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Pain-autonomic interactions: a selective review.

E E Benarroch¹

¹Department of Neurology, Mayo Clinic, Rochester, Minnesota 55905, USA. benarroch.eduardo@mayo.edu

Clinical Autonomic Research : Official Journal of the Clinical Autonomic Research Society

|January 17, 2002

Summary

The nociceptive and autonomic systems interact across multiple brain areas, influencing pain and bodily functions. Understanding these connections is crucial for unraveling chronic pain disorders.

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Area of Science:

Neuroscience
Physiology

Background:

The nociceptive system detects and transmits pain signals, while the autonomic system regulates involuntary bodily functions.
Interactions between these systems are known to occur at various levels of the nervous system.

Purpose of the Study:

To elucidate the intricate interactions between the nociceptive and autonomic systems.
To highlight the neural pathways involved in these interactions.
To emphasize the importance of these interactions in understanding chronic pain.

Main Methods:

Review of neuroanatomical pathways and functional connections between nociceptive and autonomic centers.
Analysis of afferent information convergence in the spinal cord and brainstem.
Identification of central nervous system structures involved in integrating pain and autonomic signals.

Main Results:

Spinal and visceral afferents converge on key neuronal populations, including spinothalamic neurons, nucleus tractus solitarius, and parabrachial nuclei.
These neuronal populations project to brain regions controlling autonomic outflow, endocrine function, and nociception.
Involved brain areas include the periaqueductal gray, hypothalamus, amygdala, insular cortex, and anterior cingulate gyrus.

Conclusions:

The nociceptive and autonomic systems are extensively interconnected from the periphery to the forebrain.
These complex interactions form the basis for coordinated reflex, homeostatic, and behavioral responses.
A comprehensive understanding of these neuroanatomical and functional links is essential for addressing the pathophysiology of chronic pain conditions.

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