PROJECT SUMMARY
Victims of mild traumatic brain injury (mTBI) commonly experience chronic pain, including headaches, spine
and limb pain, and are at high risk of developing long-term disability and opioid misuse. Despite this recognized
link between mTBI and chronic pain, the neurocircuitry underlying how mTBI increases pain is not known.
Emerging preclinical data suggest that the function of a major brainstem pain-modulating circuit, rostral
ventromedial medullar (RVM), is disrupted after mTBI - although the precise mechanism is still elusive.
The RVM can either enhance or suppress pain. Its pain-facilitating function is mediated by a distinct cell
class, ON-cells, which can increase noxious signal transmission through their projections to the spinal dorsal
horns. The central hypothesis of this project is that mTBI contributes to chronic pain by sensitizing RVM ON-cell
activity, which increases the body’s sensitivity to both noxious and normally innocuous stimuli. In a mouse model
of mTBI, my preliminary results suggest that 1) mTBI leads to increased sensitivity in periorbital allodynia (a
model for headache) and hindpaw allodynia (a model for distal pain), and 2) an intact ON-cell circuit is required
for the development of persistent post-mTBI pain. In two Specific Aims, this study will test the hypothesis by
characterizing the functional and electrophysiological changes in descending ON-cells (e.g., spinal/trigeminal
dorsal horn-projecting) following mTBI. First, the functional role of descending ON-cells in mTBI-induced
hypersensitivity to postsurgical pain (Aim 1a) and headache (Aim 1b) will be explored through the use of
chemogenetics. Second, the progressive changes in ON-cell activity in animals with mTBI, and subsequent
postsurgical pain (Aim 2a) and headache (Aim 2b) will be studied using in vivo calcium fiber photometry. Finally,
the synaptic characteristics of these descending ON-cells in post-mTBI animals with persistent postsurgical pain
and headache will be investigated using ex vivo patch clamp recording in RVM brain slices (Aim 2c). This project
will provide foundational information to establish the relationship between brainstem pain modulation and brain
injury. By defining the longitudinal changes in a highly important pain-facilitating circuit underlying TBI-related
pain, the proposed studies address a critical knowledge gap in how TBI leads to chronic pain. Successful
completion of this work could also more broadly facilitate our understanding of other centralized pain conditions.
Dr. Chen is a physician-scientist with a diverse training background in anesthesiology, pain medicine, and
basic neuroscience research. In addition to its scientific significance, this project will enhance his expertise in
animal genetics, neural circuit manipulation, in vivo photometry and ex vivo neurophysiological recording, as well
as lay the foundation for his future work in pain research and inform clinical practice. The detailed career
development presented in this application will provide the required resources and mentorship for Dr. Chen to
become an independent R01-funded investigator studying the pathophysiology of brainstem pain modulation
neural networks affected by brain injuries.