Su Na, Cai Pingping, Dou Zhiqiang, Yin Xiaoxue, Xu Hongmin, He Jing, Li Zhaofeng, Li Changzhong
First Clinical Medicine College, Shandong University of Traditional Chinese Medicine, Jinan, China.
Department of Traditional Chinese Medicine, Shandong Provincial Hospital, Jinan, China.
Front Neurosci. 2023 Aug 30;17:1243231. doi: 10.3389/fnins.2023.1243231. eCollection 2023.
Neuropathic pain (NP) is known to be associated with abnormal changes in specific brain regions, but the complex neural network behind it is vast and complex and lacks a systematic summary. With the help of various animal models of NP, a literature search on NP brain regions and circuits revealed that the related brain nuclei included the periaqueductal gray (PAG), lateral habenula (LHb), medial prefrontal cortex (mPFC), and anterior cingulate cortex (ACC); the related brain circuits included the PAG-LHb and mPFC-ACC. Moreover, acupuncture and injurious information can affect different brain regions and influence brain functions via multiple aspects to play an analgesic role and improve synaptic plasticity by regulating the morphology and structure of brain synapses and the expression of synapse-related proteins; maintain the balance of excitatory and inhibitory neurons by regulating the secretion of glutamate, γ-aminobutyric acid, 5-hydroxytryptamine, and other neurotransmitters and receptors in the brain tissues; inhibit the overactivation of glial cells and reduce the release of pro-inflammatory mediators such as interleukins to reduce neuroinflammation in brain regions; maintain homeostasis of glucose metabolism and regulate the metabolic connections in the brain; and play a role in analgesia through the mediation of signaling pathways and signal transduction molecules. These factors help to deepen the understanding of NP brain circuits and the brain mechanisms of acupuncture analgesia.
已知神经性疼痛(NP)与特定脑区的异常变化有关,但其背后的复杂神经网络庞大且复杂,缺乏系统总结。借助各种NP动物模型,对NP脑区和神经回路进行文献检索发现,相关脑核包括导水管周围灰质(PAG)、外侧缰核(LHb)、内侧前额叶皮质(mPFC)和前扣带回皮质(ACC);相关脑回路包括PAG-LHb和mPFC-ACC。此外,针刺和伤害性信息可影响不同脑区,并通过多个方面影响脑功能,发挥镇痛作用,通过调节脑突触的形态和结构以及突触相关蛋白的表达来改善突触可塑性;通过调节脑组织中谷氨酸、γ-氨基丁酸、5-羟色胺等神经递质和受体的分泌来维持兴奋性和抑制性神经元的平衡;抑制神经胶质细胞的过度激活,减少白细胞介素等促炎介质的释放,以减轻脑区的神经炎症;维持葡萄糖代谢的稳态,调节脑内的代谢联系;并通过信号通路和信号转导分子的介导发挥镇痛作用。这些因素有助于加深对NP脑回路和针刺镇痛脑机制的理解。