Department of Psychology, York University, Toronto, ON, Canada.
Department of Psychology, York University, Toronto, ON, Canada; Department of Anesthesia and Pain Management, Toronto General Hospital, Toronto, ON, Canada; Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, ON, Canada.
Neurosci Biobehav Rev. 2024 Jul;162:105736. doi: 10.1016/j.neubiorev.2024.105736. Epub 2024 May 23.
Chronic pain affects approximately 20% of the world's population, exerting a substantial burden on the affected individual, their families, and healthcare systems globally. Deficits in autobiographical memory have been identified among individuals living with chronic pain, and even found to pose a risk for the transition to chronicity. Recent neuroimaging studies have simultaneously implicated common brain regions central to autobiographical memory processing in the maintenance of and susceptibility to chronic pain. The present review proposes a novel neurocognitive framework for chronic pain explained by mechanisms underlying the autobiographical memory system. Here, we 1) summarize the current literature on autobiographical memory in pain, 2) discuss the role of the hippocampus and cortical brain regions including the ventromedial prefrontal cortex, anterior temporal lobe, and amygdala in relation to autobiographical memory, memory schemas, emotional processing, and pain, 3) synthesize these findings in a neurocognitive framework that explains these relationships and their implications for patients' pain outcomes, and 4) propose translational directions for the prevention, management, and treatment of chronic pain.
慢性疼痛影响着全球约 20%的人口,给患者本人、他们的家庭以及全球医疗系统都带来了巨大的负担。有研究发现,慢性疼痛患者存在自传体记忆缺陷,甚至存在发展为慢性疼痛的风险。最近的神经影像学研究同时表明,与自传体记忆处理相关的大脑中一些共同区域在维持和易患慢性疼痛中起着核心作用。本综述提出了一个新的神经认知框架,用自传体记忆系统的机制来解释慢性疼痛。在这里,我们 1)总结了关于疼痛中的自传体记忆的现有文献,2)讨论了海马体和皮质脑区(包括腹内侧前额叶、前颞叶和杏仁核)在自传体记忆、记忆图式、情绪处理和疼痛中的作用,3)将这些发现综合在一个神经认知框架中,解释这些关系及其对患者疼痛结果的影响,4)为慢性疼痛的预防、管理和治疗提出转化方向。