中英文稿

假如你要用?十分鐘完成這個(gè)拼圖。?你會(huì)用多久完成它？?如果你的手被電擊了呢？?會(huì)用更長(zhǎng)的時(shí)間是不是？?因?yàn)橥纯嘧屇銖墓ぷ髦蟹稚瘛?其實(shí)，也許不是；?這取決于你如何控制疼痛。?疼痛使有些人分心，?讓他們花更長(zhǎng)的時(shí)間去完成工作，?并讓他們做的沒有那么好。?另外有一些人通過工作忘記疼痛，?并且他們?cè)谔弁吹臅r(shí)候，?比沒有疼痛的時(shí)候，?工作得更快更好。?一些人可以轉(zhuǎn)換思維?去轉(zhuǎn)移疼痛。?為什么不同的人?在受到相同的疼痛刺激時(shí)?卻感受的疼痛程度不同？?并且為什么這是有意義的呢？?

首先，什么是疼痛？?疼痛是一個(gè)不愉悅的感知和情感經(jīng)歷，?聯(lián)系到實(shí)際的或潛在的肌肉損傷。?疼痛是我們經(jīng)歷的東西，?所以它最接近于你所感受到的。?疼痛有強(qiáng)度；?你可以把它用程度表示出來?從零級(jí)沒有疼痛，到十級(jí)最疼，?不過疼痛是有特點(diǎn)的，?比如尖銳的，緩慢的，灼燒的或心痛的。?到底是什么產(chǎn)生了疼痛的感覺呢？?其實(shí)，當(dāng)你受傷時(shí)，?特定的肌肉疼痛感知神經(jīng)細(xì)胞，?也叫傷害感受器，觸動(dòng)并發(fā)送信號(hào)?到脊髓再傳送到大腦。?這個(gè)過程是由?神經(jīng)元與神經(jīng)膠質(zhì)完成的。?這就是你的灰質(zhì)。?并且腦路攜帶信息?就像電子脈沖一樣?從一個(gè)區(qū)域到另一個(gè)，?這就是白質(zhì)。?這個(gè)攜帶疼痛信息?從神經(jīng)元到大腦的腦路?是我們的感覺通道?到皮質(zhì)層結(jié)束，?腦部的一部分決定如何處理?疼痛信號(hào)。?另外一個(gè)相互關(guān)聯(lián)的腦細(xì)胞系統(tǒng)?叫做巡航網(wǎng)絡(luò)?它決定了需要注意什么。?因?yàn)樘弁纯赡軙?huì)有嚴(yán)重的后果，?疼痛信號(hào)立刻激發(fā)?巡航網(wǎng)絡(luò)。?現(xiàn)在，你就會(huì)注意疼痛了。?大腦也會(huì)回應(yīng)疼痛?并處理這些疼痛信號(hào)。?因此，運(yùn)動(dòng)元神經(jīng)被激發(fā)?比如說，讓你把手從火爐上移開。?不過調(diào)整網(wǎng)絡(luò)也被喚醒?去傳遞安多芬和腦啡肽，?在你疼痛的時(shí)候釋放化學(xué)物質(zhì)?或在劇烈運(yùn)動(dòng)時(shí)，?使運(yùn)動(dòng)員保持高水平。?這些化學(xué)系統(tǒng)幫助調(diào)節(jié)并減輕疼痛。?所有這些網(wǎng)絡(luò)和通路互相作用?使你產(chǎn)生疼痛的體驗(yàn)，?減輕肌肉的傷害，?并幫助你處理疼痛。

?每個(gè)人的系統(tǒng)都類似，?不過大腦循環(huán)的敏感度和效率?決定了你對(duì)疼痛的感受和如何處理疼痛。?這就是為什么有些人覺得比別人疼?為什么一些人有長(zhǎng)期病痛?卻并沒有因治療好轉(zhuǎn)，?然而其他人卻好了。?疼痛感受的差異性?沒有比各種?對(duì)刺激的不同反應(yīng)更多。?就像一些人酷愛過山車，?其他人就覺得那種劇烈移動(dòng)很難受。?為什么我們疼痛的腦路差異?那么重要呢？?首先，對(duì)于不同的系統(tǒng)，?有許多對(duì)疼痛的治療手段。?對(duì)于輕微的痛苦，非處方藥?可以作用于導(dǎo)致疼痛的細(xì)胞。?其他強(qiáng)烈的疼痛藥和麻醉劑?可作用于減輕疼痛感知回路活動(dòng)?或者增強(qiáng)處理系統(tǒng)，或腦內(nèi)啡。?一些人可以?用一些方法對(duì)付疼痛?比如轉(zhuǎn)移注意力，休息，冥想，瑜伽，?或一些可以學(xué)到的策略，?如認(rèn)知行為治療。?對(duì)于一些遭受嚴(yán)重慢性疼痛的人，?那種疼痛在痊愈幾個(gè)月后?都不會(huì)減輕，?常規(guī)的治療也都不起作用。?一般來說，藥物研究是?測(cè)試大量人群的結(jié)果?來判斷它是否幫助了大部分的患者。?不過確實(shí)有些人?并沒有從治療中受益?或有副作用。?現(xiàn)在，新的治療手段直接刺激或阻斷?特定的疼痛意識(shí)或調(diào)整網(wǎng)絡(luò)?已經(jīng)被研究出來，?它針對(duì)于特定的病人，?使用像磁共振成像的工具?來繪制腦路。?研究大腦如何處理疼痛?是找到最好治療辦法的關(guān)鍵。?這才是真的私人治療。

Let's say that it would take you ten minutes to solve this puzzle.?How long would it take?if you received constant electric shocks to your hands??Longer, right??Because the pain would distract you from the task.?Well, maybe not;?it depends on how you handle pain.?Some people are distracted by pain.?It takes them longer to complete a task, and they do it less well.?Other people use tasks to distract themselves from pain,?and those people actually do the task?faster and better when they're in pain?than when they're not.?Some people can just send their mind wandering?to distract themselves from pain.?How can different people?be subjected to the exact same painful stimulus?and yet experience the pain so differently??And why does this matter??First of all, what is pain??Pain is an unpleasant sensory and emotional experience,?associated with actual or potential tissue damage.?Pain is something we experience,?so it's best measured by what you say it is.?Pain has an intensity;?you can describe it on a scale?from zero, no pain, to ten, the most pain imaginable.?But pain also has a character,?like sharp, dull, burning, or aching.?What exactly creates these perceptions of pain??Well, when you get hurt,?special tissue damage-sensing nerve cells,?called nociceptors, fire and send signals?to the spinal cord and then up to the brain.?Processing work gets done by cells called neurons and glia.?This is your Grey matter.?And brain superhighways carry information as electrical impulses?from one area to another.?This is your white matter.?The superhighway that carries pain information?from the spinal cord to the brain?is our sensing pathway?that ends in the cortex,?a part of the brain that decides what to do?with the pain signal.?Another system of interconnected brain cells?called the salience network?decides what to pay attention to.?Since pain can have serious consequences,?the pain signal immediately activates the salience network.?Now, you're paying attention.?The brain also responds to the pain?and has to cope with these pain signals.?So, motor pathways are activated?to take your hand off a hot stove, for example.?But modulation networks are also activated?that deliver endorphins and enkephalins,?chemicals released when you're in pain or during extreme exercise,?creating the runner's high.?These chemical systems help regulate and reduce pain.?All these networks and pathways work together?to create your pain experience,?to prevent further tissue damage,?and help you to cope with pain.?This system is similar for everyone,?but the sensitivity and efficacy of these brain circuits?determines how much you feel and cope with pain.?This is why some people have greater pain than others?and why some develop chronic pain?that does not respond to treatment,?while others respond well.?Variability in pain sensitivities?is not so different than all kinds of variability?in responses to other stimuli.?Like how some people love roller coasters,?but other people suffer from terrible motion sickness.?Why does it matter that there is variability?in our pain brain circuits??Well, there are many treatments for pain,?targeting different systems.?For mild pain, non-prescription medications?can act on cells where the pain signals start.?Other stronger pain medicines and anesthetics?work by reducing the activity in pain-sensing circuits?or boosting our coping system, or endorphins.?Some people can cope with pain using methods that involve?distraction, relaxation, meditation, yoga,?or strategies that can be taught, like cognitive behavioral therapy.?For some people who suffer from severe chronic pain,?that is pain that doesn't go away?months after their injury should have healed,?none of the regular treatments work.?Traditionally, medical science has been about?testing treatments on large groups?to determine what would help a majority of patients.?But this has usually left out?some who didn't benefit from the treatment?or experienced side effects.?Now, new treatments that directly stimulate or block?certain pain-sensing attention or modulation networks?are being developed,?along with ways to tailor them to individual patients,?using tools like magnetic resonance imaging?to map brain pathways.?Figuring out how your brain responds to pain?is the key to finding the best treatment for you.?That's true personalized medicine.