Core 1: Phenotyping and Outcomes Core

项目摘要/摘要 表型和结果核心(POC) 密歇根大学提出，集中性疼痛的存在将使 对针对外周/伤害性疼痛的止痛治疗反应较差的个人(手术、生物制剂、 阿片类药物)，这种集中性疼痛表型具有相似的典型临床和神经生物学特征 即使它与其他肌肉骨骼疼痛状况并存，并伴有不同的潜在疼痛，也可以进行FM 机械装置。POC支持的CORT的具体目标如下：1)论证 目前的2011年FM调查标准是疼痛集中化的有力替代，并强烈预测非 对治疗外周疼痛通常有效的治疗的反应性，包括a)手术 旨在减轻疼痛(髋关节置换术、腕管松解术)，b)使用生物制剂治疗 自身免疫性疾病(类风湿性关节炎)，以及c)围手术期急性阿片类药物应用；2)至 证明在所有三个队列中，FM分数最高的个体将具有相似的神经生物学 疼痛集中在定量感觉测试(QST)和神经成像上的发现；3)开发和试点 测试更短和更具预测性的疼痛集中自我报告测量；以及4)探索临床和 集中性疼痛的两个重要子集的机械特征：自上而下(即以前称为初级疼痛 Fm)与自下而上(即，以前称为二次fm)。具体而言，PoC将负责 以下：(1)评估每个治疗队列的治疗结果，(2)表型/特征 每个患者队列，FM对照组和健康对照组，(3)潜伏期的发展 基于自我报告、QST和神经影像发现的集中性疼痛的构建，(4)发展和 一种新的临床适用的集中化测量方法的验证，以及(5)两种潜在亚型的探索 随着可评估这些子类型的自我报告项目的发展而集中。

PROJECT SUMMARY / ABSTRACT PHENOTYPING AND OUTCOMES CORE (POC) The University of Michigan Fibromyalgia CORT proposes that presence of centralized pain will render individuals less responsive to analgesic therapies aimed at peripheral/nociceptive pain (surgery, biologics, opioids) and that this centralized pain phenotype has stereotypical clinical and neurobiological features similar to FM even when it is co-morbid with other musculoskeletal pain conditions with disparate underlying pain mechanisms. The Specific Aims of the CORT supported by the POC are as follows: 1) To demonstrate that the current 2011 FM Survey Criteria serve as a strong surrogate of pain centralization and strongly predict non- responsiveness to therapies generally effective for treating peripherally-based pain, including a) surgery intended to relieve pain (hip arthroplasty, carpal tunnel release), b) administration of a biologic agent to treat an autoimmune disorder (rheumatoid arthritis), and c) acute perioperative administration of opioids; 2) To demonstrate that in all three cohorts individuals with the highest FM scores will have similar neurobiological findings of pain centralization on quantitative sensory testing (QST) and neuroimaging; 3) To develop and pilot test a shorter and more predictive self-report measure of pain centralization; and 4) To explore the clinical and mechanistic features of two important subsets of centralized pain: top-down (i.e. previously termed primary FM) vs. bottom-up (i.e. previously termed secondary FM). Specifically, the POC will be responsible for the following: (1) Assessment of treatment outcomes for each treatment cohort, (2) Phenotyping/characterization of each patient cohort, the FM control group, and the healthy control group, (3) Development of a latent construct of centralized pain based upon self-report, QST, and neuroimaging findings, (4) Development and validation of a new clinically applicable measure of centralization, and (5) Exploration of two potential subtypes of centralization along with the development of self-report items that may assess those subtypes.