Research
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Making an Impact

Kratz Lab Studies and Discoveries

Learn About the Type of Research We Do

Our research focuses on understanding people’s experiences with their symptoms, developing tools for symptom management, and performing clinical trials to improve people’s conditions.

We begin our research by considering how symptoms affect people’s daily lives. Current measurements, such as neuropsychological exams administered during a health visit, may not fully capture the momentary fluctuation of someone's condition. Many patients describe their symptoms—such as pain, cognitive function, or fatigue—as constantly fluctuating, with “good days” and “bad days” and further variation within those days. Consequently, our research seeks to capture such day-to-day experiences with symptoms. In one of our ongoing studies, CogDetect-MS, we use a combination of in-person tests and ecological momentary assessments (or EMAs), which is a period of “home monitoring” where participants complete surveys and wear an activity watch for a number of weeks after their in-person visit. This methodology not only reveals real-life momentary fluctuation but also enables us to recommend short- and long-term symptom management strategies. 

While most research in this area focuses on finding treatments or cures, we recognize that people still live with pain and/or fatigue. Our research has found that behavioral changes can greatly improve the quality of life for people experiencing these symptoms. In one of our past studies, Pain Acceptance in SCI Study (PASS), we found that individuals who accepted their pain associated with spinal cord injury (or SCI) had lower use of pain medications and experienced less interference in their daily activities. By understanding and capturing the lived experiences of people with these symptoms, we can provide valuable information and practical tools to healthcare professionals and shape the direction of future research. These tools are also made accessible to people struggling with pain, fatigue, or cognitive dysfunction for immediate implementation (like our MyMSToolkit website available on our home page!)

Our research also involves clinical trials aimed at alleviating these symptoms. Many people with multiple sclerosis (MS) suffer from fatigue, and current options to mitigate fatigue are limited. However, these options may be more effective when used together rather than in isolation. Our previous study COMBO-MS considered this question and used cognitive-behavioral therapy (CBT), modafinil, or a combination of both to observe their effects on MS-associated fatigue. Currently, our lab is involved in another clinical trial—CANSLEEP-MS—that looks at the impact of cannabis (CBD and/or THC) on pain and sleep for people with MS.

By capturing momentary fluctuations, implementing behavioral changes, and conducting clinical trials, we create a comprehensive understanding of the impact current treatments can have on people’s daily symptoms. This insight is invaluable to impact research, inform healthcare providers, and ultimately enhance the well-being of those dealing with these symptoms.

What is it?

Our lab has a research registry for people interested in hearing about new studies in our lab.

What does it do?

The purpose of this registry is to keep the names and contact information of people who would like to hear about our future studies.

The potential benefit of joining this registry is having the opportunity to participate in studies that you may not otherwise learn about. 

The only risk involved in joining the registry is a very small chance of a loss of confidentiality. We will reduce this risk by storing your data in locked cabinets and on a password-protected, web-based database that is hosted by the University of Michigan. Only trained researchers and staff who are affiliated with the registry will be able to access your information. 

You will remain in the registry for as long as you wish, and you may withdraw at any time.

How do I join?

If you would like to join this registry or would like any additional information, you can contact the registry staff at 734-936-2844 or [email protected]. 

Current Studies

Currently Recruiting!

Study Overview

The majority of people with MS experience problems with sleep, pain, or both. Sleep problems affect more than half of people with MS. Sleep problems also have the potential to worsen chronic pain, which affects about half of people with MS. We hope to learn more about the pain-sleep connection.

What do I have to do?

If you participate in this study, you will start off with a 2-3 hour in-person visit, your first overnight sleep study, and your first 14-day “home monitoring” session with the PRO-Diary watch. We will ask you to provide about three teaspoons of blood at your initial visit and at the mid-treatment and final treatment timepoints.

After the 14-day home monitoring (PRO-Diary watch), you will be assigned 1 of 4 treatments as detailed below. Randomization and treatment delivery may be in person, or done virtually (without an in-person visit). If done virtually, study drug may be shipped directly to your home.

  1. Prescription CBD (in the form of liquid Epidiolex) + a placebo (inactive) version of THC capsule
  2. Prescription THC (in the form of dronabinol capsule) + a placebo (inactive) version of CBD liquid
  3. A combination of both prescription CBD and THC (in the form of liquid Epidiolex and dronabinol capsule)
  4. Placebo (inactive) versions of both CBD and THC (capsule + liquid with no active drug in either product).

Complete two online surveys at about 6 and 12 weeks after you begin treatment.
Begin a second 14-day session of “home monitoring” 10 weeks after treatment starts.
Complete a second overnight sleep study just before the end of your 12 weeks of treatment.

You will also complete several scheduled follow-up phone calls with the study team (lasting about 15 minutes each).

These activities will occur over a duration of about 14 weeks (with treatment lasting 12 weeks). Additional unscheduled in-person or phone assessments may occur. We will also do a final follow-up call about 30 days after your treatment ends.

Participants will receive up to $400 for full study completion.

Who is eligible?

  • Must be between 18 and 65 years old
  • Must have MS
  • Must have chronic pain

Contact

CANSLEEP-MS Study Staff

David Johnson
Phone: (734) 936-2844
Email: [email protected] 

Study ID: HUM00190734 IRB: IRBMED Date Approved: 11/3/2020

Currently Recruiting!

Study Overview/Purpose

This is a study to learn more about the caregiving experiences, friendship patterns, and how these link to health and well-being among African American and European American MS caregivers.

What Does Study Participation Involve?

Caregivers will participate in a focus group study lasting 60-90 minutes. Questions include their caregiving experiences, friendship patterns, and their implications for health and well-being.
Participants will receive a compensation of $60.

How can I join?

Interested MS caregivers, please fill in this screening survey [https://umich.qualtrics.com/jfe/form/SV_1BL0GzaUMHmHG86] for eligibility. We will follow up with eligible participants to provide more information.

Currently, our focus is on recruiting Black/African American caregivers.

Principal Investigator:

Crystal Ng, PhD
Email: [email protected] 
IRB#: HUM00237494

*NOT currently recruiting*

Study Overview

Cognitive dysfunction is common in many different clinical conditions, including multiple Multiple Sclerosis (MS). Little is known about the impact of cognitive dysfunction where it matters most – in the everyday lives of people with these conditions. This study is designed to examine the cognitive function in real-world settings in people with MS.   We expect the knowledge gained in this study will lead us to new insights about how to measure cognitive functioning in daily life and better ways to improve the overall health-related quality of life of people with MS.

What do I have to do?

  • Participants in this study will complete 3 in-person study visits and 3 “home-monitoring periods” over the course of 2 years. Each in-person study visit is followed by a 14-day home-monitoring period.
  • During the home-monitoring period, participants will wear an activity monitor on their wrist and use a study-provided smartphone to complete brief surveys and thinking tests four times daily.
  • At the end of the home monitoring period, participants will mail the devices back using pre-paid study-provided shipping boxes.

Participants will receive up to $600 for full study completion.

Who is eligible?

  • Must be at least 18 years old.
  • Must have MS.
  • Must ambulate independently at least 50% of the time.

Contact

CogDetect-MS Study Staff: Keara Ginell or Josiah Goga
Phone: (734) 936-2844
Email: [email protected] 

Study ID: HUM00199732 IRB: IRBMED Date Approved: 04/26/2022

*NOT currently recruiting*

*NOT currently recruiting*

Study Overview/Purpose

Individuals with spinal cord injury (SCI) frequently suffer from pain. Evidence suggests that patients themselves can have a significant and positive impact on their own quality of life by taking an active role in the self-management of their pain.

The purpose of this study is to improve management of pain through the use of a newly developed web-based program called My SCI Toolkit. The My SCI Toolkit provides education, guidance, and skill-building exercises that are specifically tailored for people with SCI and pain. (IRBMED: HUM00192610)

What Does Study Participation Involve?

Study participants will be randomized to one of 3 groups:

  1. Unguided: Participants will use the newly developed web-based symptom self-management program called the My SCI Toolkit on their own, following the prompt and guides built into the website for 8 weeks
  2. Coached: Participants will use a newly developed web-based symptom self-management program called the My SCI Toolkit and have weekly phone calls with a study coach for 8 weeks
  3. Continue with their care as usual. 

All participants will be asked to complete online surveys at baseline, 4-weeks, and 8-weeks. 
Participants will receive up to $150 for completing the study.  

Who is Eligible?

Participants must meet all of the following criteria.

  1. Have a diagnosis of SCI.
  2. Be at least 18 years old. 
  3. Have access to a reliable, internet-connected device (e.g. computer, tablet) and telephone.
  4. Read, speak and understand English.
  5. Have clinically significant pain.
  6. Willing to maintain stable pain medication regimen during the study period.
  7. Not currently in inpatient care or intensive outpatient physical therapy.
  8. Be willing to complete all study assessments.

What are the Potential Risks/Benefits?

There may not be any direct benefits to you for participating in the study, however, you may see an improvement in your pain self-management skills as a result of being in this study.
This is a web-based behavioral intervention so the known or expected risks are minor and infrequent and include breach of confidentiality, and fatigue and frustration. Researchers take precautions to minimize these risks. This study may limit your participation in other research studies."

*NOT currently recruiting*

Past Studies

This study examined symptoms and functioning in the daily lives of people with multiple sclerosis (MS). Common MS symptoms such as fatigue, pain, and depression may be associated with day-to-day functioning. The goal of this study was to learn more about the day-to-day experience of adults with MS to help us learn more about how to treat and prevent common MS symptoms and functional problems.

Publications:

How Do Pain, Fatigue, Depressive, and Cognitive Symptoms Relate to Well-Being and Social and Physical Functioning in the Daily Lives of Individuals With Multiple Sclerosis?
Kratz, A. L., Braley, T. J., Foxen-Craft, E., Scott, E., Murphy, J. F., 3rd, & Murphy, S. L. (2017). Arch Phys Med Rehabil, 98(11), 2160-2166.

Ecological Momentary Assessment of Pain, Fatigue, Depressive, and Cognitive Symptoms Reveals Significant Daily Variability in Multiple Sclerosis.
Kratz, A. L., Murphy, S. L., & Braley, T. J. (2017a). Arch Phys Med Rehabil, 98(11), 2142-2150. doi:10.1016/j.apmr.2017.07.002

Pain, Fatigue, and Cognitive Symptoms Are Temporally Associated Within but Not Across Days in Multiple Sclerosis.
Kratz, A. L., Murphy, S. L., & Braley, T. J. (2017b). Arch Phys Med Rehabil, 98(11), 2151-2159. doi:10.1016/j.apmr.2017.07.003

Chronic pain is a very serious and common problem for people with spinal cord injury (SCI). Unfortunately, pain is not adequately treated in SCI. Therefore, the search is on for new treatments that can help those with SCI to cope more effectively with their pain. The goal of this study was to open a window onto the day-to-day experiences of pain in adult with SCI, to help us develop better and more individualized self-management therapies for those with SCI who are struggling to cope with chronic pain. The University of Michigan was the lead site, collaborating with Wayne State University and University of Washington, to examine pain and pain coping in the day-to-day lives of adults with spinal cord injury. The purpose of this study is gather new information that will let us know how pain affects well-being and participation in people with spinal cord injury, and what types of coping are related to optimal adjustment to pain.

Publications:

Medicate or Meditate? Greater Pain Acceptance is Related to Lower Pain Medication Use in Persons With Chronic Pain and Spinal Cord Injury. 
Kratz, A. L., F. Murphy J, r., Kalpakjian, C. Z., & Chen, P. (2018). Clin J Pain, 34(4), 357-365.

Pain Acceptance Decouples the Momentary Associations Between Pain, Pain Interference, and Physical Activity in the Daily Lives of People With Chronic Pain and Spinal Cord Injury.
Kratz, A. L., Ehde, D. M., Bombardier, C. H., Kalpakjian, C. Z., & Hanks, R. A. (2017). J Pain, 18(3), 319-331. doi:10.1016/j.jpain.2016.11.006

Are Intensive Data Collection Methods in Pain Research Feasible in Those With Physical Disability? A Study in Persons With Chronic Pain and Spinal Cord Injury.
Kratz, A. L., Kalpakjian, C. Z., & Hanks, R. A. (2017). Quality of Life Research, 26(3), 587-600.

Cognitive “fog” is characterized by problems with attention and memory and is reported in a number of different conditions, including fibromyalgia (“fibrofog”), cancer treated with chemotherapy (“chemofog”), depression, and multiple sclerosis.  The aim of this study was to examine subject and objective markers of cognitive dysfunction to determine whether there are similarities and/or differences in the nature of cognitive fog in these four clinical groups.

Many people with fibromyalgia report having problems with their thinking (cognition) during their daily lives; these thinking problems are commonly called “fibrofog”. However, little is known about the nature of fibrofog and how it is experienced in daily life. This study is designed to examine thinking in real-world settings in people with and without fibromyalgia. We expect the knowledge gained in this study to lead to new insights about the nature of fibrofog and better ways to help people with fibromyalgia effectively manage problems with fibrofog.

For many persons with MS, fatigue is the most debilitating symptom of the condition. This clinical trial, which was guided by feedback from persons with MS, MS providers, community organizations, and payers, compared the effectiveness of current options available: cognitive behavioral therapy alone, modafinil alone, or a combination of both. Results of this study will help patients, providers, and policy makers determine which patients with fatigue respond best to cognitive behavioral therapy or modafinil, and which persons with MS may benefit most from a combination of these treatments.