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Descending control of nociception: Specificity, recruitment and plasticity

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Heinricher, M.M., Tavares, I., Leith, J.L., Lumb, B.M.·2009·Brain Research Reviews
DOI 10.1016/j.brainresrev.2008.12.009
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Abstract

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 segmental and supraspinal mechanisms. Descending control of spinal nociception originates from many brain regions and plays a critical role in determining the experience of both acute and chronic pain. The earlier concept of descending control as an “analgesia system” is now being replaced with a more nuanced model in which pain input is prioritized relative to other competing behavioral needs and homeostatic demands. Descending control arises from a number of supraspinal sites, including the midline periaqueductral gray-rostral ventromedial medulla (PAG-RVM) system, and the more lateral and caudal dorsal reticular nucleus (DRt) and ventrolateral medulla (VLM). Inhibitory control from the PAG-RVM system preferentially suppresses nociceptive inputs mediated by C-fibers, preserving sensory-discriminative information conveyed by more rapidly conducting A-fibers. Analysis of the circuitry within the RVM reveals that the neural basis for bidirectional control from the midline system is two populations of neurons, ON-cells and OFF-cells, that are differentially recruited by higher structures important in fear, illness and psychological stress to enhance or inhibit pain. Dynamic shifts in the balance between pain inhibiting and facilitating outflows from the brainstem play a role in setting the gain of nociceptive processing as dictated by behavioral priorities, but are also likely to contribute to pathological pain states.

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Cited by

See all 949

Metadata

Authors
Heinricher, M. M., Tavares, I., Leith, J. L., & Lumb, B. M.
Venue
Brain Research Reviews
Publisher
Elsevier BV
Published
2009-04
Volume
60
Issue
1
Pages
214-225
ISSN
0165-0173 (ISSN-L)
DOI
10.1016/j.brainresrev.2008.12.009
OpenAlex
W2004551214
Cited by
949
References
2
FWCI
21.71
Type
journal article
Language
en
Open access
green
Licence
  • www.elsevier.com/tdm/userlicense/1.0/ (tdm)
  • www.elsevier.com/legal/tdmrep-license (tdm)
Funders
  • Wellcome Trust
  • Biotechnology and Biological Sciences Research Council
  • Fundação para a Ciência e a Tecnologia (PTDC/SAU-OSM/64643/2006)
  • National Institute of Neurological Disorders and Stroke (NS052364)
  • National Institute of Development Administration (DA05608)

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

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This page
CoChat. (2026). Citation check: Descending control of nociception: Specificity, recruitment and plasticity. https://app.cochat.ai/papers/10.1016/j.brainresrev.2008.12.009
The paper
Heinricher, M. M., Tavares, I., Leith, J. L., & Lumb, B. M. (2009). Descending control of nociception: Specificity, recruitment and plasticity. Brain Research Reviews. https://doi.org/10.1016/j.brainresrev.2008.12.009

Data sources

Bibliographic data: Semantic Scholar, OpenAlex, Crossref.

Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).

Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.