Behavioral neuroscience of human pain communication: The meaning of pain expression and vicarious pain responses

达尔文的遗产包括详细描述了用于交流情感的可靠行为模式，并提出这种反应为社会物种提供了独特的适应优势。在这种情况下，疼痛的沟通构成了一个基本的过程，可能至少有两个不同的功能。首先，疼痛表达信号在旁观者的直接环境中的潜在威胁（即替代性疼痛信号），并且可以允许他们预测和预期潜在的伤害，防止和避免自我暴露于伤害感受源，和/或触发或促进自我防御或保护反应以降低伤害的风险或程度。疼痛交流的第二个功能涉及引起关心的行为，其必然假设是，这些行为可能会降低进一步伤害的风险和/或表达疼痛的人的痛苦。基于通信模型，可以区分这一过程中的三个阶段，反映了编码或“作为行动的通信”，解码或“作为互动的通信”，以及随后的社会监管过程或“作为交易的通信”。在神经心理学术语中，编码涉及激活由疼痛事件触发的疼痛表征，并在包括面部表情在内的各种输出通道中表达或“编码”。解码需要感知替代性疼痛信号，并且被认为涉及观察者对伤害性事件和相应疼痛状态的部分共享神经/心理表征的激活。最后，交互作用反映了信息交换对观察者和表达者的神经生理和心理状态的潜在影响。在这里，我们建议探索这三个阶段的疼痛通信的神经机制，在健康人的实验方法，心理生理学和功能脑成像。

Darwin's legacy includes a detailed description of the reliable behavioral patterns produced to communicate emotions and the proposal that such responses provide unique adaptive advantages to social species. In this context, the communication of pain constitutes a fundamental process that may have at least two distinct functions. First, pain expression signals potential threats in the immediate environment of the bystanders (i.e. vicarious pain signals) and may allow them to predict and anticipate potential harm, prevent and avoid self-exposure to the source of nociception, and/or trigger or facilitate self-defensive or protective responses to reduce the risk or the extent of injury. The second function of pain communication concerns the elicitation of solicitous behaviours with the corollary assumption that these may reduce the risk of further injury and/or the suffering of the person expressing pain. Based on communication models one can distinguish three phases in this process reflecting the encoding or « communication as action », decoding or « communication as interaction », and the ensuing social regulatory processes or « communication as transaction ». In neuropsychological terms, encoding involves the activation of a representation of pain triggered by a painful event and expressed or « encoded » in various output channels including facial expression. Decoding requires the perception of vicarious pain signals and is thought to involve the activation in the observer of a partly shared neural/mental representation of the nociceptive event and the corresponding pain state. Finally, transaction reflects the potential impact of the information exchanged on the observer and the expresser's neurophysiological and psychological state. Here, we propose to explore the neural mechanisms underlying these three stages of pain communication using experimental approaches, psychophysiology and functional brain imaging in healthy human.