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

你的大脑如何应对疼痛？ - Karen D. Davis

Translator: Jessica Ruby Reviewer: Caroline Cristal

翻译人员: Becky Zhao 校对人员: Yiqun Liu

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

假如你要用

十分钟完成这个拼图。

How long would it take

你会用多久完成它？

if you received constant electric shocks to your hands?

如果你的手被电击了呢？

Longer, right?

会用更长的时间是不是？

Because the pain would distract you from the task.

因为痛苦让你从工作中分神。

Well, maybe not;

其实，也许不是；

it depends on how you handle pain.

这取决于你如何控制疼痛。

Some people are distracted by pain.

疼痛使有些人分心，

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

让他们花更长的时间去完成工作，

并让他们做的没有那么好。

Other people use tasks to distract themselves from pain,

另外有一些人通过工作忘记疼痛，

and those people actually do the task

并且他们在疼痛的时候，

faster and better when they're in pain

比没有疼痛的时候，

工作得更快更好。

than when they're not.

Some people can just send their mind wandering

一些人可以转换思维

to distract themselves from pain.

去转移疼痛。

How can different people

为什么不同的人

be subjected to the exact same painful stimulus

在受到相同的疼痛刺激时

and yet experience the pain so differently?

却感受的疼痛程度不同？

And why does this matter?

并且为什么这是有意义的呢？

First of all, what is pain?

首先，什么是疼痛？

Pain is an unpleasant sensory and emotional experience,

疼痛是一个不愉悦的感知和情感经历，

associated with actual or potential tissue damage.

联系到实际的或潜在的肌肉损伤。

Pain is something we experience,

疼痛是我们经历的东西，

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

所以它最接近于你所感受到的。

Pain has an intensity;

疼痛有强度；

you can describe it on a scale

你可以把它用程度表示出来

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

从零级没有疼痛，到十级最疼，

But pain also has a character,

不过疼痛是有特点的，

like sharp, dull, burning, or aching.

比如尖锐的，缓慢的，灼烧的或心痛的。

What exactly creates these perceptions of pain?

到底是什么产生了疼痛的感觉呢？

其实，当你受伤时，

Well, when you get hurt,

special tissue damage-sensing nerve cells,

特定的肌肉疼痛感知神经细胞，

called nociceptors, fire and send signals

也叫伤害感受器，触动并发送信号

to the spinal cord and then up to the brain.

到脊髓再传送到大脑。

Processing work gets done by cells called neurons and glia.

这个过程是由

神经元与神经胶质完成的。

This is your Grey matter.

这就是你的灰质。

And brain superhighways carry information as electrical impulses

并且脑路携带信息

就像电子脉冲一样

from one area to another.

从一个区域到另一个，

This is your white matter.

这就是白质。

The superhighway that carries pain information

这个携带疼痛信息

from the spinal cord to the brain

从神经元到大脑的脑路

is our sensing pathway

是我们的感觉通道

that ends in the cortex,

到皮质层结束，

a part of the brain that decides what to do

脑部的一部分决定如何处理

with the pain signal.

疼痛信号。

Another system of interconnected brain cells

另外一个相互关联的脑细胞系统

called the salience network

叫做巡航网络

decides what to pay attention to.

它决定了需要注意什么。

Since pain can have serious consequences,

因为疼痛可能会有严重的后果，

the pain signal immediately activates the salience network.

疼痛信号立刻激发

巡航网络。

现在，你就会注意疼痛了。

Now, you're paying attention.

The brain also responds to the pain

大脑也会回应疼痛

and has to cope with these pain signals.

并处理这些疼痛信号。

So, motor pathways are activated

因此，运动元神经被激发

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

比如说，让你把手从火炉上移开。

But modulation networks are also activated

不过调整网络也被唤醒

that deliver endorphins and enkephalins,

去传递安多芬和脑啡肽，

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

在你疼痛的时候释放化学物质

或在剧烈运动时，

creating the runner's high.

使运动员保持高水平。

These chemical systems help regulate and reduce pain.

这些化学系统帮助调节并减轻疼痛。

所有这些网络和通路互相作用

All these networks and pathways work together

to create your pain experience,

使你产生疼痛的体验，

to prevent further tissue damage,

减轻肌肉的伤害，

and help you to cope with pain.

并帮助你处理疼痛。

This system is similar for everyone,

每个人的系统都类似，

but the sensitivity and efficacy of these brain circuits

不过大脑循环的敏感度和效率

determines how much you feel and cope with pain.

决定了你对疼痛的感受和如何处理疼痛。

This is why some people have greater pain than others

这就是为什么有些人觉得比别人疼

and why some develop chronic pain

为什么一些人有长期病痛

that does not respond to treatment,

却并没有因治疗好转，

while others respond well.

然而其他人却好了。

Variability in pain sensitivities

疼痛感受的差异性

is not so different than all kinds of variability

没有比各种

in responses to other stimuli.

对刺激的不同反应更多。

Like how some people love roller coasters,

就像一些人酷爱过山车，

but other people suffer from terrible motion sickness.

其他人就觉得那种剧烈移动很难受。

Why does it matter that there is variability

为什么我们疼痛的脑路差异

in our pain brain circuits?

那么重要呢？

Well, there are many treatments for pain,

首先，对于不同的系统，

targeting different systems.

有许多对疼痛的治疗手段。

For mild pain, non-prescription medications

对于轻微的痛苦，非处方药

can act on cells where the pain signals start.

可以作用于导致疼痛的细胞。

Other stronger pain medicines and anesthetics

其他强烈的疼痛药和麻醉剂

work by reducing the activity in pain-sensing circuits

可作用于减轻疼痛感知回路活动

or boosting our coping system, or endorphins.

或者增强处理系统，或脑内啡。

一些人可以

Some people can cope with pain using methods that involve

用一些方法对付疼痛

distraction, relaxation, meditation, yoga,

比如转移注意力，休息，冥想，瑜伽，

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

或一些可以学到的策略，

如认知行为治疗。

对于一些遭受严重慢性疼痛的人，

For some people who suffer from severe chronic pain,

that is pain that doesn't go away

那种疼痛在痊愈几个月后

months after their injury should have healed,

都不会减轻，

none of the regular treatments work.

常规的治疗也都不起作用。

Traditionally, medical science has been about

一般来说，药物研究是

testing treatments on large groups

测试大量人群的结果

to determine what would help a majority of patients.

来判断它是否帮助了大部分的患者。

But this has usually left out

不过确实有些人

some who didn't benefit from the treatment

并没有从治疗中受益

or experienced side effects.

或有副作用。

Now, new treatments that directly stimulate or block

现在，新的治疗手段直接刺激或阻断

certain pain-sensing attention or modulation networks

特定的疼痛意识或调整网络

are being developed,

已经被研究出来，

along with ways to tailor them to individual patients,

它针对于特定的病人，

using tools like magnetic resonance imaging

使用像磁共振成像的工具

to map brain pathways.

来绘制脑路。

研究大脑如何处理疼痛

Figuring out how your brain responds to pain

is the key to finding the best treatment for you.

是找到最好治疗办法的关键。

That's true personalized medicine.

这才是真的私人治疗。