Disrupted sleep architecture in adolescents with functional abdominal pain disorders

患有功能性腹痛疾病的青少年的睡眠结构被破坏

• 批准号: 10641146
• 负责人: Neha Richard Santucci
• 金额: $ 19.23万
• 依托单位: CINCINNATI CHILDRENS HOSP MED CTR
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-04-01 至 2028-01-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10641146
• 关键词: Abdominal Pain; Absenteeism; Adolescent; Adult; Affect; Aftercare; Anxiety; Behavioral Medicine; Case/Control Studies; Center for Translational Science Activities; Child; Childhood; Clinical; Clinical Research; Clinical Trials; Cranial Nerves; Data; Dedications; Development; Devices; Environment; Eye; Foundations; Frequencies; Funding Opportunities; Gastroenterologist; Gastroenterology; Gastrointestinal tract structure; Goals; Grant; Health; Health Care Costs; Institution; Intervention Trial; Intestines; Learning; Master of Science; Measures; Mediating; Mediation; Medical center; Mental Depression; Mentors; Monitor; Movement; Nausea; Nerve; Nociception; Nociceptors; Outcome; Pain; Pain Disorder; Pain Measurement; Pathway interactions; Patient Outcomes Assessments; Patient Self-Report; Patients; Pediatric Hospitals; Pediatrics; Persons; Pharmaceutical Preparations; Physicians; Physiological Processes; Polysomnography; Predictive Factor; Questionnaires; Records; Reporting; Research; Research Design; Research Personnel; Research Training; Resources; Risk Factors; Role; Schools; Scientist; Severities; Sleep; Sleep Architecture; Sleep Fragmentations; Sleep Stages; Sleep disturbances; Sleeplessness; Slow-Wave Sleep; Statistical Data Interpretation; Statistical Methods; Symptoms; Time; Training; Translational Research; Treatment outcome; Vagus nerve structure; Visit; Work; Wrist; Youth; actigraphy; central pain; chronic pain; chronic painful condition; clinical efficacy; clinical translation; cohort; diaries; disability; disorders of gut-brain interaction; effective therapy; gastrointestinal; gastrointestinal symptom; improved; improved outcome; improvement on sleep; innovation; non rapid eye movement; novel; pain processing; predicting response; professor; programs; psychologic; response; sleep pattern; sleep physiology; sleep quality; treatment response; treatment strategy; trend

Project Summary Functional abdominal pain disorders (FAPD) constitute one of the most common pediatric chronic pain conditions. FAPD is associated with significant disability, school absenteeism and suboptimal treatment outcomes. Treatment is hampered by an incomplete understanding of contributing factors like sleep disturbances. Subjective sleep disturbances have been reported in FAPD but the role of sleep architecture and its relationship to gastrointestinal (GI) symptoms has not been established. Preliminary data by the candidate has shown decreased slow wave sleep (%NREM3) measured via polysomnography (PSG) in FAPD patients vs. controls. Percutaneous Electrical Nerve Field Stimulation (PENFS) is an FDA cleared therapy for pediatric FAPD. Preliminary data indicates that PENFS improves sleep in addition to symptoms of FAPD. However, there is limited data on factors predicting response, effects on sleep architecture and underlying mechanisms. The primary aims of this K23 training application are to: (1) Determine the relationship of sleep architecture (NREM3 and other variables measured via PSG) with abdominal pain and other patient-reported outcomes in a case-control study of adolescents with FAPD. (2) Compare changes in sleep architecture before and after PENFS, associate with patient reported outcomes. This is the first study to objectively characterize sleep architecture in pediatric FAPD and changes with PENFS. Comprehensive measures of sleep physiology such as sleep questionnaires, daily diaries and actigraphy will be employed in addition to PSG to associate with GI measures. The primary objective is for the candidate to acquire advanced research training through a Master of Science in Clinical and Translational Research, learn sleep (PSG and actigraphy) and pain assessments, and advanced statistical methods. The long-term goal is to build an independent research program to study risk factors in pediatric FAPD and identify novel treatment targets to improve outcomes. The K23 candidate is an Assistant Professor of Pediatrics, and a pediatric gastroenterologist at Cincinnati Children's Hospital Medical Center (CCHMC). This application integrates a thoughtfully designed research and training plan developed in conjunction with mentors and collaborators who are leading scientists and clinical experts in pain, GI, sleep and behavioral medicine. CCHMC provides a rich collaborative research environment and is deeply dedicated to the development of young investigators with significant institutional funding opportunities, support in developing clinical trials, study monitoring, and statistical analysis through core resources at the Digestive Health Center, and Clinical Translation Research Center. This environment will be conducive to the candidate to complete the proposed research and training to achieve full research independence. Results will build the foundation for a subsequent R01 trial to further optimize PENFS outcomes and determine the relationship of central pain processing with NREM3 sleep.

项目摘要 功能性腹痛（FAPD）构成最常见的小儿慢性疼痛之一 状况。 FAPD与严重的残疾，学校缺勤和次优疗法有关 结果。对诸如睡眠等因素的不完全了解，阻碍了治疗 干扰。 FAPD中已经报道了主观的睡眠障碍，但睡眠结构的作用和 它与胃肠道（GI）症状的关系尚未建立。候选人的初步数据 已显示通过FAPD患者测量的慢波睡眠（％NREM3） 与控件。经皮电场刺激（PENFS）是FDA清除的小儿治疗 fapd。初步数据表明，除了FAPD症状外，PENF还可以改善睡眠。然而， 关于预测反应，对睡眠结构的影响和潜在机制的因素的数据有限。 该K23培训申请的主要目的是： （1）确定睡眠体系结构（NREM3和通过PSG测量的其他变量）与 在一项针对FAPD的青少年的病例对照研究中，腹痛和其他患者报告的结果。 （2）比较PENF之前和之后的睡眠体系结构的变化，与患者报告的结果相关联。 这是首次客观地表征儿科FAPD中睡眠体系结构的研究和PENFS的变化。 睡眠生理学的综合度量，例如睡眠问卷，每日日记和动作法 除了PSG外，还可以使用GI措施。主要目标是候选人 通过临床和转化研究科学硕士获得高级研究培训，学习 睡眠（PSG和Actraphy）和疼痛评估以及晚期统计方法。长期目标是 建立一个独立的研究计划，以研究小儿FAPD中的危险因素并确定新颖的治疗方法 改善预后的目标。 K23候选人是儿科的助理教授和儿科 辛辛那提儿童医院医疗中心（CCHMC）的胃肠病学家。此应用程序集成了 与导师和合作者共同制定了精心设计的研究和培训计划 是疼痛，胃肠道，睡眠和行为医学领域的领先科学家和临床专家。 CCHMC提供富人 协作研究环境，并深入致力于与年轻研究人员的发展 大量机构资助机会，在开发临床试验中的支持，研究监测和 通过消化健康中心的核心资源和临床翻译研究的统计分析 中心。这种环境将有利于候选人完成拟议的研究和培训 实现完整的研究独立性。结果将为随后的R01试验建立基础，以进一步 优化PENF结果，并确定中枢疼痛处理与NREM3睡眠的关系。