fMRI study of expectancy on acupuncture analgesia

针刺镇痛预期的功能磁共振成像研究

• 批准号: 6825846
• 负责人: RANDY Lyanne GOLLUB
• 金额: $ 21.85万
• 依托单位: MASSACHUSETTS GENERAL HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-09-15 至 2006-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6825846
• 关键词: acupuncture /acupressure; alternative medicine; analgesia; behavioral /social science research tag; bioimaging /biomedical imaging; clinical research; expectancy; functional magnetic resonance imaging; human subject; pain; placebos

DESCRIPTION (provided by applicant): Distinguishing acupuncture from placebo acupuncture has been a methodological challenge. We propose to move this question into a well-controlled mechanistic laboratory model using a quantitative brain imaging method (fMRI) to investigate the neurobiological mechanism of acupuncture analgesia, placebo analgesia and their interrelationship. A well tested method to induce high expectation and low expectation will be combined with acupuncture analgesia and sham acupuncture analgesia to create a 2 X 2 neuroimaging comparison of verum (real) acupuncture and sham acupuncture each paired with positive and negative expectancies. To delineate the different brain networks involved, we will compare pre- and post-treatment fMRI signal changes induced by application of calibrated noxious stimuli (pain sensory encoding) and a subsequent rating task (pain intensity evaluation) after the different treatments. We hypothesize that modulation of the pain intensity evaluation process is a critical substrate of placebo analgesia. Specifically, we hypothesize that expectancy (placebo) analgesia, which critically depends on former knowledge, belief or experience, will be initialized by activity in the central nervous system. We propose that the activity in this network of brain regions will produce analgesia by activating descending endogenous opioid systems as well as by activating what we have called the "selective pain intensity evaluation distortion process". The first mechanism may also be shared with acupuncture analgesia, however, the second mechanism should be unique for placebo analgesia in our study population who have no prior experience or expectancy for acupuncture analgesia. This proposal is directly relevant to a recent Program Announcement (PA-03-125) that calls for "biobehavioral pain research". This proposal is also relevant to a recent RFA (AT-02-002) that calls for "An Integrative Approach to Elucidation of the Underlying Mechanisms of Placebo Effect". It is also relevant to FY 2003 Research Priorities that call for "preclinical neurobiological studies of the mechanisms underlying CAM approaches to the management of acute or chronic pain".

描述（由申请人提供）：将针灸与安慰剂针灸区分开是方法论上的挑战。我们建议使用定量脑成像法（FMRI）将这个问题转移到一个控制良好的机械实验室模型中，以研究针灸镇痛，安慰剂镇痛及其相互关系的神经生物学机制。经过良好的测试方法诱导高期望和低期望的方法将与针灸镇痛和假针刺镇痛结合，以创建2 x 2的神经想像（真实）针灸和假针刺的比较，每种针灸都与正期和负的预期配对。为了描述所涉及的不同大脑网络，我们将比较通过应用校准的有害刺激（疼痛感觉编码）和随后的评估任务（疼痛强度评估）在不同处理后引起的fMRI信号变化。 我们假设调节疼痛强度评估过程是安慰剂镇痛的关键底物。具体而言，我们假设期望（安慰剂）镇痛（迫切取决于以前的知识，信念或经验）将通过中枢神经系统中的活动初始化。我们建议，这个大脑区域网络中的活性将通过激活降序的内源性阿片类药物系统以及激活我们所谓的“选择性疼痛强度评估失真过程”来产生镇痛。第一种机制也可以与针灸镇痛共享，但是，第二种机制对于我们的研究人群中的安慰剂镇痛应该是独一无二的，而安慰剂镇痛药物没有事先经验或对针灸镇痛的期望。该提案与最近的计划公告（PA-03-125）直接相关，该公告要求“生物行为疼痛研究”。 该提案也与最近的RFA（AT-02-002）有关，该提案要求“一种综合方法来阐明安慰剂效应的基本机制”。这也与2003财年的研究重点有关，该研究的优先事项要求“对急性或慢性疼痛治疗的临时性cam方法进行临床前神经生物学研究”。