Endogenous Opioid Systems and Symptom Change in Fibromyalgia

NCT ID: NCT02866461

Last Updated: 2023-04-18

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

WITHDRAWN

Study Classification

OBSERVATIONAL

Study Start Date

2021-11-30

Study Completion Date

2023-08-31

Brief Summary

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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

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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.

Conditions

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Fibromyalgia

Study Design

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Observational Model Type

ECOLOGIC_OR_COMMUNITY

Study Time Perspective

PROSPECTIVE

Study Groups

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Fibromyalgia

No treatment

No treatment

Intervention Type OTHER

Observation

Interventions

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No treatment

Observation

Intervention Type OTHER

Eligibility Criteria

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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
Minimum Eligible Age

18 Years

Maximum Eligible Age

55 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Utah

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

References

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Scott DJ, Heitzeg MM, Koeppe RA, Stohler CS, Zubieta JK. Variations in the human pain stress experience mediated by ventral and dorsal basal ganglia dopamine activity. J Neurosci. 2006 Oct 18;26(42):10789-95. doi: 10.1523/JNEUROSCI.2577-06.2006.

Reference Type BACKGROUND
PMID: 17050717 (View on PubMed)

Harris RE, Clauw DJ, Scott DJ, McLean SA, Gracely RH, Zubieta JK. Decreased central mu-opioid receptor availability in fibromyalgia. J Neurosci. 2007 Sep 12;27(37):10000-6. doi: 10.1523/JNEUROSCI.2849-07.2007.

Reference Type BACKGROUND
PMID: 17855614 (View on PubMed)

Harris RE, Zubieta JK, Scott DJ, Napadow V, Gracely RH, Clauw DJ. Traditional Chinese acupuncture and placebo (sham) acupuncture are differentiated by their effects on mu-opioid receptors (MORs). Neuroimage. 2009 Sep;47(3):1077-85. doi: 10.1016/j.neuroimage.2009.05.083. Epub 2009 Jun 6.

Reference Type BACKGROUND
PMID: 19501658 (View on PubMed)

Martikainen IK, Pecina M, Love TM, Nuechterlein EB, Cummiford CM, Green CR, Harris RE, Stohler CS, Zubieta JK. Alterations in endogenous opioid functional measures in chronic back pain. J Neurosci. 2013 Sep 11;33(37):14729-37. doi: 10.1523/JNEUROSCI.1400-13.2013.

Reference Type BACKGROUND
PMID: 24027273 (View on PubMed)

Pecina M, Martinez-Jauand M, Love T, Heffernan J, Montoya P, Hodgkinson C, Stohler CS, Goldman D, Zubieta JK. Valence-specific effects of BDNF Val66Met polymorphism on dopaminergic stress and reward processing in humans. J Neurosci. 2014 Apr 23;34(17):5874-81. doi: 10.1523/JNEUROSCI.2152-13.2014.

Reference Type BACKGROUND
PMID: 24760847 (View on PubMed)

Martikainen IK, Nuechterlein EB, Pecina M, Love TM, Cummiford CM, Green CR, Stohler CS, Zubieta JK. Chronic Back Pain Is Associated with Alterations in Dopamine Neurotransmission in the Ventral Striatum. J Neurosci. 2015 Jul 8;35(27):9957-65. doi: 10.1523/JNEUROSCI.4605-14.2015.

Reference Type BACKGROUND
PMID: 26156996 (View on PubMed)

Other Identifiers

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R01 3589819

Identifier Type: -

Identifier Source: org_study_id

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