Dental Anxiety, Pain & Melanocortin-1 Receptor Mutations

描述（由申请人提供）：这项探索性的生物行为疼痛研究将研究牙齿和天然红发男性和女性与深色头发男性和女性的焦虑性疼痛的差异。红头发是由黑素皮质素-1受体基因（MC1R）突变引起的。我们的具体目的是：1)确定感知牙痛、牙焦虑和牙科使用与MC1R基因状态和发色之间的关系；2)确定实验疼痛阈值和剂量依赖性局部麻醉敏感性与志愿者头发颜色和MC1R基因变异的关系；3)确定牙齿恢复性治疗的局部麻醉需求与头发颜色和MC1R基因变异的关系。该提案是由路易斯维尔大学牙科学院、麻醉系、成果研究所、遗传学核心实验室和心理学系合作完成的。所有参与的男性和女性受试者将对MC1R等位基因进行基因分型，并将使用新技术提供一致和客观的牙痛评估。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（年龄在18至40岁之间）将分别完成经过验证的调查工具，这些调查工具旨在测量心理症状、整体焦虑和牙科特异性焦虑、与牙齿疼痛和回避相关的构念（例如焦虑和疼痛敏感性）以及以前的牙科病史，包括牙科护理的使用情况。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。在口腔内注射不同浓度的利多卡因后，测量由于电流和热刺激对未修复的侧切牙产生的疼痛。浓度为0、0.5、1.0和1.5%，采用随机双盲法。3)在临床阶段，我们将从观察期完成的志愿者中招募60名红发志愿者和60名黑发志愿者，需要进行牙科非手术治疗。我们将采用Dixon“上下”法确定各组局部麻醉需求。这项建议的研究将有助于了解性别和遗传学在周围神经功能，疼痛感知和行为中的作用。该研究还将探索一种创新的牙齿疼痛评估方法的可行性，这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的发展，以管理牙齿焦虑和预防疼痛。

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.