Descending noxious inhibitory control (DNIC)

DNIC is a centrally mediated endogenous pain modulatory process in which a noxious stimulus applied at one body site inhibits pain responses (often measured as reduced wide dynamic range neuronal firing) to another distant noxious stimulus. This phenomenon is critically mediated via descending pain inhibitory pathways from brainstem regions (including the dorsal reticular nucleus, periaqueductal gray, and rostral ventromedial medulla), using monoaminergic (noradrenaline, serotonin) and, to some extent, opioidergic neurotransmitter systems. DNIC efficiency is diminished in several chronic pain conditions and forms the physiological basis for "pain inhibits pain" effects as well as for some clinical pain tests (CPM paradigm). While not a discrete molecular drug target, many analgesic drugs indirectly affect DNIC by modulating these descending pathways.

Other names

diffuse noxious inhibitory controlconditioned pain modulationCPM

Modulation of descending monoaminergic (noradrenergic and serotonergic) and opioidergic pathways; Activation or restoration of inhibitory (analgesic) signals in the spinal cord via these neurotransmitter systems