Chronic Pain, Interdisciplinary Multimodal Pain Therapy, Electroencephalography, Functional Connectivity Clinical Trial
Official title:
The Influence of Interdisciplinary Multimodal Pain Therapy on Cerebral Connectivity in Chronic Pain Patients
Due to its high prevalence and the substantial individual and socio-economic burden chronic
pain is a huge challenge for patients, physicians and the society. Using neuroimaging
structural and functional alterations have been described in the brain of patients suffering
from chronic pain (Apkarian, Hashmi et al. 2011, Baliki and Apkarian 2015). However,
reproducibility and functional significance of these changes are only incompletely
understood. For example it remains unclear, if these changes covariate with clinical
parameters and if they can be influenced or reversed by appropriate therapy. Some of the
structural and functional brain changes in chronic pain patients have been shown to be
reversible using magnetic resonance imaging after successful interventional pain treatment
(Seminowicz, Wideman et al. 2011) or cognitive-behavioral therapy (Seminowicz, Shpaner et al.
2013, Shpaner, Kelly et al. 2014). Interdisciplinary multimodal pain therapy (IMPT) as a
biopsychosocial treatment approach comprising physiotherapy and psychotherapy in structured
programs has been shown to be effective in alleviating chronic pain of different entities
including those where interventional therapy options are lacking or have been unsuccessful
(Kaiser, Treede et al. 2017). The present study aims to investigate the influence of a
structured IMPT approach provided in a day-clinic program of 20 treatment days on the
functional brain network structure in chronic pain patients. To this end, a graph-theory
based analysis (Bullmore and Sporns 2009) will be applied to electroencephalography (EEG)
resting-state data from 30 chronic pain patients before and after IMPT and results will be
correlated with behavioral and clinical data. In this observational study chronic pain
patients that have been screened for participation in IMPT as part of routine medical care
are invited to participate in a baseline visit prior to participation and a follow-up visit 6
months after completion of the program.
This will add to a better understanding of the complex functional brain alterations in
chronic pain and might contribute to identify neuronal markers or even predictors for
therapeutic responses in multimodal pain treatments. Moreover, the broad availability and
easy applicability of EEG-measurements might enable a wide therapeutic application of
potential findings in the near future.
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