“…Reciprocal connections are made via the PAG with the rostral ventromedial medulla (RVM) and the dorsolateral pontine tegmentum (DLPT), two structures which send serotonin (5-HT)-containing and noradrenaline (NA)-containing projections, respectively, to the spinal dorsal horn (Millan 2002). It is now well established that damage to nerves arising as a consequence of viral infection, metabolic disturbance or direct physical insult induces plasticity changes within the dorsal horn, which underlie central sensitisation and manifest behaviourally as allodynia and hyperalgesia (Woolf and Salter 2000;Blackburn-Munro 2004). Crucially, a shift in the balance between descending inhibitory and facilitatory inputs also appears to contribute to the mechanistic processes involved in the maintenance of central sensitisation (Ren and Dubner 2002;Burgess et al 2002;Gardell et al 2003).…”