CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing 100101, China.
Department of Psychology, University of Chinese Academy of Sciences, Beijing 100049, China.
Int J Mol Sci. 2021 Mar 5;22(5):2648. doi: 10.3390/ijms22052648.
Neuropathic pain is difficult to cure and is often accompanied by emotional and psychological changes. Exploring the mechanisms underlying neuropathic pain will help to identify a better treatment for this condition. The insular cortex is an important information integration center. Numerous imaging studies have documented increased activity of the insular cortex in the presence of neuropathic pain; however, the specific role of this region remains controversial. Early studies suggested that the insular lobe is mainly involved in the processing of the emotional motivation dimension of pain. However, increasing evidence suggests that the role of the insular cortex is more complex and may even be related to the neural plasticity, cognitive evaluation, and psychosocial aspects of neuropathic pain. These effects contribute not only to the development of neuropathic pain, but also to its comorbidity with neuropsychiatric diseases. In this review, we summarize the changes that occur in the insular cortex in the presence of neuropathic pain and analgesia, as well as the molecular mechanisms that may underlie these conditions. We also discuss potential sex-based differences in these processes. Further exploration of the involvement of the insular lobe will contribute to the development of new pharmacotherapy and psychotherapy treatments for neuropathic pain.
神经性疼痛难以治愈，常伴有情绪和心理变化。探索神经性疼痛的发病机制有助于找到更好的治疗方法。脑岛是一个重要的信息整合中心。大量的影像学研究记录到，在神经性疼痛存在的情况下，脑岛的活动增加；然而，该区域的具体作用仍存在争议。早期的研究表明，脑岛叶主要参与疼痛的情绪动机维度的处理。然而，越来越多的证据表明，脑岛的作用更为复杂，甚至可能与神经性疼痛的神经可塑性、认知评估和社会心理方面有关。这些影响不仅导致了神经性疼痛的发展，也导致了其与神经精神疾病的共病。在这篇综述中，我们总结了神经性疼痛和镇痛存在时脑岛发生的变化，以及可能存在的分子机制。我们还讨论了这些过程中潜在的性别差异。进一步探索脑岛的参与将有助于开发新的神经性疼痛的药物治疗和心理治疗方法。
