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Neuroanatomy of the Pain System and of the Pathways That Modulate Pain

Willis, W. D.; Westlund, K. N.

Journal of Clinical Neurophysiology: January 1997 - Volume 14 - Issue 1 - p 2-31
Review Article

We review many of the recent findings concerning mechanisms and pathways for pain and its modulation, emphasizing sensitization and the modulation of nociceptors and of dorsal horn nociceptive neurons. We describe the organization of several ascending nociceptive pathways, including the spinothalamic, spinomesencephalic, spinoreticular, spinolimbic, spinocervical, and postsynaptic dorsal column pathways in some detail and discuss nociceptive processing in the thalamus and cerebral cortex. Structures involved in the descending analgesia systems, including the periaqueductal gray, locus ceruleus, and parabrachial area, nucleus raphe magnus, reticular formation, anterior pretectal nucleus, thalamus and cerebral cortex, and several components of the limbic system are described and the pathways and neurotransmitters utilized are mentioned. Finally, we speculate on possible fruitful lines of research that might lead to improvements in therapy for pain.

Department of Anatomy & Neurosciences, University of Texas Medical Branch, Galveston, Texas, U.S.A.

Address correspondence and reprint requests to Dr. W. D. Willis at Department of Anatomy & Neurosciences, University of Texas Medical Branch, 301 University Blvd., Galveston, TX 77555-1069, U.S.A.

© Lippincott-Raven Publishers