Electrical stimulation of a nerve for relief of pain.
| Medical Glossary: Neuromodulation |
Electrical stimulation of a nerve for relief of pain.
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In neuroscience, neuromodulation is the process in which several classes of neurotransmitters in the nervous system regulate diverse populations of neurons (one neuron uses different neurotransmitters to connect to several neurons). As opposed to direct synaptic transmission, in which one presynaptic neuron directly influences a postsynaptic partner (one neuron reaching one other neuron), neuromodulatory transmitters secreted by a small group of neurons diffuse through large areas of the nervous system, having an effect on multiple neurons. Examples of neuromodulators include dopamine, serotonin, acetylcholine, histamine and others.
A neuromodulator is a relatively new concept in the field, and it can be conceptualized as a neurotransmitter that is not reabsorbed by the pre-synaptic neuron or broken down into a metabolite. Such neuromodulators end up spending a significant amount of time in the CSF (cerebrospinal fluid), influencing (or modulating) the overall activity level of the brain. For this reason, some neurotransmitters are also considered as neuromodulators. Examples of neuromodulators in this category are serotonin and acetylcholine.
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Neuromodulators may alter the output of a physiological system by acting on the associated inputs (for instance, central pattern generators). However, modeling work suggests that this alone is insufficient,[1] because the neuromuscular transformation from neural input to muscular output may be tuned for particular ranges of input. Stern et al. (2007) suggest that neuromodulators must act not only on the input system but must change the transformation itself to produce the proper contractions of muscles as output.[1]
Neurotransmitter systems are systems of neurons in the brain expressing certain types of neurotransmitters, and thus form distinct systems. Activation of the system causes effects in large volumes of the brain, called volume transmission.
The major neurotransmitter systems are the noradrenaline (norepinephrine) system, the dopamine system, the serotonin system and the cholinergic system. Drugs targeting the neurotransmitter of such systems affects the whole system, and explains the mode of action of many drugs.
Most other neurotransmitters, on the other hand, e.g. glutamate, GABA and glycine, are used very generally throughout the central nervous system.
| System | Origin | [2] Targets | [2] Effects[2] |
|---|---|---|---|
| Noradrenaline system | Locus coeruleus | adrenergic receptors in: |
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| Lateral tegmental field | |||
| Dopamine system | dopamine pathways: | Dopamine receptors at pathway terminations. | motor system, reward system, cognition, endocrine, nausea |
| Serotonin system | caudal dorsal raphe nucleus | Serotonin receptors in: | Increase (introverson), mood, satiety, body temperature and sleep, while decreasing nociception. |
| rostral dorsal raphe nucleus | Serotonin receptors in: | ||
| Cholinergic system | Pedunculopontine nucleus and dorsolateral tegmental nuclei (pontomesencephalotegmental complex) | (mainly) M1 receptors in: |
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| basal optic nucleus of Meynert | (mainly) M1 receptors in: | ||
| medial septal nucleus | (mainly) M1 receptors in: |
Further reading: Norepinephrine#Norepinephrine system
The noradrenaline system consists of just 1500 neurons on each side of the brain, which is diminutive compared to the total amount of more than 100 billion neurons in the brain. Nevertheless, when activated, the system plays major roles in the brain, as seen in table above. Noradrenaline is released from the neurons, and acts on adrenergic receptors.
Further reading: Dopamine#Functions in the brain
The dopamine system consists of several pathways, originating from the ventral tegmentum or substantia nigra as examples. It acts on dopamine receptors.
Parkinson's disease is at least in part related to failure of dopaminergic cells in deep-brain nuclei, namely the substantia nigra. Treatments potentiating the effect of dopamine precursors have been proposed and effected, with moderate success.
Further reading: Serotonin#Gross anatomy
The serotonin system in the CNS contains only 1% of total body serotonin, the rest being found as transmitters in the peripheral nervous system[citation needed]. It travels around the brain along the medial forebrain bundle and acts on serotonin receptors. In the peripheral nervous system (such as in the gut wall) serotonin regulates vascular tone.
Further reading: Acetylcholine#in CNS
The cholinergic system works primary by M1 receptors, but M2-, M3-, M4- and M5 receptors are also found in the CNS.
The gamma-aminobutyric acid (GABA) system is more generally distributed throughout the brain. Nevertheless, it has an overall inhibitory effect.
Neuromodulation also refers to a medical procedure used to alter nervous system function for relief of pain. It consists primarily of electrical stimulation, lesioning of specific regions of the nervous system, or infusion of substances into the cerebrospinal fluid. Electrical stimulation are devices such as Spinal Cord Stimulators (SCS) (surgically implanted) or transcutaneous electrical nerve stimulation devices (externally placed).
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