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Pain, Headache, and Sensory Neuroscience

RESEARCH

Pain, Headache, and Sensory Neuroscience

A significant portion of the U.S. population, approximately 45 percent, seeks medical help for chronic pain at some point in their lives. While acute pain serves as a protective mechanism to prevent further harm, chronic somatic and visceral pain are prevalent and debilitating conditions. These conditions often coexist with stress-related psychiatric disorders, including anxiety, depression, and fatigue. The lack of effective pain treatments poses a significant challenge, primarily due to our limited understanding of the underlying cellular and molecular mechanisms. At the Icahn School of Medicine at Mount Sinai, both medical professionals and researchers are committed to unraveling the molecular mechanisms and neural pathways associated with pain and other sensory disorders. Their goal is to identify new targets for analgesic drugs that are both safe and non-addictive, with the objective of effectively treating severe, persistent, and sometimes intractable pain. Additionally, they strive to educate and train the next generation of pain researchers.

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Areas of Research and Clinical Focus

People living with HIV commonly experience chronic pain, including pain from peripheral neuropathy, musculoskeletal conditions, and headache disorders. For many people, this results in a complex, multifocal, and treatment-resistant pain syndrome for which opioids are commonly prescribed. Our work at Icahn Mount Sinai has been pivotal in understanding the epidemiology of chronic pain in people living with HIV. We have also developed and tested implementation strategies to support HIV primary care providers in adopting safer opioid prescribing practices. In collaboration with the Global HIV Pain Task Force, of which Jessica Robinson-Papp, MD, MS, is the co-chair, we are collaborating with people with lived experience to develop a research agenda to guide the field.

Scientists in this research area include:

Diabetes is the most common cause of peripheral neuropathy in the United States, and many people with diabetic peripheral neuropathy experience significant pain in their feet. At Icahn Mount Sinai, we are leading the effort to develop new, non-addictive medications to treat painful diabetic peripheral neuropathy as the Principal Investigators for the National Institutes of Health-funded Early Phase Pain Investigation Clinical Network Platform Trial, which provides a venue for efficient testing of promising new treatments.

Scientists in this research area include:

Headache is the most common form of pain. While many people experience a headache once or twice a year, individuals with chronic headache disorders experience pain on 15 or more days of the month. Patients with chronic headache disorders frequently report disabling non-painful symptoms, including fatigue and cognitive dysfunction, which are not well understood. At the David S. and Ruth L. Gottesman Center for Headache Treatment and Translational Research, we aim to improve the efficiency and efficacy of treatment paradigms that address the painful and non-painful manifestations of headache. Our ongoing clinical trials examine novel treatments for the treatment of migraines in both pediatric and adult individuals with migraines. 

Scientists in this research area include:

Irritable bowel syndrome (IBS) and interstitial cystitis/bladder pain syndrome (IC/BPS) are complex disorders that present with a range of symptoms, including abdominal pain, changes in bowel habits, pelvic pain, and increased frequency of urination. These conditions are associated with physical, emotional, and psychiatric comorbidities, and significantly impact patients' quality of life. Additionally, despite their distinct origins, recent studies have revealed a strong overlap between these two syndromes. However, the mechanisms underlying the development of pelvic pain and cross-sensitization between the bladder and colon remain poorly understood. To address these knowledge gaps, our research utilizes advanced genetic tools and virally mediated techniques, along with ex vivo functional studies and in vivo behavioral testing. Through these approaches, we aim to identify crucial molecules and primary nociceptors that contribute to pelvic pain and interorgan cross-sensitization. By gaining a better understanding of these mechanisms, we hope to contribute to the development of more effective diagnostics and treatments for IBS and IC/BPS.

Scientists in this research area include:

The experience of pain involves both sensory (withdrawal reflex) and emotional (unpleasantness and aversion) aspects. Although both dimensions have significant implications for pain treatments, their underlying cellular and circuit mechanisms are not well understood. For instance, it is not well understood whether both dimensions are encoded by common or distinct neural circuits. In addition to pain-related aversive coping behavior, animals can exhibit unique self-caring coping behaviors, such as licking, to alleviate pain, but the underlying cellular and circuit mechanisms of these behaviors are not understood. To address these gaps in knowledge, we will utilize neural tracing techniques, as well as virally mediated optogenetic and chemogenetic approaches, to investigate how specific spinal projection neurons interact with supraspinal reward and analgesia circuits to drive pain-related coping behaviors.       

Scientists in this research area include:

Approximately 30 percent of adults experience back pain, a prevalent condition that causes significant disability worldwide. Back pain is closely associated with intervertebral disc (IVD) injury and degeneration (IVDD), which account for about 40 percent of back pain cases. While spinal surgery is commonly used to treat conditions such as herniation, spinal stenosis, spondylolisthesis, and deformity, there remains a need for more effective therapies to address issues like adjacent segment degeneration, recurrent herniation, and chronic back pain, which can lead to disability and discomfort. To gain a better understanding of discogenic pain, researchers at Icahn Mount Sinai will utilize rodent models of IVD injuries to develop behavioral tests that assess both evoked and spontaneous pain responses. Additionally, they will employ various techniques such as neural mapping, targeted gene knockouts in pain-sensing neurons, viral-mediated targeting of specific neural circuits, and optogenetic and chemogenetic strategies to investigate the molecular and cellular mechanisms underlying discogenic pain.

Scientists in this research area include:

Chronic itch affects 20% of the population. Despite its significant impact on patients’ quality of life, chronic itch has been relatively neglected by researchers, and its underlying mechanisms remain poorly understood. Consequently, the management of chronic itch is inadequate, leading to a substantial unmet medical need. There is an urgent need to identify specific pathways and molecules contributing to the development of chronic pruritus in order to develop effective therapeutic interventions. To this end, we will focus on the functions of itch-related receptors, ion channels, and intracellular signaling molecules in the context of neuroimmune interactions to better understand the cellular and molecular basis of chronic itch using well-established mouse models.

Scientists in this research area include:

Contact Us

Jessica Robinson-Papp, MD, MS

Annenberg Building, 2-44

1468 Madison Ave

New York, NY 10029

212-241-8390
Email

Hongzhen Hu, PhD, MS

Icahn School of Medicine at Mount Sinai

New York, NY 10029

332-243-0714
Email