The influence of raphe lesions on the effect of morphine on nociception and cortical ACh output

Supraspinal metabolic activity changes in the rat during adjuvant monoarthritis

Pain is a multi-dimensional experience including sensory-discriminative and affective-motivational components. The attribution of such components to a corresponding cerebral neuronal substrate in the brain refers to conclusions drawn from electrical brain stimulation, lesion studies, topographic mappings and metabolic imaging. Increases in neuronal metabolic activity in supraspinal brain regions, suggested to be involved in the central processing of pain, have previously been shown in various animal studies. The present investigation is the first to describe supraspinal structures which show increased metabolic activity during ongoing monoarthritic pain at multiple time-points. Experimental chronic monoarthritis of a hindlimb induced by complete Freund's adjuvant is one of the most used models in studies of neuronal plasticity associated with chronic pain. Such animals show typical symptoms of hyperalgesia and allodynia for a prolonged period. Metabolic activity changes in supraspinal brain regions during monoarthritis were assessed using the quantitative [14C]-2deoxyglucose technique at two, four, 14 days of the disease and, furthermore, in a group of 14-day monoarthritic rats which were mechanically stimulated by repeated extensions of the inflamed joint. Local glucose utilization was determined ipsi- and contralateral to the arthritic hindpaw in more than 50 brain regions at various supraspinal levels, and compared with saline-injected controls. At two and 14 days of monoarthritis significant bilateral increases in glucose utilization were seen in many brain structures, including brainstem, thalamic, limbic and cortical regions. Within the brainstem, animals with 14-day monoarthritis showed a higher number of regions with increased metabolic activity compared with two days. No differences between ipsi- and contralateral sides were detected in any of the experimental groups. Average increases ranged from 20 to 40% compared with controls and maximum values were detected in specific brain regions, such as the anterior pretectal nucleus, the anterior cingulate cortex and the nucleus accumbens. Interestingly, at four days of monoarthritis, the glucose utilization values were in the control range in almost all regions studied. Moreover, in monoarthritic rats receiving an additional noxious mechanical stimulation, the rates of glucose utilization were also comparable to controls in all brain areas investigated. Such patterns of brain metabolic activity agreed with concomitant changes in the lumbar spinal cord, described in the accompanying report. The present data show that a large array of supraspinal structures displays elevated metabolic activity during painful monoarthritis, with a non-linear profile for the time-points investigated. This observation most probably reflects mechanisms of transmission and modulation of nociceptive input arising from the monoarthritis and accompanying its development.

The dorsal raphe: an important nucleus in pain modulation

The dorsal raphe nucleus (DRN) is an important nucleus in pain modulation. It has abundant 5-HT neurons and many other neurotransmitter and/or neuromodulator containing neurons. Its vast fiber connections to other parts of the central nervous system provide a morphological basis for its pain modulating function. Its descending projections, via the nucleus raphe magnus or directly, modulate the responses caused by noxious stimulation of the spinal dorsal horn neurons. In ascending projections, it directly modulates the responses of pain sensitive neurons in the thalamus. It can also be involved in analgesia effects induced by the arcuate nucleus of the hypothalamus. Neurophysiologic and neuropharmacologic results suggest that 5-HT neurons and ENKergic neurons in the DRN are pain inhibitory, and GABA neurons are the opposite. The studies of the intrinsic synapses between ENKergic neurons, GABAergic neurons, and 5-HT neurons within the DRN throw light on their relations in pain modulation functions, and further explain their functions in pain mediation.

Lesions to ascending noradrenergic and serotonergic pathways modify antinociception produced by intracerebroventricular administration of morphine

Ascending noradrenergic and serotonergic pathways were lesioned by injection of 6-hydroxydopamine into the dorsal bundle or 5,7-dihydroxytryptamine into the ventromedial tegmentum respectively, and the antinociceptive effect of morphine, administered by intracerebroventricular injection assessed using the tail-flick test 3-14 days later. Lesions of the dorsal bundle selectively depleted levels of noradrenaline (NA) in the forebrain and increased the antinociceptive effect of morphine early, but not later, in the time course of action. Lesions to the locus coeruleus depleted NA in the forebrain and spinal cord but had no effect on the antinociceptive action of morphine. Lesions of the ventromedial tegmentum selectively depleted 5-hydroxytryptamine (5-HT) in the forebrain and transiently reduced the action of morphine. 5,7-Dihydroxytryptamine given intraventricularly depleted 5-HT in the forebrain and spinal cord and also transiently reduced the antinociceptive effect of morphine. These results indicate that aminergic pathways, projecting to the forebrain, are involved in the suppression of the tail-flick reflex produced by injection of morphine into the lateral ventricle.

The effect of different lesions of the median raphe on morphine analgesia

The effect of different manipulations of the nucleus medianus raphe (MR) on morphine analgesia was investigated in rats using the tail-immersion test. Electrolytic lesions of this structure antagonized morphine analgesia, while injections of 5,7-dihydroxytryptamine (to destroy serotonergic neurons) or ibotenic acid (to destroy cell bodies) in the medianus raphe did not alter the effect of morphine. Injection of naloxone (0.5 and 0.1 micrograms) in the MR antagonized morphine analgesia. These results suggest the importance of this structure for morphine analgesia in this test, although the substrates within the nucleus that mediate this action are still unknown.

Studies on the separate roles of forebrain and spinal serotonin in morphine analgesia

5,7-Dihydroxytryptamine (5,7-DHT) injections in the ventromedial tegmentum (VMT) at the level of nucleus interpeduncularis or in the ventral raphe area (VR) of the medulla oblongata were used to study the separate roles of forebrain and spinal 5-HT in the antinociceptive effect of morphine in rats. 5,7-DHT injections in the VMT, which caused marked, selective depletion of forebrain 5-HT, did not modify the effect of morphine in the hot plate and tail immersion tests. Direct injection of 5,7-DHT into the nucleus raphe medianus also failed to modify the effect of morphine in the two tests used to measure nociceptive responses. The effect of morphine was significantly reduced 30 min after injection to rats depleted of spinal 5-HT by 5,7-DHT injected in the VR but the areas under the curves between vehicle and 5,7-DHT treated animals were not significantly different. The data show that the integrity of 5-HT neurons in the forebrain is not necessary for the antinociceptive effect of morphine and a substantial amount of this effect is still present in rats with marked depletion of spinal 5-HT.

Modification of alpha-adrenoceptor agonist antinociceptive activity by nisoxetine: a selective inhibitor of noradrenergic uptake

The alpha-adrenoceptor agonists, clonidine and xylazine, produced a dose-dependent antinociceptive effect in the mouse writhing assay as does morphine. Fluoxetine, a highly-specific inhibitor of serotonin uptake, enhanced the antinociceptive effect of morphine in this test but not that of clonidine or xylazine. In contrast, nisoxetine, a selective inhibitor of noradrenergic uptake, significantly potentiated the antinociceptive activity of morphine, clonidine, and xylazine. These findings strengthen the evidence for an involvement of a noradrenergic mechanism in the antinociceptive effects of alpha-adrenoceptor agonists.

Muscimol injections in the nucleus raphé dorsalis block the antinociceptive effect of morphine in rats: apparent lack of 5-hydroxytryptamine involvement in muscimol's effect

The effect of morphine (3 mg kg-1 subcutaneously) on tail flick in the tail immersion test was studied in rats which had received a muscimol (100 ng) injection either in the nucleus raphé dorsalis (DR) or medianus (MR). The levels of 5-hydroxyindoleacetic acid (5-HIAA) were measured in the hippocampus and striatum of muscimol-injected animals. Muscimol injections in the DR reduced 5-HIAA concentrations in the striatum but not in hippocampus, whereas in animals which had received muscimol in the MR a selective decrease in hippocampal 5-HIAA levels was found. Muscimol injections in the DR blocked the effect of morphine while no effect was seen in animals which had received muscimol in the MR. An injection of 5,7-dihydroxytryptamine (6 micrograms in 3 microliter) in the DR did not change the effect of morphine or muscimol. These findings indicate that muscimol-sensitive neurones in the DR, which are probably not 5-hydroxytryptaminergic, are involved in the effect of morphine on tail flick in tail immersion. The muscimol-sensitive neurones involved in this effect of morphine do not seem to exist in the MR.

Relationship of duration of analgesia to opioid pharmacokinetic variables

That physiological effects are directly related to concentration at the site of action has been validated for only a few classes of drugs. For opiates, a direct correlation is known to exist between concentration and magnitude of analgesia, but has not been shown for duration of analgesia. These experiments in rats, using opiates whose elimination half-lives differ by a factor of 2 1/2, in a range of doses that produce 10-90% of maximal analgesic effect, show that duration is not dependent on dose or rate of elimination of opiate analgesics. The data suggest that analgesic duration is not determined by the pharmacokinetics of opiates at the receptors where these drugs act to elicit analgesia.

Serotonin receptor antagonists induce hyperalgesia without preventing morphine antinociception

5-Hydroxytryptamine (5-HT) receptor blockade by administration of mianserin (1 mg/kg) or metergoline (0.25 mg/kg) shortened the response latencies of rats in the hot-plate (hind-paw lick response) and tail-flick tests, but did not consistently attenuate the antinociceptive effect of morphine (1.25--5.0 mg/kg). Injection of the opiate receptor antagonist naloxone (1 mg/kg) did not change tail-flick response latencies and did not interfere with the antinociceptive action of the 5-HT receptor agonist 5-methoxy-N,N-dimethyltryptamine (5-MeODMT). The antinociceptive effect of morphine was reduced in chronically spinal rats, although significant increases in tail-flick latencies were observed after 2.5 and 5.0 mg/kg. Concomitant administration of 5-MeODMT failed to restore the effect of morphine in spinal rats. In the hot-plate test, morphine did not reliably prolong latencies to forepaw lick, indicating that this response is not a useful measure of pain sensitivity. The results suggest that different mechanisms underlie the analgesia induced by systemic administration of morphine and 5-HT mediated tonic inhibition of nociception.

Attenuation of morphine-induced analgesia by p-chlorophenylalanine and p-chloroamphetamine: test-dependent effects and evidence for brainstem 5-hydroxytryptamine involvement

A number of studies on the role of 5-HT in morphine analgesia and regulation of nociception are reviewed. Highly divergent conclusions are found in the literature with regard to the importance of serotonergic structures. Several methodological differences, particularly with regard to lesion and depletion techniques and testing procedures, may account for the controversies in the literature. The experimental findings presented demonstrate attenuation of morphine-induced analgesia in the hot-plate and tail-flick tests, and increased responsiveness to noxious electrical shock following depletion of 5-HT in ascending and descending 5-HT pathways by PCPA (200 + 100 + 100 mg/kg on 3 consecutive days prior to testing) as well as following destruction of cerebral 5-HT terminals by PCA (2 X 10 mg/kg, 7 and 8 days before testing). This was also the case when the neurotoxic effect of PCA was largely restricted to the brainstem by pretreatment with the 5-HT reuptake inhibitor zimelidine (20 mg/kg prior to each PCA injection). Attenuation of morphine analgesia was not found in the flinch-jump test or in the hot-plate test when conducted immediately after flinch-jump testing. It is concluded that brainstem 5-HT connections may contribute to the analgetic effect of morphine, but only under certain test conditions.

Naloxone fails to block substance P-induced excitation of spinal nociceptive units

In chloralose-anaesthetized cats the iontophoretic application of substance P produced an excitation of dorsal horn nociceptive units, as found in earlier studies. Naloxone (0.1-0.2 mg/kg, IV) failed to abolish this response to substance P in any of the 9 cats studied. In 4 additional cats nociceptive units were tested with morphine (1.0-3.2 mg/kg, IV) and substance P in case the antinociceptive effect of descending pathways is mediated via an excitatory action, but in each case morphine and substance P produced opposite effects (depression and excitation, respectively), suggesting that this was not the case. The present results fail to support a naloxone-antagonizable inhibitory effect of substance P in the spinal cord.

Effect of morphine on circling behaviour in rats with 6-hydroxydopamine striatal lesions and electrolesions of the raphe nucleus

Morphine antagonized d-amphetamine circling in rats which had received unilateral 6-OHDA lesions of the striatum but failed to reduce the circling in rats with both a unilateral 6-OHDA striatal lesion and a raphe (5-HT) lesion. Naloxone precipitated withdrawal of morphine tolerant rats greatly enhanced d-amphetamine circling when the rats had a 6-OHDA lesion but not when both 6-OHDA and raphe lesions were present. It is concluded that 5-HT is necessary for the morphine-induced inhibition of the circling. The effect of morphine tolerance and naloxone precipitated withdrawal on brain 5-HT function was investigated using a putative 5-HT rotation model in which both a dopamine and a 5-HT agonist were administered to rats with an asymmetrical medial raphe lesion. The findings suggest that chronic treatment with morphine increases striatal 5-HT function.

Effect of hydroxydopamine on the morphine-induced reduction in brain acetylcholine turnover

Morphine reduced brain acetylcholine turnover in normal and 6-hydroxydopamine-pretreated rats and mice. Morphine probably has a direct effect on cholinergic neurons rather than modifying acetylcholine indirectly through catecholamine neurons. Acetylcholine is not directly involved in morphine's antinociceptive action in the mouse but it could be implicated in the rat.

Changes in brain and spinal tryptophan and 5-hydroxyindoleacetic acid levels following acute morphine administration in normal and arthritic rats

The effects of morphine (10 mg/kg/s.c.) on tryptophan (TRP), 5-hydroxytryptamine (5-HT) and 5-hydroxyindoleacetic acid (5-HIAA) levels were studied in normal and arthritic rats. (1) In normal rats morphine induced a discrete but significant increase of 5-HIAA levels in the forebrain and the spinal cord. (2) By contrast, in rats suffering from experimentally induced arthritis large modifications were apparent. The basal levels of TRP, 5-HT and 5-HIAA were significantly higher than in normal rats. Morphine induced clear increases of 5-HIAA and TRP in the forebrain, the brain stem and the spinal cord, without any modification of 5-HT. The effects were dose-dependent and suppressed by naloxone (1 mg/kg/i.m.). Statistical analysis clearly revealed that arthritic rats were much more sensitive to morphine. The results support the hypothesis of an activation of a 5-HT descending pathway by morphine which parallels the activation of the ascending pathway previously demonstrated by several authors and confirmed here.

Effects of narcotic analgesics on the uptake and release of 5-hydroxytryptamine in rat synaptosomal preparations

1 The effects of various narcotic analgesics on the uptake and release of labelled 5-hydroxytryptamine (5-HT) in brain and spinal cord synaptosomes were investigated.2 Methadone was most active in inhibiting 5-HT uptake (IC(50) 2.5 x 10(-7) M). Levorphanol also inhibited 5-HT uptake to a large extent (IC(50) 8.8 x 10(-7) M) while dextrophan, pethidine and pentazocine showed much less activity. Etorphine and morphine had virtually no such activity, with IC(50)S higher than 10(-4) and 10(-3) M respectively.3 The same order of potency as ;5-HT releasers' was found when radioactivity was measured in [(3)H]-5-HT preloaded synaptosomal pellets incubated for 20 min with the various narcotics. Methadone, like chlorimipramine, showed a significant effect at a concentration of 10(-7) M while morphine, at a concentration of 10(-4) M, had no effect.4 When 5-HT release was studied by a perfusion technique, which largely prevents reuptake of the released amine, only fenfluramine, an anorectic agent proposed as a 5-HT releaser, significantly increased spontaneous 5-HT release. These data suggest that the apparent 5-HT release induced by various narcotics in traditional incubation techniques may largely depend on their ability to interfere with neurotransmitter reuptake mechanisms.5 The effects of the various narcotics on 5-HT uptake have no relationship to their relative potency as analgesics in the rat. In the light of their poor effectiveness as 5-HT releasers, it can be concluded that mechanisms other than 5-HT uptake inhibition and release are probably involved in the analgesic effects of these compounds in intact animals.

Serotonergic reduction of dorsal central gray area stimulation-produced aversion

Stimulating electrodes were implanted into the dorsal central gray area (DCG) of rats. The animals were trained to bar press to decrement the aversive DCG stimulation current. Rats treated with 5-hydroxytryptophan (5-HTP), 75 mg/kg or 150 mg/kg, showed a dose-dependent reduction in decremental bar pressing. In a second study, animals received either chlorimipramine, 15 mg/kg, protriptyline, 15 mg/kg, or 5-HTP, 150 mg/kg. Chlorimipramine, a strong blocker of serotonin reuptake, and 5-HTP produced significant reductions in decremental bar pressing. Protriptyline, a weak serotonin reuptake blocker, produced no significant effect. These results suggest that serotonin reduces aversive neural mechanisms associated with the dorsal central gray area.

Serotonin-containing neurons: their possible role in pain and analgesia

Experimental evidence is reviewed showing that brain and spinal cord serotonergic neurons are involved in nociceptive responses, as well as in the analgesic effects of opiate narcotics. This evidence, based on studies employing pharmacological, surgical, electrophysiological, and dietary manipulations of central nervous system serotonergic neurotransmission, suggests that increases in the activity of brain and spinal cord serotonin neurons are associated with analgesia and enhanced antinociceptive drug potency, whereas decreases in the activities of these neurons correlate with hyperalgesia and diminished analgesic drug potency.

Attenuation of morphine analgesia in rats with lesions of the locus coeruleus and dorsal raphe nucleus

The nociceptive reflex activity and analgesic effect of morphine were studied in rats using the hind paw stimulation test. The stimulation threshold was significantly increased in animals with bilateral destruction of the locus coeruleus (LC), and was reduced after lesion of the dorsal raphe nucleus (DR). LC lesions produced a selective lowering of noradrenaline (NA) content in the forebrain, while DR lesions resulted in a reduction in serotonin levels. Lesioning both LC and DR significantly reduced both NA and serotonin contents even when the stimulation threshold was not altered. Morphine produced a significant and dose-dependent elevation of the stimulation threshold in sham-operated animals, while morphine analgesia was almost completely inhibited by destruction of LC, DR and both the nuclei. These results imply that a depression of LC-mediated noradrenergic tone results in a decreased sensitivity to painful stimuli, whereas a reduction of raphe-derived serotonergic tone produces the opposite effect against LC. It is suggested, however, that both of these monoamines from the LC and DR are necessary for the analgesic effect of morphine.

Studies on the antagonism by raphe lesions of the antinociceptive action of systemic morphine

In rats, lesions were placed in the dorsal/median raphe (DMR), in the ventral raphe (VR: raphe magnus), in both the dorsal/median and ventral raphe (DMVR) or in the reticular formation (RF). The effect of the lesions on the antinociception and catalepsy produced by 3 doses of morphine (3, 10 and 30 mg/kg) was examined. The lesions had no significant effect on the catalepsy produced by any of the doses of morphine tested. DMR lesions produced a partial attentuation of the antinociceptive action of both the 3 and 10 mg doses. VR lesions produced a complete blockade of the 3 mg and only a partial attenuation of the 10 mg dose. In contrast, the combined (DMVR) lesions yielded virtually a total blockade of the 3 and 10 mg. Yet, as with the DMR and VR groups, the DMVR lesions failed to produce a significant antagonism on either of the nociceptive tests at the 30 mg dose. These findings suggest that the ascending and descending fiber systems emanating from the dorsal/median and ventral raphe, respectively, facilitate the expression of morphine-induced analgesia but that neither system alone can be regarded as essential for the manifestation of the antinociceptive effects of systematically administered morphine.

Acute effects of morphine on regional brain levels of acetylcholine in mice and rats

Morphine increased levels of acetylcholine in mouse striatum in a dose-dependent manner, the increase occurring at the lowest dose previously found to produce analgesia and coinciding with the time of peak analgesic effect. Naloxone blocked this increase. After repeated injections of high doses of morphine, no effect was seen. The hippocampus was the only other brain region showing an effect, and this after a high dose. In the rat, morphine (30 and 90 mg/kg) increased striatal acetylcholine levels. At these and lower doses (2.5 mg/kg and 10 mg/kg) the ratios in the striatum of levels of acetylcholine to levels of dopamine were significantly increased. Only at the highest dose did morphine increase the levels of dopamine in the striatum and of acetylcholine in the hippocampus. Morphine did not change the levels of dopamine in the striatum and of acetylcholine in the hippocampus. Morphine did not change the levels of norepinephrine in either the hypothalamus or cortex of the rat.

Morphine-naloxone interaction in the central cholinergic system: the influence of subcortical lesioning and electrical stimulation

1 The opiate antagonist naloxone, injected or topically applied to the cerebral cortex, had no significant effect on the spontaneous output of cortical acetylcholine (ACh) in rats. 2 Morphine (2.5 mg/kg) administered intravenously inhibited the release of cortical ACh. A subsequent injection of naloxone rapidly reversed morphine-induced inhibition, and produced a sustained increase in the release of ACh. Topical application of naloxone solutions, after morphine, produced a slow and weak reversal of its inhibitory action. 3 Destruction of the medial thalamus abolished both the inhibitory effects of morphine on the cortical ACh release, and its antagonism by naloxone administered after the agonist. 4 Injection of naloxone in a low dose (0.1 mg/kg) increased the release of cortical ACh provoked by electrical stimulation of either the medial thalamus or the reticular formation in normal rats. In the morphine-dependent rat, naloxone also facilitated the evoked release and its action was greater than in control animals. The facilitatory effect of naloxone on the cortical release evoked by stimulation of the medial thalamus was greater than its effect on the release evoked by stimulation of the reticular formation in both normal and morphine-dependent rats. 5 Naltrexone, a narcotic antagonist, also facilitated the electrically stimulated release of cortical ACh. 6 It is suggested that (a) morphine and naloxone act at a subcortical site, probably the medial thalamus, to modify the cortical ACh release and that (b) naloxone may facilitate the electrically-induced release of ACh in the CNS by antagonizing the effect of the endogenous morphine-like factor, enkephalin.