Summary
This project aims to investigate the physiological consequences of chronic pain on cardiovascular function and evaluate the effectiveness of neuromodulation therapy in improving circulatory control in chronic pain patients, including those with hypertension.
What they want
The project will study patients with chronic pain from lower limbs and well-matched controls to evaluate the impact of chronic pain on neurocirculatory control mechanisms, specifically the exercise pressor reflex (EPR) and arterial baroreflex sensitivity (BRS), and their consequences for hemodynamic and neuromuscular fatigue response to physical activities. Methods will include lumbar intrathecal fentanyl, Modified Oxford method, and neck pressure/neck suction technique. The study will also assess the impact of neuromodulation therapy (NMT) on muscle sympathetic nerve activity (MSNA), hemodynamic, and neuromuscular fatigue responses at rest and during exercise, using direct peroneal and radial nerve recordings. Comparisons will be made between NMT 'on' vs 'off' states. Studies will be conducted in both normotensive and hypertensive patients to determine NMT's efficacy in normalizing hemodynamic abnormalities during exercise.
Deliverables
- Scientific basis and data on the impact of chronic pain on circulatory and fatigue response to physical activity
- Evidence on the efficacy of neuromodulation therapy to improve impairments related to chronic pain and hypertension
Technical requirements
- Lumbar intrathecal fentanyl administration
- Modified Oxford method
- Neck pressure/neck suction technique
- Direct peroneal and radial nerve recordings for muscle sympathetic nerve activity (MSNA)
- Application and monitoring of neuromodulation therapy (NMT)
