TBI Disrupts Pain Signaling in the Brainstem and Spinal Cord

Chronic pain is a common consequence of traumatic brain injury (TBI) that can increase a patient’s suffering and pose a significant challenge to rehabilitative efforts. Unfortunately, the mechanisms linking TBI to pain are poorly understood and specific treatments for TBI-related pain are still lacking. Our lab has shown that TBI causes pain sensitization in areas distant to the site of primary injury, and that changes in spinal gene expression may underlie this sensitization1, 2. The aim of this study was to examine the roles that pain modulatory pathways descending from the brainstem play in pain after TBI. Deficiencies in one type of descending inhibition, diffuse noxious inhibitory control (DNIC), have been suggested to be responsible for the development of chronic pain by allowing excess and uncontrolled afferent nociceptive inputs 3. Here we expand our knowledge of pain after TBI in two ways: 1) by outlining the neuropathology in pain-related centers of the brain and spinal cord involved in DNIC usi...