Post-injury pain and behaviour: a control theory perspective.

Post-injury pain and behaviour: a control theory perspective.
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DOI:
10.1038/s41583-023-00699-5
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发表时间:
2023-06
期刊:
Nature reviews. Neuroscience
影响因子:
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其他
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各种类型的损伤在人类和其他动物的生活中普遍存在,并导致持续疼痛和恢复行为的模式,从而实现安全和有效的康复。在这里,我们提出了一个控制论框架来解释大脑中驱动损伤后生理行为的适应过程。我们提出了一种关于动物如何对伤害做出反应的进化论和行为学观点,说明了与持续性疼痛和休养相关的行为状态在确保生存方面可能与阶段性疼痛一样重要。采用一种规范的方法,我们认为大脑从不同的感觉和生理信号对当前损伤状态进行连续的最佳推断。这驱动了行为动态平衡的各种效应器控制机制,这些机制跨越了对正在进行的动机和感知的调节,以驱动休息和超保护行为。然而,这样做的一个固有问题是,这些保护行为可能在一定程度上掩盖了有关伤害是否已经解决的信息。这种信息限制可能会导致一种异常或持续推断损伤的倾向,从而促进向病理性慢性疼痛状态的转变。
Injuries of various types occur commonly in the lives of humans and other animals, and lead to a pattern of persistent pain and recuperative behaviour that allows safe and effective recovery. Here, we propose a control-theoretic framework to explain the adaptive processes in the brain that drive physiological post-injury behaviour. We set out an evolutionary and ethological view on how animals respond to injury, illustrating how the behavioural state associated with persistent pain and recuperation may be just as important as phasic pain in ensuring survival. Adopting a normative approach, we suggest that the brain implements a continuous optimal inference of the current state of injury from diverse sensory and physiological signals. This drives the various effector control mechanisms of behavioural homeostasis, which span modulation of ongoing motivation and perception to drive rest and hyper-protective behaviours. However, an inherent problem with this is that these protective behaviours may partially obscure information about whether injury has resolved. Such information-restriction may seed a tendency to aberrantly or persistently infer injury, and so promote transition to pathological chronic pain states.
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