Core 1: Phenotyping and Outcomes Core

核心 1：表型分析和结果核心

• 批准号: 9771299
• 负责人: David A Williams
• 金额: $ 17.27万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-09-20 至 2022-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9771299
• 关键词: Acute; Address; Analgesics; Autoimmune Diseases; Biological; Biological Products; Biometry; Chemicals; Clinical; Control Groups; Data; Development; Fibromyalgia; Functional Magnetic Resonance Imaging; Individual; Measures; Michigan; Musculoskeletal Pain; Neurobiology; Nociception; Operative Surgical Procedures; Opioid; Outcome; Outcome Assessment; Pain; Patient Self-Report; Patients; Perioperative; Peripheral; Phenotype; Primary Fibromyalgias; Protons; Research Personnel; Rheumatoid Arthritis; Secondary Fibromyalgias; Sensory; Spectrum Analysis; Standardization; Structure; Surveys; Testing; Treatment outcome; Universities; Validation; Work; base; central pain; central sensitization; clinical application; cohort; comorbidity; fibromyalgia patients; hip replacement arthroplasty; indexing; neuroimaging; novel; pain relief; psychologic; psychosocial; recruit

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.

项目概要/摘要 表型分析和结果核心 (POC) 密歇根大学纤维肌痛 CORT 提出，集中疼痛的存在会导致 对针对外周/伤害性疼痛的镇痛疗法（手术、生物制剂、 阿片类药物）并且这种集中疼痛表型具有相似的典型临床和神经生物学特征 FM，即使它与其他具有不同潜在疼痛的肌肉骨骼疼痛病症共存 机制。 POC 支持的 CORT 的具体目标如下： 1）证明 目前的 2011 年 FM 调查标准可作为疼痛集中化的有力替代指标，并强烈预测非 对治疗外周疼痛通常有效的疗法的反应，包括 a) 手术 旨在缓解疼痛（髋关节置换术、腕管松解术），b) 施用生物制剂来治疗 自身免疫性疾病（类风湿性关节炎），以及 c) 围手术期急性阿片类药物给药； 2) 至 证明在所有三个队列中，FM 得分最高的个体将具有相似的神经生物学特征 定量感觉测试（QST）和神经影像学中疼痛集中化的发现； 3）开发和试点 测试更短、更具预测性的疼痛集中度自我报告测量方法； 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（即以前称为原发性疼痛） FM）与自下而上（即以前称为辅助 FM）。具体来说，POC 将负责 以下：（1）评估每个治疗组的治疗结果，（2）表型/表征 每个患者队列、FM 对照组和健康对照组，(3) 潜在的发展 基于自我报告、QST 和神经影像学结果构建集中疼痛，(4) 发展和 验证一种新的临床适用的集中化测量方法，以及 (5) 探索两种潜在的亚型 集中化以及可评估这些亚型的自我报告项目的开发。