This five-year project has two main components: a mentored training plan and a research plan. It addresses the research priorities of NCCAM in three manners. First, it is the critical initial phase in assessing the effectiveness of Traditional Chinese Medicine (TCM) for the treatment of fibromyalgia. Second, the use of nociceptive dorsal reflex testing represents the use of state-of-the-art techniques in translational research. Lastly, during the mentored training, Dr. Mist will obtain the experiences and skills to make the transition from postdoctoral fellowship to independent investigator. He will be mentored in three main areas by four mentors. Dr. Kim Dupree Jones (primary mentor at Oregon Health &Science University) will mentor the candidate in fibromyalgia pathophysiology, study design, recruitment strategies, and current research in fibromyalgia. Dr. Rick Harris (University of Michigan) will supplement this with a focus on pain assessment in fibromyalgia, neuroimaging, and TCM approaches. The second area is whole systems design and analysis led by Dr. Mikel Aickin (University of Arizona). Dr. Aickin will focus on training in early phase study design, design adaptive allocation, and statistical analysis of whole systems research. The third area is the development of skills in study design, acquisition and processing of neuroimaging data and will be led by Dr. Wei Huang (Oregon Health &Science University) with the assistance of Dr. Harris. In addition, training in the responsible conduct of research and in professional development components such as running a research group, grant writing, and other important components for success will be emphasized. The primary hypothesis for this line of research is that whole systems TCM will provide significant pain reduction for women with fibromyalgia. This study represents one vital stage in assessing this hypothesis. Dr. Mist will conduct a feasibility/acceptability study of whole systems TCM for the treatment of fibromyalgia. The study will compare measures of fibromyalgia physical functioning and symptoms among participants who will receive either whole systems TCM or fibromyalgia education for 10 weeks. Comparisons will occur at end of treatment and one month post treatment. Nociceptive flexion reflex threshold will be evaluated as a possible objective pain outcome variable for a future study. Exploratory analysis of frequent pain, sleep, depression, and fatigue measures (1-3 times per day) will be modeled. Finally, exemplars of responders, non-responders and individuals with specific TCM diagnoses will be evaluated for inclusion/exclusion criteria in future R01 studies. This research represents the next logical step in a long-term investigation of the whole systems TCM for fibromyalgia as well as a search for possible mechanisms of action for components of the treatment.
This project will assess the feasibility and accessibility of whole systems Traditional Chinese medicine for the treatment of fibromyalgia as well as enhance understanding of effectiveness. It will also confirm previous research on nociceptive dorsal reflex threshold biomarkers in fibromyalgia populations providing greater confidence in it use.