Spatial and Temporal Characteristics of Central Pain Se

描述(由申请人提供)：持续的疼痛似乎有 通过正负反馈调节自身强度的潜力 (疼痛的中枢敏感化，疼痛的疼痛抑制)。如果反馈是 如果是积极的，结果就是恶性循环和逐渐增加的疼痛 敏感度。疼痛敏感度的增加意味着给定的刺激 被认为更痛苦(痛觉过敏)，或者-在更极端的情况下- 以前，非疼痛的刺激会变得痛苦(痛觉异常)。恶性循环 可能导致超出原始地形边界的敏感化 疼痛，因此它可能会使身体偏远的区域更容易疼痛。结果 可能是滚雪球效应使疼痛区域逐渐扩大。的确有 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)， 肌筋膜痛综合征(MPS)和肠易激综合征(IBS)。这 研究以4个问题为指导：1)一种 持续疼痛是否会影响疼痛敏感度随时间的变化？2) 疼痛信号的敏感化效应是否超越了地形？ 原始疼痛焦点的位置？3)是否有可能打断恶性疼痛 疼痛循环，并允许敏化状态暂时恢复正常 让可能开始这个循环的局部疼痛焦点安静下来吗？4) 致敏状态的维持依赖于中枢NMDA受体功能， 已知的分子成分在疼痛的时间整合中发挥作用 刺激和其他记忆系统？这项研究的受试者将被要求 通过在电子视觉模拟器上设置滑块来对疼痛强度进行评级 比例。将使用新的方法来探索时间和空间 中枢性痛觉调制对实验性疼痛的反应特性 延长的热脉冲序列。临床疼痛灶沉默的效果观察 经皮给药的局部麻醉药对热诱导的影响 我们将研究敏化作用。N-甲基-D-天冬氨酸受体系统在 敏感状态的维持将通过测量疼痛来评估 在药物阻断它们之前和之后的致敏特性。

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.