University of Michigan BACPAC Mechanistic Research Center

密歇根大学BACPAC机理研究中心

• 批准号: 10415416
• 负责人: Daniel J Clauw
• 金额: $ 9.86万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-01 至 2024-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10415416
• 关键词: Acupressure; Address; Algorithms; Analgesics; Autoimmune Diseases; Award; Back Pain; Chronic low back pain; Clinical; Data; Diagnostic; Effectiveness; Fatigue; Functional Imaging; Functional Magnetic Resonance Imaging; Goals; Helping to End Addiction Long-term; Individual; Inflammation; Intervention; Knowledge; Leadership; Learning Skill; Low Back Pain; Measures; Methods; Michigan; Mind-Body Intervention; Modality; Modeling; Neurobiology; Online Systems; Pain; Pain Measurement; Pain interference; Parents; Patient Outcomes Assessments; Patients; Pharmacology; Phenotype; Physical therapy; Plasma; Quality of life; Randomized; Reporting; Research; Research Design; Research Methodology; Scientist; Sensory; Series; Standardization; Technology; Testing; Training; Translating; Universities; Work; autoimmune rheumatologic disease; base; chronic pain; cohort; disability; duloxetine; evidence base; experience; functional disability; gabapentin; improved; mindfulness; mindfulness intervention; mindfulness-based stress reduction; novel; optimal treatments; pain patient; pain reduction; parent grant; precision medicine; predicting response; programs; randomized trial; response; rheumatologist; self-management program; treatment guidelines; treatment response

Project Summary / Abstract Chronic low back pain (cLBP) is highly prevalent, expensive and is associated with long term functional impairment, disability and poor quality of life. Several pharmacologic (e.g. duloxetine and gabapentin) and non-pharmacologic treatments such as physical therapy, acupressure and mindfulness-based interventions (MBIs) have shown efficacy in cLBP. Mindfulness-Based Stress-Reduction (MBSR) is an example of an increasingly widely used non-pharmacological intervention for pain reduction, and is now recommended in many treatment guidelines for cLBP. However, despite studies displaying effectiveness in cLBP, only a subset of individuals responds to each treatment modality. There is an urgent need for a greater understanding of pain mechanisms and predictors of response to different therapies with a goal of matching patients based on phenotypes to therapies to which they are most likely to respond. The parent award, a HEAL Initiative award (U19 AR076734), which uses a precision medicine approach to identify what treatments are likely to work in different patient endotypes. The proposed supplement will allow the me, a clinical rheumatologist, to learn these skills through assessment of MBSR on patient-reported pain interference in cLBP. I will also be able to use both clinically available data (such as patient-reported outcomes) as well as state-of-art phenotyping methods such as functional MRI (fMRI) and Quantitative Sensory Testing (QST), to mechanistically explore the proposed neurobiological effects of MBSR. I will subsequently be able to translate this knowledge in how to administer MBSR as well as evaluating pain mechanisms in individuals with autoimmune rheumatologic diseases, and evaluate the patient phenotypes most responsive to different therapies.

项目摘要/摘要 慢性下腰痛(CLBP)非常普遍，费用昂贵，并与长期功能障碍有关 损伤、残疾和生活质量差。几种药理作用(如度洛西汀和加巴喷丁)和 非药物治疗，如理疗、指压和正念干预 (MBIS)在cLBP中已显示出疗效。基于正念的压力减轻(MBSR)就是一个例子 越来越广泛地使用非药物干预来减轻疼痛，现在建议在 慢性下腰痛有许多治疗指南。然而，尽管研究显示了cLBP的有效性，但只有子集 每个人对每种治疗方式都有反应。迫切需要更多地了解 疼痛机制和对不同治疗反应的预测因素，目标是匹配患者的基础上 他们最有可能对治疗有反应的表型。家长奖，治愈计划奖 (U19 AR076734)，它使用精准医学方法来确定哪些治疗可能有效 不同的患者内型。拟议的补充方案将使我作为一名临床风湿病专家了解到 通过评估MBSR对患者报告的cLBP疼痛干预的这些技能。我也将能够 既使用临床可用的数据(如患者报告的结果)，也使用最先进的表型 方法如功能磁共振成像(FMRI)和定量感觉测试(QST)，以机械地探索 提出了MBSR的神经生物学效应。随后，我将能够将这些知识转化为如何 应用MBSR以及评估自身免疫性风湿病患者的疼痛机制 疾病，并评估对不同治疗最敏感的患者表型。