Fibromyalgia
Conditions
Brief summary
This study is designed to study brain mechanisms associated with symptoms and severity of Fibromyalgia. This will be accomplished by relating results from PET scans to self-reported and objective measures of disease severity.
Detailed description
The purpose of this study is to examine µ-opioid receptor (µOR)-mediated neurotransmission in patients diagnosed with persistent pain, fibromyalgia (FM), and its relationship with pain and affect measures. µOR activation is expected to take place in the following brain regions: rostral and dorsal anterior cingulate (rACC, dACC), orbitofrontal cortex (OFC), thalamus (THA), nucleus accumbens (NAC), amygdala (AMY), periaqueductal gray (PAG). Greater regional activation is expected to be associated with improvements in clinical pain ratings and affective state. The endogenous opioid system and µ-opioid receptors (µORs) play a central role in the regulation of pain, the pathophysiology of chronic pain syndromes, mood and emotion; this system is dysregulated in persistent pain syndromes. A substantial body of literature addressing these mechanisms has been developed in our laboratory, including recent data on the cognitive and molecular mechanisms associated with reductions in pain, as well as trait personality and genetic predictors of emotional effects in the context of pain. Eighty individuals who have been diagnosed with FM and who fit the inclusion and exclusion criteria will be enrolled in this 14-week protocol. An initial visit for informed consent procedures and baseline characterization will then be scheduled, as well as the visits for positron emission tomography (PET) and magnetic resonance imaging (MRI) procedures. Subjects will return for testing after 6 and 14 weeks. Volunteers will undergo imaging with structural and functional MRI and PET with \[11C\]carfentanil to determine baseline µOR non-displaceable binding potential (BPND) and changes in those BPND measures coinciding with symptom severity at the time of scanning.
Interventions
OTHERNo treatment
Observation
Sponsors
University of Utah
Study design
Observational model
ECOLOGIC_OR_COMMUNITY
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 55 Years
Healthy volunteers
No
Inclusion criteria
* Have met American College of Rheumatology (ACR) criteria for fibromyalgia for at least 1 year; * Willing to limit introduction of new treatments during the study; * Use of sleep aids no more than twice per week * 18-55 years of age * right handed * capable of providing written informed consent
Exclusion criteria
* concurrent untreated medical illnesses, autoimmune, or inflammatory disease; * Routine daily use of narcotic analgesics or history of substance abuse; * Concurrent participation in other therapeutic trials; * Pregnancy/ nursing; * Ongoing psychiatric illness; * Contraindications to PET or MRI methods; * Impairments that would prevent completion of the study protocol; * Use of sleep aids at frequency of more that twice per week; * Allergy to fentanyl
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| change in mu opioid-mediated neurotransmission | Change from baseline at 6 weeks | assessed via PET scanning |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| change in Biomarkers of pain response | Change from baseline at 6 weeks | serum cortisol |
| change in Pain | Change from baseline at 6 weeks | assessed via questionnaire |
| change in mu opioid-mediated neurotransmission | Change from 8 weeks at 14 weeks | assessed via PET scanning |
Outcome results
None listed