FIBROMYALGIA: CENTRAL FACTORS IN ITS ETIOPATHOGENESIS - SECOND CYCLE

该子项目是利用NIH/NCRR资助的中心赠款提供的资源的许多研究子项目之一。子项目和研究者（PI）可能从另一个NIH来源获得主要资金，因此可以在其他CRISP条目中表示。所列机构为中心，不一定是研究者所在机构。有大量证据表明，纤维肌痛（FM）患者的疼痛敏感性和功能性大脑活动异常。我们将测试10个假设来自我们的模型异常疼痛感知FM关于疼痛敏感性和功能活动的大脑结构，处理疼痛的压力的影响。我们将评估有害的热刺激和个人相关的，压力图像对疼痛阈值和耐受性的影响，感觉强度和不愉快的幅度估计，以及处理疼痛的感觉和情感维度的大脑结构的功能活动。我们将对120名患有FM的非抑郁右利手女性和60名非抑郁健康对照女性进行这些评估程序。根据症状发作（创伤性vs.隐匿性），将患者分为两组。我们假设，在伤害性热刺激期间，与对照组相比，患者将a）产生更高的疼痛强度和不愉快的评分;和B）显示异常的大脑激活模式，其特征在于躯体感觉皮层中的双侧局部脑血流量（rCBF）增加和同侧前扣带（AC）皮层的增加。我们还假设，在暴露于与个人相关的压力图像期间，与对照组相比，患者将表现出a）唾液皮质醇的较小增加;和B）血压、脉搏率、热痛强度和不愉快评级的较大增加，以及对侧和同侧躯体感觉皮层以及同侧AC皮层的热痛诱导变化。 这项研究将使我们能够评估压力对FM患者疼痛感知和功能性脑活动的影响，而不受情感障碍的影响。

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. There is substantial evidence of abnormal pain sensitivity and functional brain activity in patients with fibromyalgia (FM). We will test 10 hypotheses derived from our model of abnormal pain perception in FM regarding the effects of stress on pain sensitivity and functional activity in brain structures that process pain. We will assess the effects of noxious thermal stimulation and personnally relevant, stressful imagery on pain thresholds and tolerance, magnitude estimates of sensory intensity and unpleasantness, and functional activity of brain structures that process the sensory and affective dimensions of pain. We will perform these evaluation procedures with 120, non-depressed, right-handed women with FM and 60, non-depressed, healty control women. The patients will be classified in one of two groups according to symptom onset (traumatic vs. insidious). We hypothesize that during noxious thermal stimulation patients, compared to controls, will a) produce higher ratings of pain intensity and unpleasantness; and b) show an abnormal pattern of brain activation characterized by bilateral increases in regional cerebral blood flow (rCBF) in the somatosensory cortices and inceases in the ipsilateral anterior cingulate (AC) cortex. We also hypothesize that during exposure to personally relevant, stressful imagery, patients, compared to controls will show a) smaller increases in salivary cortisol; and b) greater increases in blood pressure, pulse rate, thermal pain intensity and unpleasantness ratings, and thermal pain-induced change in the contralateral and ipsilateral somatosensory cortices as well as in the ipsilateral AC cortex. This study will allow us to assess the effects of stress on pain perception and functional brain activity in patients with FM independently of the influence of affective disorders.