Posterior cerebellar resection and pain processing in the pediatric brain

描述（由申请人提供）：该R21应用程序旨在确定小脑损伤对疼痛感觉和大脑疼痛处理的影响。疼痛是由感觉、情感和认知维度组成的主观体验。研究实验和临床疼痛的人类功能成像研究一致发现小脑激活，尽管其功能意义尚不清楚。最初被认为反映了运动回路对疼痛的反应，儿童和成人小脑损伤后认知和情感缺陷的特征表明在疼痛处理中起着重要作用。我们还发表了一些工作，表明小脑可能是负面情绪的多模式调制器，是疼痛处理的重要组成部分。然而，据我们所知，对小脑肿瘤切除术后疼痛感觉变化的彻底调查从未报道过。这个项目的假设是，小脑后部调节情感脑回路，以下调对伤害性刺激的疼痛感知。具体目的是（1）通过感觉测试确定小脑肿瘤切除术对疼痛感知的影响，以及（2）通过功能性磁共振成像确定切除术对大脑疼痛处理的影响。波士顿儿童医院将提供一个理想的临床研究环境，以有效地招募病人，并评估他们与感官测试和神经成像。长期目标是确定小脑在疼痛处理中的作用。

DESCRIPTION (provided by applicant): This R21 application is designed to determine the impact of cerebellar damage on pain sensation and pain processing in the brain. Pain is a subjective experience comprised of sensory, affective, and cognitive dimensions. Human functional imaging studies investigating experimental and clinical pain consistently find cerebellar activation, though its functional implications are unclear. Initially thought to reflecta motor circuit response to pain, the characterization of cognitive and affective deficits following cerebellar damage in children and adults suggest a fundamental role in pain processing. We have also published work that suggests that the cerebellum may serve as a multimodal modulator of negative affect, a significant component in pain processing. However, as far as we know, a thorough investigation of changes in pain sensation following cerebellar tumor resection has never been reported. The hypothesis of this project is that the posterior cerebellum modulates affective brain circuits to down-regulate pain perception in response to noxious stimuli. The specific aims are (1) to define the consequences of cerebellar tumor resection on pain perception with sensory testing, and (2) define the consequences of resection on pain processing in the brain with functional magnetic resonance imaging. Boston Children's Hospital will provide an ideal clinical research environment to efficiently recruit patients, and to evaluat them with sensory testing and neuroimaging. The long-term goal is to identify the role of the cerebellum in pain processing.