The NIH Pain Consortium Mitchell Max Award for Research Excellence honors Dr. Mitchell Max, MD (1949 – 2008) for his lifetime contribution to pain research and is awarded annually to the best poster presentation at the NIH Pain Consortium Symposium.

2021 Mitchell Max Awardee

Image of Daisy Cantu


Daisy Cantu

Graduate Student
Texas Woman’s University, Denton, TX

Daisy J. Cantu is originally from Nuevo Laredo, Tamaulipas, Mexico and was adopted into the U.S. at the age of 15. She received her B.S. in Biology from Texas Woman's University (TWU) in 2018. As an undergraduate, Daisy conducted neuroscience research and continued on with this research into graduate school. Daisy earned her M.S. in Biology at TWU in 2020 and is currently a Ph.D. candidate conducting research under the mentorship of Dayna L. Averitt, Ph.D. Her dissertation research focuses on determining the neuroanatomical substrate underlying sex differences in stress-induced exacerbation of orofacial pain. While the vast majority of preclinical research on the effects of stress on orofacial pain are conducted in male rodents, Daisy’s work is focused on characterizing sex differences in the effects of stress on the activity and neurochemistry of trigeminal afferent inputs and the contribution of glial cells in the parabrachial nucleus of female rodents.

Stress Exacerbates Orofacial Pain to a Greater Degree in Female Rats 

Cantu, Daisy J., Santos, Natalia, Rodriguez, Erica, Averitt, Dayna L.
Department of Biology, Texas Woman’s University, Denton, Texas

Background: Approximately 20% of the U.S. population suffers from chronic pain, and certain pain conditions in the orofacial region are more prevalent in women. However, there is a limited understanding of why orofacial pain conditions disproportionately affect women. Clinical studies indicate that psychological stress is a contributing factor in the etiology of orofacial pain disorders. Despite this prevalence, the limited research on the effects of stress on orofacial inflammatory pain is reported exclusively in male rodents. A single study in both male and female rats indicates that restraint stress enhances mechanical orofacial allodynia to a greater degree in females during a model of infraorbital neuropathic pain. It remains unclear whether stress-induced exacerbation of orofacial pain occurs in female rodents. Possible mechanisms involved in stress exacerbated orofacial pain may involve the astrocytes, which are known to have a neuroprotective and neurotoxic effect in the brain and spinal cord. Studies have indicated that restraint stress decreases Glial Fibrillary Acid Protein in the brain (GFAP), while other studies have shown that astrocytes significantly increase 1 day after exposure to Complete Freund's Adjuvant (CFA; inflammatory agent) into the masseter muscle. However, the role of astrocytes in stress exacerbated orofacial pain in trigeminal pain pathways, and whether these glial cells are involved in stress exacerbated orofacial pain in females remains unclear. An undetected sexually dimorphic effect of stress on orofacial pain may be one factor underlying the greater prevalence of orofacial pain disorders in women.  

 Specific aim(s): In this study we examined (1) the role of sub-chronic stress (forced swim test; FST) on inflammatory orofacial mechanical allodynia in female compared to male rats and correlated pain behaviors to (2) plasma corticosterone levels, and (3) astrocyte expression in the trigeminal nucleus caudalis (TNC) and parabrachial nucleus (PBN). We hypothesized that sub-chronic stress evokes greater orofacial pain behaviors and glial activity in the ascending trigeminal pain pathway in female rats.

Results and Significance: Here, we report that CFA (30 μL) injection into the right vibrissal pad evoked significant and comparable mechanical allodynia in both male and female rats. FST evoked a significant and comparable increase in the percentage of time spent immobile. However, females developed greater and longer-lasting orofacial mechanical allodynia one, four, and eight days post-FST. Orofacial pain behaviors returned to normal on day 11, as did corticosterone levels. Also, our preliminary data indicate that inflamed males exposed to the FST express more GFAP in the PBN when compared to sham. On the other hand, female PBN expressed comparable GFAP after exposure to FST or sham conditions, indicating a potential sex dimorphism in astrocyte expression that may be contributing to sex differences during stress exacerbated orofacial pain. 

Conclusions: Our data indicate that there are sex differences in the effects of sub-chronic stress on orofacial pain. Understanding the influence of stress on orofacial pain and the role of glial cells is vital to understanding why orofacial pain conditions are more common in women. 


Past Recipients

2020 Dr. Ana Moreno 

Navega Therapeutics

Repression of Sodium Channels via Gene Therapy for Treatment of Chronic Neuropathic Pain

2019 Michael D. Burton

University of Texas at Dallas.

Delayed Onset of Neuropathic Pain in Aged Males After Peripheral Nerve Injury

2018 Ishmail Abdus-Saboor

University of Pennsylvania

A Mouse Pain Scale: Assessment of Pain Sensation in Mice Using Sub-second Behavioral Mapping and Statistical Modeling

2017 Cameron L. Randall

West Virginia University

Variation in MC1R Gene Predicts Dental Pain Sensitivity

2021 Mitchell Max Award Finalists:

Image of Dr. Melissa Accordino.


Melissa K. Accordino, MD, MS, Columbia University Medical Center, New York, NY

CONTRoL Trial: Cryotherapy vs. cOmpression Neuropathy TRiaL: randomized controlled selection trial for prevention of taxane-induced peripheral neuropathy in patients with breast cancer


Dr. Accordino is an Assistant Professor of Medicine at Columbia University. She is a breast medical oncologist and her research is focused on cancer care delivery, cancer survivorship, and disparities in cancer care. She has been the recipient of grant funding from Columbia University, the Hope Foundation, the Conquer Cancer Foundation, and the NIH. Dr. Accordino has expertise in population-based analyses, interventional trials aimed at improving gaps between evidence-based care and real-world practice, and is currently leading a pilot study of cryotherapy vs. compression therapy. vs. placebo in hopes of reducing chemotherapy induced peripheral neuropathy.  She has a strong interest in improving the quality of cancer care delivery, reducing care disparities, and improving long term quality of life for patients who have had cancer.


Image of Dr. Jo Armour Smith


Jo Armour Smith PhD, PT, Chapman University, Irvine, CA

The influence of postural behavior and brain organization on progression of back pain symptoms in young adults: a prospective longitudinal study


Jo Armour Smith is an Assistant Professor in the Department of Physical Therapy at Chapman University. Her research focuses on control of movement in the trunk, and how impairments in the sensorimotor processes underlying trunk control contribute to pain and movement dysfunction. Prior to beginning her research career, Jo worked as a physical therapist in the United Kingdom and the United States. She received her PhD from the University of Southern California (USC), where she worked in Kornelia Kulig’s lab investigating postural control of the trunk during walking and turning. She completed a post-doctoral fellowship in Beth Fisher’s lab at USC where she examined the neural correlates of impaired anticipatory postural adjustments in the trunk in older adults. Jo received the Margaret L Moore Award for Outstanding New Faculty Member from the American Physical Therapy Association in 2017. 



Mitchell B. Max, MD


Photo of Mitchell Max

Mitchell B. Max, MD, was a visiting professor of anesthesiology, medicine, and human genetics and director of the Molecular Epidemiology of Pain Program at the University of Pittsburgh Center for Pain Research. He received his undergraduate degree from Yale University and his medical degree from Harvard Medical School. He completed a fellowship in neurology and pharmacology at Memorial Sloan-Kettering Cancer Center in New York, studying the pharmacokinetics of opioid drugs. He was appointed medical director of the Pain Research Clinic in the pain and neurosensory mechanisms branch of the NIH National Institute of Dental and Craniofacial Research (NIDCR). For over two decades, he conducted research on the mechanisms and treatment of analgesics and neuropathic pain and published extensively. From 2005 to 2007 he was chief of the clinical pain research section of NIDCR. Dr. Max was a fellow of the American Neurological Association since 1990, a member of the AAN (1988–1990), and a member of the American Pain Society (APS). At the APS, he served as secretary from 1988–1990, chair of the Quality Improvement Committee (1988–1995), member of the Decade of Pain Research Planning Committee (2002–2008), and chair of the Analgesic Guidelines Committee (1986–2002), which produced the influential monograph Principles of Analgesic Use in the Treatment of Acute Pain and Cancer Pain. His multiple honors and awards include the APS Wilbert E. Fordyce Clinical Investigator Award (1996), the US Public Health Service Citation Award (1986), and the NIH Director's Award (1993).


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