This is a renewal of a K24 NINDS Mentor Award application (NS064050: Imaging Pain and Analgesia: Mentoring in Basic and Applied Research). Funding for this grant would begin at the end of the candidate's first NINDS K24 award. The major aims of this application would be to relieve the PI of substantial clinical responsibilities in order to have 50% protected time for mentoring and research (that includes both programmatic and infrastructure development).
The Specific Aims of this K24 application are to utilize currently funded programs in Adult and Pediatric Migraine as a basis for training young scientists in imaging in this domain. Migraine is a huge clinical problem affecting over 30 million Americans and costs billions of dollars. We have two research programs that form the basis of the research proposal: (1) Adult Migraine: Episodic migraine is a recurrent headache that occurs less than 14 times per month. It may occur with or without aura (focal neurological symptoms that usually develop and resolve). Most (80-95%) migraine patients remain episodic (1-4 attacks per month) throughout their lives whereas some (about 5%) progress from low to high frequency and then to daily headache/migraine One of the unsolved mysteries of the disease is the nature of how the brain changes in progressing from the low frequency (LF) episodic manifestation to the more frequent high frequency (HF) or chronic daily headache. We wish to test the hypothesis that with increased migraine frequency increased excitatory amino acids and decreased inhibitory amino acids lead to alterations in brain structure and function. (2) Pediatric Migraine: More than 20% of migraine headaches start before the age of 10 and 45% before the age of 20 and can appear in children as young as 4 years old. It has previously been considered an episodic disorder, but now is thought to be a progressive disease affecting the brain that negatively affects all aspects of an individual's life particularly during formative an productive years. We wish to test the hypotheses that there are age-related differences similarities in the migraine brain and that early changes may predict the long duration/course of the disease. Using functional imaging techniques, the proposed research will evaluate and compare the structure, chemistry and function of brains of pediatric and adult patients with migraine. The data should provide evidence for how brains are changed in the two groups leading to chronic migraine and how we use this approach to provide a basis for evaluation of medications to limit the progression of the disease.
Migraine remains a major public health problem in the United States affecting over 25 million Americans. It is the most common neurological problem. Research will focus on understanding how migraine affects brain function, structure and chemistry in pediatric and adult populations. This grant, if funded, would provide 50% protected time for clinical pain research and development of a pain research infrastructure and mentoring of young scientists with interest in pain imaging research.
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|Borsook, David; Erpelding, Nathalie; Becerra, Lino (2013) Losses and gains: chronic pain and altered brain morphology. Expert Rev Neurother 13:1221-34|
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