How does your brain respond to pain? - Karen D. Davis

Translator: Jessica Ruby Reviewer: Caroline Cristal

Translator: Alicia Novoa Reviewer: Servizo de Normalización Lingüística

Let's say that it would take you ten minutes to solve this puzzle.

Imaxina que che levase dez minutos resolver este quebracabezas.

How long would it take

Canto che levaría

if you received constant electric shocks to your hands?

se recibises descargas eléctricas constantes nas mans?

Longer, right?

Máis, verdade?

Porque a dor distraeríate da tarefa.

Because the pain would distract you from the task.

Well, maybe not;

Ou ao mellor non;

depende de como xestiones a dor.

it depends on how you handle pain.

Some people are distracted by pain.

Algunhas persoas distráense coa dor.

It takes them longer to complete a task, and they do it less well.

Lévalles máis completar unha tarefa, e fana peor.

Other people use tasks to distract themselves from pain,

Outras usan as tarefas para distraerse da dor,

and those people actually do the task

e esa xente fai a tarefa

faster and better when they're in pain

máis rápido e mellor cando sinte dor

than when they're not.

que cando non.

Some people can just send their mind wandering

Algúns poden deixar a súa mente vagando

to distract themselves from pain.

para distraerse da dor.

How can different people

Como pode algunha xente

be subjected to the exact same painful stimulus

someterse exactamente aos mesmos estímulos dolorosos

and yet experience the pain so differently?

pero experimentar a dor de xeito tan distinto?

And why does this matter?

E por que importa isto?

First of all, what is pain?

Primeiro de todo, que é a dor?

Pain is an unpleasant sensory and emotional experience,

A dor é unha experiencia sensorial e emocional desagradable,

associated with actual or potential tissue damage.

asociada cun dano real ou potencial aos tecidos.

Pain is something we experience,

A dor é algo que experimentamos,

so it's best measured by what you say it is.

así que a mellor maneira de medila é polo que dis que é.

Pain has an intensity;

A dor ten unha intensidade,

you can describe it on a scale

pódela describir nunha escala

from zero, no pain, to ten, the most pain imaginable.

de cero, sen dor, a dez, a maior dor imaxinable.

But pain also has a character,

Pero a dor tamén ten un carácter,

like sharp, dull, burning, or aching.

como punxente, xordo, ardente ou agudo.

What exactly creates these perceptions of pain?

Que é exactamente o que crea estas percepcións da dor?

Cando te fas dano,

Well, when you get hurt,

special tissue damage-sensing nerve cells,

as células nerviosas detectoras do dano nos tecidos,

called nociceptors, fire and send signals

chamadas nociceptores, acéndense e mandan sinais

to the spinal cord and then up to the brain.

á medula espiñal e logo arriba, ao cerebro.

Processing work gets done by cells called neurons and glia.

O traballo de procesamento fano unhas células chamadas neuronas e gliais.

This is your Grey matter.

Esta é a túa materia gris.

And brain superhighways carry information as electrical impulses

E as superestradas do cerebro levan información como impulsos eléctricos

from one area to another.

de unha área a outra.

This is your white matter.

Esta é a túa materia branca.

The superhighway that carries pain information

A superestrada que leva a información da dor

from the spinal cord to the brain

da medula espiñal ao cerebro

is our sensing pathway

é a nosa vía de detección

that ends in the cortex,

que acaba no córtex,

a part of the brain that decides what to do

a parte do cerebro que decide que facer

with the pain signal.

co sinal da dor.

Outro sistema de células cerebrais interconectadas,

Another system of interconnected brain cells

called the salience network

chamada a rede de saliencia,

decides what to pay attention to.

decide a que prestar atención.

Since pain can have serious consequences,

Como a dor pode ter consecuencias serias,

the pain signal immediately activates the salience network.

o sinal da dor activa a rede de saliencia inmediatamente.

Now, you're paying attention.

Ben, agora estás prestando atención.

The brain also responds to the pain

O cerebro tamén responde á dor

and has to cope with these pain signals.

e ten que xestionar estes sinais de dor.

So, motor pathways are activated

Entón, actívanse as vías motoras

to take your hand off a hot stove, for example.

para quitar a man dun fogón quente, por exemplo.

But modulation networks are also activated

Pero as redes de modulación tamén se activan

that deliver endorphins and enkephalins,

e levan endorfinas e encefalinas,

chemicals released when you're in pain or during extreme exercise,

substancias químicas que se liberan cando sentes dor ou fas exercicio intenso

creating the runner's high.

e que crean a euforia do corredor.

These chemical systems help regulate and reduce pain.

Estes sistemas químicos axudan a regular e reducir a dor.

All these networks and pathways work together

Todas estas redes e vías traballan xuntas

to create your pain experience,

para crear a túa experiencia de dor,

to prevent further tissue damage,

para previr máis dano no tecido

and help you to cope with pain.

e axudarche a xestionar a dor.

This system is similar for everyone,

Este sistema é similar para todos,

but the sensitivity and efficacy of these brain circuits

pero a sensibilidade e eficacia destes circuítos cerebrais

determines how much you feel and cope with pain.

determina canto sentes e como te enfrontas á dor.

This is why some people have greater pain than others

Por isto, algunha xente sente máis dor que outra

and why some develop chronic pain

e por que algúns desenvolven dores crónicas

that does not respond to treatment,

que non responden a tratamentos,

while others respond well.

mentres que outros responden ben.

Variability in pain sensitivities

A variabilidade na sensibilidade á dor

is not so different than all kinds of variability

non é tan diferente a todos os tipos de variabilidade

in responses to other stimuli.

en resposta a outros estímulos.

Like how some people love roller coasters,

Ao igual que algúns adoran as montañas rusas

but other people suffer from terrible motion sickness.

pero outros sofren mareos espantosos.

Why does it matter that there is variability

Por que importa que haxa variabilidade

in our pain brain circuits?

nos nosos circuítos cerebrais da dor?

Well, there are many treatments for pain,

Ben, hai moitos tratamentos para a dor,

targeting different systems.

dirixidos a diferentes sistemas.

For mild pain, non-prescription medications

Para a dor media, os medicamentos sen prescrición

can act on cells where the pain signals start.

poden actuar nas células onde comezan os sinais de dor.

Other stronger pain medicines and anesthetics

Outros medicamentos e anestésicos máis fortes

work by reducing the activity in pain-sensing circuits

actúan reducindo a actividade dos circuítos que detectan a dor

or boosting our coping system, or endorphins.

ou estimulando o noso mecanismo de xestión de problemas, ou endorfinas.

Some people can cope with pain using methods that involve

Algunhas persoas poden lidar coa dor con métodos que supoñen

distraction, relaxation, meditation, yoga,

distracción, relaxación, meditación, ioga

or strategies that can be taught, like cognitive behavioral therapy.

ou estratexias que poden ensinarse, como a terapia de conduta cognitiva.

For some people who suffer from severe chronic pain,

Para algunhas persoas que sofren dores crónicas graves,

that is pain that doesn't go away

é dicir, dores que non desaparecen meses despois da lesión,

months after their injury should have healed,

none of the regular treatments work.

os tratamentos habituais non funcionan.

Traditionally, medical science has been about

Tradicionalmente, a ciencia médica consistía

testing treatments on large groups

en probar tratamentos en grupos grandes

to determine what would help a majority of patients.

para determinar que ía axudar á maioría dos pacientes.

But this has usually left out

Pero iso adoitaba deixar fóra a quen non melloraba co tratamento

some who didn't benefit from the treatment

or experienced side effects.

ou experimentaba efectos secundarios.

Now, new treatments that directly stimulate or block

Agora estanse a crear tratamentos novos que estimulan ou bloquean directamente

certain pain-sensing attention or modulation networks

algúns detectores da dor ou redes de modulación,

are being developed,

along with ways to tailor them to individual patients,

así como maneiras de adaptalos a cada paciente

using tools like magnetic resonance imaging

usando ferramentas como a resonancia magnética

to map brain pathways.

para facer mapas das vías cerebrais.

Figuring out how your brain responds to pain

Descubrir como responde á dor o teu cerebro

is the key to finding the best treatment for you.

é fundamental para atopar o mellor tratamento para ti.

That's true personalized medicine.

Esa é a verdadeira medicina personalizada.