Mindfulness and Mechanisms of Pain Processing in Adults with Migraines

 描述(由申请人提供)：建议的K23奖项的目标是为候选人提供所需的高级技能和培训，以成为一名独立的调查者，评估偏头痛疼痛的机制以及身心干预治疗的有效性和机制。为了促进这一长期的职业目标，候选人将与健康对照组比较，检查偏头痛患者对实验性疼痛的感觉和情感反应。此外，候选人将评估为期8周的标准化心身干预-基于正念的压力减轻(MBSR)对成人偏头痛患者临床和实验疼痛的感觉和情感方面的影响和机制，并确定临床疗效的预测因素。这位候选人已经组建了一支由导师组成的专家团队来帮助她实现这些目标。全面的培训计划包括在疼痛神经生物学、疼痛定量评估的最新方法、统计学、正式课程作业、关于赠款和手稿写作的会议和研讨会以及其他相关职业发展主题方面所需的重要额外培训。这位候选人组建了一支出色的、多学科的指导和咨询团队，以促进她的研究和培训，他们在疼痛机制、感觉/疼痛测试、头痛、统计学、心身医学、临床研究和职业发展方面的综合专业知识。在他们的支持下，她将完成以下具体的培训目标：(1)获得疼痛和头痛的神经生物学方面的高级培训和知识；(2)发展疼痛定量测量方面的专业知识；(3)扩展心身医学知识和培训技能；(4)提高临床试验方法和负责任的研究方法方面的技能；(5)通过进一步的技能培训加强统计技能；(6)继续培养专业发展技能。培训计划将与一组拟议的研究协调进行，这些研究建立在候选人的初步数据基础上，这些数据证明了MBSR对成人偏头痛的有益影响。这位候选人提出的研究涉及三个具体目标。目的1旨在评估偏头痛患者(发作间歇期)与健康对照组对实验性热痛(疼痛强度、疼痛不适、情绪反应和疼痛灾变)的反应。目的2旨在测试与教育对照组相比，成人偏头痛患者的MBSR对临床头痛、实验性热痛、正念、疼痛接受、疼痛灾变、情绪反应和头痛相关残疾的影响。目的3确定预测偏头痛患者临床头痛MBSR反应的因素。这些目标的成功完成将促进对偏头痛的机制和对偏头痛的身心干预的理解，也可能适用于其他临床疼痛情况。来自此K23的额外培训将启动 候选人的职业生涯是一名独立的临床医生兼研究员，并最终成为综合医学和头痛研究领域的领先者。

 DESCRIPTION (provided by applicant): The goal of the proposed K23 award is to provide the Candidate with the advanced skills and training needed to become an independent investigator evaluating the mechanisms of migraine pain and the efficacy and mechanisms of mind-body interventions for treatment. To facilitate this long-term career goal, the Candidate will examine the sensory and affective responses to experimental pain in migraineurs compared to healthy controls. In addition, the Candidate will assess the impact and mechanisms of an 8-week standardized mind-body intervention, Mindfulness-Based Stress Reduction (MBSR), on the sensory and affective aspects of clinical and experimental pain in adults with migraines, and determine predictors of clinical efficacy. The Candidate has assembled an expert team of mentors to help her achieve these goals. A comprehensive training plan includes important additional training needed in the neurobiology of pain, state-of-the-art methodologies of the quantitative assessment of pain, statistics, formal coursework, and conferences and seminars addressing grant and manuscript writing, as well as other relevant career development topics. The Candidate has assembled a stellar, multidisciplinary mentorship and advisory team tailored to facilitate her research and training with their combined expertise in pain mechanisms, sensory/pain testing, headache, statistics, mind-body medicine, clinical research, and career development. With their support, she will accomplish the following specific training goals: (1) gain advanced training and knowledge in the neurobiology of pain and headache; (2) develop expertise in the quantitative measurements of pain; (3) expand mind-body medicine knowledge and training skills; (4) improve skills in clinical trial methodology and responsible conduct of research; (5) build on statistical skills with further skill training; (6) continue building profesional development skills. The training plan will be conducted in coordination with a proposed set of studies that build upon the Candidate's preliminary data that demonstrated a beneficial effect of MBSR in adults with migraines. The Candidate's proposed research involves three Specific Aims. Aim 1 is designed to assess response to experimental heat pain (pain intensity, pain unpleasantness, emotional reactivity, and pain catastrophizing) in migraineurs (interictally) vs. healthy controls. Aim 2 seeks to test the impact of MBSR in adults with migraines on clinical headache pain, experimental heat pain, mindfulness, pain acceptance, pain catastrophizing, emotional reactivity and headache-related disability compared to an education control group. Aim 3 is to determine the factors that predict MBSR response on clinical headache pain in migraine patients. Successful completion of these aims will advance the understanding of the mechanisms of migraine pain and of mind- body interventions for migraine, and also may be applicable to other clinical pain conditions. The additional training from this K23 will launch the Candidate's career as an independent clinician-investigator and ultimately a leader in the fields of integrative medicine and headache research.