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.

项目总结/摘要 慢性下腰痛（cLBP）的个人和社会负担是显著的，并且与长期 长期功能障碍、残疾和生活质量差。慢性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很好的理解。治疗 慢性疼痛包括几种药理学（例如，度洛西汀和加巴喷丁）和非药物 治疗，如物理疗法，穴位按摩，正念为基础的干预，和基于网络的自我， 管理方案。迫切需要更好地了解疼痛机制， 预测对不同疗法的反应，目标是根据表型匹配患者与疗法 他们最有可能做出回应。母公司奖，一个愈合倡议奖（U19 AR 076734），使用一个 精确医学方法，以确定哪些治疗可能适用于不同的患者内型。的 建议的补充将使我，一个临床风湿病学家，通过评估这些技能， 穴位按摩和基于网络的自我管理计划对cLBP患者报告的疼痛。临床 现有数据（如患者报告的结局）以及最先进的表型分析方法， 功能性磁共振成像（fMRI）和定量感觉测试（QST），将可用于机械地探索 这些治疗的拟议神经生物学效应。这些知识对我今后的研究将是无价的 基于个体的表型评价疼痛机制和对治疗的反应性， 风湿病