Recruitment of Descending Noradrenergic Inhibition：As a Key Strategy to Treat Neuropathic Pain

Abstract

In the normal or relatively early stage of neuropathic pain condition, the locus coeruleus（LC）-spinal descending noradrenergic inhibitory pathway is essential to pain-evoked endogenous analgesia, and gabapentinoids are often used as a first line treatment in neuropathic pain to produce analgesia. The present article focuses on 1）the role of the descending noradrenergic pathway for analgesia using gabapentinoids；2）the strategy of treating neuropathic pain based on neuroplasticity in this pathway after nerve injury；and 3）the mechanisms of LC dysfunction during chronification of neuropathic pain and translational approach to restore LC dysfunction using clinically available drugs.