Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital, OH, USA; Department of Pediatrics, University of Cincinnati, OH, USA; Center for Understanding Pediatric Pain, Cincinnati Children's Hospital, OH, USA.
Trends Neurosci. 2020 Oct;43(10):780-794. doi: 10.1016/j.tins.2020.07.004. Epub 2020 Aug 13.
Chronic pain remains challenging to both diagnose and treat. These challenges, in part, arise from limited systems-level understanding of the basic mechanisms that process nociceptive information and ultimately instantiate a subjectively available experience of pain. Here, I provide a framework, the distributed nociceptive system, for understanding nociceptive mechanisms at a systems level by integrating the concepts of neural population coding with distributed processing. Within this framework, wide-spread engagement of populations of neurons produces representations of nociceptive information that are highly resilient to disruption. The distributed nociceptive system provides a foundation for understanding complex spatial aspects of chronic pain and provides an impetus for nonpharmacological cognitive and physical therapies that can effectively target the highly distributed system that gives rise to an experience of pain.
慢性疼痛的诊断和治疗仍然具有挑战性。这些挑战部分源于对处理伤害性信息的基本机制的系统水平理解有限，而这些机制最终会产生主观上可感知的疼痛体验。在这里，我通过整合神经元群体编码和分布式处理的概念，提供了一个分布式伤害性系统的框架，用于从系统水平理解伤害性机制。在这个框架内，神经元群体的广泛参与产生了对伤害性信息的高度抗干扰的表示。分布式伤害性系统为理解慢性疼痛的复杂空间方面提供了基础，并为非药物认知和物理疗法提供了动力，这些疗法可以有效地针对产生疼痛体验的高度分布式系统。
