Blackburn-Munro Gordon, Blackburn-Munro Ruth
Department of Pharmacology, NeuroSearch, 93 Pederstrupvej, DK-2750 Ballerup, Denmark.
Trends Endocrinol Metab. 2003 Jan;14(1):20-7. doi: 10.1016/s1043-2760(02)00004-8.
Pain is a multi-dimensional process involving the physical, emotional and perceptual integration of noxious information. The physical component is relayed via the spinal cord to several brain areas to initiate the detection of pain. The emotional aspect is encoded by the limbic system and encapsulates the relationship between pain and mood. Within the limbic system, the hypothalamus undertakes a diversity of separate and interrelated functions. Dysfunction of the hypothalamo-pituitary-adrenal axis has been implicated in a variety of chronic pain conditions and might also be associated with increased risk of developing mood disorders. Experimental and clinical evidence also exists to implicate the effects of other hormonal modulators in the manifestation of chronic pain. Specific targeting of hormonal cascade and effector mechanisms could provide an alternative strategy for the treatment of various chronic pain conditions.
疼痛是一个多维度的过程，涉及有害信息的物理、情感和感知整合。物理成分通过脊髓传递到几个脑区，以启动对疼痛的检测。情感方面由边缘系统编码，并概括了疼痛与情绪之间的关系。在边缘系统中，下丘脑承担着多种独立且相互关联的功能。下丘脑-垂体-肾上腺轴功能障碍与多种慢性疼痛状况有关，也可能与患情绪障碍的风险增加有关。实验和临床证据也表明其他激素调节剂在慢性疼痛表现中的作用。对激素级联反应和效应机制进行特异性靶向可能为治疗各种慢性疼痛状况提供一种替代策略。
