Sluka Kathleen A, Danielson Jessica, Rasmussen Lynn, Kolker Sandra J
Department of Physical Therapy and Rehabilitation Science, University of Iowa, Iowa City, IA, USA.
Pain Rep. 2020 Dec 2;5(6):e857. doi: 10.1097/PR9.0000000000000857. eCollection 2020 Nov-Dec.
Regular physical activity/exercise is an effective nonpharmacological treatment for individuals with chronic pain. Central inhibitory mechanisms, involving serotonin and opioids, are critical to analgesia produced by regular physical activity. The rostral ventromedial medulla (RVM) sends projections to the spinal cord to inhibit or facilitate nociceptive neurons and plays a key role in exercise-induced analgesia.
The goal of these studies was to examine if regular physical activity modifies RVM-spinal cord circuitry.
Male and female mice received Fluoro-Gold placed on the spinal cord to identify spinally projecting neurons from the RVM and the nucleus raphe obscurus/nucleus raphe pallidus, dermorphin-488 into caudal medulla to identify mu-opioid receptors, and were immunohistochemically stained for either phosphorylated-N-methyl-d-aspartate subunit NR1 (p-NR1) to identify excitatory neurons or tryptophan hydroxylase (TPH) to identify serotonin neurons. The percentage of dermorphin-488-positive cells that stained for p-NR1 (or TPH), and the percentage of dermorphin-488-positive cells that stained for p-NR1 (or TPH) and Fluoro-Gold was calculated. Physically active animals were provided running wheels in their cages for 8 weeks and compared to sedentary animals without running wheels. Animals with chronic muscle pain, induced by 2 intramuscular injections of pH 4.0, were compared to sham controls (pH 7.2).
Physically active animals had less mu-opioid-expressing neurons projecting to the spinal cord when compared to sedentary animals in the RVM, but not the nucleus raphe obscurus/nucleus raphe pallidus. No changes were observed for TPH.
These data suggest that regular exercise alters central facilitation so that there is less descending facilitation to result in a net increase in inhibition.
规律的体育活动/锻炼是慢性疼痛患者一种有效的非药物治疗方法。涉及血清素和阿片类物质的中枢抑制机制对于规律体育活动产生的镇痛作用至关重要。延髓头端腹内侧区(RVM)向脊髓发出投射,以抑制或促进伤害性感受神经元,并在运动诱导的镇痛中起关键作用。
这些研究的目的是检查规律的体育活动是否会改变RVM-脊髓回路。
对雄性和雌性小鼠进行如下操作:将荧光金置于脊髓上,以识别来自RVM以及中缝隐核/中缝苍白核的脊髓投射神经元;将德莫啡-488注入延髓尾部,以识别μ-阿片受体;并进行免疫组织化学染色,以识别磷酸化N-甲基-D-天冬氨酸亚基NR1(p-NR1)来鉴定兴奋性神经元,或识别色氨酸羟化酶(TPH)来鉴定血清素神经元。计算德莫啡-488阳性细胞中p-NR1(或TPH)染色的百分比,以及德莫啡-488阳性细胞中p-NR1(或TPH)和荧光金染色的百分比。为有运动能力的动物在其笼中提供跑步轮8周,并与没有跑步轮的久坐动物进行比较。将通过两次肌肉注射pH 4.0诱导慢性肌肉疼痛的动物与假手术对照组(pH 7.2)进行比较。
与久坐的动物相比,有运动能力的动物在RVM中向脊髓投射的表达μ-阿片的神经元较少,但在中缝隐核/中缝苍白核中没有这种情况。未观察到TPH有变化。
这些数据表明,规律运动改变了中枢易化,从而减少下行易化,导致抑制作用净增加。