Neurochemistry of the dorsal horn

The dorsal horn region of the spinal cord, particularly the dorsal root entry zone (DREZ), represents the first central integration center for nociceptive afferent impulses. Here, the excitatory neurotransmitters/modulators, products of the primary sensory neurons, are released, the segmental interneuronal influences pertain, and the descending bulbospinal tracts terminate. A vast variety of compounds are thus involved in the processing of nociceptive information in these areas, among which are the 'classical' neurotransmitters and the more recently described neuropeptides. A continued vast interest exists concerning the chemistry of the dorsal horn/DREZ region. The current developments and understanding regarding the pharmacology of this region are presented. Particular emphasis is given to the interactions among the various compounds, the coexistence of some of these within single neuronal populations, the importance of the opiate receptor subtypes, and the actions and localizations of some of the newly discovered neuropeptides.