Human Affect and Pain Neuroscience Laboratory

Human Affect and Pain Neuroscience Laboratory

Lab Description

The Human Affect and Pain Neuroscience Laboratory is interested in central nervous system (brain and spinal cord) processes and alterations in individuals with chronic pain. The brain and spinal cord are known to be altered in states of chronic pain, both in structure (or anatomy) and function (or activity). We use a combination of methods using neuroimaging, quantitative sensory testing, and clinical/behavioral testing via questionnaires in our research projects. Our research focuses on questions pertaining to how central nervous system changes are related to chronic pain and associated comorbid symptoms, behavioral changes in chronic pain and opioid use.

Our goal is to contribute impactful data for increased understanding of the mechanisms underlying and contributing to chronic pain by studying the central nervous system in humans (with and without chronic pain) and its relationship to other body systems. Through our research, we hope to provide novel and fundamental knowledge for improved and targeted treatments for individuals suffering with chronic pain.

Currently, we have active clinical research projects studying:

  • Alterations in brain and cervical spinal cord structure and function in chronic pain
  • The relationship between brain reward systems and behavior in chronic pain
  • Neurophysiological effects of opioid medications in chronic pain

Altered Brain and Spinal Cord Activity and Structure in Chronic Pain

Neuroimaging research has shown over the last few decades that individuals with chronic pain show differences in brain structure and activity. It is thought that these findings represent neurophysiological alterations in the central nervous system that may underlie or contribute to the experience of chronic pain. Our lab uses a technology called magnetic resonance imaging (MRI) to study the brain and spinal cord in individuals with chronic pain. MRI uses a strong magnetic field to create images of the brain and spinal cord that can be used to study both the structure (or anatomy) and function (or activity based on changes in blood flow) without the use of radiation or injections. During these research studies, participants lie down in the MRI scanner and are asked to rest or participate in various tasks (like computer games) while brain and spinal cord images are collected. The images are then analyzed in the laboratory and used to help us understand how changes in the brain and spinal cord may contribute to chronic pain symptoms, so that in turn, we can identify new ways to reverse these changes and new treatments for chronic pain.

Relationship Between Chronic Pain and Reward/Value Systems

Several lines of neuroimaging research indicate that brain reward and value systems are altered in chronic pain. Brain reward and values systems are involved when individuals weigh options and determine courses of action to take. These are highly important processes and are used frequently in daily life. In some individuals with chronic pain, reward and value systems appear to be dysregulated – this could be due either to preexisting abnormalities prior to development of chronic pain or caused by the experience of a constant pain experience. Either way, intact reward and value processes are thought to be critical for proper functioning and daily life, and the disruption of these important processes could, in part, contribute to chronic pain itself through the interaction between psychology and physiology. Because of this, we are studying reward and value systems in individuals with chronic pain compared to healthy pain-free individuals. We hope to better understand how these systems are altered in chronic pain and to find how changes in reward/value systems may be influencing the chronic pain experience. By increasing knowledge in this area, we hope these findings will contribute to the identification of more effective psychological and pharmacological therapies to treat chronic pain.

Effects of Opioid Use on Neurophysiology in Chronic Pain

There is currently great controversy over the use of prescription opioids for chronic non-cancer pain. The long-term use of opioids for the treatment of chronic pain has not been shown to benefit or improve chronic pain over time. However, many patients are taking opioid medications and some believe that opioid medications are the only type of medication that effectively reduces their pain (as compared with other types of pain medications). Additionally, opioid medications are associated with many side effects and the potential for serious addiction and overdose. There is very limited evidence of how opioids affect central nervous system neurophysiology (brain structure and activity). We are studying the effects of opioids on central nervous system neurophysiology to determine the positive and/or negative effects of opioids on brain structure and activity. We hope that these findings will, in turn, help inform medical practice regarding the use and prescription of opioids for chronic pain. These research projects are expected to also provide new scientific knowledge that can be used to help develop new pain medications with reduced consequences of addiction and overdose.

Interactions Between Central Nervous System and Other Body Systems in Chronic Pain (Research Collaborations)

The Human Affect and Pain Neuroscience Laboratory primarily studies the central nervous system as a key system involved in and influenced by chronic pain conditions. However, several other major body systems are also involved in and influenced by chronic pain – and these other body systems interact with the central nervous system changes as well. Through collaborations with other researchers and research laboratories, we extend our research on the central nervous system (primarily brain and spinal cord neuroimaging) in order to study how the central nervous system changes interact with other body systems in chronic pain. Current ongoing collaborations include the study of how central nervous system changes are related to altered immune system function in chronic pain.

Schematic of some of the myriad interactions between the changes observed in the central nervous system and in other body systems in chronic pain states. Created by Dr. Martucci and Lisa Cha (undergraduate research assistant 2018).

Schematic of some of the myriad interactions between the changes observed in the central nervous system and in other body systems in chronic pain states. Created by Dr. Martucci and Lisa Cha (undergraduate research assistant 2018).

Human Affect and Pain Neuroscience Laboratory

Katherine Martucci, PhD
Katherine Martucci, PhD
Laboratory Director
Assistant Professor

Lindsie Boerger
Lindsie Boerger
Clinical Research Specialist, Sr.

Eden Deng
Eden Deng
Duke Undergraduate Research Assistant

Vinit (Vinny) Krishna
Vinit (Vinny) Krishna
Duke Undergraduate Research Assistant

Meghna Nanda
Meghna Nanda
Duke Undergraduate Research Assistant

Martucci KT, Weber KA 2nd, Mackey SC. Altered cervical spinal cord resting-state activity in fibromyalgia. Arthritis Rheumatol. 2019 Mar;71(3):441-450. doi: 10.1002/art.40746. Epub 2019 Feb 11. PubMed PMID: 30281205; PubMed Central PMCID: PMC6393192.

Clemens JQ, Mullins C, Ackerman AL, Bavendam T, van Bokhoven A, Ellingson BM, Harte SE, Kutch JJ, Lai HH, Martucci KT, Moldwin R, Naliboff BD, Pontari MA, Sutcliffe S, Landis JR. Urologic chronic pelvic pain syndrome: insights from the MAPP research network. Nat Rev Urol. 2019 Mar;16(3):187-200. doi: 10.1038/s41585-018-0135-5. Review. PubMed PMID: 30560936.

Martucci KT, MacNiven KH, Borg N, Knutson B, Mackey SC. Apparent effects of opioid use on neural responses to reward in chronic pain. Sci Rep. 2019 Jul 3;9(1):9633. doi: 10.1038/s41598-019-45961-y. PubMed PMID: 31270360; PubMed Central PMCID: PMC6610070.

Martucci KT, Borg N, MacNiven KH, Knutson B, Mackey SC. Altered prefrontal correlates of monetary anticipation and outcome in chronic pain. Pain. 2018 Aug;159(8):1494-1507. doi: 10.1097/j.pain.0000000000001232. PubMed PMID: 29790868; PubMed Central PMCID: PMC6053327.

Martucci KT, Mackey SC. Neuroimaging of pain: human evidence and clinical relevance of central nervous system processes and modulation. Anesthesiology. 2018 Jun;128(6):1241-1254. doi: 10.1097/ALN.0000000000002137. PubMed PMID: 29494401; PubMed Central PMCID: PMC5953782.

Martucci KT, Shirer WR, Bagarinao E, Johnson KA, Farmer MA, Labus JS, Apkarian AV, Deutsch G, Harris RE, Mayer EA, Clauw DJ, Greicius MD, Mackey SC. The posterior medial cortex in urologic chronic pelvic pain syndrome: detachment from default mode network-a resting-state study from the MAPP Research Network. Pain. 2015; 156(9):1755-64. NIHMSID: NIHMS690528 PubMed [journal]PMID: 26010458 PMCID: PMC4545714.

Katherine Martucci, PhD

Katherine Martucci, PhD

Assistant Professor in Anesthesiology
Director, Human Affect and Pain Neuroscience Laboratory
Faculty, Center for Translational Pain Medicine

Contact Us

Email: katherine.martucci@duke.edu
Office: 919-684-2136

DUMC 3094, MS #50
Durham, NC 27710

Chris KeithHuman Affect and Pain Neuroscience Laboratory