Neuroscience Graduate Program, University of Cincinnati College of Medicine, 231 Albert Sabin Way, Cincinnati, OH, 45267, USA.
Department of Anesthesiology, Pain Research Center, University of Cincinnati Medical Center, 231 Albert Sabin Way, Cincinnati, OH, 45267, USA.
J Neural Transm (Vienna). 2020 Apr;127(4):467-479. doi: 10.1007/s00702-019-02059-z. Epub 2019 Aug 9.
Pain is a necessary sensation that prevents further tissue damage, but can be debilitating and detrimental in daily life under chronic conditions. Neuronal activity strongly regulates the maturation of the somatosensory system, and aberrant sensory input caused by injury or inflammation during critical periods of early postnatal development can have prolonged, detrimental effects on pain processing. This review will outline the maturation of neuronal circuits responsible for the transmission of nociceptive signals and the generation of pain sensation-involving peripheral sensory neurons, the spinal cord dorsal horn, and brain-in addition to the influences of the neuroimmune system on somatosensation. This summary will also highlight the unique effects of neonatal tissue injury on the maturation of these systems and subsequent consequences for adult somatosensation. Ultimately, this review emphasizes the need to account for age as an independent variable in basic and clinical pain research, and importantly, to consider the distinct qualities of the pediatric population when designing novel strategies for pain management.
疼痛是一种必要的感觉,可防止进一步的组织损伤,但在慢性疾病的日常生活中,疼痛可能会使人衰弱和产生不良影响。神经元活动强烈调节着感觉系统的成熟,在出生后早期的关键时期,由损伤或炎症引起的异常感觉输入会对疼痛处理产生长期的、有害的影响。本综述将概述负责传递伤害性信号和产生疼痛感觉的神经元回路的成熟过程,包括外周感觉神经元、脊髓背角和大脑,以及神经免疫系统对感觉的影响。本综述还将重点介绍新生儿组织损伤对这些系统成熟的独特影响及其对成人感觉的后续后果。最终,本综述强调了在基础和临床疼痛研究中需要将年龄作为一个独立变量来考虑,并在设计疼痛管理的新策略时,重要的是要考虑儿科人群的独特性质。