Professor Alex Binshtok

Deconstructing and Reconstructing Pain

Pain is a multidimensional and multilevel experience involving complex sensory processing modulated by emotional and cognitive operations. This complexity exists in both adaptive pain as well as in maladaptive embodiments of pain, where pain occurs without obvious stimuli. The ability of pain systems to adapt to changes in stimuli characteristics, and, therefore, to shift the stimulus-response curve at each level of processing adds to this intricacy. Maladaptive functional or neuropathic pain represents the highest level of complexity since there is no defined stimulus that initiates the process; yet once initiated, the pain becomes perpetual due to multilevel plastic changes occurring from the primary sensory neurons all the way to the cerebral cortex. Inadequate comprehension of pain mechanisms is likely the reason that chronic pain has been implicated as the most prevalent unmet medical need. Pain presents a significant and costly liability to workers, employers and society. Yet of highest importance is the daily perpetual misery and suffering, which was perhaps best expressed by Milton in Paradise Lost: “Pain is perfect misery, the worst of Evils, and, excessive, overturns all patience.” Lack of adequate treatments for pain has a profound impact on the quality of life and health-associated costs. A comprehensive and detailed understanding of the neurobiology of pain is urgently required to enable the development of more effective treatments.

In our lab are aiming to understand the complex phenomenon of pain. We are studying molecular and cellular mechanisms of normal and abnormal (chronic) pain at all levels starting from the terminal endings of peripheral neurons at the target organs and all the way up to cerebral cortex. We also developing new approaches for pain-selective anesthesia - an effective pain treatment without side effects. In our lab we are using in vivo and in vitroelectrophysiology and imaging paired with computational and behavioral approaches.