Mechanisms, Outcomes and Treatment of Non-Articular Pain in Rheumatoid Arthritis

类风湿性关节炎非关节疼痛的机制、结果和治疗

• 批准号: 7707585
• 负责人: Yvonne Claire Lee
• 金额: $ 13.76万
• 依托单位: BRIGHAM AND WOMEN'S HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-09-30 至 2014-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7707585
• 关键词: Affect; Anesthesiology; Arthritis; Back Pain; Biometry; Chronic; Clinical; Clinical Investigator; Clinical Trials; Cross-Over Studies; Cross-Sectional Studies; Data; Databases; Degenerative polyarthritis; Disease; Enrollment; Epidemiology; Exposure to; Faculty; Female; Fibromyalgia; Funding; Future; Goals; Hand; Hospitals; Hypersensitivity; Ice; Immersion Investigative Technique; Immunology; Inflammation; Inflammatory; Intervention; Joint by Site; Joints; Knowledge; Lead; Longitudinal Studies; Mediating; Mentorship; Methods; Michigan; Neurobiology; Norepinephrine; Observational Study; Pain; Pain Threshold; Pain management; Patients; Pharmaceutical Preparations; Physical Function; Physicians; Physiologic pulse; Placebos; Principal Investigator; Process; Psychiatry; Public Health Schools; Research; Research Personnel; Rheumatism; Rheumatoid Arthritis; Rheumatology; Risk Factors; Role; Scientist; Sensory; Series; Serotonin; Severities; Site; Stimulus; Symptoms; Syndrome; Techniques; Testing; Treatment outcome; Universities; Water; Woman; Work; base; career; central pain; central sensitization; chronic widespread pain; clinical care; cohort; conditioning; diffuse noxious inhibitory control; disability; disorder control; experience; functional status; illness length; improved; inhibitor/antagonist; medical schools; meetings; member; patient oriented research; pressure; prospective; research study; response; reuptake; skills; theories; volunteer

DESCRIPTION (provided by applicant): Dr. Lee's long-term goal is to be an independently funded investigator with expertise in the mechanlsnns and treatment of pain In patients with rheumatic disease. Her Immediate objectives are to gain skills in: 1) epidemiologic techniques to analyze longitudinal data, 2) mechanistic pain studies using quantitative sensory testing techniques and 3) clinical trials. The goal of her research Is to study the role of central mechanisms In rheumatoid arthritis (RA) pain and to define the effect of widespread, non-artlcular pain on change In physical function. Physicians often attribute RA pain to Inflammation, but many patients have pain despite well-controlled disease activity. Dr. Lee proposes that widespread, non-Inflammatory, non-articular pain significantly affects physical function and that better understanding the mechanisms of non-artlcular pain may lead to improved pain treatments. Her proposal involves three studies: 1) a two-year prospective, observational study to examine the effects of widespread, non-articular pain on change in physical function among 154 RA patients; 2) a cross-sectlonal study using quantitative sensory testing to assess central pain mechanisms among 80 RA patients and 40 healthy controls; and 3) a proof-of-concept clinical trial to study the role of serotonin-norepinephrine reuptake Inhibitors on widespread, non-articular pain in 30 RA patients. This research will take place in the Brigham and Women's Hospital Arthritis Center and the Pain Management Center, two high volume centers dedicated to clinical care and research. Dr. Lee will benefit from the mentorship of Drs. Elizabeth Karlson and Daniel Clauw and members of her Scientific and Career Advisory Boards, who have backgrounds in patient-oriented research in rheumatology, anesthesiology and psychiatry. As a junior faculty member In the Division of Rheumatology, Immunology and Allergy, Dr. Lee will interact with many experienced clinical Investigators, basic scientists and clinicians. She will take classes In biostatistics, epidemiology and neurobiology at the Harvard School of Public Health, Harvard Medical School and University of Michigan School of Public Health to further her knowledge of methods and theory.

描述（由申请人提供）：李博士的长期目标是成为一名具有独立资助的研究者，具有在机械人中的专业知识和风湿病患者疼痛的治疗。她的直接目标是获得：1）分析纵向数据的流行病学技术，2）使用定量感觉测试技术和3）临床试验的机械疼痛研究。她的研究的目的是研究中心机制在类风湿关节炎（RA）疼痛中的作用，并确定广泛的，非骨骼疼痛对身体机能变化的影响。医师经常将RA疼痛归因于炎症，但是尽管疾病活动良好，许多患者仍会疼痛。 Lee博士提出，普遍的非炎症性，非关节疼痛会显着影响身体机能，并且更好地理解非前疼痛的机制可能会改善疼痛治疗。她的提议涉及三项研究：1）一项为期两年的前瞻性，观察性研究，以研究154名RA患者对身体功能变化的广泛，非关节疼痛的影响； 2）使用定量感觉测试进行跨侧隆研究，以评估80名RA患者和40个健康对照组中的中心疼痛机制； 3）概念验证临床试验，研究5-30名RA患者对5-羟色胺 - 肾上腺素再摄取抑制剂在广泛的非关节疼痛中的作用。这项研究将在Brigham and妇女医院关节炎中心和疼痛管理中心进行，这是两个专门用于临床护理和研究的大容量中心。李博士将从博士的指导中受益。伊丽莎白·卡尔森（Elizabeth Karlson）和丹尼尔·克劳维（Daniel Clauw）以及她的科学和职业咨询委员会成员，他们在风湿病学，麻醉学和精神病学方面具有患者研究的背景。作为风湿病学，免疫学和过敏系的初级教师，李博士将与许多经验丰富的临床研究人员，基础科学家和临床医生互动。她将在哈佛大学公共卫生学院，哈佛医学院和密歇根大学公共卫生学院参加生物统计学，流行病学和神经生物学课程，以进一步了解她对方法和理论的了解。