The studies being presented at the World Congress of Neurology were conducted with the integral involvement of UPS doctor of physical therapy students and undergraduate neuroscience interns.
The main focus of Dr. Allen's sabbatical work was to integrate findings from more than ten year's research work on how plantar stimulation can reduce sensations of vertigo. This research direction began when DPT student Allison Miner ('04) was curious as to why the spinning sensation of vertigo would diminish when a person places his/her foot firmly on the floor. Along with student colleagues Corie Cortez Good ('04), Brooke Maury ('04), and Cynthia Rainey ('04), Allison conducted a study validating the phenomenon using calorically induced vertigo in normal individuals that was first presented at APTA's 2004 Combined Sections Meeting in Nashville. Seeing the potential for a simple and cost effective treatment for pathological vertigo, other DPT student research groups advanced this line of inquiry by comparing the relative efficacy of various somatosensory stimulation approaches, such as direct pressure, TENS, and acupressure; and investigating the viability of plantar somatosensory treatment for patients with benign paroxysmal positional vertigo. Over the past decade, DPT students involved in this continued work were Matt Kirchoff ('08), Lars Kellow ('08), Nick Siewert ('08), Brett Neilson ('09), Megan Hoover ('09), Holly Collings ('09), Lindsey Cartwright ('06), Natash Nicolai ('06), Levi Frasier ('06), and Shawn Quenga ('06).
Two other presentations at the Vienna Congress by Dr. Allen involve new findings regarding delayed modulation of neuropathic pain as a function of psychogenic stress. An initial longitudinal study found that the experience of significant psychological stressors consistently increased perceived pain intensity ten days later in patients with complex regional pain syndrome (CRPS). This investigation was conducted with DPT student collaborators Julie Spitaro ('03), Mike Roelofsen ('03), Tracy Martin ('03), and Shanda McCormick ('03). Subsequent student research groups verified that this delayed pain modulation response was not unique to CRPS, but was present in patients with another chronic neuropathic pain condition - fibromyalgia syndrome. Students who worked to explore various manifestations of delayed pain modulation and fibromyalgia included Lexi Harlow ('05), Ty Allen ('05), Kelsey Kumiji ('05), Karin Townson ('09), Katy Smith ('09), Carin Bittenbender ('09), and Sara Blankenship ('09), Amy Moe ('10), Casey Pyle, Chelsea Athing ('10), Elizabeth Lupino ('10), and Mauri Terao ('10). Looking to provide evidence for the psychoneuroendocrine mechanism behind this curious ten day delayed pain response, Chad McCann ('08) and undergrad neuroscience intern Kelsy Higa ('11) made major contributions to validating and understanding how the stress-related release of thyroid hormones influence neural sensitivity and account for pain flares that occur ten days after significant stressors. The first of Dr. Allen's presentations in this area will discuss evidence for thyroid modulation of delayed neuropathic pain responses and offer a comprehensive model of our current understanding of central and peripheral nervous system changes due to increased thyroid hormone levels that impact perceived pain.
Undergraduate neuroscience intern, Chelsea Clarke ('13), wished to explore whether this delayed modulation mechanism might be a factor in pain intensity of episodic migraine headaches. After following patients with migraine over a ten-week period, Chelsea and Dr. Allen uncovered two unique manifestations of delayed episodic headache pain modulation, both of which are consistent with the psychoneuroendocrine influences of thyroid hormone activity on neural sensitivity. Their findings represent the third presentation offered at this year's World Congress of Neurology.
Aside from the direct scientific and clinical implications of the studies presented, the main take-home message here is that these sustained research directions were conducted with meaningful ongoing faculty/student collaborations. In an environment where knowledge of existing state of the art can be blended with openness to fresh perspectives and recognition of novel connections, potentially new useful ideas can take root and be explored.