Bio-Behavioral Core

慢性下腰痛（cLBP）的综合生物心理社会模型承认， 生物、心理和社会因素决定LBP的病程。本研究核心的目标是 贡献生物行为学的观点。与UCSF REACH的其他核心密切合作，它将增加 神经科学和心理学的专业知识和最先进的技术， 生物力学和结构参数。该CORE将利用现有资源（SFVAHCS MRI），现有 临床队列（脊柱中心; SFVAHCS）和现有数据集进行生物行为研究， 进一步表征LBP机制并改善cLBP患者的表型。我们将 通过以下具体目标实现这些目标： 目标1：提供、维护和支持最先进的自我报告措施，定量感觉测试 (QST)以及用于评估和分类cLBP的个体处理的脑成像方法： A.行为自我报告测量/患者报告结果，使用a）NIH- 推荐的，B）经验证的补充和c）紧急心理自我报告结果测量。 1)定量感觉测试，以评估感知，疼痛和耐受阈值，以及各种指数 使用经验证的心理物理测试评估内源性疼痛调节能力。 2)应用实验性疼痛任务分别评价疼痛成分的功能性MRI 体验并确定哪些神经网络最受cLBP表型变化的影响。 3)结构MRI和弥散MRI，用于评估皮质/皮质下结构可塑性和 各种cLBP表型。 目的2：为新兴的生物行为学提供验证和临床效用确定的基础设施 cLBP患者的数据元素 我们将促进在一个单独的cLBP个体样本中进行临床效用的评估， 强化疼痛康复计划数据将持续输入信息学核心，并在 与机械中心的所有核心以及BACPAC的其他中心密切合作 财团 目的3：开发和提供基于证据的新型cLBP干预措施。 加强生物行为核心研究创新行为治疗的能力 我们将开发和验证基于正念理论的创新干预措施。 目标4：提供促进合作、学习和改进我们现有方法的论坛 在那里，我们将向REACH和BACPAC社区展示新的研究和技术创新。

The integrated biopsychosocial model of chronic low back pain (cLBP) acknowledges that interactions of biological, psychological and social factors determine the course of LBP. The goal of this research core is to contribute the bio-behavioral perspective. In close cooperation with the other cores of UCSF REACH, it will add the neuroscience and psychological expertise and state-of-the-art technology to be integrated with biomechanic and structural parameters. This CORE will leverage existing resources (SFVAHCS MRI), existing clinical cohorts (Spine Center; SFVAHCS), and existing datasets to conduct bio-behavioral research leading to further characterization of LBP mechanisms and improved phenotyping of patients with cLBP. We will accomplish these goals with the following Specific Aims: Aim 1: To provide, maintain, and support state-of-the-art self-report measures, quantitative sensory testing (QST) and brain imaging methods for evaluating and classifying individual processing of cLBP: A. Behavioral Self-Report Measures / Patient-Reported Outcomes using a comprehensive battery of a) NIH- recommended, b) validated supplemental and c) emergent psychological self-report outcome measures. 1) Quantitative Sensory Testing to assess perception, pain and tolerance thresholds, and various indices assessing endogenous pain modulatory capacity using validated psychophysical tests. 2) Functional MRI with application of an experimental pain task to separately evaluate components of the pain experience and determine which neural networks are mostly affected by variations of cLBP phenotypes. 3) Structural MRI and Diffusion MRI to assess cortical/subcortical structural plasticity and microstructure within various cLBP phenotypes. Aim 2: To provide infrastructure for validation and clinical utility determination for the emerging biobehavioral data elements in individuals with cLBP We will facilitate evaluation of the clinical utility in a separate sample of individuals with cLBP undergoing an intensive pain rehabilitation program. Data will be fed continuously into the Informatics Core and analyzed in close cooperation with all Cores of the Mechanistic Center and with other Centers across the BACPAC Consortium. Aim 3: To develop and provide evidence-based novel interventions for cLBP. To strengthen the Bio-Behavioral Core's capabilities for studying innovative behavioral treatment approaches, we will develop and validate innovative interventions based on mindfulness-based theories. Aim 4: To provide forums for stimulating collaboration, learning, and improving upon our current approaches where we will present new research and technology innovation to the REACH and BACPAC communities.