Anatomical basis for the dynamic processing of nociceptive input

The involvement of the lamina I, or marginal zone, of the spinal cord dorsal horn in pain processing has been extensively demonstrated. Its neuronal population comprises four structurally distinct neuronal groups, which were shown to be present in species as different as the rat, cat and pigeon. In the rat, each neuronal type presents a particular neurochemical nature and supraspinal projection pattern. In addition, there is recent evidence that supraspinal modulatory actions may affect differentially cells of different types. By combining retrograde tracing with noxious-evoked induction of the c fos proto-oncogene, it was verified that activation of different neuronal groups varies as a function of the brain site they target and the nature of the stimulus. These data suggest that the responsiveness of lamina I neurones is under controlling mechanisms which reflect the stimulus characteristics. Accordingly, both the spinal GABAergic and opioidergic anti-nociceptive actions appear to differ when different kinds df input are being processed. Moreover, supraspinal pain-modulatory circuits are also likely to control the excitability of each cell group. Not only reciprocal connections between the spinal cord and various pain-control centres have been identified, but also a correlation between the number of cfos positive projecting cells and the pain-inhibitory or facilitating role of their target has been observed. It is proposed that the compound nature of the nociceptive system serves a dynamic interplay between the spinal cord and the brain, which, by controlling the activation of distinct projection neurones, modulates the nociceptive signal while integrating nociceptive processing with several brain functions.