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Quantitative Assessment of Dental Pain using a smartphone-attachable electrodermal activity sensor

使用智能手机连接的皮肤电活动传感器对牙痛进行定量评估

基本信息

批准号：
10171570
负责人：
I-Ping Chen
金额：
$ 20.32万
依托单位：
UNIVERSITY OF CONNECTICUT SCH OF MED/DNT
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-06-01 至 2023-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10171570
关键词：
Acute Adult Affect Algorithms Amplifiers Analgesics Anesthesia procedures Arousal Biological Markers Blood Vessels Cellular Phone Cessation of life Child Clinic Clinical Clinical Trials Cognition Disorders Data Data Analyses Data Collection Data Reporting Dental Dental Care Dental Clinics Dental Pulp Dental caries Dentinal Fluid Dentistry Dentists Detection Devices Diagnosis Diagnostic Disease Effectiveness Electric Stimulation Electrodes Enrollment Esthesia Exploratory/Developmental Grant Fingers Future Galvanic Skin Response Goals Hand Home Individual Infection Jaw Laboratories Language Lead Life Lip structure Local anesthesia Measures Methods Monitor Movement Necrosis Nerve Nerve Fibers Neuropeptides Numbness Odontoblasts Operative Surgical Procedures Orthopedics Pain Pain Measurement Pain Research Pain management Participant Patient Care Patient Self-Report Patients Pilot Projects Postoperative Pain Production Public Health Publications Pulp Canals Pulp Chambers Pulpitis Reporting Research Rewards Role Selection Criteria Sensitivity and Specificity Sensory Signal Transduction Source Stimulus Sympathetic Nervous System System Testing Time Tongue Tooth structure Toothache Visceral pain Visual Wireless Technology accurate diagnosis afferent nerve analog arthritic pain base clinical care clinical pain cost experience high risk improved indexing miniaturize nerve supply novel novel marker opioid abuse opioid overuse optimal treatments pain scale patient response pediatric patients prescription opioid pulpal blood flow remote monitoring research study response sensor standard care theories time use

项目摘要

Project Summary/Abstract Our long-term goal is to develop a personalized pain-control strategy for toothache, which is the primary reason patients seek dental treatment. An objective and quantitative assessment of dental pain is essential to develop efficient treatment for pain control. Diagnosing the source for toothache accurately is crucial as some conditions not only can cause excruciating pain but even be life-threatening. Current dental pain diagnosis relies fully on subjective responses from patients, which is problematic when patients are unable to communicate such as young children and individuals with cognitive disorders or langauge problems. Minimizing pain during and after dental treatment is another important concern for patients and dentists. Numbness of lip and tongue is typically used as a sign of successful local anesthesia for teeth of the lower jaw. This method is rather ineffective, as 30-40% of patients still experience pain during treatment. Furthermore, the selection of painkillers is partially patient-driven, which can lead to the abuse of opiods. This exploratory project aims to test whether electrodermal activity (EDA) can be used to assess dental pain objectively and reliably. When we experience pain, our activity of the sympathetic nervous system (SNS) is increased. Although the role of the SNS in dental pain is not fully understood, increased numbers of sympathetic nerve fibers have been reported in the pulp of infected teeth. EDA devices measure skin conductance on fingers, which strongly correlates to sweat production and exclusively mirrors acitivity of the SNS. When healthy teeth receive cold and electrical stimulation, patients feel a sensation that recovers quickly. In our pilot study, such sensations were highly correlated with EDA recordings using a time-varying index (TVSymp) algorithm, which we developed. We thus hypothesize that the time-varying index (TVSymp) of EDA can reflect pulpal status and is a sensitive and specific measure for dental pain. In this proposed study, we will develop a smartphone-based miniaturized EDA system for data collection and analysis of TVSymp (Aim 1). This low-cost smartphone-based EDA device could easily be used in clinical settings and for wireless reporting of pain levels from a patient’s home, for example after surgery, to better adjust pain medication. It may also enhance compliance of participants in future clinical pain studies. We will determine whether TVSymp can reliably be used to diagnose pulpal status and assess levels of dental pain using the existing large-sized EDA device as well as the smartphone-based device once ready to use (Aim 2). If successful, TVSymp recordings would improve the accuracy of pulpal diagnosis and be a novel biomarker for dental pain to replace subjective pain reporting. This project is conceptually and technically novel because: 1) the activity of SNS has never been used for pulp diagnosis and assessing dental pain; 2) the TVSymp index is more sensitive and more consistent compared to other EDA indices used in previous pain assessment studies. Findings from this study have a great potential to significantly impact dental care and dental pain research.

项目总结/摘要我们的长期目标是为牙痛开发个性化的疼痛控制策略，这是主要的患者寻求牙科治疗的原因。客观和定量评估牙痛是必不可少的，开发有效的治疗方法来控制疼痛。准确地诊断牙痛的来源是至关重要的，因为一些这种情况不仅会造成剧痛，甚至会危及生命。当前牙痛诊断完全依赖于患者的主观反应，当患者无法沟通，如幼儿和个人与认知障碍或语言问题。最大限度地减少牙科治疗期间和之后的疼痛是患者和牙医的另一个重要问题。嘴唇和舌头的麻木通常被用作下颌牙齿局部麻醉成功的标志。这种方法是相当无效的，因为30-40%的患者在治疗过程中仍然会感到疼痛。而且止痛药的选择在一定程度上是由病人决定的，这可能导致阿片类药物的滥用。这个探索性的项目目的是测试皮肤电活动（EDA）是否可以用于客观可靠地评估牙痛。当我们经历疼痛时，我们的交感神经系统（SNS）的活动增加。虽然 SNS在牙痛中的作用还没有完全了解，交感神经纤维数量的增加，在受感染牙齿的牙髓中发现。EDA设备测量手指上的皮肤电导，与汗液产生相关，并专门反映SNS的活性。当健康的牙齿受到寒冷时，和电刺激，病人感觉到一种很快恢复的感觉。在我们的初步研究中，使用时变指数（TVSymp）算法与EDA记录高度相关，我们开发因此，我们假设EDA的时变指数（TVSymp）可以反映牙髓状态，一种敏感而特异的牙痛测量方法。在这项研究中，我们将开发一个基于智能手机的用于TVSymp（Aim 1）数据采集和分析的小型化EDA系统。这种基于低成本智能手机的 EDA设备可以很容易地在临床环境中使用，并从患者的疼痛水平无线报告在家，例如手术后，以更好地调整止痛药。它还可以提高遵守未来临床疼痛研究的参与者。我们将确定TVSymp是否可以可靠地用于诊断使用现有的大型EDA设备以及智能手机设备一旦准备好使用（目标2）。如果成功的话，TVSymp的记录将改善牙髓诊断的准确性，并成为一种新的生物标志物的牙齿疼痛，以取代主观的疼痛报告。这个项目在概念和技术上都是新颖的，因为：1）SNS的活性从来没有用于纸浆诊断和评估牙痛; 2）TVSymp指数更敏感，更一致相比，其他EDA指标用于既往疼痛评估研究。这项研究的结果有很大的潜力，显著影响牙科护理和牙痛研究。