Decoding Pain Sensitivity in Migraine With Multimodal Brainstem-based Neurosignature
調査の概要
詳細な説明
Migraine causes a tremendous disease burden around the world. Migraine is one of the most prevalent neurological disorders and is reported by the WHO as the second leading cause of disease-related disabilities globally (No. 1 in the population under the 50s). There has been no much change in the ranking of disability for migraine for the past two decades, reflecting an unmet need for better treatment options. Even with the recently available calcitonin-gene related peptide (CGRP)-based treatment, the treatment response versus placebo is still disappointing (6.4-17.6% in acute treatment, 10.2-23.7% in preventive treatment). There is an urgent need to push further the current understanding of the pathophysiology of migraine, based on which novel treatment strategies can be developed. The lack of appropriate research tools hinders the acceleration of migraine research. As a neurological disorder, many neuroimaging studies have been focused on brain alterations; however, the majority focused on the cerebrum. Limited by the currently available neuroimaging and electrophysiological technologies, the deep brain structures especially the brainstem involved in the sensory and nociceptive neurotransmission in migraine, such as the trigeminal nucleus, could only be investigated to a limited extent. Obviously, there is an unmet need for novel technologies that can be used to delineate structural or functional alterations in the brainstem. Elucidation of the role of these deep brain structures may fill the gap in the current understanding of migraine pathophysiology, and pave the way to precise and efficient treatment. Studies restricted to single methodologies are insufficient for the complexity of migraine. Migraine is a complex and dynamic disorder. However, most prior studies were limited to single methodologies and provided limited insights into such a multifaceted disorder. Studies with an integrated approach are lacking. An exhaustive examination of the discrete components of a phenotype, i.e., 'deep phenotyping', can help understand different aspects of its clinical manifestations, and facilitate patient classification. Coupled with neuroimaging and electrophysiological research methodologies, a multi-modal decoding approach would help identify a constellation of migraine-specific biosignatures, rather than just one. This can not only provide clues to decipher migraine pathophysiology in various dimensions but also serve as the basis of the development of a prediction algorithm that can be applied in clinical practice. To pursue the overall goal, the present project schemes as a composition of the following 5 aims:
Aim 1: Deep phenotyping for sensory processing in patients with migraine Aim 2: Brainstem-based functional and structural connectomics in migraine Aim 3: Capturing brainstem electro-neurosignature in migraine Aim 4: Constructing a data fusion platform and developing an EEG cap with a built-in analytic chip Aim 5: Exploring brainstem-based connectome sequencing in migraine animal model
研究の種類
入学 (予想される)
段階
- フェーズ 4
連絡先と場所
研究連絡先
- 名前:Shuu-Jiun Wang
- 電話番号:28712121
- メール:k123wang@gmail.com
研究連絡先のバックアップ
- 名前:Li-Ling Pan
- メール:hope881212@hotmail.com
研究場所
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Taipei、台湾、112
- 募集
- Headache Center, Teipei Veterans General Hospital
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コンタクト:
- Shuu-Jiun Wang, MD
- 電話番号:7578 +886-2-28712121
- メール:sjwang@vghtpe.gov.tw
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コンタクト:
- Li-Ling Pan, Ph.D.
- 電話番号:1291 +886-2-28712121
- メール:hope881212@hotmail.com
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-
参加基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
説明
Migraine:
Inclusion criteria:
- fulfill the diagnostic criteria of migraine in ICHD-3,
- 20-65 yrs,
- understand the study design and willing to join the study
- at least four headache days per month,
- the onset of headache is prior to 50 yrs.,
- normal neurological examination findings.
Exclusion criteria:
- history or family history of epilepsy,
- taking migraine prophylactics,
- women who are breastfeeding or pregnant,
- severe psychological disorders, including major depression, PTSD, personality disorders, bipolar disorder, schizophrenia,
- medical, neurological or psychiatric disease discovered by the researcher that would hinder the research,
- contraindications for MR scan (pacemaker, claustrophobia, stent, metal implants…).
Healthy:
Inclusion criteria:
- 20-65 yrs,
- normal neurological examination findings,
- understand the study design and willing to join the study.
Exclusion criteria:
- history or family history of epilepsy,
- women who are breastfeeding or pregnant,
- severe psychological disorders, including major depression, PTSD, personality disorders, bipolar disorder, schizophrenia,
- medical, neurological or psychiatric disease discovered by the researcher that would hinder the research,
- contraindications for MR scan (pacemaker, claustrophobia, stent, metal implants…),
- history of headache will be included (the tension-type headache occurs < 1 time per month is allowed)
研究計画
研究はどのように設計されていますか?
デザインの詳細
- 主な目的:処理
- 割り当て:非ランダム化
- 介入モデル:並列代入
- マスキング:なし(オープンラベル)
武器と介入
参加者グループ / アーム |
介入・治療 |
---|---|
実験的:patients with migraine
patient with migraine will be prescribed with flunarizine or routine clinical care per clinician's decision based on the condition of each individual patient
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The flunarizine will be given per clinical routine
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他の:healthy control
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no intervention for healthy control
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この研究は何を測定していますか?
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
---|---|---|
Clinical change after treatment (1) headache frequency
時間枠:6 months
|
clinical change (headache frequency) after treatment unit: attacks per month analysis: comparing the mean headache frequency in each month after treatment (M1/M2/M3/M4/M5/M6) to that before treatment (M0)
|
6 months
|
Clinical change after treatment (2) headache intensity
時間枠:6 months
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clinical change (headache intensity) after treatment unit: NRS (numeric rating scale, 0-10) analysis: comparing the mean headache intensity in each month after treatment (M1/M2/M3/M4/M5/M6) to that before treatment (M0)
|
6 months
|
Clinical change after treatment (3) headache duration
時間枠:6 months
|
clinical change (headache duration) after treatment unit: hours/day analysis: comparing the mean headache duration (hours/day) in each month after treatment (M1/M2/M3/M4/M5/M6) to that before treatment (M0)
|
6 months
|
二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
---|---|---|
EEG change after treatment (1) Linear analysis of EEG before and after treatment
時間枠:12 months
|
power spectral density change of EEG before and after treatment • Four EEG sessions will be arranged. The first one is done before treatment, and the 2nd/3rd/4th one will be done after a 3-month/6-month/12-month treatment course, respectively. |
12 months
|
EEG change after treatment (2) Nonlinear analysis of EEG before and after treatment
時間枠:12 months
|
functional connectivity change of EEG before and after treatment • Four EEG sessions will be arranged. The first one is done before treatment, and the 2nd/3rd/4th one will be done after a 3-month/6-month/12-month treatment course, respectively. |
12 months
|
EEG change after treatment (3) Nonlinear analysis of EEG before and after treatment
時間枠:12 months
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evoked potential amplitude change of EEG before and after treatment • Four EEG sessions will be arranged. The first one is done before treatment, and the 2nd/3rd/4th one will be done after a 3-month/6-month/12-month treatment course, respectively. |
12 months
|
Sensory threshold change after treatment
時間枠:12 months
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Using quantitative sensory testing (QST) to evaluate the sensory threshold before and after treatment • Four standard QST sessions will be arranged. The first one is done before treatment, and the 2nd/3rd/4th one will be done after a 3-month/6-month/12-month treatment course, respectively. |
12 months
|
fMRI change after treatment (1)
時間枠:12 months
|
functional connectivity change of fMRI before and after treatment • Three fMRI sessions will be arranged. The first one is done before treatment, and the 2nd/3rd one will be done after a 6-month/12-month treatment course, respectively. |
12 months
|
fMRI change after treatment (2)
時間枠:12 months
|
activation change of fMRI before and after treatment • Three fMRI sessions will be arranged. The first one is done before treatment, and the 2nd/3rd one will be done after a 6-month/12-month treatment course, respectively. |
12 months
|
MRI change after treatment (1)
時間枠:12 months
|
VBM changes of MRI before and after treatment • Three MRI sessions will be arranged. The first one is done before treatment, and the 2nd/3rd one will be done after a 6-month/12-month treatment course, respectively. |
12 months
|
MRI change after treatment (2)
時間枠:12 months
|
SBM changes of MRI before and after treatment • Three MRI sessions will be arranged. The first one is done before treatment, and the 2nd/3rd one will be done after a 6-month/12-month treatment course, respectively. |
12 months
|
Humoral change after treatment (1)
時間枠:12 months
|
Test the cytokine level using ELISA kit to evaluate the status before and after treatment • Four blood test sessions and saliva collection will be arranged. The first one is done before treatment, and the 2nd/3rd/4th one will be done after a 3-month/6-month/12-month treatment course, respectively. |
12 months
|
Humoral change after treatment (2)
時間枠:12 months
|
Test the hormone level using ELISA kit to evaluate the status before and after treatment • Four blood test sessions and saliva collection will be arranged. The first one is done before treatment, and the 2nd/3rd/4th one will be done after a 3-month/6-month/12-month treatment course, respectively. |
12 months
|
Genetic variance
時間枠:5 minutes
|
Genetic variants associated with baseline demographics and treatment response as assessed with genome-wide association study using the genotyping data derived from the Axiom Genome-wide array • Blood draw before the treatment to extract DNA for further sequencing |
5 minutes
|
協力者と研究者
研究記録日
主要日程の研究
研究開始 (実際)
一次修了 (予想される)
研究の完了 (予想される)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (実際)
学習記録の更新
投稿された最後の更新 (実際)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
本研究に関する用語
追加の関連 MeSH 用語
その他の研究ID番号
- 2020-11-004C
医薬品およびデバイス情報、研究文書
米国FDA規制医薬品の研究
米国FDA規制機器製品の研究
米国で製造され、米国から輸出された製品。
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