Dr. Lee's long-term goal is to be an independently funded investigator with expertise in the mechanlsnns and treatment of pain In patients with rheumatic disease. Her Immediate objectives are to gain skills in: 1) epidemiologic techniques to analyze longitudinal data, 2) mechanistic pain studies using quantitative sensory testing techniques and 3) clinical trials. The goal of her research Is to study the role of central mechanisms In rheumatoid arthritis (RA) pain and to define the effect of widespread, non-artlcular pain on change In physical function. Physicians often attribute RA pain to Inflammation, but many patients have pain despite well-controlled disease activity. Dr. Lee proposes that widespread, non-Inflammatory, non-articular pain significantly affects physical function and that better understanding the mechanisms of non-artlcular pain may lead to improved pain treatments. Her proposal involves three studies: 1) a two-year prospective, observational study to examine the effects of widespread, non-articular pain on change in physical function among 154 RA patients;2) a cross-sectlonal study using quantitative sensory testing to assess central pain mechanisms among 80 RA patients and 40 healthy controls;and 3) a proof-of-concept clinical trial to study the role of serotonin-norepinephrine reuptake Inhibitors on widespread, non-articular pain in 30 RA patients. This research will take place in the Brigham and Women's Hospital Arthritis Center and the Pain Management Center, two high volume centers dedicated to clinical care and research. Dr. Lee will benefit from the mentorship of Drs. Elizabeth Karlson and Daniel Clauw and members of her Scientific and Career Advisory Boards, who have backgrounds in patient-oriented research in rheumatology, anesthesiology and psychiatry. As a junior faculty member In the Division of Rheumatology, Immunology and Allergy, Dr. Lee will interact with many experienced clinical Investigators, basic scientists and clinicians. She will take classes In biostatistics, epidemiology and neurobiology at the Harvard School of Public Health, Harvard Medical School and University of Michigan School of Public Health to further her knowledge of methods and theory.

National Institute of Health (NIH)
National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
Mentored Patient-Oriented Research Career Development Award (K23)
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Arthritis and Musculoskeletal and Skin Diseases Special Grants Review Committee (AMS)
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Serrate-Sztein, Susana
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Brigham and Women's Hospital
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Lee, Yvonne C; Frits, Michelle L; Iannaccone, Christine K et al. (2014) Subgrouping of patients with rheumatoid arthritis based on pain, fatigue, inflammation, and psychosocial factors. Arthritis Rheumatol 66:2006-14
Lee, Yvonne C (2014) Swollen to tender joint count ratio: a novel combination of routine measures to assess pain and treatment response in rheumatoid arthritis. Arthritis Care Res (Hoboken) 66:171-2
Lee, Yvonne C; Lu, Bing; Boire, Gilles et al. (2013) Incidence and predictors of secondary fibromyalgia in an early arthritis cohort. Ann Rheum Dis 72:949-54
Lee, Yvonne C; Lu, Bing; Edwards, Robert R et al. (2013) The role of sleep problems in central pain processing in rheumatoid arthritis. Arthritis Rheum 65:59-68
Lee, Yvonne C (2013) Effect and treatment of chronic pain in inflammatory arthritis. Curr Rheumatol Rep 15:300
Lee, Yvonne C; Padera, Robert F; Noss, Erika H et al. (2012) Clinical course and management of a consecutive series of patients with "healed temporal arteritis". J Rheumatol 39:295-302
Lee, Yvonne C; Nassikas, Nicholas J; Clauw, Daniel J (2011) The role of the central nervous system in the generation and maintenance of chronic pain in rheumatoid arthritis, osteoarthritis and fibromyalgia. Arthritis Res Ther 13:211
Lee, Yvonne C; Cui, Jing; Lu, Bing et al. (2011) Pain persists in DAS28 rheumatoid arthritis remission but not in ACR/EULAR remission: a longitudinal observational study. Arthritis Res Ther 13:R83
Lee, Yvonne C; Lu, Bing; Bathon, Joan M et al. (2011) Pain sensitivity and pain reactivity in osteoarthritis. Arthritis Care Res (Hoboken) 63:320-7