Endogenous pain control mechanisms: Review and hypothesis

  title={Endogenous pain control mechanisms: Review and hypothesis},
  author={Allan I. Basbaum and Howard L Fields},
  journal={Annals of Neurology},
The anatomy, physiology, and pharmacology of an intrinsic neural network that monitors and modulates the activity of pain‐transmitting neurons is reviewed. This system can be activated by opiate administration or by electrical stimulation of discrete brainstem sites. Evidence is presented that its pain‐suppressing action is mediated in part by endogenous opiatelike compounds (endorphins). 
The physiology of pain: A review
  • J. Edmeads
  • Psychology, Biology
    Progress in Neuro-Psychopharmacology and Biological Psychiatry
  • 1983
Pain II: New approaches to management
  • H. Fields
  • Medicine, Biology
    Annals of neurology
  • 1981
The present review critically evaluates the analgesic efficacy of the following therapies: placebo administration, transcutaneous electrical nerve stimulation, acupuncture, intrathecal and epidural opiate injection, electrical stimulation of the brain, and psychotropic drugs.
The physiology of pain mechanisms: from the periphery to the brain.
  • Serge Marchand
  • Medicine, Psychology
    Rheumatic diseases clinics of North America
  • 2008
Acute Pain Modulation in the Central Nervous System: A Chronological Review
A short historical and philosophical chronology on the neuronal and neurochemical systems that, in the spinal cord and in the brain, modulate the nociceptive information caused by an algogenic stimulus is traced.
Nociceptive Pathways and Transmitters
An appropriate discussion of nociceptive pathways must consider three levels of processing: peripheral, spinal and supraspinal. A large amount of neurophysiological data has accumulated on peripheral
Sensory-Discriminative Capacities of Nociceptive Pathways and Their Modulation by Behavior
Progress has been made on the characterization of neural pathways participating in the sensory component of pain sensations and how these signals can be modified by control systems originating at other brain sites.
Neurophysiology of pain and pain modulation.
  • H. Fields
  • Biology, Medicine
    The American journal of medicine
  • 1984
Neuromodulation techniques for medically refractory chronic pain.
The theoretical basis and the clinical applications of neurostimulation for the treatment of medically intractable chronic pain are reviewed.


Stimulation of internal capsule for relief of chronic pain.
The severe spontaneous pain associated with lesions of the central nervous system has been successfully suppressed by electrical stimulation of the posterior limb of the internal capsule by stimulation of parietal corticofugal inhibitory fibers.
The narcotic antagonist naloxone enhances clinical pain
It is demonstrated here that following the extraction of impacted wisdom teeth, naloxone causes a significantly greater increase in reported pain intensity than placebo, an observation consistent with the suggested participation of endorphins in an intrinsic pain suppression system.
Analgesia mediated by a direct spinal action of narcotics.
Narcotic analgetics administered directly into the spinal subarachnoid space of the rat via a chronically inserted catheter produce a potent analgesia that can be antagonized by naloxone. The
Opiate and stimulus-produced analgesia: functional anatomy of a medullospinal pathway.
Evidence supports the hypothesis that this neuron population mediates the analgesia produced by opiates and electrical stimulation of certain diencephalic and brainstem sites.
The laminar organization of dorsal horn and effects of descending impulses
  • P. Wall
  • Biology
    The Journal of physiology
  • 1967
1. An examination of the physiological properties of cells in cat lumbar dorsal horn shows that there are three horizontal laminae which correspond approximately to Rexed (1952) laminae 4, 5, and 6.
Antinociceptive Effect of Intrathecally Administered Serotonin
  • J. Wang
  • Biology, Psychology
  • 1977
Serotonin, 100 or 200 µg, administered into the lumbar intrathecal space, produced an analgesic effect for as long as 40 minutes, and behavioral and morphologic observations after serotonin injections showed no adverse reaction.
Analgesia from Electrical Stimulation in the Brainstem of the Rat
Stimulation at several mesencephalic and diencephalic sites abolished responsiveness to intense pain in rats while leaving responsiveness to other sensory modes relatively unaffected. The peripheral