Preclinical studies coupled with clinical pharmacologic and neuroimaging investigations
have advanced our understanding of brain circuits that modulate pain. Descending pain …

It has long been appreciated that the experience of pain is highly variable between
individuals. Pain results from activation of sensory receptors specialized to detect actual or …

The dorsal horn of the spinal cord is the location of the first synapse in pain pathways, and
as such, offers a very powerful target for regulation of nociceptive transmission by both local …

Stress is most often associated with aversive states. It rapidly induces the release of
hormones and neuropeptides including dynorphin, which activates kappa opioid receptors …

Abstract Purpose of Review The goal of the review was to highlight recent advances in our
understanding of descending pain-modulating systems and how these contribute to …

Recent studies indicate that persistent pain after tissue or nerve injury is accompanied by an
enhanced net descending facilitatory drive that contributes to an amplification and spread of …

The analgesic effects of morphine are mediated, in part, by periaqueductal gray (PAG)
neurons that project to the rostral ventromedial medulla (RVM). Although much of the neural …

The response of diffuse noxious inhibitory controls (DNIC) is often decreased, or lost, in
stress-related functional pain syndromes. Because the dynorphin/kappa opioid receptor …

Opioids are widely used, effective analgesics to manage severe acute and chronic pain,
although they have recently come under scrutiny because of epidemic levels of abuse …

In perilous and stressful situations, the ability to suppress pain can be critical for survival.
The rostral ventromedial medulla contains neurons that robustly inhibit nocioception at the …