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Neurophysiologie psychosomatischer Schmerzen

Neurobiologie des douleurs psychosomatiques

Neurobiology of psychosomatic pain

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Psychotherapie Forum Aims and scope

Summary

Chronic psychosomatic pain in the back and neck region is often stress related but may also result from early traumatic and painful experience stored in the (implicit) memory. It is associated with alterations in the sensitivity of central neurons and in the connectivity of brain structures that are engaged in the transmission and perception of pain. Patients with fibromyalgia suffering from chronic backache may also show varying proportions of comorbid anxiety disorders and depression. In turn such psychosocial characteristics will modulate the perception of pain which, however, may also be affected by cognitive factors such as attention or distraction.

Zusammenfassung

Psychosomatische chronische Rückenschmerzen sind oftmals die Folge von psychosozialem Stress, aber auch von früheren traumatischen und schmerzhaften Erfahrungen, die sich ins Schmerzgedächtnis eingeschrieben haben und damit funktionelle und strukturelle Veränderungen in Gehirnstrukturen hervorrufen, die der Perzeption von Schmerzen dienen. Patienten mit Weichteilrheumatismus (Fibromyalgie) leiden aber nicht nur an Rückenschmerzen, sondern meist auch an Depressionen und Angststörungen. Umgekehrt beeinflussen Angst und Depressionen mit "Katastrophendenken" wiederum die Intensität der Schmerzwahrnehmung, die aber auch von der Aufmerksamkeit und Bedeutung abhängt, die man dem Schmerz beimisst.

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Correspondence to Johann Caspar Rüegg.

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Rüegg, J. Neurophysiologie psychosomatischer Schmerzen. Psychotherapie Forum 13, 136–142 (2005). https://doi.org/10.1007/s00729-005-0109-y

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