Twin Study of Chronic Widespread Pain

慢性广泛性疼痛的双胞胎研究

• 批准号: 7032872
• 负责人: Niloofar Afari
• 金额: $ 34.45万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-09-25 至 2006-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7032872
• 关键词: autonomic nervous system; chronic pain; clinical research; disease /disorder etiology; exercise; family genetics; female; fibromyalgia; genetic susceptibility; human subject; hypothalamic pituitary adrenal axis; pain threshold; psychic activity level; sibling relations; twin /multiplet

DESCRIPTION: Chronic widespread pain (CWP) occurs in 4-13% of people and is one of the defining characteristics of Fibromyalgia (FM). Although tender points were originally considered as essential to the diagnosis of FM, it is now felt that they reflect pain severity and distress, and that FM lies at one end of the CWP continuum. To truly understand the pathogenesis of CWP, it would be optimal to study the entire spectrum of individuals who have this symptom. Another critical issue in the mechanistic study of CWP is what to study. Over the past two decades, FM researchers have described abnormalities in various components of the central nervous system and high rates of psychological co-morbidities and other chronic multi-symptom illnesses. The role and significance of each of these factors in predisposing to the illness, directly causing the symptoms, or occurring as a consequence of the condition, are unclear. The complexity of FM and the continuum of CWP have led us to develop a theoretical model of CWP that is synergistic and multidimensional. Predisposing factors are of particular interest in this model since these represent premorbid risk or protective factors that relate to the development of CWP. Further, predisposing factors can be differentiated from illness-associated features that occur as a consequence of the condition. A co-twin control study is a powerful means for examining specific hypotheses about the etiology and consequences of CWP derived from the theoretical model. Twenty-one MZ and 21 DZ twin pairs discordant for CWP, along with 22 MZ and DZ pain-free control twin pairs will be recruited from the population-based University of Washington Twin Registry. Twin will undergo an intensive evaluation of the autonomic nervous system (ANS) function, hypothalamic-pituitary-adrenal (HPA) axis function, exercise capacity, sleep and activity levels, evoked pain processing, and psychiatric and psychosocial factors involved in CWP. There are 2 Specific Aims: 1) Assess similarities and differences in ANS function, HPA axis function, exercise capacity, sleep and activity levels, evoked pressure pain sensitivity, and psychiatric and psychosocial factors between female twins with CWP and their pain-free co-twins. 2) Determine if the association between CWP and the above illness characteristics is due to confounding by genetics or common environmental factors by comparing CWP-discordant MZ female twin pairs with CWP-discordant DZ and pain-free MZ and DZ pairs. Additionally, investigating the pattern of differences between twin groups can help to distinguish factors that are predisposing to CWP and those that occur after the onset of the illness.

描述：慢性广泛疼痛（CWP）发生在4-13％的人中，是纤维肌痛（FM）的定义特征之一。尽管招标点最初被认为对FM的诊断至关重要，但现在人们认为它们反映了疼痛的严重程度和困扰，并且FM位于CWP连续体的一端。为了真正了解CWP的发病机理，研究具有这种症状的个体的整个频谱将是最佳的。 CWP机理研究的另一个关键问题是研究。在过去的二十年中，FM研究人员描述了中枢神经系统各个组成部分的异常，心理合并症的率很高和其他慢性多症状疾病。这些因素中每个因素的作用和意义在疾病诱发的疾病中，直接导致症状或由于疾病而出现的作用和意义尚不清楚。 FM的复杂性和CWP的连续性使我们开发了一种协同和多维的CWP的理论模型。诱发因素在该模型中特别感兴趣，因为这些因素代表了与CWP发展有关的前虫风险或保护因素。此外，诱发因素可以与疾病所致的疾病相关特征区分开。联合控制研究是一种有力的手段，用于检查有关从理论模型得出的CWP的病因和后果的特定假设。 CWP不一致的21个MZ和21 dz双子对，以及22 MZ和DZ无疼痛的对照双子对，将从华盛顿双胞胎登记册中招募。双胞胎将对自主神经系统（ANS）功能，下丘脑 - 垂体 - 肾上腺（HPA）轴功能，运动能力，睡眠和活动水平，诱发疼痛处​​理以及涉及CWP中涉及的精神病和心理社会因素进行深入评估。有2个特定目的：1）评估ANS功能，HPA轴功能，运动能力，睡眠和活动水平，诱发压力疼痛敏感性以及CWP女性双胞胎与无痛的共晶型的相似性和差异。 2）确定CWP与上述疾病特征之间的关联是否是由于遗传学或常见环境因素的混淆，通过将CWP-验证的MZ女性双胞胎与CWP触发DZ以及无疼痛的MZ和DZ Pairs进行比较。此外，研究双胞胎组之间的差异模式可以帮助区分易于CWP的因素和疾病发作后发生的因素。