The role of the dorsal column pathway in visceral nociception

Current Pain and Headache Reports

Volumn 5, Issue 1, 2001, Pages 20-26

  Willis, William D ^a   Westlund, Karin N ^a  

^a University of Texas Medical Branch School of Medicine   (United States)

Author keywords

Dorsal Column; Dorsal Column Nucleus; Regional Cerebral Blood Volume; Sacral Spinal Cord; Spinothalamic Tract

Indexed keywords

BRADYKININ RECEPTOR;

ANIMAL; COLON; DUODENUM; ELECTROPHYSIOLOGY; HAPLORHINI; HUMAN; INNERVATION; LESIONS AND DEFECTS; METABOLISM; NEOPLASM; NUCLEAR MAGNETIC RESONANCE IMAGING; PAIN; PANCREAS; PATHOPHYSIOLOGY; RAT; RECTUM; REVIEW; SENSORY NERVE; SPINAL CORD; VISCERA;

AFFERENT PATHWAYS; ANIMALS; COLON; DILATATION, PATHOLOGIC; DUODENUM; ELECTROPHYSIOLOGY; HAPLORHINI; HUMANS; MAGNETIC RESONANCE IMAGING; NEOPLASMS; PAIN; PANCREAS; RATS; RECEPTORS, BRADYKININ; RECTUM; SPINAL CORD; VISCERA; VISCERAL AFFERENTS;

EID: 0035256761     PISSN: 15313433     EISSN: 15343081     Source Type: Journal    
DOI: 10.1007/s11916-001-0006-1     Document Type: Article

References (22)

1. Milne RJ, Foreman RD, Giesler GJ, Willis WD: Convergence of cutaneous and pelvic visceral nociceptive inputs onto primate spinothalamic neurons. Pain 1981, 11:163–183. DOI: 10.1016/0304-3959(81)90003-8
2. Foreman RD: Organization of the spinothalamic tract as a relay for cardiopulmonary sympathetic afferent fiber activity. In In Progress in Sensory Physiology, vol 9. Edited by Ottoson D. Berlin: Springer-Verlag; 1989:1–51.
3. Gybels JM, Sweet WH: Neurosurgical Treatment of Persistent Pain; Physiological and Pathological Mechanisms of Human Pain. Basel: Karger; 1989.
4. Gildenberg PL, Hirshberg RM: Limited myelotomy for the treatment of intractable cancer pain. J Neurol Neurosurg Psychiatry 1984, 47:94–96. DOI: 10.1136/jnnp.47.1.94
5. Hirshberg RM, Al-Chaer ED, Lawand NB, et al.: Is there a pathway in the posterior funiculus that signals visceral pain? Pain 1996, 67:291–305. Summarizes eight cases in which Hirshberg performed a limited midline myelotomy to relieve pelvic cancer pain and the initial anatomic and electrophysiologic studies done in the Willis and Westlund laboratories to confirm the presence of a visceral nociceptive pathway in the dorsal column in animals. It illustrates a section from the spinal cord of one of Hirshberg’s patients that shows bilateral demyelination of the medial gracile fasciculi. Before surgery, this patient’s colon cancer pain was insufficiently relieved by intravenous morphine; after surgery, he had no visceral pain and required no pain medication during his postoperative survival period of 3 months. DOI: 10.1016/0304-3959(96)03127-2
6. Nauta HJW, Hewitt E, Westlund KN, Willis WD: Surgical interruption of a midline dorsal column visceral pain pathway: case report and review of the literature. J Neurosurg 1997, 86:538–542. DOI: 10.3171/jns.1997.86.3.0538
7. Nauta HJW, Soukup VM, Fabian RH, et al.: Punctate midline myelotomy for the relief of visceral cancer pain. J Neurosurg 2000, 92:125–130. Summarizes six cases in which Nauta performed punctuate midline myelotomy for the relief of visceral pain. There was a significant reduction in pain ratings and in daily narcotic use with no adverse neurologic effects. The duration of pain reduction was for up to 31 months.
8. Kim YS, Kwon SJ: High thoracic midline dorsal column myelotomy for severe visceral pain due to advanced stomach cancer. Neurosurgery 2000, 46:85–90. DOI: 10.1097/00006123-200001000-00018
9. Becker R, Sure U, Bertalanffy H: Punctate midline myelotomy. A new approach in the management of visceral pain. Acta Neurochir (Wien) 1999, 141:881–883. DOI: 10.1007/s007010050390
10. Al-Chaer ED, Lawand NB, Westlund KN, Willis WD: Visceral nociceptive input into the ventral posterolateral nucleus of the thalamus: a new function for the dorsal column pathway. J Neurophysiol 1996, 76:2661–2674. Recordings were made in anesthetized rats from neurons of the VPL nucleus of the thalamus that responded to noxious CRD or to inflammation of the colon induced by mustard oil. The responses to noxious visceral input were nearly eliminated by a lesion of the dorsal column at T10, whereas there was only a small reduction in the response following a lesion of the ventrolateral white matter, including the spinothalamic tract, at the same segmental level.
11. Al-Chaer ED, Lawand NB, Westlund KN, Willis WD: Pelvic visceral input into the nucleus gracilis is largely mediated by the postsynaptic dorsal column pathway. J Neurophysiol 1996, 76:2675–2690. Recordings were made in anesthetized rats from neurons of the gracile nucleus or from postsynaptic dorsal column neurons in the central region of the sacral spinal cord that responded to noxious CRD or to inflammation of the colon by mustard oil. Microdialysis administration of morphine into the sacral spinal cord produced a profound nalozonereversible reduction in the visceral responses, and administration of a non-NMDA glutamate receptor antagonist had a similar effect. It was concluded that most of the input to the gracile nucleus (and hence to the VPL thalamic nucleus) was converted by postsynaptic dorsal column neurons, rather than by directly projecting primary afferent fibers.
12. Ness TJ, Gebhart GF: Colorectal distension as a noxious visceral stimulus: physiologic and pharmacologic characterization of pseudoaffective reflexes in the rat. Brain Res 1988, 450:153–169. DOI: 10.1016/0006-8993(88)91555-7
13. Ness TJ, Metcalf AM, Gebhart GF: A psychophysical study in humans using phasic colonic distention as a noxious visceral stimulus. Pain 1990, 43:377–386. DOI: 10.1016/0304-3959(90)90035-C
14. Al-Chaer ED, Westlund KN, Willis WD: Nucleus gracilis: an integrator for visceral and somatic information. J Neurophysiol 1997, 78:521–527.
15. Feng Y, Cui M, Al-Chaer Ed, Willis WD: Epigastric antinociception by cervical dorsal column lesions in rats. Anesthesiology 1998, 89:411–420. DOI: 10.1097/00000542-199808000-00018
16. Willis WD, Coggeshall RE: Sensory Mechanisms of the Spinal Cord, edn 2. New York: Plenum Press; 1991.
17. Houghton AK, Wang C-C, Westlund KN: Do nociceptive signals from the pancreas travel in the dorsal column? Pain 2000, 87:311–314.
18. Houghton AK, Kadura S, Westlund KN: Dorsal column lesions reverse the reduction of homecage activity in rats with pancreatitis. Neuroreport 1997, 8:3795–3800. DOI: 10.1097/00001756-199712010-00028
19. Wang C-C, Willis WD, Westlund KN: Ascending projections from the area around the spinal cord central canal: a phaseolus vulgaris leucoagglutinin study in rats. J Comp Neurol 1999, 415:341–367. DOI: 10.1002/(SICI)1096-9861(19991220)415:3<341::AID-CNE3>3.0.CO;2-7
20. Al-Chaer ED, Feng Y, Willis WD: A role for the dorsal column in nociceptive visceral input into the thalamus of primates. J Neurophysiol 1998, 79:3143–3150.
21. Al-Chaer ED, Feng Y, Willis WD: Comparative study of viscerosomatic input onto postsynaptic dorsal column and spinothalamic tract neurons in the primate. J Neurophysiol 1999, 82:1876–1882.
22. Willis WD, Al-Chaer ED, Quast MJ, Westlund KN: A visceral pain pathway in the dorsal column of the spinal cord. Proc Natl Acad Sci U S A 1999, 96:7675–7679. Reviews the experimental basis for the posterior column myelotomy procedure. The illustrations include fMRI evidence that the regional cerebral blood volume changes in monkeys that result from CRD can be essentially eliminated by surgical interruption of the dorsal column at a midthoracic level. This effect persists for at least months. DOI: 10.1073/pnas.96.14.7675