University of Bristol: Bristol researcher awarded fellowship to help change the lives of people suffering with chronic pain

More than a third of the UK population – around 28 million people – are thought to be affected by chronic pain, yet historic under-investment in pain research has led to a gap in our understanding, as well as a lack of effective treatment options.

Chronic pain can have a devastating impact on nearly all aspects of everyday life, both for people directly afflicted by pain and their families. It affects mobility, mood, sleep, and appetite, and can lead to mental health issues such as anxiety and depression.

Chronic pain also carries a large societal and economic burden by putting extra strain on healthcare systems, as well as contributing to unemployment and work absence due to sickness. This is estimated to cost the UK economy billions of pounds every year.

Four exceptional mid-career researchers, from King’s College London, University College London (UCL), Northumbria University and the University of Bristol, will each receive around £300,000 in fellowship funding, in order to help change the lives of people suffering with chronic pain.

Dr Robert Drake is a Senior Research Associate from the University of Bristol. His research explores how injury affects brain function to cause chronic pain.

Disabling chronic pain has various sensory, emotional, and cognitive components, and there is a pressing need to understand which brain processes underpin their development and why this occurs in some people but not others.

Dr Drake’s research has shown that a loss of function in a neuronal pathway that links the brain and spinal cord is a critical step in the emergence of chronic pain in male rats.

With support from the Foundation, Dr Drake will investigate how this loss of function affects a wider brain network that supports emotional reactivity, coping behaviour and sensory hypersensitivity. He will use state of the art computational methods to identify subtle changes in rodent behaviour related to pain, stress, and pain relief. By combining this with recordings, and the manipulation of brain activity, he will be able to relate brain function to experiences of pain and changes in behaviour.

Another major focus of Dr Drake’s fellowship will be investigating sex differences in chronic pain development.

Women are more than twice as likely to develop chronic pain, compared to men.

“By contrasting the effect of injury on brain function and how this impacts pain-like behaviour in male and female rats, I hope to reveal key mechanisms that differentiate chronic pain development in men and women,” says Dr Drake.

In collaboration with a mental health company, Dr Drake will also assess the therapeutic effects of psilocybin, a psychedelic drug which has shown promise as a treatment for mental health conditions including depression and post-traumatic stress disorder. He added: “If we can demonstrate the therapeutic potential of psilocybin, while identifying which brain pathways are used to deliver any beneficial effects, this could all support the future development of treatments for chronic pain in people.”

Dr Anna Andreou is a Senior Research Fellow and Director of Headache Research at the Headache Centre, King’s College London and Guy’s and St Thomas’ NHS Foundation Trust. Dr Andreou’s Foundation-funded fellowship will investigate a non-paralytic botox-like molecule for the potential treatment of facial pain and headaches.

The excruciating pain caused by chronic facial pain disorders can have a considerable impact on quality of life for patients and their families. However, a lack of awareness and research funding means there are very few studies which have explored long-term treatment options. Current treatments offer little control over pain and often come with considerable side effects.

A potential treatment option is ‘botulinum toxin A’ injections, commonly known as Botox. Botox has significant pain preventive actions; however, especially for the region of the face, such actions are curtailed by its paralytic side effects.

Over the past four years, along with her collaborators at the University of Sheffield and Neuresta (a University of Sheffield spin-out company), Dr Andreou has been working with a new botox-like molecule called BITOX, which lacks paralytic effects.

In the lab Dr Andreou will first examine how effective BITOX is for preventing pain, and how long its effects last, by looking specifically at silencing pain-specific neurons in the brain. She will then use these findings to explore how safe and effective BITOX is for patients suffering with facial pain, recruited via the Guy’s and St Thomas’ Headache Centre.

“There is a huge unmet need for new treatments,” says Dr Andreou. “My fellowship offers an untapped opportunity to create a truly significant and tangible outcome for patients suffering from facial pain, headaches, and other pain conditions.”

Dr Stephanie Koch, a Senior Research Fellow from UCL, will study how childhood experiences influence lifelong vulnerability to pain.

Chronic pain is often difficult to treat, and we don’t yet know why certain people are more vulnerable. This gap in knowledge significantly delays the discovery of new treatments.

Early research suggests that childhood experiences may influence our lifelong vulnerability to pain.

“We now know that pain responses are controlled by groups of cells, or circuits, in central areas such as in the brain,” says Dr Koch. “These circuits use cues from the environment, experienced during childhood, to mature. While this is necessary for the development of healthy adult pain responses, it also leaves pain circuits vulnerable to adverse adaptation to pain, especially after injury early in life.”

Dr Koch’s work suggests that adverse adaptation to pain in childhood can increase lifelong vulnerability to pain. Using cutting-edge genetics, her research in mice aims to identify how childhood experience can change the development of brain circuits; determine how this altered brain development can shape adult pain vulnerability; and reveal the life stages most susceptible to adverse learning.

“Understanding how the young brain learns to respond to pain is the first step in identifying how these circuits can lead to chronic pain in adulthood,” says Dr Koch.

Dr Jenni Naisby is a Senior Lecturer from Northumbria University. Her Foundation fellowship aims to understand the impact of pain in people with Parkinson’s disease, and improve how this pain is managed.

Pain can affect up to 85 per cent of people with Parkinson’s, having a significant impact on movement, mood and quality of life. Despite this, Dr Naisby’s earlier work has shown a lack of awareness among healthcare professionals, and a dearth of existing evidence to help guide treatment.

Dr Naisby will co-design a pain management toolkit for people with Parkinson’s, and a training package for healthcare professionals, before testing these resources in clinical practice.

“We have an extremely limited understanding of how pain in Parkinson’s behaves over time and whether it interacts with other symptoms,” says Dr Naisby. “We’ll be speaking directly to people with Parkinson’s, their carers, and healthcare professionals, to better understand these issues and develop resources that will improve how pain in Parkinson’s is managed.”

Dr Naisby will share her research findings through blog posts, a video animation, and a public event aimed at people with Parkinson’s.

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