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Association between Chronic Pain and Alterations in the Mesolimbic Dopaminergic System
Brain Sciences ( IF 2.7 ) Pub Date : 2020-10-02 , DOI: 10.3390/brainsci10100701
Seoyon Yang , Mathieu Boudier-Revéret , Yoo Jin Choo , Min Cheol Chang

Chronic pain (pain lasting for >3 months) decreases patient quality of life and even occupational abilities. It can be controlled by treatment, but often persists even after management. To properly control pain, its underlying mechanisms must be determined. This review outlines the role of the mesolimbic dopaminergic system in chronic pain. The mesolimbic system, a neural circuit, delivers dopamine from the ventral tegmental area to neural structures such as the nucleus accumbens, prefrontal cortex, anterior cingulate cortex, and amygdala. It controls executive, affective, and motivational functions. Chronic pain patients suffer from low dopamine production and delivery in this system. The volumes of structures constituting the mesolimbic system are known to be decreased in such patients. Studies on administration of dopaminergic drugs to control chronic pain, with a focus on increasing low dopamine levels in the mesolimbic system, show that it is effective in patients with Parkinson’s disease, restless legs syndrome, fibromyalgia, dry mouth syndrome, lumbar radicular pain, and chronic back pain. However, very few studies have confirmed these effects, and dopaminergic drugs are not commonly used to treat the various diseases causing chronic pain. Thus, further studies are required to determine the effectiveness of such treatment for chronic pain.

中文翻译:

慢性疼痛与中脑边缘多巴胺能系统改变之间的关联

慢性疼痛(持续3个月以上的疼痛)会降低患者的生活质量,甚至降低职业能力。它可以通过治疗来控制,但即使在治疗后也常常持续存在。为了适当地控制疼痛,必须确定其基本机制。这篇综述概述了中脑边缘多巴胺能系统在慢性疼痛中的作用。中脑边缘系统是神经回路,将多巴胺从腹侧被盖区输送到神经结构,例如伏隔核,前额叶皮层,前扣带回皮层和杏仁核。它控制执行,情感和激励功能。慢性疼痛患者在该系统中多巴胺的产生和递送较低。已知在这类患者中构成中脑边缘系统的结构的体积减小。对控制多巴胺能药物以控制慢性疼痛的研究(重点是增加中脑边缘系统中的低多巴胺水平)显示,它对帕金森氏病,腿部躁动综合征,纤维肌痛,口干综合征,腰部神经根性疼痛和慢性背痛。但是,很少有研究证实这些作用,多巴胺能药物并不常用于治疗引起慢性疼痛的各种疾病。因此,需要进一步的研究来确定这种治疗慢性疼痛的有效性。很少有研究证实这些作用,多巴胺能药物并不常用于治疗引起慢性疼痛的各种疾病。因此,需要进一步的研究来确定这种治疗慢性疼痛的有效性。很少有研究证实这些作用,多巴胺能药物并不常用于治疗引起慢性疼痛的各种疾病。因此,需要进一步的研究来确定这种治疗慢性疼痛的有效性。
更新日期:2020-10-02
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