Tissue Damage and Pain - Modelling Cutting Behavior in BPD

组织损伤和疼痛 - BPD 中的切割行为建模

• 批准号: 206470637
• 负责人: Professor Dr. Ulf Baumgärtner
• 金额: --
• 依托单位: Klinik für Psychosomatik und Psychotherapeutische Medizin
• 依托单位国家: 德国
• 项目类别: Clinical Research Units
• 财政年份: 2011
• 资助国家: 德国
• 起止时间: 2010-12-31 至 2018-12-31
• 项目状态: 已结题
• 来源: https://gepris.dfg.de/gepris/projekt/206470637?language=en
• 关键词: Tissue; Damage; Pain; Modelling; Cutting

The overall aim of this project is the elucidation of neurobiological mechanisms underlying nonsuicidal self-injury (NSSI) in BPD. In addition to pain processing, aspects of NSSI include tissue damage (the most frequent form of NSSI being cutting), the visual impact of seeing blood, and the perspective of the injury as being self-inflicted rather than other-inflicted. In Study 1 of the first funding period, we investigated the influence of tissue injury on stress regulation, and developed a surrogate stimulus that evoked sensory and affective responses that were very similar to those evoked by tissue injury. This stimulus, a non-invasive mechanical "blade", was matched for pain intensity with an incision stimulus. In Study 2, we compared the effects of the incision stimulus on stress levels in BPD patients, the mechanical blade stimulus, and a sham control stimulus (non-painful touch). Interim analysis has revealed a trend for stronger reduction of stress levels following incision and blade compared to the sham stimulus, and similar time courses of tension reduction for the mechanical blade and for incision. In addition, pilot studies have 1) investigated the influence on tension reduction of the experience of seeing (artificial) blood in addition to experiencing pain, and 2) used MR spectroscopy to quantify glutamate and GABA levels in pain-processing brain regions. As the blade stimulus showed both pain-characteristics and stress-regulation properties that were very similar to those induced by incision, it will be used in the studies of the second funding period, which has two major objectives. First, we aim to further elucidate neurochemical and neurofunctional mechanisms related to antinociception in BPD, using recently established neuroimaging methods. Whole-brain echo-planar sprectroscopic imaging will be used to determine glutamate metabolism in pain-processing regions, and GABA and glutamate levels in the posterior insula will be measured. Pseudo-continuous Arterial Spin Labeling, which allows absolute quantification of blood flow in pain-processing regions following single stimuli, will be conducted before and after blade stimulation. In the second part of the project, patients with current NSSI will be randomized into four groups in order to investigate the stress-regulating effects of seeing artificial blood and of self-application of the pain stimulus vs. application by an investigator.

该项目的总体目标是阐明 BPD 中非自杀性自伤 (NSSI) 的神经生物学机制。除了疼痛处理之外，NSSI 的各个方面还包括组织损伤（NSSI 最常见的形式是割伤）、看到血的视觉影响以及将伤害视为自己造成的而非他人造成的。在第一个资助期的研究1中，我们研究了组织损伤对压力调节的影响，并开发了一种替代刺激，它能引起与组织损伤引起的感觉和情感反应非常相似。这种刺激是一种非侵入性机械“刀片”，与切口刺激的疼痛强度相匹配。在研究 2 中，我们比较了切口刺激、机械刀片刺激和假控制刺激（无痛触摸）对 BPD 患者压力水平的影响。中期分析揭示了与假刺激相比，切口和刀片后应力水平有更强降低的趋势，并且机械刀片和切口的张力降低的时间过程相似。此外，试点研究还包括：1) 调查除了经历疼痛之外，看到（人造）血液的体验对降低张力的影响；2) 使用 MR 光谱来量化处理疼痛的大脑区域中谷氨酸和 GABA 的水平。由于刀片刺激显示出与切口引起的疼痛特征和压力调节特性非常相似，因此它将用于第二个资助期的研究，该研究有两个主要目标。首先，我们的目标是利用最近建立的神经影像学方法进一步阐明与 BPD 镇痛相关的神经化学和神经功能机制。全脑回波平面光谱成像将用于确定疼痛处理区域的谷氨酸代谢，并测量后岛叶的 GABA 和谷氨酸水平。伪连续动脉旋转标记可以在单次刺激后对疼痛处理区域的血流进行绝对量化，将在刀片刺激之前和之后进行。在该项目的第二部分中，当前患有 NSSI 的患者将被随机分为四组，以研究观看人造血液以及自行施加疼痛刺激与由研究者施加疼痛刺激的压力调节效果。

项目成果

Posterior Insular GABA Levels Inversely Correlate with the Intensity of Experimental Mechanical Pain in Healthy Subjects

• DOI: 10.1016/j.neuroscience.2017.09.043
• 发表时间: 2017-10
• 期刊: Neuroscience
• 影响因子: 3.3
• 作者: Margot Thiaucourt;Polina Shabes;N. Schloss;M. Sack;U. Baumgärtner;C. Schmahl;G. Ende

A novel human surrogate model of noninjurious sharp mechanical pain

一种新型的非伤害性尖锐机械疼痛的人类替代模型

• DOI: 10.1097/j.pain.0000000000000352
• 发表时间: 2016
• 期刊: PAIN
• 影响因子: 7.4
• 作者: Shabes;Schloss;Magerl;Schmahl;Treede;Baumgartner
• 通讯作者: Baumgartner

The role of seeing blood in non-suicidal self-injury in female patients with borderline personality disorder

看到血在女性边缘型人格障碍患者非自杀性自伤中的作用

• DOI: 10.1016/j.psychres.2016.10.066
• 发表时间: 2016
• 期刊: Psychiatry Research
• 影响因子: 11.3
• 作者: Krause-Utz;Kleindienst;Willis;Kuniss;. . . Schmahl
• 通讯作者: . . . Schmahl

Incision and stress regulation in borderline personality disorder: neurobiological mechanisms of self-injurious behaviour

• DOI: 10.1192/bjp.bp.114.153379
• 发表时间: 2015-08-01
• 期刊: BRITISH JOURNAL OF PSYCHIATRY
• 影响因子: 10.5
• 作者: Reitz, Sarah;Kluetsch, Rosemarie;Schmahl, Christian
• 通讯作者: Schmahl, Christian

The role of nociceptive input and tissue injury on stress regulation in borderline personality disorder

伤害性输入和组织损伤对边缘性人格障碍压力调节的作用

• DOI: 10.1097/j.pain.0000000000000787
• 发表时间: 2017
• 期刊: PAIN
• 影响因子: 7.4
• 作者: Willis;Kuniss;Kleindienst;. . . Schmahl
• 通讯作者: . . . Schmahl