Spatial and Temporal Characteristics of Central Pain Se

中枢性疼痛的时空特征

• 批准号: 6901090
• 负责人: ANDRE P MAUDERLI
• 金额: $ 16.53万
• 依托单位: UNIVERSITY OF FLORIDA
• 依托单位国家: 美国
• 财政年份: 2002
• 资助国家: 美国
• 起止时间: 2002-07-01 至 2007-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6901090
• 关键词: NMDA receptors; analgesics; chronic pain; clinical research; fibromyalgia; hand; heat stimulus; human subject; inhibitor /antagonist; irritable bowel syndrome; local anesthesia; local anesthetics; neuroanatomy; neuropharmacologic agent; nontherapeutic iontophoresis; patient oriented research; skin; temporal lobe /cortex; temporomandibular joint syndrome

DESCRIPTION (provided by the applicant): Prolonged pain appears to have the potential to modulate its own intensity through positive and negative feedback (central sensitization by pain, pain inhibition by pain). If the feedback is positive, the result is a vicious pain cycle and a progressive increase in pain sensitivity. Increased pain sensitivity means that a given stimulus is perceived as more painful (hyperalgesia), or - in more extreme cases - that a previously non-painful stimulus becomes painful (allodynia). The vicious cycle may lead to sensitization beyond the topographical boundaries of the original pain, and thus it may render remote body regions more pain-prone. The result may be a snowball effect of progressive expansion of the painful area. There is evidence suggesting that the vicious cycle may be a pathophysiological factor in certain chronic pain diseases, including fibromyalgia syndrome (FMS), myofascial pain syndrome (MPS), and irritable bowel syndrome (IBS). This research is guided by 4 questions: 1) Does the intensity and duration of a persistent pain have an effect on how pain sensitivity changes over time? 2) Does the sensitizing effect of pain signals reach beyond the topographical location of the original pain focus? 3) Is it possible to interrupt the vicious pain cycle and allow the sensitized state to return to normal by temporarily silencing the local pain focus that presumably started the cycle? 4) Does the maintenance of the sensitized state depend on central NMDA receptor function, molecular constituents known to play a role in temporal integration of pain stimuli and other memory systems? The subjects in this study will be asked to rate pain intensities by setting the slider on an electronic visual analog scale. Novel methodology will be used for probing the temporal and spatial response properties of central pain modulation with experimental pain with prolonged series of thermal pulses. The effect of silencing clinical pain foci with transdermally delivered local anesthetics on thermallyinduced sensitization will be studied. The importance of NMDA receptor systems in the maintenance of a sensitized state will be assessed by measuring pain sensitization properties before and after pharmacologically blocking them.

描述（由申请人提供）：持续疼痛似乎具有 通过正反馈和负反馈调节自身强度的潜力 （疼痛引起的中枢致敏，疼痛引起的疼痛抑制）。如果反馈是 积极的，结果是一个恶性疼痛循环和疼痛的逐步增加 灵敏度增加的疼痛敏感性意味着给定的刺激是 被认为是更痛苦的（痛觉过敏），或者-在更极端的情况下- 先前非疼痛的刺激变得疼痛（异常性疼痛）。恶性循环 可能会导致超出原始地形边界的敏化 疼痛，因此它可能会使远程身体区域更容易疼痛。结果 可能是疼痛区域逐渐扩大的雪球效应。有 有证据表明，恶性循环可能是一个病理生理因素， 在某些慢性疼痛疾病中，包括纤维肌痛综合征（FMS）， 肌筋膜疼痛综合征（MPS）和肠易激综合征（IBS）。这 研究是由4个问题指导的：1）是否强度和持续时间的a 持续性疼痛会影响疼痛敏感性随时间的变化吗？（二） 疼痛信号的致敏作用是否超越了局部解剖学 最初疼痛点的位置3)有没有可能打断 疼痛周期，并允许敏感状态恢复正常， 抑制了可能引发循环的局部疼痛4)是否 致敏状态的维持依赖于中枢NMDA受体功能， 已知在疼痛的时间整合中起作用的分子成分 刺激和其他记忆系统本研究中的受试者将被要求 通过在电子视觉模拟上设置滑块来评定疼痛强度 规模新的方法将用于探索时间和空间 实验性疼痛的中枢疼痛调制的反应特性 长时间的热脉冲临床疼痛病灶沉默的效果 在热诱导下， 将进行致敏性研究。NMDA受体系统的重要性， 通过测量疼痛来评估致敏状态的维持 敏化性能之前和之后的荧光阻断它们。