TMS Effects on Pain Perception

描述（由申请人提供）：本K23的目的是支持申请人获得必要的技能，以开展以患者为导向的疼痛和共病精神疾病新治疗方法的研究。慢性疼痛是一个巨大的公共卫生问题，在基本的神经生物学水平上，人们通常知之甚少。缺乏在疼痛神经生物学方面受过足够训练的人，他们也缺乏对新疗法进行高质量临床评估的技能。候选人希望支持培训，使其成为一名临床转化科学家，在评估新疗法方面具有特定的专业知识，这将为他的职业生涯奠定基础，使他成为开发和评估新的慢性疼痛躯体或设备治疗方法的领导者。候选人将熟悉新的治疗方法，如经颅磁刺激（TMS），迷走神经刺激和深部脑刺激。该奖项的培训方面将侧重于增加候选人在功能神经解剖学，疼痛的经验和理论机制以及基于技术的治疗方面的知识。在此基础上，该研究项目将重点研究经颅磁刺激对疼痛感知的影响。先前的研究表明，经颅磁刺激可以减轻健康成人和临床样本的疼痛。然而，关于经颅磁刺激和疼痛的系统研究相对较少，这些研究涉及最佳的经颅磁刺激装置参数、最佳皮层靶点以及健康受试者和慢性疼痛人群对经颅磁刺激反应的潜在差异。本研究项目的具体目的是：1)验证经颅磁刺激运动皮层对痛觉变化的重复性，研究镇痛效果的持续时间；2)确定与受控实验室疼痛刺激下急性疼痛感知变化最大相关的TMS装置参数；3)确定哪些经颅磁刺激皮层靶点与痛觉变化最大相关；4)确定实验室调查结果是否适用于三叉神经痛患者。该培训计划和研究项目将以候选人在临床心理学、统计学、心理生理学和计算机编程方面的知识基础为基础，帮助候选人成为开发和评估疼痛新疗法的创新和批判性专家。

DESCRIPTION (provided by applicant): The purpose of this K23 is to provide support for the candidate to acquire the skills necessary to conduct patient-oriented research on novel treatments for pain and co-morbid psychiatric disorders. Chronic pain represents a huge public health concern and is generally poorly understood at a basic neurobiological level. There is a lack of individuals with adequate training in the neurobiology of pain who also have the skills to perform high quality clinical evaluations of new treatments. The candidate wishes support for training to become a clinical translational scientist with specific expertise in evaluating novel treatments that will serve as the foundation for his career as a leader in the development and evaluation of new somatic or device-based treatments for chronic pain. The candidate will become familiar with new treatments such as transcranial magnetic stimulation (TMS), vagus nerve stimulation, and deep brain stimulation. The training aspects of the Award will focus on increasing the candidate's knowledge regarding functional neuroanatomy, empirical and theoretical mechanisms of pain, and technology-based treatments. Building on this foundation, the research project will focus on investigating the effects of TMS on pain perception. Previous research suggests that TMS may reduce pain in healthy adults and clinical samples. However, there is relatively little systematic research on TMS and pain that addresses optimal TMS device parameters, optimal cortical targets, and potential differences in response to TMS between healthy subjects and chronic pain populations. The Specific Aims of the research project are to: 1) Test for replication, findings that stimulation of the motor cortex with TMS results in changes in pain perception and investigate the duration of analgesic effect; 2) Determine the TMS device parameters that are associated with the largest changes in acute pain perception to controlled laboratory pain stimuli; 3) Determine which TMS cortical targets are associated with the largest changes in pain perception; and 4) Determine if findings from the laboratory investigations generalize to patients with trigeminal neuralgia. Building on the candidate's knowledge base in clinical psychology, statistics, psychophysiology and computer programming, the proposed training program and research project will help the candidate develop into an innovative and critical expert in developing and evaluating new treatments for pain.