University of Michigan BACPAC Mechanistic Research Center

密歇根大学BACPAC机理研究中心

• 批准号: 10650650
• 负责人: Daniel J Clauw
• 金额: $ 11.28万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-09-26 至 2024-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10650650
• 关键词: Acupressure; Address; Analgesics; Autoimmune Diseases; Award; Chronic low back pain; Clinical; Data; Effectiveness; Evaluation; Functional Imaging; Functional Magnetic Resonance Imaging; Goals; Helping to End Addiction Long-term; Individual; Inflammation; Intervention; Knowledge; Learning Skill; Measures; Methods; Michigan; Modality; Neurobiology; Online Systems; Pain; Pain Measurement; Parents; Patient Outcomes Assessments; Patients; Pharmacology; Phenotype; Physical therapy; Plasma; Predictive Factor; Quality of life; Randomized; Reporting; Research; Rheumatism; Self Care; Sensory; Series; Standardization; Testing; Training; Treatment Effectiveness; Universities; Work; base; chronic pain; cohort; debilitating pain; digital; digital intervention; disability; duloxetine; efficacious treatment; efficacy evaluation; evidence base; experience; functional disability; gabapentin; mindfulness intervention; pain patient; parent grant; precision medicine; predicting response; response; rheumatologist; self-management program; treatment effect; treatment response

Project Summary / Abstract Individual and societal burdens from chronic low back pain (cLBP) are significant and associated with long term functional impairment, disability, and poor quality of life. There are many efficacious treatments in cLBP but the factors that predict treatment effectiveness in an individual are still not well understood. Treatments for chronic pain include several pharmacologic (e.g., duloxetine and gabapentin) and non-pharmacologic treatments such as physical therapy, acupressure, mindfulness-based interventions, and web-based self- management programs. 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), uses a precision medicine approach to identify what treatments are likely to work in different patient endotypes. The proposed supplement will allow me, a clinical rheumatologist, to learn these skills through assessments of acupressure and the web-based self-management program on patient-reported pain in cLBP. Clinically available data (such as patient-reported outcomes) as well as state-of-the-art phenotyping methods such as functional MRI (fMRI) and Quantitative Sensory Testing (QST), will be available to mechanistically explore the proposed neurobiological effects of these treatments. This knowledge will be invaluable in my future research on evaluation of pain mechanisms and responsiveness to treatment based on phenotypes of individuals with rheumatic disease.

项目摘要/摘要 慢性下腰痛(CLBP)造成的个人和社会负担是重大的，并与长期 终末期功能障碍、残疾和生活质量差。慢性下腰痛有多种有效的治疗方法。 但是，预测个体治疗效果的因素仍然没有得到很好的理解。治疗 慢性疼痛包括几种药理作用(如度洛西汀和加巴喷丁)和非药理作用 理疗、指压、基于正念的干预和基于网络的自我 管理课程。迫切需要更好地了解疼痛的机制和 根据表型将患者与治疗相匹配的不同治疗反应的预测因素 他们最有可能对此做出回应。父级奖是Hear Initiative奖(U19 AR076734)，使用 精准医学方法，以确定哪些治疗方法可能对不同的患者内型有效。这个 拟议的补充剂将使我作为一名临床风湿病专家，通过评估 穴位按压和基于网络的自我管理程序对慢性下腰痛患者报告的疼痛。临床上 可用的数据(如患者报告的结果)以及最先进的表型方法，如 功能磁共振成像(FMRI)和定量感觉测试(QST)将可用于机械地探索 提出了这些治疗的神经生物学效应。这些知识在我未来的研究中将是无价的。 根据精神分裂症患者的表型评价疼痛机制和治疗反应性 风湿病。