Department of Anesthesiology, Hubei Key Laboratory of Geriatric Anesthesia and Perioperative Brain Health, and Wuhan Clinical Research Center for Geriatric Anesthesia, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No.1095 Jiefang Avenue, Wuhan, Hubei, China.
Wuhan Institute of Physics and Mathematics, Chinese Academy of Sciences, Wuhan, Hubei, China.
Mol Neurobiol. 2024 Oct;61(10):8123-8143. doi: 10.1007/s12035-024-04073-z. Epub 2024 Mar 12.
Cognitive impairment is a common comorbidity of chronic pain, significantly disrupting patients' quality of life. Despite this comorbidity being clinically recognized, the underlying neuropathological mechanisms remain unclear. Recent preclinical studies have focused on the fundamental mechanisms underlying the coexistence of chronic pain and cognitive decline. Pain chronification is accompanied by structural and functional changes in the neural substrate of cognition. Based on the developments in electrophysiology and optogenetics/chemogenetics, we summarized the relevant neural circuits involved in pain-induced cognitive impairment, as well as changes in connectivity and function in brain regions. We then present the cellular and molecular alternations related to pain-induced cognitive impairment in preclinical studies, mainly including modifications in neuronal excitability and structure, synaptic plasticity, glial cells and cytokines, neurotransmitters and other neurochemicals, and the gut-brain axis. Finally, we also discussed the potential treatment strategies and future research directions.
认知障碍是慢性疼痛的常见合并症，严重扰乱了患者的生活质量。尽管这种合并症在临床上已得到认可，但潜在的神经病理学机制仍不清楚。最近的临床前研究集中在慢性疼痛和认知能力下降共存的基本机制上。疼痛的慢性化伴随着认知神经基质的结构和功能变化。基于电生理学和光遗传学/化学遗传学的发展，我们总结了与疼痛引起的认知障碍相关的相关神经回路，以及大脑区域连接和功能的变化。然后，我们介绍了临床前研究中与疼痛引起的认知障碍相关的细胞和分子变化，主要包括神经元兴奋性和结构、突触可塑性、神经胶质细胞和细胞因子、神经递质和其他神经化学物质以及肠-脑轴的改变。最后，我们还讨论了潜在的治疗策略和未来的研究方向。
