NIH Clinical Research Studies

Protocol Number: 04-D-0125

Active Accrual, Protocols Recruiting New Patients

Title:
Imaging Neural Mechanisms Underlying Pain Modulation
Number:
04-D-0125
Summary:
This study will evaluate brain pathways involved in feeling pain and pain relief following administration of pain medication. Magnetic resonance imaging (MRI) will be used to measure brain activity at sites that become more active following oral surgery and then to see if the activity changes after pain medication is administered. MRI combines a powerful magnet with an advanced computer system and radio waves to produce detailed pictures of organs and tissues. During the scan, the subject lies on a table in a narrow cylinder containing a magnetic field. He or she can speak with a staff member via an intercom system at all times during the procedure.

Healthy dental patients recruited through the NIH Clinical Research Volunteer Program may enroll in this study. Participants will undergo the following tests and procedures in two clinic visits:

Visit 1 - Sensitivity Testing

Participants are tested for sensitivity to warm and hot temperatures. A probe is applied to the skin (usually the forearm) and heated to temperatures ranging from room temperature to that of a hot cup of coffee. Participants rate the temperature using a scale ranging from "no pain" to the "worst pain imaginable" and rate the unpleasantness of the heat using a similar scale. The probe is applied up to 30 times, using random heat intensities. Participants are also asked compare the heat intensity to varying levels of sounds and to rate the magnitude of different sensations they have experienced in the past, such as the brightness of the sun and the loudness of a jet plane. A blood sample of about 2 ounces is also collected at this visit for DNA analysis to look for genes related to pain.

Visit 2 - Oral Surgery

Under local anesthetic, participants undergo extraction of their lower right wisdom tooth. After surgery, the patient is moved to the MRI scanner for brain imaging over 1-2 hours while the local anesthetic wears off. Patients may request a postoperative pain drug (Toradol) during the procedure, if needed. When the scan is complete, patients are dismissed from the clinic with additional pain medication (flurbiprofen) to use at home as directed.

Sponsoring Institute:
National Institute of Dental And Craniofacial Research (NIDCR)
Recruitment Detail
Type: Active Accrual Of New Subjects
Gender: Male & Female
Referral Letter Required: No
Population Exclusion(s): None

Eligibility Criteria:
ELIGIBILITY CRITERIA:

Subjects will be a convenience sample selected from the pool of 500 - 700 new patients screened annually for acute pain studies. Inclusion and Exclusion criteria will be applied to result in a homogeneous population of subjects with respect to the surgical difficulty of the tooth being extracted, a single lower right third molar.

Special Instructions: Currently Not Provided
Keywords:
MRI
NSAID Analgesia
Pain Mechanisms
SNP's
Acute Pain
Recruitment Keywords:
Wisdom Teeth
Third Molar Extraction
Third Molar Impaction
Conditions:
Healthy
Tooth Extraction
Investigational Drug(s):
None
Investigational Device(s):
None

Contacts:
Patient Recruitment and Public Liaison Office
Building 61
10 Cloister Court
Bethesda, Maryland 20892-4754
Toll Free: 1-800-411-1222
TTY: 301-594-9774 (local),1-866-411-1010 (toll free)
Fax: 301-480-9793

Electronic Mail:prpl@mail.cc.nih.gov

Citations:
Bingel U, Quante M, Knab R, Bromm B, Weiller C, Buchel C. Related Articles, Links Abstract Subcortical structures involved in pain processing: evidence from single-trial fMRI. Pain. 2002 Sep;99(1-2):313-21. PMID: 12237210

Apkarian AV, Krauss BR, Fredrickson BE, Szeverenyi NM. Related Articles, Links Abstract Imaging the pain of low back pain: functional magnetic resonance imaging in combination with monitoring subjective pain perception allows the study of clinical pain states. Neurosci Lett. 2001 Feb 16;299(1-2):57-60. PMID: 11166937

Chen AC. Related Articles, Links Abstract New perspectives in EEG/MEG brain mapping and PET/fMRI neuroimaging of human pain. Int J Psychophysiol. 2001 Oct;42(2):147-59. Review. PMID: 11587773

Active Accrual, Protocols Recruiting New Patients

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