The rostral ventromedial medulla (RVM) exerts a powerful modulatory effect on the spinal transmission of pain. Microinjection of neurotensin (NT) in the RVM produces biphasic effects; low doses (0.03-0.3 pmol) facilitate nociception, while higher doses (30 pmol-3 nmol) are antinociceptive. We examined the localization of the neurotensin receptor 1 (NTR1) in retrogradely labeled spinally-projecting, serotonergic neurons of the RVM. We found that 96±1% of RVM neurons that express the NTR1 are serotonergic. Of these serotonergic NTR1 expressing cells, 41±5% clearly descend directly to the spinal cord, while 59±5% do not. In addition, 53±2% of the RVM serotonergic neurons express NTR1 (n=4 rats). Furthermore, intrathecal (i.th.) injection of the serotonergic antagonist methysergide attenuates the antinociceptive effect of NT microinjection in the RVM. NT (3 nmol), increased tail and paw withdrawal latencies to a noxious thermal stimulus by 229±74% and 252±136%, respectively (n = 5). Subsequent i.th. injection of methysergide (60 μg/0.05 μl) reduced this antinociceptive effect to 42±23% and 125±69% (n=6 and n=2), but produced no effect in the absence of NT (n=5). Together these findings suggest that high doses of NT act to produce antinociception that is mediated in part by activation of spinally-projecting RVM serotonergic neurons. NTR1-immunoreactive serotonergic neurons that do not project to the spinal cord may also contribute to the antinociceptive actions of NT. Supported by NIH DA 02879-27, T32 DK07663-08, and DA 03980-22.
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