原发性痛经的脑神经机制:来自神经影像与动物模型研究的证据

The neural basis underlying primary dysmenorrhea:evidence from neuroimaging and animal model studies

原发性痛经(primary dysmenorrhea,PDM)是指育龄女性在无明显器质性病变的情况下出现的痉挛性月经期疼痛,具有急性、慢性疼痛双重特点。PDM严重影响患者的生活质量并导致社会经济的损失,PDM普遍没有得到根治,患者日后常罹患其它慢性疼痛。PDM的临床治疗现状、流行病学上PDM与慢性疼痛的共病,以及PDM患者表现出的异常生理和心理特征都表明PDM不仅与子宫周围的炎症有关,也可能与患者中枢系统疼痛加工调节功能异常相关。因此,探究PDM的脑神经机制是理解疾病病理学过程不可或缺的重要内容,也是近年来脑科学研究的热点。相关研究为探寻干预PDM的靶点带来新的启发。本文立足于PDM脑神经机制研究进展,系统归纳了来自神经影像与动物模型研究的证据。

Primary dysmenorrhea(PDM),cyclic menstrual pain in the absence of pelvic anomalies,is characterized by acute and chronic gynecological pain disorders in childbearing age women.PDM strongly affects the quality of life of patients and leads to economic losses.PDM generally do not receive radical treatment and often develop into other chronic pain disorders later in life.The clinical treatment status of PDM,the epidemiology of PDM and chronic pain comorbidities,and the abnormal physiological and psychological characteristics of patients with PDM suggest that PDM not only is related to the inflammation around the uterus,but also may be related to the abnormal pain processing and regulation function of patients' central system.Therefore,exploring the brain neural mechanism of PDM is indispensable and important to understand the pathological mechanism of PDM,and is also a hotspot of brain science research in recent years,which will bring new inspiration to explore the target of PDM intervention.Based on the progress of the neural mechanism of PDM,this paper systematically summarizes the evidence from neuroimaging and animal model studies.