Brain Activation and Pain Reports in People with Alzheimer's Disease

 描述(申请人提供)：阿尔茨海默病(AD)老年患者的疼痛治疗不当是一个严重的公共卫生问题，了解与AD相关的疼痛功能差异是美国国家老龄研究所(NIA)的优先领域。与健康成年人相比，在存在类似已知疼痛情况的情况下，患有阿尔茨海默病的老年人接受的止痛药较少。造成这种差异的原因人们知之甚少。疼痛治疗不当会对生活质量产生负面影响，并增加医疗保健成本。探索疼痛过程中变化的生物学原因对于增加我们对疼痛的理解是必不可少的。 患有老年痴呆症的老年人。有证据表明，阿尔茨海默病患者的大脑结构和功能会发生改变。然而，目前尚不清楚这些结构和功能神经系统的改变如何影响AD患者对疼痛的心理物理和神经生理反应。这一职业发展项目的目标是为PI提供过渡所需的培训和技能 一个独立科学家的导师角色，专注于疼痛、衰老和痴呆症。职业发展计划在第一年和第二年实现了培训和课程工作的平衡，在第三年和第四年增加了研究和独立性。培训将包括选定的课程，以增加特定领域的知识(神经科学、神经生物学、伦理学、赠款撰写和领导力)。此外，还包括讲习班，以提高设计研究和进行神经成像分析所需的技能。这项拟议的研究将研究患有和不患有AD的老年人对急性实验性热痛的心理物理反应有何不同，以及这些差异如何映射到局部和网络的脑功能变化。实验性急性热痛分娩可以很好地预测对痛苦医疗条件的反应。我们建议检测健康成年人(65岁或以上)和老年AD匹配成年人(65岁或以上)对实验性热刺激的心理物理和神经生理学反应。这项研究的目的是确定患有和不患有AD的成年人在皮肤热刺激期间的感觉(刺激强度)和情感(刺激不快)反应是否不同。我们假设阿尔茨海默病与感觉性疼痛和情感疼痛系统的迟钝反应有关。这些变化可能源于与AD相关的大脑结构和功能的变化，以及与疼痛相关的大脑网络的特定变化。检测患有和不患有AD的成年人之间实验性热疼痛的基线差异将为了解可能导致未经治疗的疼痛风险的因素以及在老年人群中开发新的评估、预防和治疗策略提供基础。

 DESCRIPTION (provided by applicant): Poorly treated pain in older adults with Alzheimer's disease (AD) is a critical public health problem, and understanding AD-related differences in pain function is an National Institute of Aging (NIA) priority area. When compared to healthy adults, and in the presence of similar known painful conditions, older adults with AD receive less pain medication. Reasons for this discrepancy are poorly understood. Inadequately treated pain negatively impacts quality of life and increases health care costs. Exploring the biological reasons for alterations in pain processing is essential for increasing our understanding of pain in older adults with AD. Evidence suggests that brain structure and brain function are altered in AD. However, it is unclear how these structural and functional nervous system alterations impact psychophysical and neurophysiological responses to pain in AD. The goals of this career development project are to provide the PI with the training and skills necessary to transition from a mentored role to an independent scientist focused on pain, aging, and dementia. The career development plan strikes a balance of training and coursework in years one and two, with increased research and independence in years three and four. Training will include courses selected to increase knowledge in specific areas (neuroscience, neurobiology, ethics, grant writing, and leadership). In addition, workshops are included that will increase the skills necessary to both design studies and carry out neuroimaging analysis. The proposed research will examine how psychophysical responses to acute experimental thermal pain differs between older adults with and without AD, and how these differences map onto regional and network brain functional changes. Experimental acute thermal pain delivery predicts well the response to painful medical conditions. We propose to examine the psychophysical and neurophysiological response to experimental thermal stimuli in healthy adults (aged 65 or older) and aged match adults with AD (aged 65 or older). The aims of this study are to determine whether sensory (stimulus intensity) and affective (stimulus unpleasantness) responses differ in adults with and without AD during cutaneous thermal stimulation. We hypothesize that AD will be associated with a blunted response in sensory pain and affective pain systems. These changes may arise from AD-associated changes in brain structure and function as well as from specific alterations in pain-related brain networks. Examining baseline differences in experimental thermal pain between adults with and without AD will provide a foundation for understanding factors that may contribute to untreated pain risk, as well as for developing novel assessment, prevention, and treatment strategies in the older population.