Impact of CBT for Insomnia on Pain Symptoms and Central Sensitization in Fibromyalgia.
CBT 治疗失眠对纤维肌痛疼痛症状和中枢敏化的影响。
基本信息
- 批准号:10163918
- 负责人:
- 金额:$ 59.41万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2018
- 资助国家:美国
- 起止时间:2018-08-27 至 2023-05-31
- 项目状态:已结题
- 来源:
- 关键词:AffectAffectiveAftercareAnteriorAreaArousalBrainBrain regionCharacteristicsChronic InsomniaCognitionCognitiveCognitive TherapyCollectionDimensionsExhibitsFeedbackFibromyalgiaGoalsHealthcare SystemsInferior frontal gyrusInsula of ReilLateralLeadLinkLong-Term EffectsMedialMediatingMediator of activation proteinMethodologyModelingNervous System PhysiologyNeuraxisNeuronal PlasticityOutcomePainPatternPeripheralPrefrontal CortexPublic HealthResolutionRestRoleSleepSleep disturbancesSleeplessnessStimulusStressStructureSuggestionTestingThickThinnessTimeactive comparatorbaseblood oxygen level dependentbrief interventioncentral sensitizationchronic painchronic pain patientcingulate cortexcingulate gyrusclinical paincognitive testingfibromyalgia painfibromyalgia patientsgray matterheart rate variabilityimprovedimprovement on sleepneuroimagingneuromechanismnovelpain processingpain sensitivitypain symptompilot trialpoor sleeprelating to nervous systemresponsesleep healthsleep onsettheorieswhite matter
项目摘要
PROJECT SUMMARY
Chronic pain patients exhibit maladaptive neural plasticity compared to controls. Further, insomnia affects
67-88% of chronic pain patients. We hypothesize that pain processing and sleep share common neural
underpinnings and thus, improving sleep may reverse pain related maladaptive neural plasticity and improve
clinical pain. The Cognitive Activation Theory of Stress (CATS) provides a model linking chronic insomnia
and pain. CATS asserts sustained arousal and lack of arousal resolution (through restful sleep) lead to critical
changes in CNS functioning (aka Central Sensitization, CS) that result in increased pain sensitivity. We recently
examined cognitive behavioral treatments for insomnia (CBT-I) and pain (CBT-P) in fibromyalgia (FM)
patients. We found novel preliminary evidence that improved sleep, decreased pain-related cognitive-affective
arousal, and neural plastic changes suggestive of CS reversal (i.e., normalized brain function in pain processing
areas) were associated with improved pain following CBT-I. This is the first evidence of its kind.
Consistent with CATS, we hypothesize that pain improvements are mediated by improvements in
arousal, sleep, and CS immediately following CBT-I. In the trial proposed herein, we examine the novel
hypothesis that a sustained feedback loop of improvements in arousal, sleep, and CS will result in sustained (or
possibly increased) pain improvements over time.
The proposed study has four specific aims. Aim 1 examines the effects of CBT-I on arousal, sleep, and pain
in FM patients. Inclusion of peripheral arousal is novel as it was not tested in our previous trial. Aim 2 examines
treatment related changes in resting state brain activity as well as neural activation patterns of functional brain
networks and Blood-Oxygen-Level Dependent (BOLD) responses to painful stimuli in regions associated with
pain processing. Aim 3 investigates the longitudinal impact of treatment on brain structures associated with
pain. Aim 4 examines the mediating impact of arousal, sleep, and CS on pain and evaluates whether these
mediating effects explain unique variance of pain improvement over and beyond the mediating effects of global
or possibly pain- and/or sleep-specific cognitive-affective factors. All hypotheses tested are consistent with our
conceptual model – CATS.
Public Health Implications: Demonstration that a relatively brief intervention can reverse or even resolve
pain related maladaptive neural plasticity, and improve or even resolve clinical pain would have immediate and
far-reaching implications for millions of chronic pain sufferers and the US healthcare system and economy.
项目总结
项目成果
期刊论文数量(0)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
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Christina S McCrae其他文献
Christina S McCrae的其他文献
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{{ truncateString('Christina S McCrae', 18)}}的其他基金
Improving Sleep and Reducing Opioid Use in Individuals with Chronic Pain
改善慢性疼痛患者的睡眠并减少阿片类药物的使用
- 批准号:
10587972 - 财政年份:2023
- 资助金额:
$ 59.41万 - 项目类别:
Web-based CBT for Insomnia in Rural Dementia Caregivers: Examination of Sleep, Arousal, Mood, Cognitive, and Immune Outcomes
针对农村痴呆症护理人员失眠的基于网络的 CBT:睡眠、觉醒、情绪、认知和免疫结果的检查
- 批准号:
10610439 - 财政年份:2021
- 资助金额:
$ 59.41万 - 项目类别:
Contributions of Sleep and Pain to Alzheimer's Disease Related Biomarkers: Identifying Modifiable Risk Factors in Women with Normal to Mildly Impaired Cognitive Function
睡眠和疼痛对阿尔茨海默病相关生物标志物的影响:识别认知功能正常至轻度受损女性的可改变危险因素
- 批准号:
10289504 - 财政年份:2021
- 资助金额:
$ 59.41万 - 项目类别:
Web-based CBT for Insomnia in Rural Dementia Caregivers: Examination of Sleep, Arousal, Mood, Cognitive, and Immune Outcomes
针对农村痴呆症护理人员失眠的基于网络的 CBT:睡眠、觉醒、情绪、认知和免疫结果的检查
- 批准号:
10739134 - 财政年份:2021
- 资助金额:
$ 59.41万 - 项目类别:
Web-based CBT for Insomnia in Rural Dementia Caregivers: Examination of Sleep, Arousal, Mood, Cognitive, and Immune Outcomes
针对农村痴呆症护理人员失眠的基于网络的 CBT:睡眠、觉醒、情绪、认知和免疫结果的检查
- 批准号:
10428576 - 财政年份:2021
- 资助金额:
$ 59.41万 - 项目类别:
Impact of CBT for Insomnia on Pain Symptoms and Central Sensitization in Fibromyalgia.
CBT 治疗失眠对纤维肌痛疼痛症状和中枢敏化的影响。
- 批准号:
10414802 - 财政年份:2018
- 资助金额:
$ 59.41万 - 项目类别:
Impact of CBT for Insomnia on Pain Symptoms and Central Sensitization in Fibromyalgia.
CBT 治疗失眠对纤维肌痛疼痛症状和中枢敏化的影响。
- 批准号:
9769887 - 财政年份:2018
- 资助金额:
$ 59.41万 - 项目类别:
Impact of CBT for Insomnia on Pain Symptoms and Central Sensitization in Fibromyalgia.
CBT 治疗失眠对纤维肌痛疼痛症状和中枢敏化的影响。
- 批准号:
9927672 - 财政年份:2018
- 资助金额:
$ 59.41万 - 项目类别:
Sleep and Pain Interventions in Fibromyalgia: Hyperalgesia and Central Sensitizat
纤维肌痛的睡眠和疼痛干预:痛觉过敏和中枢敏化
- 批准号:
7941684 - 财政年份:2009
- 资助金额:
$ 59.41万 - 项目类别:
Sleep in Cardiac patients with Implantable Cardioverter Defibrillators (ICD)
使用植入式心脏复律除颤器 (ICD) 的心脏病患者的睡眠
- 批准号:
7839764 - 财政年份:2009
- 资助金额:
$ 59.41万 - 项目类别:
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