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Dr Siobhan Schabrun

TEAM LEADER PROFILE

Senior Research Scientist and Group Leader, NeuRA Associate Professor, Faculty of Medicine, UNSW
R.D Wright Biomedical Fellow, NHMRC

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Dr Siobhan Schabrun trained as a physiotherapist before completing a PhD in neuroscience at The University of Adelaide in 2009. Supported by a NHMRC Early Career Fellowship, she undertook post-doctoral training in pain neuroscience at The University of Queensland. In 2014, she received a Fulbright scholarship to further her interest in the neuroplasticity of pain in the USA and was awarded a QLD Young Tall Poppy Science Award. In 2018 she moved to NeuRA where she leads a program of research that seeks to understand why some people recover after an episode of musculoskeletal pain while others develop long-lasting, disabling pain.

Research interests include the discovery of biomarkers that can predict who will develop chronic pain – even before pain begins, investigation of the neurobiological mechanisms that underpin the transition from acute to chronic pain and the development and testing of non-invasive brain stimulation treatments for chronic pain. She is also passionate about improving the translation of research evidence into clinical practice.

Siobhan is deputy lead of the low back pain working group of the SPHERE musculoskeletal clinical academic group, a nominated member of the Global Young Academy and is one of the inaugural Superstars of STEM.

Projects Dr Siobhan Schabrun is currently involved with

CURRENT PROJECTS

Medicines for Back Pain

Medicines are the most common treatment for back pain. The aim of this program of research is to improve our understanding of the clinical effects of medicines.

Studies currently in progress:

  1. Scoping review of paracetamol, NSAIDs and opioid analgesics for chronic low back pain (led by Matthew K Bagg). The objective of this study is to identify and describe the characteristics of available clinical trials of commonly used analgesic medicines for chronic low back pain. This information will inform the design and conduct of other studies in the research program.
  2. Paracetamol, NSAIDs and opioid analgesics for chronic low back pain: a network meta-analysis (led by Matthew K Bagg). The objective of this study is to produce information about the clinical effects of available analgesic medicines for chronic low back pain. This information will be available in a Cochrane review to assist clinical prescription of medicines. The protocol is published and available here.
  3. Prescribing practices of medicines for adults with low back pain: a systematic review (led by Michael Wewege). The objective of this study is to determine how different medicines are prescribed to adults with low back pain and how this differs across countries. The protocol for this study is being developed.
  4. Analgesic medicines for adults with low back pain: a network meta-analysis (led by Michael Wewege). The objective of this study is to evaluate the comparative effectiveness of a range of analgesic medicines for adults across different classifications of low back pain. The protocol for this study has been submitted for publication.
  5. Muscle relaxant medicines for low back pain: a systematic review and meta-analysis (led by Aidan Cashin and Thiago Folly). The objective of this study is to determine the effectiveness and tolerability of muscle relaxant medicines for adults with low back pain. The protocol is available here.
  6. Novel biologic medicines for low back pain: a systematic review and meta-analysis (led by Rodrigo Rizzo). The objective of this study is to determine the effectiveness and tolerability of novel biologic medicines for adults with low back pain. The protocol is available here.

Completed studies:

  1. Evaluation of the impact of unpublished data from clinical trial registries on the effects of medicines for low back pain (led by Matthew Bagg). The objective of this study was to evaluate whether there is a difference between clinical trial data that are published and those that are not published. The findings are published in the Journal of Clinical Epidemiology.
  2. Antidepressant medicines for low back pain: a systematic review and meta-analysis (led by Michael Ferraro). The objective of this study was to determine the effectiveness and tolerability of antidepressant medicines for adults with low back pain. The findings have been submitted for publication. The protocol is available here.

Medicines for Back Pain – Publications:

  • Bagg MK, McLachlan AJ, Maher CG, Kamper SJ, Williams CM, Henschke N, Wand BM, Moseley GL, Hübscher M, O’Connell NE, van Tulder MW, Nikolakopoulou A, McAuley JH. (2018). Paracetamol, NSAIDS and opioid analgesics for chronic low back pain: a network meta-analysis [Protocol]. Cochrane Database of Systematic Reviews, Issue 6. doi: 10.1002/14651858.CD013045. PMCID: PMC6513465
  • Bagg MK, O’Hagan E, Zahara P, Wand BM, Hübscher M, Moseley GL, McAuley JH. (2020). Reviews may overestimate the effectiveness of medicines for back pain: systematic review and meta-analysis. Journal of Clinical Epidemiology. doi: 10.1016/ j.jclinepi.2019.12.006. PMID: 31816418

Medicines for Back Pain – Registrations of Study Protocols:

  • Folly T, Bagg MK, Wewege M, Ferraro MC, Schabrun S, Gustin SM, Day R, McAuley JH. (2019) UMbRELLA: Understanding efficacy and safety of Muscle RELaxant medicines for Low back pain – systematic Literature review and meta-Analysis (protocol).Open Science Framework, available at: https://osf.io/xuw5h
  • Rizzo RN, Bagg MK, Ferraro MC, Wewege M, Cashin A, Leake HB, O’Hagan E, Jones M, McAuley JH. (2020). Efficacy and safety of medicines targeting neurotrophic factors in the management of low back pain: protocol for a systematic review and meta-analysis. Open Science Framework, available at: https://osf.io/zax6d
  • Ferraro MC, Bagg MK, McAuley JH. (2019). RADICAL: Systematic Review of Anti-Depressant Medicines if Considered Analgesics for Low Back Pain (protocol). Open Science Framework, available at: https://osf.io/cedm3

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Medicines for Back Pain

Social Media for Low Back Pain

Social media is a potentially powerful tool to provide a message of education and reassurance to the general public about low back pain. This project will use social media to educate the general public about low back pain and promote self-management.

The project involves three stages. Firstly, we will conduct a content analysis to gain an insight into social media users’ perceptions and understanding about low back pain. This could determine whether social media could serve as an educational tool through which accurate information related to low back pain could be disseminated to the public.

Second, a recent Delphi survey of 150 low back pain researchers identified 30 key messages considered to be important for the general public to know about LBP. These statements provide evidence-based information on the diagnosis, prognosis and management of LBP and are intended to educate, reassure and promote self-management. We will investigate the attitude of the general public towards these messages.

Third, working in conjunction with a media company Y&R, we will design and test a social media campaign to encourage self-management for people with low back pain.

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Social Media for Low Back Pain

TRANSLATE: Improving the translation of research evidence into practice

Effective, safe and cost-efficient healthcare is achieved when treatment is evidence based. Yet, it takes 17 years on average for research evidence to be translated into clinical care. This results in the overuse of ineffective treatments – those that do more harm than good – and the underuse of effective treatments – those that can improve symptoms and promote faster recovery after illness of injury. As a result, there is a huge gap between the healthcare people should receive and the care they do receive. TRANSLATE seeks to reduce the evidence-clinical care gap by implementing and monitoring evidence-based models of care in private practice.

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TRANSLATE: Improving the translation of research evidence into practice

BRAIN-Boost: Non-invasive brain stimulation combined with exercise for knee OA

Osteoarthritis is a major global health problem with no cure. Exercise is the cornerstone of conservative treatment, but effects on pain and physical function are at best, moderate. Non-invasive brain stimulation has the potential to bolster the effects of exercise therapy, resulting in greater improvements in pain and function than can be achieved with exercise alone. Here we will investigate this possibility in a randomized controlled trial of people living with knee osteoarthritis.

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BRAIN-Boost: Non-invasive brain stimulation combined with exercise for knee OA

DISCOVER-pain: Discovery of a cortical biomarker signature for pain

Low back pain (LBP) is ranked as the top single cause of disability worldwide. Costs have risen faster than for any other health condition and LBP is now equal to ischemic heart disease, and second only to cancer, as the costliest health condition. Approximately 40% of people who experience acute LBP develop chronic pain. These individuals are unresponsive to treatment, experience high levels of pain, struggle to perform daily tasks and frequently develop psychosocial comorbidities. The enormous scale of the problem is matched only by the mystery that accompanies it: despite decades of research, why some people develop chronic LBP while others do not, remains unknown.

The identification of biomarkers that can predict who will develop chronic LBP is a holy grail of pain research. Our new research has uncovered evidence for a unique biomarker signature that appears to predict i) an individual’s susceptibility to high pain severity, even before pain begins and ii) an individual’s susceptibility to developing chronic LBP following an acute episode. These biomarkers are now undergoing detailed investigation in on-going studies.

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DISCOVER-pain: Discovery of a cortical biomarker signature for pain

UNmaPPed: Understanding the physiology of persistent pain

People in pain move differently. Yet, the biological basis for altered movement in pain is poorly understood. This lack of understanding has led to treatments for persistent pain that target generic symptoms with limited effect. This NHMRC-funded trial is the first to examine how different aspects of the nervous system are altered in pain and how this relates to movement. This information will guide the development of new treatment strategies for persistent pain in future.

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UNmaPPed: Understanding the physiology of persistent pain

UPWaRD: Understanding persistent pain where it resides – in the brain.

Persistent musculoskeletal pain is one of the most significant health issues in the developed world. Termed a ‘Western epidemic’, low back pain is the most common form of persistent musculoskeletal pain and a leading cause of suffering and disability. Despite the enormity of the problem, many current therapies target generic symptoms, not underlying mechanisms, with limited effect. In 2010, the Australian National Pain Summit concluded ‘the management of pain is shockingly inadequate’. This assessment is not surprising given that critical information on the biological changes that underpin persistent low back pain is lacking. The UPWaRD study is a 5-year NHMRC-funded trial that investigates the role of brain plasticity, along with biological changes in the spinal cord, hormonal changes, genetics and stress, in the development of persistent low back pain.

 

https://www.upwardbackpainstudy.com

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UPWaRD: Understanding persistent pain where it resides – in the brain.

CHANGING THE BRAIN PODCAST – ABC RADIO NATIONAL’S BIG IDEAS PROGRAM

MIND-BENDING DRUGS ANDDEVICES: CAN THEY MAKE US SMARTER?

CAN THE WAY WE MOVE LEAD TO CHRONIC PAIN?

IT’S ELECTRIFYING: NON-INVASIVE BRAIN STIMULATION

HOW TEXTING TURNS YOU INTO A WALKING DISASTER

RESEARCH TEAM

KATARZYNA BILSKA PhD Student

LUKE JENKINS PhD Student

REBECCA LIVINGS PhD Student

CHELSEA CUNNINGHAM Research Assistant

WEI-JU CHANG Postdoctoral Fellow