Скачать или смотреть Ascending Tracts | Pain Modulation: Gate Control Theory

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In this lecture, Professor Zach Murphy explores the Gate Control Theory of pain modulation, an essential concept in understanding how the nervous system regulates the perception of pain. We begin by reviewing the key players involved in nociception, including primary afferent pain fibers (A-delta and C fibers) that transmit painful stimuli, and large-diameter A-beta fibers that convey non-painful mechanical information like touch and pressure. These signals enter the dorsal horn of the spinal cord, where the “gate” mechanism resides, primarily within the substantia gelatinosa of the dorsal horn (lamina II).

We then examine how the “gate” works to either facilitate or inhibit pain transmission. When nociceptive fibers are activated alone, they stimulate projection neurons that send pain signals to the brain via the spinothalamic tract. However, when non-painful stimuli activate A-beta fibers simultaneously, inhibitory interneurons are engaged, releasing neurotransmitters like GABA and glycine to dampen the activity of projection neurons. This is why rubbing or applying pressure to an injured area can temporarily reduce pain sensation.

Finally, we discuss descending pain modulation from higher brain centers such as the periaqueductal gray (PAG) and the rostral ventromedial medulla (RVM), which can release endogenous opioids and serotonin to enhance inhibitory control over incoming pain signals.

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