Differentiation of Clinical Phenotypes of Inflammatory and Neuropathic Ocular Pain Conditions with Morphologic Measures and Functional Brain Imaging

通过形态学测量和功能性脑成像区分炎症性和神经性眼痛的临床表型

• 批准号: 10585427
• 负责人: Eric Alan Moulton
• 金额: $ 99.11万
• 依托单位: BOSTON CHILDREN'S HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-30 至 2027-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10585427
• 关键词: Adult; Affect; Affective; Age; Amygdaloid structure; Anatomy; Animal Model; Anterior; Anti-Inflammatory Agents; Brain; Brain Stem; Brain imaging; Brain region; Chronic; Classification; Clinical; Clinical Research; Complex; Confocal Microscopy; Cornea; Data; Diagnosis; Diffuse; Diffusion Magnetic Resonance Imaging; Disease; Distress; Emotions; Event; Exhibits; Eye; Foundations; Functional Magnetic Resonance Imaging; Future; Goals; Human; Immune; Individual; Inflammation; Inflammatory; Infrastructure; Insula of Reil; Investigation; Knowledge; Lesion; Light; Lubrication; Machine Learning; Magnetic Resonance Imaging; Measures; Mechanics; Mental Health; Microscopy; Modeling; Monitor; Morbidity - disease rate; Morphology; Nerve; Nerve Fibers; Nervous system structure; Neural Pathways; Neuraxis; Neurologic; Neuropathy; Nociception; Pain; Pathology; Pathway interactions; Patient Monitoring; Patients; Peripheral; Peripheral Nerves; Persons; Phenotype; Photophobia; Population; Positioning Attribute; Research; Rest; Sensory; Sjogren' s Syndrome; Source; Stains; Stimulus; Structure; Structure of trigeminal ganglion; Symptoms; System; Techniques; Testing; Therapeutic Effect; Translational Research; Trigeminal System; Trigeminal nerve structure; aqueous; base; blood oxygenation level dependent response; brain morphology; central pain; central sensitization; chronic pain; clinical decision-making; clinical diagnosis; clinical diagnostics; clinical phenotype; comorbidity; density; diagnostic biomarker; disability; disease phenotype; effective therapy; eye dryness; improved; in vivo; inflammatory pain; lens; multimodality; nerve supply; neural circuit; neural network; neuroimaging; neuromechanism; ocular pain; pain processing; pain symptom; painful neuropathy; physical conditioning; programs; reflectance confocal microscopy; response; sex; somatosensory; spontaneous pain; tissue injury; tool; white matter

Chronic ocular pain is a highly distressing symptom as its occurrence results in high morbidity without effective treatment. Patients with dry eye (DE) commonly have painful ocular symptoms, yet the neural mechanisms underlying this type of pain may include inflammatory (as in Sjogren's syndrome) and/or neuropathic contributors (as in neuropathic ocular pain [NOP]). The cornea is innervated by the trigeminal nerve, which conveys peripheral input to the central nervous system. Using neuroimaging to evaluate peripheral nerves to supraspinal structures, we propose to define the structural and functional differences in the trigeminal circuit that differentiate inflammatory and neuropathic pain. In aim 1, we will determine trigeminal nerve pathology in persons with Sjogren's vs. NOP vs. controls using quantitative sensory testing (QST), in vivo corneal nerve microscopy (IVCM), and diffusion tensor imaging (DTI). In aim 2, we will define differences between Sjogren's vs. NOP in the central nervous system by comparing functional responses to light-induced pathways associated with photophobia using fMRI, and structure using MRI and DTI. This study is likely to yield (1) structural and functional diagnostic markers to differentiate inflammatory and neuropathic ocular pain with neuroimaging, and (2) evince a neurological source of pain symptoms with neuropathic ocular pain. Data generated from this investigation may be used to improve the diagnosis and monitoring of patients suffering from chronic ocular pain, and provide an objective marker to base clinical decision making.

慢性眼痛是一种非常痛苦的症状，因为它的发生导致高发病率而没有有效的治疗