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Early Menstrual Pain Impact on Multisensory Hypersensitivity

月经早期疼痛对多感觉超敏反应的影响

基本信息

批准号：
10878181
负责人：
Frank Fu-sheng Tu
金额：
$ 32.41万
依托单位：
NORTHSHORE UNIVERSITY HEALTHSYSTEM
依托单位国家：
美国
项目类别：
财政年份：
2023
资助国家：
美国
起止时间：
2023-08-01 至 2024-11-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10878181
关键词：
Address Adolescence Adolescent Awareness Brain Brain Stem Cataloging Child Childhood Data Development Dysmenorrhea Electroencephalography Electrophysiology (science)Equipment and supply inventories Exposure to Friends Future High Prevalence Hypersensitivity Learning Link Longitudinal Studies Measurement Measures Mediating Mediator Menarche Methods Mission National Institute of Child Health and Human Development Neuronal Plasticity Observational Study Pain Pain Measurement Pain intensity Participant Patient Self-Report Pattern Peripheral Prevention strategy Quality of life Questionnaires Refractory Reproductive Biology Reproductive Process Research Risk Risk Factors Sensory Spinal Symptoms Testing Time Uterine Diseases Uterus Vertebral column Visceral Woman biopsychosocial factor chronic pain chronic painful condition chronic pelvic pain density diaries experience follow-up girls innovation multisensory neural pain chronification pain sensitivity pressure preventive intervention prospective psychosocial reproductive response sensory cortex success timeline tool

项目摘要

This proposed supplement allows for extended follow up and analysis of participants to obtain EEG data and menstrual data at a critical time point after menarche. The early trajectory of menstrual pain intensity and the long-term impact of repeated exposure to menstrual pain on chronic pelvic pain (CPP) risk are unknown, despite the high prevalence of dysmenorrhea. Observational studies implicate both heightened menstrual pain and excess general bodily symptom awareness as strong risk factors for CPP. Since current treatments for CPP have limited success, preventative strategies, targeting known risk factors, remain an urgent, unmet need. Menstrual pain, or dysmenorrhea, itself has a profound negative impact on quality of life for many women, and is refractory to treatment in 10-20% of adolescents. During pubertal development, neuroplasticity could permit repeated adverse sensory experiences from moderate-to-severe menstrual pain to establish multisensory hypersensitivity during adolescence, increasing the risk for chronic pain. However, which patterns of menstrual pain create this vulnerability need to be determined, and how they effect neural changes. Therefore, Aim 1 of this study will characterize the trajectory patterns of dysmenorrhea longitudinally over the two years post-menarche and determine the biopsychosocial factors defining these trajectories. To determine risk factors for persistent heightened dysmenorrhea, girls will be studied for two years of follow-up after menarche, using prospective menstrual symptom diaries along with careful cataloging of menstrual, psychosocial and developmental factors. Aim 2 will then test whether the worst, persistent dysmenorrhea trajectory has the highest subsequent risk for multisensory hypersensitivity two years later, as a likely precursor to full blown CPP. Additionally, this aim will assess if change in risk of multisensory hypersensitivity following repeated menstrual pain is mediated by specific spinal or central mechanisms. Multisensory hypersensitivity will be measured by composite latent variable encompassing both self-reported symptom inventories and experimentally evoked responses to a standard battery of different sensory provocation tests. Specific mechanisms to be tested as mediators include prefrontal and primary sensory cortex activity, brainstem descending modulation of pain and peripheral pressure pain sensitivity using quantitative sensory testing and high-density EEG methods. The innovative experimental methods for measuring multisensory hypersensitivity (including non-invasive methods for measuring visceral sensitivity), with simultaneous kid- friendly electrophysiological measurements of brain activity, build on tools used by the combined research team, that is extensively engaged in uterine and pediatric pain assessment. Successful completion of this project, targeting the developmental timeline of chronic pelvic pain vulnerability, likely will define ideal windows for future preventative interventions and refine tools for evaluating visceral and multisensory sensitivity. Findings in this study will be valuable for understanding the transition from acute to chronic pain.

这项拟议的补充资料允许对参与者进行更广泛的跟踪和分析，以获得脑电月经初潮后关键时间点的数据和月经数据。月经疼痛的早期轨迹反复月经疼痛对慢性盆腔疼痛(CPP)风险的强度和长期影响都是未知的，尽管痛经的发病率很高。观察性研究表明，这两种疾病的程度都很高月经疼痛和对全身症状的过度认识是CPP的强烈危险因素。自当前起 CPP的治疗效果有限，针对已知危险因素的预防策略仍然是一种迫切的、未得到满足的需求。月经疼痛或痛经本身对生活质量有深远的负面影响对许多妇女来说，而且在10%-20%的青少年中对治疗是难治的。在青春期发育期间，神经可塑性可以允许反复的不良感觉体验，从中到重度的月经疼痛到在青春期建立多感官过敏，增加慢性疼痛的风险。然而，需要确定哪些月经疼痛模式导致这种易损性，以及它们如何影响神经。改变。因此，本研究的目标1将纵向描述痛经的轨迹模式。在月经初潮后的两年，并确定定义这些轨迹的生物、心理和社会因素。至确定持续性痛经升高的危险因素，女孩将进行为期两年的随访研究月经初潮后，使用预期的月经症状日记以及仔细的月经分类，心理社会和发展因素。目标2将测试最严重的，持续性痛经轨迹在两年后患上多感官过敏的风险最高，因为是CPP的前身。此外，这一目标将评估多感官过敏风险的变化反复月经疼痛是由特定的脊椎或中枢机制调节的。多感官超敏反应将通过包含两种自我报告症状的复合潜变量来衡量清单和实验唤起了对不同感觉刺激测试的标准电池的反应。作为媒介进行测试的具体机制包括前额叶和初级感觉皮质活动，定量感觉对疼痛和外周压痛敏感性的脑干下行调节测试和高密度脑电方法。多感官测量的创新实验方法过敏(包括非侵入性测量内脏敏感性的方法)，同时儿童- 友好的脑活动电生理测量，建立在联合研究使用的工具基础上该团队广泛从事子宫和儿科疼痛评估。成功完成这项工作该项目以慢性盆腔疼痛易损性的发展时间表为目标，可能会定义理想的窗口用于未来的预防性干预，并改进评估内脏和多感官敏感性的工具。这项研究的发现将对理解从急性疼痛到慢性疼痛的转变有价值。