Spiegel David R, Pattison Alexander, Lyons Alexis, Ansari Umer, Mccroskey Aidan L, Luehrs Eric, Barr Lauren, Le Stephanie
All authors are with the Department of Psychiatry and Behavioral Sciences at Eastern Virginia Medical School in Norfolk, Virginia.
Innov Clin Neurosci. 2017 Jun 1;14(5-6):11-20. eCollection 2017 May-Jun.
Pain, pruritus, and nausea are complex sensory and emotional physiological symptoms that can vary widely between people and even within an individual, depending on the context and meaning of the symptom and the psychological state of the person. This article reviews the acute neural transmission of pain, pruritus, and nausea symptoms, which can begin in the periphery and/or viscera. The subsequent multiple pathways in the central nervous system that become involved in the processing of these symptoms are also discussed. The authors describe human brain imaging studies that have revealed consistent cortical and subcortical networks activated by these symptoms, including sensory, limbic, and associative regions. In particular, the authors discuss information revealed by the studies regarding the primary somatosensory cortex, secondary somatosensory cortex, anterior cingulate cortex, insula, prefrontal cortex and thalamus, are the brain areas most commonly activated by noxious stimuli. Finally, the authors describe treatment options for chronic presentations of these symptoms, which are, in part, based on central nervous processing of these sensations.
疼痛、瘙痒和恶心是复杂的感觉和情感生理症状，人与人之间甚至同一个人内部都会有很大差异，这取决于症状的背景和意义以及人的心理状态。本文综述了疼痛、瘙痒和恶心症状的急性神经传导，这些症状可始于外周和/或内脏。还讨论了随后参与这些症状处理的中枢神经系统中的多条通路。作者描述了人类脑成像研究，这些研究揭示了由这些症状激活的一致的皮质和皮质下网络，包括感觉、边缘和联合区域。特别是，作者讨论了这些研究揭示的有关主要躯体感觉皮层、次要躯体感觉皮层、前扣带回皮层、脑岛、前额叶皮层和丘脑的信息，这些是最常被有害刺激激活的脑区。最后，作者描述了这些症状慢性表现的治疗选择，这些选择部分基于对这些感觉的中枢神经处理。
