Congratulations to our T32 postdoctoral scholar Ben Alter, MD, PhD, whose project “Mechanisms and Translational Application of Endogenous Analgesia” was selected to receive a 2019 IARS (International Anesthesia Research Society) Mentored Research Award (IMRA). IMRAs are intended to support investigations that will further the understanding of clinical practice in anesthesiology and related sciences. The IARS selects up to four research projects annually to support the creation of future leaders and prepare applicants to apply for independent research funding. Dr. Alter’s award letter stated that his project was selected “because of its superior promise to produce significant work in our field” and that he had been “recognized as an outstanding and well-trained candidate who is under the tutelage of an excellent mentor with substantial institutional support.” Dr. Alter will work with mentor Ajay D. Wasan, MD, MSc on the project.
The project’s overall goal is to gain a better understanding of endogenous analgesia and optimize it for clinical translation. Endogenous systems modulate pain and underlie “conditioned analgesia,” which contributes to placebo analgesia. Although placebo analgesia elicits powerful effects, systematic translation to the clinic has been challenging since most placebo manipulations rely on deception to maintain expectations about getting an active drug. Patient deception prevents clinical translation since it is unethical. Dr. Alter’s research proposes an alternative and novel approach to capitalize on a component mechanism underlying placebo analgesia, i.e. “conditioned analgesia”. Associative conditioning techniques will be combined with a psychophysical analgesic manipulation, leading to a conditioned association between conditioning cues and analgesia. Preliminary data indicate that visual conditioning cues can be used to condition offset analgesia. Future translation of this conditioning technique is likely to reduce total opioid requirements for pain management.