title: Hyperalgesia during naloxone-precipitated withdrawal from morphine is associated with increased on-cell activity in the rostral ventromedial medulla.
abstract: Hyperresponsiveness to noxious stimulation (hyperalgesia) is observed with naloxone-precipitated morphine withdrawal in several experimental models, and may be due to changes in central nervous system neurons. Previous studies have demonstrated that certain neurons in the rostral ventromedial medulla (on-cells) discharge just prior to nocifensive withdrawal reflexes and are inhibited by morphine. Because the tail flick latency (TFL) is shorter when on-cells are active, it has been proposed that on-cells facilitate nocifensive reflexes. The present study examined the hypothesis that the hyperalgesia observed following naloxone-precipitated withdrawal from morphine is caused by increased on-cell discharge. Rats were maintained in a lightly anesthetized state with chloral hydrate. Administration of saline (1.25 cc, i.v.) or morphine sulfate (1.25 mg/kg, i.v.) was followed by naloxone (1.0 mg/kg, i.v.). On- and off-cell activity was continuously recorded and was correlated with TFL and paw withdrawal threshold (PWT). As previously reported, morphine increased off-cell activity, blocked on-cell activity, and suppressed the tail flick and paw withdrawal reflexes. When naloxone was given after morphine, TFL and PWT were reduced to values significantly below baseline (hyperalgesia). Both spontaneous and reflex-related on-cell activity increased to levels greater than the premorphine baseline. Spontaneous off-cell activity decreased abruptly to near zero when morphine was followed by naloxone. Linear regression analysis during the hyperresponsive state revealed a significant correlation between increased on-cell activity and reduced TFL, but not between decreased off-cell activity and TFL. These findings are consistent with the hypothesis that on-cells facilitate spinal nocifensive reflexes, and that the naloxone-precipitated hyperalgesia is at least in part accounted for by increased on-cell activity. A neural model of opiate dependence, tolerance, and withdrawal is proposed.
authors.affiliation: Department of Neurosurgery, School of Medicine, University of California, San Francisco 94143.
authors.forename: J B
authors.initials: JB
authors.lastname: Bederson
authors.forename: H L
authors.initials: HL
authors.lastname: Fields
authors.forename: N M
authors.initials: NM
authors.lastname: Barbaro
mesh_terms: D000344:Afferent Pathways / Q000187:drug effects; D000818:Animals; D001931:Brain Mapping; D008297:Male; D008526:Medulla Oblongata / Q000187:drug effects* / Q000503:physiopathology; D009020:Morphine / Q000009:adverse effects*; D009021:Morphine Dependence / Q000503:physiopathology*; D009270:Naloxone / Q000008:administration & dosage*; D009474:Neurons / Q000502:physiology; D009619:Nociceptors / Q000187:drug effects* / Q000503:physiopathology; D011903:Raphe Nuclei / Q000187:drug effects; D051381:Rats; D011930:Reaction Time / Q000502:physiology; D012684:Sensory Thresholds / Q000187:drug effects; D013375:Substance Withdrawal Syndrome / Q000503:physiopathology*
chemical_list: D009270:Naloxone; D009020:Morphine