Shifting the Balance: How Top-Down and Bottom-Up Input Modulate Pain via the Rostral Ventromedial Medulla

Qiliang Chen; Mary M. Heinricher

doi:10.3389/fpain.2022.932476

Shifting the Balance: How Top-Down and Bottom-Up Input Modulate Pain via the Rostral Ventromedial Medulla

Qiliang Chen, Mary M. Heinricher

Research output: Contribution to journal › Short survey › peer-review

11 Scopus citations

Abstract

The sensory experience of pain depends not only on the transmission of noxious information (nociception), but on the state of the body in a biological, psychological, and social milieu. A brainstem pain-modulating system with its output node in the rostral ventromedial medulla (RVM) can regulate the threshold and gain for nociceptive transmission. This review considers the current understanding of how RVM pain-modulating neurons, namely ON-cells and OFF-cells, are engaged by “top-down” cognitive and emotional factors, as well as by “bottom-up” sensory inputs, to enhance or suppress pain.

Original language	English (US)
Article number	932476
Journal	Frontiers in Pain Research
Volume	3
DOIs	https://doi.org/10.3389/fpain.2022.932476
State	Published - 2022

Keywords

RVM
analgesia
brainstem
descending control
hyperalgesia
pain-modulation
rostral ventromedial medulla

ASJC Scopus subject areas

Anesthesiology and Pain Medicine
Public Health, Environmental and Occupational Health
Neuroscience (miscellaneous)
Health Professions (miscellaneous)

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10.3389/fpain.2022.932476

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title = "Shifting the Balance: How Top-Down and Bottom-Up Input Modulate Pain via the Rostral Ventromedial Medulla",

abstract = "The sensory experience of pain depends not only on the transmission of noxious information (nociception), but on the state of the body in a biological, psychological, and social milieu. A brainstem pain-modulating system with its output node in the rostral ventromedial medulla (RVM) can regulate the threshold and gain for nociceptive transmission. This review considers the current understanding of how RVM pain-modulating neurons, namely ON-cells and OFF-cells, are engaged by “top-down” cognitive and emotional factors, as well as by “bottom-up” sensory inputs, to enhance or suppress pain.",

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AB - The sensory experience of pain depends not only on the transmission of noxious information (nociception), but on the state of the body in a biological, psychological, and social milieu. A brainstem pain-modulating system with its output node in the rostral ventromedial medulla (RVM) can regulate the threshold and gain for nociceptive transmission. This review considers the current understanding of how RVM pain-modulating neurons, namely ON-cells and OFF-cells, are engaged by “top-down” cognitive and emotional factors, as well as by “bottom-up” sensory inputs, to enhance or suppress pain.

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Shifting the Balance: How Top-Down and Bottom-Up Input Modulate Pain via the Rostral Ventromedial Medulla

Abstract

Keywords

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