title: Modulation of pain, nociception, and analgesia by the brain reward center.
abstract: The midbrain dopamine center comprises a key network for reward, salience, motivation, and mood. Evidence from various clinical and preclinical settings points to the midbrain dopamine circuit as an important modulator of pain perception and pain-induced anxiety and depression. This review summarizes recent findings that shed light to the neuroanatomical, electrophysiological and molecular adaptations that chronic pain conditions promote in the mesolimbic dopamine system. Chronic pain states induce changes in neuronal plasticity and functional connectivity in several parts of the brain reward center, including nucleus accumbens, the ventral tegmental area and the prefrontal cortex. Here, we discuss recent findings on the mechanisms involved in the perception of chronic pain, in pain-induced anxiety and depression, as well as in pain-killer addiction vulnerability. Several new studies also show that the mesolimbic dopamine circuit potently modulates responsiveness to opioids and antidepressants used for the treatment of chronic pain. We discuss recent data supporting a role of the brain reward pathway in treatment efficacy and we summarize novel findings on intracellular adaptations in the brain reward circuit under chronic pain states.
authors.affiliation: Department of Basic Sciences, Faculty of Medicine, University of Crete, Heraklion, Crete 71003, Greece; Fishberg Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States.
authors.forename: Vasiliki
authors.initials: V
authors.lastname: Mitsi
authors.affiliation: Fishberg Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States. Electronic address: venetia.zachariou@mssm.edu.
authors.forename: Venetia
authors.initials: V
authors.lastname: Zachariou
mesh_terms: D000700:Analgesics / Q000494:pharmacology* / Q000627:therapeutic use*; D000818:Animals; D001921:Brain / Q000000981:diagnostic imaging / Q000187:drug effects / Q000503:physiopathology*; D006801:Humans; D009434:Neural Pathways / Q000000981:diagnostic imaging / Q000187:drug effects / Q000503:physiopathology; D059225:Nociception / Q000187:drug effects / Q000502:physiology*; D010146:Pain / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000503:physiopathology* / Q000523:psychology; D012201:Reward
chemical_list: D000700:Analgesics
keywords: antidepressants; dopamine; nucleus accumbens; pain-killers; prefrontal cortex; ventral tegmental area