Laboratory of Neuroscience, Hospital Sírio Libanês, São Paulo, SP, 01308-060, Brazil.
Department of Physiology and Biophysics, Institute of Biomedical Sciences, University of São Paulo, São Paulo, SP, 05508-900, Brazil.
Behav Brain Funct. 2019 Mar 25;15(1):5. doi: 10.1186/s12993-019-0156-0.
Motor cortex stimulation (MCS) is an effective therapy for refractory neuropathic pain. MCS increases the nociceptive threshold in healthy rats via endogenous opioids, inhibiting thalamic nuclei and activating the periaqueductal gray. It remains unclear how the motor cortex induces top-down modulation of pain in the absence of persistent pain. Here, we investigated the main nuclei involved in the descending analgesic pathways and the spinal nociceptive neurons in rats that underwent one session of MCS and were evaluated with the paw pressure nociceptive test. The pattern of neuronal activation in the dorsal raphe nucleus (DRN), nucleus raphe magnus (NRM), locus coeruleus (LC), and dorsal horn of the spinal cord (DHSC) was assessed by immunoreactivity (IR) for Egr-1 (a marker of activated neuronal nuclei). IR for serotonin (5HT) in the DRN and NRM, tyrosine hydroxylase (TH) in the LC, and substance P (SP) and enkephalin (ENK) in the DHSC was also evaluated. MCS increased the nociceptive threshold of the animals; this increase was accompanied by activation of the NRM, while DRN activation was unchanged. However, cortical stimulation induced an increase in 5HT-IR in both serotonergic nuclei. MCS did not change the activation pattern or TH-IR in the LC, and it inhibited neuronal activation in the DHSC without altering SP or ENK-IR. Taken together, our results suggest that MCS induces the activation of serotonergic nuclei as well as the inhibition of spinal neurons, and such effects may contribute to the elevation of the nociceptive threshold in healthy rats. These results allow a better understanding of the circuitry involved in the antinociceptive top-down effect induced by MCS under basal conditions, reinforcing the role of primary motor cortex in pain control.
运动皮层刺激(MCS)是治疗难治性神经性疼痛的有效方法。MCS 通过内源性阿片类物质增加健康大鼠的痛觉阈值,抑制丘脑核并激活导水管周围灰质。目前尚不清楚在没有持续性疼痛的情况下,运动皮层如何诱导疼痛的自上而下调制。在这里,我们研究了参与下行镇痛途径的主要核团以及接受单次 MCS 并通过足底压力疼痛测试进行评估的大鼠脊髓背角中的伤害感受神经元。通过 Egr-1(激活神经元核的标志物)的免疫反应性(IR)评估背侧中缝核(DRN)、中缝大核(NRM)、蓝斑核(LC)和脊髓背角(DHSC)中的神经元激活模式。还评估了 DRN 和 NRM 中的 5-羟色胺(5HT)、LC 中的酪氨酸羟化酶(TH)以及 DHSC 中的 P 物质(SP)和脑啡肽(ENK)的 IR。MCS 增加了动物的痛觉阈值;这种增加伴随着 NRM 的激活,而 DRN 的激活没有变化。然而,皮质刺激诱导了两个 5HT 能核团中 5HT-IR 的增加。MCS 没有改变 LC 中的激活模式或 TH-IR,并且它抑制了脊髓神经元的激活,而不改变 SP 或 ENK-IR。总之,我们的结果表明,MCS 诱导了 5HT 能核团的激活以及脊髓神经元的抑制,这些效应可能有助于提高健康大鼠的痛觉阈值。这些结果使我们更好地了解了在基础条件下 MCS 诱导的抗伤害性自上而下效应所涉及的回路,从而加强了初级运动皮层在疼痛控制中的作用。