Pain Rep. 2018 Jul 17;3(4):e659. doi: 10.1097/PR9.0000000000000659. eCollection 2018.
Pain relief by supraspinal gabapentin requires descending noradrenergic inhibitory controls.
Pain reports
Dina L Juarez-Salinas, Joao M Braz, Katherine A Hamel, Allan I Basbaum
Affiliations
Affiliations
- Department of Anatomy, University of California, San Francisco, San Francisco, CA, USA.
PMID: 30123855
PMCID: PMC6085145 DOI: 10.1097/PR9.0000000000000659
Abstract
INTRODUCTION: Gabapentin regulates pain processing by direct action on primary afferent nociceptors and dorsal horn nociresponsive neurons. Through an action at supraspinal levels, gabapentin also engages descending noradrenergic inhibitory controls that indirectly regulate spinal cord pain processing. Although direct injection of gabapentin into the anterior cingulate cortex provides pain relief independent of descending inhibitory controls, it remains unclear whether that effect is representative of what occurs when gabapentin interacts at multiple brain loci, eg, after intracerebroventricular (i.c.v.) injection.
METHODS: We administered gabapentin i.c.v. in a mouse model of chemotherapy (paclitaxel)-induced neuropathic pain. To distinguish spinal from supraspinally processed features of the pain experience, we examined mechanical hypersensitivity and assessed relief of pain aversiveness using an analgesia-induced conditioned place preference paradigm.
RESULTS: Paclitaxel-treated mice showed a preference for a 100-μg i.c.v. gabapentin-paired chamber that was accompanied by reduced mechanical allodynia, indicative of concurrent engagement of descending controls. As expected, the same dose in uninjured mice did not induce place preference, demonstrating that gabapentin, unlike morphine, is not inherently rewarding. Furthermore, a lower dose of supraspinal gabapentin (30 μg), which did not reverse mechanical allodynia, did not induce conditioned place preference. Finally, concurrent injections of i.c.v. gabapentin (100 μg) and intrathecal yohimbine, an α2-receptor antagonist, blocked preference for the gabapentin-paired chamber.
CONCLUSION: We conclude that pain relief, namely a reduction of pain aversiveness, induced by supraspinal gabapentin administered by an i.c.v. route is secondary to its activation of descending noradrenergic inhibitory controls that block transmission of the "pain" message from the spinal cord to the brain.
Keywords: Chemotherapy-induced neuropathic pain; Conditioned place preference; Gabapentin; Neuropathic pain; Noradrenergic
Conflict of interest statement
Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article.
References
- Pain. 2014 Dec;155(12):2510-6 - PubMed
- Neuropharmacology. 1993 Apr;32(4):367-71 - PubMed
- J Neurosci Methods. 1994 Jul;53(1):55-63 - PubMed
- Pain. 1990 Oct;43(1):113-20 - PubMed
- Neurology. 2005 Aug 9;65(3):444-7 - PubMed
- Biol Pharm Bull. 2009 Apr;32(4):732-4 - PubMed
- Nature. 2012 May 13;486(7401):122-5 - PubMed
- Eur J Pharmacol. 2007 Feb 5;556(1-3):69-74 - PubMed
- J Neurochem. 2008 May;105(3):933-42 - PubMed
- J Pharmacol Exp Ther. 2002 Dec;303(3):1199-205 - PubMed
- Pain. 1998 Apr;75(2-3):261-72 - PubMed
- PLoS One. 2015 Jun 12;10(6):e0128951 - PubMed
- Br J Pharmacol. 2006 May;148(2):233-44 - PubMed
- Life Sci. 2004 Apr 9;74(21):2593-604 - PubMed
- Brain Res. 1984 Apr 30;298(2):329-37 - PubMed
- Eur Neurol. 1998 Nov;40(4):191-200 - PubMed
- Pain. 2007 Dec 5;132(3):237-51 - PubMed
- Anesth Analg. 2013 Jan;116(1):224-31 - PubMed
- J Neurosci Res. 2008 Nov 15;86(15):3258-64 - PubMed
- J Pain. 2003 Oct;4(8):465-70 - PubMed
- Anesthesiology. 2013 Sep;119(3):675-86 - PubMed
- Pain. 2015 Jun;156(6):1084-91 - PubMed
- Anesthesiology. 2005 Jan;102(1):132-40 - PubMed
- Anesthesiology. 2007 Mar;106(3):557-62 - PubMed
- Exp Physiol. 1992 Sep;77(5):761-4 - PubMed
- Pain. 2017 Dec;158(12):2386-2395 - PubMed
- Br J Pharmacol. 2005 Mar;144(5):703-14 - PubMed
- Nat Neurosci. 2009 Nov;12(11):1364-6 - PubMed
- Eur J Pain. 2016 Jul;20(6):917-25 - PubMed
- Neurology. 2010 Feb 2;74(5):413-20 - PubMed
- J Neurosci. 2009 Apr 1;29(13):4076-88 - PubMed
- Proc Natl Acad Sci U S A. 2012 Dec 11;109(50):20709-13 - PubMed
- J Neurosci. 2001 Mar 15;21(6):1868-75 - PubMed
Publication Types
Grant support