A Pain-staking Intramural Research Program

NCCAM Has a New Scientific Director and a New Focus

by heather dolan

With the arrival of new scientific director Catherine Bushnell, the National Center for Complementary and Alternative Medicine (NCCAM) is redefining its intramural program. Bushnell, an internationally recognized pain and neuroscience researcher, has launched a program on pain research.

Every year, the U.S. health-care system spends over $600 billion to treat the more than 100 million Americans who suffer from chronic pain, according to a recent Institute of Medicine report. “Clearly, there is a big gap between what patients and clinicians need and what we are achieving in pain management,” said NCCAM Director Josephine Briggs.

Bushnell hopes to bridge this gap using a combination of preclinical and clinical approaches. Her research will focus on the role of the brain in pain processing and control; how emotion, attention, environment, and genetics affect pain perception; and how chronic pain alters the brain response to analgesic drugs such as opioids.

Bushnell is no stranger to NIH and is looking forward to being back. She did her postdoctoral work in neurophysiology at the National Eye Institute (1978–1979) and was a staff fellow at the National Institute of Dental Research (1980–1984). She is returning from Montreal, where she was a professor of anesthesia and held other faculty positions at McGill University.

“I started my career at NIH, and so I was aware of the richness of the environment here,” said Bushnell. “It has a wonderful brain-imaging center [and] a rich neuroscience community.”

NCCAM’s intramural program, which began in 2001, previously did research on the effectiveness and safety of complementary and alternative (CAM) modalities used to treat endocrinology-, diabetes-, and oncology-associated diseases. Under Bushnell’s leadership, the program will center on pain research and will touch on many other diseases as well. “Chronic pain itself leads to things like depression, anxiety disorders, cognitive deficits, and physical deficits,” she noted.

At first, Bushnell’s laboratory will make up NCCAM’s entire intramural program. She plans to transfer two postdocs and a staff scientist from McGill and will be hiring technical staff in the near future. Her laboratory will include two groups—one for rodent behavioral testing and brain imaging (in the Porter Neuroscience Research Center, Buildings 35 and 36) and one for human brain imaging and psychophysical testing (in Building 10). In the next four or five years, Bushnell hopes to expand the program and hire more principal investigators.

Bushnell’s group has recently demonstrated that chronic pain is more than just a symptom and may even be a disease in itself. Analyzing magnetic-resonance brain images of patients with fibromyalgia, a widespread pain disorder, she found evidence of a more rapid decrease in brain gray matter with age than in healthy individuals (J Neurosci 27:4004-4007, 2007). In a related study, using positron-emission tomography to examine deep muscle pain, her group observed abnormal dopamine release in response to pain in fibromyalgia patients versus healthy participants (Euro J Neurosci 25:3576–3582, 2007).

Under the umbrella of NCCAM, Bushnell hopes her program will also satisfy the public’s interest in alternative medicine. According to a 2008 NCCAM and National Center for Health Statistics study, an estimated 38 percent of adults and 12 percent of children in the United States are using some form of CAM. “There are things that people use to try and treat their own pain, such as meditation, yoga practice, exercise, acupuncture, and various types of complementary treatments,” said Bushnell. “We’re interested in looking [at] these and how they work in the brain.”

The NCCAM intramural pain program will be a collaborative effort with other institutes studying pain, including NINDS, NIDA, and NIMH. Bushnell also foresees collaborations with NIDDK to understand neuropathic pain associated with diabetes; with NCI to investigate the debilitating pain experienced by cancer survivors; and with NIAMS to study arthritis-related pain.

With Bushnell as director, NCCAM’s intramural program faces an ambitious redirection. “It is an exciting and promising time in the field of pain research,” said Bushnell. “I look forward to strengthening our understanding of the mechanisms and modulation of pain.

For more on Bushnell’s research, see the write-up in the Recently Tenured section.