CHRONIC NEUROPATHIC PAIN MECHANISMS AND MANAGEMENT

慢性神经病理性疼痛的机制和治疗

基本信息

批准号：
6744335
负责人：
MICHAEL C ROWBOTHAM
金额：
$ 12.07万
依托单位：
UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
依托单位国家：
美国
项目类别：
财政年份：
2000
资助国家：
美国
起止时间：
2000-06-28 至 2005-04-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/6744335
关键词：
analgesia analgesics biopsy capsaicin chronic pain clinical research human subject human therapy evaluation hyperalgesia intravenous administration opiate alkaloid oral administration pain threshold quality of life shingles

项目摘要

DESCRIPTION (Adapted From The Applicant's Abstract): Michael Rowbotham, a clinical neurologist and clinical neuroscientist specializing in chronic pain, has an international reputation as a leader in patient-oriented research on neuropathic pain mechanisms and clinical analgesic trials. The UCSF Pain Clinical Research Center (PCRC), started by Dr. Rowbotham in 1990, is a clinical research unit located in University-owned space that receives NIH, private, and industry support for exploratory clinical research and clinical trials. As a PI in the NINDS Program Project on Pain Mechanisms at UCSF, clinical research that translates advances from the Program's four basic science labs is fostered. Dr. Rowbotham has mentored 15 beginning clinical scientists from diverse backgrounds in the PCRC, and is developing a unique two year research/clinical training program that brings together the PCRC, the Neurology Pain Research Training Grant, and the Anesthesia-Pain Management Center Fellowship. K-24 support for a 5 year period will assist Dr. Rowbotham achieve his long-term career goal of establishing an integrated clinical research program that: (1) has a comprehensive pain research training curriculum for beginning clinical investigators; (2) conducts exploratory clinical research on pain mechanisms underlying different neuropathic pain disorders; (3) uses experimental pain models to evaluate new analgesics in healthy volunteers and patients, (4) translates basic science advances into well designed clinical trials to advance pain therapy; (5) relates pain mechanisms to opioid sensitivity, tolerance, and long term efficacy. The experiments in Project I will: (a) determine if opioid-insensitive chronic pains exist by simultaneously measuring the response of experimentally induced pain and ongoing clinical pain to i.v. remifentanil infusion; (b) determine if a prolonged i.v. remifentanil infusion can produce acute analgesic tolerance to both the experimentally induced pain and hyperalgesia and the ongoing chronic pain; and (c) prospectively assess development of opioid analgesic tolerance during long term oral opioid therapy. Project II will test the hypothesis that development of chronic post-herpetic neuralgia after herpes zoster strongly depends on the severity of the initial neural injury and the quality of neural recovery. Patients with acute zoster pain will be followed for 6 months on measures of pain intensity, mood, quality of life, allodynia, extent of affected skin, quantitative tests of sensory function, response to controlled applications of capsaicin, and serial skin punch biopsy measurement of cutaneous innervation in affected and normal skin.

描述（改编自申请人的摘要）：Michael Rowbotham，a 专门研究慢性疼痛的临床神经学家和临床神经科学家，作为以患者为导向的研究领域的领导者而享有国际声誉神经病理性疼痛机制和临床镇痛试验。加州大学旧金山分校的痛苦临床研究中心 (PCRC) 由 Rowbotham 博士于 1990 年创办，是一家临床研究单位位于大学拥有的空间内，接收 NIH，对探索性临床研究和临床的私人和行业支持试验。作为 UCSF 疼痛机制 NINDS 项目的 PI，转化该计划的四个基本进展的临床研究科学实验室得到培育。 Rowbotham 博士指导了 15 名临床新手 PCRC 中来自不同背景的科学家，正在开发一种独特的两种年研究/临床培训计划，汇集了 PCRC、神经病学疼痛研究培训补助金和麻醉疼痛管理中心联谊会。为期 5 年的 K-24 支持将为 Rowbotham 博士提供帮助实现他建立综合临床的长期职业目标研究计划：(1) 进行全面的疼痛研究培训初级临床研究人员课程；（二）进行探索不同神经病理性疼痛的疼痛机制的临床研究疾病； (3) 使用实验疼痛模型来评估新型镇痛药健康志愿者和患者，（4）将基础科学进步转化为精心设计的临床试验以推进疼痛治疗； (5) 与疼痛有关阿片类药物敏感性、耐受性和长期疗效的机制。这项目 I 中的实验将：（a）确定阿片类药物不敏感的慢性病是否疼痛是通过同时测量实验诱发的反应而存在的静脉注射疼痛和持续的临床疼痛瑞芬太尼输液； (b) 确定是否延长静脉注射瑞芬太尼输注可产生急性镇痛耐受实验诱发的疼痛和痛觉过敏以及持续的慢性疼痛疼痛; (c) 前瞻性评估阿片类镇痛耐受性的发展在长期口服阿片类药物治疗期间。项目 II 将检验以下假设：带状疱疹后慢性带状疱疹后神经痛的发展取决于最初神经损伤的严重程度和神经的质量恢复。患有急性带状疱疹疼痛的患者将被随访 6 个月疼痛强度、情绪、生活质量、异常性疼痛、疼痛程度的测量受影响的皮肤，感觉功能的定量测试，对受控的反应辣椒素的应用，以及连续皮肤穿刺活检测量受影响和正常皮肤的皮肤神经支配。