TWIN STUDY OF CHRONIC WIDESPREAD PAIN

这个子项目是许多研究子项目中利用 资源由NIH/NCRR资助的中心拨款提供。子项目和 调查员(PI)可能从NIH的另一个来源获得了主要资金， 并因此可以在其他清晰的条目中表示。列出的机构是 该中心不一定是调查人员的机构。 慢性广泛性疼痛(CWP)发生在4%-13%的人中，是纤维肌痛(FM)的特征之一。调频的复杂性和水煤浆的连续体使我们发展了水煤浆的多维理论模型。易感因素在这个模型中是特别重要的，因为这些因素代表了与煤工尘肺的发展相关的发病前风险或保护性因素。此外，易感因素可以与疾病相关特征区分开来，这些特征是作为疾病的结果出现的。同卵双生子对照研究是检验从我们的模型中得出的关于煤工尘肺病因和后果的具体假说的有力手段。40对MZ和40对DZ对CWP的不协调双胞胎，以及40对MZ和DZ无痛对照双胞胎将从基于人群的华盛顿大学双胞胎登记处招募。这对双胞胎将接受对自主神经系统(ANS)功能、下丘脑-垂体-肾上腺(HPA)轴功能、运动能力、睡眠和活动水平、诱发疼痛处理以及与CWP有关的精神和心理社会因素的密集评估。有两个具体目标：1)评估在ANS功能、HPA轴功能、运动能力、睡眠和活动水平、诱发疼痛敏感性以及精神和心理社会因素方面的对内差异。2)评估配对效应，以确定煤工尘肺与上述疾病特征之间的关联是由于遗传因素还是共同的环境因素。研究双胞胎组之间的差异模式有助于区分易患煤工尘肺的因素和发病后发生的因素。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Chronic widespread pain (CWP) occurs in 4-13% of people and is one of the defining characteristics of Fibromyalgia (FM). The complexity of FM and the continuum of CWP have led us to develop a multidimensional theoretical model of CWP. Predisposing factors are of particular interest in this model since these represent premorbid risk or protective factors that relate to the development of CWP. Further, predisposing factors can be differentiated from illness-associated features that occur as a consequence of the condition. A co-twin control study is a powerful means for examining specific hypotheses about the etiology and consequences of CWP derived from our model. Forty MZ and 40 DZ twin pairs discordant for CWP, along with 40 MZ and DZ pain-free control twin pairs will be recruited from the population-based University of Washington Twin Registry. Twins will undergo an intensive evaluation of autonomic nervous system (ANS) function, hypothalamic-pituitary-adrenal (HPA) axis function, exercise capacity, sleep and activity levels, evoked pain processing, and psychiatric and psychosocial factors involved in CWP. There are 2 Specific Aims: 1) To assess within-pair differences in ANS function, HPA axis function, exercise capacity, sleep and activity levels, evoked pain sensitivity, and psychiatric and psychosocial factors. 2) To assess between-pair effects to determine if the association between CWP and the above illness characteristics is due to genetics or common environmental factors. Investigating the pattern of differences between twin groups can help to distinguish factors that are predisposing to CWP and those that occur after the onset of the illness.