Development and identification of magnetic resonance, electrophysiological, and fiber-optic imaging biomarkers of myofascial pain

项目总结 肌筋膜痛是一种起源于肌肉和周围筋膜的疼痛，并伴有 失去活动范围，虚弱，有时还有自主神经症状。影响了85%以上的一般 人们在生活中的某个时候，肌筋膜疼痛一直是就诊、旷工、 和伤残抚恤金--这是一个重大的健康问题和经济负担。然而，尽管 高发病率的肌筋膜痛和巨大的经济成本，其潜在的病理生理在很大程度上仍然存在 未知。因此，肌筋膜痛的临床诊断和治疗在很大程度上是经验性的。目标和 不存在通过成像、肌电图、实验室测试或肌肉活检获得的定量生物标志物 在临床上评估肌筋膜疼痛。为了应对这一未得到满足的挑战，我们建议开发和 将多模式、多参数、多尺度成像方法转化为全面评估不同 局部触发点和整个区域肌筋膜痛的病理生理学方面 整个肌筋膜组织，在此基础上，我们将确定候选生物标记物(S)是最敏感和 特异性地区分肌筋膜痛的不同状态，然后测试生物标记物监测治疗的能力 一项随机临床试验中的反应和预测临床结果。具体而言，在R61阶段(技术 发展和观察性研究)，我们将发展无创磁共振和电生理 并行成像生物标记物和微创光纤成像生物标记物(目标1)，然后识别 最能区分不同相关状态(健康、潜伏和活跃)的候选生物标志物 一项观察性临床研究中的肌筋膜痛(目标2)。我们之前的研究和初步研究提供了 为拟议的生物标记物开发和临床测试奠定坚实的前提。在R33阶段(介入 研究)，我们的研究团队-由成像、肌筋膜疼痛、定量分析和临床方面的专业知识组成 试验-将检查在R61阶段确定的成像生物标记物(S)监测反应的能力 到局部化学注射治疗和在随机临床试验中预测临床结果。建议数 研究将创造关于肌筋膜疼痛的重要知识，并有助于创造定量成像 可能指导我们选择适当的疼痛治疗和减少阿片成瘾的生物标志物。

PROJECT SUMMARY Myofascial pain is a type of pain that originates in the muscle and surrounding fascia and is accompanied by a loss of range of motion, weakness, and sometimes autonomic symptoms. Affecting more than 85% of the general population sometime in their lives, myofascial pain has been a leading cause of health-care visits, absenteeism, and invalidity pensions—representing a significant health concern and economic burden. However, despite the high incidence of myofascial pain and substantial financial cost, the underlying pathophysiology remains largely unknown. As a result, clinical diagnosis and management of myofascial pain are largely empirical. Objective and quantitative biomarkers acquired by imaging, electromyography, laboratory tests, or muscle biopsy do not exist in the clinic for the assessment of myofascial pain. To address this unmet challenge, we propose to develop and translate a multi-modal, multi-parametric, multi-scale imaging approach to comprehensively assess the different aspects of the pathophysiology underlying myofascial pain both locally at the trigger point and regionally across the entire myofascial tissue, based on which we will identify candidate biomarker(s) that are most sensitive and specific to distinguish different states of myofascial pain and then test the biomarker’s ability to monitor treatment responses and predict clinical outcomes in a randomized clinical trial. Specifically, in the R61 phase (technology development & observational study), we will develop noninvasive magnetic resonance and electrophysiological imaging biomarkers and minimally invasive fiber-optic imaging biomarkers in parallel (Aim 1), and then identify candidate biomarkers that are best capable of differentiating different states (healthy, latent, and active) related to myofascial pain in an observational clinical study (Aim 2). Our prior research and preliminary studies provide strong premises for the proposed biomarker development and clinical testing. In the R33 Phase (interventional study), our research team—consisting of expertise in imaging, myofascial pain, quantitative analysis, and clinical trial—will examine the ability of the imaging biomarker(s) identified in the R61 phase for monitoring the responses to local chemical injection treatment and predicting clinical outcomes in a randomized clinical trial. The proposed research will create vital knowledge about myofascial pain and contribute to the creation of quantitative imaging biomarkers that may guide our choices of appropriate pain management and reduce opioid addiction.