The Impact of Physical Activity on the Neurophysiologic and Gene Expression Profiles of Chronic Low Back Pain: A Longitudinal Cohort Study
PI: Dr. Wanli XuIn response to the National Pain Strategy’s call for “improvements in pain self-management programs that can help affected individuals improve their knowledge, skills and confidence to prevent, reduce and cope with pain...”, the Center’s team developed the Problem-solving Pain to Enhance Living Well (PROPEL) program. PROPEL incorporates evidence-based, standard of care methods to promote physical activity among individuals with pain, and tools to improve knowledge, skills and confidence to cope with cLBP. In order to gain mechanistic insight into the impact of physical activity on the neurophysiologic and gene expression profiles of cLBP, we will engage participants in PROPEL, with support of nurse consultations and wearable activity tracking technology. Neurophysiologic measures will be obtained using a standardized protocol of quantitative sensory testing (QST). Gene expression profiling will be assayed using RNA sequencing, which has been successfully used to identify differential gene expression in small cohorts of patients with fibromyalgia, cluster headache, and migraine. To test the central hypothesis of this application, which is that moderate physical activity will exert a significant change in neurophysiological and gene expression profiles, we will conduct a one group, longitudinal cohort study of cLBP participants during the PROPEL program.
Integrated Pain Self-Management for Comorbid Diabetes and Low Back Pain
PI: Dr. Louise ReaganChronic pain is common among persons with type 2 diabetes (T2D) and negatively affects T2D self-management (SM). Chronic low back pain (cLBP) is the most frequently reported painful condition, affecting approximately 37% of patients with T2D and surpassing the prevalence of painful diabetic neuropathy. The primary goal of the proposed study is to identify the influence of cLBP flare on daily T2D and pain self-care by comparing SM context factors and daily self-care among 3 distinct patient cohorts: pain-free patients with T2D, patients with cLBP and patients with coexisting T2D and cLBP during a period of cLBP flare.
Development of a SPINE Mobile Application to Improve Low Back Pain Self-Management
PI: Dr. Angela StarkweatherThe Sensitivity to Pain IN mE (SPINE), is designed to increase individuals’ self-management knowledge and skills for activating pain modulatory pathways that are known to reduce nociceptive signaling and expression of pain sensitivity genes. Furthermore, to enhance accessibility to the intervention, we propose to adapt SPINE to a mobile format (SPINE-M) and evaluate the usability, feasibility and initial efficacy on self-management knowledge, skills and outcomes in patients with aLBP ages 45-65 when cLBP susceptibility peaks. Our SPINE-M will empower patients with limited health literacy to make decisions about their pain care by reducing health literacy demands needed for pain management.
Neurophysiological and Transcriptomic Predictors of Chronic Low Back Pain: TOWARDS PRECISION PAIN MANAGEMENT
PIs: Dr. Angela Starkweather (UConn) in collaboration with Drs. Cynthia Renn and Susan Dorsey (University of Maryland, Baltimore SON)
Study Coordinator: Bright Eze, UConn SON PhD Candidate
Chronic low back pain (cLBP) is one of the most common and costly pain conditions in the United States, and a leading cause of disability. A majority of cLBP cases are not associated with underlying structural abnormalities, however, accumulating evidence suggests the prolonged, intense sensitivity to pain that characterizes cLBP is caused by distinct changes in expression of immune and other related pain sensitivity genes. The NEAT study aims to discover gene expression biomarkers that predict cLBP so that we may uncover new therapeutic targets, identify patients at risk, and develop early, targeted interventions to reduce disability and improve quality of life for patients.