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VUSN Grant: Brain Activity and Pain in People with Alzheimer’s Disease

The Vanderbilt University School of Nursing (VUSN) has been awarded a four-year $660,633 grant by the National Institute of Health/National Institute on Aging under Award Number K23AG046379. The study examines how psychophysical responses to acute experimental thermal pain differs between older adults with and without Alzheimer’s Disease (AD).

Assistant Professor Todd Monroe, PhD, RN, FAAN, the principal investigator, is exploring if older adults with AD will have altered responses in sensory pain and affective pain systems that may place them at risk for poor pain management and unnecessary suffering.

In addition to his primary mentor, Vanderbilt University Institute of Imaging Science Director, John Gore, PhD, Monroe’s mentorship team includes Lorraine Mion, PhD, Nursing), Paul Newhouse, MD, (Psychiatry), Steve Bruehl, PhD, (Anesthesiology), and Ronald Cowan, MD, PhD (Psychiatry).

“As a society, as scientists and as clinicians, we need to have a much deeper understanding of the connection between pain and Alzheimer’s Disease. Todd is an innovative researcher who is determined to find answers that may result in a higher quality of life for individuals with this disease,” said Linda Norman, DSN, RN, FAAN, Valere Potter Menfee Professor of Nursing and VUSN Dean.

In this four-year career development and research study, Monroe will examine differences in experimental thermal pain between adults with and without AD. He will also look at how these differences map onto regional and network brain functional changes. This NIH/NIA career development award will allow Monroe to transition from an internally funded Vanderbilt CTSA KL2 award.

Monroe and his team will examine the psychophysical and neurophysiological response to experimental thermal stimuli in healthy older adults (65-plus years old) and aged-match adults with AD. This will provide a foundation for understanding factors that may contribute to untreated pain risk, as well as for developing novel assessment, prevention, and treatment strategies in this older population.

“We are proud of Todd’s accomplishments as one of our former post-docs and bow a tenure track faculty member. He is an integral part of VUSN’s Hartford Designated Center of Gerontological Nursing Excellence. His work continues to build momentum and is at the forefront of emerging research in this important area,” said Ann Minnick, PhD, RN, FAAN, Senior Associate Dean of Research for VUSN.

Since coming to VUSN in 2010, Monroe completed a three-year post-doctoral fellowship with VUSN and Vanderbilt University Institute of Imaging Science. He also began building a research program in pain, aging and Alzheimer’s Disease and led two pilot studies using psychophysical and functional magnetic resonance imaging (fMRI) methods to examine pain responses in adults with and without Alzheimer’s Disease. Preliminary findings suggest that when compared to healthy older adults, people with AD may have decreased pain sensitivity placing them at risk of late or failed detection of reporting pain. Further analysis revealed an extensive pattern of deactivation in several brain regions.

This line of research is being conducted at a time when there are a growing number of older adults with Alzheimer’s Disease. According to the Alzheimer’s Association, there are 5.1 million older adults with Alzheimer’s Disease in the U.S. By 2025, the group estimates 7.1 million older adults will have Alzheimer’s Disease — a 40 percent increase.

Monroe believes that the support provided by Gordon Bernard, MD, and Katherine Hartmann, PhD, MD, through the Clinical and Translational Science Awards (CTSA) Coordinating Center were instrumental in providing him the necessary support to compete for this external award.

“I am very grateful for the opportunity to work for an institution that provides such extraordinary support for early stage investigators. Dr. Hartmann and the entire CTSA career development program staff are outstanding,” said Monroe.


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