Andrew Segerdahl

Pain is one of the largest and costliest medical problems in the developed world and it is likely to get worse^1,2. There is no cure for pain and the current treatments are poorly suited as long-term solutions^3,4. Developing sensible strategies to this complex clinical problem depends on our understanding of the fundamental biology of pain.

At the most basic level, it is well known that the magnitude of pain experienced by an individual is not necessarily related to the nociceptive input to the body ^5,6.  In part, this is because pain is a complex subjective experience that is contingent upon numerous factors. Implementation of brain neuroimaging methods has greatly facilitated our understanding of the key role that the central nervous system (CNS) plays in these processes ^7-18. 

 What is lacking is a mechanistic understanding of how the perception of pain emerges from nociceptive afferent input to the brain; and further, how these processes can become dysfunctional in chronic pain patients.

 My research targets this need by interrogating pain-related neural activity across multiple spatial and temporal scales in the brain, brainstem and spinal cord using advanced neuroimaging and analysis techniques.

 Deliverables from my work include both forward and reverse translation studies into relevant animal models of nociception and chronic pain patients – projects which I am pursuing in collaboration with both clinical and basic science researchers in the UK and USA.

 My work has been published in top neuroscience, neuroimaging and clinical research journals (e.g.  Nature Neuroscience, Brain, Neuroimage, and Pain), and was recently featured as part of a documentary on BBC Radio 4 (see: http://www.bbc.co.uk/programmes/w3cswdkg).

1. Fayaz, A., Croft, P., Langford, R.M., Donaldson, L.J., Jones, G.T., 2016. Prevalence of chronic pain in the UK: a systematic review and meta-analysis of population studies. BMJ Open 6, e010364.
2. Gaskin, D.J., Richard, P., 2012. The Economic Costs of Pain in the United States. The Journal of Pain 13, 715–724. doi:10.1016/j.jpain.2012.03.009
3. Woolf, C.J., 2010. Overcoming obstacles to developing new analgesics. Nature Medicine 16, 1241–1247.
4. Borsook, D., Kalso, E., 2013. Transforming pain medicine: Adapting to science and society: Towards individualized pain medicine. European Journal of Pain 17, 1109–1125. doi:10.1002/j.1532-2149.2013.00297.x
5. Beecher, H.K., 1956. RELATIONSHIP OF SIGNIFICANCE OF WOUND TO PAIN EXPERIENCED. Journal of the American Medical Association 161, 1609. doi:10.1001/jama.1956.02970170005002
6. Koyama, T., McHaffie, J.G., Laurienti, P.J., Coghill, R.C., 2005. The subjective experience of pain: Where expectations become reality. Proceedings of the National Academy of Sciences 102, 12950–12955.
7. Berna, C., Leknes, S., Holmes, E.A., Edwards, R.R., Goodwin, G.M., Tracey, I., 2010. Induction of Depressed Mood Disrupts Emotion Regulation Neurocircuitry and Enhances Pain Unpleasantness. Biological Psychiatry 67, 1083–1090. doi:10.1016/j.biopsych.2010.01.014
8. Denk, F., McMahon, S.B., Tracey, I., 2014. Pain vulnerability: a neurobiological perspective. Nature Neuroscience 17, 192–200. doi:10.1038/nn.3628
9. Leknes, S., Berna, C., Lee, M.C., Snyder, G.D., Biele, G., Tracey, I., 2013. The importance of context: when relative relief renders pain pleasant. Pain 154, 402–410. doi:10.1016/j.pain.2012.11.018
10. Ploghaus, A., 1999. Dissociating Pain from Its Anticipation in the Human Brain. Science 284, 1979–1981.
11. Ploner, M., Lee, M.C., Wiech, K., Bingel, U., Tracey, I., 2010. Prestimulus functional connectivity determines pain perception in humans. Proceedings of the National Academy of Sciences 107, 355–360.
12. Tracey, I., 2017. Neuroimaging mechanisms in pain: from discovery to translation. PAIN 158, S115–S122.
13. Tracey, I., 2010. Getting the pain you expect: mechanisms of placebo, nocebo and reappraisal effects in humans. Nature Medicine 16, 1277–1283. doi:10.1038/nm.2229
14. Tracey, I., 2005. Nociceptive processing in the human brain. Current Opinion in Neurobiology 15, 478–487.
15. Tracey, I., Mantyh, P.W., 2007. The Cerebral Signature for Pain Perception and Its Modulation. Neuron 55, 377-91. doi:10.1016/j.neuron.2007.07.012
16. Wiech, K., 2016. Deconstructing the sensation of pain: The influence of cognitive processes on pain perception. Science 354, 584–587. doi:10.1126/science.aaf8934
17. Wiech, K., Ploner, M., Tracey, I., 2008. Neurocognitive aspects of pain perception. Trends in Cognitive Sciences 12, 306–313. doi:10.1016/j.tics.2008.05.005
18. Wiech, K., Tracey, I., 2009. The influence of negative emotions on pain: Behavioral effects and neural mechanisms. NeuroImage 47, 987–994. doi:10.1016/j.neuroimage.2009.05.059