Prognostic biomarkers for high-impact chronic pain: Development and validation

高影响力慢性疼痛的预后生物标志物：开发和验证

• 批准号: 10157953
• 负责人: SEAN C MACKEY
• 金额: $ 725.54万
• 依托单位: STANFORD UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-30 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10157953
• 关键词: Accelerometer; Adult; Affect; American; Anxiety; Area Under Curve; Behavioral; Biological; Biological Markers; Biology; Chronic; Clinical; Clinical Trials; Computer Analysis; Data; Data Set; Demographic Factors; Development; Diagnostic; Dimensions; Enrollment; Functional disorder; Future; Goals; Immune; Individual; Interdisciplinary Study; Link; Machine Learning; Measures; Modality; Modeling; Musculoskeletal; Neuraxis; Outcome; Pain; Pain interference; Pain management; Patients; Phase; Population; Preventive treatment; Prognostic Marker; Public Health; Publishing; Recovery; Refractory; Risk; Risk stratification; Sample Size; Self Care; Sensory; Severities; Sleep; Social isolation; Societies; Structure; Subgroup; Validation; Work; actigraphy; analysis pipeline; base; biopsychosocial; candidate marker; chronic musculoskeletal pain; chronic pain; chronic pain patient; cohort; conditioned pain modulation; cost; diagnostic biomarker; experience; individualized medicine; insight; large datasets; machine learning algorithm; microbiome; multidisciplinary; multimodality; multiple omics; neuroimaging; new therapeutic target; novel marker; opioid use disorder; patient stratification; predictive modeling; prescription opioid; prognostic; prognostic signature; prognostic value; psychosocial; recruit; social; treatment strategy; treatment stratification

PROJECT SUMMARY Chronic pain represents a public health crisis that affects more than 100 million Americans and costs over $500 billion dollars annually. Chronic musculoskeletal pain conditions comprise 70-80% of all chronic pain. An estimated 8% of US adults suffer from high-impact chronic pain, or pain associated with substantially restricted work, social, and self-care activities for six or more months. Chronic pain—and high-impact chronic pain in particular—is often treated with prescription opioids and is linked to opioid-use disorder. Multidisciplinary chronic pain treatments show incomplete recovery at the population level. However, subgroups of individuals completely respond, do not change, or even worsen following pain management. Thus, robust and validated diagnostic and prognostic biomarkers are needed to identify those with high-impact chronic pain and determine the trajectory of outcome (i.e., recovery versus persistence), respectively. Therefore, our overall goal is to discover and validate diagnostic and prognostic biomarkers for musculoskeletal high-impact chronic pain. This goal will require comprehensive, multidimensional assessments with an integrated dataset and a sophisticated computational analysis pipeline to yield reliable and validated diagnostic and prognostic biomarkers. To this end, we have assembled an interdisciplinary research and clinical team to implement the HEAL initiative. The goal of this initiative is to elucidate diagnostic and prognostic biomarker signatures of chronic pain by integrating CNS, multiomic, sensory, functional, psychosocial, and demographic domains. We will achieve this goal through two specific aims: (1) develop diagnostic and prognostic markers of musculoskeletal high-impact chronic pain following multidisciplinary pain treatment (R61 Discovery Phase) and (2) analytically validate the multimodal signatures developed in the first aim (R33 Validation Phase). This proposal will yield valid and clinically useful diagnostic and prognostic biomarker signatures to facilitate risk and treatment stratification in patients with musculoskeletal chronic pain. Such biomarkers are essential to develop safer, more effective patient-specific treatment strategies, particularly for those who are refractory to current pain management options. We will also identify potentially modifiable biological and behavioral factors that can change the course of the pain trajectory and thereby reduce the impact of chronic pain on the individual and society as a whole.

项目总结