Clinical Research Fellowship in Translational Pain Medicine (NCCIH)

This clinical research fellowship, housed in the National Center for Complementary and Integrative Health (NCCIH), is organized with the goal to provide training and broad experience and skills in human pain research, which is designed to develop improved diagnostic skills and targeted interventions. This fellowship draws from a wealth of knowledge and ongoing research at NIH from preclinical and human research exploring the underlying molecular, cellular, physiological, neurobiological, and psychosocial mechanisms of pain. The program also seeks to develop deep pain phenotyping and pain biomarkers. Clinical fellows will have the opportunity to engage and participate in current ongoing studies that employ a range of methodological pain research approaches and tools to study nociception and pain perception in human participants, including normal healthy volunteers, and patients with acute and chronic pain, either as a primary pain disease or as a comorbid condition. Fellows will also gain exposure to preclinical pain models through seminars and collaborations, as well as the process of translational pain research and medicine.

Under the mentorship of a team of mentors, fellows will be guided to develop their own study protocols with the goal to enable them to gain a strong skillset in designing pain research studies working toward independence as clinical researchers and investigators. 

Current Research Activities:

  • Deep phenotyping of patients with wide range of different types of pain in painful disorders, utilizing:
    • Phenotypic pain profiling on the basis of symptoms
    • Profiling on the basis of psychophysical testing, such as Quantitative Sensory Testing (QST), and on the basis molecular and genetic biomarkers
  • Neurobiological mechanisms by which emotional state, placebo, and psychosocial factors affect pain perception
  • Functional neuroimaging including functional MRI and functional near-infrared spectroscopy (fNIRS) to assess the role of the central nervous system (CNS) in pain perception and modulation.
  • Phenotyping studies with patients with a wide range of illnesses that are associated with pain or discomfort, including cancer, sickle cell disease (SCD), and various chronic pain disorders.

Research projects planned for near future:

  • Human experimental models (e.g., intradermal capsaicin) used to study cardinal pain related phenomena of allodynia and hyperalgesia in normal healthy volunteers
  • Early phase clinical trials
  • PET studies characterizing the role of endogenous opioids and dopamine signaling in pain and placebo analgesia
  • Functional properties of peripheral nociceptors studied with microneurography
  • Magnetic and/or electrical stimulation as an investigational probe to study nociception and pain mechanism, as well as therapeutic modality

Training:

  • Fellows will be expected to participate in at least one research project of their choice, depending on their interest and time commitments and requirements. Choices are: fellows will be encouraged to develop their own projects in the area of their interest, otherwise they will be offered opportunity to participate in one or a few ongoing studies.
  • Fellows will have access to state-of-the-art facilities, resources, and training.
  • Main modalities available:
    • Protocol development
    • Psychophysical testing, QST
    • Psychosocial interviewing
    • Functional neuroimaging including fMRI, PET scanning, fNIRS, EEG, MEG
    • Genetics
    • Bioinformatics
    • Autonomic testing
    • Neuromuscular ultrasound
    • Magnetic and/or electrical stimulation
    • Clinical trials

Teaching and formal instruction curriculum:

  • Weekly research meetings, journal club, clinical conferences, Grand Rounds
  • Formal coursework in clinical research, pharmacology, statistics, grant writing etc. available through the NIH and other institutions
  • Master of Health Sciences in Clinical Research degree is available
  • Wide range of conferences and lectures on campus or available via telecast
  • Funding provided for travel to conferences and educational programs

Eligibility:

Candidates interested in this fellowship must be residency trained and U.S. licensed physicians with an M.D. or a D.O. degree.

For more information contact Miroslav “Misha” Backonja, MD, Pain Research Center, NCCIH, at misha.backonja@nih.gov.