突触重塑在慢性疼痛共患焦虑障碍中的作用

Role of the synaptic plasticity in chronic pain comorbidity anxiety disorder

慢性疼痛患者常合并焦虑障碍,两者在一定程度上促进彼此疾病进程的发展,严重影响患者的生活质量,但是调控二者间的共患病机制尚未阐明。突触重塑即突触结构和功能发生改变,进而影响神经元之间的信号传递。突触重塑是慢性疼痛和焦虑障碍研究领域的热点,但其在慢性疼痛共患焦虑障碍中的病理变化研究较少。本文将近年来的相关研究进行总结后发现,慢性疼痛共患焦虑障碍的发生与大脑区域内突触结构、突触传递效能及突触功能改变密切相关。突触重塑通过离子型氨基酸受体,神经元传递以及神经元和神经胶质细胞间的相互作用,导致中枢疼痛调节能力下降,加重慢性疼痛伴发焦虑发生。了解慢性疼痛与焦虑障碍共患病机制的最新进展,有助于为其治疗提供理论依据和潜在的新靶点。

Chronic pain patients are often accompanied with anxiety disorder,which promote the development of each other's disease process to a certain extent and seriously affect the quality of life of patients.However,the mechanism regulating the comorbidity between the two has not been clarified.Synaptic remodeling is the alteration of synaptic structure and function,which affects the transmission of signals between neurons.Synaptic remodeling is a hot topic in the field of chronic pain and anxiety disorders,but only few studies have explored its pathological changes in chronic pain and anxiety disorders.By summarizing the relevant researches in recent years,the occurrence of chronic pain co-anxiety disorder is closely related to changes in synaptic structure,synaptic transmission efficiency and synaptic function in brain regions.Synaptic remodeling could lead to the decline of centra pain regulation ability and aggravate the progression of chronic pain accompanied by anxiety disorder through ionic amino acid receptors,neuronal transmission and interactions between neurons and glial cells.Understanding the latest research progress of the co-morbidity mechanism of chronic pain and anxiety disorder is helpful to provide theoretical basis and potential new targets for its treatment.