Clinical and neuroimaging determinants of persistent joint pain in psoriatic arthritis

Rebecca Haberman, MD, MSCI is an Assistant Professor (tenure track) in the Division of Rheumatology at NYU Grossman School of Medicine. Dr. Haberman has a Master’s degree in Clinical Investigation and, despite her early career stage, has been remarkably prolific with multiple first author publications in high impact journals and

has received competitive extramural funding from NIH/NIAMS (T32 grant), the National Psoriasis Foundation, and the Rheumatology Research Foundation. Her long-term career goal is to become an independent investigator who leads both clinical and epidemiologic innovative studies at the intersection of psoriatic disease

and determinants of inflammatory and non-inflammatory pain. Dr. Haberman, together with an expert mentorship team, guided by Drs. Jose U. Scher and Alexis Ogdie, have designed a career development plan intended to lead to independence by the end of the K23 award period, including training in outcomes research, advanced

epidemiologic methods, statistical modeling, and clinical trial development as well as developing a fundamental framework in which to study pain using neuroimaging and validated tools in psoriatic arthritis (PsA). Her work will be supported by a diverse team of collaborators who have specific areas of expertise in biostatistics,

neuroradiology, pain, and behavioral health and have long committed to helping Dr. Haberman achieve her goal of independence. Through this award, she will cement her niche within rheumatology and acquire the data and publications necessary to support a strong R01 application(s). In this proposal, Dr. Haberman seeks to

understand the clinical and physiologic basis of persistent joint pain in patients who have seemingly controlled inflammation. To do so she proposes to: a) define the prevalence and clinical drivers of persistent joint pain, b) interrogate the biologic underpinnings of persistent pain using advanced neuroimaging, and c) identify predictive

factors of persistent pain prior to the initiation of PsA treatment. The scientific premise is that while the pain experience in PsA is mediated by both inflammatory and non-inflammatory processes, persistent pain is largely non-inflammatory in nature. The central hypothesis posits that, in PsA, a significant proportion of patients

experience persistent joint pain which prevents the achievement of remission unless an effective pain-mitigating therapy is used as a co-adjuvant. Aim 1 will define the prevalence, phenotype, and drivers of persistent pain in a large and diverse PsA cohort. Aim 2 will employ neuroimaging (functional brain MRIs) cross-sectionally to

characterize neuroconnectivity differences between patients in full remission and those with persistent joint pain. Aim 3 will follow newly diagnosed, treatment naïve patients with PsA to assess predictors of having persistent pain at 6 months after exposure to biologic treatments (including integration of clinical tools with

neuroconnectivity features). The successful completion of the proposed project will provide Dr. Haberman with a unique perspective and robust tools to study the clinical and neuroimaging features that can serve as the basis for personalized therapies in PsA, and constitute the foundation of a future competitive R01 grant application.