CHRONIC NEUROPATHIC PAIN MECHANISMS AND MANAGEMENT

慢性神经病理性疼痛的机制和治疗

• 批准号: 6088141
• 负责人: MICHAEL C ROWBOTHAM
• 金额: $ 10.72万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2000
• 资助国家: 美国
• 起止时间: 2000-06-28 至 2005-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6088141
• 关键词: analgesia; analgesics; biopsy; capsaicin; chronic pain; clinical research; human subject; human therapy evaluation; hyperalgesia; intravenous administration; opiate alkaloid; oral administration; pain threshold; quality of life; shingles

DESCRIPTION (Adapted From The Applicant's Abstract): Michael Rowbotham, a clinical neurologist and clinical neuroscientist specializing in chronic pain, has an international reputation as a leader in patient-oriented research on neuropathic pain mechanisms and clinical analgesic trials. The UCSF Pain Clinical Research Center (PCRC), started by Dr. Rowbotham in 1990, is a clinical research unit located in University-owned space that receives NIH, private, and industry support for exploratory clinical research and clinical trials. As a PI in the NINDS Program Project on Pain Mechanisms at UCSF, clinical research that translates advances from the Program's four basic science labs is fostered. Dr. Rowbotham has mentored 15 beginning clinical scientists from diverse backgrounds in the PCRC, and is developing a unique two year research/clinical training program that brings together the PCRC, the Neurology Pain Research Training Grant, and the Anesthesia-Pain Management Center Fellowship. K-24 support for a 5 year period will assist Dr. Rowbotham achieve his long-term career goal of establishing an integrated clinical research program that: (1) has a comprehensive pain research training curriculum for beginning clinical investigators; (2) conducts exploratory clinical research on pain mechanisms underlying different neuropathic pain disorders; (3) uses experimental pain models to evaluate new analgesics in healthy volunteers and patients, (4) translates basic science advances into well designed clinical trials to advance pain therapy; (5) relates pain mechanisms to opioid sensitivity, tolerance, and long term efficacy. The experiments in Project I will: (a) determine if opioid-insensitive chronic pains exist by simultaneously measuring the response of experimentally induced pain and ongoing clinical pain to i.v. remifentanil infusion; (b) determine if a prolonged i.v. remifentanil infusion can produce acute analgesic tolerance to both the experimentally induced pain and hyperalgesia and the ongoing chronic pain; and (c) prospectively assess development of opioid analgesic tolerance during long term oral opioid therapy. Project II will test the hypothesis that development of chronic post-herpetic neuralgia after herpes zoster strongly depends on the severity of the initial neural injury and the quality of neural recovery. Patients with acute zoster pain will be followed for 6 months on measures of pain intensity, mood, quality of life, allodynia, extent of affected skin, quantitative tests of sensory function, response to controlled applications of capsaicin, and serial skin punch biopsy measurement of cutaneous innervation in affected and normal skin.

描述（改编自申请人的摘要）：Michael Rowbotham，a 临床神经学家和临床神经科学家专门研究慢性疼痛， 作为以患者为导向的研究领域的领导者， 神经病理性疼痛机制和临床镇痛试验。UCSF疼痛 临床研究中心（PCRC）由Rowbotham博士于1990年创立，是一家 临床研究单位位于大学拥有的空间，接收NIH， 私人和行业支持探索性临床研究和临床 审判作为加州大学旧金山分校NINDS疼痛机制项目的PI， 临床研究，从该计划的四个基本转化的进展 科学实验室是培养。罗博瑟姆博士已经指导了15个临床初期 来自PCRC不同背景的科学家，并正在开发一个独特的两个 一年的研究/临床培训计划，汇集了PCRC， 神经病学疼痛研究培训基金和麻醉-疼痛管理 中心奖学金。K-24支持5年期间将协助博士. Rowbotham 实现他的长期职业目标，建立一个综合的临床 研究计划：（1）具有全面的疼痛研究训练 课程开始临床研究者;（2）进行探索性 不同神经病理性疼痛机制的临床研究 （3）使用实验性疼痛模型来评估新的镇痛药， 健康的志愿者和患者，（4）将基础科学进步转化为 精心设计的临床试验，以推进疼痛治疗;（5）与疼痛相关 阿片类药物敏感性、耐受性和长期疗效的机制。的 项目I的实验将：（a）确定阿片类药物不敏感的慢性 通过同时测量实验诱导的 静脉输注瑞芬太尼引起的疼痛和持续的临床疼痛;（B）确定 长时间静脉输注瑞芬太尼可产生急性镇痛耐受， 实验诱导的疼痛和痛觉过敏以及正在进行的慢性 （c）前瞻性评估阿片类镇痛剂耐受性的发展 长期口服阿片类药物治疗项目二将检验以下假设： 带状疱疹后慢性神经痛的发展强烈 取决于初始神经损伤的严重程度和神经损伤的质量。 复苏急性带状疱疹疼痛患者将随访6个月， 疼痛强度、情绪、生活质量、异常性疼痛、 受影响的皮肤，感觉功能的定量测试，对控制的 辣椒素的应用，以及连续皮肤打孔活检测量 受影响和正常皮肤的皮肤神经支配。