Brain Mechanisms Supporting Individual Differences in Pain

描述(申请人提供)：急性和慢性疼痛都与人类痛苦的不可估量的代价有关，并且是一个重大的经济问题。治疗疼痛的主要挑战之一来自对疼痛的主观报告的巨大个体间差异。有类似损伤的人通常会报告非常不同的疼痛体验。由于对疼痛主观报告的有效性或真实性的担忧，这种个体差异往往导致治疗不充分。尽管疼痛的个体差异具有深远的临床意义，但人们对支持这种差异的基本大脑机制知之甚少。主观上这种个体间差异的一部分 疼痛的报告可能是由于身体因素，如大脑连接。其他因素来自心理倾向，可能涉及认知控制、冲动、抑郁和焦虑等因素。最后，性别和种族等人口统计变量也可能在很大程度上导致疼痛敏感度的个体差异。令人惊讶的是，人们对这些因素在单个个体水平上影响疼痛体验构建的大脑机制知之甚少。因此，这项拟议研究的基本目的是描绘导致疼痛敏感性个体差异的大脑机制。我们将从大量(392名)志愿者那里获得功能和结构磁共振数据。招聘的目的将是获得真正的社区样本，以促进调查结果的推广。因此，这项研究将涉及不同社会经济水平的个人、肥胖个人、患有严重抑郁和焦虑的个人以及那些身心健康状况良好的人。参与者还将接受广泛的感觉测试和心理评估，以全面描述他们的疼痛表型。多元回归统计分析将被用来识别与结构和功能神经成像数据中个体间敏感性差异相关的大脑区域。诸如心理生理相互作用分析等技术将被用来检验关于功能连接对疼痛敏感性的影响的假说。大脑支持机制的识别 疼痛敏感性的个体差异将大大有助于我们对疼痛的大脑机制的基本理解，并将批判性地评估我们现有的观念，即每个人都以相同的方式处理伤害性信息。建议的研究结果将为个性化疼痛治疗策略的发展提供坚实的理论基础。

DESCRIPTION (provided by applicant): Both acute and chronic pain are associated with an incalculable toll in human suffering and present a significant economic problem. One of the major challenges in treating pain arises from the tremendous inter- individual variation in subjective reports of pain. Individuals with similar injuries will frequently report vastly differet experiences of pain. Such individual differences often result in inadequate treatment due to concerns about the validity or veracity of subjective reports of pain. Despite the profound clinica significance of individual differences in pain, remarkably little is known about the basic brain mechanisms that support such differences. Portions of this inter-individual variation in subjective reports of pain may be due to physical factors such as brain connectivity. Other components arise from psychological disposition and may involve factors such as cognitive control, impulsivity, depression, and anxiety. Finally, demographic variables such as sex and ethnicity may also substantially contribute to individual differences in pain sensitivity. Surprisingly littl is known about the brain mechanisms by which these factors influence the construction of the pain experience at the level of a single individual. Thus, the fundamental aim of the proposed research is to delineate the brain mechanisms that give rise to individual differences in pain sensitivity. We will acquire both functional and structural MRI data from a large number (392) of volunteers. Recruitment will be designed to obtain a true community sample in order to facilitate generalizability of findings. As such, this research will involve individuals of differing socio-economic levels, obese individuals, individuals with active depression and anxiety, as well as those in excellent physical and mental health. Participants will also undergo extensive sensory testing and psychological evaluation in order to fully characterize their pain phenotype. Multiple regression statistical analyses will be used to identify brain regions related to inter-individual differences in sensitivity in both structural and functional neuroimaging data. Techniques such as psychophysiological interaction analyses will be used to test hypotheses about the influence of functional connectivity on pain sensitivity. The identification of brain mechanisms that support individual differences in pain sensitivity will contribute substantially to our basic understandingof brain mechanisms of pain and will critically evaluate our existing notions that every individual processes nociceptive information in the same way. The results from the proposed studies will provide a solid rationale for the development of individualized pain treatment strategies.