Clinical Focus

• Anesthesia
• Pain Management

Administrative Appointments

• Chief, Pain Management Division, Stanford University (2007 - present)
• Associate Professor, Anesthesia & Pain Management, Stanford University (2007 - present)
• Director, Stanford Systems Neuroscience and Pain Lab (SNAPL) (2002 - present)
• Co-Director, Stanford Pain Research and Clinical Center (SPARCC) (2004 - present)
• Co-Director, Pain Working Group, Neuroscience Institute, Stanford University (2005 - present)

Honors and Awards

• Neuroimaging and Mentoring in Translational Pain Research, NIH K24 DA029262 (2010-2015)
• Learned Control of Frontal and Limbic Systems via Real-Time fMRI, NIH R21 DA026092 (2009-2011)
• fMRI of Pain in the Human Spinal Cord, NIH R01 NS053961 (2006-2010)
• Central Mechanisms of Urologic Pelvic Pain: Functional and Structural Analysis by MRI, NIH U01 DK082316 (2008-2013)
• Development and Applications of Real Time fMRI Technology, Stanford Bio-X (2009-2010)

Professional Education

Postdoctoral Advisees

Heather Chapin,  Jennifer Hah,  Jiang-Ti Kong,  Sam Lahidji,  Katherine Martucci,  Paul Nash,  Pamela Ng

Graduate & Fellowship Program Affiliations

• Anesthesia
• Neurosciences
• Bioengineering

Internet Links

• Stanford Systems Neuroscience and Pain Lab

Current Research Interests

Virtual Reality and real-time fMRI
Applications of real-time fMRI Phase II
The goal of this study is to use real time imaging of the functions of the human brain to train patients to change activations in brain regions that control the experience of pain. Using fMRI, we are able to visualize activity taking place in brain areas involved in the perception and control of pain. By visually feeding back the subjects/patients own brain signal we are training them to learn how to control and change their pain experience. If successful, this allows patients to have greater control over their own pain. Several studies underway use fMRI to assess treatment and identify the most effective brain regions and cognitive strategies.
PIs: Drs. Sean Mackey, John Gabrieli, and Christopher deCharms

Cortical Restructuring in Patients with Chronic Pain
Recent research has demonstrated that chronic pain can induce changes in the brain that can amplify and maintain the pain experience. We are characterizing this phenomenon in patients with a variety of chronic pain conditions using a variety of neuroimaging techniques. We are following these preliminary studies with further investigations into the effects of treatment on reversing the brain changes induced by chronic pain.
PI: Dr. Sean Mackey

Cognitive Load and Perceived Pain Intensity
The aim of this study is to examine the role of attention in the experience of pain using a cognitive load task. We use various cognitive loads and thermal heat temperatures in order to determine how cognitive load can influence the experience of pain in both healthy and pain patients. By better understanding and characterizing this phenomena, we can design more effective therapies to help those with chronic pain.
PI: Dr. Sean Mackey

fMRI of the Human Cervical Spine
The way in which the brain processes pain is becoming better understood with the use of fMRI. However, significant processing of pain occurs in the spinal cord as well. We have developed novel techniques that allow us to, for the first time, image pain processing within the human spinal cord. Ultimately, we believe by better understanding the spinal-brain system, more effective targets for therapy can be designed & implemented.
PIS: Drs. Sean Mackey and Gary Glover

Neurotoxins Based Therapies in Chronic Pain
We are utilizing specific neurotoxins in novel ways to investigate their effectiveness in treating lower extremity neuropathic pain and the pain associated with peripheral vascular disease (PVD). Neurotoxins are compared with a placebo in a randomized, blinded cross-over study in which each patient will receive both a placebo and the neurotoxin at two different points in time.
PIs: Drs. Ian Carroll, David Clark, Stanley Rockson (PVD study) and Sean Mackey

Intravenous Lidocaine in Neuropathic Pain
Intravenous (IV) lidocaine has been used for years as a diagnostic test to determine potential effectiveness of certain neuropathic pain medications. We are using a computer controlled infusion system to deliver IV lidocaine to patients with chronic pain to characterize its pain relieving properties and its effectiveness in predicting response to neuropathic pain medications.
PIs: Drs. Kim Kaplan, Paul Reynolds, Sean Mackey

Outcome Assessment in Chronic Pain
We are using validated outcome measurements that capture the pain experience and its impact on patients in order to better understand the factors that contribute to their pain.
PIs: Drs. Ian Carroll, Kim Kaplan, Sean Mackey

Opiate Induced Hyperalgesia
Recent research has suggested that chronic use of opiates may induce a state of sensitization in which the patients experience more pain as a consequence of taking these medications. We are utilizing validated pain measures and tests in patients who are admitted to our chronic pain unit to have their opiates adjusted as part of their therapy.
PIs: Drs. Ian Carroll, Larry Chu, Kim Kaplan, Sean Mackey

Clinical Trials

• Acupuncture and Pain Processing Recruiting
• Effect of IV Lidocaine Infusions on Pain Recruiting
• Study of Gabapentin to reduce duration of postoperative pain and opioid use Recruiting
• Study of T3 for the treatment of Fibromyalgia Recruiting
• Subcutaneous Botulinum Toxin for Cutaneous Allodynia Recruiting

Publications

• Sensory pain qualities in neuropathic pain. Mackey S, Carroll I, Emir B, Murphy TK, Whalen E, Dumenci L. J Pain. 2012; 13 (1): 58-63
• Human response to unintended intrathecal injection of botulinum toxin. Carroll I, Fischbein N, Barad M, Mackey S. Pain Med. 2011; 12 (7): 1094-7
• Morphine and its metabolites after patient-controlled analgesia: considerations for respiratory depression. Sam WJ, MacKey SC, Lötsch J, Drover DR. J Clin Anesth. 2011; 23 (2): 102-6
• Prescription opioid analgesics rapidly change the human brain. Younger JW, Chu LF, D'Arcy NT, Trott KE, Jastrzab LE, Mackey SC. Pain. 2011; 152 (8): 1803-10
• Strategy-dependent dissociation of the neural correlates involved in pain modulation. Lawrence JM, Hoeft F, Sheau KE, Mackey SC. Anesthesiology. 2011; 115 (4): 844-51