PhD studentship: The role of neuropsychological changes in the manifestation and treatment of chronic pain

We welcome applications for a full-time University PhD studentship to support and work in our Department of Psychology.

The student will join a growing research active department where they will become part of the Cognition, Affective Science and Technology laboratories. The student will also be affiliated with the Centre for Pain Research in the Department for Health.


Background

Approximately 20% of people experience chronic pain. In many such people pain is disproportionate to any pathology in the painful site. Examples include repetitive strain injury, back pain, whiplash as well as Complex Regional Pain Syndrome (CRPS), which can follow a relatively minor injury. Unusual sensations and movement difficulties in people with CRPS along with changes in brain function (Eisenberg et al., 2005, Pain; Pleger et al., 2009, NeuroImage) suggest that symptoms may be partly driven by problems in integrating sensory and movement signals in the brain (McCabe et al., 2003, Rheumatology). Poor sensorimotor integration is though to trigger pain signals in order to alert the person to a potential problem with their body (Harris, 1999, Lancet). Patients with CRPS also show deficits in attention and sensory processing that resemble the clinical syndrome Hemispatial Neglect (‘neglect’), which is usually seen following brain injury. Taken together, the problems with sensorimotor integration and attention in people with CRPS suggest that the condition has a neuropsychological component. Understanding the role of neuropsychological changes in chronic pain conditions could facilitate better prevention and treatment.

This studentship will investigate the contribution of neuropsychological changes to chronic pain and how to target these for rehabilitation.

The student will conduct their research under the supervision of Dr Janet Bultitude and Dr Michael Proulx.


The project

The studentship will consist of three projects.

Project 1

This is a clinical trial of a novel treatment for CRPS called prism adaptation. Prism adaptation is a technique that forces a person to compensate for a temporary mismatch between sensory and motor information, thus triggering sensorimotor integration. It is also used in the treatment of neglect following brain injury (Rossetti et al., 1998, Nature). Dr Bultitude showed that 11 daily sessions of prism adaptation eliminated pain in one patient (Bultitude and Rafal, 2010; Experimental Brain Research). However, the support for prism adaptation is limited to unblinded trials in only six CRPS patients (Bultitude and Rafal, 2010, Experimental Brain Research; Sumitani et al., 2007, Neurology). The student will compare the effects of two weeks of PA versus sham treatment in two groups of 16 patients using a longitudinal double-blind randomized design. Outcomes will be 1) pain and other indicators of well-being, and 2) computer-based tasks measuring sensorimotor integration, attention and other cognitive functions.

All project 1 participants will be enrolled by month 18. The last post-treatment research session will occur by month 30, after which the student will become unblinded as to the patients’ treatment conditions.

The student will also examine two possible triggers of the neuropsychological changes that underlie CRPS and related conditions: chronic sub-clinical pain and immobilisation.

Project 2

The student will measure cognitive changes in 100 people with chronic sub-clinical pain using web-based experiments (months 7-18).

Project 3

The student will test 30 people with cast immobilisation of their forearms (months 19-30).

The student will spend the first six months completing a literature review, obtaining ethical approval and recruiting participants. Pathways are already in place for recruiting CRPS patients, people with chronic sub-clinical pain and healthy controls. The student will establish new pathways for recruiting people with cast immobilisation of their forearms through hospitals in Bath and Oxford. The student will spend the final 6 months writing up the thesis.


Eligibility

The successful candidate should:
- fulfil the entrance requirements for a Department of Psychology PhD (http://www.bath.ac.uk/study/pg/programmes/mphi-psyc/)
- have an interest (and preferably previous experience) in at least one of the following areas and the associated statistical methodologies:
cognitive psychology
psychophysics
longitudinal research
- have a valid UK driver’s license (access to a car is also desirable but not essential)

How to apply

- Apply online (http://www.bath.ac.uk/hss/graduate-school/research-programmes/how-to-apply/) to study for a full-time PhD in the Department of Psychology
you must quote the project title in section 3.2 of your application: The role of neuropsychological changes in the manifestation and treatment of chronic pain
you do not need to upload a formal research proposal as this studentship is for a specific project
- Complete the application form for an academic-led PhD studentship (https://fs9.formsite.com/hss-web/form7/index.html)

The closing date for the receipt of applications is 12.00 noon (GMT), Thursday 4 February 2016.