Periaqueductal gray/dorsal raphe dopamine neurons contribute to sex differences in pain-related behaviors

Sex differences in pain severity, response, and pathological susceptibility are widely reported, but the neural mechanisms that contribute to these outcomes remain poorly understood. Here we show that dopamine (DA) neurons in the ventrolateral periaqueductal gray/dorsal raphe (vlPAG/DR) differentially regulate pain-related behaviors in male and female mice through projections to the bed nucleus of the stria terminalis (BNST). We find that activation of vlPAG/DRDA+ neurons or vlPAG/DRDA+ terminals in the BNST reduces nociceptive sensitivity during naive and inflammatory pain states in male mice, whereas activation of this pathway in female mice leads to increased locomotion in the presence of salient stimuli. We additionally use slice physiology and genetic editing approaches to demonstrate that vlPAG/DRDA+ projections to the BNST drive sex-specific responses to pain through DA signaling, providing evidence of a novel ascending circuit for pain relief in males and contextual locomotor response in females. [Display omitted] •vlPAG/DRDA to BNST activation promotes anti-nociception in male mice•vlPAG/DRDA to BNST activation promotes locomotion in female mice•Membrane-gated currents driven by optically evoked DA release differ by sex•Dopamine is required for vlPAG/DR-driven anti-nociception Yu et al. demonstrate that dopamine neurons in the periaqueductal gray/dorsal raphe target the bed nucleus of the stria terminalis to reduce pain sensitivity in male mice and increase locomotion in female mice. Dopamine signaling is required for sex-specific expression of these adaptive behaviors.