疼痛发展认知神经科学:研究现状与未来趋势

Developmental cognitive neuroscience of pain:present and future

疼痛认知神经科学在过去几十年间经历了高速发展,但多数研究的对象局限于中青年成人,对年龄差异的考虑不够充分.为加深对儿童和老年人疼痛加工机制的理解并开发有针对性的疼痛治疗方法,有必要弥补这一不足.从毕生发展的角度看,疼痛评估的准确性和治疗的有效性受特定年龄群体生理和心理特征的影响,因而儿童和老年人的疼痛评估和治疗需要采取有针对性的方法,不能简单推广基于中青年成人的研究成果.未来的研究将更加强调新兴技术在疼痛毕生发展领域的应用,采取多维度的整合性研究视角,着力研发针对不同年龄群体的非成瘾性镇痛方法,并大力推广开放的科学研究文化.考虑到我国的研究现状、现实需求和独特优势,建议我国未来在疼痛毕生发展领域致力于:(ⅰ)开发可靠的疼痛特异性客观指标;(ⅱ)建立大规模、多尺度的疼痛毕生发展数据库;(ⅲ)探明年龄及心理因素对慢性疼痛发生、发展和维持的影响;(ⅳ)开发针对不同年龄群体的高效非成瘾性疼痛治疗方法,推动基础研究成果的临床转化.

Past several decades have witnessed a booming research field of cognitive neuroscience of pain,yet the majority of such studies include young adult participants only,largely ignoring the age differences.The field needs to fill the gap and provide more comprehensive understanding on how pain is processed in the brain of the young and the elderly,and how pain can be successfully managed for different age groups.Importantly,the developmental perspective gives the invaluable insight that psychological and physiological characteristics of different age groups influence the validity of pain assessment and the efficacy of pain treatment,thus necessitating different pain measures and treatments for children,adolescents,adults,and the elderly.Future studies will exploit emerging innovative and advanced technologies,fully appreciate the multidimensional nature of pain,develop age-specific nonaddictive pain treatment,and ensure transparency and openness in developmental pain research.Considering the current situation of the field in our country,we shall focus on four promising research projects in the future:(i)to develop reliable and valid objective pain measures;(ii)to establish a large-scale and comprehensive database on pain development;(iii)to untangle the role of age and psychological factors in the development and maintenance of chronic pain;(iv)to develop effective and safe pain management strategies for different age groups and promote clinical translation of basic research.