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Pain pp 21-23 | Cite as

Spinal and Medullary Dorsal Horn Mechanisms

  • Thomas S. McDowellEmail author
Chapter

Abstract

The dorsal horn of the spinal cord is the first relay in the transmission of painful stimuli from the periphery to higher brain centers. Primary nociceptor terminals enter the dorsal horn and form synapses with projection neurons as well as both excitatory and inhibitory interneurons, primarily in laminae I and II. The dorsal horn also receives input from nuclei in the brainstem and other subcortical structures that facilitate or inhibit nociceptive transmission. All these interactions make the spinal dorsal horn a site of complex integration and modulation of nociceptive input.

Keywords

Dorsal horn Marginal layer Substantia gelatinosa Projection neuron Substance P NK1 receptor Interneuron Nociceptor Pain Gate control theory 

References

  1. 1.
    Todd AJ, Koerber HR. Neuroanatomical substrates of spinal nociception. In: McMahon SB, Koltzenburg M, Tracey I, Turk DC, editors. Wall and Melzack’s textbook of pain. 6th ed. Philadelphia: Saunders; 2013. p. 77–93.Google Scholar
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    Todd AJ. Neuronal circuitry for pain processing in the dorsal horn. Nat Rev Neurosci. 2010;11:823–36.Google Scholar
  3. 3.
    Benarroch EE. Dorsal horn circuitry. Neurology. 2016;86:1060–9.Google Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of AnesthesiologyUniversity of Wisconsin School of Medicine and Public HealthMadisonUSA

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