Colleen M. FiTZGERALD MD, MS
Michael R. CLARK MD, MPH, MBA
A prominent psychiatrist and pain educator discusses the challenge of managing patients with chronic pain who also suffer with borderline personality disorder and depression, including the special difficulties associated with demanding, noncompliant, and high-utilizer patients. Dr. Clark is Vice Chair of Clinical Affairs, Johns Hopkins University School of Medicine, the Director of the Adolf Meyer […]
Joseph P. FURMAN JD
Charles E. ARGOFF MD, CPE
- Improving Animal Research to Promote Better Pain Therapies
An interdisciplinary team of scientists and engineers at Stanford University is developing a small wireless device to advance the state of the art in chronic pain research. The work builds on existing expertise in the deployment of micro devices that function within the body and are powered remotely. The device would allow researchers to bypass a major hurdle in their current animal study model: the fiber-optic cable used for optogenetics. Optogenetic research involves genetically engineering nerves in mice to be responsive to light, and offers promise as a new model for studying pain mechanisms. But the cable from which the light is emitted limits the mice’s activities, resulting in an unnatural environment. The wireless device under development would allow the mice to move and socialize freely and, the team asserts, may assist in the design of studies that more closely emulate the human experience with chronic pain. Read a news story about the work here. A press release from the university detailing the work of the Stanford team may be read here.
- Awareness of Possible Link Between Bariatric Surgery and Headache May Promote Better Treatment, Fewer Misdiagnoses
A new study published online in the journal Neurology® suggests that bariatric surgery may be a risk factor for a specific condition that is known to trigger severe headache. Researchers found that the surgical procedures were sometimes associated with later developing a condition called spontaneous intracranial hypotension. The condition is often caused by a leak of the cerebrospinal fluid (CSF) out of the spinal canal, lowering spinal fluid pressure and triggering sudden headaches with accompanying nausea, vomiting, neck stiffness, and difficulty concentrating. It is known that body weight plays an important role in CSF pressure. Spontaneous intracranial hypotension is typically associated with a tall and lanky build, while obesity is a risk factor for intracranial hypertension, or high CSF pressure. The authors hypothesize that the loss of fat tissue may uncover a susceptibility to spontaneous intracranial hypotension. More research is needed to understand the relationship between body weight and spinal pressure, but awareness of the possible link may promote more proactive treatment of severe headache. Read more about the findings here.
- Identification of Cell Signaling Pathway may Illuminate Future Research and Treatment of RA
Researchers at Hospital for Special Surgery (HSS) have identified a new cell signaling pathway that contributes to the development and progression of inflammatory bone erosion, which occurs in patients with rheumatoid arthritis (RA). Bone erosion in joints is a major cause of disability in RA patients. The findings were published online this month in the Journal of Clinical Investigation. Rheumatoid arthritis is a systemic inflammatory autoimmune disease that affects millions of people worldwide. Earlier research identified a variant in a gene called RBP-J that is associated with the development of RA, but its specific role was unknown. The study authors believe that their success in discovering the RBP-J controlled signaling pathway will provide potential novel therapeutic targets for the prevention and treatment of RA, thus opening a new avenue for both basic research and clinical care. A news story about the study may be read here.
- Study Suggests New Marker for Chronic Pain Susceptibility
A study published this month in the Journal of Pain by researchers at the Rutgers School of Dental Medicine finds a relationship between the level of postexercise pain sensitivity and the likelihood of developing chronic pain. The results suggest that exercise could be a valuable component in helping doctors predict susceptibility to pain, particularly following injury or surgery. The phenomenon of pain reduction after exercise is known as "exercise-induced hypoanalgesia" or (EIH). The authors believe that an individual's EIH profile can indicate how efficiently their body modulates pain. Chronic pain conditions such as fibromyalgia, migraine, chronic low back pain, and temporomandibular disorder have been shown to be associated with faulty pain modulation. Read more about the findings here.
Department of Public Health and Community Medicine
Tufts Medical Center