Di Lernia Daniele, Serino Silvia, Cipresso Pietro, Riva Giuseppe
Department of Psychology, Università Cattolica del Sacro Cuore Milan, Italy.
Department of Psychology, Università Cattolica del Sacro CuoreMilan, Italy; Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico ItalianoMilan, Italy.
Front Neurosci. 2016 Jun 30;10:314. doi: 10.3389/fnins.2016.00314. eCollection 2016.
Pain is a complex and multidimensional perception, embodied in our daily experiences through interoceptive appraisal processes. The article reviews the recent literature about interoception along with predictive coding theories and tries to explain a missing link between the sense of the physiological condition of the entire body and the perception of pain in chronic conditions, which are characterized by interoceptive deficits. Understanding chronic pain from an interoceptive point of view allows us to better comprehend the multidimensional nature of this specific organic information, integrating the input of several sources from Gifford's Mature Organism Model to Melzack's neuromatrix. The article proposes the concept of residual interoceptive images (ghosts), to explain the diffuse multilevel nature of chronic pain perceptions. Lastly, we introduce a treatment concept, forged upon the possibility to modify the interoceptive chronic representation of pain through external input in a process that we call interoceptive modeling, with the ultimate goal of reducing pain in chronic subjects.
疼痛是一种复杂的多维度感知，通过内感受性评估过程体现在我们的日常体验中。本文回顾了有关内感受以及预测编码理论的近期文献，并试图解释在以内感受缺陷为特征的慢性疾病中，全身生理状况的感觉与疼痛感知之间缺失的联系。从内感受的角度理解慢性疼痛，使我们能够更好地理解这种特定机体信息的多维度本质，整合从吉福德的成熟机体模型到梅尔扎克的神经矩阵等多个来源的输入信息。本文提出了残留内感受图像（幻影）的概念，以解释慢性疼痛感知的弥漫性多层次本质。最后，我们引入一种治疗概念，该概念基于通过我们称为内感受建模的过程中的外部输入来改变疼痛的内感受性慢性表征的可能性，其最终目标是减轻慢性患者的疼痛。
