【摘要】 目前研究比较清楚的痛觉调制通路有 :中脑导水管周围灰质 (PAG) -延脑头端腹内侧区 (RVM) -脊髓背角 /三叉神经脊束核通路 ;PAG -伏核 -杏仁核 -缰核 -PAG回路 ;丘脑中央下核 -腹外侧眶皮层 -PAG通路 ;大脑皮层下行抑制通路 :皮层SⅡ -伏核 /缰核 -中缝大核(NRM) -脊髓背角通路 ;皮层SⅡ区 -运动皮层 -丘脑髓板内核群通路 ;皮层SmⅠ区 -尾核 -丘脑束旁核通路 ;下丘脑弓状核 (ARH)痛觉调制通路 :ARH -中缝背核 /蓝斑 /PAG通路 ;ARH -中缝背核 -脊髓背角通路 ;ARH -垂体前叶、中间叶 -丘脑束旁核通路 ;边缘系统 -外侧缰核 -中缝背核 /PAG -NRM/蓝斑 -脊髓背角 /三叉神经脊束核通路 ;痛觉调制的易化通路 :RVM -脊髓背角通路 ;大脑皮层SⅡ -SⅠ通路更多还原

【Abstract】 In the present paper, we review the researches on the neural pathways involving analgesia modulation. Up to now, the clarified pain modulation pathways are 1) the descending inhibitory pathway originating from the brain stem: periaqueductal gray (PAG)-rostral ventromedial medulla(RVM)-spinal dorsal horn/nucleus tractus spinalis nervi trigemini; 2) the mesolibic neuronal loop: PAG-ucleus accumbens-ucleus amygdala-habenula-PAG; 3) thalamic nucleus submedium-ventrolateral orbital cortex-PAG pathway; 4) the descending inhibitory pathways originating from the cerebral cortex: second somatosensory cortex(SⅡ)-accumbens/habenula-nucleus raphe magnus(NRM)-spinal dorsal horn pathway, SⅡ-motor cortex-thalamic intralaminar nuclei pathway and sensorimortor area Ⅰ of the cerebral cortex-caudate nucleus-parafascicular nucleus pathway; 5) the neural pathways emanating from arcuate nucleus of hypothalamus (ARH): ARH-dorsal raphe nucleus/locus coeruleus/PAG pathway, ARH-dorsal raphe nucleus-spinal dorsal horn pathway, ARH-anterior and medial pituitary-parafascicular nucleus pathway; 6) the limbic system-lateral habenula-dorsal raphe nucleus/PAG-NRM/locus coeruleus-spinal dorsal horn/nucleus tractus spinalis nervi trigemini pathways; and 7) the facilitatory neural pathways for analgesia modulation : RVM-spinal dorsal horn pathway and SⅡ-SI somatosensory cortex pathway.更多还原