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你有耳鸣?或(多年不治的)慢性疼痛?(更新版)

已有 942 次阅读 2022-6-7 08:06 |个人分类:Health & Health-Care System|系统分类:科普集锦


耳鸣和慢性疼痛与大脑异常有关!

我曾经写过一篇博客

《有意识头脑与无意识头脑:心身疾病的流行》

 

开场白:如果你有背痛、腰疼、腿痛,而且多年不治。也许,你应该看看这本书。(我周围不少朋友有各种各样的病痛,我自己患有“功能性神经紊乱”。这是我推荐这本书的原因。)

 

想看全文的点开下面的链接。

 

https://blog.sciencenet.cn/blog-306792-1321862.html


 

前几天,不小心听了TED talk。

Tinnitus: Ringing in the Brain 

by Josef Rauschecker 

at TEDxCharlottesville



我非常想把演讲稿复制下来,和大家分享。但是,我当时没有办法复制全文。然后,我就上网找、找、找。感觉下面的这个报道还不错。借用机器翻译成中文。



NEUROSCIENTISTS UNCOVER BRAIN ABNORMALITIES RESPONSIBLE FOR TINNITUS AND CHRONIC PAIN

神经科学家发现导致耳鸣和慢性疼痛的大脑异常


https://neuro.georgetown.edu/rauschecker-abnormalities-tinnitus/


 

SEPTEMBER 23, 2015—Neuroscientists at Georgetown University Medical Center and Germany’s Technische Universität München have uncovered the brain malady responsible for tinnitus and for chronic pain — the uncomfortable, sometimes agonizing sensations that persist long after an initial injury.

乔治城大学医学中心和德国慕尼黑工业大学的神经科学家发现了导致耳鸣和慢性疼痛的脑部疾病——这种不舒服的、有时是痛苦的感觉在初次受伤后仍会持续很长时间。

 

In the October issue of Trends in Cognitive Sciences, researchers say identifying the problem is the first step to developing effective therapies for these disorders, which afflict millions of people. None now exist.

在 10 月份的《认知科学趋势》,研究人员表示,找出问题是为这些困扰着数百万人的疾病开发有效疗法的第一步。 现在没有任何有效治疗法。



The scientists describe how the neural mechanisms that normally “gate” or control noise and pain signals can become dysfunctional, leading to a chronic perception of these sensations. They traced the flow of these signals through the brain and showed where “circuit breakers” should be working — but aren’t.

科学家们描述了通常“门控”或控制噪音和疼痛信号的神经机制如何变得功能失调,导致对这些感觉的长期【过分】感知。 他们追踪了这些信号在大脑中的流动,并显示了“断路器”应该在哪里工作––但“断路器”没有起作用。

 

In both disorders, the brain has been reorganized in response to an injury in its sensory apparatus, says Josef Rauschecker, PhD, DSc, director of the Laboratory for Integrative Neuroscience and Cognition at GUMC. Tinnitus can occur after the ears are damaged by loud noise, but even after the brain reorganizes itself, it continues to “hear” a constant hum or drum. Chronic pain can occur from an injury that often is healed on the outside but persists inside the brain.

GUMC 综合神经科学与认知实验室主任 Josef Rauschecker 博士说,在这两种疾病中,大脑都因感觉器官损伤而进行了重组。 耳鸣可能发生在耳朵被巨响损坏后,但即使在大脑自我重组后,它仍会继续“听到”持续不断的嗡嗡声或鼓声。 慢性疼痛可能是由通常在外部愈合但在大脑内部持续存在的损伤引起的。



“Some people call these phantom sensations, but they are real, produced by a brain that continues to ‘feel’ the initial injury because it cannot down-regulate the sensations enough,” he says. “Both conditions are extraordinarily common, yet no treatment gets to the root of these disorders.”

“有些人将这些称为幻觉感觉,但它们是真实的,由继续‘感觉’最初伤害的大脑产生,因为它不能足够地下调感觉,”他说。 “这两种情况都非常普遍,但没有任何治疗方法可以根除这些疾病的根源。”



Areas of the brain responsible for these errant sensations are the nucleus accumbens, the reward and learning center, and several areas that serve “executive” or administrative roles —the ventromedial prefrontal cortex (VNPFC) and the anterior cingulate cortex.

负责这些错误感觉的大脑区域是伏隔核,即奖励和学习中心,以及几个充当“执行”或行政角色的区域––腹内侧前额叶皮层 (VNPFC) 和前扣带皮层。



All of these areas are also important for evaluating and modulating emotional experiences, Rauschecker says. “These areas act as a central gatekeeping system for perceptual sensations, which evaluate the affective meaning of sensory stimuli — whether produced externally or internally — and modulates information flow in the brain. Tinnitus and chronic pain occur when this system is compromised.”

Rauschecker 说,所有这些领域对于评估和调节情绪体验也很重要。 “这些区域充当感知感觉的中央把关系统,它评估感觉刺激的情感意义––无论是外部产生还是内部产生––并调节大脑中的信息流。 当这个系统受到损害时,就会出现耳鸣和慢性疼痛。”



Other issues often arise in “lockstep” with tinnitus and/or chronic pain, such as depression and anxiety, which are also modulated by the nucleus accumbens, he says. Uncontrollable or long-term stress is another important factor.

他说,其他问题通常与耳鸣和/或慢性疼痛“同步”出现,例如抑郁和焦虑,这些问题也受到伏隔核的调节。 无法控制的或长期的压力是另一个重要因素。



Ironically, the brain plasticity that produces some of these changes provides hope that this gatekeeping role can be restored, Rauschecker says. Because these systems rely on transmission of dopamine and serotonin between neurons, drugs that modulate dopamine may help restore sensory gating, he says.

Rauschecker 说,具有讽刺意味的是,产生其中一些变化的大脑可塑性为恢复这种把关角色提供了希望。 他说,因为这些系统依赖于神经元之间的多巴胺和血清素传递,调节多巴胺的药物可能有助于恢复感觉门控。



“Better understanding could also lead to standardized assessment of individuals’ risk to develop chronic tinnitus and chronic pain, which in turn might allow for earlier and more targeted treatment,” adds Markus Ploner, MD, PhD, a consultant neurologist and Heisenberg Professor of Human Pain Research at the Technische Universität München (TUM).

“更好的理解还可以导致对个人患慢性耳鸣和慢性疼痛的风险进行标准化评估,这反过来可能允许更早和更有针对性的治疗,” 医学博士Markus Ploner医生补充道。他是顾问神经学家和慕尼黑工业大学 (TUM) 的人类学疼痛研究所的海森堡教授。



Rauschecker, an expert in tinnitus, collaborated with Ploner, who studies chronic pain, during his senior fellowship at the Institute of Advanced Study at TUM. Co-authors include Audrey Maudoux, MD, PhD, from GUMC and Elisabeth May, PhD, from TUM.

耳鸣专家 Rauschecker 在 TUM 高级研究所担任高级研究员期间与研究慢性疼痛的Ploner 合作。合著者包括来自 GUMC 的医学博士 Audrey Maudoux 医生和来自 TUM 的 Elisabeth May 博士。

 

The National Institutes of Health (RC1-DC010720), the American Tinnitus Association, the Skirball Foundation, the Tinnitus Research Initiative and the Tinnitus Research Consortium have supported tinnitus research in the Rauschecker lab.

美国国立卫生研究院 (RC1-DC010720)、美国耳鸣协会、Skirball 基金会、耳鸣研究计划和耳鸣研究联盟支持 Rauschecker 实验室的耳鸣研究。




https://blog.sciencenet.cn/blog-306792-1341885.html

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