Prolonged primary afferent induced alterations in dorsal horn neurones, an intracellular analysis in vivo and in vitro.

1.) Peripheral tissues injury produces long lasting sensory and motor disturbances in man that present as the post-injury hypersensitivity syndrome with a reduction in the threshold required to elicit either pain or the flexion withdrawal reflex and an exaggeration of the normal response to suprathreshold stimuli. 2.) Two mechanisms contribute to these changes; sensitization of the peripheral terminals of high threshold primary afferents and an increase in the excitability of the spinal cord; a phenomenon known as central sensitization. 3.) Central sensitization has previously been shown by our laboratory to be the consequence of activity in unmyelinated primary afferents. Brief (20 s) C-fibre strength conditioning stimuli have the capacity to produce both a prolonged heterosynaptic facilitation of the flexion reflex and an alteration in the response properties of dorsal horn neurones, that long outlast the conditioning stimulus. 4.) In the adult decerebrate-spinal rat preparation we have, using intracellular recordings of dorsal horn neurones, examined the time course of the central effects of different types of orthodromic inputs. The hemisected spinal cord preparation isolated from 12-14 day rat pups has been used to see whether prolonged alterations in dorsal horn properties induced by orthodromic inputs can be studied in vitro. 5.) Single stimuli applied to a cutaneous nerve at graded strengths to successively recruit A beta, A delta and C-afferents produce, in the majority of neurones recorded in the deep dorsal horn in vivo, a series of post synaptic potentials that last from between ten and several hundred milliseconds. 6.) Repeated low frequency stimulation of C but not A-afferent fibres results in a pattern of progressive response increment or windup in a proportion of dorsal horn neurones. In some of the neurones the windup is associated with a depolarization that outlasts the stimulus period for tens of seconds. 7.) Application of the chemical irritant mustard oil to the skin activates chemosensitive C-afferent fibres for 1-3 minutes. Such a conditioning stimulus results however in an expansion in the size and an alteration in the response properties of the receptive fields of dorsal horn neurones that lasts for tens of minutes. 8.) In dorsal horn neurones recorded intracellularly in the isolated hemisected spinal cord, both intrinsic membrane properties and the orthodromic responses to primary afferent input can be studied. Repeated stimulation of a dorsal root produces in some neurones a prolonged heterosynaptic facilitation with both an augmentation of the response to the conditioning root (homosynaptic potentiation) and to adjacent test roots (heterosynaptic potentiation).(ABSTRACT TRUNCATED AT 400 WORDS)