High resolution interrogation of the insula in mechanisms of chronic pain

慢性疼痛机制中岛叶的高分辨率询问

• 批准号: 10575673
• 负责人: Wynn Legon
• 金额: $ 22.89万
• 依托单位: VIRGINIA POLYTECHNIC INST AND ST UNIV
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-02-22 至 2025-01-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10575673
• 关键词: Acute; Affect; American; Anterior; Behavior; Brain; Central Nervous System; Cephalic; Characteristics; Clinical; Data; Economics; Effectiveness; Electric Stimulation; Epidemic; Evoked Potentials; Feeling; Fibromyalgia; Focused Ultrasound; Functional disorder; Goals; Health; Human; Human Volunteers; Hyperalgesia; Individual; Insula of Reil; Lasers; Link; Measures; Mental Depression; Methods; Neurosurgical Procedures; Opioid; Pain; Pain management; Penetration; Pharmacological Treatment; Public Health; Reporting; Resolution; Role; Safety; Sensory; Source; Spottings; Stimulus; Surface; Syndrome; Techniques; Testing; Transcranial magnetic stimulation; Translations; United States; addiction; allodynia; autism spectrum disorder; behavior measurement; central pain; central sensitization; chronic pain; chronic pain management; chronic painful condition; conditioned pain modulation; cost; cranium; effective therapy; effectiveness testing; experience; fibromyalgia patients; millimeter; neuroregulation; noninvasive brain stimulation; novel; pain processing; response; sensory gating; sensory input; sensory system; social; stem; tool; ultrasound

ABSTRACT Chronic pain is a major public health problem. An estimated 100 million Americans have experienced chronic pain producing significant economic and social burden. Pharmacological treatments frequently require the use of opioids resulting in a major epidemic of abuse in the United States. New, non-addicting treatments for pain are critically needed. Neuromodulation with low intensity focused ultrasound (LIFU) may provide a non- pharmacological treatment for chronic pain. The enormous potential of LIFU stems from the ability to focus ultrasound through the intact skull to a millimeter-sized focal spot size anywhere in the brain. One promising target to treat chronic pain is the insular cortex. Multiple lines of evidence support the involvement of the insula in abnormal pain modulation or central sensitization and pain chronicity. Unfortunately, the insula lies deep to the cortex and contains small discrete sub-regions making non-invasive access difficult. Preliminary data demonstrates that LIFU can target individual sub-regions of the insula non-invasively to inhibit laser-evoked potentials as well as reduce subjective report of pain in humans. It is the purpose of this proposal to investigate the causal influence of LIFU to sub-regions of the insula on brain activity and behavior related to central sensitization in healthy human volunteers and fibromyalgia patients. This is important as central sensitization is a shared characteristic of many chronic pain conditions. It is the long-term goal of this project to advance LIFU as a human pain management tool to enhance the health and reduce suffering in those with chronic pain.

抽象的 慢性疼痛是一个主要的公共卫生问题。据估计，有 1 亿美国人患有慢性病 疼痛造成重大的经济和社会负担。药物治疗经常需要使用 阿片类药物的使用导致美国滥用阿片类药物的情况严重流行。新的、非成瘾性的疼痛治疗方法 是迫切需要的。低强度聚焦超声 (LIFU) 的神经调节可能提供非 慢性疼痛的药物治疗。 LIFU 的巨大潜力源于专注的能力 超声波穿过完整的头骨，到达大脑任何地方的毫米大小的焦点。一位有前途的 治疗慢性疼痛的目标是岛叶皮质。多种证据支持岛叶的参与 异常的疼痛调节或中枢敏化和慢性疼痛。不幸的是，岛叶位于深部 皮层并包含小的离散子区域，使得非侵入性访问变得困难。初步数据 表明 LIFU 可以非侵入性地针对岛叶的各个子区域来抑制激光诱发的 潜力并减少人类疼痛的主观报告。本提案的目的是调查 LIFU 对岛叶亚区域对中枢神经系统相关大脑活动和行为的因果影响 健康人类志愿者和纤维肌痛患者的敏化。这很重要，因为中枢敏化是 许多慢性疼痛的共同特征。推进LIFU是该项目的长期目标 作为人类疼痛管理工具，可增强慢性疼痛患者的健康并减少其痛苦。