Chronic pain-autonomic interactions

Research output: Contribution to journalArticle

Abstract

The nociceptive and the autonomic nervous systems interact at the levels of the periphery, spinal cord, brainstem, and forebrain. Spinal and visceral afferents provide converging information to spinothalamic neurons in the dorsal horn and to neurons of the nucleus tractus solitarius and parabrachial nuclei. These structures project to areas involved in reflex, homeostatic and behavioral control of autonomic outflow and nociception. Clinical and experimental observations on migraine suggest that a general hyperexcitability could develop along nociceptive trigeminal neurons allowing the activation of descending pathways that facilitate pain processing or the suppression of pathways that slow down pain transmission. Slowly progressive dysfunction of central pain systems secondary to the repetition of attacks of the originating headache has been implicated in transforming the process from an episodic to a chronic condition. This concept of an irritable focus in the central nervous system is currently known as "central sensitization" and is a characteristic feature of visceral pain. Considering primary headache as the result of the interactions between the nociceptive and autonomic systems (visceral pain) can help us to understand the complex pathophysiology of these disorders and to explore new treatments.

Original languageEnglish
JournalNeurological Sciences
Volume24
Issue numberSUPPL. 2
Publication statusPublished - May 2003

Fingerprint

Chronic Pain
Visceral Pain
Pain
Headache
Visceral Afferents
Central Nervous System Sensitization
Posterior Horn Cells
Nociceptors
Solitary Nucleus
Nociception
Autonomic Nervous System
Prosencephalon
Migraine Disorders
Brain Stem
Reflex
Spinal Cord
Central Nervous System
Neurons
Therapeutics
Parabrachial Nucleus

Keywords

  • Autonomic nervous system
  • Chronic pain
  • Migraine
  • Visceral pain

ASJC Scopus subject areas

  • Clinical Neurology
  • Neuroscience(all)

Cite this

Chronic pain-autonomic interactions. / Cortelli, P.; Pierangeli, G.

In: Neurological Sciences, Vol. 24, No. SUPPL. 2, 05.2003.

Research output: Contribution to journalArticle

@article{2ff3153189484e2dbfd01e43b85322a6,
title = "Chronic pain-autonomic interactions",
abstract = "The nociceptive and the autonomic nervous systems interact at the levels of the periphery, spinal cord, brainstem, and forebrain. Spinal and visceral afferents provide converging information to spinothalamic neurons in the dorsal horn and to neurons of the nucleus tractus solitarius and parabrachial nuclei. These structures project to areas involved in reflex, homeostatic and behavioral control of autonomic outflow and nociception. Clinical and experimental observations on migraine suggest that a general hyperexcitability could develop along nociceptive trigeminal neurons allowing the activation of descending pathways that facilitate pain processing or the suppression of pathways that slow down pain transmission. Slowly progressive dysfunction of central pain systems secondary to the repetition of attacks of the originating headache has been implicated in transforming the process from an episodic to a chronic condition. This concept of an irritable focus in the central nervous system is currently known as {"}central sensitization{"} and is a characteristic feature of visceral pain. Considering primary headache as the result of the interactions between the nociceptive and autonomic systems (visceral pain) can help us to understand the complex pathophysiology of these disorders and to explore new treatments.",
keywords = "Autonomic nervous system, Chronic pain, Migraine, Visceral pain",
author = "P. Cortelli and G. Pierangeli",
year = "2003",
month = "5",
language = "English",
volume = "24",
journal = "Neurological Sciences",
issn = "1590-1874",
publisher = "Springer-Verlag Italia s.r.l.",
number = "SUPPL. 2",

}

TY - JOUR

T1 - Chronic pain-autonomic interactions

AU - Cortelli, P.

AU - Pierangeli, G.

PY - 2003/5

Y1 - 2003/5

N2 - The nociceptive and the autonomic nervous systems interact at the levels of the periphery, spinal cord, brainstem, and forebrain. Spinal and visceral afferents provide converging information to spinothalamic neurons in the dorsal horn and to neurons of the nucleus tractus solitarius and parabrachial nuclei. These structures project to areas involved in reflex, homeostatic and behavioral control of autonomic outflow and nociception. Clinical and experimental observations on migraine suggest that a general hyperexcitability could develop along nociceptive trigeminal neurons allowing the activation of descending pathways that facilitate pain processing or the suppression of pathways that slow down pain transmission. Slowly progressive dysfunction of central pain systems secondary to the repetition of attacks of the originating headache has been implicated in transforming the process from an episodic to a chronic condition. This concept of an irritable focus in the central nervous system is currently known as "central sensitization" and is a characteristic feature of visceral pain. Considering primary headache as the result of the interactions between the nociceptive and autonomic systems (visceral pain) can help us to understand the complex pathophysiology of these disorders and to explore new treatments.

AB - The nociceptive and the autonomic nervous systems interact at the levels of the periphery, spinal cord, brainstem, and forebrain. Spinal and visceral afferents provide converging information to spinothalamic neurons in the dorsal horn and to neurons of the nucleus tractus solitarius and parabrachial nuclei. These structures project to areas involved in reflex, homeostatic and behavioral control of autonomic outflow and nociception. Clinical and experimental observations on migraine suggest that a general hyperexcitability could develop along nociceptive trigeminal neurons allowing the activation of descending pathways that facilitate pain processing or the suppression of pathways that slow down pain transmission. Slowly progressive dysfunction of central pain systems secondary to the repetition of attacks of the originating headache has been implicated in transforming the process from an episodic to a chronic condition. This concept of an irritable focus in the central nervous system is currently known as "central sensitization" and is a characteristic feature of visceral pain. Considering primary headache as the result of the interactions between the nociceptive and autonomic systems (visceral pain) can help us to understand the complex pathophysiology of these disorders and to explore new treatments.

KW - Autonomic nervous system

KW - Chronic pain

KW - Migraine

KW - Visceral pain

UR - http://www.scopus.com/inward/record.url?scp=0038314404&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0038314404&partnerID=8YFLogxK

M3 - Article

C2 - 12811596

AN - SCOPUS:0038314404

VL - 24

JO - Neurological Sciences

JF - Neurological Sciences

SN - 1590-1874

IS - SUPPL. 2

ER -