The comorbidity of insomnia, chronic pain, and depression: dopamine as a putative mechanism.
The comorbidity of insomnia, chronic pain, and depression: dopamine as a putative mechanism.
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DOI：
10.1016/j.smrv.2012.03.003
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发表时间：
2013-06
影响因子：
10.5
通讯作者：
Smith MT
中科院分区：
文献类型：
--
作者：
Finan PH;Smith MT
流行病学、横断面和前瞻性研究表明，失眠、慢性疼痛和抑郁经常同时发生，并且是相互作用的条件。然而，这些合并症的机制尚未阐明。中枢神经系统的重叠机制表明，一个共同的神经生物学底物可能是这些疾病发展和相互作用的基础。我们认为，中脑边缘多巴胺系统是一个未被充分认识和有吸引力的场所，用于检查涉及这种症状复合体的相互作用、发展、恶化和维持的神经生物学过程。在这篇文章中，从多个学科的研究进行了回顾，以强调多巴胺能功能的改变在促进觉醒，疼痛敏感性和情绪障碍中的作用。我们认为，旨在阐明失眠、慢性疼痛和抑郁共病的共同因素的研究应该评估中脑边缘多巴胺能系统的功能及其对已知在这三种疾病中失调的共同过程的影响。
Epidemiological, cross-sectional, and prospective studies suggest that insomnia, chronic pain, and depression frequently co-occur and are mutually interacting conditions. However, the mechanisms underlying these comorbid disorders have yet to be elucidated. Overlapping mechanisms in the central nervous system suggest a common neurobiological substrate(s) may underlie the development and interplay of these disorders. We propose that the mesolimbic dopamine system is an underappreciated and attractive venue for the examination of neurobiological processes involved in the interactions, development, exacerbation, and maintenance of this symptom complex. In the present article, studies from multiple disciplines are reviewed to highlight the role of altered dopaminergic function in the promotion of arousal, pain sensitivity, and mood disturbance. We argue that studies aiming to elucidate common factors accounting for the comorbidity of insomnia, chronic pain, and depression should evaluate functioning within the mesolimbic dopaminergic system and its effect on common processes known to be dysregulated in all three disorders.
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