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Descending Controls: The Self-Regulation of Chronic Pain

하행성 조절계 : 만성 통증에 대한 제어 작용

  • Kim, Min-Jae (Department of Orofacial Pain and Oral Medicine, School of Dentistry, Kyung Hee University) ;
  • Kang, Soo-Kyung (Department of Orofacial Pain and Oral Medicine, School of Dentistry, Kyung Hee University) ;
  • Chun, Yang-Hyun (Department of Orofacial Pain and Oral Medicine, School of Dentistry, Kyung Hee University) ;
  • Hong, Jung-Pyo (Department of Orofacial Pain and Oral Medicine, School of Dentistry, Kyung Hee University) ;
  • Auh, Q-Schick (Department of Orofacial Pain and Oral Medicine, School of Dentistry, Kyung Hee University)
  • 김민재 (경희대학교 치의학전문대학원 안면통증구강내과학교실) ;
  • 강수경 (경희대학교 치의학전문대학원 안면통증구강내과학교실) ;
  • 전양현 (경희대학교 치의학전문대학원 안면통증구강내과학교실) ;
  • 홍정표 (경희대학교 치의학전문대학원 안면통증구강내과학교실) ;
  • 어규식 (경희대학교 치의학전문대학원 안면통증구강내과학교실)
  • Received : 2013.05.26
  • Published : 2013.06.30

Abstract

The descending control system is composed of a group of structures in the midbrain, medulla oblongata and pons that form a network of descending inhibitory projections. In the clinical setting, it has been shown that the application of a electrical counterirritant to these structures and diminishes the pain in patients. Thus, depression and anxiety have been shown to predict the development of chronic neuropathic pain state. These factors could influence pain might also involve descending controls. Interestingly, reduced descending controls are seen in patients with irritable bowel syndrome and theses patients had greater anxiety, depression compared to controls. And, the influence of anxiety on the chronicity of pain and on the descending control pathways should be tested in animal models, using modern techniques. Given this Knowledge, it is no wonder that pain is a highly personal experience that is susceptible to a variety of biologic, pharmacologic, and environmental influences.

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