Dental Anxiety, Pain & Melanocortin-1 Receptor Mutations

描述（由申请人提供）：这项探索性生物行为疼痛研究将研究牙科和自然红发男性和女性与黑发男性和女性相比的焦虑疼痛差异。红头发是由黑素皮质素-1受体基因（MC 1 R）突变引起的。我们的具体目标是：1）确定感知牙痛，牙科焦虑症，牙科使用与MC 1 R基因状态和头发颜色之间的关联; 2）确定实验痛阈和剂量依赖性局部麻醉敏感性作为志愿者头发颜色和MC 1 R基因变异的函数;以及3）确定作为头发颜色和MC 1 R基因变异的函数的用于修复性牙科治疗的局部麻醉剂需求。这项提案是路易斯维尔大学牙科学院、麻醉学系、OUTCOMES研究所、遗传学核心实验室和心理学系之间的合作。将对所有参与的男性和女性受试者进行MC 1 R等位基因基因分型，并将使用新技术对牙痛进行一致和客观的评估。该研究将分三个阶段完成：1）在观察阶段，74名红发和74名黑发参与者（年龄18至40岁）将各自完成经验证的调查工具，该调查工具旨在测量心理学、整体和牙齿特异性焦虑、与牙痛和回避相关的结构（例如，焦虑和疼痛敏感性），以及既往牙科病史，包括牙科护理使用情况。2)在实验阶段，我们将从完成观察阶段的志愿者中招募60名红发志愿者和60名黑发志愿者。在口内注射不同浓度的利多卡因后，测量未修复侧切牙上电流和热刺激引起的疼痛。随机化和双盲序列中使用的浓度为0、0.5、1.0和1.5%。3）在临床阶段，我们将从完成观察阶段的志愿者中招募60名红发和60名黑发志愿者，他们需要进行非手术牙科治疗。我们将使用狄克逊“上下”法来确定每组的局部麻醉需求。拟议的研究将有助于了解性别和遗传学在外周神经功能，疼痛感知和行为中的作用。该研究还将探索一种创新的牙痛评估方法的可行性，该方法可能为未来的研究项目提供基础，并可以指导生物行为干预措施的发展，以管理牙科焦虑症和预防疼痛。

DESCRIPTION (provided by applicant): This exploratory biobehavioral pain research will study differences anxiety pain in dental and in natural red-haired men and women compared with dark-haired men and women. Red hair results from mutations of the melanoncortin-1 receptor gene (MC1R). Our specific aims are to 1) determine the association between perceived dental pain, dental anxiety, and dental utilization with MC1R gene status and hair color; 2) determine experimental pain thresholds and dose-dependent local anesthetic sensitivity as a function of hair color and MC1R gene variation in volunteers; and 3) determine local anesthetic requirement for restorative dental treatment as a function of hair color and MC1R gene variation. This proposal is collaboration between the School of Dentistry, the Department of Anesthesiology, the OUTCOMES RESEARCH Institute, the Genetics Core Laboratory, and the Department of Psychology -- all at the University of Louisville. All participating male and female subjects will be genotyped for MC1R alleles, and new technology will be used that provides consistent and objective assessment of dental pain. The study will be accomplished in three phases: 1) In the Observational Phase, 74 redheads and 74 dark-haired participants (aged 18 to 40) will each complete validated survey instruments designed to measure psychological symptomatology, global and dental-specific anxiety, constructs associated with dental pain and avoidance (e.g., anxiety and pain sensitivity), and previous dental history including dental care utilization. 2) In the Experimental Phase, we will recruit 60 redheaded and 60 dark-haired volunteers from those completing the Observational phase. Pain, perceived as a result of electrical current and thermal stimuli on unrestored lateral incisor teeth, will be measured after intra-oral injection of various lidocaine concentrations. The concentrations, which will be used in a randomized and double-blinded sequence, will be 0, 0.5, 1.0, and 1.5%. And 3) in the Clinical Phase, we will recruit 60 redheaded and 60 dark-haired volunteers requiring non-surgical dental treatment from those completing the Observational phase. We will use the Dixon "up-and-down" method to determine local anesthetic requirement in each group. The proposed research will contribute to the knowledge of the role of gender and genetics in peripheral nerve function, pain perception, and behavior. The research will also explore the feasibility of an innovative dental pain assessment approach that may provide a basis for future research projects and could guide the development of biobehavioral interventions to manage dental anxiety and prevent pain.