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Serotonin (5-HT) is involved in pain modulation via descending pathways in the central nervous system.
If descending pathways are interrupted, sensitization can be evoked from a much wider area.
There is a growing body of evidence suggesting that descending pathways are not exclusively inhibitory, but also include excitatory actions.
These changes could lead to an alteration in the descending pathways of pain modulation [23], facilitating pain widespread and disability.
One final limitation of the model is seen via direct activation of the antinociceptive descending pathways, which elicits c-fos expression in spinal neurons even in the absence of any nociceptive input [50].
Clinical and experimental observations [13] on migraine suggest that a general hyper excitability could develop along nociceptive trigeminal neurons allowing the activation of descending pathways that facilitate pain processing or the suppression of pathways that slow down pain transmission.
Although the first neurological event leading to migraine pain is still not completely understood, it has been suggested that dysfunction of the brainstem involved in the modulation of craniovascular afferents may lead to activation of ascending and descending pathways with onset of a perimeningeal vasodilatation and neurogenic inflammation [18].
It is also possible that descending pathways are required to modulate burst duration in ovo but that they do not modulate RLM activity.
We do not know the mechanisms responsible for RLM rhythms, but descending pathways are well established by E15 [36], [36], and might provide excitatory drive as maturing spinal neurons lose their intrinsic excitability.
Monoaminergic descending pathways, located in the ventral and lateral columns of the spinal cord [25], [26] modulate the excitability of spinal cord circuitries capable of initiating and controlling rhythmic coordinated movements [27], [28].
Emotional stimuli always reach the HPA axis via the amygdala and descending pathways from the forebrain.
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