Neural and psychological mechanisms of pain perception

疼痛感知的神经和心理机制

• 批准号: 9155500
• 负责人: Lauren Atlas
• 金额: $ 37.8万
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/9155500
• 关键词: Acute Pain; Affective; Animal Model; Attention; Behavioral; Behavioral Assay; Belief; Brain; Caliber; Calibration; Clinical; Cognitive; Computer Simulation; Computers; Cues; Data; Data Analyses; Data Collection; Decision Making; Development; Dissociation; Electrocardiogram; Emotions; Environment; Expectancy; Experimental Psychology; Eye Movements; Functional Magnetic Resonance Imaging; Galvanic Skin Response; Goals; Heart Rate; Heating; Human; Human Resources; Individual; Institutional Review Boards; Knowledge; Laboratories; Learning; MRI Scans; Measurement; Measures; Mediating; Modality; National Institute of Neurological Disorders and Stroke; Nervous system structure; Neuraxis; Neurobiology; Organism; Outcome; Outpatients; Pain; Pain Threshold; Participant; Pathway interactions; Patient Self-Report; Patients; Perception; Peripheral; Physiologic pulse; Physiological; Placebo Effect; Population; Positioning Attribute; Procedures; Process; Protocols documentation; Provider; Psychological Factors; Psychophysiology; Pupil; Questionnaires; Reporting; Research; Research Design; Respiration; Reversal Learning; Review Committee; Sample Size; Shock; Signal Transduction; Stimulus; Students; Taste Perception; Temperature; Testing; Variant; Work; affective neuroscience; base; classical conditioning; conditioning; contextual factors; emotional experience; expectation; experience; gaze; healthy volunteer; heat stimulus; hedonic; human subject; neurobiological mechanism; neuroimaging; neuromechanism; psychologic; relating to nervous system; research study; response; screening; social

Pain can be modulated by explicit beliefs about treatments, prior experience and learning, interpersonal processes that support the patient-provider relationship, and contextual factors related to the treatment environment. In this project, we systematically investigate the neural and psychological mechanisms that mediate the effects of these factors on acute pain. We focus on expectations, attention, emotion, conditioning/associative learning, and social factors. Our experiments principally use functional magnetic resonance imaging (fMRI) and psychophysiological measurements, as well as behavioral assays and self-reports. We are examining the effects of different types of pain-related expectations on decisions about pain as well as responses in the brain and body. We also plan to compare acute pain with other hedonic and perceptual processes. This will allow us to distinguish processes that are unique to pain perception from those that are not specific to pain, such as processes involved in perception and decision-making across domains. This was our first year, and we focused on setting up the lab (the Section on Affective Neuroscience and Pain) and beginning data collection. The human subjects protocol "Neural and psychological mechanisms of pain perception" received approval from the NINDS Protocol Implementation Review Committee and the Institutional Review Board. The protocol includes five sub-studies designed to a) isolate different aspects of pain modulation, b) compare acute pain modalities (e.g., thermal pain versus shock-induced pain), and c) compare and contrast pain with other hedonic and perceptual domains (e.g., taste). In all studies, we measure decisions about pain experience (self-report) as well as neural and physiological responses to noxious stimuli that cause pain. During analysis, we will combine computational modeling with advanced neuroimaging analyses to isolate the neural and psychological mechanisms that mediate the effects of expectations, attention, and emotion on subjective pain. During the protocol approval process, we hired lab personnel, established laboratory standards, and developed our experiment room in the Outpatient Center. We can now administer noxious thermal stimuli (calibrated to each individuals pain sensitivity) while simultaneously collecting physiological responses, including pupil diameter, skin conductance, heart rate (via electrocardiogram and peripheral pulse) and respiration. Our computer tasks are self-paced based on patient eye movements, which allows us to use gaze position as an additional dependent measure in our tasks. Data collection commenced in May of this year. We have completed testing on 23 healthy volunteers who participated as behavioral pilots in our first sub-study. Following screening, all participants completed questionnaires, followed by a pain calibration procedure that measures pain ratings in response to noxious heat stimuli and determines each participants pain threshold and tolerance. Participants then went on to a pilot sub-study designed to examine the effects of classical conditioning and instructed knowledge on pain and reversal learning. Data from our behavioral sub-studies are used for task development prior to fMRI scanning, as well as for effect size estimation and power analysis. Three summer students analyzed data from these initial pilot subjects. Preliminary analyses of our data from the pain calibration indicate that a) our healthy volunteers show statistical relationships between noxious stimulus temperature and reported pain; 2) pupil diameter is correlated with noxious heat and subjective pain reports; 3) skin conductance response amplitude correlates with noxious heat and subjective pain. Preliminary analyses of our behavioral pilot data indicate possible dissociations between cue-based expectancy effects on pain reports and skin conductance responses. We aim to collect four more pilot participants in our current variant of the first sub-study, and then will estimate our effect size and perform power analyses to determine sample size for the fMRI sub-study. We anticipate the first fMRI sub-study will begin in several weeks, at the end of FY15 or the start of FY16.

疼痛可以通过关于治疗的明确信念、先前的经验和学习、支持患者-提供者关系的人际过程以及与治疗环境相关的背景因素来调节。 在这个项目中，我们系统地研究了介导这些因素对急性疼痛的影响的神经和心理机制。 我们专注于期望，注意力，情绪，条件反射/联想学习和社会因素。 我们的实验主要使用功能性磁共振成像（fMRI）和心理生理测量，以及行为分析和自我报告。 我们正在研究不同类型的疼痛相关预期对疼痛决策以及大脑和身体反应的影响。 我们还计划将急性疼痛与其他享乐和知觉过程进行比较。 这将使我们能够区分疼痛感知所特有的过程和那些不特定于疼痛的过程，例如涉及跨领域感知和决策的过程。 这是我们的第一年，我们专注于建立实验室（情感神经科学和疼痛部分）并开始收集数据。 人类受试者方案“疼痛感知的神经和心理机制”获得了NINDS方案实施审查委员会和机构审查委员会的批准。 该方案包括五个子研究，设计用于a）分离疼痛调节的不同方面，B）比较急性疼痛模式（例如，热疼痛与冲击引起的疼痛），以及c）将疼痛与其他享乐和感知领域进行比较和对比（例如，味道）。在所有的研究中，我们测量了关于疼痛体验的决定（自我报告）以及对引起疼痛的有害刺激的神经和生理反应。 在分析过程中，我们将结合联合收割机计算建模与先进的神经成像分析，以隔离神经和心理机制，介导的期望，注意力和情绪对主观疼痛的影响。 在方案批准过程中，我们聘请了实验室人员，建立了实验室标准，并在门诊中心开发了实验室。 我们现在可以管理有害的热刺激（根据每个人的疼痛敏感度进行校准），同时收集生理反应，包括瞳孔直径，皮肤电导，心率（通过心电图和外周脉搏）和呼吸。 我们的计算机任务是基于患者眼球运动的自定进度的，这允许我们使用凝视位置作为我们任务中的附加依赖措施。 数据收集工作于今年5月开始。 我们已经完成了对23名健康志愿者的测试，他们作为行为飞行员参加了我们的第一个子研究。 筛选后，所有参与者完成问卷调查，然后进行疼痛校准程序，测量对有害热刺激的疼痛评级，并确定每个参与者的疼痛阈值和耐受性。 然后，参与者继续进行一项试点子研究，旨在研究经典条件反射和指导知识对疼痛和逆转学习的影响。从我们的行为子研究的数据被用于任务开发之前，功能磁共振成像扫描，以及效果大小估计和功率分析。 三名暑期学生分析了这些初步试点受试者的数据。 对我们的疼痛校准数据的初步分析表明：a）我们的健康志愿者显示有害刺激温度和报告疼痛之间的统计关系; 2）瞳孔直径与有害热和主观疼痛报告相关; 3）皮肤电导反应幅度与有害热和主观疼痛相关。我们的行为试点数据的初步分析表明，基于线索的预期对疼痛报告和皮肤电导反应的影响之间可能存在分离。 我们的目标是在第一个子研究的当前变体中再收集四名试点参与者，然后估计我们的效应量并进行功效分析以确定fMRI子研究的样本量。我们预计第一个fMRI子研究将在几周内开始，在FY 15年底或FY 16年初。