What is the Direction of DNIC/CPM/DCN?
An important and increasingly well-studied phenomenon is that which is commonly known as “counter-irritation”, the idea that “pain inhibits pain”. The phenomenon goes by a number of formal, unwieldy names, including “diffuse noxious inhibitory controls” (DNIC), “conditioned pain modulation” (CPM), and “descending control of nociception” (DCN). A ubiquitous observation about DNIC/CPM/DCN is its large interindividual variability, which not only spans from analgesia to no analgesia, but includes many instances of hyperalgesia (i.e., increased pain sensitivity) as well. A few years ago, the MOGILab observed, in mice and rats, that the direction of DNIC/CPM/DCN is dependent on the noxious intensity of the “test” (as opposed to the “conditioning”) stimulus used, such that high-intensity test stimuli produced analgesia and low-intensity test stimuli produced hyperalgesia. More recently, we have investigated the neurochemical basis of hyperalgesic “anti-DNIC/CPM/DCN”, and provided evidence for the role of noradrenergic α2 and serotonergic 5-HT7 receptors. In an ongoing study, we have determined that low-intensity test stimuli produces hyperalgesia in humans as well.