Functional Magnetic Resonance Imaging (fMRI)
The purpose of this study is to investigate whether a psychotherapeutic approach, group Cognitive Behavioral Therapy (CBT), alters the dysfunctional emotional and sensory neural circuitry associated with chronic pain as examined by functional magnetic resonance imaging (fMRI). Magnetic Resonance Imaging (MRI) is a three dimensional picture of the brain using magnetic waves. Researchers are able to utilize functional MRI while participants are performing various tasks to examine what areas of the brain are activated by each particular task. In this study participants will be asked to perform two types of tasks.
The primary goal of this project is to investigate whether group CBT can modify the dysfunctional neural circuitry associated with chronic pain. By combining a noxious pain stimulation paradigm, an emotional stimulation paradigm, and brain imaging, and putting this approach into a clinical framework, we will open important, new avenues of research on chronic pain. Our approach may represent a valuable strategy for advancing our understanding of the neurobiology of emotional control related to pain and the effects of cognitive-behavioral therapy in the group setting. Measuring directly the effects of CBT on brain function could ultimately improve clinical decision making and contribute to development of the individualized treatment of patients with chronic pain.
Since chronic pain is not just an isolated sensory event, but rather a complex sensory and emotional experience, we plan to test both a painful thermal stimuli paradigm and an emotional provocative stimuli paradigm to see whether there is a relationship between changes in brain activation areas associated with the attentional, affective, and sensory aspects of chronic pain. We are also looking at quantifiable improvement in clinical measures (questionnaires) reported at the conclusion of group CBT.
Subjects who meet our inclusion and exclusion criteria will be recruited, consented and randomly assigned to one of two study conditions:
- A 11-week group CBT Treatment Condition
- An Attention Control Condition
Prior to the onset of their treatment, study participants will undergo the first of three fMRI scanning sessions where they will be asked to perform tasks while being scanned. Each participant will also complete clinical questionnaires about their pain, coping and mood. Next, participants will commence with 11 consecutive weeks of either group CBT or an educational group based on randomized assignment. Upon completion of their eleven week intervention, participants will undergo their second fMRI scanning session. After four months of practice, subjects will undergo their third and final fMRI scanning session. Those participants who took part in the educational group are allowed to begin group CBT, if they desire. Participants are reimbursed with a stipend for their time and participation.
View an online video orientation for research participants.