Annals of the Russian academy of medical sciencesAnnals of the Russian academy of medical sciencesВестник Российской академии медицинских наук0869-60472414-3545"Paediatrician" Publishers LLC26810.15690/vramn.v67i9.407PROCEEDINGS OF THE RAMS SESSIONМАТЕРИАЛЫ СЕССИИ РАМНCHRONIC PAIN: MEDICO-BIOLOGIC AND SOTSIO-ECONOMIC ASPECTSХРОНИЧЕСКАЯ БОЛЬ: МЕДИКО-БИОЛОГИЧЕСКИЕ И СОЦИАЛЬНО-ЭКОНОМИЧЕСКИЕ АСПЕКТЫYakhnoN. N.ЯхноН. Н.
Russian Federation

доктор медицинских наук, профессор, академик РАМН, заведующий кафедрой нервных болезней Первого Московского государственного медицинского университета имени И.М. Сеченова Адрес: 119021, Москва, ул. Россолимо, д. 11 Тел.: (499) 248-65-38

yahno@mma.ruKukushkinM. L.КукушкинМ. Л.
Russian Federation

доктор медицинских наук, профессор, заведующий лабораторией фундаментальных и прикладных проблем боли ФГБУ НИИ общей патологии и патофизиологии РАМН Адрес: 125315, Москва, ул. Балтийская, д. 8 Тел.: (495) 601-24-20; (916) 803-79-16

mkuk57@gmail.comThe first Moscow state medical universityПервый Московский государственный медицинский университет имени И.М. СеченоваScientific research institute of the general pathology and pathophysiologyФГБУ НИИ общей патологии и патофизиологии РАМН10092012679Вестник Российской академии медицинских наук545807082015Copyright ©; 2012, "Paediatrician" Publishers LLCCopyright ©; 2012, Издательство "Педиатръ"2012"Paediatrician" Publishers LLCИздательство "Педиатръ"https://vestnikramn.spr-journal.ru/jour/article/view/268

In this article the role of neurobiological, psychological and social factors in pathogenesis of chronic pain is analyzed. The chronic pain is considered not as a symptom of damage of tissue and as independent illness due to non-adequate neuroplasticity of systems involved into regulation of pain sensitivity. The major role in development and maintenance of chronic pain is devoted to the primary genetically determined and/or secondary disturbance of interaction between nociceptive and antinociceptive systems at various levels - from peripheral neuron to central structures – that provides pain perception and painful behaviour development.

В работе анализируется значение нейробиологических, психологических и социальных факторов в патогенезе хронической боли. Хроническая боль рассматривается не как симптом повреждения тканей, а как самостоятельная болезнь, возникающая вследствие неоптимальной нейропластической реорганизации систем, осуществляющих регуляцию болевой чувствительности. Важнейшая роль в развитии и поддержании хронической боли отводится первичному генетически детерминированному и/или вторичному нарушению взаимодействия ноцицептивной и антиноцицептивной систем на различных уровнях — от периферического нейрона до центральных структур, обеспечивающих восприятие боли и формирование болевого поведения.

chronic painperipheral and central sensitizationneuroplasticitynociceptionantinociceptionхроническая больпериферическая и центральная сенситизациянейропластичностьноцицепцияантиноцицепция1. Diagnostika i lechenie boli. Pod red. Van Roenn Dzh.Kh., Peis Dzh.A., Preoder M.I. [Diagnosis and treatment of pain. Edited by J.H. Van Roen, Pace J.A., Preoder M.I.]. Moscow, Izdatel'stvo BINOM, 2012. 496 p.2. Breivik H., Collett B., Ventafridda V., Cohen R., Gallacher D. Survey of chronic pain in Europe: Prevalence, impact on daily life, and treatment. European Journal of Pain. 2006; 10: 287–333.3. Erdes Sh.F., Dubinina T.V., Galushko E.A. Pain in the lower back in the general clinical ppaktike. Terapevticheskii arkhiv = Therapeutic archive. 2008; 5: 59–61.4. Yakhno N.N., Kukushkin M.L., Danilov A.B., Amelin A.V., Davydov O.S., Kulikov S.M. Results of an epidemiological study of the Russian prevalence of neuropathic pain, its causes and characteristics of the population of outpatients who have turned to a neurologist. Bol' = Pain. 2008; 3: 24–32.5. Torrance N., Elliot A.M., Lee A.J., Smith B.H. Severe chronic pain is associated with increased 10 year mortality. A cohort record linkage study. European journal of pain. 2010; 14: 380–386.6. Classification of chronic pain: descriptions of chronic pain syndromes and definitions of pain terms /prepared by International Association for the Study of Pain, Task Force on Taxonomy; editors, H. Merskey, N.Bogduk. 2nd ed. Seattle. IASP Press. 1994. 222.7. Tunks E. R., Weir R., Crook J. Epidemiologic Perspective on Chronic Pain Treatment. The Canadian Journal of Psychiatry. 2008; 53 (4): 235–242.8. Dizregulyatsionnaya patologiya. Pod red. akademika RAMN G.N. Kryzhanovskogo [Disregulative Pathology. Edited by academician G.N. Kryzhanovsky]. Moscow, Meditsina, 2002. 632 p.9. Yakhno N.N., Kukushkin M.L. Bol' (prakticheskoe rukovodstvo dlya vrachei) [Pain (a Practical Guide for Physicians)]. Moscow, Izdatel'stvo RAMN, 2011. 512 p.10. Treede R.D., Jensen T.S., Campbell G.N. et al. Neuropathic pain: redefinition and a grading system for clinical and research diagnostic purposes. Neurology. 2008; 70: 3680–3685.11. Kukushkin M.L., Khitrov N.K. Obshchaya patologiya boli [General Pain Pathology]. Moscow, Meditsina, 2004. 144 p.12. Wall and Melzack’s Textbook of Pain. 5th Edition S. B. McMahon, M. Koltzenburg (Eds). Elsevier Churchill Livingstone. 2005. 1239.13. Jetzer A.K., Morel A., Magnin M., Jeanmonod D. Cross-modal plasticity in the human thalamus: evidence from intraoperative macrostimulations. Neuroscience. 2009; 164: 1867–1875.14. Buskila D. Genetics of chronic pain states. Best Pract. Res. Clin. Rheumatol. 2007; 21: 535–547.15. Edwards R.R. Genetic predictors of acute and chronic pain. Curr. Rheumatol. Rep. 2006; 8: 411–417.16. Diatchenko L., Nackley A.G., Slade G.D., Bhalang K., Belfer I., Max M.B., Goldman D., Maixner W. Catechol-O-methyltransferase gene polymorphisms are associated with multiple pain-evoking stimuli. Pain. 2007; 129: 365–370.17. Diatchenko L., Slade G.D., Nackley A.G., Bhalang K., Sigurdsson A., Belfer I., Goldman D., Xu K., Shabalina S.A., Shagin D., Max M.B., Makarov S.S., Maixner Genetic basis for individual variations in pain perception and the development of a chronic pain condition. Human. Molecular. Genetics. 2005; 14 (1): 135–143.18. Lacroix-Fralish M.L., Mogil J.S. Progress in genetic studies of pain and analgesia. Annu. Rev. Pharmacol. Toxicol. 2009; 49: 97–121.19. Pshennikova M.G., Smirnova V.S., Grafova V.N. , Shimkovich M.V., Malyshev I.Yu., Kukushkin M.L. Resistance to the development of neuropathic pain in rats August and Wistar population having different innate resistance to stresses. Bol' = Pain. 2008; 2: 13–16.20. Attal N., Cruccu G., Haanpaa M., Hansson P., Jensen T.S., Nurmikko T., Sampaio C., Sindrup S., Wiffen P. EFNS guidelines on pharmacological treatment of neuropathic pain. European Journal of Neurology. 2006; 13: 1153–1169.21. Seifert F., Maihöfner C. Functional and structural imaging of pain-induced neuroplasticity. Curr. Opin. Anaesthesiol. 2011; 24: 515–523.22. Tabeeva G.R., Yakhno N.N. Migren' [Migraine]. Moscow, GEOTAR-Media, 2011. 624 p.23. Krupina N.A., Khadzegova F.R., Maichuk E.Yu., Kukushkin M.L., Kryzhanovskii G.N. The analysis of the electrical activity of the brain in patients with irritable bowel syndrome. Bol' = Pain. 2008; 2: 6–12.24. Buskila D., Sarzi-Puttini P., Ablin J.N.The genetics of fibromyalgia syndrome. Pharmacogenomics. 2007; 8: 67–74.25. Yakhno N.N., Kukushkin M.L., Podchufarova E.V. About dysfunctional mechanism of chronic pain. Rossiiskii zhurnal boli = Russian journal of pain. 2012; 1: 24–25.