Pain and Memory

Öz

It is increasingly accepted that potential psychological and cognitive disorders related to pain have effects on human health. Pain is a sensory/differential stimulus and can encourage the organism’s need for protection from danger, recovery. It is a multidimensional stimulus that also has motivational and emotional components. Pain pathways represent a complex sensory system with cognitive, emotional and behavioral implications. Common neurotransmitters and similar mechanisms of neural plasticity (e.g., central sensitization, long-term potentiation) suggest a mechanistic overlap between chronic pain and memory. These anatomical and mechanical correlations suggest that chronic pain and memory interact closely at various levels. Neuroimaging studies suggest that spatio-temporal reorganization of brain activity accompanies the transition to chronic pain, in which the representation of pain gradually shifts from sensory structures to emotional and limbic structures. Furthermore, these studies show that psychological and social factors related to pain affect the health and cognitive status of the individual. In addition to the basic neuroscience processes of pain, which is a multidimensional experience, psychosocial factors should also be examined. Biopsychosocial assessment and treatment methods for pain should be applied. In this review, it is aimed to create a general perspective on the connection between pain and memory processes.

Anahtar Kelimeler

• Chronic pain
• memory
• biopsychosocial approach
• neuroplasticity

Ağrı ve Bellek

Öz

Öz Ağrıya bağlı olası psikolojik ve bilişsel bozuklukların insan üzerinde etkileri olduğu giderek daha fazla kabul görmektedir. Ağrı, duyusal/ayırt edici bir uyarıdır ve organizmanın tehlikeden korunma, iyileşme vb. için gerekli eylemleri teşvik edebilmektedir. Aynı zamanda motivasyonel ve duygusal bileşenleri de olan çok boyutlu bir uyarandır. Zararlı bir uyarana verilen yanıtta öğrenme deneyimi sağlayan bilişsel/değerlendirme boyutu yer alır. Öğrenilen ağrı deneyimleri, gelecekteki ağrı deneyimlerinin algılanmasını da etkileyebilmektedir. Ağrı yolları bilişsel, duygusal ve davranışsal etkileri olan kompleks bir duyusal sistemi temsil eder. Yaygın nörotransmitterler ve nöral plastisitenin benzer mekanizmaları (örneğin, merkezi sensitizasyon, uzun süreli güçlenme (long term potentiation), kronik ağrı ve hafıza arasında mekanik bir örtüşme olduğunu düşündürür. Bu anatomik ve mekanik bağıntılar, kronik ağrı ve hafızanın çeşitli seviyelerde yakından etkileşime girdiğini gösterir. Nörogörüntüleme çalışmaları, beyin aktivitesinin uzaysal-zamansal yeniden düzenlenmesinin, ağrının temsilinin yavaş yavaş duyusal yapılardan duygusal ve limbik yapılara kaydığı kronik ağrıya geçişe eşlik ettiğini ileri sürmektedir. Ayrıca bu çalışmalar ağrıya ilişkin psikolojik ve sosyal faktörlerin, bireyin sağlığını, bilişsel durumunu etkilediğini de göstermektedir. Çok boyutlu bir deneyim olan ağrının temel sinirbilim süreçlerinin yanı sıra psikososyal faktörlerinin de incelenerek ağrıya dair biyopsikososyal değerlendirme ve tedavi yöntemlerinin uygulanması ve araştırılması önem arz etmektedir. Bu derlemede bellek süreçleri ile ilişkili olarak ağrıya dair genel bir bakış açısı oluşturmak hedeflenmiştir.

Anahtar Kelimeler

• Kronik ağrı
• bellek
• biyopsikososyal yaklaşım
• nöroplastisite

Kaynakça

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