Stephen Bruehl, Ph.D.

Professor of Anesthesiology

Dr. Stephen Bruehl is a Professor of Anesthesiology at Vanderbilt University School of Medicine.  He received his Ph.D. in Clinical Psychology in 1994, and has worked clinically in the past with chronic pain patients as a member of a multidisciplinary chronic pain management team.  Throughout his career, Dr. Bruehl has conducted research focused on understanding the mechanisms of and factors influencing chronic pain.  He has had long-standing interests in topics that include Complex Regional Pain Syndrome, the influence of endogenous opioids and psychosocial factors on pain, and interactions between the cardiovascular and pain modulatory systems.  His work has more recently focused on identifying factors that predict responses to opioid analgesics, and understanding the mechanisms that contribute to these predictive effects.  He has published more than 160 peer-reviewed articles regarding pain, as well as a number of book chapters regarding CRPS.  Dr. Bruehl has been principal investigator on eight pain-related NIH R01 research projects, and he is Associate Editor of the journals Pain and Annals of Behavioral Medicine.  Dr. Bruehl was as a member of the IASP committee that developed the 2012 IASP diagnostic criteria for CRPS, and was co-leader of the research consortium that conducted the studies validating the Budapest Criteria.  

Research Description

Dr. Bruehl’s lab is focused on enhancing understanding of the mechanisms underlying chronic pain and successful pain management.  The lab studies chronic pain from an integrated biopsychosocial perspective that acknowledges the mind-body connection and its’ impact on both the experience of pain and responses to interventions.   

Studies in the lab combine clinical, pharmacological, and laboratory evoked pain methodologies to elucidate the impact of individual differences in endogenous opioids (“endorphins”) on chronic pain.  By evaluating the effects of pharmacological opioid receptor blockade on both clinical pain and responses to controlled laboratory stimuli, the functional role of endogenous opioids in chronic pain and responses to interventions can be quantified.  Recent work in the lab has demonstrated a role for endogenous opioid function in determining clinical responses to opioid analgesic medications.  Several predictors of opioid analgesic responses have been identified, with the long-term goal of enabling a personalized pain medicine approach.  As part of this work, the lab has also sought to identify risk factors related to individual’s analgesic responses that may contribute to problematic use of opioid analgesics.  Ongoing work in the lab is investigating whether a behavioral intervention (aerobic exercise training) improves pain and function in chronic back pain patients via enhancements in endogenous opioid function, and the degree to which such changes impact on responses to opioid analgesic medications.  Recently funded work is evaluating diverse biopsychosocial mechanisms, including endogenous opioid-related, through which two widely-used complementary medicine interventions (mindfulness training and spinal manipulation therapy) may reduce chronic back pain and improve function. 

Another focus of the lab is on the mechanisms that contribute to the transition from acute to chronic pain.  Ongoing work is examining the potentially interactive role of preoperative psychosocial status and perioperative oxidative stress as contributors to chronic pain experienced following total knee arthroplasty.  One particular focus of this work is on enhancing understanding of the mechanisms that may contribute to symptoms of Complex Regional Pain Syndrome (CRPS) following surgical procedures.  CRPS is a poorly understood and difficult to treat chronic pain condition associated with neuropathic, inflammatory, and autonomic features.

In addition to the projects above, other interests of the lab include studying the impact of genetic factors on analgesic responses using “Big Data,” the role of central sensitization in chronic pain and overactive bladder syndrome, the impact of anger and associated endogenous opioid system alterations on pain, and how dysfunction in interrelated cardiovascular and pain modulatory systems may contribute to chronic pain and risk for comorbid hypertension. 

Active Grants: 

Bruehl, S. (Co-PI).  Evaluating specific and non-specific mechanisms in two distinct complementary/integrative interventions for chronic pain. (Multi-PI: Bruehl/Burns).  Grant #R01-AT009680. NCCIH/NIH.  Project Period: 8/1/18 – 7/31/23. 

Bruehl, S. (Co-PI).  Reduced opioid analgesic requirements via improved endogenous opioid function. (Multi-PI: Bruehl/Burns).  Grant #R01-DA037891.  NIDA/NIH.  Project Period: 04/01/15 - 03/31/19 (in No Cost Extension). 

Bruehl, S. (PI).  Psychosocial and oxidative stress mechanisms of post-surgical chronic pain. (PI: Bruehl). Grant #R01-AG048915. NIA/NIH.  Project Period: 03/01/17 – 02/28/21.

Bruehl, S. (Co-Inv).  Development of co-morbid PTSD and chronic pain among inner-city women. (Multi-PI: Hobfoll/Burns). Grant #R01-DA039522.  NIDA/NIH.  Project Period: 08/01/15- 05/31/20. 

Bruehl, S. (Co-Inv).  The RCMI Program in Health Disparities Research at Meharry Medical College: Mechanisms Linking Adversity and Pain in African American Adults (Project 3). (PI: Hildreth, Project Leader: Morris).  Grant #U54 MD007586-31.  NIMHD/NIH.  Project Period: 09/21/17 – 09/20/22.

Bruehl, S. (Co-Inv).  Sex Differences in Pain Reports and Brain Activation in Older Adults with Alzheimers Disease. (Multi-PI: Cowan/Monroe).  Grant #AG059861.  NIA/NIH.  Project Period: 09/16/18-5/31/23.

Past Grants:

Bruehl, S. Endogenous opioid mediation of behavioral coping styles.  (PI).  American Psychological Association Dissertation Research Award.  Awarded: 1992.

Bruehl, S. (PI).  Pain regulatory system dysfunction in chronic pain.  Grant #R01-NS038145, National Institute of Neurological Disorders and Stroke, National Institutes of Health.   Project Period: 1/15/99-6/30/04.

Bruehl, S.  (Co-PI).  Validation of new CRPS/RSD diagnostic criteria.  Reflex Sympathetic Dystrophy Syndrome Association.  Project Period: 7/1/05-6/30/06.

Bruehl, S. (Co-PI on consortium grant).  Anger expression, endogenous opioids, and acute pain. Grant #R01- MH071260.  National Institute of Mental Health, National Institutes of Health. (Co-PI: Burns, J.W.)  Project Period: 9/1/05-5/31/09.

Bruehl, S. (PI).  Pain regulatory dysfunction in chronic pain.  Grant #R01-NS046694, National Institute of Neurological Disorders and Stroke, National Institutes of Health.  Project Period: 9/15/04 – 6/30/08.

Bruehl, S. (PI).  Anger expression, opioid dysfunction, and chronic pain.  Grant #R01-NS050578, National Institute of Neurological Disorders and Stroke, National Institutes of Health.  Project Period: 7/1/06 – 6/30/11. 

Bruehl, S. (Co-Investigator).  Developmental outcomes of pediatric chronic abdominal pain (PI: Lynn Walker, Ph.D.).  Grant #R01-HD232264, National Institute of Child Health and Human Development, National Institutes of Health.  Project Period: 4/1/07 – 3/31/12. 

Bruehl, S. (PI).  Genetic polymorphisms and pain.  NIH/Vanderbilt University VICTR Grant ($23,000).  Awarded 2011.

Bruehl, S. (Co-Inv).  Age-related differences in psychophysical and neurobiological response to pain. (Co-PI’s: Monroe/Cowan).  Grant # R21-AG045735.  NIA/NIH.  Project  Period: 7/1/14-6/30/16. 

Bruehl, S. (PI).  Quantitative cry acoustics for measurement of pain in neonates: correlations with cortical nociceptive processing and neurodevelopment.  Vanderbilt Kennedy Center Hobbs Discovery Grant ($25,476).  Awarded 2014.

Bruehl, S. (PI).  An exploratory study of genetic, epigenetic, proteomic, metabolomic, and gene expression-related factors in CRPS.  Reflex Sympathetic Dystrophy Syndrome Association.  Awarded: January, 2016. (Total Costs: $56,812). 

Bruehl, S. (Co-PI).  Predictors of opioid analgesic responses and common endogenous opioid mechanisms (Multi-PI: Bruehl/Burns). Grant #R01-DA031726.  NIDA/NIH.  Project Period: 9/1/11 – 5/31/17. 

Bruehl, S. (Co-Inv).  Differences in pain between Alzheimer's Disease and Vascular Dementia in older females.  (PI: Monroe).  Grant #R21AG049332.  NIA/NIH.  Project Period: 9/30/16 – 4/40/18. 

Bruehl, S. (Co-Inv).  VIPER II: Chronic pain after amputation.  (PI: Van de Ven).  Grant #MR130082.  DoD.  Project Period: 9/1/15 – 9/29/18. 

Bruehl, S. (Co-Inv).  Predicting treatment response in pediatric functional abdominal pain. (PI: Walker).  Grant #R01-HD076983.  NICHD/NIH.  Project Period: 5/1/14-3/31/19.