The role of N-methylaspartate receptors in mediating responses of rat and cat spinal neurones to defined sensory stimuli

Selective antinociceptive effects of a combination of the N-methyl-D-aspartate receptor peptide antagonist [Ser(1)]histogranin and morphine in rat models of pain

Numerous rather than a few analgesic endogenous neuropeptides are likely to work in concert in vivo in ameliorating pain. Identification of effective neuropeptide combinations would also facilitate the development of gene or cell-based analgesics. In this study, opioid peptides endomorphin-1 (EM-1) and endomorphin-2 (EM-2) and the peptide histogranin analogue [Ser¹]histogranin (SHG), which possess activity as an N-methyl-d-aspartate (NMDA) receptor antagonist, were intrathecally (i.t.) injected alone and in combination in rat models of acute and persistent pain. None of the peptides when injected alone altered hind paw responses of uninjured rats to acute noxious stimulation. EM-1 and EM-2 showed divergent efficacies in the persistent pain models. For example, EM-1 injected alone was antinociceptive in rats with neuropathic pain, whereas EM-2 demonstrated no efficacy. Demonstration of synergism was also divergent across the models. For example, while SHG combined with EM-1 did not alter the efficacy of EM-1 in rats with neuropathic pain, SHG significantly increased the efficacy of EM-1 in the formalin test. By contrast, the potency and efficacy of the peptides alone and combinations were much less than those of the reference analgesic morphine. Furthermore, morphine combined with the clinically used NMDA receptor antagonist ketamine showed synergism across a broad range of pain states. While the current set of neuropeptides could serve as a basis for analgesic therapeutics, there could be other neuropeptides with greater efficacy and potency and broader therapeutic application.

Ionotropic glutamate receptors in spinal nociceptive processing

Glutamate is the predominant excitatory transmitter used by primary afferent synapses and intrinsic neurons in the spinal cord dorsal horn. Accordingly, ionotropic glutamate receptors mediate basal spinal transmission of sensory, including nociceptive, information that is relayed to supraspinal centers. However, it has become gradually more evident that these receptors are also crucially involved in short- and long-term plasticity of spinal nociceptive transmission, and that such plasticity have an important role in the pain hypersensitivity that may result from tissue or nerve injury. This review will cover recent findings on pre- and postsynaptic regulation of synaptic function by ionotropic glutamate receptors in the dorsal horn and how such mechanisms contribute to acute and chronic pain.

Neurons in the ventral spinal cord are more depressed by isoflurane, halothane, and propofol than are neurons in the dorsal spinal cord

BACKGROUND

Volatile anesthetics act primarily in the spinal cord to produce immobility but their exact site of action is unclear. Between 0.8 and 1.2 minimum alveolar anesthetic concentration (MAC), isoflurane does not depress neurons in the dorsal horn, suggesting that it acts at a more ventral site within the spinal cord such as in premotor interneurons and motoneurons. We hypothesized that isoflurane, halothane, and propofol would exert a greater depressant effect on nociceptive responses of ventral horn neurons when compared with dorsal horn neurons.

METHODS

Rats were anesthetized with isoflurane or halothane and responses of dorsal (<1200 microm deep) and ventral (>1200 microm) lumbar neurons to noxious mechanical stimulation of the hindpaw were determined at 0.8 and 1.2 MAC. In a third group anesthetized with isoflurane at 0.8 MAC, we administered 5 mg/kg propofol while recording responses from dorsal horn or ventral horn neurons.

RESULTS

Dorsal horn neuronal responses were not significantly affected when either isoflurane or halothane was increased from 0.8 to 1.2 MAC; propofol also had no significant effect. On the other hand, with increased isoflurane or halothane concentration, responses of ventral horn neurons were depressed by 60% and 45%, respectively. Propofol profoundly depressed (>90%) ventral horn neurons.

CONCLUSIONS

These data suggest that, in the peri-MAC range, isoflurane, halothane, and propofol have little or no effect on neuronal responses to noxious mechanical stimulation in the spinal dorsal horn but depress such responses in the ventral horn. Immobility produced in the 0.8-1.2 MAC range by these anesthetics appears to result from a depressant action in the ventral horn.

Antinociceptive effects, metabolism and disposition of ketamine in ponies under target-controlled drug infusion

Ketamine is widely used as an anesthetic in a variety of drug combinations in human and veterinary medicine. Recently, it gained new interest for use in long-term pain therapy administered in sub-anesthetic doses in humans and animals. The purpose of this study was to develop a physiologically based pharmacokinetic (PBPk) model for ketamine in ponies and to investigate the effect of low-dose ketamine infusion on the amplitude and the duration of the nociceptive withdrawal reflex (NWR). A target-controlled infusion (TCI) of ketamine with a target plasma level of 1 microg/ml S-ketamine over 120 min under isoflurane anesthesia was performed in Shetland ponies. A quantitative electromyographic assessment of the NWR was done before, during and after the TCI. Plasma levels of R-/S-ketamine and R-/S-norketamine were determined by enantioselective capillary electrophoresis. These data and two additional data sets from bolus studies were used to build a PBPk model for ketamine in ponies. The peak-to-peak amplitude and the duration of the NWR decreased significantly during TCI and returned slowly toward baseline values after the end of TCI. The PBPk model provides reliable prediction of plasma and tissue levels of R- and S-ketamine and R- and S-norketamine. Furthermore, biotransformation of ketamine takes place in the liver and in the lung via first-pass metabolism. Plasma concentrations of S-norketamine were higher compared to R-norketamine during TCI at all time points. Analysis of the data suggested identical biotransformation rates from the parent compounds to the principle metabolites (R- and S-norketamine) but different downstream metabolism to further metabolites. The PBPk model can provide predictions of R- and S-ketamine and norketamine concentrations in other clinical settings (e.g. horses).

Spinal ventral root after-discharges as a pain index: Involvement of NK-1 and NMDA receptors

Nociceptive signals are transmitted to the spinal dorsal horn via primary afferent fibers, and the signals induce withdrawal reflexes by activating spinal motoneurons in the ventral horn. Therefore, nociceptive stimuli increase motoneuronal firing and ventral root discharges. This study was aimed to develop a method for the study of pain mechanisms and analgesics by recording ventral root discharges. Spinalized rats were laminectomized in the lumbo-sacral region. The fifth lumbar ventral root was sectioned and placed on a pair of wire electrodes. Multi unit efferent discharges from the ventral root were increased by mechanical stimulation using a von Frey hair applied to the plantar surface of the hindpaw. The low-intensity mechanical stimuli increased the discharges during stimulation (during-discharges) without increasing the discharges after cessation of stimulation (after-discharges), and the high-intensity mechanical stimuli increased both during- and after-discharges. Pretreatment with resiniferatoxin, an ultrapotent analogue of capsaicin, halved during-discharges and eliminated after-discharges, suggesting that after-discharges are generated by heat- and mechanosensitive polymodal nociceptors. Ezlopitant, a neurokinin-1 (NK-1) receptor antagonist, but not its inactive enantiomer, selectively reduced the after-discharges. Ketamine, an N-methyl-D-aspartate (NMDA) receptor antagonist, preferentially reduced the after-discharges, demonstrating that NK-1 and NMDA receptors mediate the after-discharges. Morphine reduced the after-discharges without affecting during-discharges. By contrast, mephenesin, a centrally acting muscle relaxant, reduced both during- and after-discharges. There results suggest that simultaneous recordings of during- and after-discharges are useful to study pain mechanisms and analgesics as well as to discriminate the analgesic effects from the side effects such as muscle relaxant effects.

Effects of ketamine on electroencephalographic and autonomic arousal and segmental reflex responses in the cat

OBJECTIVE

To provide evidence concerning doses of ketamine that affect electroencephalographic (EEG) and autonomic signs of arousal during nociceptive stimulation.

STUDY DESIGN

Prospective psychophysical test in people. Single injection or progressively increasing infusions of ketamine in cats. ANIMALS AND PEOPLE: Seven people (20-60 years old) and three cats (3-5 kg) for EEG recording and six cats for EMG recordings.

METHODS

In order to define innocuous and nociceptive stimulus intensities which could be applied to cats to evaluate arousal, psychophysical evaluations of sensations elicited by compression of the skin overlying phalangeal bones of the hand were obtained from human subjects. Then, following administration of ketamine, recordings of EEG frequency and of autonomic responses (heart rate, respiratory rate and arterial blood pressure) were obtained before and during stimulation of the tails of cats at pressures identified by human observers as either innocuous or nociceptive. Observations of withdrawal reflexes of the hindlimbs following interdigital skin stimulation were interposed between recording periods. In separate sessions, stretch reflex activity was assessed during awake and anesthetic conditions by recording electromyographic activity from soleus muscles and resistive force to dorsiflexion of the tibiotarsal joint.

RESULTS

There were no changes in either total EEG (0.5-30.0 Hz), low-frequency (0.6-7.5 Hz) or high-frequency (7.5-30.0 Hz) power produced by nociceptive stimulation for a period of 18-24 minutes following an intramuscular bolus dose of ketamine (33.0 mg kg-1), although withdrawal reflexes were present. Thereafter, nociceptive stimulation produced EEG arousal responses in the low-frequency and total power range and increased systolic blood pressure and respiration rate. In tests after intravenous infusion of ketamine (10.0-22.2 mg kg-1 hour-1), total and low-frequency EEG power and autonomic responses to nociceptive stimulation were eliminated. Organized motor responses were never elicited during IV infusion, but withdrawal reflexes were observed at each dosage. Also, stretch reflexes were shown by quantitative analysis to be retained at all doses of ketamine infusion.

CONCLUSIONS AND CLINICAL RELEVANCE

These results show that testing of withdrawal reflexes does not reveal the adequacy of ketamine anesthesia. Segmental stretch and withdrawal reflexes are preserved and can be investigated during infusion of ketamine at doses that eliminate arousal from brief periods of nociceptive stimulation.

Spinal NMDA-receptor dependent amplification of nociceptive transmission to rat primary somatosensory cortex (SI)

The role of NMDA mechanisms in spinal pathways mediating acute nociceptive input to the somatosensory cortex is not clear. In this study, the effect of NMDA-antagonists on nociceptive C fibre transmission to the primary somatosensory cortex (SI) was investigated. Cortical field potentials evoked by CO(2)-laser stimulation of the skin were recorded in the halothane/nitrous oxide anaesthetized rat. The SI nociceptive evoked potential (EP) amplitudes were dependent on the frequency of noxious heat stimulation. The amplitudes of SI potentials evoked by CO(2)-laser pulses (duration 15-20 ms, stimulation energy 21-28 mJ/mm(2)) delivered at a frequency of 0.1 Hz were approximately 40% of the amplitudes of potentials evoked by 1.0 Hz stimulation. After intrathecal lumbar application of either of the NMDA-antagonists CPP or MK-801, the amplitudes of nociceptive SI potentials, evoked by 1.0 Hz stimulation of the contralateral hindpaw, were reduced to approximately 40% of controls. By contrast, field potentials evoked by 0.1 Hz stimulation of the hindpaw were unaffected by MK-801. SI potentials evoked by 1.0 Hz stimulation of the contralateral forepaw did not change after lumbar application of CPP or MK-801, indicating that the depression of hindpaw EPs was due to a segmental effect in the spinal cord. It is concluded that spinal NMDA-receptor mechanisms amplify the acute transmission of nociceptive C fiber input to SI in a frequency-dependent way.

The Effects of NMDA Antagonists on Neuronal Activity in Cat Spinal Cord Evoked by Acute Inflammation in the Knee Joint

In alpha-chloralose-anaesthetized, spinalized cats we examined the effects of NMDA antagonists on the discharges of 71 spinal neurons which had afferent input from the knee joint. These neurons were rendered hyperexcitable by acute arthritis in the knee induced by kaolin and carrageenan. They were located in the deep dorsal and ventral horn and some of them had ascending axons. The N-methyl-d-aspartate (NMDA) antagonists ketamine and d-2-amino-5-phosphonovalerate (AP5), were administered ionophoretically, and ketamine was also administered intravenously. In some of the experiments the antagonists were tested against the agonists NMDA and quisqualate. The effects of the NMDA antagonists consisted of a significant reduction in the resting activity of neurons and/or the responses of the same neurons to mechanical stimulation of the inflamed knee. Intravenous ketamine was most effective in suppressing the resting and mechanically evoked activity in 25 of 26 neurons tested. Ionophoretically applied ketamine had a suppressive effect in 11 of 21 neurons, and AP5 decreased activity in 17 of 24 cells. The reduction in the resting and/or the mechanically evoked discharges was achieved with doses of the antagonists which suppressed the responses to NMDA but not those to quisqualate. These results suggest that NMDA receptors are involved in the enhanced responses and basal activity of spinal neurons induced by inflammation in the periphery.

The in vivo relevance of the varied channel-blocking properties of uncompetitive NMDA antagonists: tests on spinal neurones

The voltage dependence and channel-blocking kinetics of uncompetitive NMDA receptor antagonists have been well-described using in vitro techniques, but there is little evidence concerning the functional significance of these properties in vivo. We have now compared the effects of NMDA antagonists that display varied profiles of voltage-dependent block in vitro, on responses of spinal neurones in anaesthetised rats. The compounds examined were the uncompetitive channel blockers memantine, ketamine and MK-801 and, for comparison, an antagonist that acts at the strychnine-insensitive glycine binding site (MRZ 2/502). Using frequency of spike discharge as an indicator of somatic depolarisation, we have compared the effects of these antagonists on responses evoked by iontophoretic NMDA application and on synaptic responses evoked by pinch or electrical stimulation (the latter eliciting "wind-up"). The effectiveness of the antagonists was directly but variably related to the discharge frequency of the test response. The rank order of dependence on firing rate matched the rank order of voltage dependence reported in vitro, namely: memantine > ketamine > MK-801> or = MRZ 2/502. Doses that reduced responses to iontophoretic application of NMDA were less effective at reducing responses to pinch, perhaps due to the major non-NMDA component of the synaptic response. Memantine preferentially reduced "wind-up" relative to responses to pinch, whereas ketamine and MK-801 reduced both types of synaptic responses in parallel. This "filtering" by low affinity, voltage-dependent NMDA antagonists such as memantine, of non-physiological activity whilst leaving normal synaptic events relatively untouched, may contribute to their more favourable clinical profile.

Supraspinal vs spinal sites of the antinociceptive action of the subtype-selective NMDA antagonist ifenprodil

The N-methyl-D-aspartate (NMDA) antagonist ifenprodil and several structurally related compounds are highly selective for the NR2B-containing receptor subtype. This selectivity could provide an explanation for the reported difference of the analgesic and side-effect profile of ifenprodil-like compounds from other NMDA antagonists. In this work, we have queried if the ifenprodil-induced antinociception can be attributed to the block of NMDA receptors in the spinal cord. Ifenprodil and some other NMDA antagonists (MK-801, memantine) were tested in a model of inflammatory pain (Randall-Selitto) in rats. The in vivo NMDA antagonism was assessed in anaesthetised rats on responses of spinal dorsal horn (DH) neurones to iontophoretic NMDA and in the model of single motor unit (SMU) wind-up. Ifenprodil, MK-801 and memantine dose-dependently increased nociceptive thresholds in the Randall-Selitto model. Antinociceptive doses of the channel blockers selectively antagonised NMDA responses of DH neurones and inhibited wind-up. In contrast, antinociceptive doses of ifenprodil did not show any NMDA antagonism in electrophysiological tests. Although ifenprodil did not inhibit the SMU responses to noxious stimuli in spinalised rats, it markedly and dose-dependently inhibited nociceptive SMU responses in sham-spinalised rats. These results argue against the spinal cord being the principal site of antinociceptive action of ifenprodil; supraspinal structures seem to be involved in this effect.

Mu opiates inhibit long-term potentiation induction in the spinal cord slice

Long-term potentiation (LTP) involves a prolonged increase in neuronal excitability following repeated afferent input. This phenomenon has been extensively studied in the hippocampus as a model of learning and memory. Similar long-term increases in neuronal responses have been reported in the dorsal horn of the spinal cord following intense primary afferent stimulation. In these studies, we utilized the spinal cord slice preparation to examine effects of the potently antinociceptive mu opioids in modulating primary afferent/dorsal horn neurotransmission as well as LTP of such transmission. Transverse slices were made from the lumbar spinal cord of 10- to 17-day-old rats, placed in a recording chamber, and perfused with artificial cerebrospinal fluid also containing bicuculline (10 microM) and strychnine (1 microM). Primary afferent activation was achieved in the spinal slice by electrical stimulation of the dorsal root (DR) or the tract of Lissauer (LT) which is known to contain a high percentage of small diameter fibers likely to transmit nociception. Consistent with this anatomy, response latencies of LT-evoked field potentials in the dorsal horn were considerably slower than the response latencies of DR-evoked potentials. Only LT-evoked field potentials were found to be reliably inhibited by the mu opioid receptor agonist [D-Ala(2), N-Me-Phe(4), Gly(5)] enkephalin-ol (DAMGO, 1 microM), although evoked potentials from both DR and LT were blocked by the AMPA/kainate glutamate receptor antagonist 6-cyano-7-nitroquinoxalene-2,3-dione. Moreover repeated stimulation of LT produced LTP of LT- but not DR-evoked potentials. In contrast, repeated stimulation of DR showed no reliable LTP. LTP of LT-evoked potentials depended on N-methyl-D-aspartate (NMDA) receptor activity, in that it was attenuated by the NMDA antagonist APV. Moreover, such LTP was inhibited by DAMGO interfering with LTP induction mechanisms. Finally, in whole cell voltage-clamp studies of Lamina I neurons, DAMGO inhibited excitatory postsynaptic current (EPSC) response amplitudes from LT stimulation-evoked excitatory amino acid release but not from glutamate puffed onto the cell and increased paired-pulse facilitation of EPSCs evoked by LT stimulation. These studies suggest that mu opioids exert their inhibitory effects presynaptically, likely through the inhibition of glutamate release from primary afferent terminals, and thereby inhibit the induction of LTP in the spinal dorsal horn.

Differential effects of calcitonin gene-related peptide and calcitonin gene-related peptide 8-37 upon responses to N-methyl-D-aspartate or (R, S)-alpha-amino-3-hydroxy-5-methylisoxazole-4-propionate in spinal nociceptive neurons with knee joint input in the rat

Calcitonin gene-related peptide is involved in the spinal processing of nociceptive input from the knee joint and in the generation and maintenance of joint inflammation-evoked hyperexcitability of spinal cord neurons. The present study examined whether this peptide influences the excitation of nociceptive spinal cord neurons by agonists at the N-methyl-D-aspartate and the non-N-methyl-D-aspartate [(R, S)-alpha-amino-3-hydroxy-5-methylisoxazole-4-propionate (AMPA)/kainate] receptors, both of which are essential for the excitation and hyperexcitability of spinal cord neurons. In anaesthetized rats extracellular recordings were made from dorsal horn neurons with knee input, and compounds were administered ionophoretically close to the neurons recorded. When calcitonin gene-related peptide was administered the responses of the neurons to the application of both N-methyl-D-aspartate and AMPA were increased. The coadministration of the antagonist calcitonin gene-related peptide 8-37 had no effect on the responses to N-methyl-D-aspartate, but it prevented the enhancement of the responses to N-methyl-D-aspartate by calcitonin gene-related peptide. By contrast, the administration of calcitonin gene-related peptide 8-37 enhanced the responses of the neurons to AMPA, and it did not antagonize but rather increased the effects of calcitonin gene-related peptide on these responses. The data suggest that the facilitatory role of calcitonin gene-related peptide on the development and maintenance of inflammation-evoked hyperexcitability is caused at least in part by the modulation of the activation of the dorsal horn neurons through their N-methyl-D-aspartate and non-N-methyl-D-aspartate receptors. The different effects of calcitonin gene-related peptide 8-37 on the respones to N-methyl-D-aspartate and AMPA suggest that different intracellular pathways may facilitate the activation of N-methyl-D-aspartate and ionotropic non-N-methyl-D-aspartate receptors.

Effect of muscle pain and intrathecal AP-5 on electromyographic patterns during treadmill walking in the rat

1. A physio-neuropharmacological model to assess in the rat the contribution of muscular nociceptive input to motor dysfunction and pharmacological aspects of spinal sensorimotor interaction, during treadmill walking, is presented. 2. Rats were trained to walk on a treadmill prior to chronic electromyographic electrode implantation and intrathecal catheterization. 3. Changes in electromyographic activities were recorded from the median gastrocnemius and tibialis anterior muscles of the right hindlimb, during rhythmic locomotor movements. 4. Intramuscular hypertonic saline 6% was injected into the right triceps surae muscles to produce an experimental muscle pain during treadmill walking. 5. Pain produced a decrease in both median gastrocnemius and tibialis anterior electromyographic activities during rhythmic locomotion. Mean gastrocnemius burst duration decreased while tibialis anterior burst duration increased. 6. AP-5, an NMDA receptor antagonist known to block the synaptic excitatory drive to central pattern generators, was injected intrathecally at the level of the lumbar spinal cord to validate this neuropharmacological model. 7. Intrathecal AP-5 induced a decrease of both median gastrocnemius and tibialis anterior muscle activities during treadmill walking. This pharmacological intervention aggravated behavioural and motor effects of muscle pain.

Severe lightning pain after subarachnoid block in a patient with neuropathic pain of central origin: which drug is best to treat the pain?

OBJECTIVE

There have been many reports that spinal anesthesia induces severe lightning pain in the lower limbs of patients with phantom limb pain, tabes dorsalis, or causalgia. We report on a patient with neuropathic pain of central origin who showed newly developed severe lightning pain after therapeutic subarachnoid block (SAB). We performed SAB 16 times in this patient, and he complained of severe pain each time. We investigated which drug was best for treating such induced pain by administering various drugs to the patient.

SETTING

The patient was hospitalized for treatment and observation.

PATIENT

The patient was a 48-year-old man with neuropathic pain secondary to an incomplete spinal cord injury at the cervical segment.

INTERVENTIONS

Various drugs were administered for relieving the newly developed severe pain, and the effectiveness of these agents was compared.

RESULTS AND CONCLUSIONS

Intravenous thiopental, fentanyl, butorphanol, ketamine, midazolam, droperidol, and sevoflurane-oxygen anesthesia were quite effective. Intramuscular butorphanol was not effective. Intravenous physiologic saline and atropine sulfate as a placebo, intrathecal morphine hydrochloride, intravenous mexiletine, and lidocaine were ineffective. Intravenous thiopental (approximately 1 mg/kg) was thought to obtain the best pain relief because it stopped the pain quickly, the dose needed was subanesthetic, and there was no adverse effect.

Synaptic control of motoneuronal excitability

Movement, the fundamental component of behavior and the principal extrinsic action of the brain, is produced when skeletal muscles contract and relax in response to patterns of action potentials generated by motoneurons. The processes that determine the firing behavior of motoneurons are therefore important in understanding the transformation of neural activity to motor behavior. Here, we review recent studies on the control of motoneuronal excitability, focusing on synaptic and cellular properties. We first present a background description of motoneurons: their development, anatomical organization, and membrane properties, both passive and active. We then describe the general anatomical organization of synaptic input to motoneurons, followed by a description of the major transmitter systems that affect motoneuronal excitability, including ligands, receptor distribution, pre- and postsynaptic actions, signal transduction, and functional role. Glutamate is the main excitatory, and GABA and glycine are the main inhibitory transmitters acting through ionotropic receptors. These amino acids signal the principal motor commands from peripheral, spinal, and supraspinal structures. Amines, such as serotonin and norepinephrine, and neuropeptides, as well as the glutamate and GABA acting at metabotropic receptors, modulate motoneuronal excitability through pre- and postsynaptic actions. Acting principally via second messenger systems, their actions converge on common effectors, e.g., leak K(+) current, cationic inward current, hyperpolarization-activated inward current, Ca(2+) channels, or presynaptic release processes. Together, these numerous inputs mediate and modify incoming motor commands, ultimately generating the coordinated firing patterns that underlie muscle contractions during motor behavior.

Effects of NMDA receptor antagonists on nociceptive responses in vivo: comparison of antagonists acting at the glycine site with uncompetitive antagonists

We have shown that members of a new series of tricyclic pyridophthalazine diones, defined as glycineB site NMDA antagonists in vitro, are selective and systemically active NMDA antagonists in vivo. In electrophysiological tests in alpha-chloralose anaesthetised rats, these compounds reduced nociceptive reflex responses. In conscious rats they displayed analgesic properties. These glycineB antagonists were compared electrophysiologically with several uncompetitive NMDA channel blockers. The degree of voltage dependence previously reported in vitro related to the effectiveness of the agents against different amplitude nociceptive responses of spinal cord neurones in vivo.

Sensitivity of the N-methyl-D-aspartate receptor channel to butyrophenones is dependent on the epsilon2 subunit

The effects of three kinds of butyrophenones, haloperidol, droperidol and spiperone, on the N-methyl-D-aspartate (NMDA) receptor channel were examined on the epsilon1/zeta1, epsilon2/zeta1, epsilon3/zeta1 and epsilon4/zeta1 heteromeric NMDA receptor channels, expressed in Xenopus oocytes. Micromolar concentrations of haloperidol selectively inhibited the epsilon2/zeta1 channel, whereas the epsilon1/zeta1, epsilon3/zeta1 and epsilon4/zeta1 channels were enhanced or minimally affected by higher concentrations of haloperidol. Similarly, droperidol and spiperone inhibited the epsilon2/zeta1 channel more strongly than the other epsilon/zeta channels, although sensitivities of the epsilon2/zeta1 channel to droperidol and spiperone were lower than those to haloperidol. These results suggest that the sensitivities of the NMDA receptor channels to butyrophenones are dependent on the epsilon2 subunit. Furthermore, the replacement with glutamine of the conserved asparagine residue in segment M2, which constitutes the Mg2+ block sites, of the epsilon2 and zeta1 subunits (the mutations epsilon2-N589Q and zeta1-N598Q, respectively) reduced the sensitivities to haloperidol. The mutation zeta1-N598Q reduced the sensitivities to haloperidol more effectively than the mutation epsilon2-N589Q. These results, together with previous findings, suggest that the haloperidol block sites of the NMDA receptor channel partially overlap the Mg2+ block sites.

Electrophysiological evidence for an antinociceptive effect of ketamine in the rat spinal cord

BACKGROUND

The dissociative anesthetic ketamine also has antinociceptive effects. The mechanism and the site of action of such effect of ketamine have been, however, elusive and controversial. The present study was conducted to examine the effect of systemically administered ketamine on spinal nociceptive transmission.

METHODS

We investigated and compared the effects of ketamine (0.25-8 mg/kg) on the hamstring flexor reflex in intact, lightly anesthetized rats and spinally transected rats. The opioid receptor antagonist naloxone was used to examine the involvement of opioid receptors in the actions of ketamine. Finally, the effects of ketamine on dorsal horn neuronal activity to electrical stimulation of peripheral nerves were also studied.

RESULTS

Ketamine caused similar dose-dependent depression of the hamstring flexor reflex recorded from spinally intact rats and from spinalized rats. Even the highest dose of ketamine failed to influence the monosynaptic reflex. The depressive effect of ketamine on the flexor reflex was not reversed by naloxone. Ketamine i.v. also exerted a relatively selective inhibition of the responses of dorsal horn wide-dynamic-range neurons to C-fiber input of electrical stimulation of the plantar nerve.

CONCLUSIONS

Our present results support the notion that ketamine can exert a direct antinociceptive effect in rat spinal cord. Moreover, the data indicated that the spinal antinociceptive effect of ketamine does not involve naloxone-sensitive opioidergic mechanisms.

Morphine and dextrorphan lose antinociceptive activity but exhibit an antispastic action in chronic spinal rats

Within 3-4 weeks after spinal transection, morphine-induced antinociception, assessed with the tail flick reflex in rats, is profoundly reduced. The cause of this decrement is unknown. The present studies were conducted to determine whether this phenomenon reflects a general loss in opiate activity or a selective decline in opiate antinociception. This was accomplished by assessing the effect of morphine on two different responses, the tail flick reflex and the hindlimb spasticity that develops in chronic spinal rats. Because excitatory amino acid antagonists are also antinociceptive in acute spinal rats, the effect of one such drug, dextrorphan, on these two behaviors was also evaluated in chronic spinal animals. The antinociceptive and antispastic effect of subcutaneous (6 mg/kg) and intrathecal (5 micrograms) morphine injections were assessed in intact and chronic (21-28 days) spinal rats, whereas the effect of subcutaneous (25 and 40 mg/kg) and intrathecal (350 micrograms) dextrorphan was assessed in acute (1 day) and chronic spinal rats. The antinociceptive effect of both drugs was significantly reduced in chronic spinal animals, relative to saline controls. However, each drug treatment produced a significant antispastic effect in the same animals, indicating a selective decline in opiate action. This outcome also suggests that excitatory amino acid antagonists may be useful as adjunct antispastic agents.

Stimulus intensity, cell excitation and the N-methyl-D-aspartate receptor component of sensory responses in the rat spinal cord in vivo

The importance of receptors for N-methyl-D-aspartate in synaptic plasticity and in triggering long-term pronociceptive changes is explained by their voltage-dependence. This suggests that their contribution to acute nociceptive responses would be determined both by the magnitude of synaptic input and by the level of background excitation. We have now examined the role of N-methyl-D-aspartate receptors in acute nociceptive transmission in the spinal cord. Drugs selectively affecting activity mediated by these receptors were tested on responses of dorsal horn neurons to noxious stimuli of different intensities and at different levels of ongoing spike discharge. The drugs used were the N-methyl-D-aspartate receptor channel blocker ketamine; the competitive antagonists, 3-((R)-2-carboxypiperazin-4-yl)-propyl-1-phosphonic acid (D-CPP) and D-2-amino-5-phosphonopentanoic acid (D-AP5), and the positive modulator thyrotropin-releasing hormone. The activity of dorsal horn wide dynamic range neurons was recorded extracellularly in alpha-chloralose-anaesthetized spinalized rats. Their responses to noxious stimuli (pinch, heat and electrical) were monitored in parallel with responses to iontophoretic N-methyl-D-aspartate and (RS)-alpha-amino-3-hydroxy-5-methyl-4-isoxazole-propionic acid (AMPA). Drugs were given i.v. or (D-AP5) iontophoretically. At doses that selectively inhibited responses to exogenous N-methyl-D-aspartate, ketamine (4 or 8, mean 5 mg/kg i.v.) reduced the nociceptive responses of the majority of the cells in deep dorsal horn. Ketamine also reduced wind-up of the responses to repetitive electrical stimulation. Ketamine (4 or 8 mg/kg). D-CPP (2 mg/kg), D-AP5 (iontophoretically) and thyrotrophin-releasing hormone (1 mg/kg) were tested on different magnitude nociceptive responses evoked by alternating intensities of noxious heat or pinch. In percentage terms, the less vigorous responses were affected by all four drugs as much as or more than the more vigorous responses. When background activity of neurones was enhanced by continuous activation of C-fibres with cutaneous application of mustard oil, ketamine was less effective against superimposed noxious pinch responses. Ongoing background activity was affected in parallel with evoked responses. When background discharge of the cells was maintained at a stable level with continuous ejection of kainate, neither the N-methyl-D-aspartate antagonists nor thyrotrophin-relasing hormone affected the responses to noxious pinch or heat, although responses to exogenous N-methyl-D-aspartate were still blocked. The wind-up of the electrical responses was, however, reduced by ketamine irrespective of the level of background activity. The results indicate that under these conditions in vivo, N-methyl-D-aspartate receptors mediate ongoing low-frequency background activity rather than phasic high-frequency nociceptive responses. The effects of N-methyl-D-aspartate antagonists and positive modulators on nociceptive responses are evidently indirect, being secondary to changes in background synaptic excitation. These results cannot be explained simply in relation to the voltage-dependence of N-methyl-D-aspartate receptor-mediated activity; other factors, such as modulation by neuropeptides, must be involved.

Spinal conduction block by intrathecal ketamine in dogs

In addition to its use for intravenous (I.V.) anesthesia, ketamine can provide pain relief in humans when administered spinally. To elucidate the mechanisms of intrathecal (I.T.) ketamine analgesia, we observed differences in the effects of I.V. and I.T. ketamine on intraspinal evoked potentials (ISEPs) in 28 dogs anesthetized with pentobarbital. Bipolar extradural electrodes were inserted at the cervical and lumbar regions of the spinal cord for recording descending ISEPs represented by the two negative deflections, Waves I and II. I.V. ketamine 2 and 10 mg/ kg did not affect the amplitude and latency of Wave I, whereas the large dose (10 mg/kg) significantly decreased the amplitude but not the latency of Wave II. I.T. ketamine 1 and 5 mg/kg caused significant dose-dependent decreases in both Wave I and II amplitudes and prolongations of both Wave I and II latencies. These I.T. effects on ISEPs are consistent with previous in vitro observations that ketamine blocks axonal conduction. We conclude that axonal conduction block may contribute to the analgesic mechanism of I.T. ketamine.

Testing hypotheses of spatial learning: the role of NMDA receptors and NMDA-mediated long-term potentiation

The role of NMDA receptors and NMDA-mediated hippocampal long-term potentiation (LTP) in spatial learning was studied in rats using the competitive, systemically administered NMDA receptor antagonists CGS19755 ((+/-)-cis-4-phosphonomethyl-2-piperidine carboxylic acid) and NPC17742 (2R,4R,5S-2-amino-4,5-(1,2-cyclohexyl)-7-phosphonoheptanoic acid). CGS19755 caused sensorimotor disturbances and disrupted acquisition of the water maze in naive rats. The sensorimotor disturbances were greatly reduced and maze learning was normal in spite of the blockade of dentate gyrus LTP by CGS19755 in rats that had first been familiarized with the general task requirements by non-spatial pretraining. In a second experiment, antagonism of NMDA receptors caused small, but reliable, impairments in Y-maze and visible platform visual discrimination tasks. The results indicate that NMDA receptors are not crucial for water maze acquisition using a spatial learning strategy, and that NMDA antagonists cause visual and other sensorimotor disturbances in naive rats that could help account for their poor performance in this task.

Thyrotropin-releasing hormone facilitates spinal nociceptive responses by potentiating NMDA receptor-mediated transmission

The interaction of thyrotropin-releasing hormone (TRH) with NMDA receptor-mediated responses has been investigated in alpha-chloralose-anaesthetized spinalized rats with respect to its relevance to spinal nociceptive transmission. The effects of TRH and of the uncompetitive NMDA antagonist ketamine were tested on responses of dorsal horn wide dynamic range neurones to noxious pinch, heat and electrical stimuli in parallel with those to iontophoretically applied N-methyl-D-aspartate (NMDA) and AMPA (alpha-amino-3-hydroxy-5-methylisoxazole-4-propionic acid). Tests with NMDA blocking doses of ketamine (4 mg/kg i.v.) demonstrated a variable NMDA receptor-mediated component of all synaptic responses. TRH (0.5-1 mg/kg i.v.) enhanced the responses to NMDA (but not AMPA) in parallel with an increase of responses to all noxious stimuli and the 'wind-up' component of the responses to repeated electrical stimulation. This potentiation was completely reversed by a subsequent administration of ketamine (4 mg/kg i.v.). The results indicate that TRH facilitates nociceptive transmission in the spinal dorsal horn via a selective positive modulation of NMDA receptor-mediated transmission.

NMDA-receptor contribution to spinal nociceptive reflexes: influence of stimulus parameters and of preparatory surgery

The contribution of NMDA receptors to nociceptive reflexes has been assessed both in awake rats and in electrophysiological tests on alpha-chloralose anaesthetized spinalized rats prepared with different degrees of surgery. Single motor unit activity was recorded in response to alternating noxious mechanical and electrical stimuli applied to one hindpaw, and the results compared with paw pressure withdrawal reflexes in awake rats. There was little contribution by NMDA receptors to nociceptive paw pinch responses either in awake rats or in rats prepared with minimal surgery, but following extensive lumbar surgery the contribution increased significantly to a level similar to that seen in the wind-up component of responses elicited by electrical stimulation. Surgery therefore has effects several segments from the sensory input that it generates. It enhances the NMDA receptor contribution in responses to some but not all types of afferent input.

Attenuation of morphine-induced antinociception by L-glutamic acid at the spinal site in rats

The present experimental study was planned to evaluate the effect of intrathecal administration of L-glutamic acid upon antinociception produced by intrathecal morphine in a prospective-controlled manner in conscious freely mobile Sprague-Dawley albino rats. After chronic catheterization of the spinal subarachnoid space, rats were randomly allocated into 12 treatment groups of ten each and the same number of rats served as saline control for the comparison. L-glutamic acid (100 mmol), morphine (1.2 mmol), ketamine (50 mmol) and saline (150 mmol) were injected intrathecally in 5 microliters volumes. Naloxone was injected in a dose of 1 mg.kg-1 im. Immediately before and 15, 30 min, 1, 2 and 3 hr after injection, rats were subjected to a thermal noxious stimulus, using a tail-flick technoanalgesiometer and tail-flick latencies (TFL) were recorded. Intrathecal administration of L-glutamic acid attenuated the antinociceptive effect of intrathecal morphine with a decrease in TFL (1.4 +/- 0.3 sec; P < 0.0001) from 6.6 +/- 0.3 sec. Ketamine led to abolition of this effect (P < 0.01). In rats, pretreated with naloxone, there was restoration as well as augmentation of morphine-induced antinociception in the presence of L-glutamic acid with an increase in TFL (9.0 +/- 0.4 sec; P < 0.0001). We conclude that there is modulation of opioid receptors by L-glutamic acid at the spinal site in rats.

Infusion of substance P or neurokinin A by microdialysis alters responses of primate spinothalamic tract neurons to cutaneous stimuli and to iontophoretically released excitatory amino acids

The responses of 25 spinothalamic tract (STT) neurons to mechanical and thermal stimulation of the skin, as well as to a battery of iontophoretically applied excitatory amino acids (EAAs), were tested before and then during microdialysis of substance P (SP) or neurokinin A (NKA) into the dorsal horn of anesthetized monkeys. Neither peptide had significant effects on the background activity or the responses to mechanical or thermal stimulation of the skin. However, each peptide produced significant increases in the responses to iontophoretic application of one or more EAAs. In addition, following combined application of the EAAs and either SP or NKA, the responses of the cells to mechanical stimulation of the skin increased. Combined application of SP and NKA failed to produce an increase in responses to either the EAAs or to cutaneous stimuli that was greater than that produced by either peptide alone. It is concluded that SP and NKA produce an increase in the responses of STT cells to iontophoretic applications of EAAs and the combined effects of these compounds produce sustained increases in responses to mechanical stimulation of the skin. These changes mimic those observed when STT cells are sensitized by peripheral noxious stimuli, suggesting that the mechanism of induction and expression of sensitization involves the facilitation of dorsal horn neuron responses to EAAs by tachykinins.

Excitatory amino acid receptors modulate habituation of the response to visual stimulation in the cat superior colliculus

In visual neurones of the superficial layers of the superior colliculus (SSC), repetitive stimulation causes a progressive decline in the size of the response to the stimulus, usually known as response habituation or response adaptation. A mechanism has been proposed in which habituation results from coactivation of excitatory and inhibitory neurones, and the responses of the inhibitory neurones block the response to subsequent stimulus presentations. Excitatory amino acid (EAA) neurotransmitters mediate visual responses via NMDA and non-NMDA receptors in cat SSC. We have investigated the role of these receptors in the generation of response habituation. Following the iontophoretic application of the EAA antagonists CNQX, AP5 or CPP, repetitive visual stimulation paradigms which normally produce response habituation no longer do so. Indeed the response to each presentation of the stimulus is similar. Intravenous administration of the dissociative anesthetic ketamine (2-10 mg/kg) had similar actions to iontophoretically applied NMDA antagonists. The data imply that intracollicular mechanisms activated by NMDA and non-NMDA receptors contribute to the generation of the inhibitory responses in SCC which lead to response habituation. Furthermore, the effects seen with ketamine anesthesia suggest that the use of ketamine in studies of sensory systems may result in the lack of habituation.

Continuous subcutaneous administration of the N-methyl-D-aspartic acid (NMDA) receptor antagonist ketamine in the treatment of post-herpetic neuralgia

The effect of continuous subcutaneous (s.c.) infusion of ketamine on nerve injury pain was examined in patients with post-herpetic neuralgia. Five patients that reported pain relief after acute intravenous injection of ketamine were included in this open prospective study. Ketamine was administered continuously in increasing doses using a portable infusion pump (CADD-PLUS, Pharmacia), and the treatment period for each infusion rate (0.05, 0.075, 0.10, or 0.15 mg/kg/h) was 7 days and nights. Relief of continuous pain, as evaluated daily by visual analogue scales, was observed at the infusion rate of 0.05 mg/kg/h, but was most marked during infusion of 0.15 mg/kg/h. All the patients reported that ketamine reduced the severity of continuous pain as well as reduced the severity and number of attacks of spontaneous pain. Changes in evoked pain (allodynia and wind-up-like pain) were recorded before change of infusion rate. Allodynia was maximally reduced 59-100% after 1 week infusion of 0.05 mg/kg/h, and wind-up-like pain was maximally reduced 60-100% after 1 week infusion of 0.15 mg/kg/h. Itching and painful indurations at the injection site was the most bothersome side-effect and for this reason 1 patient discontinued treatment after 2 weeks. Other common side-effects were nausea, fatigue and dizziness. The present results show that continuous, spontaneous and evoked pain in patients with post-herpetic neuralgia is reduced by continuous s.c. infusion of ketamine, but is associated with intolerable side effects.

The isolated mammalian spinal cord

This review considers: spinal cord slices; isolated spinal cord sagitally or transversely hemisected; whole spinal cord; respiration control--[brain-stem spinal cord; brain-stem spinal cord with attached lungs]; nociception--[spinal cord with tail]; fictive locomotion--[spinal cord with one hind limb; spinal cord with two hind limbs]. Much of the functional circuitry of the CNS can be studied in the isolated spinal cord with the additional advantage that the isolated spinal cord can be perfused with known concentrations of ions, neurotransmitters, agonists, antagonists, and anaesthetics. These can be washed away, the circuitry allowed to recover and other drugs or different concentrations applied. Future preparations including the complete spinal cord, the two hind limbs, and a sagittal section of the complete brain will allow greater understanding of the multiple sensory and motor pathways and their interactions in the CNS.

Plasticity in spinal nociception after peripheral nerve section: reduced effectiveness of the NMDA receptor antagonist MK-801 in blocking wind-up and central sensitization of the flexor reflex

We have examined and compared the effects of systemically applied MK-801, an NMDA receptor/channel blocker, on the wind-up and facilitation of the flexor reflex during and after conditioning stimulation (CS) of C-afferents in rats with intact sciatic nerves or 13-16 days after axotomy. In rats with intact sciatic nerves, intravenous MK-801 (0.5 mg/kg) partially reduced wind-up and totally blocked reflex facilitation following C-fiber CS to the sural nerve. In contrast, 13-16 days after unilateral section of the sciatic nerve, the same dose of MK-801 failed to reduce the wind-up and reflex facilitation following C-fiber CS to the axotomized sural nerve, although the duration of reflex facilitation was significantly shortened. These findings indicate that the involvement of NMDA receptors in mediating activity-dependent spinal hyperexcitability is substantially reduced after peripheral nerve section, possibly reflecting a reduced release of glutamate by primary sensory afferents.

Exposure of rat spinal neurones to NMDA, AMPA and kainate produces only short-term enhancements of responses to noxious and non-noxious stimuli

The ability of excitatory amino acids (EAAs) to modulate nociceptive and non-nociceptive responses was tested on spinal neurones of the anaesthetized rat. NMDA (N-methyl-D-aspartate), AMPA ((RS)-alpha-amino-3-hydroxy-5-methyl-4-isoxazole-propionate) and kainate were applied by iontophoretic ejection to increase the background firing rate of each cell to approximately 25 spikes/s. Responses to noxious heat and pinch and innocuous tap stimuli were enhanced to similar degrees by all three EAAs and returned to control immediately following termination of EAA ejection. This result shows that, whilst NMDA does enhance synaptic responses of spinal neurones, this effect is little or no greater than for AMPA or kainate. Furthermore, the rapid recovery of nociceptive responses indicates that more than NMDA receptor activation alone is required to induce longer-term enhancement of nociceptive responses (hyperalgesia).

A comparison of intravenous NBQX and GYKI 53655 as AMPA antagonists in the rat spinal cord

1. The effects of intravenous administration of two alpha-amino-3-hydroxy-5-methylisoxazole-4-propionic acid (AMPA) antagonists were studied on responses of single neurones to iontophoretically applied excitatory amino acids. The tests were performed on spinal neurones in alpha-chloralose anaesthetized, spinalized rats. 2. Both the quinoxaline, NBQX (2-16 mg kg-1) and the 2,3-benzodiazepine, GYKI 53655 (2-8 mg kg-1) dose-dependently decreased responses to AMPA. 3. Both compounds were short acting, with half-recovery times of 15 min for NBQX and 7 min for GYKI 53655. 4. The selectivity for responses to AMPA over those to N-methyl-D-aspartate (NMDA) was significantly poorer for systemic NBQX than for either systemic GYKI 53655 or iontophoretic NBQX, suggesting that systemic NBQX may be converted to a less selective metabolite. 5. GYKI 53655 is therefore likely to be a more valuable tool than NBQX for the study of AMPA receptor-mediated processes in vivo.

NMDA receptors and activity-dependent tuning of the receptive fields of spinal cord neurons

After peripheral nerve section, sensory neurons regenerate but do not regain their original topographical position in the skin. Here we report that in the early stages of sciatic nerve regeneration, the cutaneous receptive fields (RFs) of dorsal horn neurons are larger than normal, reflecting the disorganized topography of the regenerated afferents. When nerve regeneration is complete, small contiguous RFs emerge, indicating a central compensation for the disrupted peripheral somatotopy. If the NMDA receptor antagonist MK801 is given during regeneration, RFs do not show this reorganization, but remain large and diffuse. We suggest that the coincident activity of afferents, newly innervating adjacent or overlapping cutaneous territory, acts through postsynaptic NMDA receptors to strengthen the central effectiveness of these inputs at the expense of other non-adjacent and non-coincidently activated inputs. In this way, dorsal horn neurons may attain and retain restricted RFs in the face of a spatially dispersed afferent input.

Memantine selectively depresses NMDA receptor-mediated responses of ratspinal neurones in vivo

The clinically used agent memantine (1-amino-3,5-dimethyladamantane) can act as an antagonist of NMDA (N-methyl-D-aspartate) when tested in vitro, but whether this applies with clinically relevant doses under in vivo conditions is not clear. In this study memantine has been compared with the known NMDA channel blocker ketamine, by intravenous administration in anaesthetized rats, for effects on the responses of spinal neurones both to iontophoretic administrations of excitatory amino acids and to peripheral noxious stimuli. Spontaneous activity, nociceptive responses and blood pressure were not significantly affected by memantine and ketamine, whereas both agents selectively reduced responses to NMDA.

Thyrotropin-releasing hormone (TRH)-induced facilitation of spinal neurotransmission: a role for NMDA receptors

Thyrotropin-releasing hormone (TRH) is known to enhance spinal reflexes and modulate NMDA receptors in supraspinal areas. We have investigated the relationship between TRH and NMDA receptors in the spinal cord of alpha-chloralose-anaesthetized spinalized rats. TRH was tested (a) on dorsal horn neurone responses to iontophoretic NMDA, AMPA and kainate and (b) on spinal reflexes evoked by noxious pinch and electrical stimulation (2 Hz) shown to involve NMDA receptor activation. TRH given i.v. (0.5 mg/kg) or iontophoretically selectively potentiated neuronal responses to NMDA. TRH (0.5-2 mg/kg) also dose-dependently increased single motor unit reflex responses. The NMDA antagonist ketamine (2 mg/kg i.v.) abolished these TRH effects; ketamine reduced single motor unit (SMU) reflex responses more effectively when administered after TRH than in pre-TRH control tests. These results indicate that TRH-induced facilitation of spinal sensory transmission involves NMDA receptor activation.

Excitatory amino acid receptor-mediated neurotransmission from cutaneous afferents in rat dorsal horn in vitro

1. The cutaneous mechanoreceptive fields (RFs) of forty-two lumbar dorsal horn neurones have been examined intracellularly using the hemisected spinal cord-hindlimb preparation of 10 to 14-day-old rats. The neurones were classified into three groups on the basis of their excitatory responses to innocuous and noxious mechanical stimulation; the majority (25/42) were activated by noxious and innocuous stimuli and were classed as 'wide-dynamic' type (WDR). 'Nociceptive-specific' neurones (NS) which were excited by noxious stimuli made up the next largest group (12/42) followed by 'low-threshold' neurones (LT, 5/42) which responded only weakly to noxious stimuli. Another fourteen neurones which did not respond to peripheral stimuli were used to test antagonist selectivity against excitatory amino acid agonists. 2. The response to light touch or pinch consisted of an initial EPSP and cell firing followed by subthreshold EPSPs. The mean +/- S.E.M. values for the amplitude (mV) and the duration (s) of the EPSP produced by noxious pinch were significantly greater than those to touch; in WDR neurones the respective values were 14.3 +/- 0.9 vs. 11.5 +/- 0.7 mV (P < 0.01) and 11.9 +/- 1.8 vs. 4.8 +/- 0.6 s (P < 0.01). 3. The non-NMDA receptor antagonist 6-cyano-7-nitroquinoxaline-2,3-dione (CNQX, 3-5 microM) antagonized DL-alpha-amino-3-hydroxy-5-methyl-4-isoxazole-propionate (AMPA)-induced depolarizations. The amplitude and duration of the EPSPs produced in response to low- and high-threshold mechanical stimulation were potently attenuated and cell firing was abolished in WDR, NS, LT neurones. A similar profile of antagonism was produced in five WDR neurones superfused with ACSF containing 1 mM D-serine. 4. The NMDA-receptor antagonist D-aminophosphonovalerate (D-AP5, 50 microM) attenuated the EPSP amplitude and duration but never abolished cell firing produced by low- and high-intensity cutaneous mechanical stimulation. A preferential effect of D-AP5 against the EPSP duration resulted in failure of longer latency spikes. 5. The data indicate that non-NMDA receptors contribute substantially to dorsal horn neurotransmission and somatosensory processing of noxious and innocuous cutaneous stimuli, while the role of NMDA receptors is restricted to longer latency synaptic components.

Central hyperexcitability triggered by noxious inputs

Repetitive activity in unmyelinated sensory afferent neurones, arising from electrical stimuli, tissue injury or nerve damage, can induce long-lasting sensitization in dorsal horn neurones. This process can be blocked by antagonists of the NMDA receptor. In the past year it has emerged that sensory neuropeptides and nitric oxide are also essential mediators of this phenomenon.

Excitatory amino acid receptor mediation of sensory inputs to functionally identified dorsal horn neurons in cat spinal cord

As excitatory amino acid receptors have been implicated in nociceptive sensory transmission, the principal objective of the present study was to investigate the effects of various excitatory amino acid antagonists on naturally evoked responses in spinal dorsal horn neurons. Extracellular single unit activity was recorded from functionally identified, spinal dorsal horn neurons in unanesthetized, decerebrated cats and in alpha-chloralose-anesthetized cats. The tests included iontophoretic application of the N-methyl-D-aspartate (NMDA) receptor antagonist 2-amino-5-phosphonovaleric acid (APV), the non-N-methyl-D-aspartate receptor antagonists 6-cyano-7-nitroquinoxaline-2,3-dione (CNQX) and kynurenate, and also the intravenous administration of the N-methyl-D-aspartate receptor antagonist, ketamine. In addition, attempts were made to determine the effects on these neurons of iontophoretic application of the excitatory amino acid agonists, L-glutamate, N-methyl-D-aspartate, quisqualate, (RS)-alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionate (AMPA) and domoate. Marked differences were noted in the actions of agonists and antagonists between the responses observed in the unanesthetized, decerebrated and the anesthetized animals. In decerebrated cats, responses to hair afferent stimulation were blocked by kynurenate, 6-cyano-7-nitroquinoxaline-2,3-dione and 2-amino-5-phosphonovaleric acid. Responses to noxious thermal stimulation were attenuated by 2-amino-5-phosphonovaleric acid and in one unit also by ketamine. Neither 6-cyano-7-nitroquinoxaline-2,3-dione nor kynurenate affected the responses to noxious thermal stimulation. The proportion of cells responding to the agonists were: N-methyl-D-aspartate 24/27 (89%), quisqualate 12/13 (92%) and domoate 6/7 (86%). In chloralose-anesthetized cats, responses to hair afferent stimulation were blocked by 6-cyano-7-nitroquinoxaline-2,3-dione and kynurenate but not by 2-amino-5-phosphonovaleric acid. Responses to noxious thermal stimulation were not affected by any of these antagonists, while the response to non-noxious thermal stimulation was blocked by 2-amino-5-phosphonovaleric acid, ketamine and kynurenate in the one neuron studied. The proportion of cells excited by the agonists differed from those observed in decerebrated cats: N-methyl-D-aspartate 9/32 (28%), quisqualate 50/54 (93%), (RS)-alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionate 19/23 (83%) and domoate 17/38 (45%). Application of the putative endogenous excitatory amino acid precursor N-acetyl-aspartyl-glutamate (NAAG) did not elicit a response in any of the neurons studied.(ABSTRACT TRUNCATED AT 400 WORDS)

Differential effects of N-methyl-D-aspartate (NMDA) and non-NMDA receptor antagonists on the responses of rat spinal neurons with joint input

In anaesthetized rats the involvement of N-methyl-D-aspartate (NMDA) and non-NMDA receptors in the processing of innocuous and noxious sensory inflow from joints was assessed in 27 spinal dorsal horn neurons. Microionophoretic application of either the NMDA antagonists ketamine and D,L-2-amino-5-phosphonovalerate (AP5) or the non-NMDA antagonist 6-cyano-7-nitroquinoxaline-2,3-dione (CNQX) reduced the responses to noxious compression of the knee and ankle joint. By contrast, the responses to innocuous pressure were consistently reduced by CNQX but only exceptionally by NMDA antagonists. Therefore non-NMDA receptors are involved in the processing of innocuous and noxious mechanical stimuli applied to the normal joint whereas NMDA receptors are activated mainly by nociceptive input.

Antagonism of synaptic potentials in ventral horn neurones by 6-cyano-7-nitroquinoxaline-2,3-dione: a study in the rat spinal cord in vitro

1. The rat spinal cord in vitro has been used to assess the effect of 6-cyano-7-nitroquinoxaline-2,3-dione (CNQX) on the dorsal root evoked extracellular ventral root reflex (DR-VRR) and the intracellular excitatory postsynaptic potential (e.p.s.p.) in ventral horn neurones and motoneurones. 2. CNQX (1-5 microM) produces a selective and dose-dependent reduction in the amplitude of the monosynaptic component of the DR-VRR recorded from lumbar spinal segments. 3. With low intensity dorsal root stimulation CNQX selectively attenuates the amplitude of the short latency intracellular e.p.s.p. (70% reduction, P < 0.005) and its rise-time (75%, P < 0.01) without affecting the half-time to decay. 4. When high intensity stimulation is used CNQX significantly attenuates the amplitude of the e.p.s.p. (56%, P < 0.005), rise-time (76%, P < 0.01) and abolishes the short latency spike. In addition longer latency synaptic components are attenuated and the half-time to decay significantly reduced (47%, P < 0.005). 5. The results with CNQX are compared to D-aminophosphonovalerate and discussed in relation to the recruitment of low versus high threshold afferents. The data supports an involvement of non-NMDA receptors in transmission through both mono- and polysynaptic pathways in the ventral horn.