ten minutes to solve this puzzle.

拚好這片拼圖

How long would it take

那如果在雙手持續受到電擊的情況下

if you received constant electric shocks to your hands?

會需要多久呢？

Longer, right?

更久，對吧？

Because the pain would distract you from the task.

因為疼痛會使你分心

Well, maybe not;

嗯~也許不一定

it depends on how you handle pain.

這取決於你如何處理疼痛感

Some people are distracted by pain.

有些人會因為疼痛而分心

It takes them longer to complete a task,

所以需要更多時間完成任務

and they do it less well.

而且做得比較不好

Other people use tasks to distract themselves from pain,

有些人利用任務分散他們對疼痛的注意力

and those people actually do the task

而這些人

faster and better when they're in pain

在疼痛時完成任務的速度

than when they're not.

比不痛時來得更快也更好

Some people can just send their mind wandering.

而有些人可以讓自己進入恍神狀態

to distract themselves from pain.

以便分散對疼痛的注意力

How can different people

為什麼不同人

be subjected to the exact same painful stimulus

對於完全相同的疼痛刺激

and yet experience the pain so differently?

所感受到的痛楚是如此不一樣呢？

And why does this matter?

而這又為什麼重要？

First of all, what is pain?

首先，疼痛是什麼？

Pain is an unpleasant sensory and emotional experience,

疼痛會造成知覺及情緒上的不愉快

associated with actual or potential tissue damage.

與已受傷或可能受傷的細胞組織有關

Pain is something we experience,

因為疼痛是我們親身經歷的感受

so it's best measured by what you say it is.

所以你說它有多痛，它就有多痛

Pain has an intensity;

疼痛有不同的強度

you can describe it on a scale from zero, no pain, to ten, the most pain imaginable.

你可以把它分為0~10級，代表從無感到無法想像的痛

But pain also has a character,

但是疼痛也有不同特性

like sharp, dull, burning, or aching.

像是刺痛、重擊的痛、燒灼的痛、或是隱隱作痛

What exactly creates these perceptions of pain?

到底是什麼引發這些痛覺感受呢？

Well, when you get hurt,

嗯~當你受傷時

special tissue damage-sensing nerve cells,

一種偵測傷害的特殊神經細胞

called nociceptors, fire and send signals

「疼痛感受器」被啟動

to the spinal cord and then up to the brain.

它向脊髓發出訊號，接著傳送到大腦

Processing work gets done

傳遞訊息的工作

by cells called neurons and glial.

由神經元及膠質細胞完成

This is your grey matter.

它們是大腦中的灰質

And brain superhighways carry information

接著腦部超級高速公路 (胼胝體，連接左右腦的主要路徑)

as electrical impulses

將訊息以電脈衝的方式

from one area to another.

在大腦區域中互相傳導

This is your white matter.

這是大腦中的白質

The superhighway that carries pain information

胼胝體將疼痛訊號從脊髓

from the spinal cord to the brain

運送到大腦的這段距離

is our sensing pathway

是我們的感覺傳導路徑

that ends in the cortex,

這條路徑延伸到腦皮層

a part of the brain that decides what to do

也就是大腦中控制我們

with the pain signal.

如何反應疼痛訊號的地方

Another system of interconnected brain cells

另一個相互影響的腦細胞系統

called the salience network

叫做顯著性神經網絡

decides what to pay attention to.

它決定我們的注意力放在什麼地方

Since pain can have serious consequences,

因為疼痛會帶來嚴重的後果

the pain signal immediately activates

所以疼痛訊號一產生

the salience network.

便立即啟動顯著性神經網絡

Now, you're paying attention.

就像這樣讓你集中注意力！

The brain also responds to the pain

大腦也對疼痛做出反應

and has to cope with these pain signals.

以處理這些疼痛訊號

So, motor pathways are activated

舉例來說，大腦啟動運動神經

to take your hand off a hot stove, for example.

我們的手才會離開滾燙的火爐

But modulation networks are also activated

同時，調節網絡也被啟動

that deliver endorphins and enkephalins,

產生安多酚及腦內啡

chemicals released when you're in pain or during extreme exercise,

這些化學物質在感到疼痛或是激烈運動的時候被釋放

creating the runner's high .

讓你產生「跑者愉悅感」

These chemical systems help regulate and reduce pain.

這些化學系統幫助你調節及緩和疼痛

All these networks and pathways work together

所有的網絡與路徑共同合作

to create your pain experience,

創造你的疼痛感受

to prevent further tissue damage,

避免身體組織受更多傷害

and help you to cope with pain.

同時也幫助你面對疼痛

This system is similar for everyone,

每個人疼痛系統作用的方式很類似

but the sensitivity and efficacy of these brain circuits

但是大腦迴路的敏感度及效能

determines how much you feel and cope with pain.

決定你的疼痛程度及反應機制

This is why some people have greater pain than others

這是為什麼有些人感受到的疼痛比別人多

and why some develop chronic pain

為什麼有些人得到慢性疼痛後

that does not respond to treatment,

接受治療卻沒什麼效果

while others respond well.

而另一些人受相同治療卻有效

Variability in pain sensitivities

疼痛感受程度的差異

is not so different than all kinds of variability

其實與對其它刺激的反應差異

in responses to other stimuli.

沒什麼兩樣

Like how some people love roller coasters,

像有些人喜歡坐雲霄飛車

but other people suffer from terrible motion sickness.

有些人卻感到嚴重的頭暈目眩

Why does it matter that there is variability

究竟大腦存在這種反應疼痛的差異

in our pain brain circuits?

對我們有什麼影響呢？

Well, there are many treatments for pain,

針對不同類型的疼痛

targeting different systems.

有各種不同的治療方式

For mild pain, non-prescription medications

對於比較輕微的症狀

can act on cells where the pain signals start.

非處方藥就能在疼痛產生的地方發揮療效

Other stronger pain medicines and anesthetics

而其它針對較大疼痛的止痛藥或麻醉劑

work by reducing the activity in pain-sensing circuits

是藉著降低疼痛感受迴路的活性

or boosting our coping system, or endoprhins.

或增強支持系統及安多酚，來達到效果

Some people can cope with pain

有些人會運用一些方法

using methods that involve

幫助自己面對疼痛，包含：

distraction, relaxation, meditation, yoga,

分散注意力、放鬆心情、冥想、做瑜珈

or strategies that can be taught,

或是一些需要經過學習的應對方法

like cognitive behavioral therapy.

像是認知行為治療

For some people who suffer from severe chronic pain,

有些人患有嚴重慢性疼痛

that is pain that doesn't go away

這代表疼痛感無影隨行

months after their injury should've healed,

即使是在傷口復原數個月之後

none of the regular treatments work.

一般性治療對慢性疼痛可是一點用都沒有

Traditionally, medical science has been about

傳統上，醫療科學仍然持續為廣大的族群

testing treatments on large groups

測試更有效的治療方法

to determine what would help a majority of patients.

以幫助大多數的病患

But this has usually left out

但是慢性疼痛常常被忽略

some who didn't benefit from the treatment

有些人的症狀沒有因為治療而改善

or experienced side effects.

有些人則經歷一些副作用

Now, new treatments that directly stimulate or block

但是現今已發展出新的治療方式了！

certain pain-sensing attention or modulation networks

透過阻擋疼痛感受器作用

are being developed,

或促使調節網絡啟動

along with ways to tailor them to individual patients,

再加上依個別病患需求而調整的治療方法

using tools like Magnetic Resonance Imaging (MRI)

例如用核磁共振影像

to map brain pathways.

來描繪出大腦路徑

Figuring out how your brain responds to pain

了解你的大腦如何反應疼痛

is the key to finding the best treatment for you.

是找到最佳治療方式的關鍵

That's true personalized medicine.

也是真正為你量身訂做的藥方