CNS Pain Mechanisms in Early Rheumatoid Arthritis: Implications for the Acute to Chronic Pain Transition

早期类风湿关节炎的中枢神经系统疼痛机制:对急性疼痛向慢性疼痛转变的影响

基本信息

  • 批准号:
    10693840
  • 负责人:
  • 金额:
    $ 108.89万
  • 依托单位:
  • 依托单位国家:
    美国
  • 项目类别:
  • 财政年份:
    2013
  • 资助国家:
    美国
  • 起止时间:
    2013-07-01 至 2025-07-31
  • 项目状态:
    未结题

项目摘要

PROJECT SUMMARY/ABSTRACT Millions of Americans spend each day in severe pain associated with arthritis. The longer the pain persists, the harder it is to treat. Efficacious prevention strategies are needed. A major barrier to chronic pain prevention is a gap in knowledge about how acute joint pain leads to changes in central nervous system (CNS) pathways responsible for sensing, transmitting and regulating pain. This process, which results in widespread pain sensitivity, is termed pain centralization. The long-term goal of this research program is to design interventions to prevent pain centralization, and hence chronic pain, in rheumatoid arthritis (RA). The objective is to identify modifiable clinical factors and neurobiological pathways that lead to the development of chronic pain in early RA. The focus of this application is early RA because the first 12 months after RA diagnosis likely represents a critical time in which to prevent the acute to chronic pain transition. Preliminary data from the Canadian Early Arthritis Cohort (CATCH) showed that the incidence of fibromyalgia, the prototypical centralized pain condition, is highest during the first year after RA diagnosis. The central hypothesis is that sleep problems, psychosocial factors, and abnormal CNS (e.g., brain, spinal cord) regulatory mechanisms predict the development of pain centralization in the first year after RA diagnosis. The central hypothesis will be tested by pursuing the following three specific aims: 1) to identify modifiable factors that predict symptoms of pain centralization in early RA; 2) to identify quantitative sensory testing (QST) evidence of augmented CNS pain processing that predict symptoms of pain centralization; and 3) to define the functional and anatomic brain pathways underlying pain centralization in early RA. For the first aim, 534 early RA patients from CATCH and CATCH- US (US extension of CATCH) will be enrolled to complete measures of sleep, pain, psychosocial factors, and disability administered at 0, 3, 6 and 12 months after entry into the cohorts. For the second aim, 125 early RA patients will undergo QST, a type of testing that involves assessing response to well-defined, quantifiable painful stimuli (e.g., pressure and cold), at 0, 3 and 12 months. For the third aim, 95 patients from Aim 2 will undergo magnetic resonance imaging at 0 and 12 months to assess neuroimaging markers (e.g., correlations in activity between different brain regions, volume of tissue in brain areas consisting of nerve cell bodies) that have previously been shown to be involved in pain centralization. The proposed research is innovative because it represents a substantive departure from the status quo by: 1) focusing on early RA, 2) incorporating assessments of pain-related constructs into two multi-site early RA registries, and 3) employing a multimodal approach, including patient-reported measures of pain, QST, and neuroimaging, to assess pain pathways. The proposed research is significant because it will set the stage for intervention design (e.g., cognitive behavioral therapy to treat sleep problems, early treatment of pain with gabapentin) and future trials to prevent chronic pain, ultimately leading to a paradigm shift in the management of pain in systemic inflammatory diseases.
项目总结/文摘

项目成果

期刊论文数量(4)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
Factors associated with complementary medicine use in pediatric musculoskeletal conditions: Results from a national survey.
与儿科肌肉骨骼疾病补充药物使用相关的因素:全国调查的结果。
  • DOI:
    10.1016/j.ctim.2017.02.001
  • 发表时间:
    2017
  • 期刊:
  • 影响因子:
    3.6
  • 作者:
    Cohen,EzraM;Dossett,MichelleL;Mehta,DarshanH;Davis,RogerB;Lee,YvonneC
  • 通讯作者:
    Lee,YvonneC
Multibiomarker disease activity score and C-reactive protein in a cross-sectional observational study of patients with rheumatoid arthritis with and without concomitant fibromyalgia.
  • DOI:
    10.1093/rheumatology/kev388
  • 发表时间:
    2016-04
  • 期刊:
  • 影响因子:
    0
  • 作者:
    Lee YC;Hackett J;Frits M;Iannaccone CK;Shadick NA;Weinblatt ME;Segurado OG;Sasso EH
  • 通讯作者:
    Sasso EH
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Yvonne Claire Lee其他文献

Yvonne Claire Lee的其他文献

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{{ truncateString('Yvonne Claire Lee', 18)}}的其他基金

Mentored Patient-Oriented Research of Novel Mechanisms Linking Pain, Sleep-Wake Patterns, and Autonomic Activity in Rheumatic Diseases
指导以患者为导向的风湿性疾病中疼痛、睡眠-觉醒模式和自主活动相关新机制的研究
  • 批准号:
    10592158
  • 财政年份:
    2023
  • 资助金额:
    $ 108.89万
  • 项目类别:
Investigating immunophenotypic and transcriptional heterogeneity as biomarkers of pain centralization in rheumatoid arthritis
研究免疫表型和转录异质性作为类风湿性关节炎疼痛集中的生物标志物
  • 批准号:
    10354816
  • 财政年份:
    2022
  • 资助金额:
    $ 108.89万
  • 项目类别:
Investigating immunophenotypic and transcriptional heterogeneity as biomarkers of pain centralization in rheumatoid arthritis
研究免疫表型和转录异质性作为类风湿性关节炎疼痛集中的生物标志物
  • 批准号:
    10569603
  • 财政年份:
    2022
  • 资助金额:
    $ 108.89万
  • 项目类别:
Central Pain Mechanisms, Pain Intensity and Drug Response in Rheumatoid Arthritis
类风湿关节炎的中枢疼痛机制、疼痛强度和药物反应
  • 批准号:
    8562781
  • 财政年份:
    2013
  • 资助金额:
    $ 108.89万
  • 项目类别:
Central Pain Mechanisms, Pain Intensity and Drug Response in Rheumatoid Arthritis
类风湿关节炎的中枢疼痛机制、疼痛强度和药物反应
  • 批准号:
    8917093
  • 财政年份:
    2013
  • 资助金额:
    $ 108.89万
  • 项目类别:
CNS Pain Mechanisms in Early Rheumatoid Arthritis: Implications for the Acute to Chronic Pain Transition
早期类风湿关节炎的中枢神经系统疼痛机制:对急性疼痛向慢性疼痛转变的影响
  • 批准号:
    9887303
  • 财政年份:
    2013
  • 资助金额:
    $ 108.89万
  • 项目类别:
Central Pain Mechanisms, Pain Intensity and Drug Response in Rheumatoid Arthritis
类风湿关节炎的中枢疼痛机制、疼痛强度和药物反应
  • 批准号:
    9305759
  • 财政年份:
    2013
  • 资助金额:
    $ 108.89万
  • 项目类别:
Central Pain Mechanisms, Pain Intensity and Drug Response in Rheumatoid Arthritis
类风湿关节炎的中枢疼痛机制、疼痛强度和药物反应
  • 批准号:
    9097403
  • 财政年份:
    2013
  • 资助金额:
    $ 108.89万
  • 项目类别:
Central Pain Mechanisms, Pain Intensity and Drug Response in Rheumatoid Arthritis
类风湿关节炎的中枢疼痛机制、疼痛强度和药物反应
  • 批准号:
    8697015
  • 财政年份:
    2013
  • 资助金额:
    $ 108.89万
  • 项目类别:
CNS Pain Mechanisms in Early Rheumatoid Arthritis: Implications for the Acute to Chronic Pain Transition
早期类风湿关节炎的中枢神经系统疼痛机制:对急性疼痛向慢性疼痛转变的影响
  • 批准号:
    10251850
  • 财政年份:
    2013
  • 资助金额:
    $ 108.89万
  • 项目类别:

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