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Brain Imaging and Pain: Analysis of Placebo Analgesia

脑成像和疼痛：安慰剂镇痛分析

基本信息

批准号：
9929722
负责人：
Michael E ROBINSON
金额：
$ 0.73万
依托单位：
UNIVERSITY OF FLORIDA
依托单位国家：
美国
项目类别：
财政年份：
2003
资助国家：
美国
起止时间：
2003-03-15 至 2022-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9929722
关键词：
Absence of pain sensation Accounting Adult Affect American Anterior Brain Brain Stem Brain imaging Brain region Cerebrum Cervical spine Ethics Expectancy Experimental Designs Functional Magnetic Resonance Imaging Institute of Medicine (U.S.)Insula of Reil Intervention Investigation Ipsilateral Literature Mediating Memory Methods Midbrain structure Modeling Music Nervous system structure Opioid Pain Pain management Participant Pathway interactions Patient Recruitments Patients Peer Review Peripheral Nervous System Placebos Posterior Horn Cells Prefrontal Cortex Price Procedures Productivity Public Health Publications Publishing Quality of life Research Research Design Research Personnel Role Sensory Somatosensory Cortex Spinal Spinal Cord Spinal cord posterior horn Spine pain Stimulus Suggestion Testing Thalamic structure United States Wages Work addiction base chronic pain chronic pain patient chronic painful condition cingulate cortex clinical practice cognitive function cost design dorsal horn endogenous opioids executive function experience heat stimulus improved innovation interest midbrain central gray substance neuroimaging novel strategies pain processing pain reduction relating to nervous system response somatosensory spinal cord imaging

项目摘要

Chronic pain represents a significant public health concern, affecting over 100 million adults, and accounting for over $600 billion US annually. Current treatments for chronic pain lack efficacy, and opioid treatments have led to a significant misuse, addiction, and secondary public health crisis. We have shown that endogenous pain modulation, in the form of “placebo” manipulations have a now well-defined neural underpinning, suggestive of descending pain modulation within and perhaps from the brain to lower nervous system. Our work has identified placebo as a potentially acceptable intervention for patients with chronic pain either as a method to enhance existing treatments, or perhaps as a stand-alone treatment. To date, the contribution of spinal cord mechanisms to placebo analgesia has been largely speculative. We propose to investigate specific hypotheses about both brain and spinal cord mechanisms, and their interactions to a model of placebo analgesia through the use of functional magnetic resonance imaging (FMRI). The neural imaging of the spinal cord is an innovative new approach heretofore not feasible for the investigation of placebo mechanisms. We will combine this new approach with our previously published, and well articulated placebo manipulation and experimental design that will allow us to investigate the relative contribution of brain and cord mechanisms in placebo analgesia. We will employ both traditional fMRI, as well as functional connectivity analyses to investigate relationships among a priori regions of interest in the brain and the spinal cord. Our innovative research design, previously employed with only brain imaging, will allow for the investigation of more centrally dependent mechanisms, vs. those that are more peripheral nervous system dependent. Our team of investigators has all the necessary expertise in chronic pain, pain processing, quantitative sensory testing, neuroimaging, and experimental design to successfully accomplish the aims proposed in this application. We have repeatedly shown our ability to successfully recruit participants for the proposed design, and have successfully employed all the procedures, either in peer reviewed publications, or as demonstrated in our preliminary studies. One critical finding from our previous work has shown that the acceptability of placebo interventions is the empirical support and understanding of the mechanisms of placebo. Thus, in addition to developing a complete understanding of the mechanisms of placebo that might results in new treatment approaches, being able to describe these mechanisms to the public, pain practitioners, and to patients will increase the acceptability of them in clinical practice, thus improving pain treatment.

慢性疼痛是一个重大的公共卫生问题，影响着1亿多成年人，