The trigeminal nociceptive-pain pathway in pediatric mTBI: peripheral and central contributions to photophobia

儿科 mTBI 中的三叉神经伤害性疼痛通路：畏光的外周和中枢贡献

• 批准号: 10656665
• 负责人: Scott Holmes
• 金额: $ 43.82万
• 依托单位: BOSTON CHILDREN'S HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-08-01 至 2028-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10656665
• 关键词: Adolescent; Adopted; Adult; Afferent Pathways; Area; Behavior; Brain; Brain Concussion; Brain imaging; Case Study; Central Nervous System; Child; Childhood; Clinical; Cognitive; Cornea; Craniocerebral Trauma; Data; Development; Diagnosis; Diffusion Magnetic Resonance Imaging; Edema; Event; Eye; Face; Functional Magnetic Resonance Imaging; Functional disorder; Growth; Headache; Health; Hypersensitivity; Image; Incidence; Investigation; Length; Life; Light; Masks; Measures; Mediating; Microscopy; Monitor; Nerve; Nerve Fibers; Neural Pathways; Neurobiology; Neurologic; Neuronal Plasticity; Nociception; Optometry; Organ; Pain; Pain Disorder; Pain Threshold; Paper; Pathology; Pathway interactions; Patient Monitoring; Patients; Peripheral; Peripheral Nervous System; Persons; Photophobia; Population; Psychology; Radial; Reporting; Rest; Risk; Rodent; Role; Sensory; Signal Transduction; Source; Structure; Symptoms; Testing; Trigeminal System; Trigeminal nerve structure; Visual; Visual Psychophysics; Vulnerable Populations; Work; afferent nerve; base; brain behavior; central sensitization; clinical decision-making; cohort; density; detection method; diagnostic biomarker; disability; experience; improved; in vivo; insight; interdisciplinary approach; light intensity; mild traumatic brain injury; multidisciplinary; nerve injury; nervous system disorder; neuroimaging; neuroinflammation; pain perception; pain symptom; pediatric traumatic brain injury; programs; psychologic; sensory input; statistics; symptomatology

Concussion, also referred to as mild traumatic brain injury (mTBI), is a neurological disorder that causes disability in children and predisposes them to challenges later in life, including significant physical, cognitive, and psychological disability. The trigeminal nerve extends from the central nervous system to innervate the greater portion of face and eye, and may offer insight into head trauma pathophysiology. In particular, painful sensitivity to light (photophobia), corneal nerve pathology, and atypical functional activity within the brain have all been reported in preliminary work evaluating persons with mTBI and trigeminal nerve pathology. Our overall hypothesis is that the trigeminal nerve is sensitive to mTBI and accounts for pain-related symptomatology. To test this hypothesis, in aim 1, we will define trigeminal nerve pathology in persons with mTBI using quantitative sensory testing (QST), in vivo corneal nerve microscopy (IVCM), and diffusion tensor imaging (DTI). In aim 2, we will define central nervous system changes to light-induced pathways with mTBI-related photophobia using fMRI and DTI. This study is likely to yield (1) a diagnostic marker that is sensitive to mTBI, (2) evince a neurological source of mTBI-related pain symptoms. Data generated from this investigation can be used to improve the diagnosis, treatment and monitoring of patients suffering from head trauma and provide an objective marker to base clinical decision making.

脑震荡，也称为轻度创伤性脑损伤（MTBI），是一种导致的神经系统疾病 儿童的残疾，使他们在以后的生活中挑战，包括重要的身体，认知， 和心理残疾。三叉神经从中枢神经系统延伸到支配 大部分面部和眼睛可能会深入了解头部创伤病理生理学。特别是痛苦 对光的敏感性（恐惧症），角膜神经病理学和大脑内的非典型功能活性具有 所有这些都在评估MTBI和三叉神经病理的人的初步工作中报道。我们的整体 假设是三叉神经对MTBI敏感，并解释了与疼痛相关的症状学。到 在AIM 1中检验该假设，我们将使用定量在MTBI的人中定义三叉神经病理 感觉测试（QST），体内角膜神经显微镜（IVCM）和扩散张量成像（DTI）。在AIM 2中， 我们将使用MTBI相关恐惧症来定义中枢神经系统变化对光引起的途径 fMRI和DTI。这项研究可能会产生（1）对MTBI敏感的诊断标记，（2） MTBI相关疼痛症状的神经系统来源。从本调查产生的数据可用于 改善对头部创伤患者的诊断，治疗和监测，并提供 基础临床决策的客观标记。