Mechanical Biomarkers of Chronic Low Back Pain

慢性腰痛的机械生物标志物

• 批准号: 10440260
• 负责人: Louis E. DeFrate
• 金额: $ 61.68万
• 依托单位: DUKE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-07-22 至 2024-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10440260
• 关键词: 3-Dimensional; Acute; Address; Adult; Affect; Back Pain; Behavior Therapy; Behavioral; Biochemical; Biochemical Markers; Biological Markers; Characteristics; Chronic; Chronic low back pain; Clinical; Clinical Trials; Cluster Analysis; Cognitive; Complex; Data; Development; Etiology; Goals; Heterogeneity; Image; Imaging Device; Individual; Inflammatory; Intervention; Intervertebral disc structure; Knowledge; Lead; Low Back Pain; Machine Learning; Magnetic Resonance Imaging; Measurement; Measures; Mechanical Low Back Pain; Mechanics; Methods; Modeling; National Institute of Arthritis and Musculoskeletal and Skin Diseases; Nature; Neuropeptides; Operative Surgical Procedures; Pain; Pain Research; Participant; Patient Selection; Patient Self-Report; Patient-Focused Outcomes; Patients; Pharmacologic Substance; Phenotype; Population; Process; Public Health; Rehabilitation therapy; Research; Research Priority; Risk Factors; Role; Sensory; Site; Source; Speed; Subgroup; Symptoms; Techniques; Testing; Vertebral column; Work; base; biopsychosocial; biopsychosocial factor; central pain; chronic musculoskeletal pain; clinical care; clinical development; clinical imaging; clinical phenotype; cost; demographics; experience; imaging biomarker; improved; improved outcome; in vivo; in vivo imaging; inflammatory pain; innovation; intervertebral disk degeneration; longitudinal analysis; novel; optimal treatments; patient subsets; radiological imaging; random forest; three-dimensional modeling

Abstract The intervertebral disc (IVD) has an essential role in transferring load during normal spine function and when this normal function fails, symptoms, degeneration and altered spine mechanics may occur. The overall scientific premise of this work is that there is a gap in knowledge of the relationship between contributions from mechanical, inflammatory and biopsychosocial factors that lead to chronic low back pain (LBP). An important gap is a poor understanding of the relationship between IVD degeneration and LBP. This lack of understanding leads to discordance between imaging and self-reported pain and, ultimately, treatments being delivered by an exclusionary process. To address this gap, we will use innovative in vivo imaging tools to quantify the mechanical function of the IVD. We will also measure quantitative sensory factors, biochemical markers, and biopsychosocial factors that, when combined with mechanical function, may better identify subgroups or phenotypes of LBP. The overall goal of this project is to identify if mechanical function of the IVD is a potential risk factor and whether mechanical function can assist with defining phenotypes of LBP. The findings from this study would lead to longitudinal analyses to determine whether these phenotypes predict the transition from acute to chronic LBP. The rationale for this proposed research is that: 1) altered mechanical function of the IVD contributes to LBP. 2) LBP is a heterogeneous condition that can result from a combination of mechanical, inflammatory, and central pain based sources. The central hypothesis is that in vivo measured IVD mechanical function will be an important potential risk factor for both acute and chronic non-specific LBP and that this measure will improve the phenotyping of LBP. In Aim I, we will quantify the association between in-vivo measured IVD mechanical function among acute and chronic non-specific LBP participants and asymptomatic controls. In Aim II, we will derive well-defined phenotypes of LBP using combinations of potential risk factors. Identifying phenotypes of LBP will allow for specific rehabilitation, surgical, pharmaceutical or behavioral treatments to be targeted, resulting in improved patient outcomes.

抽象的 椎间盘 (IVD) 在正常脊柱功能期间以及当 这种正常功能失效，可能会出现症状、退化和脊柱力学改变。整体 这项工作的科学前提是，对来自不同领域的贡献之间的关系的了解存在差距。 导致慢性腰痛 (LBP) 的机械、炎症和生物心理社会因素。一个重要的 差距在于对 IVD 变性与 LBP 之间关系的了解不足。这种不理解 导致影像学和自我报告的疼痛之间的不一致，最终由医生提供的治疗 排除过程。为了解决这一差距，我们将使用创新的体内成像工具来量化 IVD 的机械功能。我们还将测量定量感官因素、生化标记物和 生物心理社会因素与机械功能相结合，可以更好地识别亚组或 LBP的表型。该项目的总体目标是确定 IVD 的机械功能是否具有潜在的潜力。 危险因素以及机械功能是否可以帮助定义腰痛表型。由此得出的结论 研究将进行纵向分析，以确定这些表型是否预测从 急性腰痛至慢性腰痛。这项研究的基本原理是：1) 改变 IVD 的机械功能 有助于 LBP。 2) LBP 是一种异质状况，可能由机械、 炎症和中枢性疼痛来源。中心假设是体内测量的 IVD 机械 功能将是急性和慢性非特异性腰痛的一个重要的潜在危险因素，并且这 措施将改善 LBP 的表型。在目标 I 中，我们将量化体内 测量急性和慢性非特异性 LBP 参与者和无症状患者的 IVD 机械功能 控制。在目标 II 中，我们将利用潜在风险因素的组合得出明确定义的腰痛表型。 识别腰痛的表型将有助于进行特定的康复、手术、药物或行为治疗 治疗有针对性，从而改善患者的治疗效果。