Interactive Pain Lecture Series

September 13, 2023

Review of topics from spring semester lecture series (to be presented by postbacs) 

• Definitions of pain terms and concepts
  Diana King (CC/DPM)
• Peripheral nociception and peripheral sensitization 
  Catherine Kwiat (NINR)
• Spinal mechanisms and central sensitization
  Nathan Camarillo (CC/RMD)
  Rafael Hernandez Latorre (NIDCR)
• Brain, pain perception and descending mechanisms
  Grace Ratley (NIAID)
• Measurement of pain 
  Ally Niemiec (CC/RMD)
  Nathan Camarillo (CC/RMD)

September 27, 2023       

Neuropathic pain 
Barbara Karp, M.D. (NINDS)
Ellen Staedtler, M.D., Ph.D. (CC/SURG)

October 11, 2023 [Canceled]            

Cancer pain [Canceled]

October 25, 2023            

Inflammatory and visceral pain 
Barbara Karp, M.D. (NINDS) 

November 8, 2023          

Headache and trigeminal pain        
Michael Oshinsky, Ph.D. (NINDS)

December 13, 2023        

Musculoskeletal pain
Miroslav "Misha" Bačkonja, M.D. (NCCIH)

February 8, 2023

Why study pain? 
Definitions of pain; biological significance of pain; nociceptive, nociplastic, and neuropathic pain 

In the first part of this session participants in this session will present critical reasons why it is important to learn about pain, conduct research about pain, and present pain in a way that would be accessible to NIH IRTA participants. During the second half of this session, we will review definitions of pain and a few major categories of pain.

February 22, 2023

Overall anatomy and physiology of pain across organ systems—neural basis and contribution of other organ systems 

Pain is a complex biological phenomenon subserved primarily by the nervous system, from peripheral nerve receptors to cortical neurons and other peripheral nervous system and central nervous system structures, which interact along the way. This session will review the general organization of the nociceptive system that underlies the experience of pain as well as the contribution of other systems, such as the immune system. 

March 8, 2023

Peripheral mechanisms: transduction of injury and noxious stimulation, transmission, excitability and sensitization

Noxious stimulation and tissue injury set into motion a cascade of events from receptors that transduce the force of injury and translate it into action potentials in the peripheral sensory nerve fibers. As a result of injury, the peripheral immune system and other tissues respond, leading to a hyperexcitable state of peripheral nerve fibers known as peripheral sensitization. Manifestations of this sensitization are ongoing pain, allodynia, and hyperalgesia.

March 22, 2023

Central transmission, central sensitization, and dorsal horn circuits

As nociceptive peripheral afferents, peripheral nerve fibers connect to the spinal cord via the dorsal horn and from there via specialized fiber tracts project to the brainstem and thalamus. From there, nociceptive signals project to multiple areas of the brain, where multiple dimensions of pain are experienced. With sustained input from the periphery, central circuits themselves become sensitized leading to central sensitization, which also contributes to the experience of ongoing pain, allodynia, and hyperalgesia.

April 12, 2023

Central modulation and descending control 

In the previous sessions, we presented peripheral and central transmission, where information is transmitted from the site of injury that initiates nociception and pain, as well as physiological circumstances that enhance that transmission, leading to what is known as sensitization, including peripheral and central sensitization. Sensitization is a contributor to clinical phenomena of allodynia and hyperalgesia. Central sensitization is a part of modulation that occurs in the spinal cord, and this mechanism is intimately linked with descending control mechanisms, which can be impaired in patients with chronic pain.

April 26, 2023

Pain perception and coping with pain 

Once the nociceptive transmission reaches the brain, it is distributed to many brain structures, which then contribute to all of the aspects of what we call pain. Until that point, all of the physiological processes are nociception. It is activation of these multiple mechanisms that allows the person experiencing pain to also form their resources to cope with pain, at which point their brain structures become a part of descending pain modulation.

May 10, 2023

Affective, cognitive, behavioral, psychosocial, and spiritual aspects of pain

Multiple areas of the central nervous system participate in perception of and coping with pain as outlined in the previous presentations. In addition to sensory perception of pain,  affective, cognitive, psychosocial, and spiritual factors in perception of  pain interact with the environment to result in what is finally the experience of pain that is unique to each person. 

May 24, 2023

Pain measurement and assessment in humans

The preceding sessions of this course presented the complexity of the pain experience in healthy people as well as in people with acute and chronic pain. This session will present overall strategies to assess and measure pain in a variety of clinical circumstances, as well as challenges of obtaining and interpreting that information.

June 14, 2023

Pain measurement and assessment in animals, including chronic pain models 

Animal models are very important for the study of pain mechanisms on a finer anatomical level including molecular approaches and invasive physiological methods, which provide the finer details of pain mechanisms. 

June 28, 2023

Animal models of pain and human models of pain

This session will be a grand summary of the IPLS course, demonstrating how animal and human models provide a platform to study pain and pain mechanisms, which are then used to translate that knowledge into approaches for assessment and treatment of pain.