Schaible Hans-Georg
Institut für Physiologie 1/Neurophysiologie, Universitätsklinikum Jena, Teichgraben 8, 07743, Jena, Deutschland.
Orthopadie (Heidelb). 2025 Aug 11. doi: 10.1007/s00132-025-04703-x.
Harmful (noxious) stimuli and many diseases cause pain. The pain described can reflect the nociception, i.e., the coding of the noxious stimulus or the pathological process. In many cases, however, this is not the case, especially if the pain lasts for along time. For this reason, it is important to understand pain in a broader sense as an expression of brain activity that also expresses other experiences in addition to nociception. This article describes the brain network which, according to our current understanding, generates the subjective sensation of pain. In addition to the areas of the brain that encode noxious stimuli, neuronal circuits of the limbic system, which evaluate the stimuli affectively and emotionally and are involved in response selection, are becoming important. Taking into account the complex neuronal mechanisms of pain development can contribute to better diagnostics and therapy.
有害(伤害性)刺激和许多疾病都会引起疼痛。所描述的疼痛可以反映伤害感受,即伤害性刺激或病理过程的编码。然而,在许多情况下并非如此,尤其是当疼痛持续很长时间时。因此,从更广泛的意义上理解疼痛作为大脑活动的一种表现很重要,这种大脑活动除了伤害感受之外还表达其他体验。本文描述了根据我们目前的理解产生疼痛主观感觉的大脑网络。除了对有害刺激进行编码的脑区外,边缘系统的神经回路也变得很重要,该神经回路对刺激进行情感和情绪评估并参与反应选择。考虑到疼痛产生的复杂神经机制有助于更好地进行诊断和治疗。