Tonic GABAergic and cholinergic influences on pain control and cardiovascular control neurones in nucleus paragigantocellularis lateralis in the rat

Inhibitory effects evoked from the rostral ventrolateral medulla are selective for the nociceptive responses of spinal dorsal horn neurons

The aim of the present study was to determine whether or not descending control of spinal dorsal horn neuronal responsiveness following neuronal activation at pressor sites in the rostral ventrolateral medulla is selective for nociceptive information. Extracellular single-unit activity was recorded from 49 dorsal horn neurons in the lower lumbar spinal cord of anaesthetized rats. The 30 Class 2 neurons selected for investigation responded to noxious (pinch and radiant heat) and non-noxious (prod, stroke and/or brush) stimulation within their cutaneous receptive fields on the ipsilateral hindpaw. The excitatory amino acid, DL-homocysteic acid, was microinjected into either the rostral or the caudal rostral ventrolateral medulla at sites that evoked increases in arterial blood pressure. Effects of neuronal activation at these sites were then tested on the responses of Class 2 neurons to noxious and non-noxious stimulation within their excitatory receptive fields. The noxious pinch and radiant heat responses of Class 2 neurons were depressed, respectively to 13+/-3.8% (n=23) and to 16+/-3.7% (n=18) of control, following stimulation at sites in the rostral rostral ventrolateral medulla. In contrast, the low-threshold (prod) responses of eight Class 2 neurons tested were not depressed following neuronal activation at the same sites. When tested, control injections of the inhibitory amino acid, GABA, at the same sites in the rostral rostral ventrolateral medulla had no significant effects on neuronal activity. Neither intravenous administration of noradrenaline (to mimic the pressor responses evoked by DL-homocysteic acid microinjections in the rostral ventrolateral medulla) nor activation at pressor sites in the caudal rostral ventrolateral medulla had any significant effect on neuronal responsiveness. With regard to sensory processing in the spinal cord, these data suggest that descending inhibitory control that originates from neurons in pressor regions of the rostral rostral ventrolateral medulla is highly selective for nociceptive inputs to Class 2 neurons. These data are discussed in relation to the role of the rostral ventrolateral medulla in executing the changes in autonomic and sensory functions that are co-ordinated by higher centres in the CNS.

Synaptically released 5-HT modulates the activity of tonically discharging neuronal populations in the rostral ventral medulla (RVM)

There is substantial evidence for an important modulating role of monoamines (catecholamines and serotonin, 5-HT) in the rostral ventral medulla (RVM), a region which plays an important role in cardiovascular and nociceptive functions. We investigated in slices the role of endogenous monoamines in the synaptic control of the activity of rat RVM neuronal populations using intracellular recordings in the lateral RVM plus lateral aspect of nucleus paragigantocellularis lateralis. A triple-labelling protocol allowed us to identify the location of impaled neurons and their eventual monoaminergic phenotype within the serotonergic and catecholaminergic populations of the RVM. Focal electrical stimulation revealed the existence of a functional monoaminergic input onto RVM neurons which was mediated by endogenous 5-HT acting at inhibitory 5-HT1A receptors but did not involve noradrenergic neurotransmission. The slow 5-HT-mediated inhibitory postsynaptic potential (IPSP) was only observed in the regularly discharging neurons, which were found to be neither catecholaminergic nor serotonergic. The synaptic release of 5-HT was, itself, under an inhibitory control involving GABAA (gamma-aminobutyric acid) receptors. Moreover, we characterized the effect of the 5-HT-releasing agent fenfluramine on this functional 5-HT-mediated synaptic transmission. Our results show that the effect of fenfluramine is biphasic consisting of an initial prolongation of the serotonergic IPSP followed by a decrease in amplitude. Our data provide a basis for the previously reported inhibitory effects of exogenously applied serotonin agonists/antagonists on the autonomic functions controlled by the RVM. This 5-HT pathway, which functionally links the serotonergic and catecholaminergic regions, might play an important role in cardiovascular and nociceptive functions.

Regional blood flow and nociceptive stimuli in rabbits: patterning by medullary raphe, not ventrolateral medulla

1. Regional blood flow was measured with Doppler ultrasonic probes in anaesthetized rabbits. We used focal microinjections of pharmacological agents to investigate medullary pathways mediating ear pinna vasoconstriction elicited by electrical stimulation of the spinal tract of the trigeminal nerve or by pinching the lip, and pathways mediating mesenteric vasoconstriction elicited by electrical stimulation of the afferent abdominal vagus nerve. 2. Bilateral injection of kynurenate into the rostral ventrolateral medulla reduced arterial pressure and prevented the mesenteric vasoconstriction and the rise in arterial pressure elicited by abdominal vagal stimulation. However, kynurenate did not prevent ear pinna vasoconstriction or the fall in pressure elicited by trigeminal tract stimulation. Similar injections of muscimol also failed to prevent the trigeminally elicited cardiovascular changes. 3. Injections of kynurenate into the raphe-parapyramidal area did not diminish trigeminally elicited ear vasoconstriction or the depressor response. However, injections of muscimol substantially reduced or abolished the trigeminally elicited ear vasoconstriction, without affecting the depressor response. Raphe-parapyramidal muscimol injections also entirely abolished ear vasoconstriction elicited by pinching the rabbit's lip. 4. The trigeminal depressor response does not depend on either the rostral ventrolateral medulla or the raphe-parapyramidal region. 5. Mesenteric vasoconstriction elicited by stimulation of the afferent abdominal vagus nerve is mediated via the rostral ventrolateral medulla, but ear vasoconstriction elicited by lip pinch or by stimulation of the trigeminal tract is mediated by the raphe-parapyramidal region. Our study is the first to suggest a brainstem pathway mediating cutaneous vasoconstriction elicited by nociceptive stimulation.

Differential potentiative effects of GABA receptor agonists in the production of antinociception induced by morphine and beta-endorphin administered intrathecally in the mouse

The effect of muscimol or baclofen injected intrathecally (i.t.) on the inhibition of the tail-flick response induced by morphine and beta-endorphin administered i.t. was studied in ICR mice. The i.t. injection of muscimol (100 ng) or baclofen (10 ng) alone did not affect the basal inhibition of the tail-flick response. Morphine (0.2 microg) and beta-endorphin (0.1 microg) caused only slight inhibition of the tail-flick response. Baclofen, but not muscimol, injected i.t. enhanced the inhibition of the tail-flick response induced by i.t. administered morphine. Both muscimol and baclofen injected i.t. significantly enhanced i.t. injected beta-endorphin-induced inhibition of the tail-flick response. Our results suggest that the GABA(B), but not GABA(A), receptors located in the spinal cord appear to be involved in enhancing the inhibition of the tail-flick response induced by morphine administered spinally. In addition, both GABA(A) and GABA(B) receptors are involved in enhancing the inhibition of the tail-flick response induced by beta-endorphin administered i.t.

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.

Does intravenous administration of GABA(A) receptor antagonists induce both descending antinociception and touch-evoked allodynia?

Effects of intravenous administration of picrotoxin (PTX), a GABA(A) receptor antagonist, upon activities of wide dynamic range (WDR) neurons in the lumbar spinal cord were studied in urethane-chloralose anesthetized cats. Intravenous PTX augmented tactile evoked responses of WDR neurons, but reduced nociceptive responses dose-dependently. Spinal transection reversed the suppression of nociceptive responses. In the spinal cat, intravenous PTX enhanced the tactile evoked response. Intravenous PTX enhanced the spontaneous firing of nucleus raphe dorsalis (NRD) and/or ventral periaqueductal gray (PAG) neurons projecting to nucleus raphe magnus. Lidocaine injected into NRD/PAG reversed the antinociceptive action of intravenous PTX. PTX injected into NRD/PAG reduced heat-evoked responses of WDR units. These data suggest that antinociceptive effects of intravenous PTX is primarily due to disinhibitory activation of the descending antinociceptive system originating from NRD and PAG, and that PTX reinforces touch-evoked responses in the spinal cord.

Rostroventrolateral medulla neurons preferentially project to target-specified sympathetic preganglionic neurons

The rostroventrolateral medulla is a key site for the regulation of vasomotor tone. Sympatho-excitatory neurons project from this region to contact sympathetic preganglionic neurons located in the intermediolateral nucleus of the thoracic and lumbat spinal cord. Functional studies show that stimulation of specific sites in the ventral medulla lead to selective activation of different vascular effectors. The present study was designed to determine the anatomical basis for this selectivity in vasomotor control. Anterograde and retrograde tracing methods were utilized to determine if the descending rostral ventrolateral projection is topographically organized such that neurons in particular locations within the nucleus project preferentially and contact a specific group of sympathetic preganglionic neurons. For this purpose spinally-projecting neurons at 15 sites from three separate rostrocaudal locations within the rostroventrolateral medulla in nine rats were anterogradely labelled with biotin dextran amine. The spinal cord was examined for axon terminals having close apposition to two groups of sympathetic preganglionic neurons, those projecting to the superior cervical ganglion and those to the adrenal medulla which were retrogradely labelled with cholera B chain-conjugated horseradish peroxidase. Areas of close apposition between retrogradely-labelled dendrites, cell bodies and anterogradely-labelled axons were found. Axons descending from the more rostral part of the rostroventrolateral medulla produced the highest density of close appositions to sympathetic preganglionic neurons in both target-specific populations. Caudal rostroventrolateral medulla injection sites gave rise to a less dense distribution of axons and terminals around the spinal sympathetic nuclei. This study has demonstrated that spinally-projecting neurons in the rostroventrolateral medulla are both topographically and viscerotopically organized. It is suggested that such an arrangement provides the means for selective and differential control of autonomic effectors and in particular those involved in cardiovascular regulation.

Intravenous midazolam suppresses noxiously evoked activity of spinal wide dynamic range neurons in cats

The effects of intravenously (i.v.) administered midazolam on noxiously evoked activity of spinal wide dynamic range (WDR) neurons were investigated in decerebrate, spinal-cord-transected cats. Extracellular, single-unit recordings were measured during stimulation by pinching the receptive field on the hind paw and the effect of midazolam at doses of 0.25, 0.5, 1, 2, and 4 mg/kg were measured. Two series of experiments were performed to characterize the analgesic effects of midazolam. In the first, dose-response experiments (n = 59) demonstrated a dose-dependent suppression of the noxiously evoked activity of spinal WDR neurons after midazolam administration. This effect of midazolam was maximal at a dose of 1 mg/kg i.v.. The second series of experiments (n = 14) demonstrated that a benzodiazepine antagonist, flumazenil (n = 8), promptly reversed the effect of midazolam, while an opioid antagonist, naloxone (n = 6), had no effect on the effect of midazolam. The present study demonstrates that i.v. administered midazolam suppresses noxiously evoked activity of spinal WDR neurons that is reversible by a benzodiazepine antagonist. This is consistent with an analgesic action of midazolam.

Descending antinociceptive pathway from the rostral ventrolateral medulla: a correlative anatomical and physiological study

Microinjections of the excitatory amino acid L-glutamate were made into the rostral ventrolateral medulla (RVLM) of anesthetised cats, to map the sites at which selective stimulation of cell bodies elicited a significant antinociceptive response (> or = 15% inhibition of the increase in L7 ventral root activity reflexly evoked by stimulation of C-fiber afferents). Antinociceptive sites were largely confined to the RVLM subregion ventromedial to the retrofacial nucleus, extending from the caudal pole of the facial nucleus to the level approximately 2.5 mm more caudal. Increases in arterial pressure were also elicited from some sites in the RVLM, but these were mainly lateral to the antinociceptive sites. In a second series of experiments, rhodamine labeled microspheres or cholera toxin B-gold (CTB-gold) were injected into the dorsal horn of the L7 segment. In three of these experiments in which the injection sites were restricted to the dorsal horn, retrogradely labeled cells in the caudal pons and medulla were virtually all within either the nucleus raphe magnus or the RVLM. Furthermore, the labeled cells in the RVLM were virtually confined to a discrete group located just ventromedial to the retrofacial nucleus, i.e. within the antinociceptive region as mapped by glutamate microinjection. The results of the present study indicate that antinociceptive effects are elicited by stimulation of a subregion in the RVLM, which is located medial to the pressor region. Further, the antinociceptive effects may be mediated, at least in part, by cells projecting directly to the dorsal horn in the spinal cord.

GABA-mediated inhibition in rostral ventromedial medulla: role in nociceptive modulation in the lightly anesthetized rat

Local microinjection of GABAA receptor agonists and antagonists was used to characterize the role of GABA-mediated inhibitory processes in the nociceptive modulatory functions of the rostral ventromedial medulla (RVM) in the lightly anesthetized rat. Microinjection of selective GABAA receptor antagonists bicuculline methiodide and SR95531 produced a significant increase in tail-flick (TF) latency. This antinociception was dose related, showed recovery and was attenuated by prior injection of the GABAA receptor agonist THIP at the same site. Microinjection of saline or the glycine receptor antagonist strychnine did not significantly affect TF latency. In contrast, administration of GABAA receptor agonists THIP and muscimol resulted in a significant decrease in TF latency. Microinjections at sites surrounding the RVM did not significantly affect TF latency. These results demonstrate that a GABA-mediated process within the RVM is crucial in permitting execution of the TF and, presumably, other spinal nociceptive reflexes.

The sympathoexcitatory response following selective activation of a spinal cholinergic system in anesthetized rats

This study was performed to help elucidate the role of spinal cholinergic neurons in cardiorespiratory function by selective activation of spinal or medullary cholinergic systems in anesthetized rats. A selective site of action of cholinergic drugs on the spinal cord was obtained by refining the method of intrathecal (i.t.) drug injection to localize drug distribution to specific spinal segments. I.t. injection of the cholinesterase (ChE) inhibitor, neostigmine (NEO), produced a significant reduction in spinal, but not medullary tissue levels of ChE, and evoked marked pressor and tachycardic responses without any changes in respiratory parameters. In contrast to i.t. injection, intracisternal (i.c.) injection of NEO which inhibited both spinal and medullary ChE, produced characteristic respiratory changes--increased tidal volume and decreased respiratory rate and minute volume, as well as pressor and tachycardic responses. I.t. injection of the muscarinic antagonist, methylatropine, inhibited the cardiovascular responses to i.t. NEO, but not the cardiorespiratory responses to i.c. NEO. These cardiovascular responses to i.t. NEO were blocked by spinal transection, but not by midcollicular transection. Finally, the pressor and tachycardic responses to i.t. NEO were inhibited following peripheral alpha-adrenergic and beta-adrenergic blockade, respectively. These results indicate that activation of the spinal cholinergic system selectively produces a sympathoexcitatory response through spinal muscarinic receptor activation independent of respiratory changes. This finding is consistent with the possibility that such responses are elicited by activation of a non-cholinergic bulbo-spinal sympathoexcitatory pathway at the spinal level, or at higher centers through an ascending pathway. In either case, the spinal cholinergic system appears to be anatomically and pharmacologically distinct from the medullary pathway and may subserve a different function.

GABAergic circuitry in the rostral ventral medulla of the rat and its relationship to descending antinociceptive controls

This study used postembedding immunocytochemistry to examine the organization of GABA-immunoreactive synapse in the rostral ventral medulla (RVM) of the rat. To determine whether the outflow neurons of the RVM are under GABAergic control, we examined the distribution of GABA-immunoreactive synapses upon bulbospinal projection neurons that were labelled by retrograde transport of wheatgerm agglutinin-HRP from the cervical spinal cord. To study the possible convergence of GABAergic and periaqueductal gray (PAG) synaptic inputs to RVM neurons, we also made lesions in the PAG and examined the relationship between degenerating PAG axons and GABA-immunoreactive terminals. Approximately 45% of all synapses in the RVM, which includes the midline nucleus raphe magnus and the nucleus reticularis paragigantocellularis lateralis, were GABA-immunoreactive. The vast majority of GABA-immunoreactive terminals contained round, clear, and pleomorphic vesicles and made symmetrical axodendritic synapses; axoaxonic synapses were not found. Almost 50% of the retrogradely labeled dendrites in the NRM were postsynaptic to GABA-immunoreactive terminals. Several examples of convergence of degenerating PAG terminals and GABAergic terminals onto the same unlabelled dendrite were also found. These data indicate that the projection neurons of the RVM are under profound GABAergic inhibitory control. The results are discussed with regard to the hypothesis that the analgesic action of narcotics and electrical stimulation of the midbrain PAG involves the regulation of tonic GABAergic inhibitory controls that are exerted upon spinally-projecting neurons of the nucleus raphe magnus.

Spinal mediation of the increases in arterial pressure and heart rate in response to intrathecal administration of bicuculline

The present experiments were designed to determine the mechanisms by which the intrathecal administration of the GABAA antagonist, bicuculline (2.2 and 8.8 nmol), at the second thoracic spinal segment (T2) affects cardiovascular function in the anaesthetized rat. Bicuculline produced a dose-related, transient increase in arterial pressure and heart rate which peaked at 5-7 min and persisted for 30 min or more, depending on dose. There was a mutually reversible interaction between bicuculline and intrathecal administration of the GABAA agonist, muscimol (8.8 nmol), which alone decreased arterial pressure and heart rate. Bicuculline was given intrathecally at the third lumbar spinal level (8.8 nmol) and intravenously (8.8 nmol), but in these cases it failed to affect these cardiovascular parameters. Pretreatment with intrathecal infusion of 15 microliters of 1% lidocaine or with intravenous injection of hexemathonium (10 mg/kg) prevented the responses to intrathecal administration of 8.8 nmol of bicuculline at T2. These results demonstrate that the effects of bicuculline on arterial pressure and heart rate are due to an action in the spinal cord on GABAA receptors, and the data may be interpreted as indicating that there is a tonic GABAergic inhibition of sympathetic outflow at the spinal level.

The psychopharmacology of GABA synapses: update 1989

Recent advances in the psychopharmacology of GABA synapses are reviewed. The usefulness of GABA mimetics in tardive dyskinesia and epilepsy has been confirmed, as has a dysfunction of GABA synapses in the etiopathology of these conditions. The antidepressant profile of GABA agonists in animal models for depression has been extended. The role of GABA receptors in the mechanism of action of antidepressants has been further delineated, with a parallelism occurring between the behavioral and biochemical response to antidepressant drug treatment in different animal models of depression.

Relationship between cardiovascular neurones and descending antinociceptive pathways in the rostral ventrolateral medulla of the cat

It has been previously reported that injection of neuroexcitatory compounds into the rostral ventrolateral medulla (RVLM) can produce an inhibition of nociceptive reflexes, often associated with a rise in arterial blood pressure. The aim of this study was to determine whether the subretrofacial (SRF) nucleus, which is a highly circumscribed group of cells within the RVLM known to play a major role in cardiovascular regulation also has an antinociceptive function. In barbiturate-anaesthetised and paralysed cats, unilateral microinjections of the neuroexcitatory compound sodium glutamate (8-20 nl of 0.5 M solution) into the SRF nucleus produced large increases in mean arterial pressure but had only small and inconsistent effects on the simultaneously measured ventral root responses to stimulation of primary afferent C-fibres. On the other hand, glutamate microinjections into RVLM sites closely adjacent to the SRF nucleus, or into the nucleus raphe magnus, produced powerful inhibition of the C-fibre evoked response in the ventral root which was accompanied by no or only small changes in arterial pressure. It is concluded that the SRF pressor cells do not exert any control over nociceptive spinal reflexes, but that such a function may be served by cells in closely adjacent parts of the RVLM. Moreover, the method of recording C-fibre evoked responses in ventral roots as a measure of the magnitude of nociceptive spinal reflexes, combined with the glutamate microinjection procedure, was shown to have a sufficient resolution to allow an accurate mapping of the location of antinociceptive cell groups within the ventrolateral medulla.

GABA-mediated inhibition in nucleus paragigantocellularis lateralis in the cat

In decerebrate cats electrical stimulation (10-20 ms trains, 35-450 microA, 0.1 ms pulses, 450 Hz) in nucleus tractus solitarius (NTS, medial or lateral divisions) or nucleus raphe magnus (NRM) inhibited spontaneous or amino acid-induced neuronal activity in nucleus paragigantocellularis lateralis (PGL) for 8-140 (mean 51) ms. Iontophoretically applied GABA (2-50 nA) also inhibited these cells. Iontophoretically applied bicuculline methiodide (10-80 nA) blocked the effects of GABA and reduced the duration of the inhibition evoked from NRM by greater than 50% (5/6 cells) but had no effect on the inhibition evoked from NTS (6/7 cells). The results are discussed in relation to the role of GABA in mediating inhibitory afferent input to PGL.

Convergent afferent inputs to neurones in nucleus paragigantocellularis lateralis in the cat

Neuronal activity was recorded in nucleus paragigantocellularis lateralis (PGL) of the cat in response to stimulation of the dorsal periaqueductal grey matter (dPAG), parabrachial nucleus (PBN) nucleus raphe magnus (NRM), and nucleus tractus solitarii (NTS). Stimulation in dPAG or PBN evoked excitatory responses whilst the prevalent response to stimulation in NRM or NTS was inhibition of neuronal activity. 45/55 (82%) of cells tested received convergent inputs from 2 or more sites of stimulation. These findings are discussed in relation to the role of PGL in cardiovascular control and descending control of noxious input.