CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, 100101, China.
Department of Psychology, University of Chinese Academy of Sciences, Beijing, 100101, China.
Sci China Life Sci. 2021 Jun;64(6):879-896. doi: 10.1007/s11427-020-1822-4. Epub 2020 Nov 23.
Pain is a multidimensional subjective experience with biological, psychological, and social factors. Whereas acute pain can be a warning signal for the body to avoid excessive injury, long-term and ongoing pain may be developed as chronic pain. There are more than 100 million people in China living with chronic pain, which has raised a huge socioeconomic burden. Studying the mechanisms of pain and developing effective analgesia approaches are important for basic and clinical research. Recently, with the development of brain imaging and data analytical approaches, the neural mechanisms of chronic pain have been widely studied. In the first part of this review, we briefly introduced the magnetic resonance imaging and conventional analytical approaches for brain imaging data. Then, we reviewed brain alterations caused by several chronic pain disorders, including localized and widespread primary pain, primary headaches and orofacial pain, musculoskeletal pain, and neuropathic pain, and present meta-analytical results to show brain regions associated with the pathophysiology of chronic pain. Next, we reviewed brain changes induced by pain interventions, such as pharmacotherapy, neuromodulation, and acupuncture. Lastly, we reviewed emerging studies that combined advanced machine learning and neuroimaging techniques to identify diagnostic, prognostic, and predictive biomarkers in chronic pain patients.
疼痛是一种具有生物学、心理学和社会因素的多维主观体验。急性疼痛可以作为身体避免过度损伤的警告信号,而长期持续的疼痛则可能发展为慢性疼痛。中国有超过 1 亿人患有慢性疼痛,这给社会带来了巨大的经济负担。研究疼痛的机制和开发有效的镇痛方法对于基础和临床研究都很重要。最近,随着脑成像和数据分析方法的发展,慢性疼痛的神经机制已经得到了广泛的研究。在这篇综述的第一部分,我们简要介绍了用于脑成像数据的磁共振成像和常规分析方法。然后,我们回顾了几种慢性疼痛疾病引起的大脑改变,包括局部和广泛的原发性疼痛、原发性头痛和颌面疼痛、肌肉骨骼疼痛和神经性疼痛,并呈现了荟萃分析结果,以显示与慢性疼痛病理生理学相关的大脑区域。接下来,我们回顾了疼痛干预引起的大脑变化,如药物治疗、神经调节和针灸。最后,我们回顾了一些新兴的研究,这些研究结合了先进的机器学习和神经影像学技术,以确定慢性疼痛患者的诊断、预后和预测生物标志物。
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