Melzack R
Department of Psychology, McGill University, Montreal, Quebec, Canada.
J Dent Educ. 2001 Dec;65(12):1378-82.
The neuromatrix theory of pain proposes that pain is a multidimensional experience produced by characteristic "neurosignature" patterns of nerve impulses generated by a widely distributed neural network-the "body-self neuromatrix"-in the brain. These neurosignature patterns may be triggered by sensory inputs, but they may also be generated independently of them. Acute pains evoked by brief noxious inputs have been meticulously investigated by neuroscientists, and their sensory transmission mechanisms are generally well understood. In contrast, chronic pain syndromes, which are often characterized by severe pain associated with little or no discernible injury or pathology, remain a mystery. Furthermore, chronic psychological or physical stress is often associated with chronic pain, but the relationship is poorly understood. The neuromatrix theory of pain provides a new conceptual framework to examine these problems. It proposes that the output patterns of the body-self neuromatrix activate perceptual, homeostatic, and behavioral programs after injury, pathology, or chronic stress. Pain, then, is produced by the output of a widely distributed neural network in the brain rather than directly by sensory input evoked by injury, inflammation, or other pathology. The neuromatrix, which is genetically determined and modified by sensory experience, is the primary mechanism that generates the neural pattern that produces pain. Its output pattern is determined by multiple influences, of which the somatic sensory input is only a part, that converge on the neuromatrix.
疼痛的神经矩阵理论提出，疼痛是一种多维体验，由大脑中一个广泛分布的神经网络——“身体-自我神经矩阵”产生的神经冲动的特征性“神经信号”模式所引发。这些神经信号模式可能由感觉输入触发，但也可能独立于感觉输入而产生。神经科学家对短暂有害输入引发的急性疼痛进行了细致研究，其感觉传导机制已基本为人所知。相比之下，慢性疼痛综合征通常表现为严重疼痛，却几乎没有或完全没有可识别的损伤或病理变化，仍然是个谜。此外，慢性心理或身体压力常与慢性疼痛相关，但这种关系却鲜为人知。疼痛的神经矩阵理论为研究这些问题提供了一个新的概念框架。该理论提出，身体-自我神经矩阵的输出模式在损伤、病理变化或慢性压力后激活感知、稳态和行为程序。那么，疼痛是由大脑中一个广泛分布的神经网络的输出产生的，而不是直接由损伤、炎症或其他病理变化引发的感觉输入产生的。神经矩阵由基因决定，并受感觉经验影响而改变，是产生引发疼痛的神经模式的主要机制。其输出模式由多种影响因素决定，其中躯体感觉输入只是其中一部分，这些因素汇聚于神经矩阵。
