Relationships of affect and neuroinflammation with clinical pain in Veterans with Fibromyalgia.

PROJECT SUMMARY/ABSTRACT Fibromyalgia (FM) is a chronic pain condition that disproportionately impacts Veterans. Individuals diagnosed with FM patients experience lower self-esteem and positive affect, as well as greater levels of depression, anxiety, negative affect, and pain catastrophizing. Among those experiencing FM, clinical and experimental pain are associated with specific dispositional trait profiles, which are indexed by levels of negative affect and positive affect. Neuroinflammation and [inflammation] also play a role in FM- related affect and pain. Recent studies that have highlighted neuroinflammation and [inflammation] as physiological mechanisms associated with changes in dysregulated affect and chronic pain. Veterans with FM can ameliorate their dispositional traits—i.e., increasing positive affect and reducing negative affect— by participating in exercise. However, a gap exists regarding how to optimally engage Veterans with FM in an exercise program. Thus, to fully take advantage of all potential therapeutic benefits of exercise for FM, there is a critical need to identify those factors underlying exercise engagement for FM pain management. The purpose for this study is to 1) determine associations of dispositional trait styles, neuroinflammation, and [inflammation] with pain outcomes in Veterans with FM; and 2) develop and design a Veteran-informed exercise program. We propose to recruit 20 Veterans with FM and 20 Veterans without FM who will undergo magnetic resonance spectroscopy imaging (MRSI) scans, pain assessments, and semi-structured interviews. A sub-set of 15 individuals will undergo a 6-week moderate intensity continuous training exercise intervention and follow-up MRSI scans, pain assessments, and semi-structured interviews. Our central hypothesis is that dispositional trait styles, neuroinflammation, and [inflammation] will be associated with pain outcomes and exercise will induce beneficial anti-inflammatory changes. The [research objective] of this proposal is two-fold: [1) to acquire data on the associations between dispositional trait styles, neuroinflammation, inflammation, and pain in Veterans with FM and 2) to develop a Veteran-informed exercise program with potential to modify dispositional trait styles, neuroinflammation, inflammation, and pain] in Veterans with FM for a Career Development Award (CDA)-2 application. The training objective is to develop expertise in FM-related research, exercise clinical trial development for Veterans with FM, neuroinflammmation, inflammation, and semi- structured interviews.] The proposed study and complementary training activities will provide Dr. Buchanan with specialized training, hands-on experience, as well as foundational data toward her long-term goal of elucidating specific mechanisms, and modifiable factors, to develop efficacious interventions to reduce clinical pain in Veterans with FM.