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Linking Altered Cortical Sensorimotor Integration with Movement Impairments in Back Pain

Award Number: R01HD095959
ORGANIZATION: NATIONAL INSTITUTE OF CHILD HEALTH AND HUMAN DEVELOPMENT
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

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Abstract Despite a wide array of treatment options, the number of people whose acute painful back injuries progress to chronic pain states continues to grow at an alarming rate. The reasons for this rapid increase in persistent back pain-related symptoms remains unknown. However, based upon previous research, we believe that a primary cause for this failure of recovery relates to maladaptive neurophysiological changes that occur within the brain in response to low back injury and pain. Specifically, injury to the back often results in acute changes to functional movement. In the short-term these movement changes protect injured tissues and avoid further pain provocation. However, the movement adaptations may not resolve when symptoms decrease and will become maladaptive over time. They contribute to reinjury and in some cases the transition to chronic low back pain (LBP). The association between these altered trunk movement patterns and chronic LBP is strongly supported in the literature. In addition, an individual’s unconsciously acquired fear of pain can change behaviors (fear of movement) and their cognitive and emotional adaptations, can drive pain persistence and be associated with sensorimotor cortical changes. We believe that these maladaptive movement patterns are driven, in large part, by brain changes in the way sensorimotor cortical regions integrate somatosensory information. Our preliminary neuroimaging data supports our central hypothesis that, individuals with chronic LBP have altered cortical sensorimotor integration that are associated with back movements. We will use a cross-sectional design (50 chronic LBP; 50 asymptomatic individuals) and two novel neuroimaging protocols to assess differences in sensorimotor brain function (Aim 1). Our innovative fMRI protocols use direct sensory stimulation to the trunk, and trunk and pelvis movements performed in the scanner to assess sensorimotor integration. This approach allows us to capture brain activation in response to loads and stresses on both the musculoskeletal structures (e.g., muscles, joints) and sensory components (e.g., muscle spindles) of the trunk. We will also collect biomechanical data during tasks that challenge trunk posture and movement control, and clinical data related to pain, fear of movement, anxiety and depression. These measures will be used to evaluate the impact of altered sensorimotor brain function on control of trunk movements (Aim 2) and to explore the relationship between cortical systems and sensory-motor associations (conditioned fear behaviors), attention-monitoring (cognitive factors), and sensory expectations and emotional responses (acquired emotional states) (Aim 3). We expect an immediate impact of our findings on back rehabilitation programs as they will have direct implications for how back exercise and movement training is taught and practiced. Longer term impact will be realized by testing efficacy and dosing of treatment approaches for prevention of recurrence and progression to chronicity.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2025 ( Subtotal = $0 )
2025	2022	UNIVERSITY OF SOUTH CAROLINA	1600 HAMPTON ST	COLUMBIA	SC	29208	RICHLAND	USA	Child Health and Human Development Extramural Research	000	4	10/17/2024	NON-COMPETING CONTINUATION	$0
														Subtotal = $0

Issue Date FY: 2023 ( Subtotal = $0 )
2023	2022	UNIVERSITY OF SOUTH CAROLINA	1600 HAMPTON ST # 414	COLUMBIA	SC	29208	RICHLAND	USA	Child Health and Human Development Extramural Research	000	4	6/28/2023	NON-COMPETING CONTINUATION	$0
														Subtotal = $0

Issue Date FY: 2022 ( Subtotal = $361,285 )
2022	2022	UNIVERSITY OF SOUTH CAROLINA	1600 HAMPTON ST # 414	COLUMBIA	SC	29208	RICHLAND	USA	Child Health and Human Development Extramural Research	000	4	6/6/2022	NON-COMPETING CONTINUATION	$361,285
														Subtotal = $361,285

Issue Date FY: 2021 ( Subtotal = $0 )
2021	2020	UNIVERSITY OF SOUTH CAROLINA	1600 HAMPTON ST # 414	COLUMBIA	SC	29208	RICHLAND	USA	Child Health and Human Development Extramural Research	000	3	5/28/2021	NON-COMPETING CONTINUATION	$0
														Subtotal = $0

Issue Date FY: 2020 ( Subtotal = $390,769 )
2020	2020	UNIVERSITY OF SOUTH CAROLINA	1600 HAMPTON ST # 414	COLUMBIA	SC	29208	RICHLAND	USA	Child Health and Human Development Extramural Research	001	3	7/1/2020	NON-COMPETING CONTINUATION	$390,769
2020	2019	UNIVERSITY OF SOUTH CAROLINA	1600 HAMPTON ST # 414	COLUMBIA	SC	29208	RICHLAND	USA	Child Health and Human Development Extramural Research	000	2	12/6/2019	NON-COMPETING CONTINUATION	$0
														Subtotal = $390,769

Issue Date FY: 2019 ( Subtotal = $402,929 )
2019	2019	UNIVERSITY OF SOUTH CAROLINA	1600 HAMPTON ST # 414	COLUMBIA	SC	29208	RICHLAND	USA	Child Health and Human Development Extramural Research	000	2	5/29/2019	NON-COMPETING CONTINUATION	$402,929
														Subtotal = $402,929

Issue Date FY: 2018 ( Subtotal = $417,811 )
2018	2018	UNIVERSITY OF SOUTH CAROLINA	1600 HAMPTON ST # 414	COLUMBIA	SC	29208	RICHLAND	USA	Child Health and Human Development Extramural Research	000	1	9/7/2018	NEW	$417,811
														Subtotal = $417,811

Grand Total All Awards = $1,572,794

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Linking Altered Cortical Sensorimotor Integration with Movement Impairments in Back Pain

Award Number: R01HD095959

ORGANIZATION: NATIONAL INSTITUTE OF CHILD HEALTH AND HUMAN DEVELOPMENT

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

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