Pathways descending from the brainstem are important in regulating and modulating pain 12 Descending pathway neurons use noradrenaline and serotonin 23 Neurons in the descending pathway may control pain via ID: 1037905
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1. MigraineRegulation of pain – the descending pathwayPathways descending from the brainstem are important in regulating and modulating pain1,2Descending pathway neurons use noradrenaline and serotonin2,3Neurons in the descending pathway may control pain via:3Direct actions on dorsal horn cellsInhibition of excitatory dorsal horn neuronsExcitation of inhibitory dorsal horn neuronsAdditionally, interneurons in the spinal cord provide tonic inhibition by the release of endogenous opioids, enkephalins2The ascending and descending pathways1-31. Purves et al. Neuroscience. 6th edition. 2018; 2. Urch. Rev Pain 2007;1(1):2–6; 3. Steeds. Surgery 2016;34(2):55–59Spinal cordBrainCross section of spinal cordDescending pathways downregulate signalling in the dorsal horn --Interneurons release endogenous opioids2nd order neurons1st order neuron3rd order neuronMidbrain – Locus coeruleus and periaqueductal grey matter