Price D D
Department of Oral and Maxillofacial Surgery, University of Florida, Health Science Center, Post Office Box 100416, Gainesville, FL 32610-0416, USA.
Science. 2000 Jun 9;288(5472):1769-72. doi: 10.1126/science.288.5472.1769.
The affective dimension of pain is made up of feelings of unpleasantness and emotions associated with future implications, termed secondary affect. Experimental and clinical studies show serial interactions between pain sensation intensity, pain unpleasantness, and secondary affect. These pain dimensions and their interactions relate to a central network of brain structures that processes nociceptive information both in parallel and in series. Spinal pathways to limbic structures and medial thalamic nuclei provide direct inputs to brain areas involved in affect. Another source is from spinal pathways to somatosensory thalamic and cortical areas and then through a cortico-limbic pathway. The latter integrates nociceptive input with contextual information and memory to provide cognitive mediation of pain affect. Both direct and cortico-limbic pathways converge on the same anterior cingulate cortical and subcortical structures whose function may be to establish emotional valence and response priorities.
疼痛的情感维度由不愉快的感觉以及与未来影响相关的情绪组成，称为次级情感。实验和临床研究表明，痛觉强度、疼痛不愉快感和次级情感之间存在一系列相互作用。这些疼痛维度及其相互作用与一个大脑结构的中央网络相关，该网络并行和串行处理伤害性信息。通向边缘结构和内侧丘脑核的脊髓通路为参与情感的脑区提供直接输入。另一个来源是从脊髓通路到躯体感觉丘脑和皮质区域，然后通过皮质-边缘通路。后者将伤害性输入与情境信息和记忆整合起来，以提供对疼痛情感的认知调节。直接通路和皮质-边缘通路都汇聚于相同的前扣带回皮质和皮质下结构，其功能可能是确定情绪效价和反应优先级。
