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）：针对K23“指导患者的研究职业发展奖”的这一建议将为候选人提供五年的持续资金，以在复杂的临床口腔健康试验的设计和行为方面获得广泛的知识。这项培训将增强肯塔基大学牙科学院的口肤疼痛中心和指导能力的研究环境。这位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头疼痛研究生培训。该奖项将使候选人能够演变成独立的研究者，并准备候选人成功地指导MS和PhD候选者，从事口面疼痛研究。培训计划包括两个阶段：一个教学成分，强调研究设计，生物统计学，数据分析和流行病学中的课程，以及一个研究阶段，涉及对慢性疼痛患者中心疼痛处理的神经影像学研究。 在本培训应用中提出了三个具体目标：具体目的1。评估慢性咀嚼性肌筋膜疼痛患者的疼痛增加的存在；具体目的2。研究慢性咀嚼肌肉疼痛和无疼痛志愿者的三叉神经疼痛处理的位置和激活程度的差异；和特定的目的3。研究雌激素水平对慢性咀嚼肌肉疼痛和无疼痛志愿者的急性实验疼痛刺激的影响。查尔斯·卡尔森（Charles Carlson）博士，医生，心理学和口腔健康科学系教授，口面痛中心的研究主任，以及校友解剖学和神经生物学系的Don Gash博士以及磁共振成像和光谱中心的校友教授兼主席，将指导候选人。响应健康的无痛志愿者以及慢性疼痛患者中三叉神经结构的刺激，脑激活的信息有限。与无疼痛受试者相比，可用的数据支持慢性疼痛患者疼痛的脑处理存在重要差异。此外，现有数据表明，在慢性疼痛条件下，内侧疼痛系统，与疼痛的情绪影响成分相关的结构表现出改变的活性。此外，缺乏有关雌激素对疼痛中心处理的影响的信息。可用的数据表明，雌激素可能会通过调节内源性阿片类药物系统对疼痛感知产生抑制 /抗焦虑作用。由于对该主题的神经影像学数据很少，因此慢性疼痛状况在生殖年龄的女性中占主导地位，因此应进一步探讨雌激素对疼痛的作用。