MRCP, FRCA, D.Phil
Clinical Research Fellow
- Cardiothoracic Anaesthetic Fellow
My research focus is on understanding how analgesics modulate neural activity that underlies nociception and pain perception to ultimately optimize pain relief in chronic pain patients.
Chronic pain is poorly managed, lack of effective analgesics being a key reason. Even opioids, one of the most powerful analgesics that are available for treating moderate to severe pain, has a mixed success rates in treating chronic pain. The amount of analgesia patients experience is variable and inconsistent with some patients developing tolerance, heightened pain sensitivity and even dependence and misuse.
Inherent variability in subjective pain reports and the expectation driven effects on pain reports make assessment of analgesics efficacy challenging especially during analgesic drug development.
Using functional neuroimaging I study the analgesic modulation of neural mechanisms that underpin nociception, central sensitisation and pain processing. I work with a range of analgesics including the intravenous opioid remifentanil. My work is targeted at improving early analgesic drug development processes by using mechanism based disease models to demonstrate analgesic modulation of the pain and nociception related neural activity.
As a practicing anaesthetist, I am interested in identifying predictors of opioid analgesic efficacy and susceptibility to the development of tolerance and hyperalgesia in chronic pain patients aiming to help personalize analgesic therapy in this population of patients.
I collaborate both with industry and NHS Primary Healthcare providers in my research.
The effect of treatment expectation on drug efficacy: imaging the analgesic benefit of the opioid remifentanil.
Bingel U. et al, (2011), Sci Transl Med, 3
Baseline reward circuitry activity and trait reward responsiveness predict expression of opioid analgesia in healthy subjects.
Wanigasekera V. et al, (2012), Proc Natl Acad Sci U S A, 109, 17705 - 17710
Disambiguating pharmacological mechanisms from placebo in neuropathic pain using functional neuroimaging.
Wanigasekera V. et al, (2018), Br J Anaesth, 120, 299 - 307
Opioid suppression of conditioned anticipatory brain responses to breathlessness.
Hayen A. et al, (2017), Neuroimage, 150, 383 - 394
NEUROIMAGING EVIDENCE OF CENTRAL SENSITIZATION IN PATIENTS WITH KNEE OSTEOARTHRITIS
Soni A. et al, (2016), OSTEOARTHRITIS AND CARTILAGE, 24, S443 - S443
Disambiguating Pharmacodynamic Efficacy from Behavior with Neuroimaging: Implications for Analgesic Drug Development.
Wanigasekera V. et al, (2016), Anesthesiology, 124, 159 - 168
Learning to identify CNS drug action and efficacy using multistudy fMRI data.
Duff EP. et al, (2015), Sci Transl Med, 7