Brain Activation and Pain Reports in People with Alzheimer's Disease

阿尔茨海默病患者的大脑激活和疼痛报告

• 批准号: 9282410
• 负责人: Todd Bryant Monroe
• 金额: $ 16.14万
• 依托单位: VANDERBILT UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-09-30 至 2019-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9282410
• 关键词: Acute; Acute Pain; Adult; Affective; Age; Aging; Alzheimer' s Disease; Amygdaloid structure; Analgesics; Anterior; Area; Balance training; Biological; Biological Assay; Brain; Brain region; Cerebellum; Clinical; Cognitive; Complex; Cutaneous; Data; Dementia; Detection; Development Plans; Educational workshop; Elderly; Employee Strikes; Ensure; Environment; Ethics; Exhibits; Fellowship; Foundations; Functional Magnetic Resonance Imaging; Goals; Grant; Health Care Costs; Individual; Injury; Institutes; Insula of Reil; K-Series Research Career Programs; Knowledge; Lateral; Leadership; Maps; Medial; Medical; Mentors; Monitor; Nervous system structure; Neurobiology; Neurosciences; Older Population; Pain; Pain Threshold; Pain management; Pathway interactions; Pattern; Pilot Projects; Postdoctoral Fellow; Prefrontal Cortex; Prevention strategy; Psychophysics; Public Health; Quality of life; Reporting; Research; Research Design; Research Infrastructure; Rest; Risk; Role; Sampling; Scientist; Sensory; Sex Characteristics; Somatosensory Cortex; Stimulus; Structure; System; Techniques; Temperature; Time; Training; Woman; Work; Writing; aged; base; career development; chronic pain; cingulate cortex; enhancing factor; experience; imaging modality; infancy; men; neuroimaging; neurophysiology; novel; older men; older women; professor; programs; public health relevance; response; sensory stimulus; sex; skills; treatment strategy; young woman

 DESCRIPTION (provided by applicant): Poorly treated pain in older adults with Alzheimer's disease (AD) is a critical public health problem, and understanding AD-related differences in pain function is an National Institute of Aging (NIA) priority area. When compared to healthy adults, and in the presence of similar known painful conditions, older adults with AD receive less pain medication. Reasons for this discrepancy are poorly understood. Inadequately treated pain negatively impacts quality of life and increases health care costs. Exploring the biological reasons for alterations in pain processing is essential for increasing our understanding of pain in older adults with AD. Evidence suggests that brain structure and brain function are altered in AD. However, it is unclear how these structural and functional nervous system alterations impact psychophysical and neurophysiological responses to pain in AD. The goals of this career development project are to provide the PI with the training and skills necessary to transition from a mentored role to an independent scientist focused on pain, aging, and dementia. The career development plan strikes a balance of training and coursework in years one and two, with increased research and independence in years three and four. Training will include courses selected to increase knowledge in specific areas (neuroscience, neurobiology, ethics, grant writing, and leadership). In addition, workshops are included that will increase the skills necessary to both design studies and carry out neuroimaging analysis. The proposed research will examine how psychophysical responses to acute experimental thermal pain differs between older adults with and without AD, and how these differences map onto regional and network brain functional changes. Experimental acute thermal pain delivery predicts well the response to painful medical conditions. We propose to examine the psychophysical and neurophysiological response to experimental thermal stimuli in healthy adults (aged 65 or older) and aged match adults with AD (aged 65 or older). The aims of this study are to determine whether sensory (stimulus intensity) and affective (stimulus unpleasantness) responses differ in adults with and without AD during cutaneous thermal stimulation. We hypothesize that AD will be associated with a blunted response in sensory pain and affective pain systems. These changes may arise from AD-associated changes in brain structure and function as well as from specific alterations in pain-related brain networks. Examining baseline differences in experimental thermal pain between adults with and without AD will provide a foundation for understanding factors that may contribute to untreated pain risk, as well as for developing novel assessment, prevention, and treatment strategies in the older population.

 描述（由申请人提供）：阿尔茨海默病（AD）老年人的疼痛治疗不良是一个严重的公共卫生问题，了解AD相关的疼痛功能差异是国家老龄化研究所（NIA）的优先领域。与健康成人相比，在存在类似已知疼痛状况的情况下，患有AD的老年人接受的止痛药较少。造成这种差异的原因尚不清楚。治疗不当的疼痛会对生活质量产生负面影响，并增加医疗保健费用。探索疼痛处理改变的生物学原因对于增加我们对疼痛的理解是至关重要的。 老年人AD有证据表明，AD患者的脑结构和脑功能发生了改变。然而，目前还不清楚这些结构和功能的神经系统的改变如何影响心理物理和神经生理反应的疼痛在AD。该职业发展项目的目标是为PI提供从 一位独立科学家的指导角色，专注于疼痛，衰老和痴呆症。职业发展计划在第一年和第二年实现培训和课程的平衡，在第三和第四年增加研究和独立性。培训将包括选定的课程，以增加特定领域的知识（神经科学，神经生物学，伦理学，赠款写作和领导力）。此外，还包括研讨会，这将增加设计研究和进行神经成像分析所需的技能。拟议的研究将研究患有和没有AD的老年人对急性实验性热痛的心理物理反应如何不同，以及这些差异如何映射到区域和网络脑功能变化。实验性急性热疼痛递送很好地预测了对疼痛医疗条件的反应。我们建议检查的心理物理和神经生理反应的实验性热刺激在健康成人（65岁或以上）和老年匹配成人AD（65岁或以上）。本研究的目的是确定是否感觉（刺激强度）和情感（刺激不愉快）的反应不同，在成人与AD和无皮肤热刺激。我们假设AD与感觉疼痛和情感疼痛系统的迟钝反应有关。这些变化可能来自AD相关的脑结构和功能变化以及疼痛相关脑网络的特定改变。检查患有和不患有AD的成年人之间实验性热痛的基线差异将为理解可能导致未经治疗的疼痛风险的因素以及在老年人群中开发新的评估，预防和治疗策略提供基础。