This application is for a Mentored Career Development Award (K23) to support Dr. Kevin Johnson's research and training in patient-oriented research related to understanding the central mechanisms of chronic pain, addiction and their intersection. Chronic pain conditions have a tremendous societal and personal impact. The treatment of chronic pain with long-term opioids may lack efficacy and even induce hyperalgesia. Methadone maintenance is a treatment for substance abuse, but the impact of long-term methadone on pain systems is not well-characterized. Dr. Johnson has a unique educational background in biomedical engineering, psychology, neuroscience, nursing, and patient-oriented neuroscience research. He will gain further training in the conduct of research, with a specialized focus on patients with chronic low back pain (CLBP) and on patients with methadone maintenance treatment for substance abuse. The first primary research aim is to characterize the effects of long-term opioid use on pain processing, using the follow participant groups: (1) healthy controls (2) control patients with CLBP taking no opioids, (3) patients with CLBP on long-term opioids, and (4) patients with no chronic pain on long-term methadone maintenance. Dr. Johnson will utilize clinical and behavioral assessments, quantitative sensory testing, and a variety of neuroimaging techniques to address this primary aim. Didactic and individualized training in advanced neuroimaging methods and analysis will allow Dr. Johnson to apply novel approaches for detecting the effects of long-term opioid use. The second research aim is determine the effects of Transcranial Magnetic Stimulation (TMS) over prefrontal cortex on nociceptive processing in each of the participant groups. TMS is a potential therapeutic tool for treating chronic pain, and Dr. Johnson will pursue training in translation research. Ultimately, the proposed research will advance knowledge regarding the effects of long-term opioid use and the potential for TMS to become a non-opioid therapy for treating chronic pain. Through the 5 years of this award period, Dr. Johnson will gain experience leading research in a mentored environment. Building on the training and research of this award, he will apply for independent funding to further investigate current opioid treatments approaches and to develop novel therapies for managing pain.

Public Health Relevance

This training award will develop Dr. Johnson as patient-oriented researcher in the intersecting fields of pain and addiction. His research will focus on the potential negative effects of long-term opioid use on pain processing. He will also evaluate non-invasive brain stimulation (TMS) as a tool to alter pain processing, which would demonstrate the potential of TMS as a non-pharmacologic treatment for pain.

National Institute of Health (NIH)
National Institute on Drug Abuse (NIDA)
Mentored Patient-Oriented Research Career Development Award (K23)
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Special Emphasis Panel (ZDA1-GXM-A (14))
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Lin, Yu
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Stanford University
Schools of Medicine
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Jarrahi, Behnaz; Mackey, Sean (2018) Measuring the Influence of Physiological Noise Corrections on ICA Derived Intrinsic Connectivity Brain Networks in Rest and Task fMRI. Conf Proc IEEE Eng Med Biol Soc 2018:1046-1049
Gaertner, Mark; Kong, Jiang-Ti; Scherrer, Kristen H et al. (2018) Advancing Transcranial Magnetic Stimulation Methods for Complex Regional Pain Syndrome: An Open-Label Study of Paired Theta Burst and High-Frequency Stimulation. Neuromodulation 21:409-416
Sturgeon, John A; Hah, Jennifer M; Sharifzadeh, Yasamin et al. (2018) Predictors of Daily Pain Medication Use in Individuals with Recurrent Back Pain. Int J Behav Med 25:252-258
Jarrahi, Behnaz; Mackey, Sean (2018) Characterizing the Effects of MR Image Quality Metrics on Intrinsic Connectivity Brain Networks: A Multivariate Approach. Conf Proc IEEE Eng Med Biol Soc 2018:1041-1045
Mackey, Ian G; Dixon, Eric A; Johnson, Kevin et al. (2017) Dynamic Quantitative Sensory Testing to Characterize Central Pain Processing. J Vis Exp :
Taub, Chloe J; Sturgeon, John A; Johnson, Kevin A et al. (2017) Effects of a Pain Catastrophizing Induction on Sensory Testing in Women with Chronic Low Back Pain: A Pilot Study. Pain Res Manag 2017:7892494
Tran, Patrick; Sturgeon, John A; Nilakantan, Aneesha et al. (2017) Pain catastrophizing mediates the relationship between trait happiness and depressive symptoms in individuals with current pain. J Appl Biobehav Res 22:
Dixon, Eric A; Benham, Grant; Sturgeon, John A et al. (2016) Development of the Sensory Hypersensitivity Scale (SHS): a self-report tool for assessing sensitivity to sensory stimuli. J Behav Med 39:537-50
Bernaba, Mario; Johnson, Kevin A; Kong, Jiang-Ti et al. (2014) Conditioned pain modulation is minimally influenced by cognitive evaluation or imagery of the conditioning stimulus. J Pain Res 7:689-97