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

Kako vaš mozak reaguje na bol? - Karen D. Dejvis (Karen D. Davis)

Translator: Jessica Ruby Reviewer: Caroline Cristal

Prevodilac: Tijana Mihajlović Lektor: Mile Živković

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

Recimo da će vam trebati deset minuta da rešite ovu zagonetku.

How long would it take

Koliko bi to trajalo

if you received constant electric shocks to your hands?

ako biste konstantno dobijali elektrošokove po rukama?

Longer, right?

Duže, zar ne,

Because the pain would distract you from the task.

jer bi vam bol odvraćao pažnju sa zadatka.

Well, maybe not;

Pa, možda i ne;

it depends on how you handle pain.

sve zavisi od toga kako se nosite sa bolom.

Some people are distracted by pain.

Neke ljude bol ometa.

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

Treba im više vremena da završe zadatak, a rade ga gore.

Other people use tasks to distract themselves from pain,

Drugi ljudi koriste zadatke da odvrate pažnju sa bola,

and those people actually do the task

a oni rade na zadatku

faster and better when they're in pain

brže i bolje dok trpe bol

than when they're not.

nego kada ih ništa ne boli.

Some people can just send their mind wandering

Neki ljudi mogu da odlutaju mislima

to distract themselves from pain.

da bi odvratili pažnju sa bola.

How can different people

Kako različiti ljudi mogu

be subjected to the exact same painful stimulus

da se podvrgnu potpuno istom bolnom nadražaju,

and yet experience the pain so differently?

a da ipak doživljavaju bol toliko drugačije

And why does this matter?

i zašto je ovo važno?

First of all, what is pain?

Kao prvo - šta je bol?

Pain is an unpleasant sensory and emotional experience,

Bol je neprijatno čulno i emocionalno iskustvo

associated with actual or potential tissue damage.

vezano za stvarno ili potencijalno oštećenje tkiva.

Pain is something we experience,

Bol je nešto što doživljavamo,

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

pa ga je najbolje meriti ga prema onome što vi kažete da jeste.

Pain has an intensity;

Bol ima intenzitet;

you can describe it on a scale

možete ga opisati na skali

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

od nule - bez bola, do deset - najveća moguća bol.

But pain also has a character,

Bol, međutim, ima i karakter,

like sharp, dull, burning, or aching.

kao što je oštar, tup, gorući ili kuckajući.

What exactly creates these perceptions of pain?

Šta tačno stvara ovu percepciju bola?

Well, when you get hurt,

Pa, kada se povredite,

special tissue damage-sensing nerve cells,

posebne nervne ćelije koje osećaju oštećenja tkiva

called nociceptors, fire and send signals

pod nazivom nociceptori, aktiviraju se i šalju signale

to the spinal cord and then up to the brain.

u kičmenu moždinu, a zatim i u mozak.

Processing work gets done by cells called neurons and glia.

Obrađivanje podataka odrađuju ćelije pod nazivom neuroni i glije.

This is your Grey matter.

To je vaša siva materija,

And brain superhighways carry information as electrical impulses

a moždani putevi prenose informacije kao električne impulse

from one area to another.

iz jednog područja u drugo.

This is your white matter.

To je vaša bela materija.

The superhighway that carries pain information

Put koji prenosi informacije o bolu

from the spinal cord to the brain

od kičmene moždine do mozga

is our sensing pathway

je naš senzorni put

that ends in the cortex,

koji se završava u korteksu,

a part of the brain that decides what to do

delu mozga koji odlučuje šta da radi

with the pain signal.

sa signalom bola.

Još jedan sistem međusobno povezanih moždanih ćelija

Another system of interconnected brain cells

called the salience network

pod nazivom mreža upadljivosti,

decides what to pay attention to.

odlučuje na šta obratiti pažnju.

Since pain can have serious consequences,

Pošto bol može imati ozbiljne posledice,

the pain signal immediately activates the salience network.

signal bola momentalno aktivira mrežu upadljivosti.

Now, you're paying attention.

Sada obraćate pažnju.

The brain also responds to the pain

Mozak takođe reaguje na bol

and has to cope with these pain signals.

i mora da se nosi sa signalima bola.

So, motor pathways are activated

Tako se motorni putevi aktiviraju

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

da vam sklone ruku sa vrele ringle, na primer.

But modulation networks are also activated

Međutim, aktiviraju se i modulacione mreže

that deliver endorphins and enkephalins,

koje isporučuju endorfine i enkefaline,

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

hemikalije koje se oslobađaju kada trpite bol

ili tokom zahtevnog vežbanja,

creating the runner's high.

stvarajući sportsku euforiju.

These chemical systems help regulate and reduce pain.

Ovaj hemijski sistem reguliše i smanjuje bol.

All these networks and pathways work together

Sve ove mreže i putevi rade zajedno na stvaranju

to create your pain experience,

doživljaja bola,

to prevent further tissue damage,

kako bi sprečile oštećenje tkiva

and help you to cope with pain.

i da bi vam pomogle da se nosite sa bolom.

This system is similar for everyone,

Ovaj sistem je sličan za sve,

but the sensitivity and efficacy of these brain circuits

ali osetljivost i efikasnost ovih moždanih kola

determines how much you feel and cope with pain.

određuje koliko osećate i kako se nosite sa bolom.

This is why some people have greater pain than others

Zbog ovoga neki ljudi osećaju više bola

and why some develop chronic pain

i zašto neki razviju hroničan bol

that does not respond to treatment,

koji ne reaguje na tretman,

while others respond well.

dok drugi dobro reguju.

Variability in pain sensitivities

Razlika u osećanju bola

is not so different than all kinds of variability

nije mnogo drugačija od drugih razlika

in responses to other stimuli.

kada se reaguje na nadražaje.

Like how some people love roller coasters,

Slično tome je da neki ljudi vole rolerkostere,

but other people suffer from terrible motion sickness.

dok drugi osećaju strašnu mučninu.

Why does it matter that there is variability

Zašto je postojanje razlika

in our pain brain circuits?

u našim moždanim kolima važno?

Well, there are many treatments for pain,

Pa, postoje mnogi tretmani za umanjivanje bola

targeting different systems.

koji ciljaju različite sisteme.

For mild pain, non-prescription medications

Za blagi bol, lekovi koji se uzimaju bez recepta

can act on cells where the pain signals start.

mogu da deluju na ćelije gde započinju signali bola.

Other stronger pain medicines and anesthetics

Drugi jaki medicinski lekovi i anestetici

work by reducing the activity in pain-sensing circuits

deluju tako što smanjuju aktivnost senzornih moždanih kola za bol

or boosting our coping system, or endorphins.

ili povećavaju naš odbrambeni sistem, ili endorfine.

Some people can cope with pain using methods that involve

Neki ljudi se nose sa bolom kroz korišćenje metoda

distraction, relaxation, meditation, yoga,

koje uključuju skretanje pažnje, relaksaciju, meditaciju, jogu,

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

ili strategije koje se mogu naučiti,

kao što je kognitivna bihevioristička terapija.

For some people who suffer from severe chronic pain,

Za neke ljude koji pate od ozbiljnog hroničnog bola,

that is pain that doesn't go away

a to je bol koji ne nestaje

months after their injury should have healed,

mesecima pošto bi povreda trebalo da zaraste,

none of the regular treatments work.

a nijedno od regularnih lečenja ne pomaže.

Traditionally, medical science has been about

Tradicionalno, medicina se bavila

testing treatments on large groups

testiranjem lečenja na velikim grupama

to determine what would help a majority of patients.

kako bi odredila šta bi moglo pomoći većini pacijenata.

But this has usually left out

Međutim, ovo je zapravo izostavljalo

some who didn't benefit from the treatment

neke ljude koji nisu imali koristi od lečenja

or experienced side effects.

ili koji su iskusili nuspojave.

Now, new treatments that directly stimulate or block

Novi tretmani koji direktno stimulišu ili blokiraju

certain pain-sensing attention or modulation networks

neke mreže obraćanja pažnje na bol ili modulacione mreže

are being developed,

su se razvili,

along with ways to tailor them to individual patients,

zajedno sa načinima da se prilagode pojedinačnim pacijentima,

koristeći sredstva kao što je

using tools like magnetic resonance imaging

vizualizacija kroz korišćenje magnetne rezonance

to map brain pathways.

da bi se mapirali moždani putevi.

Figuring out how your brain responds to pain

Razumevanje kako vaš mozak reaguje na bol

is the key to finding the best treatment for you.

je ključ za pronalaženje najboljeg lečenja za vas.

That's true personalized medicine.

To je prava personalizovana medicina.