Nociplastic mechanisms in somatic and visceral pain

躯体和内脏疼痛的伤害性机制

• 批准号: 10746147
• 负责人: Noah C. Waller
• 金额: $ 4.33万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-01 至 2025-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10746147
• 关键词: Acoustic Stimulation; Address; Attention; Auditory; Biological; Bone Tissue; Brain; Brain imaging; Carpal Tunnel Syndrome; Central Nervous System; Characteristics; Data; Data Set; Degenerative polyarthritis; Development; Diagnosis; Diagnostic; Disparity; Economic Burden; Elements; Exhibits; Fatigue; Fibromyalgia; Foundations; Functional Magnetic Resonance Imaging; Functional disorder; Funding; Goals; Gynecologic; Healthcare Systems; Heterogeneity; Hip Osteoarthritis; Hyperalgesia; Hypersensitivity; Hysterectomy; Individual; Insula of Reil; Interstitial Cystitis; Investigation; Knowledge; Label; Literature; Lower urinary tract; Measures; Mediating; Mentors; Methods; Mission; National Institute of Diabetes and Digestive and Kidney Diseases; Needs Assessment; Neurobiology; Nociception; Organ; Outcome; Outcome Measure; Overactive Bladder; Pain; Pain Disorder; Pain Free; Pain Research; Pain management; Painless; Participant; Patient Outcomes Assessments; Patients; Pelvic Pain; Peripheral; Phase; Phenotype; Photic Stimulation; Protocols documentation; Public Health; Reporting; Research; Research Activity; Research Personnel; Rest; Rheumatoid Arthritis; Sensory; Symptoms; Syndrome; Techniques; Testing; Time; United States National Institutes of Health; Viscera; Visceral; Visceral pain; Visual; Work; allodynia; analog; arthritic pain; career; central pain; central sensitization; chronic pain; chronic pain patient; chronic painful condition; chronic pelvic pain; cohort; fibromyalgia patients; imaging modality; improved; insight; interdisciplinary approach; multimodality; neural; neuroimaging; novel; osteoarthritis pain; pain perception; pain processing; poor sleep; response; social; soft tissue; somatosensory; tool; training opportunity; urologic; urologic chronic pelvic pain syndrome

PROJECT SUMMARY/ABSTRACT Chronic pain is a significant social and economic burden. Despite considerable progress over the last several decades of research, our understanding of the neurobiological underpinnings of chronic pain remains incomplete and this presents obstacles for improvement in pain management. Multimodal investigations into the mechanistic heterogeneity within and across chronic pain conditions are critical for the development of new and efficacious precision pain treatments. The central nervous system (CNS) governs the perception of pain. Sensitization of the CNS is a mechanism hypothesized to underly the increased pain and sensory sensitivity observed in patients with chronic pain. This mechanism is referred to as nociplastic pain. Quantitative sensory testing (QST), functional magnetic resonance imaging (fMRI), and patient-reported outcome measures (PROMs) are methods that can be used together to build multimodal profiles that characterize the degree and features of an individual’s nociplastic pain phenotype. The proposed F99 and K00 projects will use these methods to distinguish convergent and divergent nociplastic mechanisms across diagnostically distinct somatic (emanating from bones and soft tissue) and visceral (emanating from internal organs) chronic pain conditions. The overall objective for the proposed project is to identify shared and distinct nociplastic profiles between somatic and visceral pain conditions to ultimately stimulate the development of precision pain management tools. The goal of the F99 portion is to characterize sensory and neurobiological features of nociplastic pain in patients with somatic pain, including those with rheumatoid arthritis (RA), osteoarthritis (OA), and carpal tunnel syndrome (CTS), relative to healthy controls and patients with fibromyalgia – the archetypal nociplastic pain condition. This analysis will build a foundation for the long-term aim of this work’s K00 portion, where parallel sensory and neurobiological measures will be assessed in patients with visceral pain, including those with urologic chronic pelvic pain syndrome (UCPPS), overactive bladder (OAB), and gynecological chronic pelvic pain (CPP). Data from the NIDDK-funded Multidisciplinary Approach to the Study of Chronic Pelvic Pain (MAPP) Research Network and Lower Urinary Tract Dysfunction Research Network (LURN) will be leveraged to complete the K00 project. Together, the mentoring and research activities of this F99 and K00 work will establish a career trajectory for me to become an independent researcher with expertise in urological pain.

项目概要/摘要 尽管过去几年取得了很大进展，但慢性疼痛仍然是一个重大的社会和经济负担。 经过数十年的研究，我们对慢性疼痛的神经生物学基础的理解仍然存在 不完整，这给疼痛管理的多模式研究的改进带来了障碍。 慢性疼痛疾病内部和之间的机械异质性对于新疗法的开发至关重要 和有效的精确疼痛治疗。 中枢神经系统（CNS）控制疼痛的感知。中枢神经系统的敏化是一种机制。 刺激导致慢性疼痛患者的疼痛和感觉敏感性增加。 机制被称为伤害性疼痛（QST）、功能性磁力。 可以使用磁共振成像 (fMRI) 和患者报告结果测量 (PROM) 的方法 共同构建多模态概况，表征个体伤害塑料的程度和特征 拟议的 F99 和 K00 项目将使用这些方法来区分收敛和疼痛表型。 诊断上不同的体细胞（来自骨骼和软组织）存在不同的伤害性机制 组织）和内脏（来自内部器官）慢性疼痛状况。 拟议项目的总体目标是确定之间共享和独特的伤害性特征 躯体和内脏疼痛状况最终刺激精准疼痛管理的发展 F99 部分的目标是表征伤害性疼痛的感觉和神经生物学特征。 患有躯体疼痛的患者，包括患有类风湿性关节炎 (RA)、骨关节炎 (OA) 和腕管炎的患者 综合征（CTS），相对于健康对照者和纤维肌痛患者——典型的伤害性疼痛 该分析将为这项工作的 K00 部分的长期目标奠定基础。 将对内脏疼痛患者（包括患有内脏疼痛的患者）进行感觉和神经生物学测量评估 泌尿科慢性盆腔疼痛综合征（UCPPS）、膀胱过度活动症（OAB）和妇科慢性盆腔疼痛 疼痛 (CPP) 的数据来自 NIDDK 资助的慢性盆腔疼痛研究多学科方法。 将利用 (MAPP) 研究网络和下尿路功能障碍研究网络 (LURN) F99 和 K00 工作的指导和研究活动将共同完成 K00 项目。 为我建立职业轨迹，成为一名具有泌尿科疼痛专业知识的独立研究员。