Gastrointestinal Biopsychosocial Research Center

描述(由申请人提供)：此R24申请请求基础设施支持，以建立胃肠道生物心理社会(心身)研究中心。研究人员长期记录了由NIH资助的关于功能性胃肠道疾病的病理生理学和治疗的研究，包括肠易激综合征、大便失禁和盆底协同失调。这些疾病非常普遍--肠易激占15%，大便失禁占2-7%，盆底协同失调约占2%--这些疾病极大地影响了生活质量，导致每年总计超过250亿美元的医疗费用。关于肠易激的病理生理学的中心研究主题包括内脏痛觉的作用及其通过认知和心理过程的调节、中枢神经系统调节内脏疼痛的机制的神经成像研究、生殖激素对肠易激症状的影响、应激、虐待病史和其他心理社会因素对临床结果的作用、肠易激通过遗传和社会学习的代际传递以及肠易激与其他躯体疾病的过度共病。临床试验研究包括对认知行为疗法、催眠、抗抑郁药物的评估，以及对肠易激患者的教育，以及对大便失禁和便秘的生物反馈。请求为以下核心提供支持：(1)管理核心。(2)由学习协调员和专职招聘人员组成的研究核心。(3)与调查人员共同开展多中心研究的机构(梅奥诊所、华盛顿大学、多伦多大学)的研究网络。(4)数据技术核心，提供可扫描的纸质和互联网管理的调查问卷，用于数据采集的自动电话系统，以及用于跟踪登记和管理多中心研究的互联网软件。(5)提供生物统计支持和数据管理的生物测量核心。(6)种子资助核心，每年为青年研究人员开展的4个试点项目提供资金。(7)教育/传播核心，通过中心通讯和网站传播研究成果。我们还请求支持招聘一名在感染后肠易激方面具有专业知识的新教员。拟议的中心是大学范围的，包括来自心理学、精神病学、外科(妇科)、神经放射学、牙科和公共卫生学院的研究人员。

DESCRIPTION (provided by applicant): This R24 application requests infrastructure support to establish a Gastrointestinal Biopsychosocial (mind-body) Research Center. The investigators have a longstanding record of NIH-funded research on the pathophysiology and treatment of functional GI disorders including irritable bowel syndrome, fecal incontinence, and pelvic floor dyssynergia. These are prevalent disorders-- 15% for irritable bowel, 2-7% for fecal incontinence, and approximately 2% for pelvic floor dyssynergia--that greatly impair quality of life and result in aggregate health care costs exceeding $25 billion annually. Center research themes on the pathophysiology of irritable bowel include the role of visceral pain perception and its modulation by cognitive and psychological processes, neuroimaging studies of central nervous system mechanisms modulating visceral pain, effects of reproductive hormones on irritable bowel symptoms, the role of stress, abuse history, and other psychosocial factors on clinical outcomes, intergenerational transmission of irritable bowel through heredity and social learning, and excess comorbidity of irritable bowel with other somatic disorders. Clinical trial research includes evaluation of cognitive behavior therapy, hypnosis, antidepressants, and patient education for irritable bowel, and biofeedback for fecal incontinence and constipation. Support is requested for the following cores: (1) Administrative core. (2) Research core consisting of study coordinators and full-time recruiter. (3) Research network of institutions that carry out multicenter studies jointly with the investigators (Mayo Clinic, University of Washington, University of Toronto). (4) Data technology core that provides scannable paper and internet-administered questionnaires, automated telephone systems for data acquisition, and intemet software for tracking enrollment and managing rnulticenter studies. (5) Biometry core providing biostatistical support and data management. (6) Seed grant core providing funding for 4 pilot projects by young investigators annually. (7) Education/ dissemination core to disseminate research findings through a Center newsletter and website. We also request support to recruit a new faculty member with expertise in post-infectious irritable bowel. The proposed Center is university wide and includes investigators from psychology, psychiatry, surgery (gynecology division), neuroradiology, dentistry, and the school of public health.