Tajerian Maral, Clark J David
Department of Anesthesiology, Stanford University School of Medicine, Stanford, CA, USA; Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA.
Neural Plast. 2017;2017:2038573. doi: 10.1155/2017/2038573. Epub 2017 Feb 16.
Chronic pain is a highly prevalent and debilitating condition that is frequently associated with multiple comorbid psychiatric conditions and functional, biochemical, and anatomical alterations in various brain centers. Due to its widespread and diverse manifestations, chronic pain is often resistant to classical pharmacological treatment paradigms, prompting the search for alternative treatment approaches that are safe and efficacious. The current review will focus on the following themes: attentional and cognitive interventions, the role of global environmental factors, and the effects of exercise and physical rehabilitation in both chronic pain patients and preclinical pain models. The manuscript will discuss not only the analgesic efficacy of these therapies, but also their ability to reverse pain-related brain neuroplasticity. Finally, we will discuss the potential mechanisms of action for each of the interventions.
慢性疼痛是一种高度普遍且使人衰弱的病症,常与多种共病的精神疾病以及各个脑区的功能、生化和解剖学改变相关。由于其广泛多样的表现形式,慢性疼痛往往对传统药物治疗模式具有抗性,这促使人们寻求安全有效的替代治疗方法。本综述将聚焦于以下主题:注意力和认知干预、全球环境因素的作用,以及运动和身体康复对慢性疼痛患者和临床前疼痛模型的影响。本文不仅将讨论这些疗法的镇痛效果,还将探讨它们逆转与疼痛相关的脑可塑性的能力。最后,我们将讨论每种干预措施的潜在作用机制。