Veinante Pierre, Yalcin Ipek, Barrot Michel
Institut des Neurosciences Cellulaires et Intégratives, UPR3212, Centre National de la Recherche Scientifique, 21 Rue René Descartes, 67084 Strasbourg Cedex, France ; Université de Strasbourg, 21 Rue René Descartes, 67084 Strasbourg Cedex, France.
J Mol Psychiatry. 2013 Jun 5;1(1):9. doi: 10.1186/2049-9256-1-9. eCollection 2013.
The amygdala is a structure of the temporal lobe thought to be involved in assigning emotional significance to environmental information and triggering adapted physiological, behavioral and affective responses. A large body of literature in animals and human implicates the amygdala in fear. Pain having a strong affective and emotional dimension, the amygdala, especially its central nucleus (CeA), has also emerged in the last twenty years as key element of the pain matrix. The CeA receives multiple nociceptive information from the brainstem, as well as highly processed polymodal information from the thalamus and the cerebral cortex. It also possesses the connections that allow influencing most of the descending pain control systems as well as higher centers involved in emotional, affective and cognitive functions. Preclinical studies indicate that the integration of nociceptive inputs in the CeA only marginally contributes to sensory-discriminative components of pain, but rather contributes to associated behavior and affective responses. The CeA doesn't have a major influence on responses to acute nociception in basal condition, but it induces hypoalgesia during aversive situation, such as stress or fear. On the contrary, during persistent pain states (inflammatory, visceral, neuropathic), a long-lasting functional plasticity of CeA activity contributes to an enhancement of the pain experience, including hyperalgesia, aversive behavioral reactions and affective anxiety-like states.
杏仁核是颞叶的一个结构，被认为参与赋予环境信息情感意义，并触发适应性的生理、行为和情感反应。大量关于动物和人类的文献表明杏仁核与恐惧有关。由于疼痛具有强烈的情感维度，在过去二十年中，杏仁核，尤其是其中央核（CeA），也已成为疼痛矩阵的关键要素。CeA从脑干接收多种伤害性信息，以及来自丘脑和大脑皮层的经过高度处理的多模式信息。它还具有能够影响大多数下行疼痛控制系统以及参与情感、情感和认知功能的高级中枢的连接。临床前研究表明，CeA中伤害性输入的整合对疼痛的感觉辨别成分贡献很小，而是对相关行为和情感反应有贡献。CeA在基础状态下对急性伤害性反应没有重大影响，但在厌恶情境（如压力或恐惧）中会诱导痛觉减退。相反，在持续性疼痛状态（炎症性、内脏性、神经性）下，CeA活动的长期功能可塑性会导致疼痛体验增强，包括痛觉过敏、厌恶行为反应和情感焦虑样状态。
