Goldman Nanna, Hablitz Lauren M, Mori Yuki, Nedergaard Maiken
Center for Translational Neuromedicine, University of Rochester Medical Center, Rochester, NY, USA.
Center for Basic and Translational Neuroscience, University of Copenhagen, Copenhagen, Denmark.
Med Acupunct. 2020 Dec 1;32(6):373-376. doi: 10.1089/acu.2020.1489. Epub 2020 Dec 16.
The glymphatic system is network of perivascular spaces through which cerebrospinal fluid and interstitial fluid can move through the brain, clearing metabolic waste, such as amyloid beta, lactate and more, from the parenchyma. This cleaning system is regulated by sleep and norepinephrine, with increased levels of norepinephrine during wakefulness inhibiting fluid movement. Norepinephrine is also essential for transition from acute to chronic pain, and sufferers of chronic neuropathic pain frequently present with sleep disruption. These connections among glymphatic clearance, sleep, and pain are very intriguing, and might lead to nonpharmaceutical interventions for pain treatment. This short perspective provides a rationale for the hypothesis that mind-body interventions-such as acupuncture-can reduce norepinephrine and increase glymphatic function, ultimately relieving chronic neuropathic pain.
类淋巴系统是一个由血管周围间隙组成的网络，脑脊液和间质液可通过该网络在大脑中流动，清除脑实质中的代谢废物，如β-淀粉样蛋白、乳酸等。这个清洁系统受睡眠和去甲肾上腺素调节，清醒时去甲肾上腺素水平升高会抑制液体流动。去甲肾上腺素对于从急性疼痛转变为慢性疼痛也至关重要，慢性神经性疼痛患者经常伴有睡眠障碍。类淋巴清除、睡眠和疼痛之间的这些联系非常有趣，可能会带来疼痛治疗的非药物干预方法。这篇简短的观点文章为以下假设提供了理论依据：身心干预措施，如针灸，可以降低去甲肾上腺素水平并增强类淋巴功能，最终缓解慢性神经性疼痛。
