5-Hydroxytryptamine and antinociception.

The considerable evidence supporting a role for 5-hydroxytryptamine (5-HT) in the modulation of nociceptive thresholds is reviewed. The postulate that an antinociceptive system of neurones projects from periaqueductal gray (PAG) to nucleus raphe magnus (NRM) and then to the dorsal horn, via cells containing 5-HT, has proved difficult to support experimentally. 5-Hydroxytryptamine, applied iontophoretically to dorsal horn neurones, does reduce the nociceptive responses of these neurones but it is not clear that activity in 5-HT cells of the raphe-spinal system is responsible for the descending inhibition of nociception. Although antagonists of 5-HT block some of the antinociceptive effects of both stimulation of the periaqueductal gray and systemically-applied morphine, they do not block the centrifugal inhibition of dorsal horn cells or the effects of iontophoretically applied 5-HT. Nor do they displace [3H]5-HT binding at low concentrations. Damage to, or selective depletion of 5-HT from the raphe-spinal 5-HT system has been reported not to alter nociceptive thresholds or the effects of stimulation of the periaqueductal gray. There is anatomical evidence for cells in the periaqueductal gray which contain 5-HT and project to the n. raphe magnus. Microinjected into the n. raphe magnus, 5-HT is antinociceptive in the tail-flick test and microinjection of an inhibitor of uptake of 5-HT or a 5-HT releasing agent, both cause antinociception. Furthermore, the effects of electrical stimulation of the periaqueductal gray are blocked by microinjection of a 5-HT antagonist into the n. raphe magnus.(ABSTRACT TRUNCATED AT 250 WORDS)