Complex Persistant Pain Conditions: Unique & Shared Pathways of Vulnerability

复杂的持续性疼痛状况：独特

• 批准号: 8457063
• 负责人: WILLIAM MAIXNER
• 金额: $ 129.73万
• 依托单位: UNIV OF NORTH CAROLINA CHAPEL HILL
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-09-30 至 2015-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8457063
• 关键词: Address; Biological; Characteristics; Clinical; Complex; Coupled; Environmental Exposure; Epidemiologist; Etiology; Fatigue; Fibromyalgia; Functional disorder; Genetic; Genetic Polymorphism; Genetic Variation; Goals; Headache; Infection; Injury; Irritable Bowel Syndrome; Migraine; Molecular; Pain; Pathway interactions; Patients; Persistent pain; Physiological; Predisposition; Psychological Stress; Research Personnel; Risk Factors; Sleep; Temporomandibular Joint Disorders; chronic pain; programs; psychologic; psychological distress; vulvar vestibulitis

DESCRIPTION (provided by applicant): Complex persistent pain conditions (CPPCs) such as headache conditions, fibromyalgia, temporomandibular disorders, irritable bowel syndrome, and vulvar vestibulitis are high prevalent and shared or comorbid chronic pain conditions. There are two features of CPPCs that are fundamental to the aims and goals of this proposal: 1) the etiology of CPPCs is multifactorial and 2) the clinical manifestations of CPPCs are diverse. In this Program Project, we expect to identify a mosaic of risk factors for each of five CPPCs: fibromyalgia (FM), episodic migraine (EM), vulvar vestibulitis (VVS), irritable bowel syndrome (IBS), and temporomandibular joint disorders (TMD). Furthermore, we expect to characterize clusters of patients within each CPPC that vary significantly according to manifestations of their condition in addition to its painful characteristics (e.g., fatigue, dysfunction, sleep loss). Importantly, we expect some clusters of patients to be more alike across CPPCs than within any single CPPC, consistent with our view that there is some overlap in the manifestations of CPPCs. A unifying hypothesis integrating this Program is that multiple genetic factors, when coupled with environmental exposures (e.g. injury, infections, physical and psychological stress), increase the susceptibility to highly prevalent CPPCs by enhancing pain sensitivity and/or increasing psychological distress. To address the aims and goals of the subprojects and cores described in this application, a group of accomplished pain clinicians, pain researchers, psychophysiologists, molecular and cellular geneticists, biostatisticians and epidemiologists have been brought together to form this Program. Studies proposed in this Program Project application seek to identify the psychological and physiological risk factors, clusters, and associated genetic polymorphisms, that influence pain amplification and psychological profiles in enrollees who have established CPPDs. Additionally, the proposed studies seek to characterize the biological pathways through which these genetic variations causally influence CPPCs.

描述（由申请人提供）：复杂的持续性疼痛病症（CPPC），例如头痛、纤维肌痛、颞下颌疾病、肠易激综合征和外阴前庭炎，是高度普遍且共同或共存的慢性疼痛病症。 CPPC 有两个特征对于本提案的目的和目标至关重要：1）CPPC 的病因是多因素的；2）CPPC 的临床表现多种多样。在这个项目中，我们期望确定五种 CPPC 中每一种的危险因素：纤维肌痛 (FM)、阵发性偏头痛 (EM)、外阴前庭炎 (VVS)、肠易激综合征 (IBS) 和颞下颌关节紊乱 (TMD)。此外，我们希望能够描述每个 CPPC 中的患者群，这些患者群除了疼痛特征（例如疲劳、功能障碍、睡眠不足）之外，还根据其病情表现而存在显着差异。重要的是，我们预计 CPPC 中的一些患者群比任何单个 CPPC 中的患者更加相似，这与我们认为 CPPC 的表现存在一些重叠的观点一致。整合该计划的一个统一假设是，多种遗传因素与环境暴露（例如受伤、感染、身体和心理压力）相结合，通过增强疼痛敏感性和/或增加心理困扰，增加对高度流行的 CPPC 的易感性。为了实现本申请中描述的子项目和核心的目的和目标，一群有成就的疼痛临床医生、疼痛研究人员、心理生理学家、分子和细胞遗传学家、生物统计学家和流行病学家聚集在一起形成了这个计划。 本计划项目申请中提出的研究旨在确定影响已建立 CPPD 的参与者的疼痛放大和心理特征的心理和生理风险因素、集群和相关遗传多态性。此外，拟议的研究旨在描述这些遗传变异因果影响 CPPC 的生物学途径。