At the IASP 2021 Virtual World Congress on Pain, to take place June 9-11 and June 16-18, the International Association for the Study of Pain (IASP) will present awards to honor the achievements of up-and-coming as well as more established investigators (these awards were originally to be presented at the 2020 World Congress on Pain in Amsterdam, which was canceled due to the COVID-19 pandemic). In advance of the meeting, PRF spoke with each of the winners. In this interview, we chat with Siobhan Schabrun, PhD, winner of the Ulf Lindblom Young Investigator Award for Clinical Science. This award honors an individual who has achieved a level of independence as a scholar in the field of pain for clinical science.
Schabrun is a National Health and Medical Research Council (NHMRC) Fellow and senior research scientist at Neuroscience Research Australia, where she and her team work to understand why acute pain becomes chronic in some people but not others. Here, Schabrun speaks with freelance writer Francie Moehring to discuss her research, her work to increase the representation of girls and women in STEM (science, technology, engineering and mathematics), and much more. What follows is an edited transcript of the conversation.
You first trained as a physiotherapist before completing your PhD. Is that what drove you to become interested in pain research?
Yes, it did. During my physiotherapy undergrad, we had a course on pain science, which was relatively new back then. It was clear that our knowledge about chronic pain conditions was limited, especially compared to what we knew about the mechanisms underpinning other conditions like stroke.
At that time, the idea of neuroplasticity was starting to develop; it was a relatively new term for pain science. I was really drawn to the idea of discovery and these big black boxes that we knew so little about. As part of my physio undergrad, I did an honors degree, including a two-year research component, and realized how much I enjoyed research. I loved the problem solving, coming up with questions, designing research projects, and interpreting findings. So when I finished my physiotherapy degree, it was clear that I wanted to pursue research, and pain science/neuroplasticity seemed like a great path to take.
What is your overall goal of your research?
My team is interested in understanding why some people develop chronic pain after an acute injury, while others get better. To do so, we’re interested in looking at the brain, predominately things like sensorimotor cortical activity, along with other neurophysiological and psychosocial measures. Can we predict who will develop chronic pain? If so, can we use this information to develop better treatments?
You have a number of ongoing projects. What is your area of greatest focus right now?
At the moment we have a couple of projects we’re focusing on. One is the UPWaRD trial, which is just coming to an end. That was a large-scale, five-year study where we looked at 120 people with acute low back pain and followed them over 12 months. We looked at measures of sensorimotor cortical activity, and took saliva for genotyping and blood to look at inflammatory markers and proteomics. Additionally, we used measures of spinal hyperexcitability and a range of psychosocial questionnaires, ultimately looking at whether these things alone or in combination could predict who got better. The data collection and most of the analyses are finished, and we’re just starting to work through the interpretation now, which is really exciting.
We have two other funded studies. One is from the NHMRC [National Health and Medical Research Council] in Australia, and one is from the NIH [National Institutes of Health] in the US, which are looking at the question of biomarkers. Even before pain begins, can we use techniques like electroencephalogram [EEG] recordings, or transcranial magnetic stimulation [TMS], to predict who is susceptible to chronic pain? If successful, this would allow early intervention in those who are at risk.
Alongside these large-scale projects are lots of smaller exploratory projects that generate interesting pilot data. It’s important to note that I lead a team of very talented postdocs and PhD students; by no means am I doing all of this myself. These individuals are a huge asset, and they do a lot of work on these projects. It wouldn’t be possible to run projects of this nature without them.
What has been the most exciting finding from your research thus far?
The most exciting thing at the moment is this question of biomarkers. We have some preliminary data, which we are following up in a larger trial, which suggest that a combination of peak alpha frequency measured with EEG [neural oscillations in the range of 8-12 Hz thought to be related to cognitive performance] and corticomotor excitability measured with TMS might be able to identify those who have high pain susceptibility, and therefore experience worse pain and slower recovery. It’s potentially an exciting finding, although large-scale follow-up is needed before we draw too many conclusions.
With the biomarkers, do you think one would try to intervene before a patient has a big surgery? When is the ideal time to start an intervention?
There are a lot of different applications. One of those is surgical – if we could identify that someone is at risk of developing chronic pain from surgery, we could intervene before the surgery or very early in the post-operative phase. There are also applications in conditions like chronic back pain. Although we might not be able to intervene before someone presents with acute pain, if we could intervene very early in their pain journey we could conceivably interfere with the transition to chronic pain.
What other questions do you hope your research will answer in the next five or 10 years?
It would be great to have a mechanistic understanding of why some people develop chronic pain while others recover. In the longer term, the really exciting questions are around better treatment and even prevention of chronic pain. There’s a huge global effort toward answering these questions with many different avenues being explored. I hope our research can contribute to that effort and help improve the lives of people living with pain.
What is the most challenging aspect of your area of research?
Probably the same thing that is challenging in any field of research, especially for young investigators: funding and, often, the relative instability of positions. It’s always disappointing when you have really nice pilot data or really great ideas, and you apply for funding and then you get rejected. But it’s a universal problem in research; it’s not limited to pain science.
What is it like to be an early investigator in the pain research field? Are there any resources that you didn’t have that you wish could be available for young investigators?
I think it’s important for young investigators to talk to people about their failures. It’s so easy to look at people you perceive as successful and think that every grant they applied for was successful and every paper had an easy journey to acceptance. But that’s very rarely the case. It would be great if there was a resource where people not only listed their successes, but also their rejections.
Is there any other advice you would like to pass on to young investigators in the pain research field?
It’s important to be positive and persistent. It’s hard in the face of rejection, but in the end, a big proportion of the people who succeed are those who persisted. Additionally, collaborations are key. I find people in pain research, regardless of career level, to be really generous with their time. Don’t be afraid to approach people, share your ideas, and ask for input.
You are one of the inaugural “Superstars of STEM” [science, technology, engineering and mathematics], which was started by Science and Technology Australia. What is the aim of this program?
The aim is to increase the visibility and profile of women who work in STEM, in the hope that more young girls and women will pursue careers in science. Currently, most of the scientists who appear in the media are male. That can be a big deterrent for young women who might have otherwise pursued these kinds of careers. The program supports a number of initiatives including greater media opportunities for women in STEM as well as programs in schools.
You are also a member of the Global Young Academy [GYA]. Could you tell me a little bit about that?
The GYA is an international organization that aims to provide a voice for young scientists across the world, with a particular focus on supporting young scientists from low-income countries. It has an advocacy role and produces papers around women in science, open science frameworks, the research environment, and funding issues affecting young investigators, as examples. Those papers are then available to policymakers worldwide and can be used to assist decision making.
What accomplishments are you most proud of in your career?
I find mentoring really rewarding. For example, new PhD students often start in the lab lacking self-confidence and feeling like "impostors." Watching them grow over the duration of their PhD program into independent scientists who can generate novel ideas, design research studies, and interpret findings is extremely rewarding.
You participated in a podcast titled "Changing the Brain" for the Australian Broadcasting Corporation [ABC]. What do you find most rewarding, and most challenging, about educating the general public about research and engaging with them?
The most rewarding aspect is that the members of the public you can access are very engaged. When I give talks, podcasts, or interviews, I find people are really interested in the research we do – they have lots of questions and are keen to understand how our research applies to their daily lives, and what the future might look like.
The flip side is that it’s easy to get stuck in an echo chamber – the people who are already interested and engaged are easy to access, but there’s a big proportion of the public who are hard to engage with. We need to find better ways of accessing and engaging those individuals, especially with the spread of misinformation and "fake news" on social media.
What is something people might not know about you?
As a kid, I really wanted to be a ballet dancer. I did a lot of dance training, and when I finished high school I applied and was awarded scholarships to go to full-time dance schools. At the same time, I was offered a spot to study physiotherapy. It was quite a hard decision at the time. I ended up going down the path of physiotherapy because it offered more job security than dancing. Ironically, I ended up in research, which does not have the greatest job security!
Have you ever regretted the choice?
I don’t think so. It would have been a really different path, and it probably would have been great, but I love working in research.
Francie Moehring is a freelance writer based in Milwaukee, US.