Descending analgesia – When the spine echoes what the brain expects

@article{Goffaux2007DescendingA,
  title={Descending analgesia – When the spine echoes what the brain expects},
  author={Philippe Goffaux and William John Redmond and Pierre Rainville and Serge Marchand},
  journal={PAIN},
  year={2007},
  volume={130},
  pages={137-143}
}
Cortical influences on brainstem circuitry responsible for conditioned pain modulation in humans
TLDR
These data suggest that during multiple or widespread painful stimuli, engagement of the prefrontal and cingulate cortices prevents the generation of CPM analgesia, raising the possibility altered responsiveness in these cortical regions underlie the reduced CPM observed in individuals with chronic pain.
Cerebral and Cerebrospinal Processes Underlying Counterirritation Analgesia
TLDR
This fMRI study investigates brain responses to phasic painful electrical stimulation administered to the sural nerve to evoke a spinal nociceptive response (RIII reflex) before, during and after counterirritation induced by the immersion of the left contralateral foot in cold water to provide evidence for the implication of at least two partly separable neural mechanisms underlying the effects of counteririttation on pain and spinal nock in humans.
PLACEBO ANALGESIA 1 Placebo Analgesia
TLDR
A more complete understanding of the placebo analgesic response could lead to new treatments that exploit psychological methods for activating pain-modulating circuitry and for ethically and optimally enhancing the placebo component of active treatments.
How expectations shape pain
A meta-analysis of brain mechanisms of placebo analgesia: consistent findings and unanswered questions.
TLDR
Meta-analyses of neuroimaging studies of placebo analgesia revealed that placebo effects and expectations for reduced pain elicit reliable reductions in activation during noxious stimulation in regions often associated with pain processing, including the dorsal anterior cingulate, thalamus, and insula.
Intracortical modulation, and not spinal inhibition, mediates placebo analgesia
TLDR
The selective suppression of late LEPs indicates that placebo analgesia is mediated by direct intracortical modulation rather than inhibition of the nociceptive input at spinal level, suggesting that higher order sensory processes are modulated during placebo analgesIA.
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