Abnormal connections created by central nervous system linked to persistence of chronic pain

Chronic pain is an epidemic. One in four Americans suffers from chronic pain due to disease—including cancer and HIV—and the medications used to treat those diseases. One reason for the persistence of chronic pain may be that the patient's central nervous system creates abnormal connections or improves connections that shouldn't be strengthened, explains Susan G. Dorsey, PhD, RN, co-director of the School of Nursing's Center of Excellence in Disorders of Neuroregulatory Function.

"Chronic pain makes a memory that shouldn't be made, such as the lasting damage to peripheral nerves sometimes caused by cancer drugs," she says. "The pain can still last after cancer treatment stops, and once memories are formed, they are difficult to unlearn."

Exploring why the central nervous system creates improper connections is a simple definition of the Center's complex, cutting-edge research conducted by Dorsey, co-director Christopher Ward, PhD, and their team of faculty and student investigators, who study the molecular, cellular, and genetic mechanisms underlying the development and persistence of chronic pain. "We study the nervous system and diseases of muscles and how the nervous system regulates muscle function," explains Dorsey, who received both her MS and PhD from the School of Nursing and was a critical care/ICU nurse before earning her PhD in nursing/neuroscience.

In 2005, Ward first collaborated with Dorsey on a set of experiments measuring the level of calcium in neurons, his area of expertise. "We discovered our overlapping research interests in the neuromuscular system," says Ward, who came to the School of Nursing in 2001. The Center was formally created in 2006 and is a key objective of the School's 2007-2011 Strategic Plan.

"By consolidating intellectual and capital resources within our School, we can work greater than the sum of our parts," notes Ward.

While Dorsey and Ward maintain independent labs at the School, the Center has created and sustained a collaborative effort with the School of Medicine, the Dental School, and other institutions across and beyond the campus, giving the School of Nursing a significant campus presence across the University of Maryland Medical System and "a seat at the table," notes Dorsey.

Adds Ward, "The depth, breadth, and energy around our collaborative projects provides great opportunities for undergraduate and graduate students to actively participate in research."

In 2009, the National Institutes of Health awarded the Center $2.4 million over five years to formalize campus partnerships with Medicine, Dentistry, and the Greenbaum Cancer Center and to develop the infrastructure to support translational cancer pain studies on the University of Maryland, Baltimore (UMB) campus, resulting in the UMB Center for Pain Studies.

The American Recovery and Reinvestment Act of 2009 funded the Center with $2.8 million over two years to study muscular dystrophy, a project that includes collaboration with the Children's National Medical Center. "The genetic heritability behind muscular dystrophy is well known," explains Dorsey. "What we don't know is why that muscle is more easily injured, and why it does not repair itself as a normal muscle does.

"We are blazing a trail for the analysis and use of genome sequencing by characterizing the genes that are turned on and turned off in dystrophic versus normal muscle. Our Center and research program is truly translational. We make discoveries at the bench, and we can validate our findings in the clinic, and vice versa.

There are very few nursing schools that have significant bench lab research programs with the infrastructure and capacity for research and training our future nurse scientists."