Control Pain & Heal Faster with Your Brain

Andrew Huberman:

安德鲁·休伯曼：

Welcome to the Huberman Lab podcast, where we discuss science and science-based tools for everyday life.

欢迎来到休伯曼实验室播客，我们在这里讨论科学和基于科学的日常生活工具。

Andrew Huberman:

安德鲁·休伯曼：

I'm Andrew Huberman and I'm a professor of neurobiology and ophthalmology at Stanford School of Medicine.

我是安德鲁·胡伯曼，斯坦福大学医学院神经生物学和眼科教授。

This podcast is separate from my teaching and research roles at Stanford.

这个播客与我在斯坦福大学的教学和研究角色是分开的。

It is, however, part of my desire and effort to bring zero-cost-to-consumer information about science and science related tools to the general public.

然而，我的愿望和努力的一部分是将有关科学和科学相关工具的零成本消费者信息带给公众。

In keeping with that theme, I'd like to thank the sponsors of today's podcast.

为了与这个主题保持一致，我要感谢今天播客的赞助商。

Andrew Huberman:

安德鲁·休伯曼：

Let's continue our discussion about neuroplasticity, this incredible feature of our nervous system that allows it to change itself in response to experience, and even in ways that we consciously and deliberately decide to change it.

让我们继续讨论神经可塑性，神经系统的这一令人难以置信的特征使其能够根据经验而改变自身，甚至以我们有意识和故意决定改变它的方式。

That's an incredible feature.

这是一个令人难以置信的功能。

No other organ in our body has that capability.

我们体内没有其他器官具有这种能力。

Our nervous system, which governs everything about who we are, how we feel and what we do does have that capability.

我们的神经系统控制着我们是谁、我们的感受以及我们所做的一切，它确实具有这种能力。

Andrew Huberman:

安德鲁·休伯曼：

The issue is most people don't know how to access neuroplasticity.

问题是大多数人不知道如何获得神经可塑性。

Children readily access neuroplasticity, and they don't even realize that they're doing it.

孩子们很容易获得神经可塑性，但他们甚至没有意识到自己正在这样做。

Adults want neuroplasticity.

成年人想要神经可塑性。

And so that's what this entire month of the Huberman Lab podcast has been about.

这就是休伯曼实验室播客整个月的内容。

We've explored neuroplasticity from a variety of different perspectives.

我们从各种不同的角度探索了神经可塑性。

We talked about representational plasticity.

我们讨论了表征可塑性。

We talked about the importance of focus and reward.

我们讨论了专注和奖励的重要性。

We talked about this amazing, and somewhat surprising, aspect of the vestibular system, how altering our relationship to gravity and in addition to that, making errors as we try and learn, can open up windows to plasticity.

我们讨论了前庭系统这个令人惊奇且有些令人惊讶的方面，如何改变我们与重力的关系，除此之外，在我们尝试和学习时犯错误，可以打开可塑性的窗户。

Andrew Huberman:

安德鲁·休伯曼：

But we have not really talked so much about directing the plasticity toward particular outcomes.

但我们并没有真正谈论将可塑性导向特定结果。

And thus far, we really haven't talked yet about how to undo things that we don't want.

到目前为止，我们确实还没有讨论如何撤消我们不想要的事情。

I've talked about learning, and I say learn a language, learn free throws, learn a particular motor skill, et cetera.

我谈到了学习，我说学习语言、学习罚球、学习特定的运动技能等等。

But what about what we would call "unlearning" or about removing some aspect of our experience that we don't want?

但是我们所说的“忘却”或者删除我们不想要的经验的某些方面呢？

Andrew Huberman:

安德鲁·休伯曼：

And so today we are going to explore that aspect of neuroplasticity, and we are going to do that in the context of a very important and somewhat sensitive topic, which is pain, regeneration, and in some cases, injury to the nervous system.

因此，今天我们将探讨神经可塑性的这一方面，我们将在一个非常重要且有些敏感的主题背景下进行探讨，即疼痛、再生，以及在某些情况下对神经系统的损伤。

Now, for those of you that are fortunate enough to not have or had a concussion, or not have or know someone who's experiencing chronic or acute pain, I encourage you to stay in here with us because a lot of the information that we are going to cover has direct relevance to neuroplasticity for other purposes.

现在，对于那些幸运地没有遭受过脑震荡的人，或者没有或不认识正在经历慢性或急性疼痛的人，我鼓励你们留在我们这里，因为我们将要介绍的许多信息与用于其他目的的神经可塑性直接相关。

Andrew Huberman:

安德鲁·休伯曼：

We, as always here on this podcast, are going to discuss some of the science, we get into mechanism, but we also really get at principles.

一如既往，在这个播客中，我们将讨论一些科学，我们深入探讨机制，但我们也真正了解原理。

Principles are far more important than any one experiment or one description of mechanism.

原理比任何一项实验或一种机制描述都重要得多。

And certainly far more important than any one protocol because principles allow you to think about your nervous system and work with it in ways that best serve you.

当然比任何一种协议都重要得多，因为原则可以让你思考你的神经系统，并以最适合你的方式使用它。

They are very flexible batches of information.

它们是非常灵活的批量信息。

So we are going to talk about the principles of neuroplasticity for removing pain, and wound healing and injury.

因此，我们将讨论消除疼痛、伤口愈合和损伤的神经可塑性原理。

Andrew Huberman:

安德鲁·休伯曼：

We're going to talk about acupuncture of, all things.

我们要谈论针灸的所有事情。

We are going to talk about modern medicine's attempt to try and restore youth to the aging or injured or demented brain.

我们将讨论现代医学试图使衰老、受伤或痴呆的大脑恢复青春的尝试。

And we are going to definitely talk about tools.

我们肯定会谈论工具。

Got a lot of tools.

得到了很多工具。

I consulted a number of fantastic colleagues at Stanford, at Harvard Medical School and in the greater community of tissue rehabilitation, injury and pain management in preparation for this podcast.

为了准备这个播客，我咨询了斯坦福大学、哈佛医学院以及组织康复、损伤和疼痛管理领域的一些出色的同事。

Andrew Huberman:

安德鲁·休伯曼：

I do want to be very clear and just remind you that I'm not a medical doctor, I'm a professor, so I don't prescribe anything.

我确实想非常清楚地提醒您，我不是医生，我是教授，所以我不会开任何处方。

I profess things.

我承认事情。

I have my beliefs.

我有我的信念。

But the podcast is for information purposes.

但播客仅供参考。

I do hope that the tools that we discuss will be of benefit to you.

我衷心希望我们讨论的工具能够对您有所帮助。

But as always, you should talk to your doctor or healthcare provider about any tools that you plan to add or are looking to explore, as well as anything that you might look to remove from your daily protocols.

但与往常一样，您应该与您的医生或医疗保健提供者讨论您计划添加或希望探索的任何工具，以及您可能希望从日常方案中删除的任何工具。

In other words, don't change anything without consulting an expert first.

换句话说，在没有咨询专家的情况下不要改变任何东西。

You are responsible for your health, not me.

你要对自己的健康负责，而不是我。

And I say this not just to protect me, but also to protect you.

我这样说不仅是为了保护我，也是为了保护你。

So please keep that in mind as we move forward.

因此，在我们前进时请记住这一点。

And I'm very excited to share with you this information because I do feel that it can be of great benefit to a number of people.

我很高兴与大家分享这些信息，因为我确实觉得它可以给很多人带来很大的好处。

Andrew Huberman:

安德鲁·休伯曼：

So let's start our discussion about pain and sensation and regeneration and wound healing with a discussion about a very important system in the nervous system, which is the somatosensory system.

因此，让我们从神经系统中一个非常重要的系统——体感系统——开始讨论疼痛和感觉、再生和伤口愈合。

The somatosensory system is, as the name implies, involved in understanding touch, physical feeling on our body.

顾名思义，体感系统涉及理解触觉，即我们身体上的物理感觉。

And the simplest way to think about the somatosensory system is that we have little sensors, and those sensors come in the form of neurons, nerve cells, that reside in our skin and in the deeper layers below the skin.

思考体感系统的最简单方法是，我们几乎没有传感器，而这些传感器以神经元、神经细胞的形式出现，存在于我们的皮肤和皮肤下的更深层中。

And indeed we do.

我们确实这样做了。

Andrew Huberman:

安德鲁·休伯曼：

We have some that correspond to, and we should say, respond to, mechanical touch.

我们有一些与机械触摸相对应，我们应该说，对机械触摸做出反应。

So pressure on the top of my hand or a pinpoint.

所以压在我的手上或者针尖上。

Or other sensors, for instance, respond to heat, to cold.

或者其他传感器，例如，对热、冷做出反应。

Some respond to vibration.

有些对振动有反应。

We have a huge number of different receptors in our skin, and they take that information and send it down these wires that we call axons in the form of electrical signals to our spinal cord and then up to the brain.

我们的皮肤中有大量不同的受体，它们获取这些信息并将其以电信号的形式沿着我们称为轴突的电线发送到我们的脊髓，然后到达大脑。

And within the spinal cord in brain, we have centers that interpret that information, that actually make sense of those electrical signals.

在大脑的脊髓内，我们有解释这些信息的中心，这些中心实际上理解这些电信号。

And this is amazing because none of those sensors has a different unique form of information that it uses.

这是令人惊奇的，因为这些传感器都没有使用不同的独特形式的信息。

It just sends electrical potentials into the nervous system.

它只是将电势发送到神经系统。

Andrew Huberman:

安德鲁·休伯曼：

So the nervous system — you somehow decode what a given stimulus on your skin is.

所以神经系统——你以某种方式解码皮肤上的给定刺激是什么。

So maybe it's the wind blowing gently and deflecting some of the hairs on your arm.

所以也许是风轻轻吹过，吹动了你手臂上的一些毛发。

Or maybe it's a sharp pinprick or a hot stove or the warmth of a glowing fire.

或者可能是尖锐的针刺或热炉或炽热的火焰的温暖。

That all arrives in your nervous system in the form of these electrical things we call action potentials, which is just amazing.

所有这些都以我们称之为动作电位的电子形式到达你的神经系统，这真是太神奇了。

And then the brain computes them and makes sense of them.

然后大脑计算它们并理解它们。

So we have peripheral sensors, and we've got stations up in our brain and within our spinal cord that make sense of all the stuff coming in.

所以我们有外围传感器，我们的大脑和脊髓内都有站，可以理解所有进入的东西。

Andrew Huberman:

安德鲁·休伯曼：

Pain, and the sensation of pain is, believe it or not, a controversial word in the neuroscience field.

不管你信不信，疼痛和疼痛的感觉在神经科学领域是一个有争议的词。

People prefer to use the word no susception.

人们更喜欢使用“不怀疑”这个词。

No susceptors are the sensors in the skin that detect particular types of stimuli.

皮肤中没有感受器来检测特定类型的刺激。

It actually comes from the Latin word "nocera," which means to harm.

它实际上来自拉丁语“nocera”，意思是伤害。

And why would neuroscientists not want to talk about pain?

为什么神经科学家不想谈论疼痛？

Well, it's very subjective.

嗯，这是非常主观的。

It has a mental component and a physical component.

它有心理成分和身体成分。

We cannot say that pain is simply an attempt to avoid physical harm to the body, and here's why.

我们不能说疼痛只是为了避免对身体造成身体伤害，原因如下。

They actually can be dissociated from one another.

它们实际上可以彼此分离。

Andrew Huberman:

安德鲁·休伯曼：

A good example would be if, God forbid, you were exposed to high levels of radiation, such as working with some sort of material that was radioactive, or you were near a former radioactive plant or some radiation, excessive x-rays, et cetera, you wouldn't feel any pain during the x-rays.

一个很好的例子是，如果（上帝保佑）您暴露在高水平的辐射下，例如使用某种放射性材料，或者您靠近以前的放射性工厂或一些辐射、过量的 X 射线等等，那么在 X 射线检查期间您不会感到任何疼痛。

In fact, you don't.

事实上，你不知道。

If you've ever had x-rays as I have, you don't feel anything.

如果您像我一样接受过 X 光检查，您不会有任何感觉。

They put you under that lead blanket.

他们把你放在铅毯下面。

They run behind a wall, and then in my case, they take these pictures of your teeth.

他们跑到墙后，然后就我而言，他们给你的牙齿拍了这些照片。

It's really scary, because you go, well, something really terrible must be happening here, but you don't feel anything.

这真的很可怕，因为你会想，好吧，这里一定发生了一些非常可怕的事情，但你却没有任何感觉。

But there can be a lot of tissue damage: there can be mutations introduced to cells, et cetera.

但可能会造成很多组织损伤：可能会向细胞引入突变，等等。

Andrew Huberman:

安德鲁·休伯曼：

I've had x-rays.

我已经拍过X光片了。

I'm not saying people shouldn't have x-rays, but excessive x-rays certainly are not good for human beings, likewise with excessive exposure to any radiation.

我并不是说人们不应该接受 X 射线检查，但是过多的 X 射线检查肯定对人类没有好处，过度接触任何辐射也是如此。

So there can be tissue damage without the physical perception or mental perception of pain at all.

因此，可能存在组织损伤，而根本没有疼痛的身体感知或精神感知。

As well, there can be the belief of pain or the feeling of pain without there being tissue damage.

同样，在没有组织损伤的情况下，也可能存在疼痛的信念或疼痛的感觉。

And there's a famous case that was published in the British Journal of Medicine where a construction worker, I think he fell, is how the story went and a 14-inch nail went through his boot and up through the boot.

《英国医学杂志》上发表了一个著名的案例，一名建筑工人，我认为他摔倒了，故事的情节是这样的，一根 14 英寸的钉子穿过他的靴子，然后向上穿过靴子。

And he was in excruciating pain, just beyond anything he'd experienced.

他正承受着难以忍受的痛苦，这是他从未经历过的。

He reported that he couldn't even move in any dimension, even a tiny bit, without feeling excruciating pain.

他报告说，他甚至无法在任何维度移动，哪怕是一点点，都会感到剧烈的疼痛。

They brought him into the clinic, into the hospital; they were able to cut away the boot, and they realized that the nail had gone between two toes and it had actually not impaled the skin at all.

他们把他带到诊所、医院；他们把靴子切掉，发现钉子已经进入两个脚趾之间，实际上根本没有刺穿皮肤。

Andrew Huberman:

安德鲁·休伯曼：

His visual image of the nail going through his boot gave him the feeling, the legitimate feeling, that he was experiencing the pain of a nail going through his foot, which is incredible because it speaks to the power of the mind in this pain scenario.

钉子穿过靴子的视觉形象给了他一种感觉，一种合法的感觉，他正在经历钉子穿过脚的疼痛，这是令人难以置信的，因为它说明了在这种疼痛场景中心灵的力量。

And it also speaks to the power of the specificity.

这也说明了特异性的力量。

It's not like he thought that his foot was on fire; he thought because he saw a nail going through his foot, well, it was going through his boot, but he thought was going through his foot, that it was sharp pain of the sort that a nail would produce.

他并不认为自己的脚着火了；而是认为自己的脚着火了。他想，因为他看到一颗钉子穿过他的脚，好吧，它正在穿过他的靴子，但他认为正在穿过他的脚，那是钉子会产生的那种剧痛。

And there are thousands of these kinds of case reports out there.

此类案例报告有数千份。

Now that is not to say that all pain that we experience is in our head, but it really speaks to the incredible capacity that these top down, these higher level cognitive functions have in interpreting what we're experiencing out in the periphery, even just on the basis of what we see.

这并不是说我们经历的所有痛苦都在我们的头脑中，但它确实说明了这些自上而下的、这些更高层次的认知功能在解释我们在外围经历的事情方面具有令人难以置信的能力，即使只是基于我们所看到的。

And the example of radiation speaks to the fact that pain and tissue damage are dissociable from one another.

辐射的例子说明了这样一个事实：疼痛和组织损伤是相互分离的。

Andrew Huberman:

安德鲁·休伯曼：

Okay, so why are we talking about pain during a month on neuroplasticity?

好吧，那么我们为什么要谈论神经可塑性一个月内的疼痛呢？

Well, turns out that the pain system offers us a number of different principles that we can leverage to: A, ensure that if we are ever injured, we are able to understand the difference between injury and pain, because there is a difference.

事实证明，疼痛系统为我们提供了许多不同的原则，我们可以利用它们：A，确保如果我们受伤，我们能够理解受伤和疼痛之间的区别，因为这是有区别的。

That if we're ever in pain, that we can understand the difference between injury and pain.

如果我们经历过疼痛，我们就能理解受伤和疼痛之间的区别。

That we will be able to interpret our pain.

我们将能够解释我们的痛苦。

And during the course of today's podcast, I'm going to cover protocols that help eliminate pain from both ends of the spectrum, from the periphery at the level of the injury and through these top-down mental mechanisms.

在今天的播客中，我将介绍一些协议，这些协议有助于消除疼痛范围的两端、受伤部位的外围以及通过这些自上而下的心理机制。

A lot of times on this podcast, in fact mostly, I tend to center on the physiology, on the really objective things that you can describe and talk about: diaphragmatic movement or sunlight of a particular number of photons, et cetera.

在这个播客中，很多时候，事实上，大多数时候，我倾向于集中在生理学上，集中在你可以描述和谈论的真正客观的事物上：隔膜运动或特定数量光子的阳光，等等。

But today is a really exciting opportunity for us to discuss some of the more subjective things.

但今天对我们来说是一个非常令人兴奋的机会来讨论一些更主观的事情。

Andrew Huberman:

安德鲁·休伯曼：

Believe it or not, we're going to talk about love.

不管你信不信，我们要谈论爱情。

A colleague of mine at Stanford who runs a major pain clinic is working on and has published quality peer-reviewed data on the role of love in modulating the pain response.

我在斯坦福大学的一位同事经营着一家大型疼痛诊所，他正在研究并发表了关于爱在调节疼痛反应中的作用的高质量同行评审数据。

Only, there's a twist to it, and I'm not going to reveal it just yet.

只是，其中有一个转折点，我现在不打算透露它。

But it turns out that the specific type of connection one has to a romantic partner actually dictates whether or not their love for them will alleviate physical pain.

但事实证明，一个人与浪漫伴侣之间的特定联系类型实际上决定了他们对伴侣的爱是否会减轻身体上的疼痛。

And the effects are really robust.

而且效果确实很强劲。

It's an amazing literature.

这是一部了不起的文学作品。

And so what we're talking about today is plasticity of perception, which has direct bearing on emotional pain and has direct bearing on trauma.

所以我们今天讨论的是感知的可塑性，它与情绪痛苦有直接关系，也与创伤有直接关系。

And other things that we've discussed in previous episodes a little bit, but that we are going to explore even more in an entire month about those topics.

以及我们在前几集中讨论过的其他事情，但我们将在整整一个月的时间里探索更多有关这些主题的内容。

Andrew Huberman:

安德鲁·休伯曼：

So let's get started in thinking about what happens with pain.

那么让我们开始思考疼痛会发生什么。

And I will describe some examples of some kind of extreme cases.

我将描述一些极端情况的例子。

For instance, I will tell you just now that there is a mutation, a genetic mutation in a particular sodium channel.

比如说我刚才告诉大家，有一个突变，一个特定钠通道的基因突变。

A sodium channel is one of these little holes in neurons that allows them to fire action potentials.

钠通道是神经元中的这些小孔之一，使神经元能够激发动作电位。

It's important to the function of the neuron.

它对神经元的功能很重要。

It's also important for the development of certain neurons.

它对于某些神经元的发育也很重要。

And there's a particular mutation.

并且有一个特殊的突变。

There are kids that are born without this sodium channel 1.7; if you want to look it up.

有些孩子出生时就没有这种钠通道 1.7；如果你想查一下。

Those kids experience no pain, no pain whatsoever.

那些孩子没有经历任何痛苦，没有任何痛苦。

And it is a terrible situation.

这是一个可怕的情况。

Andrew Huberman:

安德鲁·休伯曼：

They burn themselves, they tend to rest on their limbs too long.

他们会烧伤自己，他们往往会在四肢上休息太久。

They don't make the micro adjustments.

他们不进行细微调整。

You might see me swiveling around on my chair moving around a lot.

你可能会看到我在椅子上旋转并移动很多。

Those micro adjustments are actually normal, healthy micro adjustments that prevent us from going into pain.

这些细微调整实际上是正常、健康的细微调整，可以防止我们陷入痛苦。

They don't make those adjustments; they don't get the feedback that they're in a particular position.

他们不做这些调整；他们没有得到自己处于特定位置的反馈。

And so they never make those adjustments, and their joints get destroyed essentially.

因此他们从不进行这些调整，他们的关节基本上被破坏了。

They don't tend to live very long due to accidents.

由于事故，他们往往寿命不长。

It's a really terrible and unfortunate circumstance.

这是一个非常可怕和不幸的情况。

Andrew Huberman:

安德鲁·休伯曼：

Some people have a mutation in the same channel where they make too much of this channel so they feel too much pain.

有些人的同一个通道发生了突变，他们过度使用该通道，因此感到太多疼痛。

In fact, it's reasonable to speculate that one of the reasons, not all, but one of the reasons why people might differ in their sensitivity to pain is by way of genetic variation in how many of these sorts of receptors that they express.

事实上，可以合理地推测，人们对疼痛的敏感性可能不同的原因之一（不是全部）是他们表达的此类受体数量的遗传变异。

People who make too much of this receptor experience extreme pain from even subtle stimuli.

这种受体分泌过多的人，即使是轻微的刺激也会感到极度疼痛。

Now the good news is there are good drug treatments that can block, specifically, this sodium channel 1.7.

现在好消息是有很好的药物治疗可以阻断这种钠通道 1.7。

And so those people get a lot of relief from taking such drugs.

因此，这些人通过服用此类药物可以得到很大的缓解。

Andrew Huberman:

安德鲁·休伯曼：

So pain and how much pain we are sensitive to, or insensitive, to probably has some genetic basis.

因此，疼痛以及我们对疼痛的敏感程度或不敏感程度可能有一定的遗传基础。

And then, of course, there are things that we can do to make sure that we experience less pain, although pain has this adaptive role.

当然，我们可以采取一些措施来确保我们减少疼痛，尽管疼痛具有这种适应性作用。

So let's talk about some of the features of how we're built physically and how that relates to pain and how we can recover from injury.

那么，让我们来谈谈我们身体构造的一些特征，以及它们与疼痛的关系，以及我们如何从伤害中恢复。

So first of all, we have maps of our body surface in our brain.

首先，我们的大脑中有身体表面的地图。

It's called a homunculus.

它被称为人造人。

In a rat, believe it or not, I'm not making this up.

不管你信不信，在老鼠身上，这不是我编造的。

It's called a ratunculus.

它被称为毛藤。

In Costello, my dog who's snoring behind me.

在科斯特洛，我的狗在我身后打呼噜。

It's a dogunculus.

这是一只狗。

I could get into the nomenclature and why it's called this, but it's basically a representation of the body surface.

我可以了解命名法以及为什么这么称呼，但它基本上是身体表面的表示。

Andrew Huberman:

安德鲁·休伯曼：

That representation is scaled in a way that matches sensitivity.

该表示以与灵敏度相匹配的方式缩放。

So the areas of your body that are most sensitive have a lot more brain real estate devoted to them.

因此，你身体最敏感的区域有更多的大脑空间专门用于它们。

Your back is an enormous piece of tissue compared to your fingertip.

与指尖相比，您的背部是一块巨大的组织。

But your back has fewer receptors devoted to it, and the representation of your back in your brain is actually pretty small, whereas the representation of your finger is enormous.

但是你的背部专门用于它的感受器较少，并且你的背部在大脑中的代表实际上非常小，而你的手指的代表却很大。

So how big a brain area is devoted to a given body part is directly related to the density of receptors in that body part, not the size of the body part.

因此，特定身体部位的大脑区域有多大，与该身体部位的受体密度直接相关，而不是与身体部位的大小直接相关。

And that's why if we were to draw your homunculus or Costello's dogunculus, what we would find is that certain areas like the lips, like the fingertips, like the genitalia, like the eyes and the area around the face would have a huge representation.

这就是为什么如果我们要画你的小人或科斯特洛的狗，我们会发现某些区域，比如嘴唇、指尖、生殖器、眼睛和脸部周围的区域会有很大的代表。

Whereas the back, the torso and areas of the body that are less sensitive are going to have smaller representation.

而背部、躯干和不太敏感的身体区域的代表性较小。

So it'll be a very distorted map.

所以这将是一张非常扭曲的地图。

Andrew Huberman:

安德鲁·休伯曼：

You can actually know how sensitive a given body part is and how much brain area is devoted to it through what's called two-point discrimination.

通过所谓的两点辨别，您实际上可以知道特定身体部位的敏感度以及有多少大脑区域专门用于该部位。

You can do this experiment if you want.

如果你愿意的话，你可以做这个实验。

I think I've described this once or twice before.

我想我之前已经描述过一两次了。

But basically if you have someone maybe take two pens and put them maybe six inches apart on your back and touch while you're facing away, and they'll ask you how many points they're touching you and you say, "Two." But if they move those closer together, say three inches, you're likely to experience it as one point of contact.

但基本上，如果有人拿两支笔，将它们放在你的背上，距离大约六英寸，当你背向另一侧时进行触摸，他们会问你他们触摸了你多少点，你说，“两点”。但如果他们将它们移得更近，例如三英寸，您可能会将其体验为一个接触点。

Whereas on your finger, you could play that game all day.

而在你的手指上，你可以玩这个游戏一整天。

And as long as there's a millimeter or so of spacing, you will know that it's two points, as opposed to one.

只要有一毫米左右的间距，你就会知道这是两个点，而不是一个点。

And that's because there's more pixels, more density of receptors.

那是因为像素更多，受体密度更高。

Andrew Huberman:

安德鲁·休伯曼：

This has direct bearing to pain, because it says that areas of the body that have denser receptors are going to be more sensitive to pain than to others.

这与疼痛有直接关系，因为它表明身体上感受器密集的区域比其他区域对疼痛更敏感。

And where we have more receptors, we tend to have more blood vessels and glia, which are the support cells, and other cells that lend to the inflammation response.

当我们有更多的受体时，我们往往就会有更多的血管和神经胶质细胞，它们是支持细胞，以及有助于炎症反应的其他细胞。

And that's really important.

这真的很重要。

So just as a rule of thumb, areas of your body that are injured that are large areas that have low sensitivity before injury likely are going to experience less pain.

因此，根据经验，身体受伤的大面积区域在受伤前敏感性较低，可能会经历较少的疼痛。

And the literature shows will heal more slowly because they don't have as many cells around to produce inflammation.

文献显示愈合速度会更慢，因为周围没有那么多细胞来产生炎症。

And you might say, "Wait, I thought inflammation is bad." Well, one of the things I really want to get across today is that inflammation is not bad.

你可能会说，“等等，我认为炎症是不好的。”嗯，我今天真正想了解的一件事是炎症并不坏。

Inflammation out of control is bad, but inflammation is wonderful.

炎症失控固然不好，但炎症却是美妙的。

Andrew Huberman:

安德鲁·休伯曼：

Inflammation is the tissue-repair response.

炎症是组织修复反应。

And we are going to talk about subjective and objective ways to modulate inflammation after tissue injury.

我们将讨论调节组织损伤后炎症的主观和客观方法。

Even after just exercise that's been too intense.

即使刚刚进行过剧烈运动。

Okay, so you have this map of your body surface; it's sensitive in different ways.

好的，你已经有了这张身体表面的地图；它在不同方面都很敏感。

Now you know why.

现在你知道为什么了。

So you've got your Neurobiology of Somatosensation 101 under your belt now.

现在您已经掌握了《躯体感觉神经生物学 101》。

We didn't cover everything, but we'll touch on some of the other details as we go forward.

我们没有涵盖所有内容，但我们将在接下来的过程中讨论一些其他细节。

Andrew Huberman:

安德鲁·休伯曼：

I thought it might be a nice time to just think about the relationship between the periphery and the central maps in a way that many of you have probably heard about before, which will frame the discussion a little bit better, which is phantom limb pain.

我认为现在可能是一个很好的时机，以你们许多人以前可能听说过的方式来思考外围地图和中心地图之间的关系，这将使讨论更好一些，即幻肢痛。

Now, some of you're probably familiar with this, but for people that have an arm or a leg or a finger or some other portion of their body amputated, it's not uncommon for those people to feel as if they still have that limb or appendage or piece of their body intact.

现在，你们中的一些人可能对此很熟悉，但对于手臂、腿、手指或身体其他部位被截肢的人来说，这些人感觉好像他们的肢体、附肢或身体的一部分仍然完好无损，这种情况并不少见。

Andrew Huberman:

安德鲁·休伯曼：

And typically, unfortunately, the sensation of that limb is not one of the limb being nice and relaxed and just there.

不幸的是，通常情况下，该肢体的感觉并不是一种良好、放松且就在那里的感觉。

The sensation is that the limb is experiencing pain or is contorted in the specific orientation that it was around the time of the injury.

这种感觉是肢体正在经历疼痛或在受伤时的特定方向上扭曲。

So if someone has a blunt force to the hand and they end up having their hand amputated, typically they will continue to feel pain in their phantom hand, which is pretty wild.

因此，如果某人的手受到钝器的作用而最终导致手被截肢，通常他们的幻手会继续感到疼痛，这是非常疯狂的。

And that's because the representation of that hand is still intact in the cortex in the brain.

那是因为那只手的表征在大脑皮层中仍然完好无损。

And it's trying to balance its levels of activity.

它正在努力平衡其活动水平。

Normally it's getting what's called proprioceptive feedback.

通常它会得到所谓的本体反馈。

Proprioception is just our knowledge of where our limbs are in space.

本体感觉只是我们对四肢在空间中位置的了解。

It's an extremely important aspect of our somatosensory system.

这是我们体感系统极其重要的一个方面。

And there's no proprioceptive feedback, and so a lot of the circuits start to ramp up their levels of activity, and they become very conscious of the phantom limb.

而且没有本体感觉反馈，因此许多回路开始提高其活动水平，并且它们对幻肢变得非常敏感。

Andrew Huberman:

安德鲁·休伯曼：

Now, before my lab was at Stanford, I was at UC San Diego.

现在，在我的实验室在斯坦福大学之前，我在加州大学圣地亚哥分校。

And one my colleagues was a guy — everyone just calls him by his last name, Ramachandran — who is famous for understanding this phantom limb phenomenon and developing a very simple but very powerful solution to it that speaks to the incredible capacity of top-down modulation.

我的一位同事是一个人——每个人都叫他的姓氏拉马钱德兰——他因理解这种幻肢现象并开发出一种非常简单但非常强大的解决方案而闻名，这说明了自上而下调制的令人难以置信的能力。

And top-down modulation, the ability to use one's brain cognition and senses to control pain in the body, is something that everyone, not just people missing limbs or in chronic pain, could learn to benefit from.

自上而下的调节，即利用大脑认知和感官控制身体疼痛的能力，是每个人都可以从中受益的，而不仅仅是肢体缺失或慢性疼痛的人。

Because it is a way to tap into our ability to use our mind to control perceptions of what's happening in our body.

因为它是一种利用我们的思维能力来控制对身体发生的事情的感知的方法。

And this is not a mystical statement; this is not about mind, I guess, as much as it is brain to control our perceptions of our body.

这并不是什么神秘的说法；而是一种说法。我想，这与心灵无关，而是大脑控制着我们对身体的感知。

So what did Ramachandran do?

那么拉马钱德兰做了什么？

Andrew Huberman:

安德鲁·休伯曼：

Ramachandran had people who were missing a limb put their intact limb into a box that had mirrors in it, such that when they looked in the box and they moved their intact limb, the opposite limb, which was a reflection of the intact limb— because they're missing the opposite limb— they would see it as if it was intact.

拉马钱德兰让那些失去肢体的人将他们完整的肢体放入一个装有镜子的盒子里，这样当他们在盒子里看并移动完整的肢体时，相对的肢体，这是完整肢体的反射——因为他们失去了相对的肢体——他们会看到它就好像它是完整的一样。

And as they would move their intact limb, they would visualize with their eyes the limb that's in the place of the absent limb.

当他们移动完整的肢体时，他们会用眼睛想象代替缺失肢体的肢体。

So this is all by mirrors.

所以这都是通过镜子。

Moving around, and they would feel immediate relief from the phantom pain.

只要走动一下，他们就会立即感受到幻痛的减轻。

And he would tell them and they would direct their hand toward an orientation that felt comfortable to them.

他会告诉他们，他们就会把手伸向让他们感觉舒服的方向。

Then they would exit the mirror box, they would take their hand out and they would feel as if the hand was now in its relaxed, normal position.

然后他们会退出镜盒，把手伸出来，他们会感觉手现在处于放松、正常的位置。

So you could get real time in moments remapping of the representation of the hand.

因此，您可以实时重新映射手部的表示。

Andrew Huberman:

安德鲁·休伯曼：

Now that's amazing.

现在这太棒了。

This is the kind of thing that all of us would like to be able to do if we are in pain.

这是我们所有人在痛苦时都希望能够做的事情。

If you stub your toe, if you break your ankle, if you take a hard fall on your bike or if you're in chronic pain, wouldn't it be amazing to be able to use a mind trick?

如果你撞到了脚趾，如果你扭断了脚踝，如果你在自行车上摔倒了，或者如果你患有慢性疼痛，能够使用心理技巧不是很神奇吗？

But it's not a trick, right?

但这不是诡计，对吧？

Because it's real visual imagery to remap your representation of your body surface and where your body is.

因为它是真实的视觉图像，可以重新映射您对身体表面和身体位置的表示。

That is something that we could all benefit from.

这是我们所有人都可以受益的事情。

Because if you do anything for long enough, including live, you're going to experience pain of some sort.

因为如果你做任何事情足够长的时间，包括生活，你就会经历某种痛苦。

And this, again, I just want to remind you, isn't just about physical injuries and pain.

我想再次提醒您，这不仅仅是身体伤害和疼痛。

This has direct relevance to emotional pain as well, which of course we'll talk about.

这也与情绪痛苦有直接关系，我们当然会讨论这一点。

Andrew Huberman:

安德鲁·休伯曼：

So the Ramachandran studies were really profound because they said a couple things.

所以拉马钱德兰的研究确实意义深远，因为他们说了几件事。

One, plasticity can be very fast, that it can be driven by the experience of something, just the visual experience.

第一，可塑性可以非常快，它可以由某种事物的体验（只是视觉体验）驱动。

He had people do this mirror-box thing but not look into the mirror box, and they didn't get the remapping.

他让人们做这个镜盒的事情，但不看镜盒，他们没有得到重新映射。

So it required visual imagery coming in.

所以它需要视觉图像的介入。

We also know, for instance, that in cases like where people are congenitally deaf, the cochlear implant, which is simply a way of putting, it's not simple.

我们也知道，比如说像先天性耳聋这样的情况，人工耳蜗，只是一种简单的放置方式，并不简单。

But it's a way of putting in a device that replaces the cochlea, the device that we're normally born with, in the ear that has these little, what are called hair cells that deflect according to sound waves and allow us to hear.

但这是一种在耳朵中放置一个装置来取代耳蜗的方法，耳蜗是我们通常与生俱来的装置，耳朵里有一些所谓的毛细胞，可以根据声波偏转，让我们听到声音。

By replacing the normal hearing apparatus that's deficient in deaf people with this cochlear implant.

通过用这种人工耳蜗替代聋哑人的正常听力装置。

The brain can make sense of this artificial ear basically.

大脑基本上可以理解这个人造耳。

It's not the outside ear, not the pinna, but the inner ear.

不是外耳，也不是耳廓，而是内耳。

And they can start to hear sounds.

他们可以开始听到声音。

Andrew Huberman:

安德鲁·休伯曼：

Now, some people really like the artificial cochlea.

现在，有些人真的很喜欢人工耳蜗。

They really benefit from it.

他们确实从中受益。

It restores their ability to hear and they like it.

它恢复了他们的听力，他们喜欢它。

Other people don't.

其他人则不然。

Some deaf people would prefer not to hear anything.

有些聋哑人宁愿听不到任何声音。

It can be very disruptive to them.

这对他们来说可能是非常具有破坏性的。

And some of that might have to do with the need for further better engineering of these artificial cochleas.

其中一些可能与需要进一步更好地设计这些人工耳蜗有关。

But all this really speaks to the fact that the brain is an adaptive device.

但这一切确实说明了这样一个事实：大脑是一个自适应装置。

It will respond to what you give it.

它会对你给它的东西做出反应。

It is not a device that is fixed.

它不是一个固定的设备。

In fact, the essence of the brain, especially the human brain, is to take sensory inputs and to make sense of those, meaning cognitive sense, and then to interpret those signals.

事实上，大脑，尤其是人脑的本质是接受感觉输入并理解这些输入，即认知意义，然后解释这些信号。

Andrew Huberman:

安德鲁·休伯曼：

And so this may come as a shock to some of you, and by no means am I trying to be insensitive, but pain is a perceptual thing as much as it's a physical thing; it's a belief system about what you're experiencing in your body.

因此，这可能会让你们中的一些人感到震惊，我绝不是试图表现得麻木不仁，但疼痛既是一种感觉上的东西，也是一种身体上的东西；它是一种感觉上的东西。这是一个关于你身体所经历的信念系统。

And that has important relevance for healing different types of injury and the pain associated with that injury.

这对于治疗不同类型的损伤以及与损伤相关的疼痛具有重要意义。

In people's pursuit for neuroplasticity, a question that comes up every once in a while is people will say, "If I just brush my teeth with the opposite hand for a couple nights in a row, will I get neuroplasticity?" And the answer is probably yes.

在人们追求神经可塑性的过程中，时不时会出现一个问题：“如果我连续几个晚上用另一只手刷牙，我会获得神经可塑性吗？”答案可能是肯定的。

I mean, it's a deliberate action.

我的意思是，这是一个故意的行为。

You're focusing on it.

你专注于它。

There's an end-goal.

有一个最终目标。

You're very likely to make errors, like jabbing up into lips and gums at first and then getting better at it.

你很可能会犯错误，比如一开始刺入嘴唇和牙龈，然后逐渐变得更好。

And as you heard in last episode, making errors is really important, because those errors are the signal that plasticity needs to happen.

正如您在上一集中听到的那样，犯错误非常重要，因为这些错误是可塑性需要发生的信号。

And then when you get the actions correct, then those correct actions are programmed in.

然后，当你采取正确的行动时，这些正确的行动就会被编入程序。

I'm not sure that brushing one's teeth with the opposite hand is the most effective use of this incredible thing that we have, which is plasticity.

我不确定用另一只手刷牙是对我们拥有的这种令人难以置信的东西（可塑性）的最有效利用。

It's not going to open up plasticity for many other things.

它不会为许多其他事物提供可塑性。

So if that were really important to you, for whatever reason — maybe you have a crowded bathroom, and it's easier to do on one side or the other — then fine.

因此，如果这对您来说真的很重要，无论出于何种原因 - 也许您的浴室很拥挤，并且在一侧或另一侧进行更容易 - 那么很好。

But it's kind of hard to imagine why this would be a highly adaptive behavior, unless of course you have an injured limb or you're missing a limb.

但很难想象为什么这会是一种高度适应性的行为，除非你的肢体受伤或失去了肢体。

Andrew Huberman:

安德鲁·休伯曼：

And that gets me to some really exciting and important studies that were performed mostly in the '90s as well as in the 2000s.

这让我进行了一些非常令人兴奋和重要的研究，这些研究主要在 90 年代和 2000 年代进行。

And that for now, there is really a solid base of data.

目前，确实有坚实的数据基础。

There's really a center of mass around a particular set of experiments that point to particular protocols for how to overcome motor injury.

围绕一组特定的实验确实存在一个质心，这些实验指出了如何克服运动损伤的特定方案。

And this may resonate with some of you who've ever been injured to the point where you couldn't walk well, temporarily, I hope, or even longer.

这可能会引起你们中一些人的共鸣，因为我希望，你们中的一些人曾经受伤过，暂时无法行走，甚至更长时间。

So think about a sprained ankle scenario or a broken arm scenario.

因此，考虑一下脚踝扭伤或手臂骨折的情况。

We're all familiar with the stories of people having a cast on and then getting the cast off and that the particular limb that wasn't being used that was casted is much smaller and atrophied.

我们都熟悉这样的故事：人们打上石膏，然后取下石膏，而未使用的特定肢体则变得更小且萎缩。

Most of that atrophy, you might be surprised to learn is not because the muscles aren't being used.

您可能会惊讶地发现，大部分萎缩并不是因为肌肉没有得到使用。

It's because the nerves sending signals to those muscles are not active, and therefore the muscles aren't contracting.

这是因为向这些肌肉发送信号的神经不活跃，因此肌肉不收缩。

Andrew Huberman:

安德鲁·休伯曼：

Work done by a guy named Timothy Schallert and his graduate students and postdocs, Theresa Jones and others, in the '90s and 2000s showed something really wonderful that I think we can all benefit from should we have an injury, and even if we simply want to balance out imbalances in our motor activity.

蒂莫西·沙勒特 (Timothy Schallert) 及其研究生和博士后特蕾莎·琼斯 (Theresa Jones) 等人在上世纪 90 年代和 2000 年代所做的工作显示了一些非常美妙的东西，我认为如果我们受伤，即使我们只是想平衡运动活动的不平衡，我们都可以从中受益。

And I think all of us tend to be stronger on one side or the other side, usually a right-handed person will be stronger in their left arm, not always for compensatory reasons.

我认为我们所有人都倾向于一侧或另一侧更强，通常惯用右手的人左臂会更强，并不总是出于补偿原因。

Some other time we can talk about handwriting.

改天我们可以讨论一下书法。

The lefties likely will be stronger in their right arm, although it kind of depends on whether or not people are hook-righties.

左撇子的右臂可能会更强，尽管这在某种程度上取决于人们是否是右撇子。

That's when you kind of hook around and write from the top or hook-lefties.

那是你从上或左撇子开始写作的时候。

There are all sorts of theories about this, so we can talk about right brain, left brain, math proficiency, et cetera.

关于这一点有各种各样的理论，所以我们可以谈论右脑、左脑、数学能力等等。

Andrew Huberman:

安德鲁·休伯曼：

In any event, what Schallert and colleagues showed was that if we have damage to our brain in the sensory motor pathways, any number of different sensory motor pathways, or we have damage to a limb — could be a leg, could be an arm, could be a hand — there's great benefit to restricting the use of the opposite, better-performing, uninjured limb or hand or other part of the body.

无论如何，沙勒特及其同事表明，如果我们的大脑感觉运动通路、任何数量的不同感觉运动通路受损，或者我们的肢体（可能是腿、手臂、手）受损，那么限制使用相反的、性能更好、未受伤的肢体或手或身体其他部位会有很大好处。

They had about a dozen papers showing that if there was damage centrally in the brain or there was damage to a limb, so unilateral damage as we say, one side, the thing to do is not to cast up the damaged side, although you need to do that to protect the limb of course from further damage, so if it's a broken arm, you need to cast the arm or you need to brace the arm, but that the key thing was to restrict movement of the intact, uninjured, opposite limb.

他们有大约十几篇论文表明，如果大脑中央受损或肢体受损，即我们所说的单侧损伤，一侧，要做的事情就是不要将受损的一侧抛起，尽管您需要这样做以保护肢体免受进一步的伤害，所以如果是断臂，则需要将手臂抛起或需要支撑手臂，但关键是限制完整的、未受伤的对侧肢体的运动。

Andrew Huberman:

安德鲁·休伯曼：

And when they did that, it forced some movement in the injured limb and, remarkably, through connections from the two sides of the brain, through the corpus callosum, this huge fiber pathway that links the two sides of the brain; they saw plasticity on both sides of the brain.

当他们这样做时，它迫使受伤的肢体进行一些运动，值得注意的是，通过大脑两侧的连接，通过胼胝体，这条连接大脑两侧的巨大纤维通路；他们看到了大脑两侧的可塑性。

So this makes sense when you hear it.

所以当你听到它时，这是有道理的。

Let's say I injure my left ankle and I'm limping along or I'm using crutches.

假设我的左脚踝受伤了，我一瘸一拐地走着，或者我拄着拐杖。

You would think, "Well, the last thing you want to do is injure your opposite limb or not use your opposite limb.

你可能会想：“好吧，你最不想做的就是伤害你的另一侧肢体或不使用你的另一侧肢体。

My right ankle is perfectly fine." But if I lean too hard on my right limb, and I take all the work out of the left ankle, that's actually setting up a situation where there's going to be runaway asymmetry in the central pathways and the nerve-to-muscle pathways on my left side.

我的右脚踝完全没问题。”但是，如果我过于用力地倾斜右肢，并且将所有工作都从左脚踝转移，这实际上会造成一种情况，即我左侧的中央通路和神经到肌肉通路将出现失控的不对称性。

Andrew Huberman:

安德鲁·休伯曼：

And so what they suggested, and what they showed in a variety of experiments, was that, by encouraging activity of the injured limb, provided it could be done without pain, and importantly not just exercising that limb or part of the body, but restricting the opposite healthy part of the body, that the speed of recovery was significantly faster.

因此，他们的建议以及他们在各种实验中表明的内容是，通过鼓励受伤肢体的活动，只要可以在没有疼痛的情况下完成，重要的是不仅锻炼该肢体或身体的一部分，而且限制身体的相对健康部分，恢复速度会明显更快。

Now I want to repeat, you don't want to go injuring something further.

现在我想重复一遍，你不想进一步伤害其他东西。

That's probably the worst thing you could do.

这可能是你能做的最糟糕的事情。

But in some cases where people have damage in their brain, the limbs are perfectly fine, but the motor signals aren't getting down to the limbs.

但在某些情况下，人们的大脑受损，四肢完全正常，但运动信号无法到达四肢。

And in that case, the limb is fine, so you actually are free to use the, either limb as much as you want.

在这种情况下，该肢体很好，因此您实际上可以根据需要自由使用任一肢体。

And in that case, you don't want to rely on the uninjured pathway too much.

在这种情况下，您不想过多依赖未受伤的途径。

In fact, you want to restrict the uninjured pathway.

事实上，你想限制未受伤的途径。

Andrew Huberman:

安德鲁·休伯曼：

So I find these studies remarkable.

所以我觉得这些研究很了不起。

And they've been followed up on at the molecular level, at the cellular level, many times.

他们已经在分子水平、细胞水平上进行了多次跟踪。

And I think the physiotherapists out there and the rest of you who are involved in sports medicine and some of the physicians will say, "Well, of course, that makes perfect sense." But oftentimes, this is not what happens.

我认为物理治疗师和其他从事运动医学的人以及一些医生会说：“当然，这是完全有道理的。”但通常情况并非如此。

Oftentimes, what happens is it's all about resting and limiting inflammation, et cetera, of the injured limb or the limbs corresponding to the injured part of the brain.

通常情况下，发生的事情都是关于受伤肢体或与大脑受伤部分相对应的肢体的休息和限制炎症等。

And these experiments and the collection of them point to the fact that the balance between the right and left side of our body is always dynamic.

这些实验和它们的集合指出了这样一个事实：我们身体的左右两侧之间的平衡始终是动态的。

It's always being updated at the level of neural circuitry; the Ramachandran studies with the mirror box support that too; and that even slight imbalances in the two sides of the body can get amplified.

它总是在神经回路层面上进行更新；拉马钱德兰对镜盒的研究也支持了这一点；即使身体两侧轻微的不平衡也会被放大。

Andrew Huberman:

安德鲁·休伯曼：

And so when you're in a situation where one side is injured, or the brain is injured representing one side of the body, the key thing to do is to really overwork the side that needs the work and to restrict the activity of the side that doesn't need the work because it's healthy.

因此，当你的一侧受伤，或者代表身体一侧的大脑受伤时，关键是让需要工作的一侧过度劳累，并限制不需要工作的一侧的活动，因为它是健康的。

And this has great semblance to ocular dominance plasticity, which I talked about a couple episodes ago.

这与我前几集谈到的眼睛优势可塑性非常相似。

I won't go into it in detail, but where the Nobel Prize winning neurobiologists, Torsten Wiesel and David Hubel, showed that if one eye is closed early in development, that the representation of the opposite eye in the brain is completely overtaken by the intact eye.

我不会详细讨论它，但诺贝尔奖获得者神经生物学家托斯顿·维塞尔和大卫·休贝尔表明，如果一只眼睛在发育早期就闭合，那么另一只眼睛在大脑中的表现就会完全被完整的眼睛所取代。

So this is important.

所以这很重要。

It means that all of our senses and our movements are competing for space in our brain.

这意味着我们所有的感官和动作都在争夺大脑中的空间。

And so the way to think about the principle is anytime you're injured and you're hobbling along, you don't want to injure yourself further, but you want to try and compensate in the ways that respect this competition for neural real estate.

因此，思考这个原则的方法是，每当你受伤并且一瘸一拐地前行时，你不想进一步伤害自己，但你想尝试以尊重这种神经房地产竞争的方式进行补偿。

And what that usually means is not relying on where you're still strong, because that's just going to create runaway plasticity that's going to make it very hard for you to recover the motor function, and in some cases the sensory function, of the damaged limb.

这通常意味着不要依赖于你仍然强壮的地方，因为这只会产生失控的可塑性，这将使你很难恢复受损肢体的运动功能，在某些情况下恢复感觉功能。

Andrew Huberman:

安德鲁·休伯曼：

Some of you may be wondering how long and how often one should restrict the activity of the intact or healthy limb, or limbs in some cases.

你们中的一些人可能想知道应该限制完整或健康肢体或某些情况下肢体的活动多长时间和多久一次。

And the answer is you don't have to do that all day every day.

答案是你不必每天都这样做。

These experiments centered on doing one or two hours of dedicated work, sensory motor work.

这些实验的重点是进行一两个小时的专注工作，即感觉运动工作。

So for instance, if you had the sprained ankle on the left, you might spend part of the day where your left leg, provided it's not too painful, can be exercised, again in a way that's not damaging to the injury, and the right limb can't contribute to that exercise.

举例来说，如果你扭伤了左脚踝，你可能会花一天的一部分时间来锻炼你的左腿（只要不是太痛），同样以不会损害伤处的方式进行锻炼，而右腿则不能参与该锻炼。

So this might be peddling unilaterally on a stationary bike.

所以这可能是单方面骑着固定自行车兜售。

If you can do that for a different type of limb injury like an arm injury, this might be reaching, provided the shoulder is mobile, doing reaching.

如果您可以针对不同类型的肢体损伤（例如手臂损伤）执行此操作，那么这可能是伸展运动，前提是肩膀可以活动，可以进行伸展运动。

It might be even writing with the damaged side, and then intentionally not writing with the preferred or undamaged side.

它甚至可能使用损坏的一面进行写入，然后故意不使用首选或未损坏的一面进行写入。

This has been shown to accelerate the central plasticity and the recovery of function, which I think is what most people want.

这已被证明可以加速中枢可塑性和功能恢复，我认为这是大多数人想要的。

When people are injured, they want to get back to doing what they were doing previously, and they want to be able to do that without pain.

当人们受伤时，他们想要回到之前做的事情，并且他们希望能够在没有痛苦的情况下做到这一点。

Andrew Huberman:

安德鲁·休伯曼：

Now this brings up another topic which is definitely related to neuroplasticity and injury, but is a more general one that I hear about a lot, which is traumatic brain injury.

现在这就提出了另一个话题，它肯定与神经可塑性和损伤有关，但这是我经常听到的一个更普遍的话题，那就是创伤性脑损伤。

Many injuries are not just about the limb and the lack of use of the limb, but concussion and head injury.

许多伤害不仅仅是肢体和肢体无法使用，还包括脑震荡和头部受伤。

And I want to emphasize I'm not a neurologist; I have many colleagues that are.

我想强调一下，我不是一名神经科医生；我只是一名神经科医生。我有很多同事都是这样的。

At some point, we will do a whole month on TBI, because it's such a serious issue, and it's such a huge discussion.

在某个时候，我们将用整整一个月的时间来讨论 TBI，因为这是一个如此严重的问题，而且这是一个如此巨大的讨论。

But I want to talk a little bit about what is known about recovery from concussion.

但我想谈谈关于脑震荡恢复的已知信息。

And this is very important, because it has implications for just normal aging as well in offsetting some of the cognitive decline and physical decline that occurs with normal aging.

这非常重要，因为它不仅对正常衰老有影响，而且还能抵消正常衰老引起的一些认知衰退和身体衰退。

So we shouldn't think of TBI as just for the football players or just for the kids that had an injury or just for the person that was in the car accident.

因此，我们不应该认为 TBI 只适用于足球运动员、受伤的孩子或遭遇车祸的人。

We want to learn about TBI and understand TBI for those folks.

我们希望了解 TBI 并为这些人了解 TBI。

Andrew Huberman:

安德鲁·休伯曼：

But we're also going to talk about TBI as it relates to general degradation of brain function, because there's a certain semblance there of TBI to general brain aging.

但我们还将讨论 TBI，因为它与大脑功能的普遍退化有关，因为 TBI 与一般大脑老化有一定的相似之处。

Typically after TBI, there are a number of different things that happen, and there are a huge range of things that can create TBI.

通常，在 TBI 之后，会发生许多不同的事情，并且有很多事情可以造成 TBI。

Neurologists and the emergency room physicians are going to want to know, "Was the skull itself injured?

神经科医生和急诊室医生想知道，“头骨本身受伤了吗？

Or did the brain rattle around in the skull?

或者大脑在头骨中嘎嘎作响？

Was there actually a breach through the skull?

头骨真的有裂口吗？

Is there a physical object in there?

里面有实体物体吗？

How many concussions has the person had?" I mean, everyone's situation with TBI is incredibly different.

这个人有多少次脑震荡？”我的意思是，每个人的 TBI 情况都非常不同。

But there's a constellation of symptoms that many people, if not all people, with TBI report, which is headache, photophobia — that lights become kind of aversive — sleep disruption, trouble concentrating, sometimes mood issues.

但是，许多患有 TBI 的人（即使不是所有人）都会出现一系列症状，包括头痛、畏光（即令人厌恶光）、睡眠障碍、注意力不集中，有时还有情绪问题。

There's a huge range, and of course the severity will vary, et cetera.

范围很大，当然严重程度也会有所不同，等等。

Andrew Huberman:

安德鲁·休伯曼：

In a previous episode, I mentioned the Kennard Principle.

在上一集中，我提到了肯纳德原理。

The Kennard Principle, named after the famous neurologist, named by and after the famous neurologist Margaret Kennard, said that if you're going to get a brain injury, better to get it early in life than later in life.

肯纳德原理（Kennard Principle）以著名神经学家玛格丽特·肯纳德（Margaret Kennard）的名字命名，该原理说，如果你要遭受脑损伤，最好是在生命早期而不是晚年受到伤害。

And that's because the brain has a much greater heightened capacity for repairing itself early in life than later.

这是因为大脑在生命早期的自我修复能力比生命后期要强得多。

But of course, none of us want TBI, and you can't pick when you get your TBI.

但当然，我们谁都不想要 TBI，而且当你获得 TBI 时你也无法选择。

You can avoid certain activities that would give you TBI.

您可以避免某些可能导致 TBI 的活动。

But really, when it comes to TBI, there are couple things that are agreed upon across the board.

但实际上，当谈到 TBI 时，有一些事情是得到了一致同意的。

Andrew Huberman:

安德鲁·休伯曼：

The first one is, as much as possible, you want to avoid a second traumatic brain injury or concussion.

第一个是，您希望尽可能避免第二次脑外伤或脑震荡。

Now, that's going to be a tough one for some of the athletes and even recreational athletes to swallow, because they want to continue in their sport.

现在，对于一些运动员甚至休闲运动员来说，这将是一件难以接受的事情，因为他们想继续从事自己的运动。

And I'm not here to tell you that you should or you shouldn't, but that's simply the way that it is.

我并不是来告诉你应该或不应该，但事实就是如此。

For folks that are in military or that are in certain professions; construction is a place where we see a lot of TBI.

对于军人或从事某些职业的人；建筑施工是我们经常看到 TBI 的地方。

It's not always just football.

这并不总是只有足球。

A lot of construction workers are dealing with heavy objects swinging around in space.

许多建筑工人正在处理在太空中摆动的重物。

They wear those hardhat helmets, which unfortunately don't protect much against a lot of those blunt forces and certainly not against falls and things of that sort.

他们戴着安全帽，不幸的是，这种头盔不能很好地抵御大量钝力，当然也不能防止跌倒和类似的情况。

So many people, in order to survive and feed their families, have to go back to work.

很多人为了生存和养家糊口，不得不回去工作。

Andrew Huberman:

安德鲁·休伯曼：

It's very clear that regardless of whether or not there was a skull break and regardless of when the TBI happened and how many times it's happened, that the system that repairs the brain, the adult brain, is mainly centered around this lymphatic system that we call, for the brain, the glymphatic system.

很明显，无论是否有颅骨骨折，无论 TBI 何时发生以及发生了多少次，修复大脑（成人大脑）的系统主要集中在我们称之为大脑的类淋巴系统的淋巴系统。

Now, the brain wasn't thought to have a lymphatic system.

现在，人们不认为大脑有淋巴系统。

It wasn't thought to have circulating immune cells, but about 10 years ago it was sort of rediscovered, because, if you look in the literature, you realize this stuff was around longer, that there's a glymphatic system.

人们不认为它有循环免疫细胞，但大约 10 年前，它被重新发现，因为，如果你查阅文献，你会意识到这个东西存在的时间更长，有一个类淋巴系统。

It's sort of like a sewer system that clears out the debris that surrounds neurons, especially injured neurons.

它有点像一个下水道系统，可以清除神经元周围的碎片，特别是受损的神经元。

And the glymphatic system is very active during sleep.

并且类淋巴系统在睡眠期间非常活跃。

It's been imaged in functional and magnetic resonance imaging.

它已在功能成像和磁共振成像中成像。

And the glymphatic system is something that you want very active, because it's going to clear away the debris that sits between the neurons and the cells that surround the connections between the neurons called the glia.

类淋巴系统是你想要非常活跃的东西，因为它将清除位于神经元和围绕神经元之间连接（称为神经胶质细胞）的细胞之间的碎片。

Those cells are actively involved in repairing the connections between neurons when damaged.

这些细胞在受损时积极参与修复神经元之间的连接。

Andrew Huberman:

安德鲁·休伯曼：

So the glymphatic system is so important that many people, if not all people who get TBI, are told, "Get adequate rest.

因此，类淋巴系统非常重要，以至于许多人（即使不是所有患有 TBI 的人）都被告知：“充分休息。

You need to sleep." And that's kind of twofold advice.

你需要睡觉。”这是双重建议。

On the one hand, it's telling you to get sleep, because all these good things happen in sleep.

一方面，它告诉你去睡觉，因为所有这些美好的事情都发生在睡眠中。

It's also about getting those people to not continue to engage in their activity full-time or really try and hammer through it.

这也是为了让这些人不再继续全职从事他们的活动，或者真正尝试并努力完成它。

You might say, "Well, if you have trouble sleeping, how are you supposed to get deep sleep?" Most of the activity of the glymphatic system, this washout of the debris, is occurring during slow-wave sleep.

你可能会说，“好吧，如果你睡眠困难，你应该如何获得深度睡眠呢？”类淋巴系统的大部分活动（即清除碎片）发生在慢波睡眠期间。

Slow-wave sleep, as I mentioned in a previous episode, is something that happens typically in the early part of the evening, so even for those of you that are falling...

正如我在上一集中提到的，慢波睡眠通常发生在傍晚早些时候，所以即使对于那些正在坠落的人来说......

Or early part of the night, rather.

或者更确切地说，是在深夜。

If you're falling asleep, and then waking up three, four hours later, it's important that you continue to get sleep, but know that the slow-wave sleep is mainly packed toward the early part of the night.

如果您正在入睡，然后在三、四个小时后醒来，那么继续睡眠很重要，但要知道慢波睡眠主要集中在夜晚的早些时候。

So that hopefully will alleviate some of the anxiety about the 3:00 and 4:00 a.m.

因此，这有望缓解凌晨 3:00 和 4:00 的一些焦虑。

wake up, although you really should follow some of the protocols that I've suggested, and your physician's protocols, in order to try and get regular, longer sleep of seven, eight hours.

醒来吧，尽管你确实应该遵循我建议的一些方案以及你的医生的方案，以便尝试获得规律的、更长的七、八小时睡眠。

Later, we're going to talk about the eight-hour mark as a prerequisite for repair.

稍后我们将讨论八小时标记作为修复的前提条件。

Andrew Huberman:

安德鲁·休伯曼：

The glymphatic system has been shown to be activated further in two ways.

类淋巴系统已被证明可以通过两种方式进一步激活。

One is that sleeping on one side, not on back or stomach, seems to increase the amount of washout or wash through, I should say, of the glymphatic system.

一是侧睡，而不是仰卧或俯卧，似乎会增加类淋巴系统的冲刷或冲刷量。

There aren't a ton of data on this, but the data that exists are pretty solid.

这方面的数据并不多，但现有的数据非常可靠。

Again, sleeping on one side or with feet slightly elevated, as well, has been shown to increase the rate of clearance of some of the debris.

同样，事实证明，侧睡或将脚稍微抬高也可以提高某些碎片的清除率。

And that's because the way that the lymphatic system works is it has a physical pressure fluid dynamic to it that allow it to work more efficiently, when one is sleeping on their side or with feet slightly elevated.

这是因为淋巴系统的工作方式是它具有物理压力流体动力，当一个人侧睡或双脚稍微抬高时，它可以更有效地工作。

So this means not falling asleep in a chair while watching TV.

所以这意味着看电视时不要在椅子上睡着。

Andrew Huberman:

安德鲁·休伯曼：

This means, if possible, not falling asleep on one's back or on one's stomach — sleeping on one's side.

这意味着，如果可能的话，不要仰卧或俯卧入睡，而是侧睡。

And if you can't do that...

如果你做不到...

I don't really like to sleep on my side.

我真的不喜欢侧睡。

I sleep with my feet slightly elevated.

我睡觉时双脚稍微抬高。

I put out the kind of thin pillow under my ankles.

我把那种薄枕头垫在脚踝下面。

I don't have TBI, but I have had a few concussions before, but right now I feel fine.

我没有脑外伤，但之前也有过几次脑震荡，但现在感觉很好。

But I find that putting the pillow under my ankles helps me sleep much more deeply and I wake up feeling much more refreshed.

但我发现把枕头放在脚踝下可以帮助我睡得更沉，而且我醒来时感觉更精神焕发。

The other thing that has been shown to improve the function of the glymphatic system, and this again is for sake of TBI, as well as for everyone, even without brain injury, is a certain form of exercise.

另一种已被证明可以改善类淋巴系统功能的方法是某种形式的锻炼，这也是为了 TBI，也为了每个人，即使没有脑损伤。

And I want to be very, very clear here.

我想在这里说得非常非常清楚。

I will never, and I am not suggesting that people exercise in any way that aggravates their injury or that goes against their physician's advice.

我永远不会，我也不建议人们以任何会加重伤害或违背医生建议的方式进行锻炼。

Take your physician's advice as to whether or not you should be exercising at all and how much and into what intensity.

听取医生关于是否应该锻炼、锻炼量和强度的建议。

Andrew Huberman:

安德鲁·休伯曼：

However, there's some interesting data, and we can provide a link to the review on this.

然而，有一些有趣的数据，我们可以提供对此进行评论的链接。

It shows that exercise of what, I guess, people would nowadays call it zone 2 cardio, which is kind of low-level cardio that one could do while talking to somebody else.

我想，它表明人们现在称之为第二区有氧运动的锻炼，这是一种低水平的有氧运动，人们可以在与别人交谈时进行。

You could maintain a conversation, although you don't have to talk to somebody else, it just gives you a sense of the intensity of the exercise.

你可以保持对话，尽管你不必与其他人交谈，但这只是让你感受到练习的强度。

That zone 2 cardio for 30 to 45 minutes three times a week seems to improve the rates of clearance of some of the debris after injury, and in general, injury or no, to accelerate and improve the rates of flow for the glymphatic system.

每周 3 次、每次 30 至 45 分钟的 2 区有氧运动似乎可以提高受伤后某些碎片的清除率，而且总的来说，无论是否受伤，都能加速和改善类淋巴系统的流速。

I find this really interesting, because I think nowadays there's such an obsession with high-intensity interval training and people trying to pack in as much as they can into a short workout, which is great if it brings people to the table who haven't been exercising before.

我觉得这真的很有趣，因为我认为现在人们对高强度间歇训练如此痴迷，人们试图将尽可能多的时间投入到短期锻炼中，如果它能让以前没有锻炼过的人参与进来，那就太好了。

Andrew Huberman:

安德鲁·休伯曼：

But I think it's really important that we know that the data on exercise and its relationship to brain health speak to doing 30 to 45 minutes of this kind of what we might call low-level cardio.

但我认为非常重要的是，我们知道有关运动的数据及其与大脑健康的关系需要进行 30 到 45 分钟的这种我们称之为低强度有氧运动的运动。

It could be fast walking.

走路可能很快。

It could be jogging, if you can do that with your injury safely.

如果你能在受伤的情况下安全地进行慢跑，那么可以选择慢跑。

It could be cycling.

可能是骑自行车。

This is not the kind of workout that's designed to get your heart rate up to the point where you're improving your fitness levels at some sort of massive rate or taking huge jumps in your VO2 max or anything like that.

这种锻炼的目的不是为了让你的心率达到以某种大幅度提高你的健康水平或大幅提高你的最大摄氧量或类似的程度。

This is exercise...

这是锻炼...

I do this, and I know a number of other people, especially people in communities where there is a lot of TBI, are now starting to adopt this, that the 30 to 45 minutes three times a week or so, could be more, of this zone-2-type cardio can be very beneficial for washout of debris from the brain.

我这样做，而且我知道其他一些人，尤其是患有大量 TBI 的社区的人们，现在开始采用这种方法，每周 3 次左右，每次 30 到 45 分钟，可能更多，这种 2 区型有氧运动对于清除大脑中的碎片非常有益。

Andrew Huberman:

安德鲁·休伯曼：

And this is really interesting outside of TBI, because what we know from aging is that aging is a nonlinear process.

这在 TBI 之外确实很有趣，因为我们从衰老中知道衰老是一个非线性过程。

It's not like with every year of life your brain gets a little older.

这并不是说你的大脑会随着年龄的增长而变老一点。

Sometimes it follows what's more like a step function.

有时它更像是一个阶跃函数。

You get these big jumps in markers of aging.

衰老标志物会大幅跃升。

I guess that we could think of them as jumps down, because it's a negative thing for most everybody would like to live longer and be healthier in brain and body.

我想我们可以将它们视为跳下，因为对于大多数人来说这是一件消极的事情，每个人都希望活得更长，大脑和身体更健康。

And so the types of exercise I'm referring to now are really more about brain longevity and about keeping the brain healthy, than they are about physical fitness.

因此，我现在提到的运动类型实际上更多的是关于大脑寿命和保持大脑健康，而不是关于身体健康。

There's no reason why you couldn't do this.

你没有理由不能这样做。

And also provided again it's safe for you, given your brain state and injury state, et cetera; there's no reason why you couldn't also combine it with weight training in other forms of cardio.

并且再次假设它对您是安全的，考虑到您的大脑状态和受伤状态等；您没有理由不能将其与其他形式的有氧运动的重量训练结合起来。

Andrew Huberman:

安德鲁·休伯曼：

So I think this is really interesting, and if some of you would like to know the mechanism, or at least the hypothesized mechanism, there's a molecule called aquaporin-4.

所以我认为这真的很有趣，如果你们中的一些人想了解其中的机制，或者至少是假设的机制，有一种叫做 aquaporin-4 的分子。

It almost sounds like the fourth in a sequel of movies or something like that.

这听起来几乎像是电影续集的第四部或类似的东西。

But aquaporin-4 is a molecule that is related to the glial system.

但aquaporin-4是一种与神经胶质系统相关的分子。

So glia — it means glue in Latin — are these cells in the brain, the most numerous cells in the brain in fact, that ensheathe synapses, but they're very dynamic cells.

神经胶质细胞——在拉丁语中是胶水的意思——是大脑中的细胞，实际上是大脑中数量最多的细胞，它们包裹着突触，但它们是非常动态的细胞。

They're like little ambulance cells.

他们就像小救护车。

The microglia will run in and will gather up debris and soak it up and then run out after an injury.

小胶质细胞会跑进去，收集碎片并将其吸收，然后在受伤后跑出来。

Aquaporin-4 is mainly expressed by the glial cell called the astrocyte.

Aquaporin-4 主要由称为星形胶质细胞的神经胶质细胞表达。

Astro looks like a little star, incredibly interesting cells.

Astro 看起来像一颗小星星，是非常有趣的细胞。

And the thing to remember is that the astrocytes bridge the connection between the neurons, the synapse, the connections between them, and the vasculature, the blood system, and the glymphatic system.

需要记住的是，星形胶质细胞在神经元、突触、它们之间的连接以及脉管系统、血液系统和类淋巴系统之间架起了桥梁。

Andrew Huberman:

安德鲁·休伯曼：

So they kind of sit at the interface.

所以他们有点坐在界面上。

Kind of imagine somebody on an emergency site, car crash site, who's directing everybody around as to what to do: "Get that person on a stretcher.

想象一下，有人在紧急情况现场、车祸现场，指导每个人该怎么做：“把那个人放在担架上。

Bandage them up.

把它们包起来。

Call their mother, et cetera, et cetera.

打电话给他们的母亲，等等，等等。

Get this out of the road.

把这个从路上拿出来。

Put down some flares." The astrocytes can work in that capacity, as well as doing some things more directly.

放下一些照明弹。”星形胶质细胞可以以这种能力工作，并且可以更直接地做一些事情。

So this lymphatic system and the glial astrocyte system is the system that we want chronically active throughout the day, as much as possible, so low-level walking, zone 2 cardio.

所以这个淋巴系统和神经胶质星形胶质细胞系统是我们想要在一天中尽可能长期活跃的系统，所以低水平步行，2区有氧运动。

And then at night during slow-wave sleep is then really when this glymphatic system kicks in.

然后在晚上的慢波睡眠期间，这个类淋巴系统就真正开始发挥作用了。

So that should hopefully be an actionable takeaway, provided that you can do that kind of cardio safely that I believe everybody should be doing who cares about brain longevity, not just people who are trying to get over TBI.

因此，如果你可以安全地进行这种有氧运动，那么这应该是一个可行的结论，我相信每个关心大脑寿命的人都应该这样做，而不仅仅是那些试图克服创伤性脑损伤的人。

Andrew Huberman:

安德鲁·休伯曼：

Now, I'd like to return a little bit to some of the subjective aspects of pain modulation, because I think it's so interesting and so actionable that everyone should know about this.

现在，我想稍微回顾一下疼痛调节的一些主观方面，因为我认为它非常有趣且可操作，每个人都应该了解这一点。

And in this case, we can also say that, regardless of whether or not you're experiencing pain, acute or chronic, what I'm about to tell you is as close as anything is to proof.

在这种情况下，我们还可以说，无论你是否正在经历疼痛，无论是急性还是慢性，我要告诉你的都是最接近证据的。

In science, we rarely talk about proof.

在科学中，我们很少谈论证据。

We talk about evidence in favor or against a hypothesis.

我们谈论支持或反对假设的证据。

But as close as possible to proof that our interpretation, our subjective interpretation of a sensory event, is immensely powerful for dictating our experience of the event.

但尽可能证明我们的解释，我们对感官事件的主观解释，对于决定我们对事件的体验来说是非常强大的。

Here are a couple examples.

这里有几个例子。

First of all, anyone who's ever done combat sports or martial arts knows that it's incredible how little a punch hurts during a fight.

首先，任何参加过格斗运动或武术的人都知道，在战斗中一拳所造成的伤害是如此之小，这是令人难以置信的。

And it's incredible how much it hurts after a fight.

打架后的疼痛程度令人​​难以置信。

Andrew Huberman:

安德鲁·休伯曼：

The molecule adrenaline, when it's liberated into our body, truly blunts our experience of pain.

当肾上腺素分子释放到我们体内时，它确实会减弱我们对疼痛的体验。

We all know the stories of people walking miles on stumped legs, people doing all sorts of things that were incredible feats, that allow them to move through what would otherwise be pain.

我们都知道人们用残肢行走数英里的故事，人们做了各种令人难以置信的壮举，使他们能够克服本来会带来的痛苦。

And afterward, they do experience extreme pain.

之后，他们确实经历了极度的痛苦。

But during the event, oftentimes they are not experiencing pain, and that's because of the pain-blunting effects of adrenaline.

但在活动期间，他们通常不会感到疼痛，这是因为肾上腺素具有减轻疼痛的作用。

I'll tell you exactly how this works in a few minutes when we talk about acupuncture.

当我们谈论针灸时，我会在几分钟内告诉你它是如何工作的。

But norepinephrine binding to particular receptors, adrenaline binding to particular receptors, actually shuts down pain pathways.

但去甲肾上腺素与特定受体结合，肾上腺素与特定受体结合，实际上会关闭疼痛通路。

Andrew Huberman:

安德鲁·休伯曼：

People who anticipate an injection of morphine immediately report the feeling of loss of pain.

预计注射吗啡的人会立即报告疼痛消失的感觉。

Their pain starts to diminish, because they know they're going to get pain relief.

他们的疼痛开始减轻，因为他们知道疼痛会得到缓解。

And it's a powerful effect.

这是一个强大的效果。

Now, all of you are probably saying, "Placebo effect." Placebo effects are very real.

现在，你们所有人可能都会说“安慰剂效应”。安慰剂效应非常真实。

Placebo effects and "belief effects," as they're called, have a profound effect on our experience of noxious stimuli, like pain.

安慰剂效应和所谓的“信念效应”对我们对疼痛等有害刺激的体验有着深远的影响。

And they can also have a profound effect on positive stimuli and things that we're looking forward to.

它们还可以对积极的刺激和我们期待的事情产生深远的影响。

Andrew Huberman:

安德鲁·休伯曼：

One study that I think is particularly interesting here is from my colleague at Stanford, Sean Mackey.

我认为这里特别有趣的一项研究来自我在斯坦福大学的同事肖恩·麦基（Sean Mackey）。

They did a neuro imaging study.

他们做了一项神经成像研究。

They subjected people to pain.

他们使人们遭受痛苦。

In this case, it was a heat pain.

在这种情况下，是一种热痛。

People have very specific thresholds to heat at which they cannot tolerate any more heat.

人们对热量有非常特定的阈值，一旦超过阈值，他们就无法忍受更多的热量。

But they explored the extent to which looking at an image of somebody, in this case a romantic partner that the person loved, would allow them to adjust their pain response.

但他们探索了观看某人的图像（在本例中是该人所爱的浪漫伴侣）在多大程度上可以让他们调整疼痛反应。

And it turns out it does.

事实证明确实如此。

If people are looking at an image or thinking about a person that they love, or even a thing that they love, a pet that they love, studies previous to the one that Mackey and colleagues did showed that their experience of pain was reduced; their threshold for pain was higher.

麦基和同事之前的研究表明，如果人们看着一张照片或想到一个他们所爱的人，甚至是他们所爱的一件东西、一只他们所爱的宠物，他们的疼痛体验会减少；他们对疼痛的阈值更高。

They could tolerate more pain.

他们可以忍受更多的痛苦。

And they reported it as not as painful.

他们报告说没有那么痛苦。

But there's a twist there, which is, it turns out that the extent to which love will modulate pain has everything to do with how infatuated and obsessed somebody is with the object of their love.

但这里有一个转折点，那就是，事实证明，爱调节痛苦的程度与某人对所爱对象的迷恋和痴迷程度密切相关。

People that report thinking about somebody or a pet for many hours of the day, kind of having an obsessive nature, almost a kind of what people might call "codependency." For those of you that are listening, I'm just providing air quotes ,because codependency is kind of a clinical thing now, although it's thrown around a lot all the time.

那些在一天中的很多时间里想着某人或宠物的人，有点具有强迫性，几乎是一种人们所说的“相互依赖”。对于那些正在倾听的人，我只是提供空中引述，因为相互依赖现在是一种临床问题，尽管它一直被广泛提及。

It's sort of like gaslighting.

这有点像煤气灯操纵。

People talk about gaslighting all the time now.

人们现在一直在谈论煤气灯操纵。

Gaslighting is a real thing, but then people talk about gaslighting for many things outside the clinical description.

煤气灯操纵是真实存在的，但人们在临床描述之外谈论煤气操纵的许多事情。

If people are very obsessed with somebody, they have a kind of obsessive love of somebody's face, even if the other person doesn't know them, which is a little weird.

如果人们对某人非常着迷，他们会对某人的脸有一种痴迷的爱，即使对方不认识他们，这有点奇怪。

Andrew Huberman:

安德鲁·休伯曼：

That response, that feeling of love internally can blunt the pain experience to a significant degree.

这种反应，那种内心的爱的感觉可以在很大程度上减轻痛苦的经历。

These are not small effects.

这些都不是小影响。

So it's not just that love can protect us from pain, it's that infatuation and obsession can protect us from pain.

所以，不仅仅是爱可以保护我们免受痛苦，痴情和痴迷也可以保护我们免受痛苦。

And, not surprisingly, how early a relationship is, how new a relationship is, directly correlates with people's ability, they showed, to use this love, this internal representation of love, to blunt the pain response.

而且，毫不奇怪，一段关系有多早，有多新，与人们使用这种爱、这种爱的内在表现来减弱痛苦反应的能力直接相关。

So for those of you that have been with your partners for many years and you love them very much and you're obsessed with them, terrific.

因此，对于那些与伴侣在一起多年、非常爱他们、痴迷于他们的人来说，太棒了。

You have a pre-installed...

您已经预装了...

Well, I suppose it's not pre-installed; you had to do the work because relationships are work.

嗯，我想它没有预先安装；你必须做这项工作，因为人际关系就是工作。

But you've got an installed mechanism for blunting pain.

但你已经安装了一种减轻疼痛的机制。

And again, these are not minor effects.

再说一遍，这些都不是小影响。

These are major effects.

这些都是主要影响。

And it's all going to be through that top-down modulation that we talked about.

这一切都将通过我们谈到的自上而下的调制进行。

Andrew Huberman:

安德鲁·休伯曼：

Not unlike the mirror box experiments with phantom limb that relieve phantom pain or some other top-down modulation, and the opposite example is the nail through the boot, which is a visual image that made the person think it was painful, when in fact it was painful even though there was no tissue damage.

与镜盒实验中使用幻肢缓解幻痛或其他自上而下的调制不同，相反的例子是钉子穿过靴子，这是一种视觉图像，使人认为这是痛苦的，而事实上，即使没有组织损伤，它也是痛苦的。

It was all perceptual.

这都是感性的。

So the pain system is really subject to these perceptual influences, which is remarkable, because really when we think about the somatosensory system, it has this cognitive component, it's got this peripheral component, but there's another component, which is the way in which our sensation, our somatosensory system, is woven in with our autonomic nervous system.

所以疼痛系统确实受到这些知觉的影响，这是值得注意的，因为当我们真正思考体感系统时，它有这个认知成分，它有这个外围成分，但还有另一个成分，那就是我们的感觉，我们的体感系统，与我们的自主神经系统交织在一起的方式。

Andrew Huberman:

安德鲁·休伯曼：

And we're going to get to that next, but I want to just raise the idea that the reason that this kind of infatuation and obsessive love can blunt the pain response and increase one's threshold for pain may have to do, I would say almost certainly has to do, but it hasn't been measured yet, with dopamine release, because dopamine is absolutely the molecule that's liberated in our brain and body when there's a new kind of obsession or infatuation.

我们接下来要讨论这个问题，但我只想提出这样一个想法，这种迷恋和痴迷的爱会减弱疼痛反应并提高一个人对疼痛的阈值，这可能是有关系的，我想说几乎肯定有关系，但它还没有通过多巴胺的释放进行测量，因为多巴胺绝对是当出现一种新的迷恋或迷恋时在我们的大脑和身体中释放的分子。

It's very distinct from the kind of love chemicals, if you will.

如果你愿意的话，它与爱情化学物质非常不同。

I don't even like calling them love chemicals.

我什至不喜欢称它们为爱情化学品。

That just feels weird.

就是感觉很奇怪。

If this were text, I would delete that line.

如果这是文本，我会删除该行。

Andrew Huberman:

安德鲁·休伯曼：

But from the chemicals associated with warmth and connection, such as serotonin and oxytocin, which tend to be for more stable, long-lasting relationships.

但来自与温暖和联系相关的化学物质，例如血清素和催产素，它们往往有助于建立更稳定、持久的关系。

Dopamine is what dilates the pupils, which gets people really excited.

多巴胺可以扩张瞳孔，让人非常兴奋。

They can't stop thinking about somebody.

他们无法停止思考某人。

The text messages are even exciting.

短信甚至令人兴奋。

They write to them, and they can't wait for the text messages to come back.

他们写信给他们，他们等不及短信回复。

The dot, dot, dot on the screen of the text message is excruciating.

短信屏幕上的点、点、点令人难以忍受。

They don't respond for two minutes, and people are getting flipped out.

他们两分钟都没有回应，人们都快疯了。

Andrew Huberman:

安德鲁·休伯曼：

I'm not here to support that kind of whatever.

我来这里不是为了支持那种事。

What I'm saying is that that obsessive type of love, which without question is going to be associated with the dopamine pathway, does seem to have a utility in the context of reducing the unpleasantness of physical pain and probably has to a lot to do with reducing the unpleasantness of a lot of life, like sitting in traffic, et cetera.

我想说的是，这种强迫性的爱，毫无疑问与多巴胺通路有关，似乎确实有助于减少身体疼痛的不愉快，并且可能与减少许多生活中的不愉快有很大关系，比如堵车等等。

Because when we talk about pain, emotional pain and physical pain start to become one and the same.

因为当我们谈论痛苦时，情感上的痛苦和身体上的痛苦开始变得一回事。

They are so closely intertwined that the lines between them neurally become very blurry.

它们是如此紧密地交织在一起，以至于它们之间的神经界限变得非常模糊。

What do I mean by that?

我这么说是什么意思？

Well, if love and infatuation can reduce pain, presumably through the release of dopamine, well then, does dopamine release, itself, blunt pain?

好吧，如果爱和迷恋可以减轻疼痛（大概是通过释放多巴胺），那么，多巴胺释放本身会减轻疼痛吗？

Should we be chasing dopamine release as a way to treat chronic and acute pain?

我们是否应该通过释放多巴胺来治疗慢性和急性疼痛？

And that's exactly what we're going to talk about now.

这正是我们现在要讨论的内容。

Independent of love, we're going to talk about something quite different, which is putting needles and electricity in different parts of the body, so-called acupuncture.

独立于爱，我们要谈论一些完全不同的东西，即将针和电放在身体的不同部位，即所谓的针灸。

Andrew Huberman:

安德鲁·休伯曼：

Something that, for many people, it's been viewed as a kind of alternative medicine, but now there are excellent laboratories exploring what's called electroacupuncture and acupuncture.

对于许多人来说，它被视为一种替代医学，但现在有优秀的实验室正在探索所谓的电针疗法和针灸疗法。

These are big university centers.

这些都是大型大学中心。

In fact, my source for everything I'm about to tell you next is Professor Qiufu Ma at Harvard Medical School and his papers.

事实上，我接下来要告诉你的一切的来源都是哈佛医学院的马秋福教授和他的论文。

I stand behind the information that I'm going to provide today.

我支持今天要提供的信息。

But it's extracted largely from the Ma lab's papers, which use very rigorous variable-isolating experiments to address just how does something like acupuncture work?

但它主要摘自马实验室的论文，这些论文使用非常严格的变量隔离实验来解决像针灸这样的东西是如何起作用的？

And I think what you'll be interested in and surprised to learn is that it does work, but sometimes it can exacerbate pain and sometimes it can relieve pain, and it all does that through very discrete pathways, for which we can really say this neuron connects to that neuron connects to the adrenals.

我想你会感兴趣并且惊讶地发现它确实有效，但有时它会加剧疼痛，有时它可以减轻疼痛，而且这一切都是通过非常离散的路径来实现的，为此我们可以真正说这个神经元连接到那个神经元连接到肾上腺。

And we can tie this all back to dopamine, because in the end, it's the chemicals and neural circuits that are giving rise to these perceptions, or these experiences rather, of things that we call pain, love, et cetera.

我们可以将这一切与多巴胺联系起来，因为最终，是化学物质和神经回路产生了这些感知，或者更确切地说是这些我们称之为痛苦、爱等事物的体验。

Andrew Huberman:

安德鲁·休伯曼：

In a previous podcast episode, I mentioned my experience of visiting an acupuncturist and getting acupuncture.

在之前的播客节目中，我提到了我拜访针灸师并接受针灸治疗的经历。

The acupuncture itself didn't really do that much for me, but I wasn't there for any specific reason.

针灸本身对我来说并没有多大作用，但我没有因为任何特定原因而在那里。

It was gifted to me by somebody, and I wanted to try it.

这是某人送给我的礼物，我想尝试一下。

I'm not passing judgment on acupuncture.

我不会对针灸做出判断。

In fact, I know a number of people that really derive tremendous benefit from acupuncture for pain and for gastrointestinal issues.

事实上，我认识很多人，他们确实从针灸治疗疼痛和胃肠道问题中获得了巨大的益处。

There are actually a lot of really good peer-reviewed studies supporting the use of acupuncture for, in particular, GI tract issues.

实际上有很多非常好的同行评审研究支持使用针灸治疗，特别是胃肠道问题。

In recent years, there's been an emphasis on trying to understand the mechanism of things like acupuncture, and acupuncture itself, not to support acupuncture or to try to get everybody to do acupuncture, but as a way to try and understand how these sorts of practices might actually benefit people who are experiencing pain, or for changing the nervous system or brain-body relationship in general.

近年来，人们一直强调尝试了解针灸等事物的机制以及针灸本身，不是为了支持针灸或试图让每个人都做针灸，而是作为一种尝试和理解这些做法如何真正有益于正在经历疼痛的人，或改变神经系统或大脑与身体关系的方法。

Andrew Huberman:

安德鲁·休伯曼：

And actually the National Institutes of Health in the United States now has an entire subdivision, an institute within the National Institutes of Health, which is Complementary Health.

实际上美国国立卫生研究院现在有一个完整的部门，国立卫生研究院内的一个研究所，这就是补充健康。

And that institute is interested in things like acupuncture and a variety of other practices that I think 10, 15 years ago, people probably thought were really alternative and maybe even counterculture, at least in the States.

该研究所对针灸和其他各种疗法很感兴趣，我认为 10、15 年前，人们可能认为这些疗法确实是另类的，甚至可能是反主流文化的，至少在美国是这样。

And it's exciting.

这很令人兴奋。

I think people are starting to really take a look at what's going on under the hood for certain types of treatments that are very useful, and I think it's very likely to lead to an expanded number of treatments for a number of different conditions.

我认为人们开始真正了解某些非常有用的治疗类型的幕后情况，并且我认为这很可能导致针对许多不同病症的治疗方法的增加。

What I want to talk about, in terms of acupuncture, is the incredible way in which acupuncture illuminates the crosstalk between the somatosensory system — our ability to feel stuff externally, exteroception; internally, interoception — and how that somatosensory system is wired in within communicating with our autonomic nervous system that regulates our levels of alertness or calmness.

就针灸而言，我想谈论的是针灸以令人难以置信的方式阐明了体感系统之间的串扰——我们感知外部事物的能力，外感；在内部，内感受——以及体感系统如何与我们的自主神经系统进行通信，调节我们的警觉或平静水平。

Andrew Huberman:

安德鲁·休伯曼：

After that I'm going to talk about how the acupuncture that's being done right now also points to relief for what's called referred pain.

之后我将讨论现在正在进行的针灸如何缓解所谓的牵涉痛。

So this takes us all back to the homunculus.

这让我们回到了小人身上。

Let's start there.

让我们从这里开始吧。

We have this representation of our body surface in our brain.

我们的大脑中有身体表面的这种表征。

That representation is what we call somatotopic, and what somatotopy is is it just means that areas of your body that are near one another, so your thumb and your forefinger, for instance, are represented by neurons that are nearby each other in the brain.

这种表征就是我们所说的体位（somatotopy），而体位（somatotopy）只是意味着你身体中彼此靠近的区域，例如你的拇指和食指，由大脑中彼此靠近的神经元代表。

Now you might say, well, duh, but it actually didn't have to be that way.

现在你可能会说，好吧，呃，但实际上不必是这样。

The neurons that represent the tip of my forefinger and the neurons that represent my thumb on the same hand could have been distantly located, and therefore the map of my body surface, the homunculus, would be really disordered.

代表我的食指指尖的神经元和代表我同一只手上的拇指的神经元可能位置相距较远，因此我的身体表面地图（小矮人）将会非常混乱。

But it's not that way.

但事实并非如此。

It's very ordered.

非常有秩序。

It's very smooth.

非常光滑。

Andrew Huberman:

安德鲁·休伯曼：

As, let's say you were to image my brain, if you were to stimulate my finger, my forefinger, and then march that stimulation across my finger, across the palm into the nearby thumb, you would see that neurons in the brain would also make a sort of J shape in their pattern of activation.

假设你要想象我的大脑，如果你要刺激我的手指，我的食指，然后将刺激穿过我的手指，穿过手掌传递到附近的拇指，你会发现大脑中的神经元也会在其激活模式中形成一种 J 形。

So that means they're so-called somatotopy.

这意味着它们是所谓的体细胞。

But the connections from those brain neurons are sent into the body, and they are synchronized with, meaning they crosswire with, and form synapses with, some of the input from the viscera — from our guts, from our diaphragm, from our stomach, from our spleen, from our heart.

但是这些大脑神经元的连接被发送到身体中，并且它们与来自内脏的一些输入同步，这意味着它们与来自内脏的一些输入交叉连接并形成突触——来自我们的内脏，来自我们的横膈膜，来自我们的胃，来自我们的脾脏，来自我们的心脏。

Our internal organs are sending information up to this map in our brain of the body surface, but it's about internal information — what we call interoception, our ability to look inside or imagine inside and feel what we're feeling inside.

我们的内脏器官正在将信息发送到我们大脑中的身体表面地图，但它是关于内部信息的——我们称之为内感受，我们观察内部或想象内部并感受我们内心感受的能力。

So the way to think about this accurately is that our representation of ourself is a representation of our internal workings — our viscera, our guts, everything inside our skin — and the surface of our skin and the external world, what we're seeing.

因此，准确地思考这个问题的方法是，我们对自己的表征是我们内部运作的表征——我们的内脏、内脏、皮肤内的一切——以及我们皮肤的表面和外部世界，以及我们所看到的。

Andrew Huberman:

安德鲁·休伯曼：

Those three things are always being combined in a very interesting, complex, but very seamless way.

这三件事总是以一种非常有趣、复杂但又非常无缝的方式结合在一起。

Acupuncture involves taking needles and sometimes electricity and/or heat as well, and stimulating particular locations on the body, and through these maps of stimulation that have been developed over thousands of years — mostly in Asia, but now this is a practice that's being done many places throughout the world — they have these maps that speak to, Oh, well, if you stimulate this part of the body, you get this response.

针灸涉及使用针，有时还使用电和/或热，刺激身体上的​​特定部位，并通过这些数千年来发展起来的刺激图——主要是在亚洲，但现在这是一种在世界各地许多地方进行的做法——他们有这些图，这些图会说，哦，好吧，如果你刺激身体的这个部分，你就会得到这种反应。

And if somebody has a gastrointestinal issue, like their guts are moving too quick, they have diarrhea, you stimulate this area, and it'll slow their gut motility down.

如果有人有胃肠道问题，比如他们的肠道运动太快，他们有腹泻，你刺激这个区域，就会减慢他们的肠道蠕动。

Or if their gut motility is too slow, they're constipated, you stimulate someplace else, and it accelerates it.

或者，如果他们的肠道蠕动太慢，他们就会便秘，你刺激其他地方，它就会加速。

And hearing about this stuff, it sounds kind of, to a Westerner who's not thinking about the underlying neural circuitry, it could sound kind of wacky.

对于一个不考虑潜在神经回路的西方人来说，听到这些东西听起来有点古怪。

Andrew Huberman:

安德鲁·休伯曼：

It really sounds like alternative or even kind of really out there kind of stuff.

这听起来确实像是另类，甚至是一种非常另类的东西。

But when you look at the neural circuitry, the neuroanatomy, it really starts to make sense.

但当你观察神经回路、神经解剖学时，它真的开始有意义了。

And Qiufu Ma's lab at Harvard Medical School — it's an excellent laboratory — has been exploring how stimulation of different types, intense or weak, with heat or without heat, on different parts of the body can modulate pain and inflammation.

哈佛医学院的马秋福实验室——这是一个优秀的实验室——一直在探索对身体不同部位的不同类型的刺激，无论是强烈的还是微弱的，有热的还是无热的，如何调节疼痛和炎症。

And what they've shown in a particularly exciting study is that stimulation of the abdomen, anywhere on the midsection, weakly, does nothing.

他们在一项特别令人兴奋的研究中表明，对腹部上腹部任何地方的微弱刺激没有任何作用。

That's not very interesting, you might say.

你可能会说，这不太有趣。

Intense stimulation of the abdomen, however, with this electroacupuncture, has a very strong effect of increasing inflammation in the body.

然而，通过这种电针对腹部的强烈刺激，具有非常强烈的增加体内炎症的作用。

And this is important to understand, because it's not just that stimulating the gut does this because you're activating the gut area.

理解这一点很重要，因为不仅仅是刺激肠道才能做到这一点，因为你激活了肠道区域。

It activates a particular nerve pathway.

它激活特定的神经通路。

Andrew Huberman:

安德鲁·休伯曼：

For the aficionados, it's the splenic-spinal sympathetic axis, if you really want to know.

对于爱好者来说，如果您真的想知道的话，那就是脾-脊髓交感轴。

And it's pro-inflammatory under most conditions.

在大多数情况下它都是促炎的。

However, there are other conditions where, if for instance, the person is dealing with a particular bacterial infection, that can be beneficial.

然而，在其他情况下，例如，如果一个人正在处理特定的细菌感染，这可能是有益的。

And this goes back to a much earlier discussion that we had on a previous podcast that we'll revisit again and again, which is that the stress response was designed to combat infection.

这可以追溯到我们在之前的播客中进行的更早的讨论，我们将一次又一次地重温该讨论，即压力反应旨在对抗感染。

So it turns out that there are certain patterns of stimulation on the abdomen that can actually liberate immune cells from our immune organs like our spleen and counter infection through the release of things like adrenaline.

因此，事实证明，对腹部进行某些刺激模式实际上可以从脾脏等免疫器官中释放免疫细胞，并通过释放肾上腺素等物质来抵抗感染。

Qiufu's lab also showed that stimulation of the feet and hands can reduce inflammation.

求福的实验室还表明，刺激脚和手可以减轻炎症。

And again, this was done mechanistically.

再说一次，这是机械地完成的。

This was done by blocking certain pathways with the appropriate control experiments.

这是通过适当的对照实验阻断某些途径来完成的。

This was done not in any kind of subjective way.

这不是以任何主观方式完成的。

Andrew Huberman:

安德鲁·休伯曼：

This was also done by measuring particular molecules, IL-6 and cytokines and things that are related to the inflammation response, and what they showed is that the stimulation of the, in particular, the hind limbs at low intensity led to increases in the activity that's vagal pathway, the vagus nerve being the 10th cranial nerve that serves the kind of rest and digest and parasympathetic, in other words, calming response.

这也是通过测量特定分子、IL-6和细胞因子以及与炎症反应相关的物质来完成的，结果表明，低强度的后肢刺激会导致迷走神经通路的活动增加，迷走神经是第十脑神经，负责休息、消化和副交感神经，换句话说，是镇静反应。

So what this means is that we are now at the front edge of this research field that's, its early days still, but it's discovering that, depending on whether or not the, the stimulation is intense or mild, and depending on where the stimulation is done on the body, you can get very different effects.

所以这意味着我们现在处于这个研究领域的前沿，即仍处于早期阶段，但它发现，根据刺激是强烈还是温和，以及根据刺激在身体上进行的位置，你可以获得非常不同的效果。

So this points to the idea that you can't say acupuncture good or acupuncture bad.

所以这表明你不能说针灸好或针灸坏。

There has to be a systematic understanding of what exactly the effect is that you're trying to achieve.

必须系统地了解您想要达到的效果到底是什么。

Andrew Huberman:

安德鲁·休伯曼：

And the underlying basis for this is really relevant to the thing about adrenaline that I said before, that in a fight it's rare that you ever feel pain when you get hit.

其根本基础与我之前所说的肾上腺素确实相关，即在战斗中，当你被击中时，你很少会感到疼痛。

I've experienced that.

我有过这样的经历。

But later it hurts a lot.

但后来就很痛了。

It turns out that when you stimulate these pathways that activate in particular the adrenals, the adrenal gland liberates norepinephrine and epinephrine, and the brain does as well, it binds to what are called the beta noradrenergic receptors.

事实证明，当你刺激这些特别激活肾上腺的通路时，肾上腺会释放去甲肾上腺素和肾上腺素，大脑也会释放去甲肾上腺素，它会与所谓的β去甲肾上腺素受体结合。

Okay?

好的？

So this is really getting kind of down into the weeds, but the beta noradrenergic receptors activate the spleen, which liberates cells that combat infection, and it's anti-inflammatory.

所以这确实是一种深入的研究，但β去甲肾上腺素能受体会激活脾脏，从而释放出抵抗感染的细胞，并且具有抗炎作用。

That's the short-term, quick response.

这就是短期、快速的反应。

The more intense stimulation of the abdomen and other areas can be pro-inflammatory because of the ways that they trigger certain loops that go back to the brain and trigger the sort of anxiety pathways and that place people into a state of anxiety that exacerbates pain.

对腹部和其他区域的更强烈的刺激可能会促炎，因为它们会触发某些循环，这些循环会返回大脑并触发焦虑通路，使人们陷入焦虑状态，从而加剧疼痛。

Andrew Huberman:

安德鲁·休伯曼：

So one pathway stimulates norepinephrine and blunts pain, the other one doesn't.

因此，一种途径可以刺激去甲肾上腺素并减轻疼痛，而另一种则不能。

What does all this mean?

这一切意味着什么？

How are we supposed to put all this together?

我们应该如何将所有这些放在一起？

Well, there's a paper that was published in Nature Medicine in 2014 — this is an excellent journal — that describes how dopamine can activate the vagus peripherally in the...

嗯，2014 年《自然医学》杂志上发表了一篇论文——这是一本优秀的期刊——描述了多巴胺如何激活外周迷走神经……

Not dopamine in the brain, peripherally.

不是大脑中的多巴胺，而是外周的多巴胺。

And norepinephrine can activate the vagus peripherally and reduce inflammation.

去甲肾上腺素可以激活外周迷走神经并减少炎症。

And I'm not trying to throw a ton of facts at you so you say, "Well, what am I supposed to do with all this information?" What this means is that there are real maps of our body surface that, when stimulated, communicate with our autonomic nervous system, the system that controls alertness or calmness and thereby releases either molecules like norepinephrine and dopamine, which make us more alert, as we would be in a fight, and blunt our response to pain, and they reduce inflammation.

我并不是想向你抛出大量事实，所以你会说：“那么，我应该如何处理所有这些信息呢？”这意味着我们身体表面存在真实的地图，当受到刺激时，它们会与我们的自主神经系统进行通信，该系统控制警觉性或平静性，从而释放去甲肾上腺素和多巴胺等分子，这使我们更加警觉，就像我们在战斗中一样，并减弱我们对疼痛的反应，并且它们可以减少炎症。

Andrew Huberman:

安德鲁·休伯曼：

But there are yet other pathways that, when stimulated, are pro-inflammatory.

但还有其他途径在受到刺激时会产生促炎症反应。

And that brings us to the question of what is all this inflammation stuff that people are talking about?

这给我们带来了一个问题：人们谈论的炎症到底是什么？

One of the things that bothers me so much these days, and I'm not easily irritated, but what really bothers me is when people are talking about inflammation, like inflammation is bad.

这些天让我如此困扰的事情之一，我不容易被激怒，但真正困扰我的是当人们谈论炎症时，比如炎症是不好的。

Inflammation is terrific; inflammation is the reason why cells are called to the site of injury to clear it out.

炎症非常厉害；炎症是细胞被召唤到损伤部位将其清除的原因。

Inflammation is what's going to allow you to heal from any injury.

炎症可以让你从任何伤害中痊愈。

Chronic inflammation is bad, but acute inflammation is absolutely essential.

慢性炎症是不好的，但急性炎症是绝对必要的。

Remember those kids that we talked about earlier that have mutations in these receptors for sensing pain — they never get inflammation, and that's why their joints literally disintegrate.

还记得我们之前谈到的那些感知疼痛的受体发生突变的孩子——他们永远不会发炎，这就是他们的关节真正解体的原因。

It's really horrible because they don't actually have the inflammation response, because it was never triggered by the pain response.

这真的很可怕，因为他们实际上没有炎症反应，因为它从来不是由疼痛反应触发的。

Andrew Huberman:

安德鲁·休伯曼：

So inflammation can be very beneficial.

所以炎症是非常有益的。

There's a lot of interest nowadays in taking things and doing things to limit inflammation.

如今，人们对采取和采取措施来限制炎症很感兴趣。

One of the ones that comes up a lot is turmeric.

姜黄是最常出现的一种。

I'm sure the moment anyone starts talking about inflammation, the question is, what about turmeric?

我确信当有人开始谈论炎症时，问题是，姜黄怎么样？

I have talked before about turmeric elsewhere.

我之前在其他地方谈到过姜黄。

I am very skeptical of turmeric, and I might lose a few friends, although that would be weird if my friend...

我对姜黄非常怀疑，我可能会失去一些朋友，尽管如果我的朋友……那会很奇怪。

That would say something about my friendships if I lost friends over a discussion about turmeric.

如果我因为讨论姜黄而失去了朋友，这就会影响我的友谊。

But in any case, turmeric does have anti-inflammatory properties.

但无论如何，姜黄确实具有抗炎特性。

There's no question about that.

毫无疑问。

But as we've just described, inflammation can be a very good thing, at least in the short term.

但正如我们刚才所描述的，炎症可能是一件非常好的事情，至少在短期内如此。

The other thing about turmeric is, there was a study published out of Stanford in collection with some work from other universities, showing that a lot of turmeric is heavily contaminated with lead.

关于姜黄的另一件事是，斯坦福大学发表的一项研究与其他大学的一些研究成果相结合，表明许多姜黄受到铅的严重污染。

The lead is used to get that really rich, dense, orange coloring to it that everyone wants to see.

铅用于获得每个人都想看到的非常丰富、浓密的橙色。

So you have to check your sources of turmeric.

所以你必须检查你的姜黄来源。

Andrew Huberman:

安德鲁·休伯曼：

The other thing is, for men in particular, turmeric can be very antagonistic to dihydrotestosterone.

另一件事是，特别是对于男性来说，姜黄可能与二氢睾酮非常拮抗。

Dihydrotestosterone is the more dominant form of androgen in human males, and it's involved in things like aggression and libido, and things of that sort.

二氢睾酮是人类男性中最主要的雄激素形式，它与攻击性和性欲等有关。

Many people that I've talked to who have taken turmeric get a severe blunting of affect and libido.

我采访过的许多服用姜黄的人都出现了情感和性欲严重减弱的情况。

So for some people that might be a serious negative.

因此，对于某些人来说，这可能是一个严重的负面影响。

I certainly avoid turmeric.

我当然避免姜黄。

I don't like turmeric for that reason.

因为这个原因我不喜欢姜黄。

I also think that the inflammation response is a healthy response.

我还认为炎症反应是一种健康的反应。

You have to keep it in check, and we're going to talk about specific practices for wound healing and injury in a moment.

你必须控制它，我们稍后将讨论伤口愈合和损伤的具体做法。

But this idea that just inflammation is bad and you want to reduce inflammation across the board, nothing could be further from the truth.

但这种认为炎症是不好的想法，而你想全面减少炎症，这与事实相差甚远。

We have pathways that exist in our body specifically to increase inflammation.

我们体内存在专门增加炎症的途径。

It's the inflammation that goes unchecked, just like stress, which is problematic for repair from brain injury and that can exacerbate certain forms of dementia, et cetera.

炎症不受控制，就像压力一样，会给脑损伤的修复带来问题，并可能加剧某些形式的痴呆症等。

Andrew Huberman:

安德鲁·休伯曼：

But I'd like to create a little bit more nuance or a lot more nuance, if possible, in the conversation around inflammation, because people have just taken this discussion around inflammation to be this idea that, just, inflammation is bad, and nothing could be further from the truth.

但如果可能的话，我想在围绕炎症的对话中创造更多的细微差别或更多的细微差别，因为人们刚刚将围绕炎症的讨论视为这样的想法：炎症是不好的，没有什么比事实更离谱的了。

Before I continue, I just thought I'd answer a question that I get a lot, which is, what about Wim Hof breathing?

在我继续之前，我只是想回答一个我经常遇到的问题，那就是，维姆霍夫的呼吸怎么样？

I get asked about this a lot.

我经常被问到这个问题。

Wim Hof, also called, aka the Iceman, has this breathing that's similar to tummo breathing, as it was originally called, involves basically hyperventilating and then doing some exhales and some breath holds.

Wim Hof，也被称为“冰人”，他的呼吸方式与最初的“肿瘤呼吸法”类似，基本上涉及过度换气，然后进行一些呼气和屏气。

A couple things about that.

有几件事与此有关。

It should never be done near water.

切勿在水附近进行此操作。

People who have done it near water, unfortunately, have drowned.

不幸的是，在水边这样做的人都被淹死了。

It's certainly not for everybody, and I'm not here to either promote it nor discourage people from doing it.

这当然不适合所有人，我来这里既不是为了推广它，也不是为了阻止人们这样做。

Andrew Huberman:

安德鲁·休伯曼：

But I think we should ask ourselves what is the net effect of that?

但我认为我们应该问自己这样做的最终效果是什么？

Because a number of people have asked me about it in relation to pain management.

因为很多人向我询问与疼痛管理有关的问题。

The effect of doing that kind of breathing; it's not a mysterious effect.

做那种呼吸的效果；这并不是什么神秘的效果。

It liberates adrenaline from the adrenals.

它从肾上腺中释放肾上腺素。

There is a paper published in the Proceedings of the National Academy of Sciences, which is a very fine journal, showing that that breathing pattern can counter infection from endotoxin.

《美国国家科学院院刊》上发表了一篇论文，这是一本非常好的期刊，表明呼吸方式可以抵抗内毒素的感染。

And that's because, when you have adrenaline in your system, and when the spleen is very active, that response is used to counter infection, and stress counters infection.

这是因为，当你的系统中有肾上腺素，并且脾脏非常活跃时，这种反应就会用来抵抗感染，而压力则可以抵抗感染。

We'll talk about this more going forward, but the idea that stress lends itself to infection is false.

我们将在后面详细讨论这一点，但压力会导致感染的想法是错误的。

Stress counters infection by liberating killer cells in the body.

压力通过释放体内的杀伤细胞来对抗感染。

You don't want the stress response to stay on indefinitely, however.

然而，您不希望压力反应无限期地持续下去。

Things like Wim Hof breathing, like ice baths, anything that releases adrenaline will counter the infection, but you want to regulate the duration of that adrenaline response.

像 Wim Hof 呼吸、冰浴等任何能释放肾上腺素的东西都会对抗感染，但你需要调节肾上腺素反应的持续时间。

Andrew Huberman:

安德鲁·休伯曼：

This should make perfect sense.

这应该是完全有道理的。

We, as a species, had to evolve under conditions of famine and cold.

作为一个物种，我们必须在饥荒和寒冷的条件下进化。

Actually, Texas right now is an extreme case of cold and power outages.

事实上，德克萨斯州现在正处于严寒和停电的极端情况。

I've seen the pictures, and there are a lot of people out there really suffering.

我看过这些照片，那里有很多人正在遭受痛苦。

Their systems are releasing a ton of adrenaline.

他们的系统正在释放大量的肾上腺素。

They're cold.

他们很冷。

Some of them are likely to be hungry.

其中一些人可能饿了。

They're probably stressed.

他们可能压力很大。

They're releasing a lot of adrenaline, which is keeping them safe from infection.

他们会释放大量肾上腺素，这可以保护他们免受感染。

After they get their heat back on and they relax and they can finally warm up again — which we would like for them very soon, hopefully by the time this podcast comes out that will have already happened — that's typically when people get sick, because the immune response is blunted as the stress response starts to subside.

当他们恢复体温并放松后，他们终于可以再次热身起来——我们希望他们很快就能做到这一点，希望在这个播客发布时这已经发生了——这通常是人们生病的时候，因为随着压力反应开始消退，免疫反应会减弱。

Andrew Huberman:

安德鲁·休伯曼：

So stress, inflammation, countering infection that comes from endotoxin, that comes from any number of things, it can be from cold, it can be from hyperventilation, it can be from a physical threat, it can be from the stress of an exam or an upcoming surgery, this adrenaline thing and the inflammation associated with it is adaptive.

因此，压力、炎症、对抗来自内毒素的感染，这些内毒素来自任何东西，它可以来自寒冷，它可以来自过度换气，它可以来自身体威胁，它可以来自检查或即将进行的手术的压力，这种肾上腺素物质和与之相关的炎症是适应性的。

It's highly adaptive.

它的适应性很强。

It is a short-term plasticity that is designed to make us better for what we're experiencing and challenged with, not worse.

这是一种短期的可塑性，旨在让我们更好地应对我们正在经历和面临的挑战，而不是变得更糟。

And so hopefully that will add an additional layer to this whole idea that stress is bad, inflammation is bad, et cetera.

因此，希望这能为整个观念增加一层额外的内容，即压力是不好的，炎症是不好的，等等。

Again, I'm not suggesting people do or don't do something like Wim Hof tummo breathing.

再说一遍，我并不是建议人们做或不做 Wim Hof 肿瘤呼吸之类的事情。

I just want to point to the utility; it's very similar to the utility from cold showers, ice baths, and other forms of anything that increase adrenaline.

我只想指出实用程序；它与冷水淋浴、冰浴和其他增加肾上腺素的任何形式的作用非常相似。

Andrew Huberman:

安德鲁·休伯曼：

Every episode, I want to make sure that every listener comes away with as much knowledge as possible, but also actionable tools.

每一集，我都想确保每个听众都能获得尽可能多的知识，同时也能获得可操作的工具。

And today we've talked about a variety of tools, but I want to center in on a particular sequence of tools that hopefully you won't need, but presumably if you're a human being and you're active, you will need at some point.

今天我们讨论了各种工具，但我想集中讨论一系列特定的工具，希望您不需要这些工具，但如果您是一个人并且很活跃，那么您在某个时候可能会需要它们。

It's about managing injury and recovering and healing fast, or at least as fast as possible.

这是关于管理伤害以及快速或至少尽可能快地恢复和愈合。

It includes removing the pain.

它包括消除疼痛。

It includes getting mobility back and getting back to a normal life, whatever that means for you.

它包括恢复行动能力和恢复正常生活，无论这对您意味着什么。

I want to emphasize that what I'm about to talk about next was developed in close consultation with Kelly Starrett, who many of you probably have heard of before.

我想强调的是，我接下来要讨论的内容是与凯利·斯塔雷特（Kelly Starrett）密切协商后制定的，你们中的许多人可能以前听说过她。

Kelly can be found at The Ready State.

凯利可以在“就绪州”找到。

Andrew Huberman:

安德鲁·休伯曼：

He's a formally trained, so degreed and educated, exercise physiologist.

他是一位受过正规培训、拥有学位和教育的运动生理学家。

He's a world expert in movement and tissue rehabilitation, et cetera.

他是运动和组织康复等领域的世界专家。

They are not sponsors of the podcast.

他们不是播客的赞助商。

Kelly is a friend and a colleague.

凯利是我的朋友和同事。

He's somebody that I personally trust, and his views on tissue rehabilitation and injury, I think, are really grounded extremely well in both medicine, physiology, and the real cutting edge of what's new and what you might not get in terms of advice from the typical person.

他是我个人信任的人，我认为他对组织康复和损伤的观点在医学、生理学以及新事物的真正前沿以及你可能无法从普通人那里得到的建议方面都非常有根据。

All that said, you always, always, always should consult with your physician before adopting any protocols or removing any protocols.

尽管如此，在采用任何方案或取消任何方案之前，您始终、始终、始终应该咨询您的医生。

Andrew Huberman:

安德鲁·休伯曼：

So I asked Kelly, I made it really simple.

所以我问凯利，我把事情说得很简单。

I said, "Okay, let's say I were to sprain my ankle or break my arm or injure my knee or ACL tear or something like that or shoulder injury.

我说：“好吧，假设我扭伤了脚踝、折断了手臂、膝盖受伤、前十字韧带撕裂或类似的情况或肩膀受伤。

What are the absolute necessary things to do, regardless of situation, and what science is this grounded in?" And then I made it a point to go find the studies that either supported or refuted what he was telling me, because that's why I'm here.

无论情况如何，绝对必要做的事情是什么？这有什么科学依据？”然后我决定去寻找支持或反驳他告诉我的内容的研究，因为这就是我来这里的原因。

So the first one is a very basic one that now you have a lot of information to act on, which is in terms of what we know about tissue rehabilitation, both brain and body, we know that sleep is essential.

因此，第一个是非常基本的，现在您有很多信息可以采取行动，这是根据我们对大脑和身体组织康复的了解，我们知道睡眠至关重要。

And so we both agreed at that eight hours minimum in bed per night is critical.

因此，我们都同意每晚至少在床上躺八小时至关重要。

Now, what was interesting, however, is that it doesn't have to be eight hours of sleep.

然而，现在有趣的是，睡眠不一定要八小时。

We acknowledge that some of that time might be challenging to get to sleep, especially if one is in pain or mobility is limited.

我们承认，有些时候入睡可能会很困难，尤其是在感到疼痛或活动受限的情况下。

Andrew Huberman:

安德鲁·休伯曼：

We forget how often we roll over in bed or how the conditions of our sleeping can impact those injuries too.

我们忘记了我们在床上翻身的频率，或者我们的睡眠条件也会如何影响这些伤害。

So Kelly acknowledged, and I agree, that eight hours of sleep would be ideal, but if not, at least eight hours immobile.

所以凯利承认，我也同意，八小时的睡眠是理想的，但如果不是，至少八小时不活动。

And that speaks to the power of these non-sleep deep rest protocols too.

这也说明了这些非睡眠深度休息方案的力量。

If you can't sleep, doing non-sleep deep rest protocols, we've provide links to them before.

如果您无法入睡，正在进行非睡眠深度休息方案，我们之前已经提供了这些方案的链接。

We're going to continue to provide links to the previous ones and new ones are coming soon.

我们将继续提供以前的链接，新的链接即将推出。

That is extremely beneficial.

这是极其有益的。

So that's a non-negotiable in terms of getting the foundation for allowing for glymphatic clearance and tissue clearance, et cetera.

因此，在为类淋巴清除和组织清除等奠定基础方面，这是不容谈判的。

Andrew Huberman:

安德鲁·休伯曼：

The other is, if possible, unless it's absolutely excruciating where you just can't do it, a 10-minute walk per day.

另一种是，如果可能的话，每天步行 10 分钟，除非你实在无法做到这一点。

Of course, you don't want to exacerbate the injury, at least a 10-minute walk per day and probably longer.

当然，你不想加剧伤害，每天至少步行10分钟，甚至可能更长。

This is where it gets interesting.

这就是有趣的地方。

I was taught, I learned that when you injure yourself, you're supposed to ice something.

我被教导，我知道当你伤害自己时，你应该冰敷一些东西。

You're supposed to put ice on it.

你应该把冰敷在上面。

But I didn't realize this, but when speaking to exercise physiologists and some physicians, they said that the ice is really more of a placebo.

但我没有意识到这一点，但当与运动生理学家和一些医生交谈时，他们说冰实际上更像是一种安慰剂。

It numbs the environment of the injury, which is not surprising and will eliminate the pain for a short while, but it has some negative effects that perhaps offset its use.

它使受伤的环境变得麻木，这并不奇怪，并且会暂时消除疼痛，但它有一些负面影响，可能会抵消它的使用。

Andrew Huberman:

安德鲁·休伯曼：

One, it sludges, it creates sludging within the blood and other lymphatic tissue.

第一，它会产生淤泥，它会在血液和其他淋巴组织内产生淤泥。

So it actually can create some clotting and sludging of the tissue and fluids, the fascial, the fascial interface with muscle.

所以它实际上可以造成组织和液体、筋膜、筋膜与肌肉界面的凝血和淤积。

And a number of the, stuff that's supposed to be flowing through there can slow up and increase inflammation in the wrong way, can actually restrict movement out of the injury site, which is bad because you want the macrophages and the other cell types, phagocytosing, eating up the debris and injury and moving it out of there so that it can repair.

许多本来应该流经那里的物质会以错误的方式减慢并增加炎症，实际上会限制从损伤部位的运动，这很糟糕，因为你需要巨噬细胞和其他细胞类型吞噬、吞噬碎片和损伤并将其移出那里以便修复。

Andrew Huberman:

安德鲁·休伯曼：

So that was surprising to me, which it made me ask, well then what about heat?

所以这让我感到惊讶，这让我问，那么热量呢？

Well, it turns out heat is actually quite beneficial.

事实证明，热量实际上是非常有益的。

A lot of people talk about heat shock proteins and all these genetic pathways and protein pathways that can be activated by heat.

很多人谈论热休克蛋白以及所有这些可以被热激活的遗传途径和蛋白质途径。

Very little data to support the idea that heat shock proteins are part of the wound healing process, at least in terms of the torts of conventional heat that one could use like a hot water bottle or a hot bath or a hot compress.

很少有数据支持热休克蛋白是伤口愈合过程的一部分这一观点，至少就人们可以使用的传统热量（如热水袋、热水浴或热敷）的侵权行为而言。

The major effects seem to be explained by heat improving the viscosity of the tissues and the clearance and the perfusion of fluid, blood, lymph and other fluids out of the injury area.

主要效果似乎可以通过热量改善组织的粘度以及损伤区域的液体、血液、淋巴液和其他液体的清除和灌注来解释。

Andrew Huberman:

安德鲁·休伯曼：

So, that's really interesting.

所以，这真的很有趣。

I didn't know this.

我不知道这个。

I thought, well, you're supposed to ice something.

我想，好吧，你应该加点冰块。

I said, well, whenever I would, like, see a kid get injured in soccer, never me, of course.

我说，好吧，每当我想看到一个孩子在足球中受伤时，当然不是我。

No, of course, I got injured in soccer from time to time.

不，当然，我有时会在足球比赛中受伤。

They give you an ice pack and the ice pack removes some of the pain.

他们给你一个冰袋，冰袋可以减轻一些疼痛。

I think the consensus now, which was surprising to me, is that the ice pack is actually more of the top-down modulation.

我认为现在的共识（令我惊讶的是）是冰袋实际上更多的是自上而下的调制。

You think you're doing something for the pain, and there's some interesting studies that actually show the placebo effect of the ice pack.

你认为你正在做一些事情来缓解疼痛，并且有一些有趣的研究实际上显示了冰袋的安慰剂效应。

Andrew Huberman:

安德鲁·休伯曼：

So ice packs are placebo, perhaps.

所以冰袋也许是安慰剂。

That's interesting.

那很有意思。

I'll underline perhaps, because who knows, maybe there' some people out there that are going to say this is totally crazy and the ice is actually very beneficial.

也许我会强调一下，因为谁知道呢，也许有些人会说这完全是疯狂的，而冰实际上非常有益。

But it seems like heat, mobility, sleep, keeping movement, and it turns out that the movement itself can act as a bit of an analgesic.

但看起来就像热、活动、睡眠、保持运动，事实证明运动本身可以起到一点镇痛作用。

It can actually reduce the pain, whereas the ice reduces the pain but sludges the tissue and keeps the cells that need to be removed from leaving the area.

它实际上可以减轻疼痛，而冰可以减轻疼痛，但会淤积组织并阻止需要去除的细胞离开该区域。

Now what's also interesting is in neuroscience, we know that if we want to kill neurons or silence neurons, we cool them.

现在，在神经科学中也很有趣，我们知道，如果我们想要杀死神经元或使神经元沉默，我们就会冷却它们。

Andrew Huberman:

安德鲁·休伯曼：

This is a well-known tool in the laboratory.

这是实验室中众所周知的工具。

Some of the early and most important studies in neuroscience that formed the basis for the textbooks were lowering a cooling probe into a particular area of the brain or a peripheral nerve in order to shut down that nerve.

构成教科书基础的神经科学领域的一些早期和最重要的研究是将冷却探针放入大脑或周围神经的特定区域，以关闭该神经。

So the cooling will shut down the nerve.

所以冷却会关闭神经。

But another very well-known fact in neuroscience textbooks is that when the activity of the nerve pathway or neurons comes back, there's what's called homeostatic plasticity, that it rebounds with greater pain, with a higher level of intensity, which in the pain system would equate to greater pain.

但神经科学教科书中另一个众所周知的事实是，当神经通路或神经元的活动恢复时，就会出现所谓的稳态可塑性，即它会以更大的疼痛和更高的强度反弹，这在疼痛系统中相当于更大的疼痛。

Andrew Huberman:

安德鲁·休伯曼：

So regardless of where these neurons are in the body, if you stimulate a neuron, it's active.

因此，无论这些神经元位于体内的哪个位置，如果刺激神经元，它就会活跃。

If you cool it, it becomes inactive.

如果你冷却它，它就会变得不活跃。

And when the neuron heats back up after being cooled, it becomes hyperactive.

当神经元冷却后重新升温时，它就会变得过度活跃。

And so this makes really good sense as to why heat, provided it's not damaging levels of heat, would be more beneficial for wound healing and for reducing pain in the short and long run than would be cold or ice, which I find very interesting.

因此，这非常有道理地解释了为什么热（只要不破坏热量水平）比冷或冰更有利于伤口愈合和短期和长期减轻疼痛，我觉得这很有趣。

Now, in terms of chronic pain, the manuscripts on this, my discussion with Kelly and with others point to the fact that chronic pain has basically plasticity gone wrong.

现在，就慢性疼痛而言，这方面的手稿、我与凯利和其他人的讨论都指出了这样一个事实：慢性疼痛基本上是可塑性出了问题。

Andrew Huberman:

安德鲁·休伯曼：

It's sort of like PTSD for the emotional system in the stress system.

这有点像压力系统中情绪系统的创伤后应激障碍（PTSD）。

And chronic pain is going to involve a number of different protocols to rewire both the brain centers and the peripheral centers associated with chronic pain.

慢性疼痛将涉及许多不同的方案来重新连接与慢性疼痛相关的大脑中心和外周中心。

Certain things like fibromyalgia, for instance, which is whole-body pain, relate to too little inhibition.

例如，某些疾病，如纤维肌痛，即全身疼痛，与抑制太少有关。

In the brain, you have excitation and inhibition.

在大脑中，有兴奋和抑制。

They come from different sources of neurons.

它们来自不同的神经元来源。

The inhibition is mainly from GABA and glycine and things like that.

抑制作用主要来自GABA和甘氨酸等。

In fibromyalgia, there's too little central, within the brain, modulation of the pain responses so that people experience whole-body pain.

在纤维肌痛中，大脑内对疼痛反应的中枢调节太少，因此人们会感到全身疼痛。

Andrew Huberman:

安德鲁·休伯曼：

So in that case, the emerging therapies are really interesting.

因此，在这种情况下，新兴疗法确实很有趣。

I have a friend who works for the National Institutes of Health, who unfortunately suffers from fibromyalgia, who asked me about this a lot.

我有一个在美国国立卫生研究院工作的朋友，不幸患有纤维肌痛，他经常问我这个问题。

And his question, and what he's now actually exploring, is red-light therapy, something that I've talked about on various Instagram posts.

他的问题，以及他现在正在实际探索的，是红光疗法，我在 Instagram 的各种帖子中都谈到过这一点。

Red-light therapy typically is talked about in terms of mitochondria, and the data on that are not so terrific, at least not really published in blue ribbon journals in most cases.

红光疗法通常是在线粒体方面进行讨论的，而相关数据并不那么出色，至少在大多数情况下没有真正发表在蓝带期刊上。

Andrew Huberman:

安德鲁·休伯曼：

Except for one study that I'm aware of from Glen Jeffery's lab at University College London, showing that red-light stimulation to the eyes in people 40 or older can offset some of the effects of macular degeneration by improving the health of the photoreceptors.

除了据我所知，伦敦大学学院 Glen Jeffery 实验室的一项研究表明，对 40 岁或以上人群的眼睛进行红光刺激可以通过改善光感受器的健康来抵消黄斑变性的一些影响。

People with fibromyalgia, which is this whole-body pain, are now starting to use red-light therapies.

患有纤维肌痛（这种全身疼痛）的人现在开始使用红光疗法。

Now, I asked Kelly and others and some experts in pain, what are your thoughts on this red-light therapy for things like fibromyalgia and pain, especially red-light local therapy?

现在，我问凯利和其他人以及一些疼痛专家，您对这种针对纤维肌痛和疼痛的红光疗法，特别是红光局部疗法有何看法？

Andrew Huberman:

安德鲁·休伯曼：

Their idea, and I don't think this is a field that's progressed far enough now to really place any firm conclusions on, but the idea is that red-light therapy locally may have some effect.

他们的想法，我认为这个领域现在还没有取得足够的进展，无法真正得出任何明确的结论，但他们的想法是，局部红光疗法可能会产生一些效果。

But the systemic red-light therapy, this is wearing protection to the eyes in some cases, so not from the treatment of macular degeneration, but wearing protection o the eyes and getting very bright red-light therapy, in many ways may be, and to use Kelly's words, approximating the effects of nature.

但是全身性的红光疗法，这在某些情况下是戴上保护眼睛，所以不是从治疗黄斑变性，而是戴上保护眼睛，得到非常明亮的红光治疗，在很多方面都可以，用凯利的话来说，接近大自然的效果。

These are like surrogate technologies for getting outside in the sunshine.

这些就像是在阳光下外出的替代技术。

Andrew Huberman:

安德鲁·休伯曼：

When you're in the sun, it might not look red, but there are a lot of red wavelengths coming toward you.

当你在阳光下时，它可能看起来不是红色的，但有很多红色波长向你袭来。

So the red-light therapies may have some utility, but getting into sunlight may actually have as much or more effect.

因此，红光疗法可能有一定的用处，但接受阳光照射实际上可能具有同样或更多的效果。

Of course, if these wounds are on a part of the body that you can't expose, then you could imagine why the red-light therapy might be good.

当然，如果这些伤口是在身体不能暴露的部位，那么你就可以想象红光疗法为什么会好。

I don't know.

我不知道。

Depending on the neighborhood you live in, that may or may not be a weird thing, to go outside and expose your body to sunlight.

根据您居住的社区的不同，走出去将身体暴露在阳光下可能会或可能不会是一件奇怪的事情。

Probably a number of factors that dictate whether or not that would be weird or not, but that's up to you, not me.

可能有很多因素决定这是否奇怪，但这取决于你，而不是我。

Andrew Huberman:

安德鲁·休伯曼：

And it seems that, so movement; heat, not ice; light; sleep; and in some cases the use, and I'll talk about this in a moment, some cases the use of restricting above and below the injury to then release and then increase perfusion through the site.

看来，如此运动；热，而不是冰；光;睡觉;在某些情况下使用，我稍后会讨论这一点，在某些情况下使用限制损伤上方和下方，然后释放，然后增加通过该部位的灌注。

So may actually accelerate the wound healing.

所以实际上可能会加速伤口愈合。

So all of this might sound just like common sense knowledge.

所以所有这些听起来可能就像常识知识。

But to me, at least as a 45-year-old, I always just thought it's ice.

但对我来说，至少作为一个45岁的人，我一直只认为它是冰。

It's nonsteroid anti-inflammatory drugs.

它是非类固醇类抗炎药。

It's things that block prostaglandin.

它是阻碍前列腺素的物质。

Andrew Huberman:

安德鲁·休伯曼：

So things like aspirin, ibuprofen, acetaminophen, those things generally work by blocking things like, they're called the COX prostaglandin blockers and things of that sort, things in that pathway.

So things like aspirin, ibuprofen, acetaminophen, those things generally work by blocking things like, they're called the COX prostaglandin blockers and things of that sort, things in that pathway.

Those sorts of treatments which reduce inflammation may not be so great at the beginning when you want inflammation.

当您想要炎症时，这些减轻炎症的治疗在一开始可能效果不是很好。

They may be important for limiting pain so people can be functional at all.

它们对于限制疼痛可能很重要，这样人们才能完全发挥功能。

But the things that I talked about today really are anchored in three principles.

但我今天谈到的事情确实基于三个原则。

One is that the inflammation response is a good one.

一是炎症反应良好。

This is what we're learning from Qiufu Ma lab's work on acupuncture.

This is what we're learning from Qiufu Ma lab's work on acupuncture.

Andrew Huberman:

安德鲁·休伯曼：

The immediate acute inflammation response is good.

The immediate acute inflammation response is good.

It calls to the site of injury things that are going to clean up the injury and bad cells.

它会在受伤部位召唤一些东西来清理受伤和坏细胞。

Then there are going to be things that are going to improve perfusion, like the glymphatic system, getting deep sleep, feet elevated, sleeping on one side, low-level zone 2 cardio three times a week.

然后还有一些可以改善灌注的措施，比如类淋巴系统、深度睡眠、抬高脚、侧睡、每周 3 次低水平 2 区有氧运动。

Red light perhaps is going to be useful, although sunlight might be just as good, depending on who you talk to.

红光也许会很有用，尽管阳光可能也一样好，这取决于你与谁交谈。

And we talk about that probably more at length in a future episode.

我们可能会在未来的剧集中更详细地讨论这一点。

A number of people will ask me, I'm sure, about stem cells.

我确信很多人会问我关于干细胞的问题。

Andrew Huberman:

安德鲁·休伯曼：

And I don't want to take more of your time by going into an hour-long discussion about stem cells.

我不想花费您更多的时间来进行有关干细胞的长达一个小时的讨论。

Stem cells exist in all of us during development.

干细胞在我们所有人的发育过程中都存在。

We were created from stem cells, which are cells that can become essentially anything.

我们是由干细胞创造的，干细胞基本上可以变成任何东西。

Later cells get what's called restricted in their lineage.

后来的细胞在其谱系中受到所谓的限制。

So a skin cell, unless you do some fancy molecular gymnastics to it, you can't actually turn that cell into a neuron.

因此，除非你对皮肤细胞进行一些奇特的分子体操，否则你实际上无法将该细胞变成神经元。

Yamanaka won the Nobel Prize for finding these Yamanaka factors, which you could give a skin cell to turn it into a neuron, but that's not an approved therapy at this time.

山中伸弥因发现这些山中伸弥因子而获得了诺贝尔奖，你可以将其赋予皮肤细胞，将其转变为神经元，但这目前还不是一种被批准的疗法。

Andrew Huberman:

安德鲁·休伯曼：

But many people ask me about platelet rich plasma, so-called PRP.

但很多人问我关于富含血小板的血浆，即所谓的 PRP。

They take blood, they enrich for platelets, and then they re-inject it back into people.

他们抽取血液，浓缩血小板，然后将其重新注射回人体。

Here's the deal, this deserves an entire episode.

事情就是这样，这值得一整集。

It has never been shown whether or not the injection itself is what's actually creating the effect.

从未证明注射本身是否真正产生了这种效果。

This is something that the acupuncture literature suffered from for a long time, that the sham control, as it's called — sham, we don't mean it's a sham, but in science you say a sham control, meaning you do everything exactly the same way you would.

这是针灸文献长期以来遭受的困扰，即所谓的“假控制”——“假”，我们并不是说它是假的，但在科学中，你说“假控制”，意思是你做每件事的方式都与你完全相同。

Andrew Huberman:

安德鲁·休伯曼：

So for acupuncture, you would bring the needle right up to the skin, but you wouldn't actually poke it into the skin, for instance.

So for acupuncture, you would bring the needle right up to the skin, but you wouldn't actually poke it into the skin, for instance.

That would be a sham control.

那将是一个假对照。

With a drug treatment, you would inject a drug into a person and then in the control, the sham control would be that you would bring the injection over, you might do the injection or not do the injection, because you imagine that the injection itself could have an effect.

With a drug treatment, you would inject a drug into a person and then in the control, the sham control would be that you would bring the injection over, you might do the injection or not do the injection, because you imagine that the injection itself could have an effect.

It's never really been shown whether or not PRP has effects that are separate from injecting a volume of fluid into a tissue.

从未真正证明 PRP 是否具有与向组织注射一定量液体无关的效果。

Andrew Huberman:

安德鲁·休伯曼：

The claims that PRP actually contains stem cells are very, very feeble.

PRP 实际上含有干细胞的说法是非常非常站不住脚的。

And when you look at the literature and you talk to anyone expert in the stem cell field, they will tell you that it's the number of stem cells in PRP is infinitesimally small.

当你查阅文献并与干细胞领域的任何专家交谈时，他们会告诉你，PRP 中的干细胞数量是无限小的。

In fact, so much so that these places that inject PRP for injuries are not allowed to advertise through the use of the words stem cells.

事实上，以至于这些注射PRP治疗损伤的地方都不允许使用干细胞这个词做广告。

It's actually illegal at this point, at least as far as I know.

至少据我所知，目前这实际上是非法的。

It was through the end of last year, and I'm guessing it still is now.

这是去年年底的事，我猜现在仍然如此。

Stem cells are an exciting area of technology.

干细胞是一个令人兴奋的技术领域。

Andrew Huberman:

安德鲁·休伯曼：

However, there's a clinic down in Florida that was shut down a couple years ago for injecting stem cells harvested from patients into the eye for macular degeneration.

然而，佛罗里达州有一家诊所几年前因将从患者身上采集的干细胞注射到眼睛中以治疗黄斑变性而被关闭。

These were people that were suffering from poor vision and very shortly after injecting these stem cells into the eyes, they went completely blind.

These were people that were suffering from poor vision and very shortly after injecting these stem cells into the eyes, they went completely blind.

So I'm somebody who is very skeptical of the stem cell treatment work that's out there.

所以我对现有的干细胞治疗工作非常怀疑。

It's actually very hard to get in the United States for this reason.

因为这个原因实际上很难进入美国。

It's not approved.

它没有被批准。

The PRP treatments are very complicated.

PRP 治疗非常复杂。

The marketing around them is shaky, at best.

他们周围的营销充其量也是不稳定的。

Andrew Huberman:

安德鲁·休伯曼：

I'm sure a number of people will say that they had PRP and benefited from it tremendously, and I don't doubt that.

I'm sure a number of people will say that they had PRP and benefited from it tremendously, and I don't doubt that.

Whether or not it was placebo...

不管是不是安慰剂...

Today, we talked a lot about top-down control.

今天，我们讨论了很多关于自上而下的控制。

That's just a variant on the word placebo, belief effects.

这只是安慰剂这个词的变体，即信念效应。

Whether or not it was placebo or not, I don't know.

Whether or not it was placebo or not, I don't know.

I wasn't there.

我当时不在场。

That's for you to decide, and I'm not here to tell you that you should or shouldn't do something, but I do think that anything involving stem cells, one should be very cautious of.

这是由你决定的，我并不是来告诉你应该或不应该做某事，但我确实认为任何涉及干细胞的事情都应该非常谨慎。

You should also be very cautious of anyone that tells you that PRP is injecting a lot of stem cells.

You should also be very cautious of anyone that tells you that PRP is injecting a lot of stem cells.

Andrew Huberman:

安德鲁·休伯曼：

This is an evolving area that really needs a lot more work and attention.

这是一个不断发展的领域，确实需要更多的工作和关注。

The major issue with stem cells that I think is concerning is that stem cells are cells that want to become lots of different things, not just the tissue that you're interested in.

我认为干细胞的主要问题是干细胞想要变成许多不同的东西，而不仅仅是你感兴趣的组织。

So if you damage your knee and you inject stem cells into your knee, you need to molecularly restrict those stem cells so that they don't become tumor cells.

So if you damage your knee and you inject stem cells into your knee, you need to molecularly restrict those stem cells so that they don't become tumor cells.

A tumor is a collection of stem cells.

肿瘤是干细胞的集合。

So when you get something horrible like glioblastoma in the brain, which is a terrible thing to have, it's glial cells that returned to stemness, excessive stemness.

因此，当大脑中出现像胶质母细胞瘤这样可怕的东西时，这是一件可怕的事情，神经胶质细胞就会恢复干性，过度干性。

Andrew Huberman:

安德鲁·休伯曼：

They start to produce too many of themselves.

他们开始生产太多的自己。

And glioblastoma is often deadly, not always.

胶质母细胞瘤通常是致命的，但并非总是如此。

So injecting stem cells, it sounds great and it sounds like something that one would want to do, but one needs to approach this with extreme caution, even if it's your own blood or stem cells that you're reinjecting.

因此，注射干细胞，听起来很棒，而且听起来像是人们想做的事情，但人们需要极其谨慎地对待这一问题，即使您重新注射的是您自己的血液或干细胞。

I think those technologies are coming.

我认为这些技术即将到来。

They're on the way.

他们正在路上。

If any of you are devotees of PRP, tell me your experiences with them.

If any of you are devotees of PRP, tell me your experiences with them.

I'm curious.

我很好奇。

I want to see the papers.

我想看看报纸。

I want to know the evidence.

我想知道证据。

And of course, there are always folks out there that say, "I don't care what the scientists and the physicians and the FDA say, I just want to do this."

And of course, there are always folks out there that say, "I don't care what the scientists and the physicians and the FDA say, I just want to do this."

Andrew Huberman:

安德鲁·休伯曼：

And if that's your stance, that's your stance.

如果这是你的立场，那就是你的立场。

I'm not here to govern that, but I do think that people should be informed.

我不是来管理这件事的，但我确实认为人们应该被告知。

And in thinking about tissue recovery and injury, that's what I was able to glean.

在思考组织恢复和损伤时，这就是我能够收集到的信息。

Again, check out what Kelly and his coworkers are doing at the Ready State.

Again, check out what Kelly and his coworkers are doing at the Ready State.

It's phenomenal and they've worked with all the top people in just about every domain of life, it seems.

这是惊人的，他们似乎与生活各个领域的所有顶尖人士都有过合作。

Very high integrity folks.

诚信度很高的人。

Some of you are probably saying, "Well, I'm not injured.

你们中有些人可能会说：“好吧，我没有受伤。

I'm not an athlete.

我不是运动员。

I don't want stem cell injections.

我不想注射干细胞。

I don't have..." Again, I think you shouldn't get stem cell injections for now.

I don't have..." Again, I think you shouldn't get stem cell injections for now.

Andrew Huberman:

安德鲁·休伯曼：

Please hold off until the field learns more about how to do that safely.

Please hold off until the field learns more about how to do that safely.

But I want to talk about, and end with a really interesting and somewhat weird technology, which is baby blood.

But I want to talk about, and end with a really interesting and somewhat weird technology, which is baby blood.

I have a colleague at Stanford, his name is Tony Wyss-Coray.

我在斯坦福大学有一位同事，他的名字叫托尼·怀斯-科雷。

And in 2014, his laboratory published a study showing that the blood of young rodents, mice and rats, when transfused into old demented rodents, mice and rats, made those old demented rodents recover much of their memory and seem much more vital and energetic.

And in 2014, his laboratory published a study showing that the blood of young rodents, mice and rats, when transfused into old demented rodents, mice and rats, made those old demented rodents recover much of their memory and seem much more vital and energetic.

Andrew Huberman:

安德鲁·休伯曼：

Better recall of different spatial learning tasks, tissue and wound healing, they've since shown can be improved in these older animals.

Better recall of different spatial learning tasks, tissue and wound healing, they've since shown can be improved in these older animals.

It's pretty incredible.

这太不可思议了。

They went on to show several years later that blood from umbilical cords, I'm not making this up.

几年后他们继续证明脐带血，这不是我编造的。

Blood from umbilical cords can do the same.

脐带血也能起到同样的作用。

And this is the basis of a biotech company, actually.

And this is the basis of a biotech company, actually.

One of my former postdocs is now an employee there.

我以前的一位博士后现在是那里的员工。

They've isolated the molecules from young blood that seems to vitalize or revitalize the old brain and body.

They've isolated the molecules from young blood that seems to vitalize or revitalize the old brain and body.

And one of those molecules has, it goes by the name TIMP2, T-I-M-P-2.

And one of those molecules has, it goes by the name TIMP2, T-I-M-P-2.

Andrew Huberman:

安德鲁·休伯曼：

Where's all this going?

这一切要去哪里？

Well, I don't know how long it's going to be before there are treatments based on these blood transfusions.

Well, I don't know how long it's going to be before there are treatments based on these blood transfusions.

I doubt that blood transfusions themselves from young people into old people is going to be used for the treatment of dementia.

I doubt that blood transfusions themselves from young people into old people is going to be used for the treatment of dementia.

Although, it might.

虽然，有可能。

As weird as it seems, we know that transfusions of all sorts of stuff, for instance, fecal transplants are being used to treat obesity.

As weird as it seems, we know that transfusions of all sorts of stuff, for instance, fecal transplants are being used to treat obesity.

The gut microbiome of thin people is being, not transfused, but is being transplanted into the colons and guts of obese people and leading to weight loss, which sounds really wild and is not a topic I particularly enjoy talking about.

The gut microbiome of thin people is being, not transfused, but is being transplanted into the colons and guts of obese people and leading to weight loss, which sounds really wild and is not a topic I particularly enjoy talking about.

Andrew Huberman:

安德鲁·休伯曼：

But nonetheless, it points to the importance of the gut microbiome in regulating things like blood sugar and health as it relates to obesity and diabetes and all sorts of things.

But nonetheless, it points to the importance of the gut microbiome in regulating things like blood sugar and health as it relates to obesity and diabetes and all sorts of things.

So it does appear that there are things, factors in the blood of young members of a given species that are lost over time in the older members of that species.

So it does appear that there are things, factors in the blood of young members of a given species that are lost over time in the older members of that species.

I am not going to give you a tool on the basis of these findings today.

I am not going to give you a tool on the basis of these findings today.

I am not going to tell you to consume any fluid from any other member of your species, our species, for any reason.

I am not going to tell you to consume any fluid from any other member of your species, our species, for any reason.

Andrew Huberman:

安德鲁·休伯曼：

But I do think that it's important to mention that the science is asking questions such as what are the factors within the brain that allow the young brain to recover so much better than the older brain from injury, from all sorts of things, events, et cetera, and what are the factors in the older brain that are limiting, and thinking about identifying which factors are going to allow people to restore cognitive function, physical function, wound healing and so forth.

但我确实认为值得一提的是，科学正在提出这样的问题：大脑中的哪些因素可以让年轻的大脑从各种事情、事件等的损伤中恢复得比年长的大脑好得多，年长的大脑中哪些因素受到限制，并思考确定哪些因素可以让人们恢复认知功能、身体功能、伤口愈合等。

It's a really exciting area.

这是一个非常令人兴奋的领域。

I mention it not to be sensationalist, but because it's happening.

I mention it not to be sensationalist, but because it's happening.

Andrew Huberman:

安德鲁·休伯曼：

And because there's a lot of excitement about it, and because I think it's clear that the young brain and body and blood are very different from the old brain, body and blood.

因为这令人兴奋，因为我认为很明显，年轻的大脑、身体和血液与年老的大脑、身体和血液有很大不同。

And the goal of science is to identify and isolate those factors that make that so such that people who would otherwise get dementia, or perhaps even have dementia, will be allowed to recover.

And the goal of science is to identify and isolate those factors that make that so such that people who would otherwise get dementia, or perhaps even have dementia, will be allowed to recover.

Again, not an actionable item at this point, but one to think about, perhaps not too long, but one to think about.

Again, not an actionable item at this point, but one to think about, perhaps not too long, but one to think about.

So I'm going to close there.

所以我要结束了。

I've talked about a lot of tools today.

我今天谈论了很多工具。

Andrew Huberman:

安德鲁·休伯曼：

I've talked a lot about somatosensation, about plasticity, about pain, about acupuncture, some of the nuance of acupuncture, inflammation, stress.

I've talked a lot about somatosensation, about plasticity, about pain, about acupuncture, some of the nuance of acupuncture, inflammation, stress.

We even talked a little bit about high-intensity breathing, talked about restricting limb movement to get compensatory regrowth of pathways, or I should say reactivation of pathways that have been injured or damaged.

We even talked a little bit about high-intensity breathing, talked about restricting limb movement to get compensatory regrowth of pathways, or I should say reactivation of pathways that have been injured or damaged.

So as always, we take kind of a whirlwind tour through a given topic, lay down some tools as we go.

So as always, we take kind of a whirlwind tour through a given topic, lay down some tools as we go.

Hopefully, the principles that relate to pain and injury, but also neuroplasticity in general today in the context of the somatosensory system will be of use to all of you.

Hopefully, the principles that relate to pain and injury, but also neuroplasticity in general today in the context of the somatosensory system will be of use to all of you.

Andrew Huberman:

安德鲁·休伯曼：

I don't wish injury on any of you, but I do hope that you'll take this information to mind and that you'll think about it if ever you find yourself in a situation where you have to ask, what's the difference between my perception and the actual tissue damage?

I don't wish injury on any of you, but I do hope that you'll take this information to mind and that you'll think about it if ever you find yourself in a situation where you have to ask, what's the difference between my perception and the actual tissue damage?

Is injury and pain, is it the same?

受伤和疼痛，是一样的吗？

Well, no. Do I have some control over my experience of pain?

嗯，不。 Do I have some control over my experience of pain?

Absolutely.

绝对地。

Does all of that involve taking drugs or doing certain therapeutics?

Does all of that involve taking drugs or doing certain therapeutics?

No, not necessarily.

不，不一定。

There's incredible subjective component.

其中有令人难以置信的主观成分。

There also is a need sometimes to treat the injury at the level of the pain receptors at the site of the wound.

There also is a need sometimes to treat the injury at the level of the pain receptors at the site of the wound.

Andrew Huberman:

安德鲁·休伯曼：

So please take the information, do with it what you will.

So please take the information, do with it what you will.

And in the meantime, thank you so much for your time and attention.

And in the meantime, thank you so much for your time and attention.

Before we go, I just want to remind you to please subscribe to the YouTube channel, Apple and/or Spotify.

Before we go, I just want to remind you to please subscribe to the YouTube channel, Apple and/or Spotify.

Leave us comments and feedback.

给我们留下评论和反馈。

Five star review on Apple if you think we deserve that.

Five star review on Apple if you think we deserve that.

Please check out our sponsors.

请查看我们的赞助商。

Once again, thanks so much for your time and attention today.

Once again, thanks so much for your time and attention today.

And as always, thank you for your interest in science.

一如既往，感谢您对科学的兴趣。