儿童疼痛与创伤之间复杂相互作用的叙述性综述:聚焦生物记忆、临床前数据和表观遗传过程

Narrative Review of the Complex Interaction between Pain and Trauma in Children: A Focus on Biological Memory, Preclinical Data, and Epigenetic Processes.

作者信息

Rivi Veronica, Rigillo Giovanna, Toscano Ylenia, Benatti Cristina, Blom Johanna Maria Catharina

机构信息

Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy.

Centre of Neuroscience and Neurotechnology, University of Modena and Reggio Emilia, 41125 Modena, Italy.

出版信息

Children (Basel). 2023 Jul 13;10(7):1217. doi: 10.3390/children10071217.

Abstract

The incidence and collective impact of early adverse experiences, trauma, and pain continue to increase. This underscores the urgent need for translational efforts between clinical and preclinical research to better understand the underlying mechanisms and develop effective therapeutic approaches. As our understanding of these issues improves from studies in children and adolescents, we can create more precise preclinical models and ultimately translate our findings back to clinical practice. A multidisciplinary approach is essential for addressing the complex and wide-ranging effects of these experiences on individuals and society. This narrative review aims to (1) define pain and trauma experiences in childhood and adolescents, (2) discuss the relationship between pain and trauma, (3) consider the role of biological memory, (4) decipher the relationship between pain and trauma using preclinical data, and (5) examine the role of the environment by introducing the importance of epigenetic processes. The ultimate scope is to better understand the wide-ranging effects of trauma, abuse, and chronic pain on children and adolescents, how they occur, and how to prevent or mitigate their effects and develop effective treatment strategies that address both the underlying causes and the associated physiological and psychological effects.

摘要

早期不良经历、创伤和疼痛的发生率及其总体影响持续上升。这凸显了临床研究与临床前研究之间开展转化研究的迫切需求,以便更好地理解其潜在机制并开发有效的治疗方法。随着我们通过对儿童和青少年的研究对这些问题的认识不断提高,我们能够创建更精确的临床前模型,并最终将研究结果转化应用于临床实践。多学科方法对于应对这些经历对个人和社会产生的复杂而广泛的影响至关重要。本叙述性综述旨在:(1)界定儿童和青少年时期的疼痛和创伤经历;(2)探讨疼痛与创伤之间的关系;(3)思考生物记忆的作用;(4)利用临床前数据解读疼痛与创伤之间的关系;(5)通过介绍表观遗传过程的重要性来审视环境的作用。最终目标是更好地理解创伤、虐待和慢性疼痛对儿童和青少年产生的广泛影响、这些影响是如何发生的,以及如何预防或减轻其影响,并制定能够解决根本原因以及相关生理和心理影响的有效治疗策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3f27/10378710/4aa720a93fb4/children-10-01217-g001.jpg

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