Putative nociceptive modulatory neurons in the dorsolateral pontomesencephalic reticular formation

Dual and Opposing Functions of the Central Amygdala in the Modulation of Pain

Pain perception is essential for survival and can be amplified or suppressed by expectations, experiences, and context. The neural mechanisms underlying bidirectional modulation of pain remain largely unknown. Here, we demonstrate that the central nucleus of the amygdala (CeA) functions as a pain rheostat, decreasing or increasing pain-related behaviors in mice. This dual and opposing function of the CeA is encoded by opposing changes in the excitability of two distinct subpopulations of GABAergic neurons that receive excitatory inputs from the parabrachial nucleus (PB). Thus, cells expressing protein kinase C-delta (CeA-PKCδ) are sensitized by nerve injury and increase pain-related responses. In contrast, cells expressing somatostatin (CeA-Som) are inhibited by nerve injury and their activity drives antinociception. Together, these results demonstrate that the CeA can amplify or suppress pain in a cell-type-specific manner, uncovering a previously unknown mechanism underlying bidirectional control of pain in the brain.

The brain can bidirectionally influence behavioral responses to painful stimuli. Wilson et al identify a cellular mechanism underlying a pain rheostat system within the forebrain, with activation of CeA-Som neurons attenuating pain-related responses and increases in the activity of CeA-PKCδ neurons promoting amplification of pain-related behaviors following injury.

Brainstem neuroimaging of nociception and pain circuitries

The brainstem is known to be an important brain area for nociception and pain processing, and both relaying and coordinating signaling between the cerebrum, cerebellum, and spinal cord. Although preclinical models of pain have characterized the many roles that brainstem nuclei play in nociceptive processing, the degree to which these circuitries extend to humans is not as well known. Unfortunately, the brainstem is also a very challenging region to evaluate in humans with neuroimaging. The challenges for human brainstem imaging arise from the location of this elongated brain structure, proximity to cardiorespiratory noise sources, and the size of its constituent nuclei. These challenges can require dedicated approaches to brainstem imaging, which should be adopted when study hypotheses are focused on brainstem processing of nociception or modulation of pain perception. In fact, our review will highlight many pain neuroimaging studies that have reported some brainstem involvement in nociceptive processing and chronic pain pathology. However, we note that with recent advances in neuroimaging leading to improved spatial and temporal resolution, more studies are needed that take advantage of data collection and analysis methods focused on the challenges of brainstem neuroimaging.

Altered Signaling in the Descending Pain-modulatory System after Short-Term Infusion of the μ-Opioid Agonist Remifentanil

μ-Opioid receptor agonists are widely used within the contemporary treatment of pain, but abrupt opioid suspension, even after short-term infusion, can paradoxically increase the sensitivity to noxious stimuli, a phenomenon that has been, for example, reported after application of the fast-acting μ-opioid receptor agonist remifentanil. To investigate the mechanisms underlying the effects of discontinuation of remifentanil application on pain processing in the human CNS, we analyzed neuronal responses to thermal stimuli before and after a short-term infusion of remifentanil (30 min 0.1 μg/kg body weight/min) compared with control in the brain, brainstem, and spinal cord in drug-naive male volunteers using fMRI. Subsequent to remifentanil suspension, we observed reduced heat pain thresholds and increased neuronal responses in pain-encoding as well as in key regions of the descending pain-modulatory system, such as the periaqueductal gray matter, the nucleus cuneiformis, and the rostral ventromedial medulla. Moreover, the spinal pain-related multivoxel activity pattern showed an opioid-specific change after drug suspension. Importantly, remifentanil suspension increased the functional coupling between the nucleus cuneiformis and the rostral anterior cingulate cortex, and the coupling strength between the rostral anterior cingulate cortex and the nucleus cuneiformis correlated negatively with the individual pain threshold after opioid suspension. These findings demonstrate that, already subsequent to a short-term infusion of the μ-opioid receptor agonist remifentanil, signaling in the descending pain-modulatory system is fundamentally altered and that these changes are directly related to the behavioral sensitivity to pain.SIGNIFICANCE STATEMENT Opioids are widely used in modern medicine, but, in addition to their known side effects, it is increasingly recognized that opioids can also increase sensitivity to pain subsequent to their use. Using the fast-acting μ-opioid receptor agonist remifentanil and fMRI in healthy male volunteers, this study demonstrates how signaling changes occur along the entire descending pain-modulatory pathway after opioid discontinuation and how these alterations are closely linked to increased behavioral pain sensitivity. Particularly by revealing modified responses in pain-modulatory brainstem regions that have been previously demonstrated to be causally involved in acute opioid withdrawal effects in rodents, the data provide a plausible neuronal mechanism by which the increased sensitivity to pain after opioid suspension is mediated in humans.

Challenges and opportunities for brainstem neuroimaging with ultrahigh field MRI

The human brainstem plays a central role in connecting the cerebrum, the cerebellum and the spinal cord to one another, hosting relay nuclei for afferent and efferent signaling, and providing source nuclei for several neuromodulatory systems that impact central nervous system function. While the investigation of the brainstem with functional or structural magnetic resonance imaging has been hampered for years due to this brain structure's physiological and anatomical characteristics, the field has seen significant advances in recent years thanks to the broader adoption of ultrahigh-field (UHF) MRI scanning. In the present review, we focus on the advantages offered by UHF in the context of brainstem imaging, as well as the challenges posed by the investigation of this complex brain structure in terms of data acquisition and analysis. We also illustrate how UHF MRI can shed new light on the neuroanatomy and neurophysiology underlying different brainstem-based circuitries, such as the central autonomic network and neurotransmitter/neuromodulator systems, discuss existing and foreseeable clinical applications to better understand diseases such as chronic pain and Parkinson's disease, and explore promising future directions for further improvements in brainstem imaging using UHF MRI techniques.

Disambiguating Pharmacodynamic Efficacy from Behavior with Neuroimaging: Implications for Analgesic Drug Development

BACKGROUND

Attrition rates of new analgesics during drug development are high; poor assay sensitivity with reliance on subjective outcome measures being a crucial factor.

METHODS

The authors assessed the utility of functional magnetic resonance imaging with capsaicin-induced central sensitization, a mechanism relevant in neuropathic pain, for obtaining mechanism-based objective outcome measures that can differentiate an effective analgesic (gabapentin) from an ineffective analgesic (ibuprofen) and both from placebo. The authors used a double-blind, randomized phase I study design (N = 24) with single oral doses.

RESULTS

Only gabapentin suppressed the secondary mechanical hyperalgesia-evoked neural response in a region of the brainstem's descending pain modulatory system (right nucleus cuneiformis) and left (contralateral) posterior insular cortex and secondary somatosensory cortex. Similarly, only gabapentin suppressed the resting-state functional connectivity during central sensitization between the thalamus and secondary somatosensory cortex, which was plasma gabapentin level dependent. A power analysis showed that with 12 data sets, when using neural activity from the left posterior insula and right nucleus cuneiformis, a statistically significant difference between placebo and gabapentin was detected with probability ≥ 0.8. When using subjective pain ratings, this reduced to less than or equal to 0.6.

CONCLUSIONS

Functional imaging with central sensitization can be used as a sensitive mechanism-based assay to guide go/no-go decisions on selecting analgesics effective in neuropathic pain in early human drug development. We also show analgesic modulation of neural activity by using resting-state functional connectivity, a less challenging paradigm that is ideally suited for patient studies because it requires no task or pain provocation.

Connectivity-based segmentation of the periaqueductal gray matter in human with brainstem optimized diffusion MRI

The periaqueductal gray matter (PAG) is a midbrain structure, involved in key homeostatic neurobiological functions, such as pain modulation and cardiorespiratory control. Animal research has identified four subdivisional columns that differ in both connectivity and function. Until now these findings have not been replicated in humans. This study used high‐resolution brainstem optimized diffusion magnetic resonance imaging and probabilistic tractography to segment the human PAG into four subdivisions, based on voxel connectivity profiles. We identified four distinct subdivisions demonstrating high spatial concordance with the columns of the animal model. The resolution of these subdivisions for individual subjects permitted detailed examination of their structural connectivity without the requirement of an a priori starting location. Interestingly patterns of forebrain connectivity appear to be different to those found in nonhuman studies, whereas midbrain and hindbrain connectivity appears to be maintained. Although there are similarities in the columnar structure of the PAG subdivisions between humans and nonhuman animals, there appears to be different patterns of cortical connectivity. This suggests that the functional organization of the PAG may be different between species, and as a consequence, functional studies in nonhumans may not be directly translatable to humans. This highlights the need for focused functional studies in humans. Hum Brain Mapp 36:3459–3471, 2015. © 2015 The Authors Human Brain Mapping Published by Wiley Periodicals, Inc.

Neuroplasticity underlying the comorbidity of pain and depression

Acute pain induces depressed mood, and chronic pain is known to cause depression. Depression, meanwhile, can also adversely affect pain behaviors ranging from symptomology to treatment response. Pain and depression independently induce long-term plasticity in the central nervous system (CNS). Comorbid conditions, however, have distinct patterns of neural activation. We performed a review of the changes in neural circuitry and molecular signaling pathways that may underlie this complex relationship between pain and depression. We also discussed some of the current and future therapies that are based on this understanding of the CNS plasticity that occurs with pain and depression.

Intrinsic connections within the pedunculopontine tegmental nucleus are critical to the elaboration of post-ictal antinociception

This study investigated the intrinsic connections of a key-structure of the endogenous pain inhibitory system, the pedunculopontine tegmental nucleus (PPTN), in post-ictal antinociceptive process through synaptic inactivation of the PPTN with cobalt chloride. Male Wistar rats (n = 6 or 7 per group), weighing 250-280 g, had the tail-flick baseline recorded and were submitted to a stereotaxic surgery for the introduction of a guide-cannula aiming at the PPTN. After 5 days of postoperative recovery, cobalt chloride (1 mM/0.2 µL) or physiological saline (0.2 µL) were microinjected into the PPTN and after 5 min, the tail-withdrawal latency was measured again at 0, 10, 20, 30, 40, 50, 60, 70, 80, 90, 100, 110, and 120 min after seizures evoked by intraperitoneal injection of pentylenetetrazole (64 mg/kg). The synaptic inactivation of PPTN decreased the post-ictal antinociceptive phenomenon, suggesting the involvement of PPTN intrinsic connections in the modulation of pain, during tonic-clonic seizures. These results showed that the PPTN may be crucially involved in the neural network that organizes the post-ictal analgesia.

Decrease of gray matter volume in the midbrain is associated with treatment response in medication-overuse headache: possible influence of orbitofrontal cortex

Patients with chronic daily headache and overuse of analgesics, triptans, or other acute headache compounds, are considered to suffer from medication-overuse headache (MOH). This implies that medication overuse is the cause of headache chronification. It remains a key question why only two-thirds of patients with chronic migraine-like headache and overuse of pain medication improve after detoxification, whereas the remainder continue to have chronic headache. In the present longitudinal MRI study, we used voxel-based morphometry to investigate gray matter changes related to medication withdrawal in a group of humans with MOH. As a main result, we found that only patients with significant clinical improvement showed a significant decrease of previously increased gray matter in the midbrain including periaqueductal gray matter and nucleus cuneiformis, whereas patients without improvement did not. Patients without treatment response had less gray matter in the orbitofrontal cortex. Another striking result is the correlation of treatment response with the amount of orbitofrontal gray matter. Thus, we demonstrate adaptive gray matter changes within the pain modulatory system in patients with MOH who responded to detoxification, probably reflecting neuronal plasticity. Decreased gray matter in the orbitofrontal cortex at baseline may be predictive of poor response to treatment.

Allodynia and descending pain modulation in migraine: a resting state functional connectivity analysis

OBJECTIVE

Most migraineurs develop cutaneous allodynia during migraines, and many have cutaneous sensitization between attacks. Atypical pain modulation via the descending pain system may contribute to this sensitization and allodynia. The objective of this study was to test the hypothesis that compared with non-allodynic migraineurs, allodynic migraineurs have atypical periaqueductal gray (PAG) and nucleus cuneiformis (NCF) resting-state functional connectivity (rs-fc) with other pain processing regions.

DESIGN

Ten minutes resting-state blood-oxygen-level-dependent data were collected from 38 adult migraineurs and 20 controls. Seed-based analyses compared whole-brain rs-fc with PAG and with NCF in migraineurs with severe ictal allodynia (N = 8) to migraineurs with no ictal allodynia (N = 8). Correlations between the strength of functional connections that differed between severely allodynic and non-allodynic migraineurs with allodynia severity were determined for all migraineurs (N = 38). PAG and NCF rs-fc in all migraineurs was compared with rs-fc in controls.

RESULTS

Migraineurs with severe allodynia had stronger PAG and NCF rs-fc to other brainstem, thalamic, insula and cerebellar regions that participate in discriminative pain processing, as well as to frontal and temporal regions implicated in higher order pain modulation. Evidence that these rs-fc differences were specific for allodynia included: 1) strong correlations between some rs-fc strengths and allodynia severity among all migraineurs; and 2) absence of overlap when comparing rs-fc differences in severely allodynic vs non-allodynic migraineurs with those in all migraineurs vs controls.

CONCLUSION

Atypical rs-fc of brainstem descending modulatory pain regions with other brainstem and higher order pain-modulating regions is associated with migraine-related allodynia.

Atypical resting-state functional connectivity of affective pain regions in chronic migraine

OBJECTIVE

Chronic migraineurs (CM) have painful intolerances to somatosensory, visual, olfactory, and auditory stimuli during and between migraine attacks. These intolerances are suggestive of atypical affective responses to potentially noxious stimuli. We hypothesized that atypical resting-state functional connectivity (rs-fc) of affective pain-processing brain regions may associate with these intolerances. This study compared rs-fc of affective pain-processing regions in CM with controls.

METHODS

Twelve minutes of resting-state blood oxygenation level-dependent data were collected from 20 interictal adult CM and 20 controls. Rs-fc between 5 affective regions (anterior cingulate cortex, right/left anterior insula, and right/left amygdala) with the rest of the brain was determined. Functional connections consistently differing between CM and controls were identified using summary analyses. Correlations between number of migraine years and the strengths of functional connections that consistently differed between CM and controls were calculated.

RESULTS

Functional connections with affective pain regions that differed in CM and controls included regions in anterior insula, amygdala, pulvinar, mediodorsal thalamus, middle temporal cortex, and periaqueductal gray. There were significant correlations between the number of years with CM and functional connectivity strength between the anterior insula with mediodorsal thalamus and anterior insula with periaqueductal gray.

CONCLUSION

CM is associated with interictal atypical rs-fc of affective pain regions with pain-facilitating and pain-inhibiting regions that participate in sensory-discriminative, cognitive, and integrative domains of the pain experience. Atypical rs-fc with affective pain regions may relate to aberrant affective pain processing and atypical affective responses to painful stimuli characteristic of CM.

Paralemniscal TIP39 is induced in rat dams and may participate in maternal functions

The paralemniscal area, situated between the pontine reticular formation and the lateral lemniscus in the pontomesencephalic tegmentum contains some tuberoinfundibular peptide of 39 residues (TIP39)-expressing neurons. In the present study, we measured a 4 times increase in the level of TIP39 mRNA in the paralemniscal area of lactating mothers as opposed to nulliparous females and mothers deprived of pups using real-time RT-PCR. In situ hybridization histochemistry and immunolabeling demonstrated that the induction of TIP39 in mothers takes place within the medial paralemniscal nucleus, a cytoarchitectonically distinct part of the paralemniscal area, and that the increase in TIP39 mRNA levels translates into elevated peptide levels in dams. The paralemniscal area has been implicated in maternal control as well as in pain perception. To establish the function of induced TIP39, we investigated the activation of TIP39 neurons in response to pup exposure as maternal, and formalin injection as noxious stimulus. Both stimuli elicited c-fos expression in the paralemniscal area. Subsequent double labeling demonstrated that 95% of neurons expressing Fos in response to pup exposure also contained TIP39 immunoreactivity and 91% of TIP39 neurons showed c-fos activation by pup exposure. In contrast, formalin-induced Fos does not co-localize with TIP39. Instead, most formalin-activated neurons are situated medial to the TIP39 cell group. Our data indicate that paralemniscal neurons may be involved in the processing of maternal and nociceptive information. However, two different groups of paralemniscal neurons participate in the two functions. In particular, TIP39 neurons may participate in the control of maternal functions.

Involvement of glutamatergic receptors in the nucleus cuneiformis in modulating morphine-induced antinociception in rats

The nucleus cuneiformis (CnF), located just ventrolateral to the periaqueductal gray, is part of the descending pain modulatory system. Neurons in the CnF project to medullary nucleus raphe magnus (NRM), which plays an important role on pain modulation. In this study, we investigated the effect of microinjection of the non-competitive NMDA receptor antagonist MK-801, the competitive NMDA receptor antagonist AP-7, and the kainate/AMPA receptor antagonist DNQX, alone or in combination with morphine into the nucleus cuneiformis on morphine-induced analgesia to understand the role of glutamatergic receptors in the modulating activity of morphine. Antinociception was assessed with the tail-flick test. Morphine (10, 20, 40 microg in 0.5 microl saline) had an antinociceptive effect, increasing tail-flick latency in a dose-dependent manner. Microinjection of MK-801 (10 microg/0.5 microl saline) and AP7 (3 microg/0.5 microl saline) prior to morphine microinjection (10 microg/0.5 microl saline) attenuated the antinociceptive effects of morphine, whereas DNQX (0.5 microg/0.5 microl saline) showed a partial antinociceptive effect and potentiated the analgesic effect of morphine. These results indicated that the NMDA receptor partially potentiates the antinociceptive effect of morphine. Our results suggest that NMDA but not non-NMDA receptors are involved in the antinociception produced by morphine in the CnF. The non-NMDA receptors in this area may have a facilitatory effect on nociceptive transmission. The fact that morphine's effect was potentiated by NMDA receptor suggests that projection neurons within the CnF are under tonic, glutamatergic input and when the influence of this input is blocked, the descending inhibitory system is inactivated.

Neural correlates of an injury-free model of central sensitization induced by opioid withdrawal in humans

Preclinical evidence suggests that opioid withdrawal induces central sensitization (CS) that is maintained by supraspinal contributions from the descending pain modulatory system (DPMS). Here, in healthy human subjects we use functional magnetic resonance imaging to study the supraspinal activity during the withdrawal period of the opioid remifentanil. We used a crossover design and thermal stimuli on uninjured skin to demonstrate opioid withdrawal-induced hyperalgesia (OIH) without a CS-inducing peripheral stimulus. Saline was used in the control arm to account for effects of time. OIH in this injury-free model was observed in a subset of the healthy subjects (responders). Only in these subjects did opioid infusion and withdrawal induce a rise in activity in the mesencephalic-pontine reticular formation (MPRF), an area of the DPMS that has been previously shown to be involved in states of CS in humans, which became significant during the withdrawal phase compared with nonresponders. Paradoxically, this opioid withdrawal-induced rise in MPRF activity shows a significant negative correlation with the behavioral OIH score indicating a predominant inhibitory role of the MPRF in the responders. These data illustrate that in susceptible individuals central mechanisms appear to regulate the expression of OIH in humans in the absence of tissue injury, which might have relevance for functional pain syndromes where a peripheral origin for the pain is difficult to identify.

Quantitative meta-analysis identifies brain regions activated during rectal distension in irritable bowel syndrome

BACKGROUND AND AIMS

The responsiveness of the central nervous system is altered in patients with irritable bowel syndrome (IBS). However, because of variations in experimental paradigms, analytic techniques, and reporting practices, little consensus exists on brain responses to visceral stimulation. We aimed to identify brain regions consistently activated by supraliminal rectal stimulation in IBS patients and healthy subjects (controls) by performing a quantitative meta-analysis of published studies.

METHODS

Significant foci from within-group statistical parametric maps were extracted from published neuroimaging studies that employed rectal distension. Voxel-based activation likelihood estimation was applied, pooling the results and comparing them across groups.

RESULTS

Across studies, there was consistent activation in regions associated with visceral afferent processing (ie, thalamus, insula, anterior midcingulate) among IBS patients and controls, but considerable differences in the extent and specific location of foci. IBS patients differed from controls in that there were more consistent activations in regions associated with emotional arousal (pregenual anterior cingulate cortex, amygdala) and activation of a midbrain cluster, a region playing a role in endogenous pain modulation. Controls showed more consistent activation of the medial and lateral prefrontal cortex.

CONCLUSIONS

Patients with IBS have greater engagement of regions associated with emotional arousal and endogenous pain modulation, but similar activation of regions involved in processing of visceral afferent information. Controls have greater engagement of cognitive modulatory regions. These results support a role for central nervous system dysregulation in IBS. These findings provide specific targets for guiding development of future neuroimaging protocols to more clearly define altered brain-gut interactions in IBS.

The TIP39-PTH2 receptor system: unique peptidergic cell groups in the brainstem and their interactions with central regulatory mechanisms

Tuberoinfundibular peptide of 39 residues (TIP39) is the recently purified endogenous ligand of the previously orphan G-protein coupled parathyroid hormone 2 receptor (PTH2R). The TIP39-PTH2R system is a unique neuropeptide-receptor system whose localization and functions in the central nervous system are different from any other neuropeptides. TIP39 is expressed in two brain regions, the subparafascicular area in the posterior thalamus, and the medial paralemniscal nucleus in the lateral pons. Subparafascicular TIP39 neurons seem to divide into a medial and a lateral cell population in the periventricular gray of the thalamus, and in the posterior intralaminar complex of the thalamus, respectively. Periventricular thalamic TIP39 neurons project mostly to limbic brain regions, the posterior intralaminar thalamic TIP39 neurons to neuroendocrine brain areas, and the medial paralemniscal TIP39 neurons to auditory and other brainstem regions, and the spinal cord. The widely distributed axon terminals of TIP39 neurons have a similar distribution as the PTH2R-containing neurons, and their fibers, providing the anatomical basis of a neuromodulatory action of TIP39. Initial functional studies implicated the TIP39-PTH2R system in nociceptive information processing in the spinal cord, in the regulation of different hypophysiotropic neurons in the hypothalamus, and in the modulation of affective behaviors. Recently developed novel experimental tools including mice with targeted mutations of the TIP39-PTH2R system and specific antagonists of the PTH2R will further facilitate the identification of the specific roles of TIP39 and the PTH2R.

Time-varied characteristics of acupuncture effects in fMRI studies

When studying the neural responses to acupuncture with a block-designed paradigm, its temporal dynamics predicted by the general linear model (GLM) conforms to typical "on-off" variations during a limited period of the experiment manipulation. Despite a lack of direct evidence associating its psychophysiological response, numerous clinical reports suggest that acupuncture can provide pain relief beyond a needling session. Therefore, a typical GLM analysis may be insensitive or inappropriate for identifying altered neural responses resulting from acupuncture. We developed a new approach to investigate the dynamics underlying sustained effects of acupuncture. Specifically, we designed two separate models to evaluate the baseline activities (prior to stimulation) and neural activities in sequential epochs, using three block-designed functional runs: acupuncture at acupoint ST36, nonmeridian point (NMP) stimulation, and a visual task. We found that the activity patterns during rest were associated with the stimulus types and that the resting activities might be even higher than that of stimulation phases. Such effects of the elevated activity during rest may reduce or eliminate the activity during stimulus conditions or even reverse the sign of brain activation using conventional GLM analysis. Moreover, such sustained responses, followed by acupuncture at ST36 and NMP, exhibited distinct patterns in wide brain structures, particularly in the limbic system and brainstem. These findings may pose great implications for the design and interpretation of a range of acupuncture neuroimaging studies.

Interictal dysfunction of a brainstem descending modulatory center in migraine patients

Background

The brainstem contains descending circuitry that can modulate nociceptive processing (neural signals associated with pain) in the dorsal horn of the spinal cord and the medullary dorsal horn. In migraineurs, abnormal brainstem function during attacks suggest that dysfunction of descending modulation may facilitate migraine attacks, either by reducing descending inhibition or increasing facilitation. To determine whether a brainstem dysfunction could play a role in facilitating migraine attacks, we measured brainstem function in migraineurs when they were not having an attack (i.e. the interictal phase).

Methods and Findings

Using fMRI (functional magnetic resonance imaging), we mapped brainstem activity to heat stimuli in 12 episodic migraine patients during the interictal phase. Separate scans were collected to measure responses to 41°C and noxious heat (pain threshold+1°C). Stimuli were either applied to the forehead on the affected side (as reported during an attack) or the dorsum of the hand. This was repeated in 12 age-gender-matched control subjects, and the side tested corresponded to that in the matched migraine patients. Nucleus cuneiformis (NCF), a component of brainstem pain modulatory circuits, appears to be hypofunctional in migraineurs. 3 out of the 4 thermal stimulus conditions showed significantly greater NCF activation in control subjects than the migraine patients.

Conclusions

Altered descending modulation has been postulated to contribute to migraine, leading to loss of inhibition or enhanced facilitation resulting in hyperexcitability of trigeminovascular neurons. NCF function could potentially serve as a diagnostic measure in migraine patients, even when not experiencing an attack. This has important implications for the evaluation of therapies for migraine.

The medial paralemniscal nucleus and its afferent neuronal connections in rat

Previously, we described a cell group expressing tuberoinfundibular peptide of 39 residues (TIP39) in the lateral pontomesencephalic tegmentum, and referred to it as the medial paralemniscal nucleus (MPL). To identify this nucleus further in rat, we have now characterized the MPL cytoarchitectonically on coronal, sagittal, and horizontal serial sections. Neurons in the MPL have a columnar arrangement distinct from adjacent areas. The MPL is bordered by the intermediate nucleus of the lateral lemniscus nucleus laterally, the oral pontine reticular formation medially, and the rubrospinal tract ventrally, whereas the A7 noradrenergic cell group is located immediately mediocaudal to the MPL. TIP39-immunoreactive neurons are distributed throughout the cytoarchitectonically defined MPL and constitute 75% of its neurons as assessed by double labeling of TIP39 with a fluorescent Nissl dye or NeuN. Furthermore, we investigated the neuronal inputs to the MPL by using the retrograde tracer cholera toxin B subunit. The MPL has afferent neuronal connections distinct from adjacent brain regions including major inputs from the auditory cortex, medial part of the medial geniculate body, superior colliculus, external and dorsal cortices of the inferior colliculus, periolivary area, lateral preoptic area, hypothalamic ventromedial nucleus, lateral and dorsal hypothalamic areas, subparafascicular and posterior intralaminar thalamic nuclei, periaqueductal gray, and cuneiform nucleus. In addition, injection of the anterograde tracer biotinylated dextran amine into the auditory cortex and the hypothalamic ventromedial nucleus confirmed projections from these areas to the distinct MPL. The afferent neuronal connections of the MPL suggest its involvement in auditory and reproductive functions.

Isolating the modulatory effect of expectation on pain transmission: a functional magnetic resonance imaging study

We use a novel balanced experimental design to specifically investigate brain mechanisms underlying the modulating effect of expected pain intensity on afferent nociceptive processing and pain perception. We used two visual cues, each conditioned to one of two noxious thermal stimuli [ approximately 48 degrees C (high) or 47 degrees C (low)]. The visual cues were presented just before and during application of the noxious thermal stimulus. Subjects reported significantly higher pain when the noxious stimulus was preceded by the high-intensity visual cue. To control for expectancy effects, for one-half of the runs, the noxious thermal stimuli were accompanied by the cue conditioned to the other stimulus. Comparing functional magnetic resonance imaging blood oxygenation level-dependent activations produced by the high and low thermal stimulus intensities presented with the high-intensity visual cue showed significant activations in nociceptive regions of the thalamus, second somatosensory cortex, and insular cortex. To isolate the effect of expectancy, we compared activations produced by the two visual cues presented with the high-intensity noxious thermal stimulus; this showed significant differences in the ipsilateral caudal anterior cingulate cortex, the head of the caudate, cerebellum, and the contralateral nucleus cuneiformis (nCF). We propose that pain intensity expectancy modulates activations produced by noxious stimuli through a distinct modulatory network that converges with afferent nociceptive input in the nCF.

Nocifensive reflex-related on- and off-cells in the pedunculopontine tegmental nucleus, cuneiform nucleus, and lateral dorsal tegmental nucleus

Cholinergic projections from the pedunculopontine tegmental nucleus (PPTg) to the rostral ventromedial medulla (RVM) have been implicated in nociceptive modulation. The goal of this study was to identify neurons with nocifensive reflex-related activity in the mesopontine tegmentum including the PPTg. This study used the same behavioral neurophysiological classification system to identify neurons as has been extensively described in the RVM. Extracellular microelectrode recording was conducted in lightly anesthetized rats. Changes in firing associated with the noxious heat-evoked tail flick reflex were used to classify neurons as "on-cells" (displayed a burst in neuronal activity associated with the reflex), "off-cells" (displayed a pause in activity), and neutral cells (showed no response). Of 188 neurons studied in 23 rats, 77 were classified as on-cells, 14 as off-cells, the remainder as neutral cells. Recordings during periods without noxious stimulation found that some of the on- and off-cells displayed spontaneous transitions between active and silent periods termed cell cycling. The distribution of on- and off-cells in the mesopontine tegmentum overlapped and included the cholinergic PPTg and lateral dorsal tegmental nucleus identified by NADPH diaphorase staining, as well as the cuneiform nucleus and periaqueductal gray. The mesopontine tegmentum thus contains nocifensive reflex-related neurons with neurophysiological characteristics similar to those reported in the RVM. Neurons showing reflex-related activity were frequently encountered in the cholinergic PPTg and LDTg. Further studies will be required to determine whether these neurons modulate nociception through a link to the RVM.

A comparison of visceral and somatic pain processing in the human brainstem using functional magnetic resonance imaging

Evidence from both human and animal studies has demonstrated a key role for brainstem centers in the control of ascending nociceptive input. Nuclei such as the rostral ventromedial medulla and periaqueductal gray (PAG) are able to both inhibit and facilitate the nociceptive response. It has been proposed that altered descending modulation may underlie many of the chronic pain syndromes (both somatic and visceral). We used functional magnetic resonance imaging to image the neural correlates of visceral and somatic pain within the brainstem. Ten healthy subjects were scanned twice at 3 tesla, during which they received matched, moderately painful, electrical stimuli to either the midline lower abdomen or rectum. Significant activation was observed in regions consistent with the PAG, nucleus cuneiformis (NCF), ventral tegmental area/substantia nigra, parabrachial nuclei/nucleus ceruleus, and red nucleus bilaterally to both stimuli. Marked spatial similarities in activation were observed for visceral and somatic pain, although significantly greater activation of the NCF (left NCF, p = 0.02; right NCF, p = 0.01; Student's paired t test, two-tailed) was observed in the visceral pain group compared with the somatic group. Right PAG activity correlated with anxiety during visceral stimulation (r = 0.74; p < 0.05, Pearson's r, two-tailed) but not somatic stimulation. We propose that the differences in NCF and right PAG activation observed may represent a greater nocifensive response and greater emotive salience of visceral over somatic pain.

A role for the brainstem in central sensitisation in humans. Evidence from functional magnetic resonance imaging

Animal studies have established a role for the brainstem reticular formation, in particular the rostral ventromedial medulla (RVM), in the development and maintenance of central sensitisation and its clinical manifestation, secondary hyperalgesia. Similar evidence in humans is lacking, as neuroimaging studies have mainly focused on cortical changes. To fully characterise the supraspinal contributions to central sensitisation in humans, we used whole-brain functional magnetic resonance imaging at 3T, to record brain responses to punctate mechanical stimulation in an area of secondary hyperalgesia. We used the heat/capsaicin sensitisation model to induce secondary hyperalgesia on the right lower leg in 12 healthy volunteers. A paired t-test was used to compare activation maps obtained during punctate stimulation of the secondary hyperalgesia area and those recorded during control punctate stimulation (same body site, untreated skin, separate session). The following areas showed significantly increased activation (Z>2.3, corrected P<0.01) during hyperalgesia: contralateral brainstem, cerebellum, bilateral thalamus, contralateral primary and secondary somatosensory cortices, bilateral posterior insula, anterior and posterior cingulate cortices, right middle frontal gyrus and right parietal association cortex. Brainstem activation was localised to two distinct areas of the midbrain reticular formation, in regions consistent with the location of nucleus cuneiformis (NCF) and rostral superior colliculi/periaqueductal gray (SC/PAG). The PAG and the NCF are the major sources of input to the RVM, and therefore in an ideal position to modulate its output. These results suggest that structures in the mesencephalic reticular formation, possibly the NCF and PAG, are involved in central sensitisation in humans.

Nociceptive excited and inhibited neurons within the pedunculopontine tegmental nucleus and cuneiform nucleus

The pedunculopontine tegmental nucleus (PPTg) is defined by its collection of cholinergic neurons surrounding the lateral portion of the superior cerebellar peduncle at the midbrain pontine junction. Antinociceptive functions have been attributed to the PPTg since electrical stimulation as well as injection of cholinergic agonists in this area produces analgesia. Nociceptive neurons have also been reported in the vicinity of the PPTg and cuneiform nucleus (CN). However, specific histochemical localization of nociceptive modulatory neurons has not been determined. Thus, the goal of this study was to classify neurons according to their response to a noxious stimulus and map their location based on staining of the cholinergic neurons in the PPTg. Extracellular microelectrode recordings were conducted in 19 male Sprague-Dawley rats under light halothane anesthesia. For each neuron identified, a series of noxious tail pinches were administered. The electrode tracts were marked with ionophoresis of pontamine blue. The location of 112 recorded neurons was determined on sections stained with NADPH diaphorase to identify the cholinergic boundaries of the PPTg. Neurons were classified into one of three cell types based on their consistent response to a noxious tail pinch (excited, inhibited, and non-responsive). Tail pinch excited neurons (n=16), inhibited neurons (n=10) and non-responsive neurons (n=23) were mapped within the cholinergic boundaries of the PPTg. Excited (n=9), inhibited (n=10) and non-responsive neurons (n=10) were also found more dorsally within the cuneiform nucleus. Thus, this study localizes nociception-responsive neurons to the region of the largely cholinergic PPTg, as well as the noncholinergic cuneiform nucleus.

EP3 and EP4 receptor mRNA expression in peptidergic cell groups of the rat parabrachial nucleus

This study examines the distribution of prostaglandin E2 receptors of subtype EP3 and EP4 among brain stem parabrachial neurons that were characterized with respect to their neuropeptide expression. By using a dual-labeling in situ hybridization method, we show that preprodynorphin mRNA expressing neurons in the dorsal and central lateral subnuclei express EP3 receptor mRNA. Such receptors are also expressed in preproenkephalin, calcitonin gene related peptide and preprotachykinin mRNA positive neurons in the external lateral subnucleus, whereas preprodynorphin mRNA expressing neurons in this subnucleus are EP receptor negative. In addition, EP3 receptor expression is seen among some enkephalinergic neurons in the Kölliker-Fuse nucleus. Neurons in the central part of the cholecystokininergic population in the regions of the superior lateral subnucleus express EP4 receptor mRNA, whereas those located more peripherally express EP3 receptors. Taken together with previous findings showing that discrete peptidergic cell groups mediate nociceptive and/or visceral afferent information to distinct brain stem and forebrain regions, the present results suggest that the processing of this information in the parabrachial nucleus is influenced by prostaglandin E2. Recent work has shown that prostaglandin E2 is released into the brain following peripheral immune challenge; hence, the parabrachial nucleus may be a region where humoral signaling of peripheral inflammatory events may interact with neuronal signaling elicited by the same peripheral processes.

Expression and distribution of tuberoinfundibular peptide of 39 residues in the rat central nervous system

Tuberoinfundibular peptide of 39 residues (TIP39) has been recently purified and identified as a selective ligand for the parathyroid hormone 2 receptor. As a next step toward understanding its functions, we report the expression and distribution of TIP39 in the rat central nervous system. In situ hybridization histochemistry and immunocytochemistry revealed TIP39-containing cell bodies in three distinct areas. The major one comprises the subparafascicular area posterior through the intralaminar nucleus of the thalamus; a second is the medial paralemniscal nucleus at the pontomesencephalic junction; and a third is in the dorsal and dorsolateral hypothalamic areas, which contained a few, scattered cell bodies. We found, in contrast to the highly restricted localization of TIP39-containing cell bodies, a much more widespread localization of TIP39-containing fibers. The highest density of fibers was observed in limbic areas such as the septum, the amygdala, and the bed nucleus of the stria terminalis; in areas involved in endocrine regulation, such as the hypothalamic dorsomedial, paraventricular, periventricular, and arcuate nuclei; in auditory areas, such as the ectorhinal and temporal cortices, inferior colliculus, medial geniculate body, and some of the nuclei of the superior olivary complex; and in the dorsolateral funiculus of the spinal cord. The localization of TIP39-containing nuclei and fibers provides an anatomical basis for previously demonstrated endocrine and nociceptive effects of TIP39 and suggests additional functions for TIP39, one apparent candidate being the regulation of auditory information processing.

Response of neurons in the thalamic nucleus submedius (Sm) to noxious stimulation and electrophysiological identification of on- and off-cells in rats

Previous studies have indicated that thalamic nucleus submedius (Sm) is involved in nociceptive modulation and plays an important role in an endogenous analgesic system (a feedback loop) consisting of spinal cord (Sc)-Sm-ventrolateral orbital cortex-periaqueductal gray-Sc. However, the function of different types of Sm neurons in nociceptive modulation is unclear. For this reason, on the basis of further studies of properties of the Sm neurons responding to noxious stimuli, the different effects of systemic morphine on the Sm neurons were examined and two classes of nociceptive modulatory neurons, named as off- and on-cells, in this region were identified in lightly anesthetized rats. The results showed that (1) most (84%, 132/157) of the Sm neurons responded to peripheral noxious stimuli. Of these neurons, 66% (n = 87) were inhibited, 34% (n = 45) excited. All neurons had very large and bilateral, even all body receptive fields. No neuron was found to be responsive to innocuous stimulation; (2) systemic morphine increased the firing rate of neurons inhibited by noxious stimulation, but decreased that of neurons excited by the same stimulation. Furthermore, the effects of morphine could be reversed by systemic naloxone; (3) 45 of Sm neurons examined could be divided into three different classes: off-cells that decreased the firing rate from tail heating just prior to occurrence of the tail-flick (TF) reflex (3140 +/- 167 ms, n = 27), on-cells that increased the firing rate just before the TF reflex (1720 +/- 240 ms, n = 8), and neutral-cells that did not respond to any stimuli and neuronal activities were not related to the TF reflex (n = 10). Findings of this study provided electrophysiological evidence for involvement of Sm neurons, as those in the rostral ventromedial medulla, in the opioid-receptor-mediated descending nociceptive modulation.

Distribution of prostaglandin EP(3) and EP(4) receptor mRNA in the rat parabrachial nucleus

By using in situ hybridization, the distribution of mRNA for the PGE(2) receptors EP(3) and EP(4) was examined in the rat parabrachial nucleus (PB), a major brain stem relay for autonomic and nociceptive processing. EP(3) receptor mRNA was present in most subnuclei, with the densest labeling in the external lateral, dorsal lateral, superior lateral, central lateral and Kölliker-Fuse nuclei. EP(4) receptor mRNA expressing cells had a more restricted distribution, largely being confined to the superior lateral and adjacent parts of the dorsal and central lateral nuclei in a pattern complementary to that for EP(3) receptor mRNA. These findings suggest that EP(3) and EP(4) receptors in PB have distinct functional roles that include nociceptive processing, blood pressure regulation and feeding behavior.

The activity of ON and OFF cells at the rostroventromedial medulla is modulated by vagino-cervical stimulation

In anesthetized rats it was tested whether or not the activity of the ON and OFF cells within the rostral ventromedial medulla (RVM) is modulated by the mechanical stimulation of the uterine cervix (VS). ON cells were identified by an abrupt increase in their firing rate before the tail flick in response to a noxious heat. OFF cells were identified by a sudden decrease in their firing rate before the tail flick. All (27 out of 27) identified ON cells decreased their firing rate immediately after VS was applied. The effect of VS on the activity of the cells persisted for the entire stimulation period. On the other hand, all (19 out of 19) identified OFF cells increased their firing rate immediately after VS. The effect of VS on the activity of these cells also persisted for the entire stimulation period. The activity of the neutral cells showed no change, neither during the application of noxious heat, nor during VS. These results suggest that the analgesic-like effect produced by VS can be mediated by the activity of the antinociceptive circuit at the RVM. Alternatively, it can be suggested that the afferent inflow from the genital tract can induce the activity of the antinociceptive circuit at RVM, either by projections to the periaqueductal gray matter or by direct projections to RVM.

Preproenkephalin messenger RNA-expressing neurons in the rat parabrachial nucleus: subnuclear organization and projections to the intralaminar thalamus

The pontine parabrachial nucleus, which is a key structure in the central processing of autonomic, nociceptive and gustatory information, is rich in a variety of neuropeptides. In this study we have analysed the distribution of parabrachial neurons that express preproenkephalin messenger RNA, which encodes for the precursor protein for enkephalin opioids. Using an in situ hybridization method, we found that preproenkephalin messenger RNA-expressing neurons were present in large numbers in four major areas of the parabrachial nucleus: the Kölliker-Fuse nucleus, the external lateral subnucleus, the ventral lateral subnucleus, and in and near the internal lateral subnucleus. Many preproenkephalin messenger RNA-expressing neurons were also seen in the central lateral subnucleus, and in the medial and external medial subnuclei. Few labeled neurons were found in the dorsal and superior lateral subnuclei. Injection of the retrograde tracer substance cholera toxin subunit B into the midline and intralaminar thalamus demonstrated that the enkephalinergic neurons in and near the internal lateral subnucleus were thalamic-projecting neurons. Taken together with the results of previous tract-tracing studies, the present findings show that many of the enkephalinergic cell groups in the parabrachial nucleus are located within the terminal zones of the ascending projections that originate from nociresponsive neurons in the medullary dorsal horn and spinal cord, as well as from viscerosensory neurons within the nucleus of the solitary tract. The enkephalinergic neurons in the parabrachial nucleus may thus transmit noci- and visceroceptive-related information to their efferent targets. On the basis of the present and previous observations, we conclude that these targets include the intralaminar and midline thalamus, the ventrolateral medulla and the spinal cord. Through these connections, nociceptive and visceroceptive stimuli may influence several functions, such as arousal, respiration and antinociception.

Subnuclear localization of FOS-like immunoreactivity in the rat parabrachial nucleus after nociceptive stimulation

The effect of noxious stimulation on the expression of FOS-like immunoreactivity (FOS-LI) in neurons of the parabrachial nucleus (PB) was studied in awake, freely moving rats. In one series of experiments, the rats were subjected to noxious mechanical stimulation (pinch) of either the nape of the neck or the base of the tail for 20 seconds every 5 minutes for 90 minutes, and then they were killed by transcardial perfusion after 45-210 minutes. Control animals received innocuous mechanical stimulation (brush) of the tail. Noxious stimuli resulted in FOS-LI in neurons in the dorsal part of the lateral PB, with heavy labeling in the superior lateral (PBsl) and the dorsal lateral (PBdl) subnuclei. FOS-LI was also elicited in the central lateral subnucleus (PBcl) and, although much more sparsely, in the external lateral subnucleus and the Kölliker-Fuse nucleus. Tail and neck stimulation resulted in similar labeling patterns, but more neurons, particularly in PBsl, expressed FOS-LI after pinch of the tail than of the neck. In another series of experiments, rats received injection of 5% formalin into one hindpaw. After 75-90 minutes, FOS-LI was seen in the same parts of PB as after noxious mechanical stimulation. The heaviest labeling was seen on the side contralateral to the injection side, with statistically significant (P < 0.05) side differences present in PBsl and PBdl. In a third series of experiments, rats were hemisected at low cervical-upper thoracic segments, allowed 2 weeks to recover, and then given formalin injections in both hindpaws. Significantly more neurons were FOS-labeled in PBdl, PBsl, and PBcl on the side contralateral to the hemisection than on the ipsilateral side. These observations are discussed in relation to the organization of the spinal afferent input and the efferent connections of PB. It is concluded that the FOS-LI expression in PBdl and PBsl and probably also in PBcl, to a large extent, is evoked by the ascending spinal nociceptive input to PB. Because these subnuclei project to several hypothalamic regions, it is suggested that neurons in PB that express FOS after noxious mechanical and chemical stimulation primarily are involved in autonomic and homeostatic responses to behavioral situations that involve tissue-damaging stimuli.

Altered c-fos expression in the parabrachial nucleus in a rodent model of CFA-induced peripheral inflammation

Increases in the expression of immediate early genes have been shown to occur in the lumbar spinal cord dorsal horn after peripheral inflammation. Given that the pontine parabrachial nucleus has been implicated in nociceptive as well as antinociceptive processes and is reciprocally connected with the spinal cord dorsal horn, it seems likely that peripheral inflammation will cause alterations in immediate early gene expression in this nucleus. To test this hypothesis we examined cFos-like immunoreactivity in a rodent complete Freund's adjuvant-induced peripheral inflammatory model of persistent nociception. Unilateral hind paw injections of complete Freund's adjuvant produced inflammation, hyperalgesia of the affected limb, and alterations in open field behaviors. Immunocytochemical analysis demonstrated a bilateral increase in cFos-like immunoreactivity in the lateral and Kolliker-Fuse subdivisions of the parabrachial nucleus at 6 and 24 hours postinjection and an ipsilateral decrease below basal levels in the Kolliker-Fuse subdivision at 96 hours postinjection when compared to saline controls. Taken together, these results suggest that select parabrachial neurons are activated by noxious somatic inflammation. These active parabrachial neurons are likely to participate in ascending nociceptive and/or descending antinociceptive pathways.

Enkephalinergic and catecholaminergic neurons constitute separate populations in the rat Kölliker-Fuse/A7 region

Using a double-labeling immunohistochemical and in situ hybridization technique for the simultaneous detection of tyrosine hydroxylase and preproenkephalin mRNA, we demonstrate that catecholaminergic and enkephalinergic neurons in the Kölliker-Fuse nucleus (K-F)/A7 region in the dorsolateral pons constitute separate populations. The enkephalinergic cell group is much larger than the catecholaminergic cell group. Most of the enkephalinergic neurons are located caudal to the catecholaminergic neurons, but enkephalinergic neurons are also interspersed among the catecholaminergic neurons. Taken together with previous demonstrations that the enkephalinergic neurons in K-F give rise to descending projections to the ventrolateral medulla and spinal cord, the current observations suggest that the antinociceptive effects that result from electrical stimulation of K-F may be a consequence of the activation of enkephalinergic neurons, either alone or in conjunction with catecholaminergic neurons.

Temporal modulation of antinociception by reciprocal connections between the dorsomedial medulla and parabrachial region

Microinjection of carbachol into the dorsal parabrachial regio (PBRd) of guinea pigs induces analgesia from the 5th to the 15th min postinjection, as evaluated by the reduction of the vocalization in response to an electric shock applied to one paw. When reversible blockade of the dorsomedial medulla or specifically of the nucleus tractus solitarius (NTS) is performed with xylocaine 5 min after microinjection of carbachol into the PBRd, the analgesic effect continues up to the 45th and to the 60th min, respectively. Blockade of the dorsomedial medulla is achieved by topical application of xylocaine to the area postrema (AP) or microinjection of the drug into the NTS. A prolongation of the duration of the analgesic effect also occurs after the inverse procedure, i.e., after reversible blockade of the PBRd 5 min after topical application of carbachol (1 microgram/microliter)to the AP or microinjection of carbachol into the NTS. In this case, the analgesic action, which lasted up to 30 min when carbachol was applied to the AP and 60 min when microinjected into the NTS, was prolonged up to 60 min and to 80 min, respectively, after reversible blockade of PBR. The present data suggest that the reciprocal connections between the different regions of the dorsomedial medulla and the PBR play an important role in the modulation of the duration of the analgesic effect, and that this fact may be of adaptive importance in the defensive analgesia that occurs in the confrontation between prey and predator.

Trigeminal projections to the peribrachial region in the muskrat

The anterograde and retrograde transport of wheat germ agglutinin-horseradish peroxidase was used to study the trigeminoperibrachial pathway in the muskrat after injections of tracer into either the medullary dorsal horn or the dorsolateral pons. After injections into the medullary dorsal horn, labeled fibers ascended into the ipsilateral dorsolateral pons via the spinal trigeminal tract, within the neuropil of the trigeminal sensory complex and within the reticular formation adjacent to the spinal trigeminal nucleus. At caudal levels of the ipsilateral peribrachial area, dense terminal-like label distributed in the Kölliker-Fuse nucleus continued into the lateral parabrachial nucleus. At intermediate levels ipsilaterally, the Kölliker-Fuse nucleus again was labeled densely, as were areas analogous to the external lateral and external medial subnuclei of the parabrachial nucleus in the rat. A thin band of label along the ventral spinocerebellar tract outlined an unlabeled area in the central portion of the lateral parabrachial nucleus. Rostrally near the pontomesencephalic junction, the area designated the superior lateral subnucleus in the hamster was labeled, while sparser label was present more dorsally. Contralateral to the injections, caudal and intermediate levels of the peribrachial area contained only scant reaction product. However, the rostral area of the superior lateral subnucleus was labeled densely via fibers ascending in the trigeminothalamic tract. Injections made just rostral to the obex and either centered in or including the dorsal or ventral paratrigeminal nuclei produced similar labeling at caudal and intermediate levels of the peribrachial area. An exception, however, was that the caudal medial parabrachial nucleus was also labeled after the dorsal paratrigeminal injection. Also, only scant label was found in the rostral third of the dorsolateral pons on either side after these injections. Both trigeminothalamic and trigeminolemniscal pathways were labeled contralaterally after these injections. These trigeminal projections to the dorsolateral pons were compared to the projections from the nucleus tractus solitarii and the ventrolateral medulla. Numerous trigeminal neurons were labeled retrogradely after injections of wheat germ agglutinin-horseradish peroxidase into the dorsolateral pons. In the medullary dorsal horn, they were found almost exclusively in laminae I and V. Labeled neurons in lamina I were especially prominent in rostral ventral levels of the medullary dorsal horn. Labeled cells in lamina I were continuous with others found in the displaced band of substantia gelatinosa at the interface of the subnucleus caudalis and subnucleus interpolaris, as well as with those found in the ventral and dorsal paratrigeminal nuclei.(ABSTRACT TRUNCATED AT 400 WORDS)

Electrophysiology of the dorsolateral mesopontine reticular formation during Pavlovian conditioning in the rabbit

Extracellular single-unit recording methods were used to study the activity of neurons within a restricted portion of the dorsolateral mesopontine reticular formation, an area which includes the parabrachial, pedunculopontine tegmental and cuneiform nuclei. Recordings were obtained during presentations of unfamiliar and familiar sensory stimuli, during Pavlovian differential conditioning procedures that elicited conditioned bradycardia, and while stimulating the amygdaloid central nucleus to identify neurons that projected to, or received projections from, the amygdaloid central nucleus. Activity in most dorsolateral mesopontine reticular neurons was altered during sensory stimulation, and the convergence of auditory and somatic inputs onto single neurons was common. Moreover, neural responses were often of a different magnitude and/or direction to auditory stimuli that were unfamiliar vs familiar vs reinforced (paired with pinna stimulation), and many of these differentially responsive neurons were activated orthodromically by stimulation of the amygdaloid central nucleus. In contrast, neurons activated antidromically by stimulation of the amygdaloid central nucleus were relatively quiescent during all phases of the experiment. Results are discussed in relation to current hypotheses concerning the functional significance of various neuronal subpopulations within the dorsolateral mesopontine reticular formation during Pavlovian conditioning.

Induction and suppression of immediate-early genes in the rat brain by a selective alpha-2-adrenoceptor agonist and antagonist following noxious peripheral stimulation

The effect of medetomidine, a highly selective alpha-2-adrenoceptor agonist, on noxious stimulation-induced expression of immediate-early genes was studied in the central nervous system of the rat. The expressions of c-JUN, JUN B, c-FOS FOS B and KROX-24 proteins were investigated by immunocytochemistry following the application of formalin (5%, 50 microliters) into the plantar skin of one hindpaw. Medetomidine (100 or 300 micrograms/kg i.p.) was administered 12 min or 5 min before the application of formalin. Atipamezole (1.5 mg/kg i.p.), and alpha-2-adrenoceptor antagonist, administered simultaneously with medetomidine (300 micrograms/kg), was used to reverse the alpha-2-adrenergic effects. The rats were killed and perfused 90 min after formalin injection. Formalin induced expression of all studied proteins in the ipsilateral spinal dorsal horn and the contralateral parabrachial nucleus, and in the medial thalamus bilaterally. Both medetomidine doses administered 12 min before formalin strongly suppressed the expression of c-FOS in the spinal dorsal horn; the suppression was stronger in the deep (III-VI) than in the superficial (I and II) laminae of the dorsal horn (76% and 86% for 100 micrograms/kg dose vs 97% and 99% for 300 micrograms/kg dose, respectively). However, application of medetomidine 5 min before formalin did not reduce the expression of immediate-early genes. In the parabrachial nucleus, both medetomidine doses also produced a significant suppression of c-FOS expression (68%). In contrast, medetomidine at the dose of 100 micrograms/kg was ineffective in the medical thalamus. Only the higher dose of medetomidine (300 micrograms/kg) produced a suppression by 29% and 46% in centromedian and paraventricular nuclei, respectively. Atipamezole produced a significant attenuation in spinal cord and a complete reversal in parabrachial nucleus of the medetomidine-induced suppression. However, in the medial thalamus, atipamezole produced a dramatic increase of formalin-induced c-FOS expression when compared with formalin injection alone. The expression of c-JUN, JUN B, FOS B and KROX-24 proteins paralleled that of c-FOS. It is concluded that the expression of immediate-early gene encoded proteins is more strongly suppressed by alpha-2-adrenoceptor agonists in spinal and parabrachial than in medial thalamic neurons. The increased expression of immediate-early genes in medical thalamus following atipamezole treatment may be explained by increased release of noradrenaline and the consequent activation of alpha-1- and beta-adrenoceptors. Compared with the previously reported effects of behaviorally equipotent doses of morphine, the suppression of c-FOS expression in the spinal cord was stronger following medetomidine than that following morphine.(ABSTRACT TRUNCATED AT 400 WORDS)

Factors influencing neural activity in parabrachial regions during cat vocalizations

The parabrachial nucleus in mammals is intimately connected with other vocalization controlling brainstem structures. It, along with ventromedially adjacent structures, also has been identified as the pneumotaxic center, and as such shows strong respiratory related activity in the anesthetized cat. The current study examines the neuronal activity in cat parabrachial regions during production of instrumentally conditioned vocalizations. Most of the units in our sample show considerable activity during periods between vocalizations. For many units, firing rate fluctuates during the respiratory cycle, although apparently not as strongly as reported in the decerebrate cat. Also, there is often strong phasic activity during periods where animals are licking to ingest their food rewards. During the peri-vocalization period, various neural activity patterns can be recorded. Most common is an activity increase during the vocalization itself. Moreover, in some units, this activity increase has an auditory component. A smaller number of units show other activity patterns, including a suppression of activity during vocalization and activity increases preceding the vocalization. Overall, our results suggest that the parabrachial region's involvement in vocal control is quite complex, involving convergence of respiratory, acoustic, vocalization-related, and perhaps somatosensory influences.

Bulbar reticular neurons relaying somatosensory information to the mesencephalic parabrachial area of the cat

Somatosensory neurons projecting to the mesencephalic parabrachial area (MPBA), which is located ventral to the inferior colliculus and dorsal to the brachium conjunctivum, were recorded from the bulbar reticular formation of adult cats anesthetized with alpha-chloralose. The majority (41 of 50 neurons) were nociceptive-specific neurons responding only to noxious mechanical and/or thermal stimuli to the skin, cornea and/or oral mucosa. The size of their receptive fields was smaller than that of the intrinsic MPBA-neurons, but larger than that of the trigeminal sensory nucleus neurons. Twenty-three neurons received input from the tooth pulp nerve and 10 of 32 neurons tested responded to electrical stimulation of the vagal nerve. These results indicate that these bulbar reticular neurons receive noxious inputs and transmit them to the MPBA, which also receives input from spinal or trigeminal sensory nucleus neurons projecting directly to the MPBA.

Responses of neurons in the ventromedial midbrain to noxious mechanical stimuli

Neurons of the ventromedial midbrain in pentobarbital-anesthetized rats were examined by extracellular recording for responses to mechanical stimulation of the skin. Responses were absent from neurons clearly located in the interpeduncular nucleus (IPN) (n = 20), and from 92% of linear raphe (LR) neurons (n = 26). However, 37% of neurons in the ventral tegmental area of Tsai (VTA) (n = 38) and 63% of neurons in the small interfascicular nucleus (IF) (n = 9) were inhibited, often recovering with a delay of 1-2 min. A few cells (n = 4) were weakly excited in these 4 nuclei; none responded to innocuous mechanical stimulation of the skin. It is concluded that noxious cutaneous stimuli will not modify (by feedback) any influence of the IPN on pain perception, but could dampen behavior-reinforcing effects of the VTA and IF.

Antagonism of stimulation-produced antinociception from ventrolateral pontine sites by intrathecal administration of alpha-adrenergic antagonists and naloxone

Focal electrical stimulation of the ventrolateral pontine tegmentum in conscious rats induced antinociception in approximately one-half of the animals screened, as indicated by a marked suppression of the thermally evoked tail-flick flexion reflex. The effectiveness of ventrolateral pontine stimulation in elevating tail-flick latency was significantly reduced by intrathecal microinjection of 30 micrograms of the non-selective alpha-adrenergic antagonist phentolamine, and was largely abolished by a 60-micrograms dose of this drug. The blockade of ventrolateral pontine stimulation-produced antinociception by phentolamine was maximal by 15 min postinjection, and was still evident 60 min after drug microinjection. Ventrolateral pontine stimulation-produced antinociception was also attenuated by intrathecal administration of the alpha 2-selective antagonist yohimbine (37 micrograms) and the opioid antagonist naloxone (30 micrograms), but not the alpha 1 antagonist WB-4101 (37 micrograms), the beta-adrenergic antagonist propranolol (111.6 micrograms) nor the serotonergic antagonist methysergide (30 micrograms). However, the antagonism of pontine stimulation-produced antinociception by naloxone was unlike that of phentolamine and yohimbine, in that it developed slowly and was only evident at 60 min postinjection. Hence naloxone's site of action may be distant from the injection site. These data indicate that the thermal antinociception produced by stimulation of the ventrolateral pons is mediated through spinal alpha 2-receptors and opioid receptors of uncertain location. The close proximity of many of the effective electrode placements to the rostral A5 and ventral subcoerulear A7 noradrenergic cell groups suggests that noradrenergic spinopetal projections arising from these groups are involved in mediating the antinociception induced by stimulating these sites.