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.

该提出的补充剂允许扩展随访和分析参与者以获得脑电图初潮后的关键时间点数据和月经数据。月经疼痛的早期轨迹重复暴露于月经疼痛对慢性骨盆疼痛（CPP）风险的强度和长期影响尽管痛经患病率很高，但未知。观察性研究暗示既增强了月经疼痛和过度的一般身体症状意识是CPP的强大风险因素。自当前 CPP治疗的成功有限，预防策略，针对已知危险因素，仍然是紧急，未满足的需求。月经疼痛或痛经本身对生活质量产生深远的负面影响对于许多妇女，对10-20％的青少年的治疗难治性。在青春期开发期间，神经可塑性可以允许从中度到重度月经到重复的不良感觉体验到在青春期内建立多感官超敏反应，从而增加了慢性疼痛的风险。然而，需要确定月经疼痛的哪些模式需要确定这种脆弱性，以及它们如何影响神经更改。因此，本研究的目标1将在纵向上表征痛经的轨迹模式在两年内，并确定了定义这些轨迹的生物心理社会因素。到确定持续增强痛经的危险因素，将研究女孩进行两年的随访初潮之后，使用前瞻性月经症状日记以及仔细的月经分类社会心理和发展因素。 AIM 2将测试最坏的，持续的痛经是否两年后，轨迹具有多感觉超敏性的随后风险，很可能完全吹牛CPP的前体。此外，此目标将评估多感官超敏反应的风险是否变化经过重复的月经疼痛是由特定的脊柱或中心机制介导的。多感官高敏性将通过复合潜在变量涵盖两个自我报告的症状来衡量库存和实验性诱发对不同感觉挑衅测试的标准电池的响应。要测试作为介体的特定机制包括前额叶和原发性皮层活性，使用定量感觉，脑干对疼痛和周围压力疼痛的敏感性调节测试和高密度EEG方法。测量多感官的创新实验方法高敏性（包括用于测量内脏敏感性的非侵入性方法）友好的电生理测量大脑活动，基于合并研究的工具团队，广泛从事子宫和小儿疼痛评估。成功完成项目针对慢性骨盆疼痛脆弱性的发育时间表，可能会定义理想的窗户用于未来的预防性干预措施和改进工具，以评估内脏和多感官敏感性。这项研究中的发现对于理解从急性到慢性疼痛的过渡非常有价值。