Charles University, Third Faculty of Medicine, Department of Physiology, Ke Karlovu 4, 120 00 Prague 2, Czech Republic.
Physiol Res. 2019 Dec 20;68(Suppl 3):S195-S205. doi: 10.33549/physiolres.934351.
The biological significance of pain is to protect the organism from possible injury. However, there exists a situation, where, in the interest of survival, it is more important not to perceive pain. Spontaneous suppression of pain or weakening of nociception is mediated by an endogenous antinociceptive (analgesic) system. Its anatomical substrate ranges from the periaqueductal gray matter of the midbrain, through the noradrenergic and serotonergic nuclei of the brain stem to the spinal neurons, which receive "pain" information from nociceptors. Moreover, the activity of this system is under significant control of emotional and cognitive circuits. Pain can be moderated primarily through stimulation of positive emotions, while negative emotions increase pain. Paradoxically, one pain can also suppress another pain. Analgesia can be induced by stress, physical exercise, orosensory stimulation via a sweet taste, listening to music, and after placebo, i.e. when relief from pain is expected. Since pain has sensory, affective, and cognitive components, it turns out that activation of these entire systems can, in specific ways, contribute to pain suppression.
疼痛的生物学意义是保护机体免受可能的伤害。然而，存在这样一种情况，为了生存，不感知疼痛更为重要。自发抑制疼痛或减弱伤害感受是由内源性抗伤害（镇痛）系统介导的。其解剖学基础从中脑导水管周围灰质延伸，通过脑干的去甲肾上腺素能和 5-羟色胺能核团到脊髓神经元，后者从伤害感受器接收“疼痛”信息。此外，该系统的活动受到情绪和认知回路的显著控制。疼痛主要可以通过刺激积极的情绪来调节，而消极的情绪会增加疼痛。矛盾的是，一种疼痛也可以抑制另一种疼痛。镇痛可以通过应激、身体运动、通过甜味的口感觉刺激、听音乐以及在安慰剂后（即当预期缓解疼痛时）来诱导。由于疼痛具有感觉、情感和认知成分，因此事实证明，这些系统的全部激活可以以特定的方式有助于抑制疼痛。
