Is there a pathway in the posterior funiculus that signals visceral pain?

被引:114
作者
Hirshberg, RM
AlChaer, ED
Lawand, NB
Westlund, KN
Willis, WD
机构
[1] UNIV TEXAS,MED BRANCH,DEPT ANAT & NEUROSCI,GALVESTON,TX 77555
[2] ST JOSEPH HOSP,DEPT NEUROSURG,HOUSTON,TX
关键词
colorectal distention; fasciculus gracilis; limited midline myelotomy; nucleus gracilis; postsynaptic dorsal column path; ventral posterior lateral nucleus;
D O I
10.1016/0304-3959(96)03127-2
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
The present report provides evidence that axons in the medial part of the posterior column at T10 convey ascending nociceptive signals from pelvic visceral organs. This evidence was obtained from human surgical case studies and histological verification of the lesion in one of these cases, along with neuroanatomical and neurophysiological findings in animal experiments. A restricted lesion in this area can virtually eliminate pelvic pain due to cancer. The results remain excellent even in cases in which somatic structures of the pelvic body wall are involved. Following this procedure, neurological testing reveals no additional neurological deficit. There is no analgesia to pinprick stimuli applied to the body surface, despite the relief of the visceral pain, Since it is reasonable to attribute the favorable results of limited midline myelotomies to the interruption of axons of visceral nociceptive projection neurons in the posterior column, we have performed experiments in rats to test this hypothesis. The results in rats indicate that the dorsal column does indeed include a nociceptive component that signals pelvic visceral pain. The pathway includes neurons of the postsynaptic dorsal column pathway at the L6-S1 segmental level, axons of these neurons in the fasciculus gracilis, and neurons of the nucleus gracilis and the ventral posterolateral nucleus of the thalamus.
引用
收藏
页码:291 / 305
页数:15
相关论文
共 97 条
[61]   A SPINOMEDULLARY PROJECTION TERMINATING IN THE DORSAL RETICULAR NUCLEUS OF THE RAT [J].
LIMA, D .
NEUROSCIENCE, 1990, 34 (03) :577-589
[62]   EXTRACELLULAR AND INTRACELLULAR-RECORDINGS FROM DORSAL COLUMN POSTSYNAPTIC SPINOMEDULLARY NEURONS IN THE CAT [J].
LU, GW ;
BENNETT, GJ ;
NISHIKAWA, N ;
HOFFERT, MJ ;
DUBNER, R .
EXPERIMENTAL NEUROLOGY, 1983, 82 (02) :456-477
[63]  
MANSUY L, 1976, NEUROCHIRURGIE, V22, P437
[64]  
MANSUY L, 1944, J CHIR, V60, P206
[65]   SPINAL AND TRIGEMINAL PROJECTIONS TO THE NUCLEUS OF THE SOLITARY TRACT - A POSSIBLE SUBSTRATE FOR SOMATOVISCERAL AND VISCEROVISCERAL REFLEX ACTIVATION [J].
MENETREY, D ;
BASBAUM, AI .
JOURNAL OF COMPARATIVE NEUROLOGY, 1987, 255 (03) :439-450
[66]   CONVERGENCE OF CUTANEOUS AND PELVIC VISCERAL NOCICEPTIVE INPUTS ONTO PRIMATE SPINOTHALAMIC NEURONS [J].
MILNE, RJ ;
FOREMAN, RD ;
GIESLER, GJ ;
WILLIS, WD .
PAIN, 1981, 11 (02) :163-183
[67]   ANATOMICAL AND PHYSIOLOGICAL-STUDIES OF THE GRAY-MATTER SURROUNDING THE SPINAL-CORD CENTRAL CANAL [J].
NAHIN, RL ;
MADSEN, AM ;
GIESLER, GJ .
JOURNAL OF COMPARATIVE NEUROLOGY, 1983, 220 (03) :321-335
[68]   FUNICULAR LOCATION OF THE ASCENDING AXONS OF NEURONS ADJACENT TO THE SPINAL-CORD CENTRAL CANAL IN THE RAT [J].
NAHIN, RL ;
MADSEN, AM ;
GIESLER, GJ .
BRAIN RESEARCH, 1986, 384 (02) :367-372
[69]   COLORECTAL DISTENSION AS A NOXIOUS VISCERAL STIMULUS - PHYSIOLOGIC AND PHARMACOLOGIC CHARACTERIZATION OF PSEUDAFFECTIVE REFLEXES IN THE RAT [J].
NESS, TJ ;
GEBHART, GF .
BRAIN RESEARCH, 1988, 450 (1-2) :153-169
[70]   CHARACTERIZATION OF NEURONAL RESPONSES TO NOXIOUS VISCERAL AND SOMATIC STIMULI IN THE MEDIAL LUMBOSACRAL SPINAL-CORD OF THE RAT [J].
NESS, TJ ;
GEBHART, GF .
JOURNAL OF NEUROPHYSIOLOGY, 1987, 57 (06) :1867-1892