The goal of the proposed K23 award is to provide the Candidate with the advanced skills and training needed to become an independent investigator evaluating the mechanisms of migraine pain and the efficacy and mechanisms of mind-body interventions for treatment. To facilitate this long-term career goal, the Candidate will examine the sensory and affective responses to experimental pain in migraineurs compared to healthy controls. In addition, the Candidate will assess the impact and mechanisms of an 8-week standardized mind-body intervention, Mindfulness-Based Stress Reduction (MBSR), on the sensory and affective aspects of clinical and experimental pain in adults with migraines, and determine predictors of clinical efficacy. The Candidate has assembled an expert team of mentors to help her achieve these goals. A comprehensive training plan includes important additional training needed in the neurobiology of pain, state-of-the-art methodologies of the quantitative assessment of pain, statistics, formal coursework, and conferences and seminars addressing grant and manuscript writing, as well as other relevant career development topics. The Candidate has assembled a stellar, multidisciplinary mentorship and advisory team tailored to facilitate her research and training with their combined expertise in pain mechanisms, sensory/pain testing, headache, statistics, mind-body medicine, clinical research, and career development. With their support, she will accomplish the following specific training goals: (1) gain advanced training and knowledge in the neurobiology of pain and headache; (2) develop expertise in the quantitative measurements of pain; (3) expand mind-body medicine knowledge and training skills; (4) improve skills in clinical trial methodology and responsible conduct of research; (5) build on statistical skills with further skill training; (6) continue building profesional development skills. The training plan will be conducted in coordination with a proposed set of studies that build upon the Candidate's preliminary data that demonstrated a beneficial effect of MBSR in adults with migraines. The Candidate's proposed research involves three Specific Aims.
Aim 1 is designed to assess response to experimental heat pain (pain intensity, pain unpleasantness, emotional reactivity, and pain catastrophizing) in migraineurs (interictally) vs. healthy controls.
Aim 2 seeks to test the impact of MBSR in adults with migraines on clinical headache pain, experimental heat pain, mindfulness, pain acceptance, pain catastrophizing, emotional reactivity and headache-related disability compared to an education control group.
Aim 3 is to determine the factors that predict MBSR response on clinical headache pain in migraine patients. Successful completion of these aims will advance the understanding of the mechanisms of migraine pain and of mind- body interventions for migraine, and also may be applicable to other clinical pain conditions. The additional training from this K23 will launch the Candidate's career as an independent clinician-investigator and ultimately a leader in the fields of integrative medicine and headache research.
Although many adults with migraines use meditation and yoga, there is a critical lack of research on the use of these techniques specifically for headache. This proposed K23 Mentored Career Development Award will further the understanding of the mechanisms, efficacy, and predictors of a standardized mind-body intervention, Mindfulness-Based Stress Reduction (MBSR), in adults with migraines. If effective, MBSR could be a standardized mind-body approach recommended by clinicians for migraines, which affect an estimated 36 million people (nearly 15% of the U.S. population).
| Wells, Rebecca Erwin; Baute, Vanessa; Wahbeh, Helané (2017) Complementary and Integrative Medicine for Neurologic Conditions. Med Clin North Am 101:881-893 |
| Wells, Rebecca Erwin; Phillips, Russell S; Schachter, Steven C et al. (2010) Complementary and alternative medicine use among US adults with common neurological conditions. J Neurol 257:1822-31 |
