Pain Sensitivity and Unpleasantness in People with Alzheimer's Disease and Cancer
阿尔茨海默病和癌症患者的疼痛敏感性和不愉快感
基本信息
- 批准号:10305529
- 负责人:
- 金额:$ 91.25万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2019
- 资助国家:美国
- 起止时间:2019-08-15 至 2024-05-31
- 项目状态:已结题
- 来源:
- 关键词:Academic Medical CentersAcute PainAddressAdultAffectiveAgeAlzheimer&aposs DiseaseAlzheimer&aposs disease brainAnalgesicsAssisted Living FacilitiesBrain InjuriesBreastCaregiversCaringClinicalDataDetectionDisseminated Malignant NeoplasmDistressElderlyExhibitsFemaleHome environmentIndividualInjuryInterventionKnowledgeLaboratoriesLifeMalignant NeoplasmsMalignant neoplasm of prostateMeasuresNeuraxisNursing HomesOhioOpioidPainPain ThresholdPain managementPalliative CareParticipantPatient Self-ReportPatientsPharmaceutical PreparationsPopulationProcessProstatePsychological FactorsPsychophysicsReportingResearchRiskRisk FactorsScienceSensorySiteStandardizationStimulusTemperatureTestingUniversitiesVulnerable PopulationsWorkcancer paincancer therapycentral sensitizationchronic paincognitive functioncomorbiditydesigndrug developmentend of lifeenhancing factorexperienceexperimental studyindexinginsightintense painmalemalignant breast neoplasmmechanical pressuremultimodalityneurophysiologynociceptive responsepain perceptionpain processingpain sensitivitypressureresponsestudy population
项目摘要
PROJECT SUMMARY
This multi-site (Vanderbilt University Medical Center [VUMC] and Ohio State University [OSU]) R01 application
is submitted in response to PA-18-502--Advancing the Science of Geriatric Palliative Care. This proposal
examines the impact of stage 4 breast and prostate cancer on psychophysical measures of pain sensitivity and
unpleasantness in Alzheimer's disease (AD). A considerable number of older adults will suffer from cancer and
co-occurring AD placing them at great risk of suffering under treated cancer pain. Understanding the impact of
cancer and AD on pain perception will provide key insights into cancer pain in AD. Unfortunately, the
consequences of untreated cancer pain can be devastating. More than 50% of hospitalized patients with cancer
described their pain as `distressing, horrible, or excruciating'. It remains unknown how cancer and Alzheimer's
disease alter pain processing. Altered pain processing may further increase the risk for reduced detection of pain
upon injury, increase the risk for under treatment of metastatic cancer pain, and may predispose to increased
suffering. If our results determine that cancer and co- occurring Alzheimer's disease place these individuals at
risk of increased suffering, targeted analgesic drug development strategies, and/or tailored interventions to
maximize pain treatment can then be designed for this highly vulnerable and under studied population.
We will study thermal and pressure pain thresholds as well as central sensitization (assessed via temporal
summation) to pain in 132 people balanced by group at each site (total n=264):132 males (44 with stage 4
prostate cancer, 44 with AD and stage 4 prostate cancer, and 44 with AD only) and 132 females (44 with stage
4 breast cancer, 44 with AD and stage 4 breast cancer, and 44 with AD only). Our overall hypothesis is that
when compared to older adults with AD only, older adults with stage 4 breast and prostate cancer pain develop
CNS sensitization and are at risk of experiencing intense daily cancer pain, and in those with comorbid AD, brain
damage leads to further alterations in CNS pain processing which decreases the ability to recognize and
accurately self-report pain, increases the risk of under treatment of cancer pain, and may predispose to increased
suffering at the end of life.
We have designed the proposed study to minimize the burden of participating in research to make the subjects
and their caregivers as comfortable as possible including collecting all study data wherever the participant
resides such as home, assisted living, or nursing homes. To summarize, there are extremely few studies
examining the impact of cancer and co-occurring Alzheimer's disease on pain perception and there are no
controlled experimental studies of pain in this population. The proposed study is the first to test pain threshold
and perception in this under-studied population. Results may immediately help guide pain care in this highly
vulnerable group of older adults.
项目摘要
这个多站点(Vanderbilt大学医学中心[VUMC]和俄亥俄州立大学[OSU])R01申请
根据PA-18-502的响应 - 宣传老年姑息治疗科学。这个建议
检查4期乳腺癌和前列腺癌对疼痛敏感性和
阿尔茨海默氏病(AD)中的不愉快性。大量老年人将患有癌症,
同时出现的广告将其置于治疗癌症疼痛下痛苦的巨大风险。了解
癌症和疼痛感知的AD将为AD中的癌症疼痛提供关键的见解。不幸的是,
未经治疗的癌症疼痛的后果可能是毁灭性的。超过50%的住院癌症患者
将他们的痛苦描述为“令人痛苦,恐怖或令人发指”。癌症和阿尔茨海默氏症是未知的
疾病改变疼痛处理。疼痛处理的改变可能会进一步增加疼痛检测的风险
受伤后,增加了受到转移性癌症疼痛治疗的风险,并且可能会增加
痛苦。如果我们的结果确定癌症和同事发生的阿尔茨海默氏病将这些人置于
遭受痛苦,有针对性的镇痛药物开发策略和/或量身定制干预措施的风险
然后可以为这种高度脆弱和研究人群设计最大的疼痛治疗。
我们将研究热和压力疼痛阈值以及中央敏化(通过时间评估
求和132人在每个站点平衡的132人(总n = 264):132名男性(44阶段4
前列腺癌,44岁,患有AD和4期前列腺癌,仅为AD)和132位女性(44个阶段
4个乳腺癌,44个患有AD和4期乳腺癌,仅44例AD)。我们的总体假设是
与仅具有AD的老年人相比,患有4期乳腺癌和前列腺癌疼痛的老年人
中枢神经系统的敏感性,面临每日强烈的癌症疼痛的风险,在患有合并广告的人中,大脑
损害导致CNS疼痛处理的进一步改变,从而降低了识别能力和
准确地自我报告疼痛,增加癌症疼痛治疗的风险,并可能增加
在生命的尽头。
我们设计了拟议的研究,以最大程度地减少参与研究的负担
他们的照顾者尽可能舒适,包括在任何地方收集所有研究数据
居住在家庭,辅助生活或疗养院。总而言之,很少有研究
检查癌症和同时发生的阿尔茨海默氏病对疼痛感的影响,没有
该人群疼痛的控制实验研究。拟议的研究是第一个测试疼痛阈值的研究
和在这个研究不足的人群中的看法。结果可能会立即帮助指导疼痛护理
脆弱的老年人群体。
项目成果
期刊论文数量(0)
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会议论文数量(0)
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RONALD L COWAN的其他文献
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{{ truncateString('RONALD L COWAN', 18)}}的其他基金
Pain Sensitivity and Unpleasantness in People with Alzheimer's Disease and Cancer
阿尔茨海默病和癌症患者的疼痛敏感性和不愉快感
- 批准号:
10170205 - 财政年份:2019
- 资助金额:
$ 91.25万 - 项目类别:
Pain Sensitivity and Unpleasantness in People with Alzheimer's Disease and Cancer
阿尔茨海默病和癌症患者的疼痛敏感性和不愉快感
- 批准号:
10454114 - 财政年份:2019
- 资助金额:
$ 91.25万 - 项目类别:
Pain Sensitivity and Unpleasantness in People with Alzheimer's Disease and Cancer
阿尔茨海默病和癌症患者的疼痛敏感性和不愉快感
- 批准号:
10631951 - 财政年份:2019
- 资助金额:
$ 91.25万 - 项目类别:
Differences in Pain Between Alzheimer's Disease and Vascular Dementia in Older Females
老年女性阿尔茨海默氏病和血管性痴呆的疼痛差异
- 批准号:
9353271 - 财政年份:2016
- 资助金额:
$ 91.25万 - 项目类别:
Differences in Pain Between Alzheimer's Disease and Vascular Dementia in Older Females
老年女性阿尔茨海默氏病和血管性痴呆的疼痛差异
- 批准号:
9851601 - 财政年份:2016
- 资助金额:
$ 91.25万 - 项目类别:
Age-Related Differences in Psychophysical and Neurobiological Response to Pain
对疼痛的心理物理和神经生物学反应与年龄相关的差异
- 批准号:
8702449 - 财政年份:2014
- 资助金额:
$ 91.25万 - 项目类别:
Neural mechanisms of increased cortical excitability in human MDMA/Ecstasy users
人类 MDMA/摇头丸使用者皮质兴奋性增加的神经机制
- 批准号:
8604148 - 财政年份:2013
- 资助金额:
$ 91.25万 - 项目类别:
Neural mechanisms of increased cortical excitability in human MDMA/Ecstasy users
人类 MDMA/摇头丸使用者皮质兴奋性增加的神经机制
- 批准号:
8444212 - 财政年份:2013
- 资助金额:
$ 91.25万 - 项目类别:
[18F]FPEB Studies of the mGluR5 Receptor and Methamphetamine Abuse
[18F]mGluR5 受体和甲基苯丙胺滥用的 FPEB 研究
- 批准号:
8460823 - 财政年份:2012
- 资助金额:
$ 91.25万 - 项目类别:
[18F]FPEB Studies of the mGluR5 Receptor and Methamphetamine Abuse
[18F]mGluR5 受体和甲基苯丙胺滥用的 FPEB 研究
- 批准号:
8243362 - 财政年份:2012
- 资助金额:
$ 91.25万 - 项目类别:
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