The gate control theory of pain mechanisms: a re-examination and re-statement

Wall, Peter

doi:10.1016/0304-3959(79)90069-1

Cited by 84 publications

(110 citation statements)

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“…However, it is not clear how pain relief is achieved by this procedure. The central role of the SG in the integration of nociceptive information has been well established (Wall, 1978;Cervero & Iggo, 1980) and it is conceivable that the mechanism responsible for the dorsal column stimulationproduced analgesia resides in the SG. In the present study we have analysed the synaptic responses of SG neurones to dorsal column stimulation using the in vitro adult rat spinal cord slice preparation.…”

Section: Discussionmentioning

confidence: 99%

Synaptic responses of substantia gelatinosa neurones to dorsal column stimulation in rat spinal cord in vitro.

Baba¹,

Yoshimura²,

Nishi³

et al. 1994

The Journal of Physiology

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1. To study the mechanism of dorsal column stimulation-induced depression of nociceptive transmission in the spinal cord, synaptic responses evoked in dorsal horn neurones by dorsal column and dorsal root stimulations were examined in a horizontal spinal cord slice of the adult rat. Intracellular recordings were made from substantia gelatinosa (SG) neurones. 2. All SG neurones examined received monosynaptic inputs and/or polysynaptic inputs from both dorsal column and dorsal root. Ad fibres were probably responsible for the synaptic responses. The responses evoked by dorsal column stimulation were similar to those evoked by primary afferent Ad fibre stimulation. 3. Monosynaptic excitatory postsynaptic potentials (EPSPs) evoked by dorsal column Ad fibres were depressed by 6-cyano-7-nitroquinoxaline-2,3-dione, suggesting that these fibres released L-glutamate or a related amino acid as a transmitter. 4. In 38 of 101 SG neurones, dorsal column stimulation evoked an initial EPSP followed by fast and/or slow inhibitory postsynaptic potentials (IPSPs). These IPSPs reversed polarity at a membrane potential of -73 + 2 mV. The fast IPSPs observed in 16 of the SG neurones (42 %) that received inhibitory inputs were depressed by strychnine, while the slow IPSPs observed in 22 SG neurones were depressed by bicuculline. In a few cells, a long-lasting slow IPSP with a much slower time course was detected; this IPSP was insensitive to strychnine and bicuculline, and reversed polarity at a membrane potential near -90 mV. 5. Repetitive stimulation of the dorsal column depressed the amplitude of monosynaptic EPSPs evoked by dorsal root stimulation. 6. The responses of SG neurones to dorsal column stimulation had configurations and durations similar to responses to dorsal root stimulation, and may be mediated largely by the same Ad fibres. However, a C fibre-mediated response could not be detected in SG neurones from dorsal column stimulation, although dorsal root stimulation could evoke C fibre-mediated monosynaptic EPSPs in 18 of 88 SG neurones (20 %). 7. These observations suggest that SG neurones receive abundant AS but not C fibre inputs from the dorsal column and that dorsal column stimulation inhibits primary afferent transmission in the spinal cord both by reducing transmitter release from primary Ad fibres and by hyperpolarizing SG neurones.Many fine afferent fibres that carry nociceptive information fibre classes and to modify the output of projection neurones terminate in the superficial dorsal horn of the spinal cord, located in lamina I and in deeper regions of the dorsal horn particularly in the substantia gelatinosa (SG, lamina II of (Kumazawa & Perl, 1978;Light, Trevino & Perl, 1979). Rexed) (Rexed, 1952;Maxwell & Rethelyi, 1987; Sugiura, Melzack & Wall (1965) proposed the gate control theory for Terui & Hosoya, 1989;Yoshimura & Jessell, 1989a. the dorsal horn circuitry responsible for pain transmission. SG neurones form local interneuronal circuits that are In their model, SG inhibitory neurones, activated by la...

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Section: Discussionmentioning

confidence: 99%

Synaptic responses of substantia gelatinosa neurones to dorsal column stimulation in rat spinal cord in vitro.

Baba¹,

Yoshimura²,

Nishi³

et al. 1994

The Journal of Physiology

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“…The proposed mechanism of action involves the gate control theory of pain 44 and the notion that the sensation of touch competes with the sensation of pain for transmission to the brain, thereby resulting in less pain. This technique is often referred to as providing "white noise."…”

Section: Tactile Stimulationmentioning

confidence: 99%

Reducing the pain of childhood vaccination: an evidence-based clinical practice guideline

Taddio¹,

Appleton²,

Bortolussi³

et al. 2010

Canadian Medical Association Journal

186

199

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“…Grade III, IV, or V mobilizations/manipulations were performed if joint hypomobility was found. Mobilizations/manipulations performed at the end of range are proposed to have hypoalgesic effects, 41,44,57,67,68,81 as well as mechanical effects, including connective tissue elongation through plastic deformation of the capsule and other soft tissues, 67 and/or by the breakup of intracapsular cross-linkages and adhesions. 44,67,68,78 Each mobilization/ manipulation was applied for 30 seconds, at a rate of approximately 1 mobilization every 1 to 2 seconds, followed by a 30-second rest.…”

Section: Sij and Hip Mobilization/manipulationmentioning

confidence: 99%

Proposed Algorithm for the Management of Athletes With Athletic Pubalgia (Sports Hernia): A Case Series

Kachingwe¹,

Grech²

2008

J Orthop Sports Phys Ther

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The gate control theory of pain mechanisms: a re-examination and re-statement

Cited by 84 publications

References 0 publications

Synaptic responses of substantia gelatinosa neurones to dorsal column stimulation in rat spinal cord in vitro.

Synaptic responses of substantia gelatinosa neurones to dorsal column stimulation in rat spinal cord in vitro.

Reducing the pain of childhood vaccination: an evidence-based clinical practice guideline

Proposed Algorithm for the Management of Athletes With Athletic Pubalgia (Sports Hernia): A Case Series

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