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KMID : 0355220130380020215
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Journal of Korean Academy Oral Medicine
2013 Volume.38 No. 2 p.215 ~ p.219
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Descending Controls : The Self-Regulation of Chronic Pain
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Kim Min-Jae
Kang Soo-Kyung
Chun Yang-Hyun
Hong Jung-Pyo
Auh Q-Schick
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Abstract
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The descending control system is composed of a group of structures in the midbrain, medulla oblongata and pons that form a network of descending inhibitory projections. In the clinical setting, it has been shown that the application of a electrical counterirritant to these structures and diminishes the pain in patients. Thus, depression and anxiety have been shown to predict the development of chronic neuropathic pain state. These factors could influence pain might also involve descending controls. Interestingly, reduced descending controls are seen in patients with irritable bowel syndrome and theses patients had greater anxiety, depression compared to controls. And, the influence of anxiety on the chronicity of pain and on the descending control pathways should be tested in animal models, using modern techniques. Given this Knowledge, it is no wonder that pain is a highly personal experience that is susceptible to a variety of biologic, pharmacologic, and environmental influences.
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KEYWORD
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Descending Controls, Chronic Pain, Analgesia, Nociceptor
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