纤维肌痛(FM)是影响美国States.1-4虽然疼痛约500万成人的慢性特发性肌肉骨骼疼痛疾病通常被认为是FM的主要症状,大多数人遇到的症状群,包括疲劳,睡眠障碍,抑郁症,焦虑,晨僵和认知problems.4-8后者,认知问题,是由那些具有FM约70%的报道,并且被评为最令人头痛FM symptoms.4,7-9然而,认知一个问题很少被医生处理,并严格充分研究。通常称为fibrofog,这dyscognition已经通过患者描述为具有浓度,存储器,混乱和speaking.4,6,8,10有趣的是,fibrofog链接到对生命和功能的质量的破坏性影响的问题;促进困难维系关系,工作,交流,推动,组织规划,并启动每日life.6,8令人不安知之甚少fibrofog的NATUR的活动,尽管其公认的患病率和影响力。因为在FM审查在认知测试难度研究的范围和严密性是有限的,有持续的问题,即是否fibrofog仅仅是一个与注意力和记忆力的问题,或认知的其他地区是否会受到影响。以前的研究还没有充分评估或控制的共存症状或FM相比与其他临床群体,如抑郁症患者的影响;因此,它不知道是否fibrofog是其它FM症状的表现(例如抑郁,疲劳)或一组唯一的问题。因为有在FM十分有限的神经影像学研究,有缺乏可能是导致fibrofog神经过程的理解。最后,没有出现过努力,审查的有效性和FM现有的认知评估工具的效用;因此,研究人员和临床医生没有方向,以用来评估fibrofog严重性哪些工具。 The overarching goal of this proposal is to provide education and training to the Principal Investigator (PI), Anna Kratz, PhD, so that she has the requisite knowledge and skills to address these limitations in the scientific evidence on fibrofog. Dr. Kratz is a clinical psychologist whose research has focused on chronic pain in medical conditions such as arthritis, fibromyalgia, and multiple sclerosis. The proposed training plan will allow her to extend her knowledge from chronic pain into the areas of cognitive dysfunction, neuroimaging, and outcomes measurement. The PI has demonstrated commitment to a career in clinical health research, and a history of scholarship and research productivity. The University of Michigan provides her with a supportive, stimulating, and collaborative environment that offers an abundance of resources and support for early career scientists and clinical research. A diverse and accomplished mentoring team has been assembled to guide the PI toward expertise in cognitive dysfunction in FM, neurocognitive and self-report assessment technologies, and functional magnetic resonance imaging. Dr. Kratz's short-term career goals are to gain expertise in the nature of fibrofog, neurobiological functioning, neuroimaging, and evaluating and developing contemporary measures of fibrofog. These short-term goals will support her progression toward her long-term plan to develop an independent research program that makes significant contributions to the understanding and treatment of cognitive problems in other medical conditions where dyscognition is present but not the central focus of the condition. Ultimately, the skills that she acquires through the proposed training and research may be used to identify mechanisms of cognitive dysfunction that are common across medical diagnoses. The scientific objectives of this application are to methodically describe the phenotypic nature of fibrofog, examine the neurobiological processes underlying these cognitive problems, and test the utility of cognitive measures in fibrofog. First, to characterize the major areas of cognitive problems in fibrofog, a comprehensive set of contemporary (NIH Toolbox of Neurological and Behavioral Function) and gold standard neuropsychological tests will be administered to a sample of individuals with FM and an age- and sex-matched depressed control group. Second, functional magnetic resonance imaging will be conducted on individuals with FM and depressed controls while they are completing cognitive tasks. This will examine the dynamic connectivity of relevant brain regions that might provide insight about neurobiological mechanisms underlying fibrofog. Comparisons to depressed controls in terms of neuropsychological test performance and neurobiological functioning will provide insight about how fibrofog may be distinct from depression-related cognitive problems. Third, newly-developed and traditional measures of cognitive dysfunction will be submitted to psychometric analyses to determine their validity, reliability, and utility in detecting fibrofog. The ultimate aim of this study is to improve the clinical care of individuals wth fibrofog through the advancement of our understanding and assessment of this troubling set of symptoms. This award will enable Dr. Kratz to acquire the expertise and skills necessary to become an independent researcher capable of achieving the overall goal of elucidating the scope and mechanisms of cognitive dysfunction in FM.

公共卫生相关性

疼痛可能是纤维肌痛(FM)的主要症状,但患者认为认知功能障碍(如记忆、注意力和精神清晰度问题)是纤维肌痛最令人痛苦和治疗不足的方面。认知功能障碍的性质和病因尚不清楚;因此,这个K奖的首要目标是培养一名临床心理学家严谨地描述和识别FM认知功能障碍的潜在机制所需的方法。该研究方法将使用并需要在多种评估方法上进行培训,包括客观神经心理学表现测试、认知功能障碍的自我报告评估和神经成像技术(如功能连通性)。评估认知功能障碍的多个领域以及它们的神经生物学相关性,将有助于候选人在评估和治疗患有FM或其他复杂慢性疾病的个人认知问题方面做好准备。

机构
国家卫生研究所(NIH)
研究所
关节炎和肌肉骨骼和皮肤病研究所(NIAMS)
类型
研究科学家发展奖-研究与管理培训(K01)
项目#
5 k01ar064275-05
应用#
9457335
考研
关节炎和肌肉骨骼及皮肤疾病特别资助评审委员会(AMS)
项目官员
Wang Yan Z
项目启动
2014-04-01
项目结束
2019-03-31
预算开始
2018-04-01
预算结束
2019-03-31
支持年
5
财政年度
2018
总成本
间接开销
的名字
密歇根大学安阿伯
部门
物理医学和康复
类型
学校医学
兔褐#
073133571
城市
安阿伯
状态
心肌梗死
国家
美国
邮政编码
48109
安娜,Kratz L;约翰·墨菲3号;Kalpakjian, Claire Z等人。(2018)治疗或冥想吗?对于慢性疼痛和脊髓损伤的患者,更大的疼痛接受度与更低的止痛药物使用有关。期临床疼痛34:357-365
盖斯、迈克尔·E;L Kratz,安娜(2018)如何根据不同的情况来测量疼痛强度?疼痛159:1001 - 1002
之前,诺艾尔E;先令,斯蒂芬;弗里德曼,詹娜等人。(2018)脊髓损伤个体疼痛和疼痛干扰的一天结束和生态瞬间评估的可靠性。Qual Life Res 27:3003-3012
盖斯、迈克尔·E;L Kratz,安娜(2018)认知功能障碍与疼痛:未来研究的考虑。疼痛159:189 - 190
赖,Jin-Shei;晚安,Siera;唐宁,南希等人。(2018)评估亨廷顿病患者的认知能力:神经生活认知功能测量。Qual Life Res 27:811-822
安娜,Kratz L;墨菲,苏珊L;Braley,蒂芙尼J(2017)疼痛、疲劳和认知症状在多发性硬化症患者中是暂时相关的,但在几天内不存在。Arch Phys Med Rehabil 98:2151-2159
安娜,Kratz L;蒂芙尼J Braley;Foxen-Craft, Emily等。(2017)疼痛、疲劳、抑郁和认知症状与多发性硬化症患者日常生活中的福祉、社交和身体功能有什么关系?拱物理学医学Rehabil 98:2160年至2166年
安娜,Kratz L;桑德,安吉拉•M;布里克尔,特蕾西等。(2017)创伤性脑损伤看护者:配偶和家长的角度对生活质量的定性分析。Neuropsychol Rehabil 27:16-37
威吓,Alecia K;安娜,Kratz L;Hurvitz,爱德华。(2017)儿童选择性背根切开术对疼痛、疲劳和功能的长期影响:一项病例对照研究。Dev Med Child Neurol 59:1089-1095
安娜,Kratz L;墨菲,苏珊L;Braley,蒂芙尼J(2017)对疼痛、疲劳、抑郁和认知症状的生态瞬间评估揭示了多发性硬化症显著的日变异性。拱物理学医学Rehabil 98:2142至2150年

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