Mechanical Biomarkers of Chronic Low Back Pain

慢性腰痛的机械生物标志物

• 批准号: 9981627
• 负责人: Louis E. DeFrate
• 金额: $ 62.3万
• 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/9981627
• 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; Diagnostic radiologic examination; 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; Structure; Subgroup; Symptoms; Techniques; Testing; Vertebral column; Work; base; biopsychosocial; 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; 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.

摘要 椎间盘（IVD）在正常脊柱功能期间以及当 这种正常的功能失败，症状，退化和改变脊柱力学可能会发生。整体 这项工作的科学前提是，有一个差距的知识之间的关系的贡献， 机械，炎症和生物心理社会因素导致慢性腰痛（LBP）。一个重要 差距是对IVD变性和LBP之间关系的理解不足。这种缺乏理解 导致成像和自我报告的疼痛之间的不一致，最终， 排除程序。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。我们还将测量定量的感觉因素，生化标志物， 生物心理社会因素，当与机械功能相结合时，可以更好地识别亚组或 LBP的表型。本项目的总体目标是确定IVD的机械功能是否可能 危险因素以及机械功能是否有助于确定LBP的表型。这一发现 这项研究将导致纵向分析，以确定这些表型是否预测从 急性至慢性LBP。这项拟议研究的基本原理是：1）IVD的机械功能改变 导致LBP。2)LBP是一种异质性疾病， 炎症和中枢疼痛的来源。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LBP的一个重要的潜在危险因素， 措施将改善LBP的表型。在目标I中，我们将量化体内 急性和慢性非特异性LBP参与者和无症状患者中测量的IVD机械功能 对照在目标II中，我们将使用潜在风险因素的组合来推导LBP的明确表型。 识别LBP的表型将允许特定的康复，手术，药物或行为 有针对性的治疗，从而改善患者的预后。