Changes in serotonin, serotonin transporter expression and serotonin denervation supersensitivity: Involvement in chronic central pain after spinal hemisection in the rat

Spinal cord injury (SCI) results in abnormal loco-motor and pain syndromes in humans. In a rodent SCI model, T13 unilateral spinal hemisection results in bilateral mechanical allodynia and thermal hyperalgesia, partly by interruption of tonic descending serotonin (5-HT) inhibition. In the current study, we examined changes in density and distribution of 5-HT and 5-HTT in cervical (C8) and lumbar (L5) enlargements after T13 spinal hemisection and studied the effects of intrathecally delivered 5-HT (10, 21, and 63 mug), 5-HT antagonist methysergide (125 mug/kg), and 5-HT reuptake inhibitor fluvoxamine (75 mug/kg) on pain-related behaviors. Thirty-day-old male Sprague-Dawley rats were spinally hemisected and sacrificed at 3 (n = 20) and 28 (n = 20) days postsurgery for immunohistochemistry, Western blot, and ELISA analysis and compared against sham-operated animals (n = 10). At day 3, C8 5-HT levels were not significantly changed but L5 there was a significant decrease in ipsilateral 5-HT in laminae I-II followed by incomplete recovery at 28 days postinjury. At 3 and 28 days postinjury, C8 5-HTT levels were not significantly changed, but at L5 there was significant ipsilateral up-regulation of 5- HTT in laminae I-II. A second group of animals (n = 30) was hemisected and, starting at 28 days postin-jury, behaviorally tested with intrathecal compounds. Increasing doses of 5-HT attenuated both fore- and hindlimb mechanical allodynia and thermal hyperalgesia, and effects of endogenous 5-HT were attenuated by methysergide and enhanced with fluvoxamine, all without locomotor alterations. Sham controls (n = 10) were unaffected. Thus. permanent changes occur in 5-HT and 5-HTT after SCI, denervation of 5-HT supersensitivity develops, and modulation of 5-HT attenuates pain-related behaviors. Insight gained by these studies may aid in the understanding of dynamic 5-HT systems which will be useful in treating chronic central pain after SCI. (C) 2002 Elsevier Science (USA).