The Impact of Opioids on Chronic Pain: Clinical Research and Career Training in Spinal Cord fMRI and Brain Reward Systems

阿片类药物对慢性疼痛的影响：脊髓功能磁共振成像和大脑奖励系统的临床研究和职业培训

• 批准号: 10282724
• 负责人: Katherine Theresa Martucci
• 金额: $ 8.05万
• 依托单位: DUKE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-09-01 至 2021-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10282724
• 关键词: Administrative Supplement; Advocate; Affect; Arousal; Award; Behavior; Behavioral; Benefits and Risks; Brain; Cervical spinal cord structure; Chronic; Clinical; Clinical Research; Clinical Trials; Congenital neurologic anomalies; Data; Development; Disease Progression; Dorsal; Dose; Fibromyalgia; Functional Magnetic Resonance Imaging; Funding; Future; Goals; Hyperalgesia; Knowledge; Long-Term Effects; Longitudinal Studies; Measures; Medial; Methods; Nervous System Physiology; Neuraxis; Neurobiology; Nucleus Accumbens; Opiate Addiction; Opioid; Outcome; Pain; Participant; Pathologic; Patients; Peripheral; Phase; Phenotype; Physiological; Prefrontal Cortex; Process; Psychology; Research; Research Project Grants; Research Training; Rewards; Risk; Sensory; Severities; Socioeconomic Status; Solid; Spinal; Spinal Cord; Symptoms; System; Testing; Time; Training; United States; addiction; career; chronic pain; chronic pain patient; clinical practice; cohort; demographics; fibromyalgia patients; financial incentive; improved; neuroimaging; neurophysiology; non-opioid analgesic; novel; opioid therapy; opioid use; pain symptom; prescription opioid; research study; reward processing; sensory system

Project Summary / Abstract Although opioids are prescribed for chronic pain due to fibromyalgia, scientific understanding of the effects of opioid medications on central nervous system (CNS) activity and reward behavior is limited. Current evidence strongly suggests that altered brain and spinal cord activity contributes to the chronicity of fibromyalgia symptoms, and opioids produce similar changes in CNS activity. To determine the longitudinal effects of opioids on CNS activity in fibromyalgia, the proposal includes clinical neuroimaging research projects that build upon preliminary research and training completed by Dr. Martucci during the K99 phase of her award. During the R00 independent research phase of her award, Dr. Martucci will conduct a longitudinal clinical research study of fibromyalgia patients, both opioid-dependent and opioid- naïve, to determine how changes in chronic pain, accompanying symptoms, and CNS activity over time relate to fibromyalgia disease progression both in the presence of and not in the presence of continued opioid use. The study aims will be conducted via two projects. Project #1 will extend preliminary research investigating cervical spinal cord activity and the effects of opioids in patients with fibromyalgia in a longitudinal study (over 1 year). Project #2 will extend preliminary research investigating reward behavior and brain reward systems and the effects of opioids in patients with fibromyalgia in a longitudinal study (over 1 year). Additional goals of the projects will be to replicate initial findings (from the K99 phase) in a large and independent cohort of fibromyalgia patients from a different region of the United States and to identify potential influences of participant demographics and socioeconomic status on fibromyalgia symptoms, spinal cord activity, reward processing, and opioid effects. Together, these projects will provide a more complete picture of the neurophysiological effects of opioid medications in fibromyalgia and will fill critical knowledge gaps related to potential risks of neurobiological changes and altered psychology and behavior that may occur when prescribing opioids.

项目概要/摘要 尽管阿片类药物用于治疗纤维肌痛引起的慢性疼痛，但科学认识 阿片类药物对中枢神经系统 (CNS) 活动和奖赏行为的影响 目前的证据强烈表明大脑和脊髓的活动发生了改变。 导致纤维肌痛症状的慢性化，阿片类药物也会产生类似的变化 中枢神经系统活性 为了确定阿片类药物对纤维肌痛中枢神经系统活性的纵向影响， 提案包括基于初步研究的临床神经影像研究项目 Martucci 博士在其获奖的 K99 阶段完成的培训。 在她的奖项的 R00 独立研究阶段，Martucci 博士将进行一项 对纤维肌痛患者（包括阿片类药物依赖性和阿片类药物依赖性）的纵向临床研究 天真的，以确定慢性疼痛、伴随症状和中枢神经系统活动如何变化 随着时间的推移，无论存在还是不存在，都与纤维肌痛疾病的进展有关。 持续使用阿片类药物的情况。 该研究目标将通过两个项目进行，项目#1 将扩展初步研究。 颈椎研究脊髓活动和阿片类药物对纤维肌痛患者的影响 纵向研究（超过 1 年）项目#2 将扩展初步研究调查。 奖励行为和大脑奖励系统以及阿片类药物对患者的影响 纵向研究（超过一年）中的纤维肌痛该项目的其他目标是： 在一个大型且独立的纤维肌痛队列中复制最初的发现（来自 K99 阶段） 来自美国不同地区的患者并确定潜在的影响 纤维肌痛参与者症状、脊髓的人口统计和社会经济状况 活动、奖励处理和阿片类药物的作用。 这些项目将共同提供神经生理学效应的更完整的图景 阿片类药物治疗纤维肌痛的研究，将填补与潜在风险相关的关键知识空白 可能发生的神经生物学变化以及心理和行为 开阿片类药物。

项目成果

Replication of neural responses to monetary incentives and exploration of reward-influenced network connectivity in fibromyalgia.

复制神经对金钱激励的反应并探索纤维肌痛中受奖励影响的网络连接。

• 发表时间: 2022-12
• 作者: Park, Su Hyoun;Deng, Eden Z;Baker, Anne K;MacNiven, Kelly H;Knutson, Brian;Martucci, Katherine T
• 通讯作者: Martucci, Katherine T

Interplay between noxious heat sensitivity and temporal summation magnitude in patients with fibromyalgia and long-term opioid use.

纤维肌痛和长期使用阿片类药物患者的有害热敏感性与时间总和幅度之间的相互作用。

• 发表时间: 2023
• 作者: Bao, Jason D;Rosser, Morgan A;Park, Su Hyoun;Baker, Anne K;Martucci, Katherine T
• 通讯作者: Martucci, Katherine T

Altered Reward Processing and Sex Differences in Chronic Pain.

慢性疼痛中奖励处理的改变和性别差异。

• 发表时间: 2022
• 作者: Baker, Anne K;Ericksen, Lauren C;Koppelmans, Vincent;Mickey, Brian J;Martucci, Katherine T;Zubieta, Jon;Love, Tiffany M
• 通讯作者: Love, Tiffany M

Evaluation by Survival Analysis of Cold Pain Tolerance in Patients with Fibromyalgia and Opioid Use.

通过纤维肌痛和阿片类药物使用患者的冷痛耐受性生存分析进行评估。

• 发表时间: 2022
• 作者: Deng, Eden Z;Weikel, Daniel P;Martucci, Katherine T
• 通讯作者: Martucci, Katherine T