Neuroimaging-Based Brain and Spinal Cord Biomarkers for Cervical Radiculopathy

基于神经影像的脑和脊髓颈神经根病生物标志物

• 批准号: 10000175
• 负责人: Kenneth Arnold Weber
• 金额: $ 17.51万
• 依托单位: STANFORD 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 2023-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10000175
• 关键词: Acute; Acute Pain; Address; Affect; Age; American; Area; Attention; Award; Base of the Brain; Biological Markers; Brain; Brain Stem; Brain imaging; Cell Nucleus; Cervical Radiculopathies; Cervical nerves; Cervical spinal cord structure; Clinical; Clinical Management; Clinical Research; Computing Methodologies; Data Analyses; Development; Disease; Etiology; Faculty; Failure; Functional disorder; Funding; Goals; Grant; Healthcare Systems; Household; Image; Individual; Investigation; K-Series Research Career Programs; Knowledge; Lead; Left; Link; Machine Learning; Magnetic Resonance; Maintenance; Measures; Medical Imaging; Mentors; Methods; Modeling; Motor; Musculoskeletal Pain; Neck; Neuraxis; Neurobiology; Neuronal Plasticity; Neurosciences; Pain; Pain Research; Pain intensity; Pathology; Patient imaging; Patients; Pattern; Peripheral; Plant Roots; Positioning Attribute; Prevalence; Process; Prognostic Factor; Public Health; Randomized Controlled Trials; Recovery; Research; Research Personnel; Research Training; Rest; Role; Sampling; Sensory; Severities; Side; Spinal Cord; Structure; Synaptic Transmission; Techniques; Thalamic structure; Training; Upper Extremity; Work; Writing; base; career development; chronic pain; chronic pain management; chronic pain patient; chronic painful condition; clinical pain; cohort; design; diffusion weighted; disability; falls; improved; in vivo; individualized medicine; innovation; irritation; multidisciplinary; neural network; neuroimaging; neurotransmission; novel; pain model; pain reduction; patient oriented research; predictive modeling; programs; recruit; relating to nervous system; sex; skills; spinal cord imaging; statistical learning; success; tenure track

Chronic pain is a widespread problem that affects a third of Americans and greatly burdens the health care system. Despite its prevalence, chronic pain remains poorly understood, and the current clinical strategies are minimally effective. The application of advanced neuroimaging techniques to the study of chronic pain has significantly increased our understanding of the brain’s role in the development and maintenance of chronic pain, and through these studies, researchers have uncovered previously unknown neural processes involved in pain chronification. The spinal cord is the caudal extension of the brainstem and is actively involved in the modulation and transmission of neural signals between the body and the brain. Alterations in the neural processing in the spinal cord are also thought to have an integral role in pain chronification. Recent advancements in spinal cord neuroimaging have made the quantitative study of the spinal cord’s role in chronic pain possible. Expanding the neuroimaging-based investigation of chronic pain to the spinal cord will provide a complete perspective of the central processes underlying pain chronification. In this mentored career development award (K23), Dr. Weber will identify, characterize, and longitudinally track neuroimaging-based biomarkers for chronic pain in the brain and spinal cord using cervical radiculopathy as a model condition for chronic pain. Cervical radiculopathy is a common cause of neck and upper limb pain and provides a unique opportunity to scientifically study chronic pain in a homogenous patient sample. In Aims 1 and 2, Dr. Weber will identify differences in the brain and spinal cord networks between patients with chronic pain due to right-sided cervical radiculopathy and age- and sex-matched healthy controls. In Aim 3, clinical measures in the same cohort of cervical radiculopathy patients will be longitudinally tracked at 3, 6, 9, and 12 months after the imaging session, and neuroimaging-based prognostic factors contributing to pain reduction in cervical radiculopathy will be identified. In the same cohort of patients, the imaging will be repeated at 12 months, and the links between the changes in the brain and spinal cord and recovery will be explored. This research will move the pain field forward by further elucidating the neural processes underlying chronic pain and its recovery. Throughout the award period, Dr. Weber will obtain new skills and expertise in conducting clinical studies including randomized controlled trials and applying advanced computational methods to clinical pain research. Additionally, Dr. Weber will gain further training in advanced neuroimaging methods, pain neurobiology, career development, and grant writing. To accomplish the proposed research and training, Dr. Weber has assembled a multi-disciplinary team of world-class mentors who are committed to his success. This training will build on Dr. Weber’s clinical background and doctoral research training in neuroscience and ultimately provide him with the knowledge and skillset to establish an independent research program, in which, he will lead impactful scientific research that intersects neuroimaging and clinical pain research.

慢性疼痛是一个普遍存在的问题，影响着三分之一的美国人，给医疗保健系统带来了巨大负担，尽管慢性疼痛很普遍，但人们对它的了解仍知之甚少，目前的临床策略在慢性疼痛研究中的应用效果甚微。疼痛显着增加了我们对大脑在慢性疼痛的发生和维持中的作用的了解，通过这些研究，研究人员发现了以前未知的与疼痛慢性化有关的神经过程，脊髓是脑干的尾部延伸，并且积极参与其中。在身体和大脑之间神经信号的调节和传输也被认为在疼痛慢性化中发挥着不可或缺的作用。脊髓神经影像学的最新进展已经对脊髓的作用进行了定量研究。将基于神经影像学的慢性疼痛研究扩展到脊髓将为疼痛慢性化的核心过程提供完整的视角。在这个指导性职业发展奖（K23）中，韦伯博士将确定：使用颈神经根病作为慢性疼痛的模型病症，描述并纵向跟踪基于神经影像的大脑和脊髓慢性疼痛生物标志物颈神经根病是颈部和上肢疼痛的常见原因，为科学研究慢性疼痛提供了独特的机会。在目标 1 和 2 中，Weber 博士将确定因右侧颈神经根病导致的慢性疼痛患者和年龄和性别匹配的患者之间大脑和脊髓网络的差异。在目标 3 中，将在影像学检查后 3、6、9 和 12 个月纵向跟踪同一组颈神经根病患者的临床测量，并且基于神经影像学的有助于减轻颈神经根病疼痛的预后因素。在同一组患者中，将在 12 个月时重复成像，并探索大脑和脊髓的变化与恢复之间的联系，这项研究将进一步推动疼痛领域的发展。在整个获奖期间，韦伯博士将获得开展临床研究的新技能和专业知识，包括随机对照试验以及将先进的计算方法应用于临床疼痛研究。为了完成拟议的研究和培训，韦伯博士组建了一个由世界级导师组成的多学科团队，他们致力于帮助他取得成功。以博士为基础韦伯的神经科学临床背景和博士研究培训最终为他提供了建立独立研究项目的知识和技能，在该项目中，他将领导跨神经影像学和临床疼痛研究的有影响力的科学研究。