Determining Mechanisms of Pain Reduction in Chronic Widespread Pain After Rapid Weight Loss in Non-Hispanic Black and Hispanic/Latino/a/x Adults

确定非西班牙裔黑人和西班牙裔/拉丁裔/a/x 成年人快速减肥后慢性广泛疼痛的减轻机制

• 批准号: 10591253
• 负责人: Ericka Nayram Merriwether
• 金额: $ 14.28万
• 依托单位: NEW YORK UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-03-01 至 2028-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10591253
• 关键词: Address; Adult; Affect; Age; Anxiety; Behavioral; Black race; Body Weight decreased; Classification; Clinical; Clinical Research; Clinical Trials Design; Communities; Development Plans; Dimensions; Disparity; Environment; Ethnic Origin; Evaluation; Feasibility Studies; Fiber; Florida; Fostering; Foundations; Gender Identity; General Population; Goals; Health Disparities Research; Hispanic; Hospitals; Incubators; Institution; Intervention; Joints; Knowledge; Latina; Latino; Latinx; Latinx population; Life Style; Lower Extremity; Maintenance; Measurement; Measures; Mechanics; Mediating; Mediation; Mental Depression; Mentored Patient-Oriented Research Career Development Award; Mentors; Methodology; Methods; Modeling; Motion; Movement; Musculoskeletal; Musculoskeletal Pain; New York; Nociception; Not Hispanic or Latino; Obesity; Pain; Pain Measurement; Pain Research; Pain Threshold; Pain management; Participant; Patient Self-Report; Patients; Phenotype; Physical therapy; Population; Population Heterogeneity; Psychosocial Factor; Race; Recurrence; Refractory; Research; Research Project Grants; Research Training; Resolution; Resources; Rest; Sensory; Site; Sleep disturbances; Standardization; Statistical Methods; Stress; Testing; Time; Training; Universities; Weight; Weight maintenance regimen; Work; adult obesity; bariatric surgery; biobehavior; biopsychosocial; biosignature; career; career development; chronic pain; chronic widespread pain; comorbidity; conditioned pain modulation; demographics; disability; ethnic diversity; experience; fall risk; health disparity; health equity; improved; indexing; innovation; mechanical load; multimodality; pain inhibition; pain outcome; pain perception; pain reduction; pain sensitivity; phenotypic data; pressure; primary outcome; psychosocial; racial difference; racial diversity; recruit; rehabilitation research; research and development; response; synergism; translational scientist

Project Summary/Abstract Chronic widespread pain (CWP) is a chronic pain subtype that affects multiple body sites, and is strongly associated with poor function and disability. Although CWP is highly prevalent in adults with obesity, CWP outcomes are disproportionately worse in non-Hispanic Black (NH Black) and Hispanic/Latino/a/x adults. Thus, the obesity-related health disparity in CWP could augment existing racial and ethnic pain disparities in these populations. Bariatric surgery is often prescribed to treat obesity and musculoskeletal pain comorbidities. However, there is significant variability in weight loss and pain trajectories after bariatric surgery. Moreover, many patients experience recurrent or unresolved pain after bariatric surgery that can inhibit weight loss or facilitate weight regain. There are critical gaps in our knowledge of the primary driver(s) of CWP outcomes and how driver(s) of CWP respond to weight loss, particularly in racial and ethnically diverse groups. As such, the main objective of the proposed mentored project for the Mentored Patient-Oriented Research Career Development Award (K23) is to fill these knowledge gaps by: 1) comprehensively characterizing pain at rest and movement- evoked pain (MEP) in NH Black and Hispanic/Latino/a/x adults after bariatric surgery, and 2) identifying potential key driver(s) of intra-group variability in the resolution or maintenance of pain after bariatric surgery. We will focus on pain sensitivity, joint motion and mechanical loading biosignatures, and psychosocial factors. The aims proposed in this K23 application feature highly innovative methods that synergize mechanism-based pain phenotyping with obesity and health disparities research approaches. The methodologies employed represent a substantive departure from static, self-reported pain assessment to the integration of rigorous assessment and measurement multiple dimensions of pain at rest and MEP using precise quantification of nociceptive processing and joint motion and loading biosignatures in ethnically diverse populations. For the K23, I have assembled a strong interdisciplinary and multicultural cadre of highly successful clinical, basic, and translational scientists who have a strong and demonstrable commitment to the successful implementation and completion of my career development plan and research project milestones. The primary training goals that are the linchpin of my research training and career development are: 1) developing expertise in the integration of weight loss and lifestyle change evaluations with pain phenotyping data, 2) to develop and implement clinical trial designs that identify and address pain disparities, and 3) to enhance training in advanced statistical methods to inform clinical trial design to examine pain disparities. New York University (NYU) and the University of Florida are very strong incubators of pain, obesity, and rehabilitation research. Furthermore, these institutions are robust research environments that have the resources available to me to build on my previous training to foster independence in research that is focused on improving pain management in racially and ethnically diverse adults with obesity.

项目概要/摘要 慢性广泛性疼痛 (CWP) 是一种影响身体多个部位的慢性疼痛亚型，并且 与功能不良和残疾有关。尽管 CWP 在肥胖成人中非常普遍，但 CWP 非西班牙裔黑人（NH Black）和西班牙裔/拉丁裔/a/x 成年人的结果要差得多。因此， CWP 中与肥胖相关的健康差异可能会扩大这些地区现有的种族和民族疼痛差异 人口。减肥手术通常用于治疗肥胖和肌肉骨骼疼痛合并症。 然而，减肥手术后的体重减轻和疼痛轨迹存在显着差异。而且，许多 患者在减肥手术后经历反复出现或未解决的疼痛，这可能会抑制体重减轻或促进体重减轻 体重反弹。我们对 CWP 结果的主要驱动因素以及如何实现这一目标的认识存在重大差距 CWP 的驾驶员对减肥有反应，特别是在种族和民族不同的群体中。因此，主要 拟议的以患者为导向的研究职业发展指导项目的目标 奖项（K23）旨在通过以下方式填补这些知识空白：1）全面表征休息和运动时的疼痛- NH 黑人和西班牙裔/拉丁裔/a/x 成年人减肥手术后诱发疼痛 (MEP)，以及 2) 识别潜在疼痛 减肥手术后疼痛缓解或维持的组内差异的关键驱动因素。我们将 重点关注疼痛敏感性、关节运动和机械负荷生物特征以及社会心理因素。目标 在此 K23 应用中提出的具有高度创新的方法，可以协同基于机制的疼痛 肥胖和健康差异研究方法的表型分析。所采用的方法代表了 从静态的、自我报告的疼痛评估到严格评估和疼痛评估的整合的实质性转变 使用伤害感受处理的精确量化来测量静息疼痛和 MEP 的多个维度 以及不同种族人群的关节运动和加载生物特征。对于K23，我组装了一个 由非常成功的临床、基础和转化科学家组成的强大的跨学科和多文化骨干队伍 对成功实施和完成我的职业生涯有坚定且明显的承诺 发展计划和研究项目里程碑。主要训练目标是我的关键 研究培训和职业发展是：1）发展减肥和减肥相结合的专业知识 使用疼痛表型数据评估生活方式改变，2) 开发和实施临床试验设计 识别和解决疼痛差异，3) 加强先进统计方法的培训，为临床提供信息 检查疼痛差异的试验设计。纽约大学（NYU）和佛罗里达大学很强 疼痛、肥胖和康复研究的孵化器。此外，这些机构的研究实力雄厚 为我提供可利用的资源的环境，以我以前的培训为基础，培养独立性 研究重点是改善不同种族和民族的肥胖成人的疼痛管理。