Landau model for illustrating the learning and unlearning process of nociplastic pain.

IF 2.5 Q2 CLINICAL NEUROLOGY Frontiers in pain research (Lausanne, Switzerland) Pub Date : 2024-02-20 eCollection Date: 2024-01-01 DOI:10.3389/fpain.2024.1307532
Belén Valenzuela
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Abstract

Recent advancements in understanding the consolidation of nociplastic pain point to a complex, non-conscious learned process of threat perception. Neurobiological pain education is emerging as a promising approach to unlearn nociplastic pain, supported by biopsychosocial tools such as exposure to movement, mindfulness, and group sharing formats. However, this approach is still not well-known among clinicians and the society at large, creating a communication problem that unfortunately perpetuates the suffering of patients. Herein, we propose a Landau model to describe the learning and unlearning process of nociplastic pain, aiming to clarify this complex situation and facilitate communication across different sectors of the society. Nociplastic pain corresponds to a first-order transition, with attention more likely in the alert-protection state than in the trust-explore state. Two appealing results of the model are that the perception of the critical context depends on personal history regarding the symptom and that biopsychosocial loops are formed when there is alarming learned historical information about the symptom, along with confused and contradictory expert information, as seen in nocebo messages. Learning and unlearning in the model correspond to a chang in control parametrs that can weigh more on the alert-protection state, trust-explore state, uncertain state or neutral state. This description clarifies why neurobiological education is the foundational therapy from which others must be built to embody the accessible, clear, and trustworthy information.

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用于说明神经痉挛性疼痛的学习和非学习过程的朗道模型。
最近,在理解神经痉挛性疼痛的巩固方面取得的进展表明,威胁感知是一个复杂的、非有意识的学习过程。神经生物学疼痛教育正在成为一种很有前途的方法,通过生物心理社会工具(如接触运动、正念和小组分享形式)的支持,来解除可塑性疼痛。然而,这种方法在临床医生和整个社会中仍不为人所熟知,造成了沟通问题,不幸的是,这将延续患者的痛苦。在此,我们提出一个朗道模型来描述非痉挛性疼痛的学习和非学习过程,旨在澄清这一复杂情况,促进社会各界的沟通。非痉挛性疼痛对应于一阶转变,在警觉-保护状态下比在信任-探索状态下更容易引起注意。该模型的两个吸引人的结果是:对危急情况的感知取决于与症状有关的个人历史;当出现与症状有关的令人震惊的历史信息以及混乱和矛盾的专家信息时,就会形成生物-心理-社会循环,这一点在 "恐慌 "信息中可见一斑。在该模型中,学习和不学习对应于控制参数的变化,这种变化会更多地影响警报-保护状态、信任-探索状态、不确定状态或中性状态。这一描述阐明了为什么神经生物学教育是一种基础疗法,必须在此基础上建立其他疗法,以体现可获取的、清晰的和可信的信息。
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来源期刊
CiteScore
2.10
自引率
0.00%
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0
审稿时长
13 weeks
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