Melzack R
McGill University.
Can J Exp Psychol. 1993 Dec;47(4):615-29. doi: 10.1037/h0078871.
Descartes' concept that pain is produced by a direct, straight-through transmission system from injured tissues in the body to a pain centre in the brain has dominated pain research and therapy until recently. The gate control theory of pain, published in 1965, proposes that a mechanism in the dorsal horns of the spinal cord acts like a gate which inhibits or facilitates transmission from the body to the brain on the basis of the diameters of the active peripheral fibers as well as the dynamic action of brain processes. As a result, psychological variables such as past experience, attention and other cognitive activities have been integrated into current research and therapy on pain processes. The gate control theory, however, is not able to explain several chronic pain problems, such as phantom limb pain, which require a greater understanding of brain mechanisms. A new theory of brain function, together with recent research that has derived from it, are described. They throw light on complex pain problems and have important implications for basic assumptions in psychology.
笛卡尔认为疼痛是通过一个直接的、直通的传输系统从身体受伤组织传递到大脑中的疼痛中枢，直到最近，这一观念一直主导着疼痛研究和治疗。1965年发表的疼痛闸门控制理论提出，脊髓背角中的一种机制就像一扇闸门，它根据活跃外周纤维的直径以及大脑过程的动态作用，抑制或促进从身体到大脑的传输。因此，诸如过去的经历、注意力和其他认知活动等心理变量已被纳入当前对疼痛过程的研究和治疗中。然而，闸门控制理论无法解释一些慢性疼痛问题，比如幻肢痛，而这些问题需要对大脑机制有更深入的理解。本文描述了一种新的脑功能理论以及由此产生的最新研究。它们为复杂的疼痛问题提供了启示，并对心理学的基本假设具有重要意义。
