Pro-BEPP
Research type
Research Study
Full title
Probing the Rheumatoid Arthritis Brain to Elucidate Central Pain Pathways
IRAS ID
283546
Contact name
Neil Basu
Contact email
Sponsor organisation
NHS GG&C
Duration of Study in the UK
1 years, 11 months, 30 days
Research summary
Many patients with rheumatoid joint disease continue to experience significant pain despite receiving effective, joint-specific treatment. We believe this discrepancy is due to the existence of pain sources which are supplementary to those present in the joints. In particular, we have been among the first to show that the brain may be involved in the generation of this disabling problem. Brain scanning methods have helped us to identify a specific region (the left inferior parietal lobule (L-IPL)) which appears to be an important link between the excessive inflammation in RA and pain processing.
We hope to better examine this possible link by employing a safe, non-invasive technique called transcranial magnetic stimulation (TMS). TMS uses a magnet to influence the function of a specific region on the brain surface. We will use TMS to target the left inferior parietal lobule and then assess participants for changes in aspects of brain biology (which have been considered important in other chronic pain disorders), their pain and markers of inflammation. Due to the inherent dangers of sampling the brain, we will instead use 7T magnetic resonance imaging to make indirect measurements of brain biology, including changes in specific chemistry.
This information will help us to better understand the precise role of the left inferior parietal lobule in relation to pain. The results of this modest project will inform bigger, more definitive studies and will ultimately deliver knowledge that will allow us to address the tremendous shortfall of safe and effective pain relief strategies for patients with RA and beyond.REC name
London - London Bridge Research Ethics Committee
REC reference
21/LO/0668
Date of REC Opinion
1 Oct 2021
REC opinion
Favourable Opinion