University of Michigan Fibromyalgia CORT

密歇根大学纤维肌痛 CORT

• 批准号: 9194480
• 负责人: Chad M Brummett
• 金额: $ 164.23万
• 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 2021-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9194480
• 关键词: Acute; Affect; Analgesics; Autoimmune Diseases; Caring; Carpal Tunnel Syndrome; Chemicals; Chronic; Clinical; Coin; Data; Degenerative polyarthritis; Diagnostic; Disease; Employee Strikes; Fibromyalgia; Goals; Individual; Inflammation; Knowledge; Measures; Michigan; Moods; Musculoskeletal Pain; Nerve Entrapment; Neuraxis; Neurobiology; Nociception; Operative Surgical Procedures; Opioid; Pain; Pain Research; Pain management; Patient Self-Report; Patients; Perioperative; Peripheral; Phenotype; Primary Fibromyalgias; Psychological Factors; Research; Research Personnel; Resources; Rheumatism; Rheumatoid Arthritis; Secondary Fibromyalgias; Sensory; Surveys; Symptoms; Testing; Tissues; Training; Translating; Universities; abstracting; base; central sensitization; chronic pain; chronic pelvic pain; clinical practice; cohort; common symptom; disability; experience; hip replacement arthroplasty; improved; indexing; inflammatory pain; joint injury; neuroimaging; painful neuropathy; peripheral pain; precision medicine; programs; response; surgical pain

PROJECT SUMMARY / ABSTRACT OVERALL COMPONENT Chronic musculoskeletal pain is extremely common, and pain is the most common symptom in nearly all rheumatic disorders. However, in all chronic pain conditions there is a tremendous disparity between identifiable damage/inflammation in the periphery – and pain, and classic psychological factors such as mood or catastrophizing explain very little of the variance between pain and objective findings. Many individuals with chronic pain have surgery for this problem and have continued pain despite excellent surgical results, just as many patients with autoimmune disorders continue to have pain after inflammation is well controlled with biologics. We hypothesize that the reason there is such a disparity between pain and other symptoms - and the degree of damage/inflammation in the periphery - is that individuals with chronic musculoskeletal pain display variable degrees of fibromyalgia. The University of Michigan Fibromyalgia CORT proposes that the current 2011 FM Survey Criteria is a surrogate measure of centralized pain, and that higher scores on this measure will be predictive of more pain and other symptoms originating from the central nervous system (CNS). Thus higher scores on this measure will render individuals less responsive to analgesic therapies aimed at peripheral/nociceptive pain (surgery, biologics, opioids). We will demonstrate that this centralized pain phenotype has stereotypical clinical and neurobiological features to FM even when it is co-morbid with other musculoskeletal pain conditions with disparate underlying pain mechanisms: osteoarthritis, rheumatoid arthritis, and carpal tunnel syndrome. Our specific aims are: 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; 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); and 5) To serve as a core national resource for training both researchers and clinicians in contemporary musculoskeletal pain research and care.

项目概要/摘要 整体组成 慢性肌肉骨骼疼痛极为常见，疼痛是几乎所有疼痛中最常见的症状 然而，在所有慢性疼痛疾病中，两者之间存在巨大差异。 周围可识别的损伤/炎症——以及疼痛，以及情绪等经典心理因素 或灾难化解释了疼痛与客观结果之间的差异。 慢性疼痛需要接受手术来解决这个问题，尽管手术效果很好，但疼痛仍然持续，就像 许多患有自身免疫性疾病的患者在炎症消退后仍会感到疼痛 生物制剂。 我们探究疼痛和其他症状之间存在如此差异的原因 - 以及 周围损伤/炎症的程度 - 患有慢性肌肉骨骼疼痛的个体表现出 密歇根大学纤维肌痛 CORT 提出，目前的纤维肌痛程度不同。 2011 FM 调查标准是集中疼痛的替代衡量标准，该衡量标准得分较高 将预示更多源自中枢神经系统 (CNS) 的疼痛和其他症状。 这项措施的得分越高，个体对镇痛疗法的反应就越迟钝。 外周/伤害性疼痛（手术、生物制剂、阿片类药物）我们将证明这种集中疼痛。 即使 FM 与其他疾病共存，表型也具有典型的 FM 临床和神经生物学特征 具有不同潜在疼痛机制的肌肉骨骼疼痛：骨关节炎、类风湿 关节炎和腕管综合症。 我们的具体目标是： 1) 证明当前的 2011 年 FM 调查标准是强有力的 疼痛集中的替代指标，并强烈预测对通常有效的治疗无反应 治疗外周疼痛，包括 a) 旨在缓解疼痛的手术（髋关节置换术、腕管手术） 释放），b）施用生物制剂治疗自身免疫性疾病（类风湿性关节炎），以及c） 2) 证明在所有三个队列中，阿片类药物的急性使用； 最高 FM 分数将在定量感觉上具有类似的疼痛集中化神经生物学发现 测试（QST）和神经影像学；3）开发和试点测试更短且更具预测性的自我报告 疼痛集中度的测量；4) 探索两个重要子集的临床和机制特征 集中疼痛：自上而下（即以前称为主要 FM）与自下而上（即以前称为次要 FM） FM）；5）作为培养当代研究人员和主导人才的核心国家资源 肌肉骨骼疼痛研究和护理。