Dr. Janean Holden’s research has the potential to change the way chronic pain is treated.
The National Institute of Nursing Research (NINR) granted Dr. Janean Holden, PhD, RN, FAAN, a $1.9 million, 5-year grant for her study, Posterior Hypothalamic Modulation of Pain. The hypothalamus is a section of the brain responsible for a number of functions including an important link to the nervous system. Using rat models, Dr. Holden’s research will focus on pathways in the brain that modify pain. She said, “We have a complex system of neurons in the brain that can inhibit, or turn off, pain in the spinal cord. If the pain stimulus doesn’t get to the brain, it isn’t perceived as painful. But this brain inhibition doesn’t last long, so we need to figure out how to exploit it to use it with patients. We’re identifying these pathways to figure out how to make use of this built-in system to relieve pain clinically.”
“NINR supports clinical and basic research that improves the quality of life for individuals, families, communities, and populations,” said NINR Director Dr. Patricia A. Grady.
She continued, “Part of that commitment requires gaining a better understanding of the underlying biological systems that contribute to symptoms—such as pain—and determining the most effective ways to manage these symptoms.”
The first focus of Dr. Holden’s work will be identifying the pathways that begin in the brain. Much of that work will be revolutionary. Dr. Holden said, “The overwhelming preponderance of work in pain research has been done at the spinal cord level; less has been done at the brain stem level and much less has been done in the brain because it’s much more complex.” With a smile, she added, “In a way it’s exciting because hardly anybody is doing it; in a way it’s isolating because hardly anybody is doing it.”
Dr. Holden feels strongly that previous hypothalamus-focused research shows there is potential for much more to be discovered, which could lead to major changes in pain management. Researchers have already proven it’s possible to stimulate the posterior hypothalamus to treat certain debilitating headaches. However, it’s unknown why it works and if it will work for other types of pain such as from cancer, diabetes, or neuropathy.
Dr. Grady said, “Stimulating the deep brain through the posterior hypothalamus is a therapy used clinically to successfully treat severe headaches with few side effects. However, little is known about how similar treatment could affect other types of neuropathic pain, or whether or not responses to these treatments differ by gender and type of pain. The work proposed by Dr. Holden will build on her existing body of research into the brain’s role in modulating pain. This research holds the potential for eventual translation into effective, individualized therapies for managing chronic pain.”
Dr. Holden said the NINR grant is essential to her work and she’s grateful for that support and the support from the University of Michigan School of Nursing. She said, “Getting grants doesn’t happen in a vacuum. We have a lot of help and support from the school and the university. Our dean, our associate dean for research, and our department heads support research and that makes a big difference. We have experts who read and critique our grants, and support staff who help with the detail work. Such help increases the chances for a successful grant submission.”
Dr. Grady agrees that support of this research has the potential for enormous impact. She said, “Dr. Holden’s work in exploring how stimulating certain areas of the brain affect how organisms experience pain is an excellent example of innovative research that could someday lead to effective therapies for relieving chronic pain and improving quality of life for millions of adults worldwide.”
