Pain Gating Theory

[@tinanewton-modlmayr1342]

Amazing clarity. You have a gift for explaining complicated details simply, please keep it up!

[@NeuroDocUniverse]

+Tina Newton-Modlmayr Thanks for the kind words!

[@messagemiller]

That was a great explanation thank you! I'm a med student in Atlanta and this helped clarify a concept for a neuro test tomorrow.

[@elliot0]

Thank you! You have just cleared up something that has been baffling me for the past week!!!

[@NeuroDocUniverse]

You are correct. Your confusion (an mine and others) comes from illustrations that tie the substantia gelatinosa to the posterior marginalis like the one in the following video link (YT won't let me post a link in the comments section). In truth, there is nothing separating the substantia gelatinosa (Rexed I and II) from the posterior marginalis, so they are essentially the same stucture. Thanks for your post!

[@NeuroDocUniverse]

Hi there! If you search pubmed for "presynaptic inhibition at the dorsal horn" and "mechanoreceptor inhibition of nociception" you should find what you need in abundance. Let me know if you have any difficulty.

[@SSAFADevonvolunteering]

Excellent and well paced explanation thank you so much

[@NeuroDocUniverse]

@PalmyBruce So sorry to hear about your leg, Bruce. Bone pain can take time to heal, so don't give up as it will get better. As I have not examined you or read your radiographs, I cannot give you personalized advice. Generally, movement does help in the perception of pain from many perspectives, but you must be sure to work with your physical therapist on individual limitations so that you do not inadvertently create more pain or slow your healing time. Best to you for a swift recovery!

[@BruceThomson]

Helpful thank you - I broke my leg 12 Aug and am exploring pain evasion methods that don't require drugs. I will focus on more use of mechanical activity such as the physio exercises given to me, and general activity. If you have more specific recommendations, please let me know. Bruce Thomson in New Zealand.

[@NeuroDocUniverse]

Hi, I think you are referring to the speed of the peripheral nerves increasing with myelination. More speed translates into sustained effect of the presynaptic inhibition at lamina 1. Best regards, LB

[@NeuroDocUniverse]

Thanks for the kind words!

[@geeuphorsey]

Thank you for the reply, i have written the part of my lit review on pain now, i found alot of journals but most of them were in more detail than i needed so hopefully i've picked out the most important parts (that related to pain inhibition). Sadly no journals will be able to help me link it all together into a coherent argument though! Thanks again for your videos, i've watched quite a few of them now and they really are extremely useful!

[@NeuroDocUniverse]

@DrLeoCharm Though the exact mechanisms of all the incidences of presynaptic inhibition are not fully understood, the basic understanding is the presynaptic inhibition occurs at the receptors of the postsynaptic neuron. I hope this is helpful!

[@mohitacoustic]

Really nice. refreshed College memories and the topic itself !! :)

[@NeuroDocUniverse]

You are correct, however, there is a bit of both going on. Check out this article for clarification: Axonal projections of mechanoreceptive dorsal root ganglion neurons depend on Ret Yutaka Honma1,*, Masako Kawano1, Shinichi Kohsaka2 and Masaharu Ogawa1 Development 137, 2319-2328 (2010) doi:10.1242/dev.046995 2010. Published by The Company of Biologists Ltd

[@geeuphorsey]

This video is brilliant! I'm writing my dissertation on pain and behaviour in horses, i'm primarily a visual learner so this was brilliant for me! Do you know of any journal articles that detail this latest theory as i don't think referencing from youtube would go down so well in my thesis!! Thank you, you have officially broken my writers block!

[@bigmaristuff]

Well done. I would like to know more about the mechanism described. Can you refer me to any additional publications or links.

[@NeuroDocUniverse]

Two good places to start: Coull, J. A., Boudreau, D., Bachand, K., Prescott, S. A., Nault, F., Sík, A., ... & De Koninck, Y. (2003). Trans-synaptic shift in anion gradient in spinal lamina I neurons as a mechanism of neuropathic pain. Nature, 424(6951), 938-942. Costigan, M., & Woolf, C. J. (2002). No DREAM, no pain: closing the spinal gate. Cell, 108(3), 297-300.

[@bigmaristuff]

NeuroDocUniverse Thank you.

[@tomhodgett123]

Really useful, I was told that the myelination of the cells has an effect, could you perhaps elabourate on this?

[@orbsandtea]

Sorry, the terminology is a mouthful. How does the nociceptors get inhibited by the activation of mechanoceptors? Is the placement of the two relative to the spinothalamic tract a clue? Why does the "firing back" shut off the nociception in lamina I? Good explanations and thankyou so much. : )

[@babyfacenelson08]

you are truly amazing! clear, concise and to the point :)

[@TheCraZHI]

I'm a bit confused about something (probably due to my very incomplete and knowledge of neuroscience) and I hope you can clear it up for me. So you said the first order neurones from the mechanoceptors first synapse onto the deeper laminae of the dorsal horn and then continue into dorsal column. But doesn't first order neurones of the dorsal column continue all the way to the cuneate and gracile nucleus before making their first synapse? or could they make a synapse somewhere along their axon?

[@benh9688]

Please can you explain 'why' presynaptic inhibition happens? You've been very clear to describe 'how' it happens but I'm curious as to the reason behind it. Presumably there's a purely physiological benefit?

[@NeuroDocUniverse]

Sapana, I'm having some trouble posting the link for you. Go to Google/Images/Substantia Gelatinosa/ and look for the Oxford Medicine image. It's very clear.

[@Cracklenstv]

Thank you very much sharing your knowledge!!

[@lilyjimenez1066]

what program you use to make this videos? I've always been curious. EXCELLENT VIDEO!!

[@NeuroDocUniverse]

I use Camtasia, and Intous Wacom tablet, and Paint.

[@NeuroDocUniverse]

Thanks very much!

[@natushkatzm]

Thank you for an excellent video! But I'd really appreciate if you could provide me with a reference(s) where it is stated that no T-cells exist in the dorsal horn.

[@NeuroDocUniverse]

natushkatzm Hi :-) Here's a great reference that illustrates the short comings of the original theory @109 . The correction was that there is no T cell that prefers proprioception over ncoiception.

[@natushkatzm]

NeuroDocUniverse Sorry, what is @109? :)

[@NeuroDocUniverse]

natushkatzm So sorry. I cut and pasted a link to this article: Moayedi, M., & Davis, K. D. (2013). Theories of pain: from specificity to gate control. Journal of neurophysiology, 109(1), 5-12. KZbin doesn't permit links.

[@natushkatzm]

NeuroDocUniverse Thank you so much!

[@NeuroDocUniverse]

You're welcome!

[@muneiwamadzhia7419]

wow...thanx a lot!i now understand why rubbing inhibit pain

[@sapanayonghang2951]

lamina 2 n 3 together are called substantia gelotinosa of rolando which is lower to lamina 1, isn't so? but in the picture u r showing it above lamina 1,n m confused :(

[@PelleAudiology]

What could the evolutionary reason behind this pre-synaptic inhibition be?

[@NeuroDocUniverse]

Hi Pelle, It's impossible to know, but it would make sense that an injured organism needs to get away from its attacker. It would be advantageous to the survival of the organism if movement reduced pain to allow for flight away from the source of injury.

[@CapsAdmin]

NeuroDocUniverse Running around (usually in circles) or jumping up and down tends to help a lot.

[@TheCraZHI]

Great video, i forgot to mention. :D Thank you!

[@angel220426]

Brilliant, Thank you so much !

[@dawnhoran3353]

Thank you for your fab lesson you are a star!

[@marijnb4191]

Hello, You said that the backfiring had a pre-synaptic effect and that it inhibitsthe receiving of neurotransmitter. But the receiving part is the post-synaptic part right. Or am I just asking a stupid question? :)

[@NeuroDocUniverse]

You're welcome, Lion-o R!

[@spa1982]

this is excellent

[@denaliharper]

excellent.. thank you!

[@NeuroDocUniverse]

You're welcome!

[@MixoZ]

Thanks Doc

[@NeuroDocUniverse]

You're welcome!

[@ncxmiami]

Great video! Is it me, or she sounds like Katthy Bates? :)

[@suprriyakale1379]

VERY NICE VIDEO......

[@ChrisVincentus]

explains why massage and acupuncture, chiropractic work!

[@NeuroDocUniverse]

Awesome! You're so wlecome!

[@anhumblemessengerofthelawo3858]

much applause

[@123azadeh]

Good

[@toricarraretto1737]

good video, would be better if you weren't so monotone :)

[@kalynabird4572]

you could do a vid :)