Mechanical Biomarkers of Chronic Low Back Pain

慢性腰痛的机械生物标志物

• 批准号: 10171398
• 负责人: Louis E. DeFrate
• 金额: $ 60.43万
• 依托单位: DUKE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-07-22 至 2024-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10171398
• 关键词: 3-Dimensional; Acute; Address; Adult; Affect; Back Pain; Behavior Therapy; Behavioral; Biochemical; Biochemical Markers; Biological Markers; Characteristics; Chronic; Chronic low back pain; Clinical; Clinical Trials; Cluster Analysis; Cognitive; Complex; Data; Development; Diagnostic radiologic examination; Etiology; Goals; Heterogeneity; Image; Imaging Device; Individual; Inflammatory; Intervention; Intervertebral disc structure; Knowledge; Lead; Low Back Pain; Machine Learning; Magnetic Resonance Imaging; Measurement; Measures; Mechanical Low Back Pain; Mechanics; Methods; Modeling; National Institute of Arthritis and Musculoskeletal and Skin Diseases; Nature; Neuropeptides; Operative Surgical Procedures; Pain; Pain Research; Participant; Patient Selection; Patient Self-Report; Patient-Focused Outcomes; Patients; Pharmacologic Substance; Phenotype; Population; Process; Public Health; Rehabilitation therapy; Research; Research Priority; Risk Factors; Role; Sensory; Site; Source; Speed; Structure; Subgroup; Symptoms; Techniques; Testing; Vertebral column; Work; base; biopsychosocial; biopsychosocial factor; central pain; chronic musculoskeletal pain; clinical care; clinical development; clinical imaging; clinical phenotype; cost; demographics; experience; imaging biomarker; improved; improved outcome; in vivo; in vivo imaging; inflammatory pain; innovation; intervertebral disk degeneration; longitudinal analysis; novel; optimal treatments; patient subsets; random forest; three-dimensional modeling

Abstract The intervertebral disc (IVD) has an essential role in transferring load during normal spine function and when this normal function fails, symptoms, degeneration and altered spine mechanics may occur. The overall scientific premise of this work is that there is a gap in knowledge of the relationship between contributions from mechanical, inflammatory and biopsychosocial factors that lead to chronic low back pain (LBP). An important gap is a poor understanding of the relationship between IVD degeneration and LBP. This lack of understanding leads to discordance between imaging and self-reported pain and, ultimately, treatments being delivered by an exclusionary process. To address this gap, we will use innovative in vivo imaging tools to quantify the mechanical function of the IVD. We will also measure quantitative sensory factors, biochemical markers, and biopsychosocial factors that, when combined with mechanical function, may better identify subgroups or phenotypes of LBP. The overall goal of this project is to identify if mechanical function of the IVD is a potential risk factor and whether mechanical function can assist with defining phenotypes of LBP. The findings from this study would lead to longitudinal analyses to determine whether these phenotypes predict the transition from acute to chronic LBP. The rationale for this proposed research is that: 1) altered mechanical function of the IVD contributes to LBP. 2) LBP is a heterogeneous condition that can result from a combination of mechanical, inflammatory, and central pain based sources. The central hypothesis is that in vivo measured IVD mechanical function will be an important potential risk factor for both acute and chronic non-specific LBP and that this measure will improve the phenotyping of LBP. In Aim I, we will quantify the association between in-vivo measured IVD mechanical function among acute and chronic non-specific LBP participants and asymptomatic controls. In Aim II, we will derive well-defined phenotypes of LBP using combinations of potential risk factors. Identifying phenotypes of LBP will allow for specific rehabilitation, surgical, pharmaceutical or behavioral treatments to be targeted, resulting in improved patient outcomes.

抽象的 椎间盘（IVD）在正常脊柱函数期间和 可能会发生这种正常功能，症状，变性和脊柱力学改变。总体 这项工作的科学前提是，了解贡献之间的关系存在差距 导致慢性下背痛（LBP）的机械，炎症和生物心理社会因素。一个重要的 差距是对IVD变性与LBP之间关系的不良理解。缺乏理解 导致成像和自我报告的疼痛之间的不一致，最终是由 排除过程。为了解决这一差距，我们将使用创新的体内成像工具来量化 IVD的机械功能。我们还将测量定量感觉因素，生化标记和 生物心理社会因素与机械功能结合使用，可以更好地识别亚组或 LBP的表型。该项目的总体目标是确定IVD的机械功能是否潜在 风险因素以及机械功能是否可以帮助定义LBP的表型。从中的发现 研究将导致纵向分析，以确定这些表型是否预测了从 急性到慢性LBP。这项拟议的研究的理由是：1）IVD的机械功能改变 有助于LBP。 2）LBP是一种异质条件，可以由机械的组合产生 炎症和基于中央疼痛的来源。中心假设是体内测量的IVD机械 功能将是急性和慢性非特异性LBP的重要潜在危险因素，这是 度量将改善LBP的表型。在目标I中，我们将量化体内的关联 急性和慢性非特异性LBP参与者和无症状的IVD机械功能测量的IVD机械功能 控件。在AIM II中，我们将使用潜在危险因素的组合得出LBP的明确定义的表型。 识别LBP的表型将允许特定的康复，外科手术，药物或行为 有针对性的治疗方法，从而改善了患者的预后。