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疼痛神经科学教育与神经影像学——一篇叙述性综述

Pain Neuroscience Education and Neuroimaging-A Narrative Review.

作者信息

Corbo Daniele

机构信息

Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, 25123 Brescia, Italy.

出版信息

Brain Sci. 2024 Sep 22;14(9):947. doi: 10.3390/brainsci14090947.

Abstract

BACKGROUND

Musculoskeletal pain is a leading cause of medical visits, posing significant challenges both socially and economically, encouraging the scientific community to continue researching and exploring the most effective methods to address the problem. An alternative way to deal with chronic pain is pain neuroscience education (PNE), a lesson plan that addresses the neurobiology, neurophysiology, and nervous system processing of pain. This method takes the place of the conventional one, which connected pain to tissue damage or nociception.

RESULTS

As a result, patients are taught that pain is often not a reliable measure of the health of the tissues but rather the outcome of the nervous system interpreting the injury in conjunction with additional psychosocial variables. In addition to finding research that examine, using neuroimaging, whether the administration of PNE has detectable effects at the level of the central nervous system, this narrative review seeks to clarify what PNE is, how it is administered, and if it is an effective treatment for musculoskeletal pain.

CONCLUSIONS

Based on the findings, it appears that PNE is more therapeutically beneficial when combined with therapeutic exercise, when done one-on-one, and during lengthy, frequent sessions. Lastly, even though PNE has no effect on the morphological properties of the gray matter, it appears to cause decreased activation of the regions linked to pain.

摘要

背景

肌肉骨骼疼痛是就医的主要原因,在社会和经济方面都带来了重大挑战,促使科学界继续研究和探索解决该问题的最有效方法。应对慢性疼痛的一种替代方法是疼痛神经科学教育(PNE),这是一种涉及疼痛的神经生物学、神经生理学和神经系统处理过程的教学计划。这种方法取代了将疼痛与组织损伤或伤害感受联系起来的传统方法。

结果

因此,患者了解到疼痛通常不是组织健康的可靠指标,而是神经系统结合其他心理社会变量对损伤进行解读的结果。除了寻找使用神经影像学研究PNE的给药是否在中枢神经系统水平产生可检测到的影响的研究外,本叙述性综述旨在阐明PNE是什么、如何实施以及它是否是治疗肌肉骨骼疼痛的有效方法。

结论

基于这些发现,当与治疗性运动相结合、一对一进行以及在长时间、频繁的疗程中进行时,PNE似乎在治疗上更有益。最后,尽管PNE对灰质的形态学特性没有影响,但它似乎会导致与疼痛相关区域的激活减少。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3fa2/11430525/9fdb812603a1/brainsci-14-00947-g001.jpg

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