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  • 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 glial.

  • 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 endoprhins.

  • 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've 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 (MRI)

  • 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.

Let's say that it would take you

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B1 US TED-Ed pain brain sensing cope variability

【TED-Ed】How does your brain respond to pain? - Karen D. Davis

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    keep seeing posted on 2015/02/14
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