title: Endocannabinoids in the brainstem modulate dural trigeminovascular nociceptive traffic via CB1 and "triptan" receptors: implications in migraine.
abstract: Activation and sensitization of trigeminovascular nociceptive pathways is believed to contribute to the neural substrate of the severe and throbbing nature of pain in migraine. Endocannabinoids, as well as being physiologically analgesic, are known to inhibit dural trigeminovascular nociceptive responses. They are also involved in the descending modulation of cutaneous-evoked C-fiber spinal nociceptive responses from the brainstem. The purpose of this study was to determine whether endocannabinoids are involved in the descending modulation of dural and/or cutaneous facial trigeminovascular nociceptive responses, from the brainstem ventrolateral periaqueductal gray (vlPAG). CB1 receptor activation in the vlPAG attenuated dural-evoked Aδ-fiber neurons (maximally by 19%) and basal spontaneous activity (maximally by 33%) in the rat trigeminocervical complex, but there was no effect on cutaneous facial receptive field responses. This inhibitory vlPAG-mediated modulation was inhibited by specific CB1 receptor antagonism, given via the vlPAG, and with a 5-HT1B/1D receptor antagonist, given either locally in the vlPAG or systemically. These findings demonstrate for the first time that brainstem endocannabinoids provide descending modulation of both basal trigeminovascular neuronal tone and Aδ-fiber dural-nociceptive responses, which differs from the way the brainstem modulates spinal nociceptive transmission. Furthermore, our data demonstrate a novel interaction between serotonergic and endocannabinoid systems in the processing of somatosensory nociceptive information, suggesting that some of the therapeutic action of triptans may be via endocannabinoid containing neurons in the vlPAG.
authors.affiliation: Headache Group, Department of Neurology, University of California, San Francisco, San Francisco, California 94158.
authors.forename: Simon
authors.initials: S
authors.lastname: Akerman
authors.forename: Philip R
authors.initials: PR
authors.lastname: Holland
authors.forename: Michele P
authors.initials: MP
authors.lastname: Lasalandra
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Goadsby
mesh_terms: D000818:Animals; D001095:Arachidonic Acids / Q000494:pharmacology; D001640:Bicuculline / Q000008:administration & dosage; D063386:Cannabinoid Receptor Agonists / Q000494:pharmacology; D004195:Disease Models, Animal; D063388:Endocannabinoids / Q000378:metabolism* / Q000494:pharmacology; D058787:GABA-A Receptor Antagonists / Q000008:administration & dosage; D008297:Male; D008845:Microinjections; D009413:Nerve Fibers, Myelinated / Q000187:drug effects / Q000502:physiology; D010146:Pain / Q000188:drug therapy / Q000378:metabolism / Q000503:physiopathology*; D010487:Periaqueductal Gray / Q000187:drug effects / Q000378:metabolism*; D053284:Polyunsaturated Alkamides / Q000494:pharmacology; D051381:Rats; D017207:Rats, Sprague-Dawley; D011930:Reaction Time / Q000187:drug effects; D043884:Receptor, Cannabinoid, CB1 / Q000037:antagonists & inhibitors / Q000378:metabolism*; D011985:Receptors, Serotonin / Q000378:metabolism*; D018490:Serotonin Agents / Q000494:pharmacology; D012702:Serotonin Antagonists / Q000494:pharmacology; D012867:Skin / Q000294:innervation; D014278:Trigeminal Nuclei
chemical_list: D001095:Arachidonic Acids; D063386:Cannabinoid Receptor Agonists; D063388:Endocannabinoids; D058787:GABA-A Receptor Antagonists; D053284:Polyunsaturated Alkamides; D043884:Receptor, Cannabinoid, CB1; D011985:Receptors, Serotonin; D018490:Serotonin Agents; D012702:Serotonin Antagonists; C119324:arachidonylcyclopropylamide; C078814:anandamide; D001640:Bicuculline
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