Central pain syndrome (CPS) is defined as pain associated with a lesion of the CNS and is a common consequence of spinal cord injuries.We generated a rodent model of CPS by making unilateral electrolytic or demyelinating lesions centered on the spinothalamic tract in rats. Thermal hyperalgesia and mechanical allodynia occurred in both hind paws and forepaws by 7 d postlesion and were maintained Ͼ31 d. Field potentials in the ventral posterior lateral nucleus (VPL) in thalamic brain slices from lesioned animals displayed an increased probability of burst responses. Ethosuximide, a T-type calcium channel blocker, eliminated busting in lesioned thalamic slices and attenuated lesion-induced hyperalgesia and allodynia. We conclude that CPS in this model results from an increase in the excitability of thalamic nuclei that have lost normal ascending inputs as the result of a spinal cord injury and suggest that ethosuximide will relieve human CPS by restoring normal thalamic excitability.

Wang, Gexin, Bin Tang, and Richard J. Traub. Differential processing of noxious colonic input by thoracolumbar and lumbosacral dorsal horn neurons in the rat. J Neurophysiol 94: 3788 -3794, 2005. First published August 10, 2005; doi:10.1152/jn.00230.2005. Previous studies suggest the lumbosacral (LS) spinal cord processes acute colorectal stimuli whereas the thoracolumbar (TL) and LS spinal segments process inflammatory stimuli. In this study, the effects of colorectal distention (CRD) on TL and LS dorsal horn neuronal activity were recorded in Nembutal-anesthetized male rats both with and without colonic inflammation. Both single cells (before and after inflammation) and populations (multiple cells from noninflamed or inflamed rats) were studied. CRD-responsive neurons had excitatory Abrupt (ON-OFF with stimulus) or Sustained (prolonged after discharge) responses or were Inhibited by CRD. In noninflamed rats, a significantly greater percentage of LS neurons (63% Abrupt, 27% Sustained) were excited by CRD than TL neurons (61% Abrupt, 3% Sustained). The remaining cells were Inhibited (10% LS, 36% TL). LS Abrupt neurons had lower thresholds and greater response magnitudes to CRD compared with TL Abrupt neurons. After colonic inflammation, TL neurons became more excitable: the percentage of Inhibited neurons decreased, the response magnitude of Abrupt neurons increased, and the threshold decreased. In contrast, in single-cell recordings, the response of LS Sustained neurons increased, whereas LS Abrupt neurons decreased. These data suggest that in noninflamed rats, the net response to CRD of TL visceroceptive spinal sensory neurons is less than that of LS neurons. Colonic inflammation increases the net response of TL neurons and differentially modulates the response of LS neurons. These differences may contribute to the functional dichotomy between the TL and LS spinal segments in processing acute and inflammatory colorectal pain. I N T R O D U C T I O NA unique feature of the viscera is dual innervation by sensory afferent fibers projecting in the same nerves as sympathetic (splanchnic, hypogastric) and parasympathetic (vagal, pelvic) efferents. In the rat, the descending colon and rectum are innervated by primary afferent fibers projecting in the pelvic nerve to the L6 -S2 spinal cord segments and hypogastric/lumbar colonic nerves projecting to the T13-L2 spinal cord (Mayer and Gebhart 1994; Mayer and Raybould 1990; Nadelhaft and Booth 1984; Ness and Gebhart 1988; Traub et al. 1999). However, the physiological role of this dual innervation in visceral nociceptive processing is unclear. Previous studies suggest that the lumbosacral (LS) and thoracolumbar (TL) spinal cord segments process acute and inflammatory pain from the colon and rectum differently. In humans, referred pain evoked by colorectal distention (CRD) in normal volunteers is perceived in the sacral dermatomes, whereas patients with irritable bowel syndrome or Crohn's disease report referred pain expanding into the TL dermatomes (Bernstein et al. 199...

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Sex differences in the spinal processing of somatic and visceral stimuli contribute to greater female sensitivity in many pain disorders. The present study examined spinal mechanisms that contribute to sex differences in visceral sensitivity. The visceromotor response to colorectal distention (CRD) was more robust in normal female rats and following intracolonic mustard oil compared to males. No sex difference was observed in the CRD-evoked response of lumbosacral (LS) and thoracolumbar (TL) colonic afferents in normal and mustard oil-treated rats, but there was a sex difference in spontaneous activity that was exacerbated by intracolonic mustard oil. The response of visceroceptive dorsal horn neurons to CRD was greater in normal females in the LS and TL spinal segments. The effect of intracolonic mustard oil on the CRD-evoked response of different phenotypes of visceroceptive dorsal horn neurons was dependent on sex and segment. The NMDA receptor antagonist APV dose-dependently attenuated the visceromotor response in normal rats with greater effect in males. Correspondingly, there was greater cell membrane expression of the GluN1 subunit in dorsal horn extracts in females. Following intracolonic mustard oil there was no longer a sex difference in the effect of APV nor GluN1 expression in LS segments but greater female expression in TL segments. These data document a sex difference in spinal processing of nociceptive visceral stimuli from the normal and inflamed colon. Differences in dorsal horn neuronal activity and NMDA receptor expression contribute to the sex differences in the visceral sensitivity observed in awake rats.

Background and aims-Colonic afferents project to the lumbosacral and thoracolumbar spinal cord via the pelvic and hypogastric/lumbar colonic nerves, respectively. Both spinal regions process inflammatory colonic stimuli. The role of thoracolumbar segments in processing acute colorectal pain is questionable, however, since the lumbosacral spinal cord appears sufficient to process reflex responses to acute pain. Here we demonstrate that activity in pelvic nerve colonic afferents actively modulates thoracolumbar dorsal horn neuron processing of the same colonic stimulus via a supraspinal loop: homovisceral descending modulation.