Cerebral interactions of pain and reward and their relevance for chronic pain
- 作者：Susanne Becker ; Wiebke Gandhi ; Petra Schweinhardt ; petra.schweinhardt@mcgill.ca
- 关键词：Pain&ndash ; reward interaction ; Dopamine ; Opioids ; Pain relief ; Orbitofrontal cortex ; Ventral striatum
- 刊名：Neuroscience Letters
- 出版年：2012
- 期刊代码：52_03043940
- 类别：neu
- 出版时间：29 June, 2012
- 卷：520
- 期：2
- 页码：182-187
- 文件大小：269 K
摘要
Pain and reward are opponent, interacting processes. Such interactions are enabled by neuroanatomical and neurochemical overlaps of brain systems that process pain and reward. Cerebral processing of hedonic (鈥榣iking鈥? and motivational (鈥榳anting鈥? aspects of reward can be separated: the orbitofrontal cortex and opioids play an important role for the hedonic experience, and the ventral striatum and dopamine predominantly process motivation for reward. Supported by neuroimaging studies, we present here the hypothesis that the orbitofrontal cortex and opioids are responsible for pain modulation by hedonic experience, while the ventral striatum and dopamine mediate motivational effects on pain. A rewarding stimulus that appears to be particularly important in the context of pain is pain relief. Further, reward, including pain relief, leads to operant learning, which can affect pain sensitivity. Indirect evidence points at brain mechanisms that might underlie pain relief as a reward and related operant learning but studies are scarce. Investigating the cerebral systems underlying pain-reward interactions as well as related operant learning holds the potential of better understanding mechanisms that contribute to the development and maintenance of chronic pain, as detailed in the last section of this review.