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疼痛包括感觉分辨和情绪体验两个基本成分。对疼痛感觉分辨成分的研究,在基因、分子、细胞和系统水平已获得重要进展,但对于疼痛的情绪、情感成分的研究相对滞后。越来越多的临床观察显示,疼痛特别是慢性疼痛所伴随的负性情绪状态,严重影响患者的身心健康。本文简要总结了痛厌恶情绪研究领域的主要进展,着重阐述了前扣带皮层(anterior cingulate cortex,ACC)参与痛厌恶情绪过程的神经机制,特别是ACC神经元NMDA受体和ERK-CREB信号通路的关键性作用。多种调控分子如突触相关蛋白SIP30和雌激素可通过突触前和突触后机制调控兴奋性氨基酸释放、NMDA受体功能和ACC锥体神经元突触可塑性参与痛厌恶情绪的形成。
Pain includes two basic components of sensory resolution and emotional experience. Research on the components of pain perception has made important advances at the genetic, molecular, cellular, and systemic levels, but the study of emotional components has lagged behind. More and more clinical observation shows that the pain, especially the chronic pain associated with negative emotional state, seriously affects the patient’s physical and mental health. This article briefly summarizes the major advances in the field of pain-disgusting and focuses on the neural mechanisms involved in the anorectal cortical (ACC) involvement in the pain-disgusting mood, specifically the NMDA receptor and ERK-CREB signaling pathways in ACC neurons The key role. A variety of regulatory molecules such as SIP30 and estrogen can regulate the release of excitatory amino acids through presynaptic and postsynaptic mechanisms. NMDA receptor function and synaptic plasticity of ACC pyramidal neurons are involved in the formation of pain-disgusting emotions.