PROJECT SUMMARY
Myofascial pain is a type of pain that originates in the muscle and surrounding fascia and is accompanied by a
loss of range of motion, weakness, and sometimes autonomic symptoms. Affecting more than 85% of the general
population sometime in their lives, myofascial pain has been a leading cause of health-care visits, absenteeism,
and invalidity pensions—representing a significant health concern and economic burden. However, despite the
high incidence of myofascial pain and substantial financial cost, the underlying pathophysiology remains largely
unknown. As a result, clinical diagnosis and management of myofascial pain are largely empirical. Objective and
quantitative biomarkers acquired by imaging, electromyography, laboratory tests, or muscle biopsy do not exist
in the clinic for the assessment of myofascial pain. To address this unmet challenge, we propose to develop and
translate a multi-modal, multi-parametric, multi-scale imaging approach to comprehensively assess the different
aspects of the pathophysiology underlying myofascial pain both locally at the trigger point and regionally across
the entire myofascial tissue, based on which we will identify candidate biomarker(s) that are most sensitive and
specific to distinguish different states of myofascial pain and then test the biomarker’s ability to monitor treatment
responses and predict clinical outcomes in a randomized clinical trial. Specifically, in the R61 phase (technology
development & observational study), we will develop noninvasive magnetic resonance and electrophysiological
imaging biomarkers and minimally invasive fiber-optic imaging biomarkers in parallel (Aim 1), and then identify
candidate biomarkers that are best capable of differentiating different states (healthy, latent, and active) related
to myofascial pain in an observational clinical study (Aim 2). Our prior research and preliminary studies provide
strong premises for the proposed biomarker development and clinical testing. In the R33 Phase (interventional
study), our research team—consisting of expertise in imaging, myofascial pain, quantitative analysis, and clinical
trial—will examine the ability of the imaging biomarker(s) identified in the R61 phase for monitoring the responses
to local chemical injection treatment and predicting clinical outcomes in a randomized clinical trial. The proposed
research will create vital knowledge about myofascial pain and contribute to the creation of quantitative imaging
biomarkers that may guide our choices of appropriate pain management and reduce opioid addiction.
