Borsook David, Erpelding Nathalie, Becerra Lino
Center for Pain and the Brain, P.A.I.N. Group, Boston Children's Hospital, Harvard Medical School, c/o 9 Hope Avenue, Waltham, MA, USA.
Expert Rev Neurother. 2013 Nov;13(11):1221-34. doi: 10.1586/14737175.2013.846218. Epub 2013 Oct 29.
As in many fields of neuroscience, alterations in brain morphology, and specifically gray matter volume and cortical thickness, have been repeatedly linked to chronic pain disorders. Numerous studies have shown changes in cortical and subcortical brain regions suggesting a dynamic process that may be a result of chronic pain or contributing to a more generalized phenomenon in chronic pain including comorbid anxiety and depression. In this review, we provide a perspective of pain as an innate state of pain based on alterations in structure and by inference, brain function. A better neurobiological understanding of gray matter changes will contribute to our understanding of how structural changes contribute to chronic pain (disease driver) and how these changes may be reversed (disease modification or treatment).
与神经科学的许多领域一样,脑形态学的改变,尤其是灰质体积和皮质厚度的改变,已反复与慢性疼痛障碍相关联。大量研究表明,皮质和皮质下脑区存在变化,这表明这是一个动态过程,可能是慢性疼痛的结果,或者是导致慢性疼痛中包括共病焦虑和抑郁在内的更普遍现象的原因。在本综述中,我们基于结构改变以及由此推断出的脑功能,提出将疼痛视为一种先天性疼痛状态的观点。对灰质变化有更好的神经生物学理解,将有助于我们理解结构变化如何导致慢性疼痛(疾病驱动因素)以及这些变化如何可能被逆转(疾病改善或治疗)。