Tang Yu-Long, Zhang Yu-Qiu
Institutes of Brain Science, Fudan University, Shanghai 200032, China.
Institute of Acupuncture and Moxibustion, Institutes of Integrative Medicine, Fudan University, Shanghai 200032, China.
Sheng Li Xue Bao. 2017 Oct 25;69(5):637-646.
The pain experience includes a sensory-discriminative component and an emotional-affective component. The great progress in the genetic, molecular, cellular and systemic levels on the study of the sensory dimension of pain has been made. However, the study of the emotional components of pain is relatively backward. A line of clinic observations indicates that chronic pain and pain-related negative emotion affect the physical and mental health of patients. This review summarizes the main progress from our and other laboratories regarding the affective component of pain, elaborates the neuronal mechanisms of pain-related aversive emotion in the anterior cingulate cortex (ACC), especially the critical role of NMDA receptors and ERK-CREB pathway. A variety of regulatory molecules, such as synapse associated protein SIP30 and estrogen contribute to pain-related aversive emotion via facilitating presynaptic glutamate release and postsynaptic NMDA receptor-mediated synaptic transmission. The far-reaching effects of pain-related negative emotion on patients with chronic pain are emphasized.
疼痛体验包括感觉辨别成分和情绪情感成分。在疼痛感觉维度的基因、分子、细胞和系统水平研究上已取得了巨大进展。然而,疼痛情绪成分的研究相对滞后。一系列临床观察表明,慢性疼痛和与疼痛相关的负面情绪会影响患者的身心健康。本综述总结了我们实验室和其他实验室在疼痛情感成分方面的主要进展,阐述了前扣带回皮质(ACC)中与疼痛相关的厌恶情绪的神经元机制,特别是NMDA受体和ERK-CREB通路的关键作用。多种调节分子,如突触相关蛋白SIP30和雌激素,通过促进突触前谷氨酸释放和突触后NMDA受体介导的突触传递,促成与疼痛相关的厌恶情绪。文中强调了与疼痛相关的负面情绪对慢性疼痛患者的深远影响。