Pain sensitivity and endogenous pain modulation in autistic adults

自闭症成人的疼痛敏感性和内源性疼痛调节

• 批准号: 10574757
• 负责人: Michelle Dawn Failla
• 金额: $ 22.48万
• 依托单位: OHIO STATE UNIVERSITY
• 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 2025-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10574757
• 关键词: Address; Adult; Affect; Affective; Age; Aging; Alzheimer' s Disease; Anxiety; Arthritis; Back Pain; Caring; Central Nervous System; Chronic; Communication; Coupled; Cross-Sectional Studies; Dangerousness; Data; Development; Diabetes Mellitus; Diagnosis; Dimensions; Disparate; Emotional; Functional Magnetic Resonance Imaging; Goals; Health; Health Care Costs; Individual Differences; Injury; Intervention; Knowledge; Literature; Measures; Medical; Mental Depression; Pain; Pain Assessment Tool; Pain Measurement; Pain Threshold; Pain intensity; Pain management; Pain quality; Participant; Pattern; Persistent pain; Polypharmacy; Population; Protocols documentation; Psychophysics; Quality of life; Race; Reporting; Risk; Sensory; Signal Pathway; Site; Social isolation; Stimulus; System; Testing; Work; adult with autism spectrum disorder; autism spectrum disorder; autistic; central sensitization; conditioned pain modulation; dementia risk; developmental disease; experience; health care availability; high risk; human old age (65+); intense pain; multimodality; neural; neural patterning; pain inhibition; pain outcome; pain perception; pain processing; pain sensitivity; pressure; response; sex; social communication; success; young adult with autism spectrum disorder

Project Summary/Abstract As pain is often the first sign of injury or illness, individual differences in pain perception or communication can impact diagnosis and treatment of dangerous health conditions. In this proposal, we will investigate differences in pain perception for autistic adults who may have difficulty communicating about pain due to autism-related communication difficulties. Emerging evidence suggests autistic adults experience pain differently than non- autistic adults. Autistic adults report higher pain intensity and more pain-related anxiety compared to non-autistic adults. Additionally, the pattern of neural responses to pain in autistic adults suggests altered central processing of pain. However, most of these studies have been conducted in younger autistic adults (<40yrs). This is concerning as many painful chronic medical conditions become prevalent in mid-adulthood (e.g., back pain, arthritis, diabetes) and reports suggest autistic adults experience these conditions are an even greater rate, increasing the potential for disparate pain management in this population. In non-autistic populations, older age is consistently associated with decreased pain sensitivity. Endogenous modulation of pain in aging is associated with increased central sensitization (facilitation of pain), and less efficient descending pain modulation (inhibition of pain). Our preliminary data suggests that autistic adults are affected with persistent pain in adulthood and that this increases with age. Our conceptual framework suggests that autistic adults may experience persistent pain in adulthood due to 3 factors: 1) increased pain sensitivity, 2) altered endogenous pain modulation, and 3) difficulty in pain assessment. The overall goal of this cross-sectional study is to investigate how pain differs in autistic adults (n=40, ages 30- 70 yrs) compared to age, race, and sex matched non-autistic adults (n=40). To examine how pain perception may differ for autistic adults, this exploratory R21 will address two targeted knowledge gaps. In Aim 1, we will use a standard battery of multi-modality (heat and pressure) quantitative sensory testing to address both sensory and affective pain sensitivity. In Aim 2, we will examine differences in endogenous pain modulatory systems in autistic adults using both temporal summation (to address pain facilitation) and conditioned pain modulation (to address pain inhibition). At the end of this study, we will better understand critical differences in pain perception that may place autistic adults at risk for persistent pain in adulthood. For autistic adults, differences in pain processing and endogenous pain modulation, coupled with difficulty in social communication and healthcare access, could lead to poor pain outcomes. The knowledge gained from this study on mechanistic differences in pain sensitivity and endogenous pain modulation will help build a framework for development of new pain assessment tools and targeted pain management interventions for autistic adults.

项目摘要/摘要 由于疼痛通常是受伤或疾病的第一个迹象，因此疼痛感知或交流的个体差异可以 影响危险健康状况的诊断和治疗。在此提案中，我们将调查差异 自闭症成年人的痛苦感知，这些成年人可能难以交流与自闭症有关的疼痛 沟通困难。新兴证据表明，自闭症成年人的疼痛与非非非 - 自闭症成年人。自闭症成年人报告的疼痛强度较高，与非自主相比 成年人。此外，自闭症成年人对疼痛的神经反应的模式表明中央处理发生了改变 痛苦。但是，这些研究大多数是在年轻的自闭症成年人中进行的（<40岁）。这是 关于许多痛苦的慢性病状况在多余的慢性病中变得普遍（例如，背痛， 关节炎，糖尿病）和报告表明自闭症成年人经历这些疾病的速度更高， 增加了该人群不同疼痛管理的潜力。在非自学人群中，年龄较大 与疼痛敏感性降低有关。内源性调节衰老的疼痛与 随着中央敏化的增加（疼痛的促进）和效率降低的疼痛调节（抑制作用） 疼痛）。我们的初步数据表明，自闭症成年人在成年时受到持续疼痛的影响，并且 这会随着年龄的增长而增加。我们的概念框架表明自闭症成年人可能会遭受持续的痛苦 在3个因素引起的成年中：1）增加疼痛敏感性，2）内源性疼痛调节和3） 疼痛评估的困难。 这项横断研究的总体目标是研究自闭症成年人的疼痛如何（n = 40岁，30岁） 与年龄，种族和性别相匹配的非自主成年人（n = 40）相比，70年）。检查疼痛感如何 自闭症成年人可能有所不同，此探索性R21将解决两个有针对性的知识差距。在AIM 1中，我们将 使用标准的多模式（热和压力）定量感觉测试来解决这两个感觉 和情感疼痛敏感性。在AIM 2中，我们将检查内源性疼痛调节系统的差异 自闭症成年人都使用时间求和（解决疼痛促进）和条件疼痛调节（到 解决疼痛抑制）。在这项研究结束时，我们将更好地了解疼痛感知的关键差异 这可能会使自闭症成年人在成年后有持续性疼痛的风险。对于自闭症成年人，疼痛差异 处理和内源性疼痛调节，再加上社交沟通和医疗保健的困难 进入，可能导致疼痛不良。这项研究从本研究中获得的知识 疼痛敏感性和内源性疼痛调节将有助于建立发展新疼痛的框架 评估工具和针对自闭症成年人的有针对性的疼痛管理干预措施。