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揭示催眠镇痛背后的基本机制。

Shedding light on the fundamental mechanism underlying hypnotic analgesia.

作者信息

Keppler Joachim

机构信息

Department of Consciousness Research, DIWISS, Roth, Germany.

出版信息

Ann Palliat Med. 2018 Jan;7(1):170-176. doi: 10.21037/apm.2017.04.03. Epub 2017 May 3.

Abstract

Owing to the increasing importance of clinical hypnosis in pain therapy and palliative care, there is a growing interest in uncovering the mechanism underlying hypnotic analgesia. The neurophysiological findings suggest that the hypnotic state is associated with an altered operating mode of the brain that is clearly different from the normal operating mode. While in the normal operating mode a dolorogenic stimulus induces a highly synchronized large-scale activity pattern that leads to the experience of pain, the altered operating mode inhibits the synchronization of spatially divided brain regions. As a consequence, the conscious experience of pain cannot arise. In order to gain a deeper understanding of the mechanism, a novel theoretical framework is made use of. It accepts consciousness as a fundamental property of the universe and is based on the hypothesis that the whole range of phenomenal qualities is built into the frequency spectrum of a ubiquitous background field. The body of evidence supports the view that in the normal operating mode our brains act as filters that extract the plethora of phenomenal nuances selectively from this field. In the altered operating mode, which establishes under hypnotic conditions, the extraction of phenomenal qualities is partially prevented. From this perspective, hypnotic analgesia is due to an impairment of the fundamental mechanism underlying conscious perception.

摘要

由于临床催眠在疼痛治疗和姑息治疗中的重要性日益增加,人们对揭示催眠镇痛的潜在机制越来越感兴趣。神经生理学研究结果表明,催眠状态与大脑的一种改变了的运作模式相关联,这种模式明显不同于正常运作模式。在正常运作模式下,致痛刺激会诱发一种高度同步的大规模活动模式,从而导致疼痛体验,而改变了的运作模式则会抑制空间上分散的脑区的同步性。结果,疼痛的意识体验就无法产生。为了更深入地理解这一机制,人们采用了一种新颖的理论框架。该框架将意识视为宇宙的一种基本属性,并基于这样一种假设,即整个现象性质的范围都构建在一个无所不在的背景场的频谱中。大量证据支持这样一种观点,即在正常运作模式下,我们的大脑就像过滤器一样,从这个场中选择性地提取大量的现象细微差别。在催眠条件下建立的改变了的运作模式中,现象性质的提取会部分受阻。从这个角度来看,催眠镇痛是由于意识感知的基本机制受损所致。

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