Blackburn-Munro Gordon
Department of Pharmacology, NeuroSearch A/S, 93 Pederstrupvej, DK-2750 Ballerup, Denmark.
Curr Pain Headache Rep. 2004 Apr;8(2):116-24. doi: 10.1007/s11916-004-0025-9.
Chronic pain and depressive illness are variably resistant to treatment with current pharmacologic therapies. Pain as a reflex sensory response is accompanied by a fast autonomic and delayed neuroendocrine response mediated by the sympathoadrenal and hypothalamo-pituitary-adrenal (HPA) axis, respectively. The emotional aspect of the pain response is encoded by corticolimbic systems (including the HPA axis) to encapsulate the relationship between pain, memory, and mood. These same systems contribute to the symptomatology of depression, a common symptom of which is pain. Conversely, many chronic pain patients may suffer from depressive illness, which appears to develop as a consequence of chronic pain. A comparison of key changes in HPA function after chronic stress in animals with clinical depression in humans, reveals some striking similarities. In this article, the role of the HPA axis in the etiology of chronic pain and depression is discussed.
慢性疼痛和抑郁症对当前的药物治疗存在不同程度的抵抗。疼痛作为一种反射性感觉反应，分别伴随着由交感肾上腺和下丘脑 - 垂体 - 肾上腺（HPA）轴介导的快速自主神经反应和延迟神经内分泌反应。疼痛反应的情感方面由皮质边缘系统（包括HPA轴）编码，以概括疼痛、记忆和情绪之间的关系。这些相同的系统也导致了抑郁症的症状，其中一个常见症状就是疼痛。相反，许多慢性疼痛患者可能患有抑郁症，而抑郁症似乎是慢性疼痛的结果。对动物慢性应激后HPA功能的关键变化与人类临床抑郁症进行比较，发现了一些惊人的相似之处。在本文中，将讨论HPA轴在慢性疼痛和抑郁症病因中的作用。
