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首页> 外文期刊>Journal of geriatric psychiatry and neurology >Pain in people with Alzheimer disease: Potential applications for psychophysical and neurophysiological research
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Pain in people with Alzheimer disease: Potential applications for psychophysical and neurophysiological research

机译：阿尔茨海默氏病患者的疼痛：心理生理和神经生理研究的潜在应用

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Pain management in people with dementia is a critical problem. Recently, psychophysical and neuroimaging techniques have been used to extend our understanding of pain processing in the brain as well as to identify structural and functional changes in Alzheimer disease (AD). But interpreting the complex relationship between AD pathology, brain activation, and pain reports is challenging. This review proposes a conceptual framework for designing and interpreting psychophysical and neuroimaging studies of pain processing in people with AD. Previous human studies describe the lateral (sensory) and medial (affective) pain networks. Although the majority of the literature on pain supports the lateral and medial networks, some evidence supports an additional rostral pain network, which is believed to function in the production of pain behaviors. The sensory perception of pain as assessed through verbal report and behavioral display may be altered in AD. In addition, neural circuits mediating pain perception and behavioral expression may be hyperactive or underactive, depending on the brain region involved, stage of the disease, and type of pain (acute experimental stimuli or chronic medical conditions). People with worsening AD may therefore experience pain but be unable to indicate pain through verbal or behavioral reports, leaving them at great risk of experiencing untreated pain. Psychophysical (verbal or behavioral) and neurophysiological (brain activation) approaches can potentially address gaps in our knowledge of pain processing in AD by revealing the relationship between neural processes and verbal and behavioral outcomes in the presence of acute or chronic pain.
机译：痴呆症患者的疼痛管理是一个关键问题。最近，心理物理和神经影像技术已被用于扩展我们对大脑疼痛处理的理解，并确定阿尔茨海默病（AD）的结构和功能变化。但是，要解释AD病理学，大脑激活和疼痛报告之间的复杂关系具有挑战性。这篇综述提出了一个概念框架，用于设计和解释AD患者疼痛处理的心理和神经影像学研究。先前的人体研究描述了外侧（感觉）和内侧（情感）疼痛网络。尽管有关疼痛的大多数文献都支持外侧和内侧网络，但一些证据支持了额外的延髓部疼痛网络，据信其在产生疼痛行为中起作用。通过口头报告和行为表现评估的疼痛感官知觉在AD中可能会改变。此外，取决于所涉及的大脑区域，疾病的阶段和疼痛的类型（急性实验性刺激或慢性医学状况），介导疼痛感知和行为表达的神经回路可能过度活跃或不活跃。因此，AD恶化的人可能会感到疼痛，但无法通过口头或行为报告表明疼痛，从而使他们极有可能遭受未经治疗的疼痛。心理物理（言语或行为）和神经生理学（大脑激活）方法可以通过揭示存在急性或慢性疼痛时神经过程与言语和行为结果之间的关系来解决我们在AD疼痛处理方面的知识空白。

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