University of Michigan BACPAC Mechanistic Research Center

密歇根大学BACPAC机理研究中心

• 批准号: 10650650
• 负责人: Daniel J Clauw
• 金额: $ 11.28万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-09-26 至 2024-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10650650
• 关键词: Acupressure; Address; Analgesics; Autoimmune Diseases; Award; Chronic low back pain; Clinical; Data; Effectiveness; Evaluation; Functional Imaging; Functional Magnetic Resonance Imaging; Goals; Helping to End Addiction Long-term; Individual; Inflammation; Intervention; Knowledge; Learning Skill; Measures; Methods; Michigan; Modality; Neurobiology; Online Systems; Pain; Pain Measurement; Parents; Patient Outcomes Assessments; Patients; Pharmacology; Phenotype; Physical therapy; Plasma; Predictive Factor; Quality of life; Randomized; Reporting; Research; Rheumatism; Self Care; Sensory; Series; Standardization; Testing; Training; Treatment Effectiveness; Universities; Work; base; chronic pain; cohort; debilitating pain; digital; digital intervention; disability; duloxetine; efficacious treatment; efficacy evaluation; evidence base; experience; functional disability; gabapentin; mindfulness intervention; pain patient; parent grant; precision medicine; predicting response; response; rheumatologist; self-management program; treatment effect; treatment response

Project Summary / Abstract Individual and societal burdens from chronic low back pain (cLBP) are significant and associated with long term functional impairment, disability, and poor quality of life. There are many efficacious treatments in cLBP but the factors that predict treatment effectiveness in an individual are still not well understood. Treatments for chronic pain include several pharmacologic (e.g., duloxetine and gabapentin) and non-pharmacologic treatments such as physical therapy, acupressure, mindfulness-based interventions, and web-based self- management programs. There is an urgent need for a greater understanding of pain mechanisms and predictors of response to different therapies with a goal of matching patients based on phenotypes to therapies to which they are most likely to respond. The parent award, a HEAL Initiative award (U19 AR076734), uses a precision medicine approach to identify what treatments are likely to work in different patient endotypes. The proposed supplement will allow me, a clinical rheumatologist, to learn these skills through assessments of acupressure and the web-based self-management program on patient-reported pain in cLBP. Clinically available data (such as patient-reported outcomes) as well as state-of-the-art phenotyping methods such as functional MRI (fMRI) and Quantitative Sensory Testing (QST), will be available to mechanistically explore the proposed neurobiological effects of these treatments. This knowledge will be invaluable in my future research on evaluation of pain mechanisms and responsiveness to treatment based on phenotypes of individuals with rheumatic disease.

项目概要/摘要 慢性腰痛 (cLBP) 给个人和社会带来的负担是巨大的，并且与长期腰痛有关。 长期功能障碍、残疾和生活质量差。 cLBP 有很多有效的治疗方法 但预测个体治疗效果的因素仍不清楚。治疗方法 慢性疼痛包括多种药物性疼痛（例如度洛西汀和加巴喷丁）和非药物性疼痛 物理治疗、穴位按摩、基于正念的干预措施和基于网络的自我治疗等治疗方法 管理计划。迫切需要更好地了解疼痛机制和 对不同疗法反应的预测因素，目的是根据表型将患者与疗法相匹配 他们最有可能对此做出反应。家长奖是 HEAL Initiative 奖 (U19 AR076734)，使用 精准医学方法来确定哪些治疗方法可能对不同患者的内型有效。这 拟议的补充将使我，一名临床风湿病学家，通过评估来学习这些技能 穴位按摩和基于网络的自我管理计划针对患者报告的 cLBP 疼痛。临床上 可用数据（例如患者报告的结果）以及最先进的表型分析方法，例如 功能性 MRI (fMRI) 和定量感官测试 (QST) 将可用于机械地探索 提出了这些治疗的神经生物学作用。这些知识对于我未来的研究将是无价的 根据个体的表型评估疼痛机制和对治疗的反应 风湿性疾病。