Taylor Anna M W
Department of Psychiatry, The Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, United States.
Prog Neuropsychopharmacol Biol Psychiatry. 2018 Dec 20;87(Pt B):263-268. doi: 10.1016/j.pnpbp.2017.05.009. Epub 2017 May 10.
The transition from acute to chronic pain is accompanied by increased engagement of emotional and motivational circuits. Adaptations within this corticolimbic circuitry contribute to the cellular and behavioral maladaptations associated with chronic pain. Central regions within the corticolimbic brain include the mesolimbic dopamine system, the amygdala, and the medial prefrontal cortex. The evidence reviewed herein supports the notion that chronic pain induces significant changes within these corticolimbic regions that contribute to the chronicity and intractability of pain. In addition, pain-induced changes in corticolimbic circuitry are poised to impact motivated behavior and reward responsiveness to environmental stimuli, and may modulate the addiction liability of drugs of abuse, such as opioids.
从急性疼痛到慢性疼痛的转变伴随着情绪和动机回路参与度的增加。这种皮质边缘回路内的适应性变化导致了与慢性疼痛相关的细胞和行为适应不良。皮质边缘脑区的中枢区域包括中脑边缘多巴胺系统、杏仁核和内侧前额叶皮质。本文综述的证据支持这样一种观点，即慢性疼痛会在这些皮质边缘区域引起显著变化，这些变化导致了疼痛的慢性化和难治性。此外，疼痛引起的皮质边缘回路变化可能会影响动机行为和对环境刺激的奖赏反应，并可能调节滥用药物（如阿片类药物）的成瘾倾向。
