Moderating Influence of Ovarian Hormones on Physiological Arousal and Headache

卵巢激素对生理唤醒和头痛的调节影响

• 批准号: 8068659
• 负责人: TIMOTHY T HOULE
• 金额: $ 31.56万
• 依托单位: WAKE FOREST UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-05-15 至 2014-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8068659
• 关键词: American; Arousal; Bed rest; Behavior Therapy; Behavioral; Buffers; Data; Disabled Persons; Early treatment; Estradiol; Exhibits; Female; Glean; Goals; Headache; Health; Heart Rate; Hormonal; Hormones; Impairment; Knowledge; Lead; Measures; Mediating; Menstrual cycle; Migraine; Moods; Nature; Observational Study; Ovarian; Ovarian hormone; Patients; Pharmacological Treatment; Physiological; Precipitating Factors; Process; Productivity; Progesterone; Psychophysiology; Reporting; Research; Role; Stress; Symptoms; Theoretical model; Time; United States; Women' s Group; base; cost; functional disability; heart rate variability; population based; success

DESCRIPTION (provided by applicant): Headache symptoms for a given patient may vary widely from one day to the next, ranging from days when the migraine sufferer is asymptomatic to days when he or she is functionally disabled with severe headache. Increased knowledge of the factors that precipitate migraine ("migraine triggers") will lead to an enhanced ability to accurately predict migraine attacks. This knowledge will be very beneficial for planning pharmacological and behavioral management strategies, many of which are optimally applied either before an attack begins or early in a new attack. Our current understanding of migraine precipitants is almost entirely based on single precipitants studied using cross-sectional, population-based examinations. The effect that multiple precipitants may have on initiating migraine, or the role of hormones in moderating the influence of any single precipitant is unclear. The proposed research is an observational study that utilizes the natural variability of ovarian hormones to examine the relationship between physiological arousal (e.g., heart rate, breath rate, perceived stress), ovarian hormones, and migraine activity in a group of women who are sensitive to hormonal influences (i.e., they have menstrually related migraine). The specific hypothesis behind the proposed research is that migraine activity can be independently predicted by psychophysiological arousal and that this relationship is moderated by hormonal influences. The data from the study will be used to inform a theoretical model that will greatly enhance our understanding of the interplay of this dynamic process. The specific aims are: Aim 1: To examine the relationships between several measures of psychophysiological arousal and headache activity. Aim 2: To examine the relationship between ovarian hormone levels and headache activity. Aim 3: To examine the mediating role of physiological arousal on the relationship between stress and migraine in the context of a potential moderating role of ovarian hormones on these relationships. PUBLIC HEALTH RELEVANCE: According to a recent study, 90% of migraineurs reported functional impairment with their headaches and 53% exhibited severe impairment requiring bed rest. In the United States, migraine results in 112 million bedridden days each year with the cost of migraine to the total American workforce estimated at $13 billion a year in missed workdays and lost productivity. The goal of the present research is to make migraine attacks more predictable by increasing knowledge of headache precipitants thus decreasing the burden of migraine by allowing for earlier intervention during a migraine attack.

描述（由申请人提供）：给定患者的头痛症状可能从一天到下一天都广泛，从偏头痛患者无症状的日子到他或她在功能上残疾而患有严重头痛的日子。对沉淀偏头痛的因素（“偏头痛触发”）的知识增加将导致能够准确预测偏头痛攻击的能力。这些知识将对计划药理和行为管理策略非常有益，其中许多知识是在攻击开始之前或在新攻击早期之前最佳应用的。我们目前对偏头痛降水剂的理解几乎完全基于使用横截面，基于人群的检查研究的单一降水剂。尚不清楚多种沉淀物对偏头痛的启动或激素在调节任何单个沉淀物影响中的作用的作用尚不清楚。拟议的研究是一项观察性研究，该研究利用卵巢激素的自然变异性来检查生理唤醒（例如，心率，呼吸率，感知压力），卵巢激素和偏头痛活性对激素影响敏感的女性（即她们的迁移）。拟议的研究背后的特定假设是，偏头痛活性可以由心理生理唤醒独立预测，并且这种关系受荷尔蒙影响的调节。研究的数据将用于告知理论模型，该模型将大大增强我们对这种动态过程相互作用的理解。具体目的是：目标1：检查心理生理唤醒和头痛活动的几种措施之间的关系。目标2：检查卵巢激素水平与头痛活动之间的关系。目标3：在卵巢激素在这些关系上的潜在调节作用的背景下，研究生理唤醒对压力与偏头痛之间关系的中介作用。公共卫生相关性：根据最近的一项研究，有90％的偏头痛报告了其头痛的功能障碍，而53％的偏头痛表现出了严重的障碍，需要休息。在美国，偏头痛每年导致1.12亿卧床不起的日子，偏头痛的成本降低了美国劳动力总数，估计每年缺席的工作日每年130亿美元，生产力损失。本研究的目的是通过增加头痛降水剂的知识来使偏头痛的攻击更加可预测，从而通过允许在偏头痛攻击期间进行较早的干预来减轻偏头痛的负担。