Neural correlates of hypoalgesia driven by observation

观察驱动的痛觉减退的神经相关性

• 批准号: 10452769
• 负责人: Luana Colloca
• 金额: $ 71.79万
• 依托单位: UNIVERSITY OF MARYLAND BALTIMORE
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-08-15 至 2024-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10452769
• 关键词: Absence of pain sensation; Acute; Acute Pain; Acute pain management; Address; Adjuvant; Affect; Analgesics; Behavior; Behavioral; Birth; Blood; Brain; Brain Mapping; Brain region; Chronic; Clinical Trials; Clip; Cognition; Cognitive; Color; Cues; Data; Development; Electroencephalogram; Electroencephalography; Empathy; Event; Expectancy; Exposure to; Foundations; Functional Magnetic Resonance Imaging; Future; Goals; Healthcare; Immersion; Individual; Inferior; Irritable Bowel Syndrome; Knee Osteoarthritis; Knowledge; Laboratories; Laboratory Research; Learning; Left; Low Back Pain; Marketing; Maryland; Measurement; Measures; Mental Processes; Migraine; Naloxone; Neurobiology; Opioid; Opioid Antagonist; Pain; Pain Research; Pain management; Parietal; Parietal Lobe; Participant; Peripheral; Personal Satisfaction; Persons; Pharmaceutical Preparations; Pharmacology; Physiological; Placebo Control; Placebo Effect; Placebos; Prefrontal Cortex; Process; Psyche structure; Research; Resolution; Resources; Role; Route; Science; Sensory; Signal Transduction; Solid; Suggestion; System; Techniques; Temporal Lobe; Testing; Therapeutic; Universities; attentional control; base; behavioral outcome; chronic pain; clinical pain; clinical practice; conditioning; design; emotional experience; endogenous opioids; expectation; experience; experimental study; fascinate; functional magnetic resonance imaging/electroencephalography; healing; imaging approach; imaging study; innovation; mental state; neural correlate; neurobiological mechanism; neuromechanism; novel; opioid epidemic; opioid user; pain perception; pain reduction; pain relief; pain symptom; painful neuropathy; pill; placebo analgesia; prescription opioid; relating to nervous system; response; side effect; social; social learning; tool; treatment effect; virtual reality; virtual reality environment

Project Summary Placebo effects held an ambivalent place in health care for at least two centuries. On the one hand, placebos are traditionally used as controls in clinical trials to correct for biases and the placebo response is viewed as an effect to be factored out in order to isolate and accurately measure the effects of the treatment. On the other hand, there is scientific evidence that placebo effects represent fascinating psychoneurobiological events involving the contribution of distinct central nervous as well as peripheral physiological mechanisms that influence pain perception and clinical pain symptoms and substantially modulate the response to pain therapeutics. Therefore, placebo effects have shifted from being a challenge for clinical trials to a resource to trigger the reduction of pain based on endogenous mechanisms that can be activated in the brain to promote hypolagesia, self-healing, and well-being. This is relevant in acute pain settings given that chronic opioid users die within approximately 2.5 years of being prescribed their first opioid medication to treat acute pain. Namely, analgesic effects can also occur without formal conditioning and direct prior experience because crucial information necessary to build up expectations of analgesia can be acquired through observation of a therapeutic benefit in others. Placebo analgesic effects following the observation of a benefit in another person are similar in magnitude to those induced by directly experiencing an analgesic benefit. These observations emphasize that contextual cues substantially modulate the individual placebo analgesic effects. In this project, we propose a compelling research agenda to explore the neural mechanisms of hypoalgesia driven by observation as a foundation for future development of novel nonpharmacological pain therapies using pharmacological functional magnetic resonance imaging (fMRI), electroencephalography (EEG), and combined EEG/fMRI. It builds on a decade of experience in placebo research in PI Colloca’s lab and with University of Maryland collaborators experienced in brain mapping and pain research. In Aim 1, we will determine the role of endogenous opioids on the neural mechanisms of observationally-induced hypoalgesia by using the opioid antagonist naloxone in a functional Magnetic Resonance Imaging (fMRI) setting. In Aim 2, we will identify the impact of empathy by exploring how being in the immersive environment can enhance observationally-induced analgesia. In Aim 3, we leverage the EEG/fMRI to determine the neural EEG/fMRI transient changes that could co-occur when socially-induced expectations are violated. The proposed research will generate mechanistic research that can be directly exploited to develop easily implementable therapeutic strategies such video clips and virtual reality tools for acute pain management.

项目摘要 安慰剂效应在医疗保健中至少有两个世纪的态度。 传统上被用作临床试验中的对照，以纠正偏见，安慰剂反应被视为一个 为了隔离和准确测量治疗的治疗，要考虑的效果。 手，安慰剂作用代表着迷人的心理生物学事件的科学证据 涉及独特的中心神经以及外围机制的贡献 影响疼痛感知和临床疼痛症状，并实质上调节对疼痛的反应 因此。 触发基于可以在大脑中激活的内源性机制减轻疼痛以促进 Hypolagesia，自我修复和福祉。 在大约2.5个Youars中死亡，被处方了第一种信任急性疼痛的阿片类药物。 也就是说，在没有正式调节的情况下也可以发生镇痛作用，并直接先验经验 建立镇痛期望所需的关键信息可以 在观察他人的福利之后，其他人的治疗益处 与直接经历镇痛益处引起的那些观察值相似 强调上下文提示实质上调节了个体安慰剂镇痛作用。 在这个项目中，Wepropose是一个令人信服的研究议程，以探索降和性神经的神经主义 以观察为基础，以新型非药物疼痛疗法的未来发展为基础 使用药理学功能磁共振成像（fMRI），脑电图（EEG）和D 脑电图/fMRI结合在一起。 马里兰州的合作者在AIM 1中经历了大脑图和疼痛研究。 确定内源性阿片类药物对观察性侵入性诱导性低吻合的神经机制的作用 通过在功能性磁共振成像（fMRI）设置中使用阿片类拮抗剂纳洛酮。 我们将通过探索在身临其境的环境中如何增强同理心的影响 在AIM 3中观察到的镇痛，我们利用EEG/fMRI确定神经脑电图/fMRI 瞬态变化变化可能会违反社会诱发的期望。 通过生成机械研究的支撑研究可以直接利用以轻松开发 可实施的治疗策略，例如视频剪辑和用于急性疼痛管理的虚拟现实工具。