Mechanisms of Sensory Processing in Fibromyalgia

纤维肌痛的感觉处理机制

• 批准号: 7683171
• 负责人: Richard H Gracely
• 金额: $ 41.05万
• 依托单位: UNIV OF NORTH CAROLINA CHAPEL HILL
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-09-05 至 2013-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7683171
• 关键词: Accounting; Acoustic Stimulation; Address; Affective; Anterior; Auditory; Behavioral; Brain; Brain imaging; Breathing; C Fiber; Carbon Dioxide; Categories; Characteristics; Cognitive; Data; Detection; Development; Diagnosis; Diagnostic; Discrimination; Disease; Distress; Electroencephalography; Elements; Emotions; Esthesia; Evaluation; Evoked Potentials; Feeling; Fibromyalgia; Functional Magnetic Resonance Imaging; Future; Genetic; Genotype; Goals; Heating; Homeostasis; Hunger; Hyperalgesia; Individual; Investigation; Irritable Bowel Syndrome; Knowledge; Lead; Literature; Longitudinal Studies; Loudness; Low Back Pain; Measures; Mechanics; Mediating; Methodology; Methods; Modality; Moods; Nature; Nociception; Nociceptive Stimulus; Nociceptors; Noise; Outcome Study; Pain; Painless; Patients; Pattern; Performance; Phenotype; Physiological; Predisposing Factor; Probability; Procedures; Process; Psychophysiology; Publishing; Reaction Time; Regulation; Relative (related person); Reporting; Research; Risk Factors; Risk Marker; Role; Sensory; Sensory Process; Somatosensory Cortex; Specific qualifier value; Stimulus; Symptoms; System; Techniques; Temperature; Testing; Thirst; Work; base; behavior measurement; chronic pain; cingulate cortex; clinical practice; design; emotional distress; experience; health economics; hedonic; improved; innovation; motivated behavior; neuroimaging; pressure; psychological distress; research study; response; response marker; sensory discrimination; tool; treatment response

DESCRIPTION (provided by applicant): Fibromyalgia is characterized by symptoms of widespread pain and increased sensitivity to painful and non-painful sensory stimulation. The pattern of sensory modality sensitivity varies across individuals. This variance may be due to the contribution of non-sensory factors, especially the unpleasant affective components that motivate behaviors of escape and avoidance. The relative contribution of these elements to altered sensory processing of painful and non-painful stimuli is not known and may account for the limited characterization of the underlying mechanisms of fibromyalgia. The proposed work will identify the role of mechanisms mediating feelings of distress and discomfort in patients with fibromyalgia. The methods use psychophysical multi-method techniques (aim 1), behavioral measures of discrimination performance and aversiveness (aim 2), and functional neuro-imagining (aim 3) to characterize common mechanisms of intensity and affective processing in fibromyalgia and healthy controls, and to characterize the role of brain processing regions implicated in sensory discriminative (primary and secondary somatosensory cortex) and affective (insular and anterior cingulate cortex) processing. The specific psychophysical procedures reduce spurious correlations between intensity and unpleasantness responses. These procedures and behavioral evaluation of discrimination performance and relative and absolute aversiveness will determine the contributions of increased sensory gain and central affective gain in two nociceptive (heat, pressure) and one non-nociceptive stimulus modality (audition) to the symptoms of fibromyalgia and compares these to responses from healthy control subjects. Fibromyalgia is a significant health and economic problem mediated by unknown mechanisms. Current treatments are only marginally effective. Once the mechanisms that initiate and maintain fibromyalgia are understood, this knowledge can be applied to the development of effective rational treatments. We expect that the proposed investigation of altered sensory processing will uncover important information that will significantly advance understanding of the underlying mechanisms. Such an advance is significant since it will guide further investigations of treatments. We expect these results to apply to multiple diagnostic categories and greatly increase the understanding and treatment fibromyalgia and related disorders. PROJECT NARRATIVE: This research will improve the understanding of the underlying mechanisms of fibromyalgia. A better understanding of mechanisms and pain processes will lead to improved therapies and better detection of who will respond to certain types of therapies. The outcomes of this study will also provide better information about phenotypic characteristics that will be useful in guiding future genetic studies.

描述（由申请人提供）：纤维肌痛的特征是疼痛广泛的症状以及对疼痛和非疼痛的感觉刺激的敏感性。感觉方式敏感性的模式在个人之间各不相同。这种差异可能是由于非感官因素的贡献，尤其是激励逃避和回避行为的不愉快的情感组成部分。这些元素对改变疼痛和非抚摸刺激的感觉处理的相对贡献尚不清楚，并且可能解释了纤维肌痛基本机制的有限表征。拟议的工作将确定纤维肌痛患者中介导困扰和不适感的机制的作用。该方法使用心理物理多方法技术（目标1），歧视性能和厌恶性的行为度量（目标2）以及功能性神经想象（目标3），以表征纤维元素和健康控制的强度和情感处理的强度和情感处理的特征，并表现出大脑处理的角色，并在感觉构成的角色和次要的歧视区域（主要）构成的作用（主要）。 （岛状和前扣带回皮层）加工。特定的心理物理程序减少了强度和不愉快的反应之间的虚假相关性。这些程序和行为评估对歧视性能以及相对和绝对厌恶性的行为评估将决定增加感觉增益和中央情感增益的贡献，并在两种伤害感（热，压力）和一种非感性刺激模态（试听）中对纤维肌痛的症状，并将这些反应与健康控制受试者的反应进行比较。纤维肌痛是由未知机制介导的重大健康和经济问题。当前的治疗只有略有效期。一旦理解了启动和维持纤维肌痛的机制，就可以将这些知识应用于有效理性治疗的发展。我们预计，对改变的感觉处理的拟议调查将发现重要信息，这将大大推动对潜在机制的理解。这样的进步很重要，因为它将指导对治疗的进一步研究。我们希望这些结果适用于多个诊断类别，并大大增加了理解和治疗纤维肌痛和相关疾病。项目叙述：这项研究将提高人们对纤维肌痛的潜在机制的理解。对机制和疼痛过程的更好理解将导致改善疗法，并更好地发现谁将对某些类型的疗法做出反应。这项研究的结果还将提供有关表型特征的更好信息，这些信息将有助于指导未来的遗传研究。