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Undergraduate Research Program

Pain Program Faculty

2017

Michele Curatolo, Monica Vavilala, Elisabeth Powelson - Anesthesiology and Pain Medicine

Websites: 
http://depts.washington.edu/anesth/
https://depts.washington.edu/hiprc/
http://depts.washington.edu/givemed/prof-chair/holders/michele-curatolo-m-d-ph-d-2/

http://www.uwmedicine.org/bios/monica-vavilala

Description: Among patients who have experienced a traumatic injury, rates of persistent pain after trauma are over 60%. Persistent pain is defined as pain 3-12 months after initial injury. Persistent pain after trauma has been associated with decreased participation in the workforce, decreased physical activity and worse quality of life as compared to patients without persistent pain after trauma. We are running a prospective cohort study in cooperation with the Harborview Injury Prevention & Research Center to determine the predictors of persistent post-traumatic pain. We started the study in summer 2016. We are recording extensive data on pre-trauma patient characteristics, in-hospital outcomes and aspects of management of pain during hospitalization. We are collecting the first outcome data at three months after the trauma.

In summer 2017, we would like to ask patients about their pain and related parameters like function or mood 12 months after the trauma. The collection of the outcomes 12 months after the trauma will allow us to associate the data collected in the acute post-traumatic phase with long term pain, thereby guiding future research on interventions that prevent chronic post-traumatic pain.

The student involved will work with our research team to conduct follow-up interviews via email, phone and by meeting patients at follow up hospital visits. We seek someone enthusiastic about working with patients and who is interested in the development of chronic pain after initial injury.

Requirements: We will provide literature on post-traumatic pain.

Ajay Dhaka - Molecular, Cellular and Developmental Basis of Pain

Description: In the Dhaka lab, we take a multifaceted approach to understand the molecular, anatomical and developmental basis of pain sensation. Students will employ a wide variety of molecular, genetic, imaging and behavioral approaches to understand how the pain sensation is encoded by the nervous system.

Requirements: Completed the Biol 180, 200, 220 series. Laboratory experience is preferred.

Ardith Doorenbos - Biobehavioral Nursing and Medicine

Website: https://nursing.uw.edu/person/ardith-doorenbos/

Description: Uncontrolled acute post-operative pain is a major determinant of patient suffering and dissatisfaction. It requires intensive health care resources, leads to prolonged hospital stay, delays recovery and may increase morbidity. Development of chronic post-surgical pain is frequent and recognized as major clinical problem. Persistent opioid use due to uncontrolled chronic pain is associated with increased morbidity, mortality, disability and social costs. Our long-term goal is to improve pain management for individuals undergoing spine surgery by facilitating timely and appropriate use of pain self-management. The following two aims were developed to move us further towards accomplishing our goal:
Aim 1: Evaluate the feasibility (screening, recruitment, accrual, attrition, adherence to intervention, intervention completion) of the TeleCoaching program in patients undergoing spine surgery.
Hypothesis: A TeleCoaching program will be feasible in patients undergoing spine surgery across different age groups and clinic sites.
Aim 2: Evaluate trends of T1 (baseline/pre-operative) to T2 (post intervention/ one month post-operative) on the primary outcome of dose/frequency of opiates and the secondary outcomes of pain, psychosocial factors, physical function, and quality of life.
Hypothesis: Patients undergoing spine surgery who receive the TeleCoaching program will return to preoperative dose/frequency/MEQ of opiates within one month of surgery.
Students working on this project will be assisting with data collection among patients undergoing spine surgery.

Requirements: No special preparation or requirements are required.

Pierre Mourad - Neurological Surgery

Website: http://neurosurgery.washington.edu/research/labs/mourad.asp

Description:  A patient’s acute or chronic pain may arise from many factors, from peripherally sensitized tissue due to local damage and/or central contributions, due to changes in sensory processing at the level of the spinal chord or brain, known as central sensitization.  Regardless of these underlying complexities, patients who report feeling pain do so generally in association with one or more specific parts of their body.  Because of this physicians need a means testing the sensitivity of those parts, sometimes in small volumes deep to the skin, perhaps identifying a small adhesion, perhaps ruling out the existence of peripheral tissue pathology. While imaging can identify abnormal looking tissue it cannot identify painful tissue.  This means a physician needs to perform an ‘evocative’ test such as palpation or an injection to assay the tissue’s tenderness, in addition to an image of the reported painful area. However, stimulation of deep potentially tender tissue typically requires stimulation of the intervening, generally superficial tissue, adding complexity to the diagnosis. In response to these clinical needs we have developed a non-invasive, evocative test that uses intense focused ultrasound (iFU) under image guidance (‘ig-iFU’) to stimulate candidate focal and tender tissue deep to the skin in a manner blinded to the patient. This summer we will apply the ig-iFU paradigm to amputee patients, whose painful sensations arise from neuromas deep to the skin as well as changes in the sensitivity of their spinal chord and brain, including phantom limb sensations.  You will aid in the calibration of our ig-iFU device as well as its use during pre-clinical trials at Harborview Medical Center.

Requirements: some, even just limited, experience with electronic laboratory equipment such as function generators, oscilloscopes, amplifiers, and the like; capacity to work as a team member – sometimes following, sometimes leading; and tendency towards autonomy tempered by a willingness to ask for help; maturity; willingness to consider working in my laboratory beyond the summer activity.

Tonya Palermo - Pediatric Pain Management; Psychology

Website: http://www.seattlechildrens.org/research/child-health-behavior-and-development/palermo-lab/

Description: Children can develop chronic pain from an injury or as a consequence of a disease process. Pain can also be the problem itself without any specific identifiable injury or disease and is an important public health problem, with estimates of chronic pain in almost a quarter of youth worldwide. How people think about pain and how they react when they are in pain influences their adaptation. Biopsychosocial models of chronic pain emphasize the important role of individual psychological factors, social factors, and biological factors in the individual’s pain experience. Our lab is interested in understanding how pain affects the lives of children and their families and how to prevent and manage pain so that it is not disabling. We study several different populations of children who have pain from surgery, injuries, or from chronic health conditions.  Our research has focused on the interrelationships of pain, sleep, and behavioral/psychological, and family factors. We have developed and evaluated cognitive-behavioral interventions to treat pain and to reduce sleep problems including internet-delivered interventions to improve access to treatment. Several projects are available depending upon the student’s interest.

Requirements: Enthusiasm and interest in clinical research in pediatric pain management; Completion of a research methods course is very helpful but not required.

Kushang Patel - Anesthesiology and Pain Medicine

Description: Chronic pain interferes substantially with the ability to perform routine daily activities and chronic pain patients consider increased ability to physically function as an important treatment objective. Thus, physical function is considered a core outcome domain for clinical trials of pain treatments. Although physical function has traditionally been assessed using self-reported measures, there is increased interest in objective outcomes assessment since self-reported measures are prone to social desirability, recall, and other biases. For example, in an analysis of nationally representative data (N=3,782), we observed that 47.7% of adults with chronic widespread pain self-reported, through a detailed questionnaire, that they accumulate ≥150 minutes per week of moderate to vigorous physical activity; however, only 1.4% achieved this level of activity according to the accelerometer that they wore for one week. Accelerometers are small, lightweight devices that objectively measure acceleration (physical activity/movement) in 1, 2, or 3 axial planes. The correlation between self-reported and accelerometer-measured physical activity in our study of adults with and without chronic pain was low, ranging 0.14-0.27. These results suggest that self-report and accelerometry are measuring different dimensions of physical activity (e.g., perceived versus actual intensity of activity). As part of a summer internship, we would like to investigate this further using data collected in our ongoing clinical studies of fibromyalgia and osteoarthritis.

Requirements: Since this project integrates quantitative research methods, clinical trials, and pain assessment, students should have an interest in public health or medicine; some coursework in statistics and/or experience with signal data analysis with MATLAB would be helpful, but is not required.

Jennifer Rabbitts - Pediatric Anesthesiology and Pain Medicine

Website:  http://www.seattlechildrens.org/research/child-health-behavior-and-development/palermo-lab/current-lab-members/

Description: Millions of children have surgery in the United States each year and many experience significant pain and distress. Postsurgical pain has a significant impact on healing and recovery after surgery. Many factors play a role in children’s postsurgical pain and recovery, and we found that psychosocial factors in children as well as their parents are particularly important in this process. Our current research focuses on identifying children at risk for developing problems with pain and recovery after surgery, and developing cognitive-behavioral treatments targeting psychosocial risk factors before surgery. Several specific project opportunities are available for the student, and will be determined by their interests.

Requirements:Students should have an interest in clinical research or medicine, and specific interest in pediatric pain management; Completion of a research methods course is very helpful but not required.

Sean Rundell - Rehabilitation Medicine, Health Services Research

Website:  http://www.rehab.washington.edu/education/faculty/nonproviderbios/rundell.asp

Description: The goal of my research is to improve the delivery and quality of care for people with chronic musculoskeletal pain conditions. I mostly focus on back pain in older adults. Chronic musculoskeletal pain is a complex, biopsychosocial health condition, and most of my ongoing research projects involves working with an interdisciplinary team and using large data sets to better understand this complexity from both an individual patient level and a health systems level. The projects I am working on right now involve examining how having multiple chronic health conditions impacts older adults with back pain. I am also beginning a similar project that will look at how having multiple sites of pain effects older adults with back pain. Other potential research projects that I will be working on this summer involve using spine imaging results and diagnosis codes to identify patients with a specific type of back pain, lumbar spinal stenosis. Once we identify this group of patients, we will then investigate what other chronic health conditions are common within this group and how these other health conditions impact the care they receive.

Requirements: Some experience or background with programming or data management would be helpful, but it’s not required. Familiarity with using health science databases and other library resources is also helpful.