CSRD Research Career Scientist Award Application

Veterans Affairs Med Ctr San Francisco, San Francisco CA

Investigators

Abstract

Dr. Strigo runs a cross-disciplinary program that bridges pain physiology, psychopathology, psychological and brain trauma and neuroscience. Her overall program aims to understand individual differences in pain processing and its relation to chronic pain, psychiatric disorders, and opioid addiction. By experimentally perturbing physiological, emotional, and brain responses to pain, Dr. Strigo uncovers alterations in pain processing in individuals with depressive and trauma disorders and traumatic brain injuries. This innovative approach addresses the complexity of pain and comorbidities in Veterans, leading to the development of unique neurobehavioral biomarkers for tailored non-opioid interventions. Ultimately, seeking to improve pain therapies and outcomes for all Veterans. Dr. Strigo was the first to identify and show differences in interoceptive processing in major depression. She is known for the term “emotional allodynia” -- a qualitatively altered negative emotional response to normally non-aversive stimuli or pain affect without pain sensation. Dr. Strigo also pioneered research on changes in brain response to pain in post-traumatic stress disorder through avoidant mechanism and in traumatic brain injuries through aberrant endogenous pain modulation. Her current CS R&D funded work aims to identify specific neural mechanisms for pain-PTSD co-morbidity, ultimately leading to novel, evidence-based therapeutic approaches, thereby reducing suffering and morbidity and decreasing treatment costs. Dr. Strigo’s aims to translate her research discoveries into effective and personalized pain management for Veterans living with pain, a high priority for the VA and VA primary care providers. Her current, CS R&D-funded randomized controlled trial will provide another non-opioid therapy available to Veterans with chronic pain by showing efficacy of weighted Blankets (WB) on pain and sleep symptoms in Veterans suffering from chronic pain. The proposed research findings will provide critical evidence for effects on pain and sleep disturbance for this novel, accessible and fully remote intervention. Furthermore, Dr. Strigo established and provides research infrastructure for the Intensive Pain Rehabilitation Program at SFVA. This endeavor resulted in cross-VA collaboration with five similar pain rehabilitation programs across four different VAs across the country. Additionally, her research in pain management and rehabilitation focuses on identifying unique clusters and phenotypes within chronic pain and predicting treatment response, as well as factors driving opioid use/misuse in Veterans with chronic pain. This innovative work using machine learning has begun to identify robust subgroups of patients and determine unique features that predict their treatment trajectories. This will enable the assignment of individuals to the most effective treatment options, promoting precision pain rehabilitation for Veterans with chronic pain, and improving their overall well-being and functioning. This work is pivotal in understanding the effects of intensive pain rehabilitation programs on Veterans and non-Veterans with chronic pain.