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Center for Clinical and Epidemiological Research (CCER)

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Current Projects of Chronic Pain and Chronic Fatigue Programs

Both funded and unfunded projects are currently in progress in the CCER's chronic fatigue and pain research program. We maintain and continue to enroll participants in three registries or databases that are directly related to chronic fatigue or chronic pain.

Chronic Pelvic Pain Studies

MAPP stands for Multidisciplinary Approach to the Study of Chronic Pelvic Pain. This is a research project funded by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), which is part of the National Institutes of Health (NIH). It consists of a network of thirteen sites around the country that are studying people with Chronic Pelvic Pain and comparing them to control participants who do not have pelvic pain symptoms.

Chronic Fatigue Clinic at Harborview Medical Center

The Chronic Fatigue Clinic opened in 1988, and as of January 2005, more than 1,500 individuals have been seen, totaling more than 20,000 patient visits. In addition to Dr. Buchwald, the Director, the clinic is staffed by a physician assistant, nurse, psychometrist, mental health counselor, vocational counselor, nurse coordinator, acupuncturists, massage therapists, and clerical personnel. Information collected on all patients seen in this clinic comprises the database used for identification of subjects with chronic fatigue syndrome and/or fibromyalgia. Throughout the years, the Chronic Fatigue Clinic has been the major source of participants for many research projects.

Transcranial Magnetic Stimulation in the treatment of Chronic Widespread Pain

This study is designed to test whether transcranial magnetic stimulation (TMS) is safe and effective as a treatment for Chronic Widespread Pain. TMS is a technique that uses repeated pulses from an electromagnet placed on the scalp to stimulate specific areas of the brain. TMS has been shown to have antidepressant effects in patients with Major Depression, and more recently, to decrease pain in these patients. TMS has been used in chronic pain and FM patients with success, but these studies have been small and/or uncontrolled. Participants in the study will be randomly assigned to receive TMS or a sham (or placebo) version of TMS. Participants will undergo pain assessment and questionnaires throughout the 6 months of the study.

Are Fibromyalgia and Chiari I Malformation Related?

This study, funded by the National Institutes of Health, is led by Dr. Dedra Buchwald from the Department of Medicine at UW and is evaluating the relationship between fibromyalgia and a condition called chiari I malformation. This is a brain abnormality that can damage the flow of cerebrospinal fluid in the brain and upper part of the spine. It often occurs with syringomyelia, which is a hollowing of the spinal cord. Persons with fibromyalgia usually report symptoms similar to those of patients with chiari I malformation. Since the symptoms of chiari I malformation are also similar to other conditions, common misdiagnoses may include migraine, psychiatric disorder, multiple sclerosis, and fibromyalgia. In this study, magnetic resonance imaging is used to evaluate how often this brain abnormality occurs in patients with fibromyalgia, in a group of healthy (pain- and fatigue-free) individuals, and in those confirmed with chiari I malformation. This study may help us to find out how often to expect chiari I malformation in patients with fibromyalgia. It will also help us find out which symptoms are common to patients who have both conditions, and potentially help clinicians identify fibromyalgia patients who may benefit from an evaluation for chiari I malformation.
View Chiari I and Fibromyalgia Abstract.

Chronic Fatigue/Chronic Pain Twin Registry

This registry of twins in which one or both members reported having fatigue or pain of longstanding duration was funded by the National Institutes of Health as part of the initial Cooperative Research Center. The renewed Cooperative Research Center also provided funding for the continued recruitment and maintenance of the Registry. All Registry members complete 1) a comprehensive Registry Booklet 2) a structured medical and psychiatric interview, and 3) followup surveys designed to collect data on current health status or to answer specific questions of interest to our investigators and collaborators. Currently, more than 300 twin pairs participate in the Registry. The Registry provides a rich resource of data on twins with chronic fatigue syndrome, fibromyalgia, and other overlapping conditions. It has also been the source of participants for two of the specific projects funded in the Cooperative Research Center.
View Chronic Fatigue/Chronic Pain Twin Registry Abstract.

Registry of Physicians with Chronic Fatigue

This is a registry of physicians who report having an unexplained chronically fatiguing condition. Registries of physicians and other healthcare providers have been exceedingly useful in describing the epidemiology, clinical presentation, natural history, prognosis, and other aspects of diverse well-recognized medical conditions. Currently, the registry is not actively recruiting participants but we are happy to enroll interested physicians who contact us.
View Physicians Registry Abstract.

The Temporomandibular Disorder Twin Registry

Temporomandibular disorder is an illness of unknown cause. It has been attributed to direct physical trauma, minor, chronic trauma from clenching and grinding of the teeth, and behavioral or psychological factors. The role of sleep problems, stress and psychological difficulties, other pain conditions, as well as the exact relationship to fibromyalgia, remains unclear. In fact, there appear to be many clinical similarities between this condition, fibromyalgia, and chronic fatigue syndrome. The variety of possible causes, contributing factors, and associated conditions has made the study of temporomandibular disorder difficult. We are currently developing a registry of twins with temporomandibular disorder in order to better understand the causes and consequences of this condition.
View TMD Registry Abstract.