Sandkühler J, Gebhart G F
Brain Res. 1984 Jul 2;305(1):77-87. doi: 10.1016/0006-8993(84)91121-1.
The organization in the brainstem of descending pathways of spinal inhibition was examined in the lightly pentobarbital-anesthetized rat. Thresholds for focal electrical stimulation-produced inhibition of the spinal nociceptive tail flick (TF) reflex were determined at one stimulation site in the midbrain periaqueductal gray and three sites in the rostral medulla: nucleus raphe magnus, and the adjacent medullary reticular formation contralateral and ipsilateral to the stimulating electrode in the periaqueductal gray. Lidocaine (0.5 microliter, 4%) was subsequently microinjected in the same and other medullary loci in the same coronal plane to produce a time-limited, reversible functional neural block. The functional block produced by 0.5 microliter of lidocaine microinjected in the medulla was determined to have a radius of 0.5 mm and was maximally efficacious during the first 30 min after its intramedullary microinjection. The stimulation threshold in the periaqueductal gray for inhibition of the TF reflex was not increased significantly when either the nucleus raphe magnus was fully blocked by lidocaine microinjected in three dorsoventral positions 1.0 mm apart or when the medullary reticular formation ipsilateral and contralateral were simultaneously fully blocked. Not until the nucleus raphe magnus and medullary reticular formation ipsilateral were simultaneously blocked by lidocaine was the stimulation threshold in the periaqueductal gray for inhibition of the TF reflex significantly increased. An increase in the periaqueductal gray stimulation threshold twice as great resulted when the nucleus raphe magnus and both the ipsilateral and contralateral medullary reticular formations were all simultaneously blocked by lidocaine. These results indicate that: (1) the nucleus raphe magnus is not a necessary bulbar relay in a descending antinociceptive pathway activated by stimulation in the midbrain periaqueductal gray; and (2) descending inhibitory pathways activated in the periaqueductal gray course medially as well as laterally in the rat ventral medulla.
在轻度戊巴比妥麻醉的大鼠中,研究了脊髓抑制下行通路在脑干中的组织情况。在中脑导水管周围灰质的一个刺激位点以及延髓头端的三个位点(中缝大核,以及与导水管周围灰质中刺激电极同侧和对侧相邻的延髓网状结构),测定了局灶性电刺激产生的对脊髓伤害性甩尾(TF)反射的抑制阈值。随后,将利多卡因(0.5微升,4%)微量注射到同一冠状平面的相同和其他延髓位点,以产生限时、可逆的功能性神经阻滞。经测定,微量注射到延髓中的0.5微升利多卡因所产生的功能性阻滞半径为0.5毫米,在髓内微量注射后的最初30分钟内效果最佳。当在相距1.0毫米的三个背腹位置微量注射利多卡因使中缝大核完全被阻滞,或者同侧和对侧的延髓网状结构同时被完全阻滞时,导水管周围灰质中抑制TF反射的刺激阈值并未显著升高。直到中缝大核和同侧延髓网状结构同时被利多卡因阻滞时,导水管周围灰质中抑制TF反射的刺激阈值才显著升高。当利多卡因同时阻滞中缝大核以及同侧和对侧的延髓网状结构时,导水管周围灰质刺激阈值的升高幅度会加倍。这些结果表明:(1)中缝大核并非由中脑导水管周围灰质刺激激活的下行抗伤害感受通路中必要的延髓中继站;(2)在导水管周围灰质激活的下行抑制通路在大鼠延髓腹侧既向内侧也向外侧走行。