Mechanical signals Joint degeneration InflammationPain TARGETS mechanisms – diagnosis – therapeutics MODELS Arthritis Research UK Biomechanics and Bioengineering Centre Cardiff Using interdisciplinary research to investigate relationships between mechanical loading, joint function, pain and inflammation to aid treatment, diagnosis and rehabilitation of arthritis patients

Brain changes associated with painful knee osteoarthritis Dr Ann K. Harvey Cardiff Academic Fellow, School of Medicine Arthritis Research UK Biomechanics and Bioengineering Centre Thursday 2 nd May 2013

Pain in arthritis CHALLENGE PATIENTS PAIN ARTHRITIS NEED PATHOLOGY INFLAMMATION BIOMECHANICS MOOD

Integrated Total Knee Replacement (TKR) studies TKR waiting list Pre-op period Post-op period Up to 3 months Up to 12 months TKR surgery pre+9

fMRI Studies: Clinical Questions & Experimental design pCASL Arterial spin labelling (on-going pain) BOLD resting (fluctuating pain) Structural FSPGR (long term signatures of pain) RHS TKR patients (pre- and post-op) vs matched controls Simon Jones, Debbie Mason What are the neural correlates of clinically relevant pain in end-stage knee OA? Are there (long-term) structural brain changes associated with chronic knee OA? How do pain-related brain changes relate to knee function, psychosocial and biological variables? Can we target treatment in a patient specific way? Prof Richard Wise Dr Ann Harvey

Summary of findings so far Pre-TKR: Preliminary data reveals differences between TKR patients and controls – Patients report higher ratings of persistent (background) pain – Patients reveal higher baseline perfusion in frontal lobe & somatosensory areas – Patients have enlarged subcortical structures on LHS of brain – Patients have greater knee impairment, alongside lower quality of life, and high anxiety and depression scores Post-TKR: Longitudinal aspect of study will reveal within participant changes after post-TKR Frontal cortex Sensory cortex Brainstem Cerebellum Ann Harvey, Richard Wise, Simon Jones, Debbie Mason

Thank You