Supraspinal Modulation of Nociceptive Reactions in Fibromyalgia

纤维肌痛伤害性反应的脊髓上调节

• 批准号: 7880116
• 负责人: Jamie Lynn Rhudy
• 金额: $ 6.29万
• 依托单位: UNIVERSITY OF TULSA
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-08-01 至 2012-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7880116
• 关键词: Acceleration; Adult; Affect; Affective; Aftercare; Attenuated; Brain; Brain imaging; Clinical; Congenital neurologic anomalies; Controlled Study; Development; Disease; Disease Progression; Distress; Emotional; Emotions; Equilibrium; Fibromyalgia; Future; Galvanic Skin Response; Heart Rate; Human; Hyperalgesia; Laboratories; Lead; Maintenance; Neuraxis; Nociception; Outcome; Pain; Pain Threshold; Pain management; Patients; Physical Function; Physiological; Play; Population; Procedures; Process; Productivity; Reaction; Recording of previous events; Reflex action; Relative (related person); Reporting; Rheumatoid Arthritis; Role; Spinal Cord; Stimulus; Syndrome; Work; chronic pain; chronic widespread pain; coping; design; disability; emotion regulation; emotional factor; emotional reaction; novel; psychologic; psychological distress; spinal reflex

DESCRIPTION (provided by applicant): Fibromyalgia syndrome (FMS) is an insidious disease that results in disability for 70% of those who suffer from it and tremendous loss of work and productivity. It is estimated that 8-12 million adults in the U.S. are affected by FMS, making it the most common chronic widespread pain syndrome. The exact mechanisms leading to the development and maintenance of fibromyalgia are unknown. But, accumulating evidence suggests abnormal nociceptive processing in the central nervous system (CNS) that could result from aberrations in supraspinal modulation. Our laboratory has developed procedures to assess supraspinal modulation of physiological and subjective nociceptive reactions (nociceptive flexion reflex, skin conductance, heart rate, pain report). A standardized picture-viewing paradigm is used to experimentally manipulate emotional valence (unpleasant, neutral, pleasant), and physiological-emotional manipulation checks verify emotional reactions. During picture-viewing, noxious electric stimuli are delivered (balanced across picture valence) and nociceptive reactions are recorded and averaged by picture valence. In healthy controls, we have shown that nociceptive reactions are reliably modulated in parallel by picture valence. Unpleasant pictures facilitate nociceptive reactions and pleasant pictures inhibit nociceptive reactions (an effect that explains 47-52% of the combined variance in the reactions). Because the nociceptive flexion reflex (a spinal reflex) is modulated, this suggests descending modulatory circuits are involved. Therefore, these procedures provide a non-invasive way to study supraspinal modulation. The present study will use the picture-viewing paradigm to study supraspinal modulation in FMS patients, rheumatoid arthritis (RA) patients, and no-pain controls. RA patients provide important controls for chronic pain history and other comorbid variables (eg, psychological distress, health/physical functioning, maladaptive coping) that could influence the emotion-pain relationship. Also, emotional factors are important in RA and FMS pain, but it is unclear whether emotion plays an equally potent role in both conditions. Further, there is limited human evidence for dysfunctional supraspinal modulation in RA, although RA is also associated with hyperalgesia. The specific aims of this study are: (1) To examine supraspinal modulation of nociceptive reactions in FMS patients and (2) To assess for hyperalgesia in FMS and RA patients.

描述（由申请人提供）：纤维肌痛综合征 (FMS) 是一种隐匿性疾病，会导致 70% 的患者残疾，并导致工作和生产力的巨大损失。据估计，美国有 8-1200 万成年人受到 FMS 的影响，使其成为最常见的慢性广泛疼痛综合征。导致纤维肌痛发生和维持的确切机制尚不清楚。但是，越来越多的证据表明，中枢神经系统（CNS）中的异常伤害感受处理可能是由脊髓上调节失常引起的。我们的实验室开发了评估生理和主观伤害性反应（伤害性屈曲反射、皮肤电导、心率、疼痛报告）的脊柱上调节的程序。标准化的图片观看范式用于实验性地操纵情绪效价（不愉快、中性、愉快），生理情绪操纵检查验证情绪反应。在观看图片期间，会传递有害的电刺激（在图片效价之间平衡），并记录伤害性反应并按图片效价进行平均。在健康对照中，我们已经证明伤害性反应可以通过图片效价可靠地并行调节。不愉快的图片会促进伤害性反应，而愉快的图片会抑制伤害性反应（这种效应解释了反应中 47-52% 的组合方差）。由于伤害性屈曲反射（脊髓反射）受到调节，这表明下行调节回路参与其中。因此，这些程序提供了一种研究脊柱上调制的非侵入性方法。本研究将使用图片观看范例来研究 FMS 患者、类风湿性关节炎 (RA) 患者和无痛对照患者的脊髓上调节。 RA 患者为慢性疼痛史和其他可能影响情绪-疼痛关系的共病变量（例如心理困扰、健康/身体功能、适应不良的应对方式）提供了重要的控制。此外，情绪因素在 RA 和 FMS 疼痛中也很重要，但目前尚不清楚情绪是否在这两种情况下发挥同样重要的作用。此外，尽管 RA 也与痛觉过敏相关，但人类证据表明 RA 中脊髓上调节功能失调。本研究的具体目的是：(1) 检查 FMS 患者伤害性反应的脊髓上调节；(2) 评估 FMS 和 RA 患者的痛觉过敏。

项目成果

Emotional modulation of pain and spinal nociception in persons with major depressive disorder (MDD).

重度抑郁症（MDD）患者疼痛和脊髓伤害感受的情绪调节。

• 发表时间: 2013-12
• 影响因子: 7.4
• 作者: Terry, Ellen L;DelVentura, Jennifer L;Bartley, Emily J;Vincent, Ashley L;Rhudy, Jamie L
• 通讯作者: Rhudy, Jamie L

Emotional modulation of pain and spinal nociception in fibromyalgia.

纤维肌痛中疼痛和脊髓伤害感受的情绪调节。

• 发表时间: 2013-07
• 影响因子: 7.4
• 作者: Rhudy, Jamie L;DelVentura, Jennifer L;Terry, Ellen L;Bartley, Emily J;Olech, Ewa;Palit, Shreela;Kerr, Kara L
• 通讯作者: Kerr, Kara L

Emotional modulation of pain and spinal nociception in persons with severe insomnia symptoms.

患有严重失眠症状的人的疼痛和脊髓伤害感受的情绪调节。

• 发表时间: 2014-06
• 作者: DelVentura, Jennifer L;Terry, Ellen L;Bartley, Emily J;Rhudy, Jamie L
• 通讯作者: Rhudy, Jamie L