fMRI and Central Sensitization in Chronic Knee Osteoarthritis. A Pre and Post TKR Study

University of Nottingham50 enrolled

Overview

Painful osteoarthritis (OA) is the 4th largest cause of disability in the UK. Preoperative temporal summation, a measure of central pain facilitation, has been shown to predict postoperative pain after total knee replacement surgery (TKR). The assessment of the brain's response to noxious stimuli using non-invasive functional MRI (fMRI) may be key in identifying imaging biomarkers within the brain that map central sensitization changes seen in OA. fMRI may help explain why up to 20% of patients undergoing TKR surgery develop persistent post-operative pain. To test these concepts the study aims to functionally characterise the brain activity related to temporal summation of pain in healthy individuals and OA patients using a novel fMRI cuff algometer. Assessment of outcomes in terms of pain and function will be performed 6 months post TKR surgery

Study Type

OBSERVATIONAL

Enrollment

Conditions

Osteoarthritis Pain Postoperative Pain Surgery

Interventions

Eligibility

Sex: ALLMin age: 40 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: * OA Group Unilateral Knee OA No previous knee surgery Able to give informed consent Age \> 40 years \- Healthy Volunteers Group No OA or knee pain Able to give informed consent Age \> 40 years Exclusion Criteria: -OA Group Major medical, psychiatric, neurological Cx Other chronic pain condition (fibromyalgia) Contraindications to MRI Active Cancer Neuropathic drug treatment -Healthy Volunteers Group Pregnancy Lower limb pain or previous knee surgery Contraindications to MRI Active Cancer Major medical, psychiatric, neurological condition

Outcomes

Primary Outcomes

Brain activity related to temporal summation of pain in healthy individuals and OA patients using a novel fMRI cuff algometer.

Using BOLD fMRI we aim to assess the difference in neural brain activity between patients with chronic knee OA pain and a group of healthy volunteers and to assess the reversal of this activity pattern 6 months post TKR surgery

Time frame: 6 months post total knee replacement surgery

Secondary Outcomes

Assessment of knee pain using the Visual Analogue Scale for Pain (0-10)

Pain using visual analogue scale

Time frame: 6 months post total knee replacement surgery

Assessment of improvement in the Oxford Knee Score

pain and function outcome measure

Time frame: 6 months post total knee replacement surgery

Assessment of change in healthy related quality of life measure using the EQ5D-5L questionnaire

quality of life index measure

Time frame: 6 months post total knee replacement

Central Contacts

Thomas Kurien, BMBS

CONTACT

thomas.kurien@nottingham.ac.uk

Brigitte E Scammell, FRCS

CONTACT

b.scammell@nottingham.ac.uk

fMRI and Central Sensitization in Chronic Knee Osteoarthritis. A Pre and Post TKR Study

Overview

Conditions

Interventions

Eligibility

Locations (1)

Outcomes

Primary Outcomes

Secondary Outcomes

Central Contacts