045-22 – Cerebral Mechanisms of Acceptance and Commitment Therapy for Neuropathic Pain: A Feasibility Randomised Controlled Neuroimaging Trial

The utilisation of Acceptance and Commitment Therapy (ACT) for neuropathic pain is relatively new area of research that is in need of further development, especially with regard to the underlying cognitive neuroscience and brain mechanisms responsible for effective treatment. To our knowledge, this is the first study that aims to provide a preliminary evaluation of the efficacy of an ACT treatment on neuropathic pain through a blind, randomized-controlled neuroimaging trial against standard medical care (SMC). The specific aims of this project are to investigate cognitive and brain changes before and after Acceptance and Commitment Therapy (ACT) in patients with painful diabetic neuropathic pain (PDN). Our research will comprise two types of study design: Cross-sectional clinical study, and ACT feasibility randomized controlled trial. Outcome variables and measures for the current trial correspond recommendations by (Hann & McCracken, 2014) and are guided by general recommendations of core outcome measures for chronic pain clinical trials: OMERACT (Choy & Mease, 2009), IMMPACT (Dworkin, et al., 2005) and the existing literature on PDN implicating other relevant assessments (De Groot et al., 2001; Kitty Kioskli, Scott, et al., 2019). Mechanistic assessments will include neuropsychological testing, functional magnetic resonance imaging (fMRI) and quantitative sensory testing (QST). The research is being led by Hanaa Alonezi under the supervision of Dr Christopher Brown, with supervision of the implementation of the ACT treatment by Prof. Ross White. The research will be sponsored by University of Liverpool.