My overarching goal is to improve the management of chronic pain by way of research discovery and education. Our limited understanding of the molecular mechanisms underlying chronic pain is due, in large part, to patient heterogeneity. An individual’s pain experience is as unique as their fingerprint- shaped by many factors, including the context surrounding the event, past experiences, stress level, belief systems, coping strategies, and general health. Combine with that, individual variability in genes that regulate the development and function of the nervous system, immune response, and psychological mood, and one can appreciate the complex nature of pain. This complex problem will only be solved with a complex approach.
According to Michael Rubinstein, a physicist from the Carolina Virtual Lung Project, “When nature creates something it is just science- it’s not split into biology, physics, or chemistry. To understand the full complexity of nature one has to break it into parts of the picture and then pull it all back together again.” Breaking down pain into parts of the picture requires collaboration among scientists and clinicians within an enabling infrastructure. My lab has adopted a translational bedside-to-bench and bench-to-bedside approach to the study of chronic pain conditions. We work with clinicians on large-scale collaborative projects that inform hypotheses tested in basic independent studies, which then inform more advanced clinical studies (e.g., clinical trials). By marrying pain neurobiology, behavioral pharmacology, and molecular genetics with clinical epidemiology, I hope to bridge the significant gap that exists between basic science and clinical research in order to better understand the mechanisms underlying maladaptive chronic pain conditions and identify more rational treatment strategies.
Ultimately, the management of a patient’s pain will also benefit from a stronger pain curriculum offered to medical students, who represent future treating physicians, as well as graduate students who represent future discoverers and inventors of new treatments. Thus, in addition to research, I hope to advance pain education forward.
Awards and Recognitions
Dr. Andrea Nackley Appointed Co-Chair of Early Career Forum
The American Pain Society invited Dr. Nackley to become co-chair of the Early Career Forum. The appointment starts with co-planning the 2018 Scientific Summit with the current chair, continuing through 2019 when Dr. Nackley will be appointed the chair of the Early Career Forum.
NIH/NIDCR Grant # R56DE025296-01 awarded to Dr. Andrea Nackley
Title: Proteins, MicroRNAs and Genes Associated with TMD and Overlapping Conditions
Awarded Date: September 21, 2016
Summary: The Institute of Medicine found that chronic pain affects 100 million Americans, causing extensive economic, social, and personal costs. For some the pain remains localized, while for others the pain spreads to affect multiple anatomic sites, suggesting a common underlying cause. In response to PA-14-244, we plan to use stored biospecimens and existing data from a clinical study of 1,460 adults to determine biological (proteins, microRNAs, and gene polymorphisms), psychosocial (stress, depression, anxiety), and clinical (general health and environmental exposures) factors that contribute to localized and overlapping pain conditions. Further, we will use bioinformatics methods to understand how these factors interact to influence pain, with the long-term goal to identify biomarkers for the diagnosis and treatment of chronic overlapping pain conditions.