TWIN STUDY OF CHRONIC WIDESPREAD PAIN

这个子项目是许多研究子项目中的一个 由NIH/NCRR资助的中心赠款提供的资源。子项目和 研究者（PI）可能从另一个NIH来源获得了主要资金， 因此可在其他CRISP条目中表示。所列机构为 研究中心，而研究中心不一定是研究者所在的机构。 慢性广泛性疼痛（CWP）发生在4-13%的人群中，是纤维肌痛（FM）的定义特征之一。FM的复杂性和CWP的连续性使我们发展了一个多维的CWP理论模型。诱发因素是特别感兴趣的这个模型，因为这些代表发病前的风险或保护因素，与发展的CWP。此外，诱发因素可以与作为病症的结果而发生的疾病相关特征区分开。双胞胎对照研究是一个强有力的手段，检查特定的假设的病因和后果的CWP来自我们的模型。40对MZ和40对DZ双胞胎对CWP不一致，沿着40对MZ和DZ无痛对照双胞胎对将从华盛顿大学双胞胎登记处招募。双胞胎将接受自主神经系统（ANS）功能，下丘脑-垂体-肾上腺（HPA）轴功能，运动能力，睡眠和活动水平，诱发疼痛处理，以及涉及CWP的精神和心理社会因素的强化评估。有两个具体目标：1）评估ANS功能、HPA轴功能、运动能力、睡眠和活动水平、诱发疼痛敏感性以及精神和心理社会因素的配对内差异。2)评估配对间效应，以确定CWP与上述疾病特征之间的关联是否是由于遗传或常见环境因素。调查双胞胎群体之间的差异模式有助于区分易患CWP的因素和发病后发生的因素。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Chronic widespread pain (CWP) occurs in 4-13% of people and is one of the defining characteristics of Fibromyalgia (FM). The complexity of FM and the continuum of CWP have led us to develop a multidimensional theoretical model of CWP. Predisposing factors are of particular interest in this model since these represent premorbid risk or protective factors that relate to the development of CWP. Further, predisposing factors can be differentiated from illness-associated features that occur as a consequence of the condition. A co-twin control study is a powerful means for examining specific hypotheses about the etiology and consequences of CWP derived from our model. Forty MZ and 40 DZ twin pairs discordant for CWP, along with 40 MZ and DZ pain-free control twin pairs will be recruited from the population-based University of Washington Twin Registry. Twins will undergo an intensive evaluation of autonomic nervous system (ANS) function, hypothalamic-pituitary-adrenal (HPA) axis function, exercise capacity, sleep and activity levels, evoked pain processing, and psychiatric and psychosocial factors involved in CWP. There are 2 Specific Aims: 1) To assess within-pair differences in ANS function, HPA axis function, exercise capacity, sleep and activity levels, evoked pain sensitivity, and psychiatric and psychosocial factors. 2) To assess between-pair effects to determine if the association between CWP and the above illness characteristics is due to genetics or common environmental factors. Investigating the pattern of differences between twin groups can help to distinguish factors that are predisposing to CWP and those that occur after the onset of the illness.