Spatiotemporal Thalamocortical Alterations Underlie Experimental and Chronic Pain

Study Overview
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Brief Summary
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This study aims to identify spatiotemporal alterations in thalamocortical circuitry functioning in both healthy subjects and patients with chronic pain, combining multimodal neuroimaging.

Detailed Description
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Investigators will pursue this goal in both experimental and clinical models at two sites (Florida State U/FSU & Mass General Hospital/MGH), implementing parallel enrollment of large and diverse samples (140 healthy participants and 60 patients with chronic low back pain/cLBP). Leveraging the fully developed multimodal neuroimaging methodology-simultaneous EEG-fMRI and combined EEG-MEG-fMRI, the investigators will investigate TC dysconnectivity (fMRI) and alpha dysrhythmia (EEG/MEG) during experimental pressure pain and chronic back pain.

Official Title
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Spatiotemporal Thalamocortical Alterations Underlie Experimental and Chronic Pain

Conditions
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Experimental Pain, Low Back Pain

Intervention / Treatment
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* Other: No intervention


Participation Criteria
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Eligibility Criteria
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Healthy subjects for both MGH and FSU sites Inclusion Criteria: healthy male and female adults Between the ages of 18 and 60 years Meeting the MRI / MEG / EEG screening criteria Fluent in English; English can be a second language provided that the patients understand all questions used in the assessment measures. This will be asked and judged during the phone screen. Exclusion Criteria: Current or past history of major medical, neurological, or psychiatric illness based on self-report History of cardiac, respiratory, or nervous system disease that, in the investigator's judgment, precludes participation in the study because of a heightened potential for adverse outcome (for example: asthma or claustrophobia) History of head trauma Pregnant or lactating Presence of any contraindications to MRI scanning (for example: cardiac pacemaker, metal implants, claustrophobia, pregnancy, cannot lie still in fMRI scanner) Conditions making study participation difficult (e.g., paralysis, psychoses, or other severe psychological problems as per the judgment of a study investigator during Session 1) Active substance abuse disorders (based on subject self-report) Subjects with chronic low back pain (MGH site) Inclusion Criteria: Volunteers 18-60 years of age Meet the Classification Criteria of the chronic LBP (having low back pain for more than 6 months) At least 4/10 clinical pain on the 0-10 LBP NRS Meeting the MRI / MEG / EEG screening criteria Fluent in English; English can be a second language provided that the patients understand all questions used in the assessment measures. This will be asked and judged during the phone screen. Exclusion Criteria: Specific causes of back pain (eg, cancer, fractures, spinal stenosis, infections) Complicated back problems (eg, prior back surgery, medicolegal issues) The intent to undergo surgery during the time of involvement in the study Current or past history of major medical, neurological, or psychiatric illness based on self-report History of cardiac, respiratory, or nervous system disease that, in the investigator's judgment, precludes participation in the study because of a heightened potential for adverse outcome (for example: asthma or claustrophobia) History of head trauma Pregnant or lactating Presence of any contraindications to MRI scanning (for example: cardiac pacemaker, metal implants, claustrophobia, pregnancy, cannot lie still in fMRI scanner) Conditions making study participation difficult (e.g., paralysis, psychoses, or other severe psychological problems as per the judgment of a study investigator during Session 1) Active substance abuse disorders (based on subject self-report) Regular use of pain medication such as opioids, nonopioid analgesics, coanalgesics, corticosteroids, or immunomodulatory agents Current use of psychotropic medication

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 60 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Healthy Control<br>Healthy participants will undergo multimodal neuroimaging during resting state, no-pain and painful tonic pressure presentation. At FSU, EEG and fMRI will be simultaneously acquired. At MGH, sequential MRI and MEG/EEG will be acquired. | Other: No intervention<br>* No intervention involved in this study<br>|
| Patients with chronic low back pain<br>Subjects with chronic low back pain (cLBP) patients will undergo multimodal neuroimaging during resting state, no-pain and painful tonic pressure presentation. The study will only be performed at MGH, sequential MRI and MEG/EEG will be acquired. | Other: No intervention<br>* No intervention involved in this study<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| thalamocortical functional connectivity | functional connectivity between the thalamus and cortex as measured by resting state fMRI | baseline | 
| alpha oscillations | alpha oscillations as measured by EEG and MEG | baseline | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| alpha band source | MEG and EEG data will be used to estimate the alpha band source | Baseline | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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EEG, fMRI, thalamus, pain, experimental pain, low back pain