Center for Pain and the Brain, Harvard Medical School, USA.
Prog Neurobiol. 2012 Feb;96(2):208-19. doi: 10.1016/j.pneurobio.2012.01.004. Epub 2012 Jan 14.
The habenula is a small bilateral structure in the posterior-medial aspect of the dorsal thalamus that has been implicated in a remarkably wide range of behaviors including olfaction, ingestion, mating, endocrine and reward function, pain and analgesia. Afferent connections from forebrain structures send inputs to the lateral and medial habenula where efferents are mainly projected to brainstem regions that include well-known pain modulatory regions such as the periaqueductal gray and raphe nuclei. A convergence of preclinical data implicates the region in multiple behaviors that may be considered part of the pain experience including a putative role in pain modulation, affective, and motivational processes. The habenula seems to play a role as an evaluator, acting as a major point of convergence where external stimuli is received, evaluated, and redirected for motivation of appropriate behavioral response. Here, we review the role of the habenula in pain and analgesia, consider its potential role in chronic pain, and review more recent clinical and functional imaging data of the habenula from animals and humans. Even through the habenula is a small brain structure, advances in structural and functional imaging in humans should allow for further advancement of our understanding of its role in pain and analgesia.
缰核是背侧丘脑后内侧的一个小双侧结构，它与包括嗅觉、摄食、交配、内分泌和奖赏功能、疼痛和镇痛在内的多种行为有关。来自前脑结构的传入连接将输入发送到外侧缰核和内侧缰核，其中传出主要投射到包括众所周知的疼痛调制区域（如导水管周围灰质和中缝核）在内的脑干区域。临床前数据的融合表明该区域参与了多种可能被认为是疼痛体验的一部分的行为，包括在疼痛调制、情感和动机过程中的假定作用。缰核似乎起着评估者的作用，作为接收、评估和重新引导外部刺激以产生适当行为反应的主要汇聚点。在这里，我们综述了缰核对疼痛和镇痛的作用，考虑了它在慢性疼痛中的潜在作用，并回顾了来自动物和人类的缰核的最新临床和功能成像数据。即使缰核是一个小的大脑结构，人类结构和功能成像的进步也应该使我们能够进一步了解它在疼痛和镇痛中的作用。
