Reward and motivation in pain and pain relief.
Reward and motivation in pain and pain relief.
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DOI：
10.1038/nn.3811
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发表时间：
2014-10
影响因子：
25
通讯作者：
Porreca, Frank
中科院分区：
文献类型：
--
作者：
Navratilova, Edita;Porreca, Frank
疼痛从根本上说是令人不快的，这一特征通过促进动机和学习来保护有机体。缓解包括痛苦在内的厌恶状态是有益的。对疼痛的厌恶，以及缓解疼痛的奖励，都是由大脑奖励/动机性中皮质边缘回路编码的。在这篇综述中，我们描述了从临床前模型和人类神经影像学中获得的急性和慢性疼痛对奖励/激励回路的影响的现有知识。我们强调新出现的临床证据表明，这些电路的解剖和功能变化有助于从急性到慢性疼痛的过渡。我们建议，评估这些保守回路的活性可以为镇痛疗效的临床前评价提供新的结果指标，以改善翻译和加快药物发现。我们进一步建议，针对奖励/动机回路可能提供一条路径，使慢性疼痛对大脑的影响正常化，超越症状管理，促进慢性疼痛的恢复。
Pain is fundamentally unpleasant, a feature that protects the organism by promoting motivation and learning. Relief of aversive states, including pain, is rewarding. The aversiveness of pain, as well as the reward from relief of pain, is encoded by brain reward/motivational mesocorticolimbic circuitry. In this Review, we describe current knowledge of the impact of acute and chronic pain on reward/motivation circuits gained from preclinical models and from human neuroimaging. We highlight emerging clinical evidence suggesting that anatomical and functional changes in these circuits contribute to the transition from acute to chronic pain. We propose that assessing activity in these conserved circuits can offer new outcome measures for preclinical evaluation of analgesic efficacy to improve translation and speed drug discovery. We further suggest that targeting reward/motivation circuits may provide a path for normalizing the consequences of chronic pain to the brain, surpassing symptomatic management to promote recovery from chronic pain.
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影响因子：
16.2
作者：
Baliki, Marwan N.;Geha, Paul Y.;Fields, Howard L.;Apkarian, A. Vania
通讯作者：
Apkarian, A. Vania
影响因子：
48
作者：
Dodick, David W.;Goadsby, Peter J.;Grayzel, David S.
通讯作者：
Grayzel, David S.
影响因子：
1.7
作者：
Apkarian AV
通讯作者：
Apkarian AV
DOI：
10.1016/j.jpain.2011.01.010
发表时间：
2011-08
期刊：
The journal of pain
影响因子：
--
作者：
Davoody L;Quiton RL;Lucas JM;Ji Y;Keller A;Masri R
通讯作者：
Masri R
影响因子：
11.2
作者：
DeFelice, Milena;Eyde, Nathan;Dodick, David;Dussor, Gregory O.;Ossipov, Michael H.;Fields, Howard L.;Porreca, Frank
通讯作者：
Porreca, Frank