Research

With over 50 centers, 30 academic departments, and 376,000 square feet of research laboratories, NYU School of Medicine continues to produce groundbreaking discoveries, some of which have led to Nobel prizes. The School's basic and clinical scientists conduct dynamic interdisciplinary research to address the entire range of 21st-century biomedical science.

In an attempt to provide the best and most up to date care to our patients, our clinical activities are complemented with a variety of research.

The Center for the Study and Treatment of Pain at NYU Langone Health holds research and academic activities among its primary missions. That commitment and the availability of enthusiastic mentors in our Division are for the purpose of strengthening both basic and clinical research. Research opportunities for fellows and residents are available. Residents are encouraged to become involved early in their training to begin to define an area of interest upon which they can build an academic career.

Basic Science Research

At present several main areas of basic investigation are ongoing in the Division of Pain Medicine (Anesthesiology) at NYU Langone Health and we encourage the participation of residents and fellows to help us understand and solve these interesting problems. Faculty, fellows and residents routinely contribute to national Pain Medicine meetings and have manuscripts published in peer reviewed professional and scientific journals.

Chronic postsurgical neuropathic pain is increasingly recognized as a possible outcome after surgery.  Lisa Doan, MD is investigating changes in somatosensory cortical circuits underlying chronic postsurgical pain.  Pain is important to address in the perioperative period. Dr. Doan is interested in improving perioperative pain care. Current projects include a clinical trial to examine the effects of perioperative dexmedetomidine on pain control and quality of recovery after spine surgery.  Dr. Doan and the lab team are in the process of further investigating this protocol.  Dr. Doan is also examining the effects of preoperative medication use on postoperative outcomes.

Another area of basic and translational investigation involves study of "Long lasting biochemical changes in the brain and spinal cord that underlie chronic neuropathic pain." Through two distinct projects, Jing Wang, MD, PhD and the lab team are actively investigating all three components of pain; sensory, emotional, and executive.

Other studies involve the role of NMDA (N-methyl-D-aspartic acid) receptors (NMDArs) in chronic pain following nerve injury. Esperanza Recio-Pinto, PhD and Thomas J.J. Blanck, MD, PhD, are investigating the stimulation of peripheral NMDArs. Peripheral NMDArs are an attractive target for treating chronic pain involving surgical procedures, because under normal (non-painful) stimulation NMDArs in dorsal root ganglia (DRG) neurons do not activate, some of the NMDArs isoforms are predominantly expressed in DRG neurons, and NMDArs have various regulatory sites that are isoform-dependent and hence one could select treatments directed solely at peripheral NMDAr and in this way avoid unwanted CNS side effects. In addition, the identification of paths that are under the control of peripheral NMDAr and that contribute to the maintenance of chronic pain states will help select treatments that will not only decrease but potentially also reverse the chronic pain states observed following peripheral nerve injury.

Clinical Research

Christopher G. Gharibo, MD, Medical Director of Pain Medicine, is leading an effort to investigate the role of interventional options in the care of patients with musculoskeletal and neuropathic pain conditions. These studies involve treatment options for lumbosacral radiculopathy and analyzing whether success or failure with oral prednisone treatment also predicts same with interlaminar epidural steroid injection. This is carried out in the following studies.

A study from Dr. Gharibo and his team involves the clinical outcomes in lumbosacral radiculopathy in patients who have received transforaminal vs. interlaminar epidural steroid injections. Since the transforaminal epidural steroid injection uses a fluoroscopy to guide a needle through the neural foramen on one side, as opposed to the intelaminar epidural steroid injection which is administered by hand, this alternate and arguably improved spread of the steroid across the intervertebral foramen may therefore be more effective.

“The Role of Oral Steroids in Prognosticating the Efficacy of Epidural Steroids”. The lab has tracked this studies outcome data on the successes and failures of Prednisone 10mg PO qid while proceeding to perform lumbar interlaminar epidural steroid injections on patients and found out that patients responded to epidural steroids at the same rate and extent whether or not if they responded to PO steroids. In conclusion, PO steroids do not prognosticate response to epidural steroids. Dr. Gharibo and the lab team have completed data analysis and the abstract form has been accepted for presentation at the 2010 American Academy of Pain Medicine Annual Meeting in San Antonio, TX.

Dr. Gharibo’s investigational aim is to find parameter settings in spinal cord stimulators (SCS) that have a higher likelihood of providing the desired coverage, particularly low back pain coverage. These settings can facilitate lead placement and programming, improving patient experience and intra-operative efficiency by taking into account patient diagnosis, painful region, lead type, and field configuration.

Co-investigations with the Department Physiology and Neuroscience and the Division of Pain Medicine (Anesthesiology) are ongoing. The ultimate purpose of this research is to understand the pathophysiological basis of chronic pain to provide a framework that will serve as a basis for the development of effective treatment. The purpose of this specific study is to find if there is a brain signature for pain in patients with trigeminal neuralgia (TN).

Residents are encouraged to participate in the process of protocol development and submission along with a faculty mentor.