Spinal Cord Injury Neuropathic Pain - Identifying Biopsychosocial Predictors

描述（由申请人提供）：候选人的职业目标是成为一名独立的临床研究人员，研究衰弱性损伤后疼痛的生物心理社会因素，特别是确定针对脊髓损伤（SCI）后神经性疼痛（NP）的新治疗方法。为了实现这一目标，候选人提出了一个职业发展计划，重点是疼痛的生物心理社会方面的培训，使用最先进的神经成像技术的实践培训，以及先进的多元统计方法的教学法，例如可以适应疼痛神经成像所带来的独特挑战的高维数据简化。一个高度成就的调查员团队，作为导师，将监督候选人的职业发展。该项目的研究部分解决了两个突出的差距：1）该领域在对SCI后神经病理性疼痛发展的预测因素及其病理生理学的理解方面仍然有限，并且这已经排除了成功寻找令人满意的治疗途径的努力，以及2）虽然生物心理社会模型被誉为理想的，目前还没有一项研究能够完全整合临床SCI疼痛研究中涉及的多个领域。因此，该项目将利用心理，生理和神经变量的组合来确定这些因素中的哪些与SCI相关NP的发展相关。本研究的目的是：1）确定损伤前和急性SCI后心理功能对SCI相关NP的影响; 2）确定SCI后两年内体感皮层重组的神经标志物与SCI相关NP结果之间的关系; 3）检查皮质结构和功能静息状态测量，并确定SCI后两年内SCI相关NP结果的相关性。该项目将大大提高我们对SCI后NP发展中复杂的生物心理社会因素的理解，并将为Richardson博士作为独立临床研究者的发展提供关键培训。

DESCRIPTION (provided by applicant): The candidate's career goal is to become an independent clinical investigator in the biopsychosocial factors of pain following debilitating injuries, particularly identifying novel treatment approaches targeting neuropathic pain (NP) following spinal cord injury (SCI). To meet this goal, the candidate proposes a career development plan with emphasis on training in the biopsychosocial facets of pain, hands-on training using state-of-the-art neuroimaging techniques, and didactics in advanced multivariate statistical approaches, such as high dimensional data reduction that can accommodate the unique challenges presented by pain neuroimaging. A highly accomplished team of investigators with proven track records as mentors will oversee the candidate's career development. The research component of this project addresses two prominent gaps: 1) the field remains limited in its understanding of predictors of neuropathic pain development following SCI and its pathophysiology, and this has precluded successful endeavors to find satisfactory avenues of treatment, and 2) while the biopsychosocial model is hailed as ideal, there has been no study that fully integrates the multiple domains involved in clinical SCI pain research. This proposed project will therefore utilize a combination of psychological, physiological, and neurologic variables to determine which of these factors are associated with the development of SCI-related NP. The aims of the study are to: 1) determine the effects of psychological functioning pre-injury and acutely following SCI on SCI-related NP; 2) identify relationships between neural markers for somatosensory cortical reorganization and SCI-related NP outcomes within two years of SCI; and 3) examine cortical structural and functional resting state measures and determine correlations with SCI-related NP outcomes within two years of SCI. This project will greatly enhance our understanding of the complex biopsychosocial factors involved in the development of NP following SCI, and will provide critical training for Dr. Richardson's development as an independent clinical investigator.