Central Pain Mechanisms in Primary Dysmenorrhea

原发性痛经的中枢疼痛机制

• 批准号: 8699578
• 负责人: Laura A Payne
• 金额: $ 13.1万
• 依托单位: UNIVERSITY OF CALIFORNIA LOS ANGELES
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-08-01 至 2019-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8699578
• 关键词: Acute Pain; Adolescence; Adolescent; Adolescent and Young Adult; Adult; Affect; Age; Anxiety; Autonomic nervous system; Award; Behavior Therapy; California; Child; Childhood; Chronic; Clinic; Clinical; Complex; Control Groups; Data; Data Analyses; Development; Development Plans; Discipline of obstetrics; Dysmenorrhea; Ethics; Extramural Activities; Female; Female Adolescents; Funding; Future; Galvanic Skin Response; Goals; Gonadal Steroid Hormones; Grant; Gynecologist; Gynecology; Heating; Hormonal; Hydrocortisone; Individual; Intervention; Laboratories; Los Angeles; Luteal Phase; Maintenance; Measurement; Measures; Medical; Menstrual cycle; Menstruation; Mental Depression; Mentored Patient-Oriented Research Career Development Award; Mentors; Modality; Modeling; Neurosecretory Systems; Pain; Pain Measurement; Pain Threshold; Pain intensity; Participant; Patient Self-Report; Pelvic Pain; Phase; Play; Population; Prevention strategy; Procedures; Process; Psychological Factors; Psychologist; Psychophysiology; Public Health; Qualitative Research; Recurrence; Recurrent pain; Reproductive Endocrinology; Research; Research Methodology; Research Personnel; Research Subjects; Research Training; Risk; Role; Salivary; Sampling; Scientist; Staging; Stimulus; Stress; Techniques; Testing; Time; Training; Universities; University Hospitals; Woman; Women' s Health; Work; Writing; authority; career; career development; central pain; chronic pain; chronic pelvic pain; cohort; design; disability; emerging adult; emotion regulation; experience; girls; hypothalamic pituitary axis; hypothalamic-pituitary-adrenal axis; indexing; innovation; instructor; medical schools; meetings; member; prevent; psychologic; public health relevance; research and development; response; young adult; young woman

DESCRIPTION (provided by applicant): The candidate for the proposed Mentored Patient-Oriented Research Career Development Award (K23) entitled 'Central Pain Mechanisms in Primary Dysmenorrhea' is a clinical instructor at the David Geffen School of Medicine at the University of California, Los Angeles. This five year award is expected to help the candidate transition to an independent career as a clinical scientist and to expand on the candidate's background and training in pediatric pain by exploring central pain mechanisms in adolescent girls and young adult women with primary dysmenorrhea (PD). The candidate's immediate career goals are to gain training and research experience in women's health and chronic pelvic pain (specifically, dysmenorrhea), using complex pain assessment techniques designed to evaluate excitatory and inhibitory central pain processes, and salivary assessment and analysis of stress and sex hormones. Long-term career goals are to become an independent investigator with expertise in pain mechanisms related to women's health, advance the field of chronic pain by disentangling pain processes in a highly common but understudied condition (PD), and obtain data for an eventual R01 application focused on testing potential behavioral interventions for adolescents and adults with PD. The candidate has identified nationally renowned mentors as part of her mentoring team, including an expert in chronic pain in children, an obstetrician/gynecologist who specializes in pelvic pain, and a psychologist who is an authority on psychophysiological measurement of stress. Other members of the mentoring team will provide guidance in dysmenorrhea and the relationship of pelvic pain to other chronic pain conditions, and salivary assessment and analysis of stress and sex hormones. In addition to formal and informal mentoring, the candidate is located at a nationally recognized university and hospital, such that the career development plan includes attending reproductive endocrinology didactics and clinic, classes, seminars, and meetings in obstetrics/gynecology, psychophysiology of stress, qualitative research methods, ethical considerations for research subjects, grant writing and career development, and statistical approaches to data analysis. The candidate's proposed research involves comparing adolescent and young adult girls (ages 16-21) with and without PD during each of 3 phases of the menstrual cycle (menstruation, ovulatory, luteal) across a variety of standardized experimental pain testing paradigms designed to evaluate pain sensitivity and central excitatory and inhibitory mechanisms. The specific aims for this project are: 1) to confirm previous findings of enhanced pain sensitivity in women with PD, 2) to evaluate differences in central excitatory and inhibitory pain modulation in women with and without PD, and 3) to test for differences in autonomic nervous system (ANS) and hypothalamic-pituitary axis (HPA) responses to pain in AYAs with and without PD, and 4) to assess the role of psychological factors (depression, anxiety, and emotion regulation) in relation to pain responses in both groups. This innovative study uses recently developed pain paradigms to better understand how and why adolescents and women with PD experience pain. In addition, this study is the first of its kind to explore pain responses in PD across the developmental spectrum, which has the potential to identify individuals at risk for the development of future chronic pain problems and inform new interventions and prevention strategies. The training and experience gained from the candidate's proposed research and career development plan will provide the critical early career support necessary for the candidate to fully develop as a successful independent researcher capable of obtaining extramural funding and establishing a long-term research career in women's health and pain.

描述（由申请人提供）：拟议的指导性患者导向研究职业发展奖（K23）的候选人，题为“原发性痛经的中枢疼痛机制”，是洛杉矶加州大学大卫格芬医学院的临床讲师。这个为期五年的奖项预计将帮助候选人过渡到一个独立的职业生涯作为一个临床科学家，并扩大候选人的背景和培训在儿科疼痛通过探索中枢疼痛机制在青春期女孩和年轻成年女性原发性痛经（PD）。候选人的直接职业目标是获得女性健康和慢性盆腔疼痛（特别是痛经）的培训和研究经验，使用复杂的疼痛评估技术，旨在评估兴奋性和抑制性中枢疼痛过程，以及唾液评估和压力和性激素分析。长期的职业目标是成为一名独立的研究者，在与女性健康相关的疼痛机制方面拥有专业知识，通过在一种非常常见但研究不足的情况下（PD）解开疼痛过程来推进慢性疼痛领域，并获得最终的R 01应用程序的数据，该应用程序专注于测试青少年和成年PD患者的潜在行为干预措施。候选人已经确定了全国知名的导师作为她的指导团队的一部分，包括一名儿童慢性疼痛专家，一名专门研究骨盆疼痛的产科医生/妇科医生，以及一名心理生理学测量压力的权威心理学家。指导小组的其他成员将提供痛经和盆腔疼痛与其他慢性疼痛状况的关系，以及唾液评估和压力和性激素分析方面的指导。除了正式和非正式的指导，候选人位于国家认可的大学和医院，这样的职业发展计划包括参加生殖内分泌学教学和诊所，课程，研讨会和会议在产科/妇科，压力的心理生理学，定性研究方法，研究对象的伦理考虑，赠款写作和职业发展，以及数据分析的统计方法。 候选人提出的研究涉及在月经周期的3个阶段（月经，排卵，黄体）中的每一个阶段比较青少年和年轻成年女孩（16-21岁），这些阶段旨在评估疼痛敏感性和中枢兴奋性和抑制机制。该项目的具体目标是：1）确认先前发现的PD女性疼痛敏感性增强，2）评价PD女性和非PD女性中枢兴奋性和抑制性疼痛调节的差异，3）测试AYA患者和非PD患者自主神经系统（ANS）和下丘脑-垂体轴（HPA）对疼痛的反应差异，4）评估心理因素（抑郁、焦虑和情绪调节）在两组疼痛反应中的作用。这项创新的研究使用最近开发的疼痛范式，以更好地了解如何以及为什么青少年和妇女与PD的经验疼痛。此外，这项研究是首次探索PD在整个发育范围内的疼痛反应，这有可能识别出未来慢性疼痛问题发展的风险个体，并为新的干预措施和预防策略提供信息。从候选人提出的研究和职业发展计划中获得的培训和经验将为候选人提供必要的关键早期职业支持，使其能够充分发展为一名成功的独立研究人员，能够获得校外资助并建立长期的研究职业生涯。