Chronic pain is a complex neuropsychiatric disorder characterized by sensory, cognitive, and affective symptoms. Over the past 2 decades, researchers have made significant progress toward understanding the impact of mesolimbic dopamine circuitry in acute and chronic pain. These efforts have provided insights into the circuits and intracellular pathways in the brain reward center that are implicated in sensory and affective manifestations of chronic pain. Studies have also identified novel therapeutic targets as well as factors that affect treatment responsiveness. Dysregulation of dopamine function in the brain reward center may further promote comorbid mood disorders and vulnerability to addiction. This review discusses recent clinical and preclinical findings on the neuroanatomical and neurochemical adaptations triggered by prolonged pain states in the brain reward pathway. Furthermore, this discussion highlights evidence of mechanisms underlying comorbidities among pain, depression, and addiction.

中文翻译：

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中脑边缘多巴胺系统在慢性疼痛和相关情感合并症中的作用


慢性疼痛是一种复杂的神经精神疾病，其特征是感觉、认知和情感症状。在过去的二十年里，研究人员在了解中脑边缘多巴胺回路对​​急性和慢性疼痛的影响方面取得了重大进展。这些努力提供了对大脑奖励中心的回路和细胞内通路的见解，这些回路和细胞内通路与慢性疼痛的感觉和情感表现有关。研究还确定了新的治疗靶点以及影响治疗反应的因素。大脑奖励中心的多巴胺功能失调可能会进一步促进共病情绪​​障碍和成瘾的脆弱性。这篇综述讨论了大脑奖赏通路中长期疼痛状态引发的神经解剖学和神经化学适应的最新临床和临床前发现。此外，本次讨论还强调了疼痛、抑郁和成瘾之间的共病机制的证据。