Dopaminergic and serotonergic mechanisms in the modulation of pain: In vivo studies in human brain

: Martikainen IK, Hagelberg N, Jaaskelainen SK, Hietala J, Pertovaara A

Publisher: ELSEVIER SCIENCE BV

: 2018

: European Journal of Pharmacology

: EUROPEAN JOURNAL OF PHARMACOLOGY

: EUR J PHARMACOL

: 834

: 337

: 345

: 9

: 0014-2999

: 1879-0712

DOI: https://doi.org/10.1016/j.ejphar.2018.07.038

Here we review the literature assessing the roles of the brain dopaminergic and serotonergic systems in the modulation of pain as revealed by in vivo human studies using positron emission tomography. In healthy subjects, dopamine D-2/D-3 receptor availability particularly in the striatum and serotonin 5-HT1A and 5-HT2A receptor availabilities in the cortex predict the subject's response to tonic experimental pain. High availability of dopamine D-2/D-3 or serotonin 5-HT2A receptors is associated with high pain intensity, whereas high availability of 5-HT1A receptors associates with low pain intensity. Chronic neuropathic pain is associated with high striatal dopamine D-2/D-3 receptor availability, for which low endogenous dopamine tone is a plausible explanation, although a compensatory increase in striatal dopamine D-2/D-3 receptor density may also contribute. In contrast, chronic musculoskeletal pain is associated with low baseline availability of striatal dopamine D-2/D-3 receptors. In healthy subjects, brain serotonin 5-HT1A as well as dopamine D-2/D-3 receptor availabilities associate with the subject's response criterion rather than the capacity to discriminate painful thermal stimuli suggesting that these neurotransmitter systems act mainly on non-sensory rather than sensory factors of thermally induced pain experience. Additionally, 5-HT1A receptor availability predicts the subject's discriminative ability but not response criterion for non-painful tactile test stimuli, while no such correlation is observed with dopamine D-2/D-3 receptors. These findings suggest that dopamine acting on striatal dopamine D-2/D-3 receptors and serotonin acting on cortical 5-HT1A and 5-HT2A receptors contribute to top-down pain regulation in humans.