Cited by 924Pain Mechanisms and TreatmentsPain Management and TreatmentPain Management and Placebo Effect

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

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Willis, W. D., Westlund, K. N.·1997·Journal of Clinical Neurophysiology

DOI 10.1097/00004691-199701000-00002PMC PMC7859971

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Abstract

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.

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Convergence of cutaneous and pelvic visceral nociceptive inputs onto primate spinothalamic neurons
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Activation of groups III and IV sensory units in medial articular nerve by local mechanical stimulation of knee joint.
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Effects induced by stimulation of the centralis inferior nucleus of the raphe on dorsal horn interneurons in cat's spinal cord
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Retrograde labeling of neurons in the spinal cord that project directly to the amygdala or the orbital cortex in the rat
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The ascending input to the midbrain periaqueductal gray of the primate
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Opioid peptide immunoreactivity in spinal and trigeminal dorsal horn neurons projecting to the parabrachial nucleus in the rat
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Authors: Willis, W. D., & Westlund, K. N.
Affiliations: The University of Texas Medical Branch at Galveston (US)
Corresponding author: Willis, W. D.
ORCID: Westlund, K. N.
Venue: Journal of Clinical Neurophysiology
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 1997-01
Volume: 14
Issue: 1
Pages: 2-31
ISSN: 0736-0258 (ISSN-L)
DOI: 10.1097/00004691-199701000-00002
PMC: PMC7859971
OpenAlex: W1998138279
Cited by: 924
References: 337
Citations by year: 2026: 21 · 2025: 24 · 2024: 25 · 2023: 27 · 2022: 30 · 2021: 19 · 2020: 27 · 2019: 17 · 2018: 21 · 2017: 26 · 2016: 27 · 2015: 31 · 2014: 29 · 2013: 42 · 2012: 37
FWCI: 3.72
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Locations: Journal of Clinical Neurophysiology (publishedVersion)
PubMed (publishedVersion)
PubMed Central (acceptedVersion)
Funders: National Institute of Neurological Disorders and Stroke (R01NS032778, P01NS011255)
Topics: Health Sciences › Medicine › Physiology (medical) › Pain Mechanisms and Treatments
Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
Life Sciences › Neuroscience › Cognitive Neuroscience › Pain Management and Placebo Effect
Keywords: pain system, nociception, descending pain modulation, nociceptor sensitization, spinothalamic tract, spinocervical tract, dorsal column pathway, thalamus, cerebral cortex, periaqueductal gray, locus coeruleus, parabrachial area, nucleus raphe magnus, reticular formation, anterior pretectal nucleus, limbic system, neurotransmitters, pain management
MeSH terms: Animals, Brain, Brain Mapping, Humans, Medulla Oblongata, Neurons, Nociceptors, Pain, Spinal Cord, Spinothalamic Tracts, Thalamus

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

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