Department of Health Sciences, University West, Trollhättan 461 86, Sweden.
Neurobiotechnology Laboratory, Faculty of Health Sciences, Institute of Advanced Materials (INAM), University Jaume I, Castellon 120 71, Spain.
Med Hypotheses. 2021 Dec;157:110717. doi: 10.1016/j.mehy.2021.110717. Epub 2021 Oct 20.
Attention-deficit/hyperactivity disorder (ADHD) and pathological pain are two complex syndromes of multifactorial origin. Despite their prevalence and broad impacts, these conditions are seldom recognized and managed simultaneously. The co-existence of neuropsychiatric conditions (such as ADHD) and altered pain perception and chronic pain has been noted in children, and the comorbidity of ADHD and chronic pain is well documented in adults. Pathophysiological studies have suggested dysfunction of the dopaminergic system as a common neurochemical basis for comorbid ADHD and pain. Considerable evidence supports the role of neuroinflammation in the pathophysiology of both. We suggest that central neuroinflammation underlies altered pain perception and pain sensitization in persons with ADHD. Based on our hypothesis, targeting neuroinflammation may serve as a potential new therapeutic intervention to treat ADHD and comorbid pain in children and adolescents and a preventive strategy for the development of chronic pain in adults with ADHD.
注意缺陷多动障碍(ADHD)和病理性疼痛是两种具有多因素起源的复杂综合征。尽管它们很常见,且影响广泛,但这两种病症很少同时被识别和治疗。在儿童中已经注意到神经精神疾病(如 ADHD)和改变的疼痛感知以及慢性疼痛共存,而 ADHD 和慢性疼痛的合并症在成人中也有充分的记录。病理生理学研究表明,多巴胺能系统功能障碍是 ADHD 和疼痛合并的常见神经化学基础。大量证据支持神经炎症在这两种疾病的病理生理学中的作用。我们认为,中枢神经炎症是 ADHD 患者疼痛感知和疼痛敏化改变的基础。基于我们的假设,针对神经炎症可能成为治疗儿童和青少年 ADHD 合并疼痛的潜在新治疗干预措施,也是预防 ADHD 成人慢性疼痛发展的策略。