Molecular and Functional PET-fMRI Measures of Placebo Analgesia in Migraine

描述(申请人提供)：本申请的目标是通过同时测量脑功能(FMRI)和阿片受体可用性(11C-carnetanil PET)来研究无头痛偏头痛患者的安慰剂止痛。通过在相关临床人群中研究安慰剂效应，我们将获得关于大脑功能、化学以及关键的它们相互作用的独特数据。众所周知，持续性疼痛会改变大脑的结构、功能、连通性和化学成分。此外，持续的慢性疼痛影响实验性疼痛，使得解释来自患者群体的结果变得困难。差异是由于大脑的改变，还是由于慢性疼痛的持续体验？通过研究发作间歇期(无头痛)的偏头痛患者，我们可以排除后者和 描述有疼痛改变(但无疼痛)的大脑中的安慰剂止痛，与健康大脑相比。通过同时使用功能磁共振成像和PET成像，我们将提供关于脑血流变化(功能磁共振成像)和内源性阿片释放(PET)如何相互作用的新数据，以创造安慰剂止痛的主观体验。这将对安慰剂反应的理解提供一个新的水平，并为研究和开发临床安慰剂反应的预测性生物标志物奠定基础。

DESCRIPTION (provided by applicant): The goal of this application is to study placebo analgesia in headache-free migraine patients using simultaneous measures of brain function (fMRI) and ¿-opioid receptor availability (11C-carnetanil PET). By studying the placebo effect in a relevant clinical population, we will obtain unique data on brain function, chemistry, and, critically, their interaction. It is well established that persistent pain changes bothstructure, function, connectivity and chemistry of the brain. Moreover, ongoing chronic pain influences experimental pain, making interpretations of results derived from patient populations difficult. Are differences due to the altered brain, or due to the ongoing experience of chronic pain? By studying migraine patients in the inter-ictal (headache free) state, we can rule out the latter and describe placebo analgesia in pain-altered (but pain free) brains, as compared to healthy brains. By employing simultaneous fMRI and PET imaging, we will be provide novel data on how brain blood flow changes (fMRI) and endogenous opioid release (PET) interact to create the subjective experience of placebo pain reduction. This will provide a new level of understanding of placebo responses, and lay a foundation for studying and developing predictive biomarkers for clinical placebo responses.