Utility of Functional MRI Based Biomarker for Chronic Pain

Utility of Functional MRI Based Biomarker for Chronic Pain

Chronic pain affects 70 million Americans at a cost to the US economy of over $150 billion per year and the success rate for its treatment poor with treatment largely limited to opioids. Although the mechanisms underlying chronic pain are not well known, increasing evidence suggests a critical role of central nervous system plasticity in the development and maintenance of chronic pain that involve a spectrum of somatosensory to affective or emotionally maintained chronic pain states. Progress has been hampered due to the lack of an objective diagnostic test or biomarker that can complement the subjective assessment of chronic pain conditions. To investigate the mechanism of chronic pain in adults with chronic back pain, we performed functional connectivity MRI (fcMRI) in 10 patients and 16 controls. Our goal was to compare the connectivity between patients and controls, with special attention paid to emotion/limbic regions. Preliminary data shows that the relationships of limbic brain networks with other brain networks are significantly altered in patients vs. controls and that the degree of connectivity change is correlated with pain severity. This novel approach has not been reported before. Based on these data, our working hypothesis is that a fcMRI-based biomarker can be used to help improve management of chronic pain patients with alternatives to opioids. The current proposal expands on these preliminary findings with a larger study of fcMRI in adults with chronic pain. Aims 1, 2: Evaluate the robustness and predictive value of this putative chronic pain biomarker in predicting pain levels. Aim 3: Evaluate the value of this biomarker in predicting the short and long-term success in alternative treatments for chronic pain patients. Aim 4: Evaluate the utility of this biomarker in optimizing alternative therapies for chronic pain patients.

Participant Eligibility

Inclusion Criteria:

1.  >18 years of age

2. Diagnosis of Failed Back Surgery Syndrome

3. Primarily nerve pain involving the back and/or the legs

4. Subjects previously implanted with Medtronic Spinal Cord Stimulation  systems that have been approved by the MCW MRI Safety committee, with batteries’ implanted in the buttocks area.

5. Able to be safely scanned in a 3T scanner

Exclusion Criteria:

1. < 18 years of age

2. Pregnant women

3. Subjects with a history of working with metal or patients that have metals implanted in their bodies

Contact

Peter Pahapill
(414) 805-5400