch-clamp recordings showed that unitary inhibitory postsynaptic currents from inhibitory neurons influencing excitatory neurons, including neurons projecting to the PBN, exhibited a high failure rate and were suppressed by both bicuculline and strychnine, suggesting that excitatory neurons in the Sp5C receive both GABAergic and glycinergic inhibition with low impact. Moreover, selective stimulation of IC axons increased the firing rate at the threshold responses. Finally, we demonstrated that selective stimulation of IC axons in the Sp5C by a chemogenetic approach decreased the thresholds of both mechanical and thermal nociception. Thus, IC projection to the Sp5C is likely to facilitate rather than suppress excitatory outputs from the Sp5C.

Cortico-NRM Influences on Trigeminal Neuronal Sensation

We tested the idea that migraine triggers cause cortical activation, which disinhibits craniovascular sensation through the nucleus raphe magnus (NRM) and thus produces the headache of migraine. Stimulation of the dura mater and facial skin activated neurons in the NRM and the trigeminal nucleus. Stimulation of the NRM caused suppression of responses of trigeminal neurons to electrical and mechanical stimulation of the dura mater, but not of the skin. This suppression was antagonized by the iontophoretic application of the 5-HT1B/1D receptor antagonist GR127935 to trigeminal neurons. Migraine trigger factors were simulated by cortical spreading depression (CSD) and light flash. Activity of neurons in the NRM was inhibited by these stimuli. Multiple waves of CSD antagonized the inhibitory effect of NRM stimulation on responses of trigeminal neurons to dural mechanical stimulation but not to skin mechanical stimulation. The cortico-NRM-trigeminal neuraxis might provide a target for a more universally effective migraine prophylactic treatment.

Differential effects of trigeminal tractotomy on Adelta- and C-fiber-mediated nociceptive responses

In this study we have tested in the rat, whether trigeminal tractotomy, which deprives the spinal trigeminal nucleus caudalis (Sp5C) of its trigeminal inputs, affected differentially nociceptive responses mediated by C- vs. Adelta-nociceptors from oral and perioral regions. Tractotomy had no effect on the threshold of the jaw opening reflex, induced by incisive pulp stimulation (Adelta-fiber-mediated), but blocked the formalin response (mainly C-fiber-mediated). These results suggest that nociceptive responses mediated by trigeminal C-fibers completely depend on the integrity of the Sp5C, while intraoral sensations triggered Adelta-fibers (especially of dental origin) are primarily processed in the rostral part of the spinal trigeminal nucleus.

Direct projections from the midbrain periaqueductal gray and the dorsal raphe nucleus to the trigeminal sensory complex in the rat

It is well known that analgesia can be produced by stimulation of the midbrain periaqueductal gray and dorsal raphe nucleus. This stimulation-produced analgesia may operate, at least partly, through direct projections to nociceptors in the primary sensory nuclei. In the present study, direct projections from the midbrain periaqueductal gray and dorsal raphe nucleus to the trigeminal sensory complex were studied in the rat. After injection of Phaseolus vulgaris leucoagglutinin into the periaqueductal gray or dorsal raphe nucleus, terminal labeling was found in the principal sensory trigeminal nucleus and the oral, interpolar and caudal subnuclei of the spinal trigeminal nucleus, bilaterally with an ipsilateral predominance. The terminal labeling was prominent in the ventrolateral parts of the trigeminal sensory complex; it was particularly marked in the principal sensory trigeminal nucleus and laminae I and III of the caudal subnucleus of the spinal trigeminal nucleus. After injection of cholera toxin B subunit into the principal sensory trigeminal nucleus or one of the subnuclei of the spinal trigeminal nucleus, retrogradely labeled cells were seen in the periaqueductal gray and dorsal raphe nucleus, bilaterally with an ipsilateral dominance. In the periaqueductal gray they were most often seen in the ventrolateral and dorsolateral subdivisions, but no particular topographic organization was detected in the distribution of retrogradely labeled neurons in the periaqueductal gray and dorsal raphe nucleus after tracer injection into each subdivision of the trigeminal sensory complex. After injections of Fast Blue and Diamidino Yellow, respectively, into the principal sensory trigeminal nucleus and the caudal subnucleus of the spinal trigeminal nucleus on one side of the brain, a number of doubly labeled neurons were found in the periaqueductal gray and dorsal raphe nucleus, bilaterally with an ipsilateral dominance. The results indicate that a considerable number of neurons in the periaqueductal gray and dorsal raphe nucleus send projection fibers to the trigeminal sensory complex, and that some of them send their axons to both the principal sensory trigeminal nucleus and the caudal subdivision of the spinal trigeminal nucleus by way of axon collaterals. These projections may subserve suppression of the activity of nociceptive neurons in the trigeminal system.

Rat tooth pulp projections to spinal trigeminal subnucleus caudalis are glutamate-like immunoreactive

It has been shown that glutamate-like immunoreactive axon terminals are present within the spinal trigeminal nucleus, including subnucleus caudalis. The morphology of many of these terminations is consistent with their identification as primary afferents. To establish whether primary afferent projections to subnucleus caudalis are glutamate-like immunoreactive, we injected an anterograde tract tracer into rat incisor tooth pulp, histochemically visualized this tracer within subnucleus caudalis, and then used an immunocytochemical technique to label glutamate-like immunoreactive profiles within these same sections. The anterograde tract tracer used, the B subunit of cholera toxin conjugated to horseradish peroxidase (B-HRP), is transported transganglionically and can be used to localize tooth pulp projection fibers in the spinal trigeminal nucleus. A majority of B-HRP projection fibers from rat lower incisors terminated ipsilaterally in axon terminals in the dorsal region of subnucleus caudalis. Labeled axon terminals were both scallop-shaped and smooth in profile. Small numbers of fibers containing B-HRP extended into laminae I-III caudally and were present in both the border zone between laminae IV and V and the most lateral region of lamina V rostrally. Approximately 75% of the B-HRP-labeled projection fibers were glutamate-like immunoreactive, providing evidence that the excitatory amino acid glutamate functions as a neurotransmitter in a subpopulation of these fibers. Terminals reactive for both B-HRP and glutamate-like immunoreactivity contained small, spherical round vesicles, formed asymmetric synapses, and participated in axoaxonic and axodendritic synaptic junctions. These results support the hypothesis that glutamate may be a transmitter of A delta and C fibers involved in relaying nociceptive information from the tooth pulp.

Preproenkephalin upregulation in nucleus caudalis: high and low intensity afferent stimulation differentially modulate early and late responses

Nucleus caudalis expression of preproenkephalin mRNA changes following lesions depleting small-caliber primary afferent fibers and after stimulation of trigeminal afferents at different intensities. Animals treated neonatally with capsaicin display reduced preproenkephalin gene expression in nucleus caudalis neurons. Stimulation of normal animals at low intensities enhances preproenkephalin expression in a bimodal temporal pattern. High intensity stimulation is effective only at later time points in normal animals, but it causes both early and late effects on preproenkephalin expression when applied to animals neonatally lesioned with capsaicin. Transsynaptic regulation of preproenkephalin expression in pain-modulating areas of the nucleus caudalis of the trigeminal nerve thus depends on the specific type of primary afferent input. The rapid responses noted after selective large fiber stimulation appear to be suppressed by coactivation of small caliber fibers. Later responses appear less influenced by the quality of the eliciting afferent stimulus.

Involvement of descending monoaminergic systems in the transmission of dental pain in the trigeminal nucleus caudalis of the rabbit

Perfusates were taken from the superficial layers of the subnucleus caudalis of the trigeminal sensory nuclear complex (SpVc), the first relay station of dental pain, with a push-pull cannula system and were assayed for endogenous serotonin (5-HT) and catecholamines by high-pressure liquid chromatography with an electrochemical detection. Spontaneous release of 5-HT and epinephrine was observed, while that of norepinephrine was not. Tooth pulp stimulation (ST) tended to increase the level of 5-HT in the perfusates. Pretreatment with morphine at a dose of 10 mg/kg (i.v.) significantly enhanced the release of 5-HT. However, there was no significant difference in morphine effect on the 5-HT level between stimulated and non-stimulated animals. Systemic administration of morphine (10 mg/kg i.v.) completely inhibited the release of immunoreactive substance P from the superficial layers of SpVc evoked by ST, and this inhibition was antagonized by local application of methysergide (10(-4) M). These results suggest that in the superficial layers of SpVc, morphine may primarily activate the descending 5-HT pathway which serves to modulate dental pain transmission.

Somatotopic organization of tooth pulp primary afferent neurons in the cat

Transganglionic transport of horseradish peroxidase-wheat germ agglutinin conjugate (HRP-WGA) was used to study the somatotopic organization of pulpal afferent neurons innervating the different types of teeth in the trigeminal ganglion and trigeminal sensory nuclear complex (TSNC). In separate animals, the upper first 3 incisors (UI1-3), canine (UC), second premolar (UP2) and third premolar (UP3), and the lower first three incisors (LI1-3), canine (LC), first premolar (LP1), second premolar (LP2) and molar (LM) were traced in this experiment. Cell bodies innervating posterior teeth were found with greater frequency in dorsal maxillary ganglion regions, while somata supplying more anterior teeth were predominant ventrally. In contrast, cell bodies innervating the lower teeth were not arranged in a somatotopic fashion in the mandibular subdivision. Each pulpal afferent from lower and upper teeth projected to the subnucleus dorsalis (Vpd) of the pars principalis, the rostrodorsomedial (Vo.r) and dorsomedial parts (Vo.dm) of the pars oralis (Vo), the medial regions of the pars interpolaris (Vi), and laminae I, II, and V of the medullary dorsal horn, and terminal fields between the upper and lower teeth were separated in each subdivision. Pulpal projections from both the upper and lower teeth to each subdivision were organized in a somatotopic manner, while an extensive overlap in projections was noted between the adjoining teeth. In the Vpd, the upper and lower teeth were represented dorsoventrally, and projections from the anterior to posterior teeth in the upper jaw were arranged in both rostrocaudal and ventrodorsal sequences whereas those in the lower jaw were organized caudarostrally and lateromedially. In the Vo.r and Vo.dm, the upper and lower teeth were represented in a mediolateral sequence and projections from the anterior to posterior teeth were organized in a ventrolateral to dorsomedial sequence. In the Vi, pulpal projections were organized in a topographic fashion similar to that observed in the Vo.r and Vo.dm. In the medullary dorsal horn, the upper and lower teeth were represented in laminae I, II and V in a lateromedial sequence. Their projections to laminae I and V were topographically organized in a mediolateral and rostrocaudal sequence.(ABSTRACT TRUNCATED AT 400 WORDS)

Ulex europaeus agglutinin-I binding to dental primary afferent projections in the spinal trigeminal complex combined with double immunolabeling of substance P and GABA elements using peroxidase and colloidal gold

Ulex europaeus agglutinin I (UEA-I) is a plant lectin with an affinity for L-fucosyl residues in the chains of lactoseries oligosaccharides associated with medium- and smaller-diameter dorsal root ganglion neurons and their axonal processes. These enter Lissauer's tract and terminate within the superficial laminae of the spinal cord overlapping projections known to have a nociceptive function. This implies that the surface coatings of neuronal membranes may have a relationship with functional modalities. The present investigation further examined this concept by studying a neuronal projection with a nociceptive function to determine whether fucosyl-lactoseries residues were incorporated in its primary afferent terminals. Transganglionic transport of horseradish peroxidase (HRP) following injection into tooth pulp chambers was employed to demonstrate dental pulp terminals in the trigeminal spinal complex, while peroxidase and fluorescent tags were used concomitantly to stain for UEA-I. Double immunolabeling for substance P (SP) and gamma-aminobutyric acid (GABA) using peroxidase and colloidal gold allowed a comparison of the distribution of a known excitatory nociceptive transmitter with that of UEA-I binding in specific subnuclei. Synaptic interrelationships between UEA-I positive dental pulp primary afferent inputs and specific inhibitory terminals were also examined. SP immunoreactivity occurred in laminae I and outer lamina II (IIo) of subnucleus caudalis (Vc) and in the ventrolateral and lateral marginal region of the caudal half of subnucleus interpolaris (Vi), including the periobex area in which Vi is slightly overlapped on its lateral aspect by cellular elements of Vc. The adjacent interstitial nucleus (IN) also showed an intense immunoreactivity for this peptide antibody. UEA-I binding displayed a similar distribution pattern in both Vc and Vi, but extended into lamina IIi and the superficial part of Lamina III in Vc. Dental pulp terminals were found to have a comparable distribution; however, many extended into the dorsal portion of the caudal half of Vi and the ventromedial quadrant of rostral Vi. Electron-microscopic analysis showed that transganglionically labeled dental pulp terminals contained ovoid, complex membrane-bound vacuoles laden with transported HRP. The preterminal axon and synaptic membranes of those dental pulp terminals located in zones of Vc and Vi displaying an affinity for UEA-I were usually characterized by a patchy, electron-dense coating of the peroxidase tag. SP was demonstrated ultrastructurally with Protein-A colloidal gold (3-nm particles), whereas GABA immunoreactivity was revealed by the avidin-biotin-peroxidase method.(ABSTRACT TRUNCATED AT 400 WORDS)

Inhibition of the responses of cat dorsal horn neurons to noxious skin heating by stimulation in medial or lateral medullary reticular formation

Responses of single lumbar dorsal horn units to noxious radiant heating (50 degrees C, 10 s) of glabrous footpad skin were recorded in cats anesthetized with sodium pentobarbital and 70% nitrous oxide. The heat-evoked responses of 37/40 units were reduced during electrical stimulation (100 ms trains, 100 Hz, 3/s, 25-600 microA) in the medullary nucleus raphe magnus (NRM) and/or in laterally adjacent regions of the medullary reticular formation (MRF). Inhibition was elicited by stimulation in widespread areas of the medulla, but with greatest efficacy at ventrolateral sites. The magnitude of inhibition increased with graded increases in medullary stimulation intensity. Mean current intensities at threshold for inhibition or to produce 50% inhibition were higher for NRM than for MRF sites. Units' responses to graded noxious heat stimuli increased linearly from threshold (42-43 degrees C) to 52 degrees C. During NRM (5 units) or ipsilateral MRF stimulation (7 units), responses were inhibited such that the mean temperature-response functions were shifted toward higher temperatures with increased thresholds (1.5 degrees and 1 degree C, respectively) and reduced slopes (to 60% of control). Contralateral MRF stimulation had a similar effect in 4 units. Inhibitory effects of NRM and MRF stimulation were reduced (by greater than 25%) or abolished in 4/6 and 5/12 units, respectively, following systemic administration of the serotonin antagonist methysergide. Inhibitory effects from NRM, ipsi- and contralateral MRF were reduced or abolished in 2/9, 4/8 and 6/9 cases, respectively, following systemic administration of the noradrenergic antagonist phentolamine. These results confirm and extend previous studies of medullospinal inhibition and the role of monoamines, and are discussed in terms of analgesic mechanisms.

The rostral part of the trigeminal sensory complex is involved in orofacial nociception

Single units responsive to noxious mechanical stimulation of orofacial receptive fields were recorded within the ventrobasal complex of the rat thalamus. The induced activities were compared before and after deafferentation of the subnucleus caudalis by a trigeminal tractotomy performed at the obex level. The receptive fields activated by noxious stimulation were classified as 'oral' when included in the oral, perioral or paranasal areas, and as 'facial' when included in facial regions distant from the oral cavity. After tractotomy, the unit responses to noxious stimulation of an oral field remained unchanged in 8 cases, decreased in 3 cases, and were suppressed in 4 cases. For units responding to noxious stimulation of a facial field, the responses were suppressed in 8 cases, decreased in two cases and remained unchanged in two other cases. So it appears that the rostral part of the trigeminal sensory complex (1) receives nociceptive afferents mainly from the oral and perioral areas and (2) is a relay in ascending pathways which convey painful sensations.

Response characteristics of tooth pulp-driven postsynaptic neurons in the spinal trigeminal subnucleus interpolaris of the cat: comparison with primary afferent fiber, subnucleus caudalis, reflex, and sensory responses

Tooth pulp-evoked single neuron responses were recorded in the spinal trigeminal subnucleus interpolaris of the cat. The thresholds to monopolar electric pulses of varying duration (0.2-20 ms) were determined using a constant current stimulator. The thresholds were comparable with those of primary afferent A-fibers, although the most sensitive primary afferent fibers have lower thresholds. The thresholds and latencies showed that none of the interpolaris neurons received their input solely from intradental C-fibers. The most sensitive subnucleus interpolaris neurons had lower thresholds than the respective subnucleus caudalis neurons studied in our previous work. The thresholds and strength-duration curves of the most sensitive interpolaris neurons and of the tooth pulp-elicited jaw-opening reflex are nearly similar, although the jaw reflex can be elicited at an intensity which is slightly lower than that needed to activate the most sensitive interpolaris neurons of the present sample. The most sensitive interpolaris neurons were activated at current intensities that were below the intensity needed to produce liminal dental pain in man, and the strength-duration curves of these neurons were flatter than the curve depicting liminal dental pain sensation in man. The relationship between stimulus intensity and response magnitude could be well described by power functions, the median exponent of which was 1.251. A conditioning stimulation of the tooth pulp at low intensity produced a short (less than 25 ms) enhancement of the response to the following test stimulus, whereas a high intensity conditioning stimulus produced a longer (greater than 40 ms) suppression of the response to the following stimulus. The threshold of 33% of the neurons was elevated during a noxious tail pinch, and this elevation was not reversed by naloxone, an opioid antagonist. The results indicate that in the trigeminal subnucleus interpolaris there are tooth pulp-driven neurons with an input from intradental A-fibers and that a considerable temporal summation of impulses from primary afferent fibers is needed to activate most of them. Human dental pain thresholds cannot be explained by the liminal response properties of the most sensitive interpolaris neurons, but they may be important in the mediation of near-threshold reflex events. It is possible, however, that the high-threshold interpolaris neurons may have a role in the mediation of sensory responses.

Tooth pulp-evoked activity in the spinal trigeminal nucleus caudalis of cat: comparison to primary afferent fiber, reflex, and sensory responses

Tooth pulp-evoked single-neuron responses were recorded in the spinal trigeminal nucleus caudalis of the cat. The thresholds to monopolar electric pulses of various durations (0.2 to 20 ms) were determined using a constant current stimulator. With stimulus pulse durations of 10 to 20 ms, the thresholds were comparable with those of primary afferent A-fibers, although the most sensitive primary afferent fibers had lower thresholds. Primary afferent C-fibers had higher thresholds than the postsynaptic neurons studied. The threshold for the tooth pulp-elicited jaw-opening response was obtained at a lower stimulus intensity than the liminal response in most postsynaptic neurons of this study. The threshold rise of the postsynaptic trigeminal neurons with decreasing stimulus pulse duration (from 5 to 0.2 ms) was much steeper than that of primary afferent A-fibers or jaw-opening response. The strength-duration curves for tooth pulp-elicited pain sensations in man resemble those of spinal trigeminal neurons. Sixty-two percent of the units had a threshold elevation during a noxious pinch of the tail. The results indicate that the activation of postsynaptic trigeminal neurons requires a considerable temporal summation of primary afferent impulses. The jaw reflex thresholds cannot be explained by the properties of the neurons in the subnucleus caudalis of the trigeminal tract. The results support the concept that dental pain is based on the activation of spinal trigeminal nucleus caudalis neurons receiving their input from intradental A-fibers.

Effects of nucleus raphe magnus stimulation on jaw-opening reflex and trigeminal brain-stem neurone responses in normal and tooth pulp-deafferented cats

Since we have recently shown that tooth pulp deafferentation results in changes in the receptive field properties and activity of brain-stem neurones in the adult cat's subnucleus oralis of the trigeminal (V) spinal tract nucleus, we wished to determine if these changes are associated with alterations in the powerful inhibitory influence that the nucleus raphe magnus (NRM) normally exerts on these neurones and on the related digastric jaw-opening reflex. In control cats or in cats that had undergone mandibular or maxillary tooth pulp deafferentation 7-140 days previously, the effects of NRM conditioning stimulation were tested on jaw-opening reflex responses or oralis neuronal responses evoked by stimulation of the maxillary or mandibular tooth pulp, facial skin, or oral mucosa. No statistically significant difference was noted between control and deafferented animals (n = 32) in the incidence, threshold or time course of NRM-induced inhibition of the reflex responses. Likewise, no difference was noted between control and deafferented animals in these features of the inhibition of oralis neuronal responses. In 276 neurones tested, the high incidence (92%), low threshold (0.08-0.15 mA) and prolonged time course (approximately 400 msec) of NRM-induced inhibition of responses evoked by electrical stimulation of the tooth pulp or by low-intensity electrical or mechanical stimulation of facial skin and oral mucosa were comparable in both groups of animals. These findings indicate that the alterations in properties or oralis neurones subsequent to tooth pulp deafferentation may not be associated with changes in the modulatory influence emanating from the NRM.

Influence of changes of tooth temperature on reflex and central activity evoked by stimulation of tooth pulp afferents

The importance of the temperature of the dentine was studied in teeth prepared for electrical stimulation. During experiments with the mouth open, the temperature of teeth covered by cement was normal. The digastric EMG and the brainstem--evoked response following electrical stimulation of the tooth pulp as well as the threshold for eliciting a jaw-opening response remained constant throughout prolonged experiments. However, heat produced by the cement used to fixate the tooth electrodes could have damaged the tooth if the dentine temperature had exceeded 45 degrees C. A careful preparation of the tooth pulp by repeated application of thin layers of cement allowed an adequate preparation without damage to tooth pulp afferents.

Functional difference of tooth pulp-driven neurons in oral and facial areas of the somatosensory cortex (SI) of the cat

Single-unit discharges were recorded in the oral and facial areas of the cat somatosensory cortex (SI) while electrical stimuli were individually delivered to eight tooth pulps. The incidence of the tooth pulp-driven (TPD) neurons was 44.7% in the oral area, but only 17.3% in the facial area. Both sets of neurons were also excited by nonnoxious stimulation of the oral structures or of the facial hair, and thus were polymodal. These TPD neurons were confirmed histologically to be in area 3b and were classified into monotooth input type and multitooth input type according to their response to stimulation. Neurons of the monotooth input type appeared three times more frequently in the oral area than in the facial area. The input(s) to the TPD neurons in the former area were slightly stronger from the canine(s) than from the molar(s), but the opposite was the case in the facial area. In the oral area, 83% of the TPD neurons responded with brisk discharges of short latency, whereas 54% of the TPD neurons in the facial area responded with those of a long latency. These findings suggest that the pulpal information to the somatosensory cortex is conveyed by pathways that appear, at least at certain points in the nervous system, to be spatially separated.

Evidence for peripheral, but not central modulation of trigeminal cold receptive cells in the rat

The effects of locus coeruleus (LC), periaqueductal grey (PAG) and segmental stimulation (all of which are known to inhibit convergent nociceptive cells), were tested on the activity of cold receptive cells in the trigeminal system of the rat. LC and PAG stimulation from sites which inhibited convergent nociceptive cells had no effect on cells with cold receptive input in the trigeminal nucleus caudalis. Electrical or mechanical segmental stimulation caused suppression of activity in cold receptive trigeminal nucleus neurons. Recording from the trigeminal ganglion showed this suppression to be a property of the primary afferent cold receptors themselves and therefore it is not analogous to the proposed mechanism for the segmental inhibition of convergent nociceptive neurons.

Increase in 5-HT synthesis in the dorsal part of the spinal cord, induced by a nociceptive stimulus: blockade by morphine

The effects of a nociceptive peripheral stimulus and/or morphine upon endogenous tryptophan levels (TRP), specific activity of tryptophan (S.A. of TRP) and serotonin (5-HT) synthesis in the dorsal and ventral spinal cord, the brainstem and the forebrain were investigated in anaesthetized rats. Whereas endogenous TRP and S.A. of TRP were not found to be affected by any of the manipulations described below, 5-HT synthesis was markedly altered. The application of a prolonged and intense nociceptive electrical stimulus to the tail induced a rise in 5-HT synthesis which was dependent on the part of the CNS considered, with the dorsal cord being the most sensitive (25%), the ventral cord and the brainstem being effected to a lesser extent (14% and 16% respectively), and the forebrain not being affected significantly. By contrast, the application of a prolonged and innocuous electrical stimulus on the tail was not followed by any detectable changes in 5-HT synthesis. Morphine administration (1 mg/kg; i.v.) did not significantly alter 5-HT synthesis in the four CNS regions considered. Nevertheless, the same morphine dose did induce a highly significant (P less than 0.005) reduction in the increase in 5-HT synthesis induced by the nociceptive stimulus, both in the dorsal cord and in the brainstem. Such an effect was not seen in the ventral cord. The specificity of these morphine effects was demonstrated by their naloxone reversibility; on the other hand, naloxone alone failed to modify the stimulus-induced increase in 5-HT synthesis seen in the dorsal cord and the brainstem. The results, particularly those concerning the dorsal cord, are discussed with reference to pain mechanisms and morphine analgesia. They suggest that peripheral nociceptive messages induce an increased activity in some bulbo-spinal 5-HT pathways and that a low dose of morphine can counteract such an effect. It is proposed that exogenous opiates exert a complex regulation of bulbo-spinal 5-HT pathways. Functional significances of these processes are discussed.

Projections from brain stem nuclei to the spinal trigeminal nucleus in the cat

Afferent projections to the trigeminal nucleus oralis and caudalis from the brain stem have been investigated by the use of retrograde transport of horseradish peroxidase in the cat. Both n. oralis and n. caudalis receive a projection from nucleus raphe magnus but not from other raphe nuclei in the medulla or pons. N. oralis and n. caudalis receive a bilateral projection from n. paragigantocellularis lateralis. N. oralis receives a projection from n. reticularis gigantocellularis and n. reticularis parvocellularis but not from n. reticularis magnocellularis. N. caudalis receives only sparse projections from n. reticularis gigantocellularis, n. reticularis parvocellularis and n. reticularis magnocellularis but receives an input from a layer of cells over the pyramids in the rostral medulla, here named n. paramagnocellularis ventralis. The study also revealed the presence of ascending and descending interconnections between n. oralis and n. caudalis, as well as contralateral trigeminal interconnections. Projections from the medial vestibular nuclei, n. praepositus hypoglossi and the facial nucleus to the spinal trigeminal nucleus were also noted. Since the spinal trigeminal nucleus has only sensory functions, the results indicate the source of projections, mainly from raphe and reticular nuclei, which are involved in sensory control in the trigeminal system.

The location of brainstem neurons which project bilaterally to the spinal trigeminal nuclei as demonstrated by the double fluorescent retrograde tracer technique

Cells with possible dual projections to both spinal trigeminal nuclei were identified in the rat brainstem following separate injections of different retrogradely transported markers into the right and left spinal trigeminal nucleus. The greatest number of double-labeled cells was located in the nucleus reticularis gigantocellularis. Several double-marked cells were also observed in the nucleus raphe magnus, the nucleus paragigantocellularis and the periaqueductal gray. These results suggest that some cells in the above brainstem nuclei may have a bilateral modulating effect on the spinal trigeminal nuclei.

Ischemic pain nonsegmentally produces a predominant reduction of pain and thermal sensitivity in man: a selective role for endogenous opioids

Ischemic pain was produced by a blood pressure cuff placed to the arm of healthy human subjects for 15 min which produced a mean pain score of 59% (visual analogue scale). Ischemia induced a significant dental pain threshold elevation (mean 67%) and 2 mg of naloxone did not reduce it. Thermal sensitivity of the upper lip had a tendency to reduction during ischemia and 2 mg of naloxone reduced this effect. Tactile thresholds in the forehead or in the contralateral arm were not markedly elevated. Neither ACTH nor prolactin level in the plasma was related to the dental pain threshold elevation during ischemia. The findings of the present study suggest that ischemic pain nonsegmentally produces a predominant inhibition of responses to thin afferents. Endogenous opioids may markedly contribute to the reduction of thermal sensitivity induced by ischemia, but their contribution to dental pain threshold elevations seems to be less important. Stress or other adenohypophyseal mechanisms involving the release of ACTH or prolactin do not explain the effects of ischemia found in the present study.

The nuclei of origin of brainstem serotonergic projections to the rodent spinal trigeminal nucleus

The origins of the serotonergic projections to the spinal trigeminal nucleus in the rat were determined utilizing the combined HRP retrograde transport-immunohistochemical technique. The areas providing the greatest number of serotonergic afferent projections to the spinal trigeminal nucleus are the raphe magnus, raphe obscurus, nucleus reticularis gigantocellularis pars alpha, and the nucleus reticularis paragigantocellularis. A smaller serotonergic input to the spinal trigeminal nucleus was found to arise from the raphe pallidus, periaqueductal gray, raphe dorsalis, raphe pontis and mesencephalic reticular formation. These results indicate that the spinal trigeminal nucleus receives serotonergic input from all levels of the brainstem including the midbrain cell group B7.

Dental analgesia produced by non-painful low-frequency stimulation is not influenced by stress or reversed by naloxone

The dental pain threshold elevation produced by non-painful, low-frequency transcutaneous electrical nerve stimulation (TENS) in healthy humans was not reduced by the administration of 0.8 mg of naloxone i.v. Neither ACTH, prolactin nor growth hormone (GH) release were related to the pain threshold elevations. The present study indicates that the dental pain threshold elevation during non-painful, low-frequency TENS is not based on the same opioid-dependent mechanisms as the dental pain threshold elevation during acupuncture or the clinical analgesia during low-frequency TENS. Stress or other adenohypophyseal mechanisms involving ACTH, prolactin or GH do not explain the analgesia induced by non-painful, low-frequency TENS.

Chronic peripheral nerve section diminishes the primary afferent A-fibre mediated inhibition of rat dorsal horn neurones

The inhibitory effect of A-primary afferent activity on A- and C-evoked activity in dorsal horn convergent neurones has been investigated in the decerebrate spinal rat. A-afferent conditioning stimuli produce a powerful inhibition of the C-evoked activity in the majority of units recorded in lamina 5 but were almost without effect on the C-evoked activity in units recorded within the substantia gelatinosa (laminae 1 and 2). The ability of an A-volley to inhibit the response to a C-volley begins immediately after the arrival of the A-volley and lasts for 50-70 ms. Conditioning A-stimuli also inhibit the A-evoked activity of dorsal horn neurones, the inhibition lasting up to 125 ms. Unlike the effect of A-conditioning stimuli on C-responses, which was restricted to units in lamina 5, the A-volleys inhibited the response of both substantia gelatinosa and lamina 5 units. In rats with chronically sectioned sciatic nerves (7-14 days) both A on A and A on C inhibitions were significantly diminished in spite of intact afferent volleys and postsynaptic activity. In neurones activated by stimulation of the sectioned nerve, the A-conditioning stimuli either failed to produce an inhibition or produced a weak and shorter effect. These results are discussed in terms of the possible functional significance of A-afferent mediated inhibition.