PHYSIOLOGY OF THE STRESS RESPONSE IN PATIENTS WITH TMD AND FIBROMYALGIA

TMD 和纤维肌痛患者应激反应的生理学

基本信息

批准号：
8168483
负责人：
Juan Fernando Yepes
金额：
$ 7.85万
依托单位：
UNIVERSITY OF KENTUCKY
依托单位国家：
美国
项目类别：
财政年份：
2010
资助国家：
美国
起止时间：
2010-08-01 至 2011-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8168483
关键词：
Age Autonomic nervous system Chronic Daily Headaches Chronic Fatigue Syndrome Clinical Complex Computer Retrieval of Information on Scientific Projects Database Diagnosis Diagnostic Distress Fatigue Fibromyalgia Functional disorder Funding Grant Head and Neck Muscle Hydrocortisone Immune system Impaired cognition Individual Institution Irritable Bowel Syndrome Kentucky Masticatory muscles Neurosecretory Systems Orofacial Pain Outpatients Pain Pain Clinics Patients Phenotype Physiological Physiology Process Psychosocial Stress Recruitment Activity Registries Research Research Personnel Resources Rheumatology Salivary Severities Sleep Source Stress Symptoms System Temporomandibular Joint Temporomandibular Joint Disorders Testing United States National Institutes of Health Universities Women&apos s Health biological adaptation to stress chronic pain disturbance in affect heart rate variability hypothalamic-pituitary-adrenal axis psychologic

项目摘要

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Temporomandibular disorders (TMD) are a complex, heterogeneous group of clinical conditions involving pain and/or dysfunction in the muscles of mastication and related muscles of the head and neck and/or the temporomandibular joint. The localized symptoms of TMD often co-occur with the more generalized pain syndrome of fibromyalgia (FM), defined as a widespread pain, stiffness, and altered pain processing involving the locomotor system. In addition to the chronic pain, both TMD and FM usually present with other symptoms such as fatigue, mood disturbance, cognitive dysfunction, and sleep difficulty. We and others have made the case that this symptom complex is associated with significant perceived psychological or physical stress and with physiologic deficits in the stress response. In FM and TMD, altered function of stress-response systems includes the hypothalamic-pituitary-adrenal (HPA) axis, autonomic nervous system, and immune system. All previous studies have been limited in scope, however, focusing on either specific diagnostic group or stress exposure. Indeed, a specific patient may accumulate several diagnoses in addition to TMD and FM including chronic fatigue syndrome, irritable bowel syndrome, chronic daily headache and others. The General Hypothesis is that "individuals with FM and TMD can overlap significantly with respect to symptoms and stress physiologic phenotypes (e.g., salivary cortisol, heart-rate variability). The symptoms, rather than diagnostic group, are expected to correlate with specific neuroendocrine profile. We will recruit individuals from the University of Kentucky outpatient rheumatology and orofacial pain clinics and the Kentucky Women's Health Registry. Subjects will be classified into 4 groups (FM, TMD, FM and TMD and healthy matched controls). The specific aims to be tested are: Specific Aim 1: Examine the relationship between FM and TMD and the presence and severity of symptom profiles to determine the relationship between diagnostic group and symptoms; Specific Aim 2: Determine the association between psychosocial stress and distress on symptoms, diagnostic groups (TMD, FM, TMD and FM, and healthy matched controls) and stress physiology; and, Specific Aim 3: Compare the stress physiology phenotypes of four subject groups: (1) TMD, (2) FM, (3) TMD and FM and (4) healthy age-matched controls.

该子项目是利用该技术的众多研究子项目之一资源由 NIH/NCRR 资助的中心拨款提供。子项目和研究者 (PI) 可能已从 NIH 的另一个来源获得主要资金，因此可以在其他 CRISP 条目中表示。列出的机构是对于中心来说，它不一定是研究者的机构。颞下颌疾病 (TMD) 是一组复杂、异质的临床病症，涉及咀嚼肌以及头颈部和/或颞下颌关节相关肌肉的疼痛和/或功能障碍。 TMD 的局部症状通常与更广泛的纤维肌痛 (FM) 疼痛综合征同时发生，FM 被定义为涉及运动系统的广泛疼痛、僵硬和疼痛处理改变。除了慢性疼痛外，TMD和FM通常还伴有其他症状，如疲劳、情绪障碍、认知功能障碍和睡眠困难。我们和其他人已经证明，这种症状复合体与明显的心理或身体压力以及压力反应的生理缺陷有关。在 FM 和 TMD 中，应激反应系统的功能改变包括下丘脑-垂体-肾上腺 (HPA) 轴、自主神经系统和免疫系统。然而，之前所有的研究范围都受到限制，要么集中于特定的诊断组，要么集中于压力暴露。事实上，除了 TMD 和 FM 之外，特定患者还可能积累多种诊断，包括慢性疲劳综合征、肠易激综合征、慢性每日头痛等。一般假设是“患有 FM 和 TMD 的个体在症状和应激生理表型（例如唾液皮质醇、心率变异性）方面可能显着重叠。预计症状（而不是诊断组）与特定的神经内分泌特征相关我们将从肯塔基大学门诊风湿病和口面部疼痛诊所以及肯塔基州妇女健康登记处招募人员。将被分为 4 组（FM、TMD、FM 和 TMD 以及健康匹配对照）。要测试的具体目标是：具体目标 1：检查 FM 和 TMD 之间的关系以及症状特征的存在和严重程度，以确定症状特征。诊断组与症状之间的关系；具体目标 2：确定症状、诊断组（TMD、FM、TMD 和 FM，以及健康匹配对照）和应激生理学之间的心理社会压力和痛苦之间的关联；比较四个受试者组的应激生理表型：(1) TMD、(2) FM、(3) TMD 和 FM 以及 (4) 健康年龄匹配对照。