Monday, March 3, 2014

Research Spotlight: Dr. Timothy J. Ness

Today we’re catching up with Timothy J. Ness, M.D., Ph.D., the Simon Gelman Endowed Professor of Anesthesiology.

**Editor’s Note: We just learned that Dr. Ness has been elected to the Board of Directors of the American Pain Society. Please join us in congratulating him on this well-deserved honor.

Dr. Timothy Ness has spent nearly 30 years studying acute and chronic pain, focusing his research on urologic-gastroenterologic pain. In his most recent study [An EndogenousPain Control System is Altered in Subjects with Interstitial Cystitis published in the February 2014 Journal of Urology], he and his collaborators have found a difference in the pain experienced by participants suffering from bladder pain syndrome—or interstitial cystitis—and that of healthy control subjects, aligning bladder-pain subjects with certain other chronic pain sufferers.

The researchers asked participants to rate their pain in a variety of instances, including while experiencing heat applied to their ankle, with their forearm wrapped tightly as in a tourniquet, and while immersing their hand in ice water. Later, ice water and then heat were applied to determine pain tolerance. In a normal, healthy body, pain control systems step in to manage new stimuli. This is known as conditioned pain modulation—it’s a protective mechanism that enables the body to avoid feeling too much all at once. But subjects with interstitial cystitis couldn’t take it: They felt pain with no relief, no modulation. In fact, in some cases, their pain could even be intensified.

The results show that bladder-pain subjects and sufferers of chronic pain syndromes such as fibromyalgia and irritable bowel syndrome share a similar lack of pain modulation, as well as suggest that the body’s inability to control pain contributes to the disorders. And for Dr. Ness, the hypersensitivity displayed by the patients suffering from bladder pain syndrome is among his primary concerns.

Through this and other research, Dr. Ness and his collaborators, including Meredith Robbins, Ph.D., and Alan Randich, Ph.D., are interested in getting to the root of visceral hypersensitivity. “What primed their systems?” Dr. Ness asks. Among the findings he and others have uncovered is the instance of bladder infections before age 5 in subjects with interstitial cystitis. While development of the central nervous system is taking place in childhood, an infection or other trauma may lay the groundwork for this disorder, and when another trigger (inflammation, stress, or another event) occurs later in life, hypersensitivity and lack of pain modulation can occur.

His other bailiwick is developing standard models for studying visceral pain. Whether measuring psychophysical responses in humans or rodents, the translational nature of research requires that there are reliable models in place. “There are a lot of bad models out there that aren’t predictive,” he says. “We don’t have very good models of chronic pain. So the goal of our lab is to create good models.”

Dr. Ness has collaborated on more than 150 research studies and been awarded 25 grants. He offers this piece of advice for prospective researchers interested in pursuing a similar career path: NIH funding is dependent on research that is clinically significant. “Pain is always clinically significant,” Dr. Ness says. “Every person has experienced it in some form. And we can always manage it better.”

Timothy J. Ness, M.D., Ph.D., joined the UAB Department of Anesthesiology in 1995, after completing a pain medicine fellowship and serving as an associate at the University of Iowa College of Medicine. He is a member of the American Society for Regional Anesthesia, the International Anesthesia Research Society, and the American Pain Society, among others. For more information about his lab, see this link. To view his research publications, see PubMed.

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