Neural mechanisms underlying psychosocial contributions to ethnic group differences in pain

相当多的证据表明，疼痛对美国少数种族和族裔的影响不成比例

Considerable evidence demonstrates that pain disproportionately affects racial and ethnic minorities in the United States, especially African Americans (AAs), who experience frequent, severe and disabling chronic pain compared to their non-Hispanic white (NHW) counterparts. These racial and ethnic disparities extend to many chronic pain conditions, but are perhaps best documented in people with osteoarthritis (OA). Previous research revealed that AAs with OA experience more frequent and severe clinical pain and disability and show a quantitative sensory testing profile suggesting impaired pain inhibition and enhanced generalized pain facilitation compared to NHWs. In addition, previous findings demonstrated higher pain catastrophizing (a tendency to negatively evaluate one's ability to cope with pain and to respond to anticipated or actual pain in a heightened negative cognitive and emotional manner) among AAs compared to NHWs. While multiple factors inevitably contribute, cognitive and affective processes and ethnic group differences in central pain processing represent potentially important determinants of greater clinical pain among African Americans. Despite its pervasive negative effects, no neuroimaging study to date has experimentally manipulated pain catastrophizing and measured cerebral activity during experimentally-induced pain to determine the neural mechanisms whereby catastrophizing impacts pain responses. Moreover, the extent to which the influence of pain catastrophizing on these central pathways contributes to ethnic group differences in the experience of pain remains unexplored. Therefore, the overall goal for this mentored career development proposal (K22) is to elucidate the neural mechanism involved in pain catastrophizing and its influence on pain processing in different ethnic groups. Primary training goals for the current proposal are to: 1) develop a comprehensive knowledge base in neuroimaging techniques, methodological designs, data acquisition, data analyses, and interpretation of findings; 2) expand knowledge of advanced pain assessment skills including quantitative sensory testing and clinical models of pain; 3) Obtain expertise in principles of experimental design and statistical methodology utilized for biomedical research, including neuroimaging studies; and 4) enhance translational research skills to function as an independent investigator. Study 1 (Phase I) will determine whether pain catastrophizing contributes to ethnic group differences in pain-related brain function, clinical pain, and pain sensitivity among AAs and NHWs with knee OA. Study 2 (Phase II) will characterize the impact of an anti-catastrophizing manipulation on central pain processes and pain among AAs and NHWs with knee OA. The proposed career development plan extends from the PI's prior work on pain catastrophizing and mechanisms of pain processing, and will also provide the neuroimaging training and expertise to propel a promising young investigator at the intersection of pain and neuroscience research.