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.

Public Health Relevance

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.

National Institute of Health (NIH)
National Center for Complementary & Alternative Medicine (NCCAM)
Mentored Patient-Oriented Research Career Development Award (K23)
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Special Emphasis Panel (ZAT1-PK (12))
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Weber, Wendy J
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Oregon Health and Science University
Schools of Nursing
United States
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Mist, Scott D; Jones, Kim Dupree (2018) Randomized Controlled Trial of Acupuncture for Women with Fibromyalgia: Group Acupuncture with Traditional Chinese Medicine Diagnosis-Based Point Selection. Pain Med 19:1862-1871
Zucker, Noah A; Tsodikov, Alex; Mist, Scott D et al. (2017) Evoked Pressure Pain Sensitivity Is Associated with Differential Analgesic Response to Verum and Sham Acupuncture in Fibromyalgia. Pain Med 18:1582-1592
Jones, Kim Dupree; Maxwell, Charlene; Mist, Scott D et al. (2015) Pelvic Floor and Urinary Distress in Women with Fibromyalgia. Pain Manag Nurs 16:834-40
Hullender Rubin, Lee E; Opsahl, Michael S; Wiemer, Klaus E et al. (2015) Impact of whole systems traditional Chinese medicine on in-vitro fertilization outcomes. Reprod Biomed Online 30:602-12
Firestone, Kari A; Carson, James W; Mist, Scott D et al. (2014) Interest in yoga among fibromyalgia patients: an international internet survey. Int J Yoga Therap 24:117-24
Liptan, Ginevra; Mist, Scott; Wright, Cheryl et al. (2013) A pilot study of myofascial release therapy compared to Swedish massage in fibromyalgia. J Bodyw Mov Ther 17:365-70
Firestone, Kari A; Holton, Kathleen F; Mist, Scott D et al. (2012) Optimizing fibromyalgia management. Nurse Pract 37:12-21; quiz 21-2
Elder, Charles; Ritenbaugh, Cheryl; Aickin, Mikel et al. (2012) Reductions in pain medication use associated with traditional Chinese medicine for chronic pain. Perm J 16:18-23
Ritenbaugh, Cheryl; Hammerschlag, Richard; Dworkin, Samuel F et al. (2012) Comparative effectiveness of traditional Chinese medicine and psychosocial care in the treatment of temporomandibular disorders-associated chronic facial pain. J Pain 13:1075-89
Carson, James W; Carson, Kimberly M; Jones, Kim D et al. (2012) Follow-up of yoga of awareness for fibromyalgia: results at 3 months and replication in the wait-list group. Clin J Pain 28:804-13

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