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Activity in the ventrolateral periaqueductal gray (vlPAG) has been shown to be antinociceptive
and is considered to be a major component in the expression of opioid drug-induced
analgesia. Canonically, opioids disinhibit vlPAG activity, which modulates neuronal
responses in the rostroventral medulla (RVM) and ultimately gates spinal outflow of
nociceptive information via serotonergic and opioidergic mechanisms in the spinal
dorsal horn. Fundamental pharmacological studies, however, indicate that spinal noradrenergic
signaling is consistently implicated in opioid antinociception, suggesting that there
is a gap in our knowledge of how the vlPAG may control the release of antinociceptive
neuromodulators in the dorsal horn through different output regions. Although the
locus coeruleus (LC) has been shown to modulate nociception, its role in and recruitment
by the canonical descending circuitry is unclear. Using genetically-encoded and anatomically-targeted
viral tools, immunohistochemistry, and acute pain behavior assays in conjunction with
intrathecal pharmacology in mice, we show that activity in the vlPAG is necessary
for the expression of systemic morphine analgesia at low doses, and that both systemic
morphine-induced and PAG-driven antinociception require opioidergic and noradrenergic
signaling in the spinal cord. Additionally, we find that vlPAG projection neurons
send branching axons to both the RVM and LC, which may account for the LC activation
we observed in both opioid-induced and PAG-driven antinociception. These findings
reveal a previously underappreciated architecture of the descending pain modulatory
circuitry and advance our understanding of the circuit mechanisms by which morphine
produces analgesia. Grant support from NIDA R00 DA034648, Rita Allen Foundation (non-profit),
Klingenstein-Simons Foundation (non-profit).
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© 2022 Published by Elsevier Inc.