Core 1: Phenotyping and Outcomes Core

项目总结/摘要 表型和结局核心（POC） 密歇根大学纤维肌痛CORT提出，集中性疼痛的存在将使 对针对外周/伤害性疼痛的镇痛治疗（手术，生物制剂， 阿片类药物），这种集中性疼痛表型具有典型的临床和神经生物学特征， 即使与其他具有不同潜在疼痛的肌肉骨骼疼痛病症共病， 机制等由POC支持的CORT的具体目标如下：1）证明， 目前的2011年FM调查标准作为疼痛集中的强有力替代品，并强烈预测非疼痛集中。 对通常有效治疗外周疼痛的疗法的反应性，包括a）手术 旨在缓解疼痛（髋关节成形术、腕管松解术），B）施用生物制剂以治疗 自身免疫性疾病（类风湿性关节炎），和c）阿片类药物的急性围手术期给药; 2） 证明在所有三个队列中，FM评分最高的个体将具有相似的神经生物学特征， 疼痛集中的定量感觉测试（QST）和神经影像学的结果; 3）开发和试点 测试一种更短、更有预测性的疼痛集中性自我报告测量方法; 4）探索临床和 集中性疼痛的两个重要子集的机制特征：自上而下（即以前称为原发性 FM）与自下而上（即以前称为次级FM）。具体而言，POC将负责 以下内容：（1）评估每个治疗队列的治疗结局，（2）表型分析/表征 每个患者组群、FM对照组和健康对照组中，（3）潜伏性 基于自我报告、QST和神经影像学发现的集中性疼痛的结构，（4）发展和 验证一种新的临床适用的中心化测量方法，以及（5）探索两种潜在的亚型 随着自我报告项目的发展，集中化沿着，可以评估这些亚型。

PROJECT SUMMARY / ABSTRACT PHENOTYPING AND OUTCOMES CORE (POC) The University of Michigan Fibromyalgia CORT proposes that presence of centralized pain will render individuals less responsive to analgesic therapies aimed at peripheral/nociceptive pain (surgery, biologics, opioids) and that this centralized pain phenotype has stereotypical clinical and neurobiological features similar to FM even when it is co-morbid with other musculoskeletal pain conditions with disparate underlying pain mechanisms. The Specific Aims of the CORT supported by the POC are as follows: 1) To demonstrate that the current 2011 FM Survey Criteria serve as a strong surrogate of pain centralization and strongly predict non- responsiveness to therapies generally effective for treating peripherally-based pain, including a) surgery intended to relieve pain (hip arthroplasty, carpal tunnel release), b) administration of a biologic agent to treat an autoimmune disorder (rheumatoid arthritis), and c) acute perioperative administration of opioids; 2) To demonstrate that in all three cohorts individuals with the highest FM scores will have similar neurobiological findings of pain centralization on quantitative sensory testing (QST) and neuroimaging; 3) To develop and pilot test a shorter and more predictive self-report measure of pain centralization; and 4) To explore the clinical and mechanistic features of two important subsets of centralized pain: top-down (i.e. previously termed primary FM) vs. bottom-up (i.e. previously termed secondary FM). Specifically, the POC will be responsible for the following: (1) Assessment of treatment outcomes for each treatment cohort, (2) Phenotyping/characterization of each patient cohort, the FM control group, and the healthy control group, (3) Development of a latent construct of centralized pain based upon self-report, QST, and neuroimaging findings, (4) Development and validation of a new clinically applicable measure of centralization, and (5) Exploration of two potential subtypes of centralization along with the development of self-report items that may assess those subtypes.