Consilium MedicumConsilium MedicumConsilium MedicumConsilium Medicum2075-17532542-2170Consilium Medicum9486410.26442/2075-1753_19.9.37-43ArticlesСтатьиReview ArticleSystemic psychoneurology and pain syndromesСистемная психоневрология и болевые синдромыDamulinI. VДамулинИгорь Владимирович

д-р мед. наук, проф. каф. нервных болезней и нейрохирургии; вед. науч. сотр.

damulin@mmascience.ruI.M.Sechenov First Moscow State Medical University of the Ministry of Health of the Russian FederationФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М.Сеченова» Минздрава РоссииMoscow Clinical Science-Research Center of the Department of Health of MoscowГБУЗ «Московский клинический научно-практический центр» Департамента здравоохранения г. Москвы15092017199VOL 19, NO9 (2017)ТОМ 19, №9 (2017)374328122021Copyright ©; 2017, Consilium MedicumCopyright ©; 2017, ООО "Консилиум Медикум"2017Consilium MedicumООО "Консилиум Медикум"https://creativecommons.org/licenses/by-nc-sa/4.0https://consilium.orscience.ru/2075-1753/article/view/94864

In the article review, modern data on the pathogenesis of pain are analyzed. With the help of functional neuroimaging it was shown that in response to nociceptive stimuli, there is a more extensive activation of the cerebral connections than was previously thought. Also, the importance of functional connections ensuring the integration coordination of activation of brain structures was demonstrated. In this process, during the sensation of pain, spontaneous cerebral oscillations and changes in the function of attention play a large role. The process of chronic pain is associated with changes in neural connections, their dynamics. At the same time, the changes in the emotional sphere, and cognitive reactions, also have significance. Changes in the headache of different genesis (migraine, cluster, abusus headache, tension headache), as well as with back pain, are considered in detail. It is concluded that the data obtained open up new opportunities for the development of methods of influence that can reduce or completely get rid of the pain of different genesis.

В обзорной статье анализируются современные данные о патогенезе боли. При помощи функциональной нейровизуализации было показано, что в ответ на ноцицептивные стимулы происходит более обширная активация церебральных связей, чем это считалось ранее. Также была продемонстрирована и важность функциональных связей, обеспечивающих интеграционную координацию активации структур головного мозга. При этом в процессе ощущения боли играют большую роль спонтанные церебральные осцилляции и изменения функции внимания. Процесс хронификации боли связан с изменениями нейрональных связей, их динамикой. При этом имеют значение и изменения в эмоциональной сфере, и когнитивные реакции. Детально рассматриваются изменения при головной боли разного генеза (мигрень, кластерная, абузусная головная боль, головная боль напряжения), а также при болях в спине. Делается вывод о том, что полученные данные открывают новые возможности для разработки методов воздействия, способных уменьшить или совсем избавиться от боли разного генеза.

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