1. Volume 132, Issue 4, Pages 1618-1620 (April 2007)
It’s Chickens and Eggs All Over Again: Is Central Reorganization the Result or Cause of Persistent Visceral Pain? 
G.F. Gebhart 
Gastroenterology 
Volume 132, Issue 4, Pages (April 2007)
DOI: /j.gastro
Copyright © 2007 AGA Institute Terms and Conditions

2. Figure 1
Supraspinal modulation of spinal gastrointestinal input (vagal sensory input to the brainstem is not illustrated). Spinal visceral input ascends to supraspinal sites via the spinothalamic tract, with collateral distribution in the brainstem illustrated diagrammatically (ascending input via a postsynaptic dorsal column pathway is not illustrated). Visceral input is widely distributed to the sensory cortex, perigenual portion of the anterior cingulate cortex, anterior insular cortex, and areas of the limbic cortex, which in turn can influence descending modulatory influences engaged in the PAG (periaqueductal gray) and RVM (rostral ventromedial medulla). Typically, descending inhibition dominates, but facilitatory (+) influences have been shown to be important in maintaining hypersensitive states4,5 and similarly could be important to maintenance of visceral hypersensitive states.
Gastroenterology  , DOI: ( /j.gastro )
Copyright © 2007 AGA Institute Terms and Conditions