Imaging the Cognitive Modulation of Pain in Fibromyalgia

纤维肌痛疼痛认知调节的成像

• 批准号: 6865180
• 负责人: DANE B. COOK
• 金额: $ 31.86万
• 依托单位: UNIVERSITY OF WISCONSIN-MADISON
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-09-16 至 2010-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6865180
• 关键词: attention; behavior test; behavioral /social science research tag; bioimaging /biomedical imaging; brain imaging /visualization /scanning; chronic pain; clinical research; cognition; fibromyalgia; functional magnetic resonance imaging; human subject; neural information processing; nociceptors; pain threshold; patient oriented research; psychophysiology; questionnaires; rheumatoid arthritis

DESCRIPTION: Fibromyalgia (FM) is a disabling disorder characterized by widespread medically unexplained pain. A diagnosis of FM is accompanied by a limited prognosis and less than half of all FM patients experience adequate pain relief. FM patients are often left under treated, resulting in greater functional disability and increased health care utilization. Research Aimed at uncovering mechanisms of unexplained pain in FM is needed to guide potential treatment approaches and better understand the pathophysiology of this disorder. Brain imaging data collected in laboratory have demonstrated augmented fMRI responses to both non-painful and painful heat, and support the emerging view that abnormalities in central nociceptive processes act to maintain FM pain. Nevertheless, cognitive processes such as anticipation and attention could also affect brain responses and are known to affect chronic pain outcomes. The broad objectives are to further understanding of unexplained musculoskeletal pain in FM. fMRI is an objective measure of nociceptive processing, sensitive to sensory and cognitive manipulations. Thus, the Specific Aims of the project are to: (1) determine whether augmented central processing is unique to FM or is a consequence of chronic pain by comparing FM patients to rheumatoid arthritis patients (RA); (2) determine the influence of pain anticipation on fMRI responses to non-painful stimuli in FM patients compared to healthy and RA controls, and (3) determine the influence of attention to pain on central processing of painful stimuli in FM patients compared to healthy and RA controls. To manipulate anticipation of pain, subjects will be randomly assigned to pain and no pain conditions. To manipulate attention to pain, subjects will perform the Stroop color word task while receiving either painful or non-painful heat stimuli. The study will be conducted on two separate days. Day one will be conducted in a simulated MRI unit for psychophysical analysis of pain and performance of the Stroop. Day two will consist of functional brain imaging (fMRI) while the subjects receive either non-painful or painful heat stimuli and perform the Stroop. We posit that FM is a unique chronic pain disorder that involves dysregulated processing of sensory stimuli and that augmented brain responses will not be affected by manipulations of anticipation and attention. This will be a first important step towards understanding the mechanisms of unexplained muscle pain in FM.

描述：纤维肌痛（FM）是一种残疾疾病，其特征是医学上无法解释的疼痛。 FM的诊断伴随着有限的预后，不到所有FM患者的一半经历了足够的疼痛缓解。 FM患者经常处于治疗状态，导致功能障碍更大和医疗保健利用率增加。旨在发现FM中无法解释的疼痛机制的研究是指导潜在的治疗方法，并更好地了解这种疾病的病理生理学。在实验室中收集的大脑成像数据表明，FMRI对非疼痛和痛苦的热量的反应增强，并支持新兴观点，即中央伤害感受过程中的异常起作用以维持FM疼痛。然而，诸如预期和注意力之类的认知过程也可能影响大脑反应，并已知会影响慢性疼痛结果。广泛的目标是进一步了解FM中无法解释的肌肉骨骼疼痛。 fMRI是对伤害性处理的客观度量，对感觉和认知操作敏感。因此，该项目的具体目的是：（1）确定通过将FM患者与类风湿关节炎患者（RA）进行比较，确定增强的中央处理是FM独有的还是慢性疼痛的结果； （2）与健康和RA对照相比，与健康和RA对照相比，与健康和RA对照相比，与健康和RA对照相比，确定FM患者对非疼痛刺激的疼痛反应的影响与健康和RA对照相比，确定了注意力对疼痛的影响。为了操纵对疼痛的预期，受试者将随机分配到疼痛和无疼痛状况中。为了操纵对疼痛的关注，受试者将执行Stroop彩色单词任务，同时接受痛苦或非疼痛的热刺激。该研究将在两天之间进行。第一天将在模拟的MRI单元中进行，以对Stroop的疼痛和表现进行心理物理分析。第二天将由功能性脑成像（fMRI）组成，而受试者会接受无痛苦或痛苦的热刺激并执行弹药。我们认为，FM是一种独特的慢性疼痛障碍，涉及感觉刺激的处理失调，并且增强的大脑反应不会受到预期和关注的操纵的影响。这将是理解FM无法解释的肌肉疼痛机制的第一步。