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Early Evidence of Central Nervous System Control and a Conceptual Model Revisited 

Early Evidence of Central Nervous System Control and a Conceptual Model Revisited
Chapter:
Early Evidence of Central Nervous System Control and a Conceptual Model Revisited
Author(s):

Kenneth L. Casey

DOI:
10.1093/med/9780190880231.003.0006
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date: 08 August 2020

As the International Association for the Study of Pain was organized, neurobiological evidence supported the concept that central nervous system (CNS) activity strongly modulates pain. Descending corticospinal and corticobulbar neurons far outnumber those comprising the ascending spinothalamic and trigeminothalamic pathways, emphasizing “top-down” influences. The intensity of individual neuronal responses to noxious stimuli were known to be strongly affected by levels of behavioral alertness. Behavioral studies showed that electrical current applied within the upper brainstem eliminated any evidence of pain without obviously affecting motor function or other behaviors. Neurophysiological studies showed that electrical stimulation within various CNS locations could amplify or attenuate both presynaptic and postsynaptic neuronal sensory responses to nociceptive inputs at their entry to the spinal cord and brainstem. Biochemical and neuropharmacological experiments revealed endogenous opioid compounds and their receptors within several CNS locations. Collectively, these findings increased interest in pain neurobiology, accelerated the pace of pain research, and emphasized the importance of CNS control mechanisms as determinants of pain experience.

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