Descending pain modulation: influence and impact

A myriad of complex processes marry to drive pain perception in health and chronicity. A final step in proceedings involves the activation of top-down modulatory pathways that can act directly to attenuate or enhance perceived pain via descending inhibitions or facilitations, respectively. There remains uncertainty regarding the precise and complete peripheral/central nervous system circuitry that drives the full pain experience. But while results gathered over the last decade from research laboratories all over the world have revealed as many new questions as they have answered, our understanding of the descending modulation of pain perception has never been better. Here, a sharp focus on the most relevant and recent articles published in the field shapes our current understanding of brain-spinal cord nociceptive transmission.