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With neuropathic pain, the ascending pathway is inappropriately activated to a sensation that does not cause pain. What pathway is not working?
a. Descending pathway
b. Central pathway
c. Peripheral pathway
d. Sensory pathway

Answer :

Final answer:

The correct answer is a. Descending pathway. Neuropathic pain involves abnormal activation of the ascending pathway, with the descending pain modulation pathways being crucial for controlling pain perception by modulating nociceptive signals.

Explanation:

With neuropathic pain, the ascending pathway is abnormally activated by sensations that ordinarily would not cause pain. This malfunction typically involves the descending pain modulation pathways. These pathways play a critical role in controlling or modulating pain perception by inhibiting or facilitating nociceptive signals at the spinal dorsal horn. The correct answer to the question is a. Descending pathway. The descending pathways, including various brain regions like the limbic forebrain, anterior cingulate, insular cortex, amygdala, hypothalamus, midbrain periaqueductal grey (PAG), and rostral ventromedial medulla (RVM) in the brainstem, modulate ascending pain transmission through the release of endogenous opioids and the activity of ON- and OFF-cells. These mechanisms produce analgesia and regulate the pain signal's intensity before it is consciously perceived.

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