Supraspinal Processing of Sensory Aspects of Pain

项目摘要 在美国，慢性疼痛影响大约20%的成人和儿童，并且是慢性疼痛的主要来源。 残疾和医疗费用。慢性疼痛可能是具有挑战性的诊断，由于存在不良的 了解症状。当确诊时，目前对疼痛的药物治疗显着 无效，而有效的非药物治疗仍然没有得到充分利用。这些缺点在 疼痛的诊断和治疗源于我们对基本中枢神经系统知识的巨大缺口。 处理伤害感受信息并实例化疼痛体验的系统。这些差距正在 由于缺乏基础/转化研究，在儿科慢性疼痛的情况下进一步放大。我们的团队的 基础科学家和临床科学家处于独特的地位，可以进行人类儿科研究， 功能性神经成像与定量感觉测试和心理评估，以描绘大脑 系统在慢性疼痛中的作用。我们将研究四种不同的慢性疼痛综合征：偏头痛， 复杂区域疼痛综合征、功能性腹痛和肌肉骨骼疼痛。1）识别 共享和不同的大脑系统参与不同形式的儿科慢性疼痛，2）确定是否 在不同的慢性疼痛条件下，恢复的预测因素不同，3）描述相关的大脑系统 痛苦的蔓延。我们将在开始治疗后对患者进行1年的纵向随访，以评估 疼痛的恢复和扩散程度。这项研究将提供一个关键的基础知识， 不同形式慢性疼痛的诊断标志物的未来临床试验和新的 治疗慢性疼痛。

PROJECT SUMMARY Chronic pain affects approximately 20% of both adults and children in the US and is a source of substantial disability and health care costs. Chronic pain can be challenging to diagnose due to the presence of poorly understood symptoms. When diagnosed, current pharmacologic treatments for pain are remarkably ineffective, while effective non-pharmacologic treatments remain under-utilized. These shortcomings in the diagnosis and treatment of pain arise from tremendous gaps in our knowledge about the basic central nervous system systems that process nociceptive information and instantiate an experience of pain. These gaps are further amplified in the case of pediatric chronic pain due to a lack of basic/translational research. Our team of basic scientists and clinician scientists is uniquely positioned to perform human pediatric studies integrating functional neuroimaging with quantitative sensory testing and psychological assessments to delineate brain systems engaged during chronic pain. We will examine four distinct chronic pain syndromes: migraine, complex regional pain syndrome, functional abdominal pain, and musculoskeletal pain. We seek to 1) Identify shared and distinct brain systems engaged by different forms of pediatric chronic pain, 2) Determine if predictors of recovery differ across different chronic pain conditions, 3) Delineate brain systems associated with the spread of pain. We will follow patients longitudinally for 1 year after initiation of treatment to assess the degree of recovery and spread of pain. This study will provide a critical foundation of basic knowledge for future clinical trials of diagnostic markers for different forms of chronic pain and for the development of new treatments for chronic pain.