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大脑与身体的脱节:创伤相关障碍的躯体感觉基础。

The brain-body disconnect: A somatic sensory basis for trauma-related disorders.

作者信息

Kearney Breanne E, Lanius Ruth A

机构信息

Department of Neuroscience, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.

Department of Psychiatry, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.

出版信息

Front Neurosci. 2022 Nov 21;16:1015749. doi: 10.3389/fnins.2022.1015749. eCollection 2022.

Abstract

Although the manifestation of trauma in the body is a phenomenon well-endorsed by clinicians and traumatized individuals, the neurobiological underpinnings of this manifestation remain unclear. The notion of somatic sensory processing, which encompasses vestibular and somatosensory processing and relates to the sensory systems concerned with how the physical body exists in and relates to physical space, is introduced as a major contributor to overall regulatory, social-emotional, and self-referential functioning. From a phylogenetically and ontogenetically informed perspective, trauma-related symptomology is conceptualized to be grounded in brainstem-level somatic sensory processing dysfunction and its cascading influences on physiological arousal modulation, affect regulation, and higher-order capacities. Lastly, we introduce a novel hierarchical model bridging somatic sensory processes with limbic and neocortical mechanisms regulating an individual's emotional experience and sense of a relational, agentive self. This model provides a working framework for the neurobiologically informed assessment and treatment of trauma-related conditions from a somatic sensory processing perspective.

摘要

尽管身体创伤的表现是临床医生和受创伤个体都充分认可的一种现象,但其表现的神经生物学基础仍不清楚。躯体感觉加工的概念被引入,它包括前庭和躯体感觉加工,并与涉及身体如何在物理空间中存在以及与物理空间相关的感觉系统有关,是整体调节、社会情感和自我参照功能的主要贡献因素。从系统发育和个体发育的角度来看,创伤相关症状被概念化为基于脑干水平的躯体感觉加工功能障碍及其对生理唤醒调节、情感调节和高阶能力的连锁影响。最后,我们引入了一个新颖的层次模型,将躯体感觉过程与调节个体情感体验以及关系性、能动自我感的边缘系统和新皮质机制联系起来。该模型为从躯体感觉加工角度对创伤相关病症进行基于神经生物学的评估和治疗提供了一个工作框架。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/be09/9720153/d9ba765731fe/fnins-16-1015749-g001.jpg

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