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First Published January 13, 2011

  

Facial Pain Research Foundation

 

aims to turn a page in history

 

by finding a cure for the world’s most excruciating pain

 

Finding a cure for trigeminal neuralgia, the most painful disorder known to humans, is the

mission of The Facial Pain Research Foundation. Its founders aim to reach the goal within

the decade of 2011-2020, while also developing therapies to permanently stop other

nerve-generated facial pains and diseases.

The Foundation is the brainchild of seven professionals across the United States, who are

creating the first international force of scientists to work together to cure an ancient, but poorly

understood disease. Finding a cure will restore pain-free life to millions of men, women and

children around the world, who are stricken by repeated lightning-like shocks of facial pain,

the hallmark of trigeminal neuralgia. A simple cool breeze across the face, a slight touch or

even a kiss on the cheek can trigger shooting pains that drive victims to their knees and

may last a lifetime.


Trigeminal neuralgia was first identified in the 11th century, yet it remains frequently

misdiagnosed and inappropriately treated, in many cases resistant to the best available

therapies, and tragically linked to depression, fear, fatigue and suicide. The pain has a bizarre

“hit and run” behavior; it strikes near the eyes, nose, lips, ears or teeth, sometimes disappears

for days, months or longer, then returns. The pain seems to come out of nowhere with

a stabbing intensity that stops life in its tracks and draws full attention to the need to find relief.


To conquer the problem within ten years, the Foundation has formed an international consortium

of eminent scientists, starting at the University of Florida’s McKnight Brain Institute and the

University of California San Francisco, to conduct studies aimed at translation from laboratory

to patient. Participating scientists will report outcomes at Foundation conferences and public

forums. In the process, they will expand public awareness of what has been a global silent

epidemic of facial pain.
“Some say it takes years and years to find a cure for a disease as complicated and unpredictable

as trigeminal neuralgia, but America put a man on the moon in less than a decade after our

President called for it to be done,” said Myron Hirsch of Naples, Fl., a founding trustee and

 former president of the TNA-Facial Pain Association. (In 1962, John F. Kennedy announced,

‘We choose to go to the moon in this decade,’ and seven years later, on July 20, 1969,

Neil Armstrong walked the face of the moon.)
While Hirsch does not compare curing nerve damage to putting man on the moon, he

expresses confidence that a cure can be achieved in 10 years by a united force of premier

scientists around the world working collaboratively toward the goal. Major attention will be

focused on the trigeminal (three-part) nerve that energizes facial feeling and functions, and on

how the nerve and its protective coating, known as myelin, are damaged in ways that lead to pain.
“Our search for a cure is preceded by a long circuitous trail of medical and surgical advancements

that have fallen short of permanently stopping the pain without medications or complications,”

said Michael Pasternak, Ph.D., of Gainesville, FL., a founding trustee and former president

of the TNA-Facial Pain Association. “We must fix this nerve for those suffering now,

and for future generations.”
Pasternak, whose terrorizing trigeminal neuralgia pain was halted after microvascular

decompression surgery in 1992, said only 50 to 75 percent of individuals with the typical

textbook type of TN gain long-lasting pain relief through surgery, medications or non-conventional

therapies such as acupuncture and chiropractic adjustments. Many of those who become

pain-free after surgery suffer recurrent pain months or years later, indicating new damage

in other parts of the nerve!
Neurosurgeon Albert Rhoton Jr., M.D., a Foundation trustee who treated more than

3,000 patients with trigeminal neuralgia before retiring from 40 years of surgical practice

at the University of Florida, says it is time to find a cure. Rhoton, who still jets around the

world to aid the teaching of neurosurgeons, said, “The past (regarding trigeminal neuralgia)

has been filled with medicine, often toxic medicine, and risky surgery with failures and

recurrences. This is the first time in my lifetime that a group is really going for a cure.”


Poor public awareness of trigeminal neuralgia has been attributed to the fact the disease

is rarely visible and is not fatal. Unlike cancer and heart attack, which claim many lives,

people with TN suffer pain that progressively worsens and attacks more often. Many

patients abandon their careers, social life and recreation, and isolate themselves at home.


“Over the last 20 years, we have rescued thousands of patients from the obscurity

of trigeminal neuralgia through education, outreach and personal contact,” said Roger Levy,

a founding trustee and immediate past chairman of the board of TNA-The Facial

Pain Association. “However, in that period we have seen no major breakthrough in

treatment, let alone a cure.

Through the Foundation, we will drive the direction of research, and work to increase

the pace at which discoveries are reported and shared among lab scientists,

clinicians and patients.”
The first projects undertaken through the scientific consortium are directed by two

nationally known, award-winning scientists dedicated to pain research: Neuroscience

Professor Lucia Notterpek, Ph.D., at the University of Florida’s McKnight Brain Institute and

Neurobiologist/Anatomist Allan Basbaum, Ph.D. at the University of California San Francisco.
Notterpek seeks to develop genetically altered mice as the first validated animal model of

human neuropathic facial pain—a model long needed for basic studies on pain mechanisms

and the preclinical testing of new treatments. She and Andrew Ahn, Ph.D., a neurologist

and facial pain expert, are treating mice with new pharmaceutical molecules designed to halt

nerve deterioration, and are measuring their effectiveness in reducing responses to pain stimuli. 

Eminent neuroscientist Douglas K. Anderson, Ph.D., former Director of the McKnight Brain Institute

and trustee of the Foundation says: "The fundamental problem we confront in research is why

the trigeminal nerve goes bonkers, why excellent corrective surgery ends the pain for some

patients, but not for others, why the best available pain-relieving medications help some and

not others, and why many patients gain no lasting benefit from any conventional or alternative

therapy." Anderson said he is optimistic that a breakthrough in the treatment of trigeminal

neuralgia, the most extreme facial pain disorder, will reveal therapeutic approaches worth

evaluating in the treatment of other nerve diseases, which might include multiple sclerosis.
At UCSF, Dr. Allan Basbaum’s studies in mice are aimed at solving one known cause

of facial pain: the apparent loss of chemical mediators that normally inhibit the transmission

of pain signals to the brain. In a unique approach, he is transplanting nerve cells that

secrete these inhibitory chemicals into the trigeminal area of hyperactivity. The goals

are to introduce these healthy cells into the areas of the brain influenced by nerve damage,

and to have them fully accepted as an integral part of normal nerve circuitry where they will

be expected to normalize the inhibition of pain signals traveling to the brain.
London physician Joanna Zakrzewska, M.D., who directs the largest orofacial pain clinic

in the United Kingdom and is studying the epidemiology of neuropathic facial pain and how

to measure pain more precisely, is the Foundation’s international neuroscience coordinator.

She is a professor of pain in relation to oral medicine at the Barts and the London Queen

Mary’s School of Medicine and Dentistry at the University of London. She is author of four

books, including INSIGHTS: Facts and Stories Behind Trigeminal Neuralgia for consumers,

and Orofacial Pain, a new guidebook for health-care professionals.
The Foundation’s founders share a history of close encounters with facial pain or with patients

in pain, and share a passion for stopping the pain. Together, they bring to the board room

some 200 years of accomplishments in business, medical science, law, writing, public relations

and marketing, teaching and publishing. In addition to Anderson, Rhoton, Pasternak, Hirsch

and Levy, the trustees include Suzanne N. Grenell, a creative writer, poet and motivational

speaker in Scottsdale AZ, and Jay Winer, independent public relations/marketing consultant

in Asheville, N.C.

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