Central Pain Processing in Chronic Face Pain:fMRI Study

慢性面部疼痛的中枢疼痛处理：功能磁共振成像研究

• 批准号: 6967149
• 负责人: RINSKJE DE LEEUW
• 金额: $ 13.48万
• 依托单位: UNIVERSITY OF KENTUCKY
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-02-01 至 2011-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6967149
• 关键词: analgesia; anxiety; bioimaging /biomedical imaging; brain imaging /visualization /scanning; brain morphology; brain regulatory center; chronic pain; clinical research; emotions; estrogens; experimental designs; female; functional magnetic resonance imaging; heat stimulus; human subject; hyperalgesia; menstrual cycle; neural information processing; neuroimaging; oral facial pain; patient oriented research; statistics /biometry; temporomandibular joint syndrome; trigeminal nerve

DESCRIPTION (provided by applicant): This proposal for a K23 "Mentored Patient-Oriented Research Career Development Award" will provide the candidate with five years of continuous funding to gain a broad knowledge in the design and conduct of complex clinical oral health trials. This training will enhance the research environment of the Orofacial Pain Center and mentoring capacity of the University of Kentucky College of Dentistry. The candidate earned a PhD in General Medicine from the University of Groningen and received three years of postgraduate graduate training in Orofacial Pain at the University of Kentucky. This award would allow the candidate to evolve to an independent investigator and would prepare the candidate to successfully mentor MS and PhD candidates in orofacial pain research. The training program consists of two phases: a didactic component emphasizing courses in research design, biostatistics, data analysis and epidemiology, and a research phase involving a neuroimaging investigation of central pain processing in patients with chronic face pain. Three specific aims are proposed in this training application: Specific Aim 1. To assess the presence of pain augmentation in patients with chronic masticatory myofascial pain; Specific Aim 2. To investigate differences in location and extent of activation of brain regions involved in trigeminal pain processing between patients with chronic masticatory muscle pain and pain-free volunteers; and Specific Aim 3. To investigate the influence of estrogen level on cerebral activation in response to an acute experimental pain stimulus in patients with chronic masticatory muscle pain and pain-free volunteers. Dr. Charles Carlson, PhD, Professor, Departments of Psychology and Oral Health Science and research director of the Orofacial Pain Center, and Dr. Don Gash, PhD, Alumni Professor and Chair, Department of Anatomy and Neurobiology, and director of the Magnetic Resonance Imaging and Spectroscopy Center, will mentor the candidate. There is limited information on cerebral activation in response to stimulation of trigeminal structures in healthy pain-free volunteers as well as in chronic face pain patients. The available data support that there are important differences in the cerebral processing of pain in chronic pain patients compared to pain-free subjects. Moreover, the existing data suggest that in chronic pain conditions the medial pain system, the structures associated with the processing of the emotional-affective component of pain, exhibits altered activity. Additionally, there is a lack of information about the influence of estrogen on the central processing of pain. The available data suggest that estrogen may have an inhibitory / anxiolytic effect on the perception of pain, possibly by modulating the endogenous opioid system. Because neuroimaging data on this topic are scarce, and chronic pain conditions are predominant in women of reproductive age, the role of estrogen on pain should be further explored.

描述（由申请人提供）：这项 K23“以患者为导向的研究职业发展奖”提案将为候选人提供五年的持续资助，以获得设计和进行复杂临床口腔健康试验的广泛知识。此次培训将增强口面部疼痛中心的研究环境和肯塔基大学牙科学院的指导能力。该候选人在格罗宁根大学获得了普通医学博士学位，并在肯塔基大学接受了三年的口面部疼痛研究生培训。该奖项将使候选人能够发展成为一名独立调查员，并为候选人成功指导口面部疼痛研究的硕士和博士候选人做好准备。培训计划由两个阶段组成：教学部分强调研究设计、生物统计学、数据分析和流行病学课程，研究阶段涉及慢性面部疼痛患者中枢疼痛处理的神经影像学研究。 本次培训应用提出了三个具体目标： 具体目标 1. 评估慢性咀嚼肌筋膜疼痛患者是否存在疼痛加剧；具体目标2.研究慢性咀嚼肌疼痛患者与无痛志愿者之间参与三叉神经疼痛处理的大脑区域激活的位置和程度的差异；具体目标 3. 研究雌激素水平对慢性咀嚼肌疼痛患者和无痛志愿者对急性实验性疼痛刺激的大脑激活反应的影响。 Charles Carlson 博士、心理学和口腔健康科学系教授、口面部疼痛中心研究主任；Don Gash 博士、解剖学和神经生物学系校友教授兼系主任、磁共振主任成像和光谱中心将指导候选人。关于健康无痛志愿者以及慢性面部疼痛患者三叉神经结构刺激后大脑激活的信息有限。现有数据表明，与无痛受试者相比，慢性疼痛患者的大脑对疼痛的处理存在重要差异。此外，现有数据表明，在慢性疼痛情况下，内侧疼痛系统（与疼痛的情绪情感成分处理相关的结构）表现出活动改变。此外，缺乏有关雌激素对疼痛中枢处理影响的信息。现有数据表明，雌激素可能对疼痛感知具有抑制/抗焦虑作用，可能是通过调节内源性阿片类药物系统来实现的。由于有关该主题的神经影像学数据很少，并且慢性疼痛在育龄妇女中占主导地位，因此应进一步探讨雌激素对疼痛的作用。