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

基本信息

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
项目类别：
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&apos 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

项目摘要

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.

项目概要/摘要由于疼痛通常是受伤或患病的第一个迹象，因此疼痛感知或沟通的个体差异可能会导致疼痛。影响危险健康状况的诊断和治疗。在此提案中，我们将调查差异对于自闭症成年人的疼痛感知，他们可能因自闭症相关而难以沟通疼痛沟通困难。新的证据表明，自闭症成年人对疼痛的体验与非自闭症患者不同。自闭症成人。与非自闭症患者相比，自闭症成人报告更高的疼痛强度和更多与疼痛相关的焦虑成年人。此外，自闭症成人对疼痛的神经反应模式表明中枢处理过程发生了改变的痛苦。然而，这些研究大多数是在年轻的自闭症成人（<40 岁）中进行的。这是令人担忧的是，许多痛苦的慢性疾病在中年时期变得普遍（例如背痛、关节炎、糖尿病），报告表明患有这些疾病的成人自闭症患者的比例更高，增加该人群不同疼痛管理的潜力。在非自闭症人群中，年龄较大始终与疼痛敏感性降低相关。衰老过程中疼痛的内源性调节与中枢敏化（促进疼痛）增加，下行疼痛调节（抑制）效率降低的疼痛）。我们的初步数据表明，患有自闭症的成年人在成年后会受到持续性疼痛的影响，并且这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经历持续性疼痛成年后由于 3 个因素导致：1) 疼痛敏感性增加，2) 内源性疼痛调节改变，3) 疼痛评估困难。这项横断面研究的总体目标是调查自闭症成人（n = 40，年龄 30- 70 岁）与年龄、种族和性别匹配的非自闭症成年人 (n=40) 进行比较。检查疼痛知觉如何对于自闭症成人来说可能有所不同，这个探索性的 R21 将解决两个有针对性的知识差距。在目标 1 中，我们将使用标准的多模态（热和压力）定量感官测试来解决感官问题和情感疼痛敏感性。在目标 2 中，我们将研究不同个体中内源性疼痛调节系统的差异。自闭症成人使用时间求和（以解决疼痛促进）和条件性疼痛调制（以解决疼痛抑制问题）。在这项研究结束时，我们将更好地理解疼痛感知的关键差异这可能会使患有自闭症的成年人在成年后面临持续疼痛的风险。对于患有自闭症的成年人来说，疼痛的差异处理和内源性疼痛调节，加上社交沟通和医疗保健方面的困难访问，可能会导致不良的疼痛结果。从这项关于机械差异的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新疼痛发展的框架针对成人自闭症患者的评估工具和有针对性的疼痛管理干预措施。