# Project 1: MiCAPP - Mechanisms of the CentrAlized Pain Phenotype

> **NIH NIH P50** · UNIVERSITY OF MICHIGAN AT ANN ARBOR · 2021 · $838,288

## Abstract

PROJECT SUMMARY / ABSTRACT 
 RESEARCH PROJECT 
Chronic musculoskeletal pain is extremely common, and pain is the most common symptom in nearly all 
rheumatic disorders. However, in all chronic pain conditions there is a tremendous disparity between 
identifiable damage/inflammation in the periphery – and pain, and classic psychological factors, such as mood 
or catastrophizing, explain very little of the variance between pain and objective findings. Many individuals with 
chronic pain have surgery and have continued pain despite excellent surgical results, just as many patients 
with autoimmune disorders continue to have pain after inflammation is well controlled with biologics. 
 Our CORT Research Project, “MiCAPP – Mechanisms of the CentrAlized Pain Phenotype” will have three 
cohorts with different forms of chronic musculoskeletal pain, one cohort with an autoimmune disorder and 
inflammatory pain (rheumatoid arthritis), one condition generally considered to be non-inflammatory pain 
conditions (osteoarthritis), and another considered to be neuropathic (carpal tunnel syndrome). We will 
demonstrate that in all of these individuals, higher degrees of pain centralization as measured by the 2011 
Fibromyalgia (FM) Survey Criteria, will predict non-responsiveness to peripherally-directed analgesic therapies, 
and will have a common neurobiological signature identifiable on experimental pain testing and functional 
neuroimaging. Our overall hypothesis is that the current 2011 FM Survey Criteria can identify a subset of 
individuals across chronic musculoskeletal pain disorders with centralized pain, where the central nervous 
system (CNS) plays a prominent role in symptom expression, and thus these individuals will be less 
responsive to interventions aimed at the periphery. Furthermore, we will demonstrate that this centralized pain 
phenotype has stereotypical underlying neurobiological features across cohorts of individuals with chronic 
musculoskeletal pain. The Overall Specific Aims that are specifically addressed in this study are: 1) To 
demonstrate that the current 2011 FM Criteria predict non-responsiveness to peripherally-directed therapies, 
including a) surgery meant to relieve pain, b) administration of a biologic agent to an individual with an 
autoimmune disorder, and c) acute and sub-acute administration of opioids; 2) To demonstrate that in all three 
cohorts, individuals with the highest FM Survey Criteria scores will have the most pronounced neurobiological 
findings associated with pain centralization, including abnormal QST findings and aberrant findings on 
functional, chemical and structural neuroimaging; 3) To use the data from the above aims as well as other 
ongoing studies to develop and pilot test a more efficient and predictive self-report measure of centralization 
than the 2011 FM Criteria, which we will refer to as a Centralized Pain Index (CPI); and 4) To explore the 
clinical and mechanistic features of subsets of ...

## Key facts

- **NIH application ID:** 10266751
- **Project number:** 5P50AR070600-05
- **Recipient organization:** UNIVERSITY OF MICHIGAN AT ANN ARBOR
- **Principal Investigator:** Daniel J Clauw
- **Activity code:** P50 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $838,288
- **Award type:** 5
- **Project period:** 2016-09-20 → 2023-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10266751

## Citation

> US National Institutes of Health, RePORTER application 10266751, Project 1: MiCAPP - Mechanisms of the CentrAlized Pain Phenotype (5P50AR070600-05). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10266751. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*