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- Title
Architecture and operation of a neuronal circuit that modulates pain.
- Abstract
The present article is a narrative review that describes the functional characteristics of the neurons that constitute a system whose task is to facilitate or diminish the defensive reflexes and the sensation of pain elicited by real or potential damage to one of our tissues. These neurons are located in the medulla oblongata and are known as on-cells and off-cells. They have anatomical and functional links with the nociceptive circuits of the spinal cord and the sensory nuclei of cranial nerves and control the nocifensive reflexes as well as the activation of the thalamic neurons that in turn activate the cortical neurons responsible for the sensation of pain. It was shown that the on-cells facilitate nociception when they are activated by excitatory neurotransmitters and that the off-cells inhibit nociception when their activity increases due to the attenuation of the GABAergic synapses that keep them inhibited. The results obtained additionally indicate that on-cells and off-cells are a substrate for the action of endogenous and exogenous substances capable of augmenting or diminishing pain, such as opioids, analgesics like aspirin and metamizol, opioid receptor antagonists like naloxone, cannabinoids, antagonists to synaptic neurotransmitters, etc. Many of the findings described herein were obtained by doctoral students, young researchers or visiting faculty members under the present author's guidance in the Laboratorio de Neurofisiología of the Instituto Venezolano de Investigaciones Científicas (IVIC) or by the author during a one-year research stay as Visiting Full Professor in the University of California San Francisco.
- Subjects
NEURAL circuitry; MEDULLA oblongata; NEUROTRANSMITTERS; GABAERGIC neurons; CANNABINOIDS
- Publication
Gaceta Médica de Caracas, 2020, Vol 128, Issue 4, p466
- ISSN
0367-4762
- Publication type
Article
- DOI
10.47307/GMC.2020.128.4.3