Interview with Rebecca E. Wells, Former Osher Research Fellow

Posted On: July 29th, 2022

Rebecca E. Wells, MD, MPH, Atrium Health Wake Forest Baptist

Interview with Rebecca E. Wells, Former Osher Research Fellow

Read the following interview by Osher Research Assistant, Esme Goldfinger with former Osher Post-Doctoral Integrative Medicine Research Fellow, Rebecca Wells. Dr. Wells research focus is in mind-body treatments of stress-related migraines.

Q: Tell me about your research interests:

RW: I am fascinated by the neurobiological underpinnings of mind-body interventions and how these treatments may help those with headache. I am intrigued to understand how stress may set off headaches and how mind-body treatments may offset these effects. I also want to understand if genetics help understand gender differences in headache presentation.

Q: What have been your most exciting or impactful findings?

RW: We recently conducted a randomized clinical trial evaluating mindfulness in migraine, and found that mindfulness had a statistically and clinically significant impact on depression, pain catastrophizing (magnification of pain-related thoughts), and headache-related disability. Further, using experimental heat pain testing, we found that mindfulness decreased perceived pain intensity (the sensory component of pain) and pain unpleasantness (the affective component of pain). These findings suggest that in patients with migraine, mindfulness may literally change the way the brain perceives pain. Through our qualitative interviews, we also found that through improved interoception (awareness of internal body signals), participants were able to tune into their migraine symptoms earlier during an attack and treat them sooner (with either medications or mindfulness), resulting in decreased migraine attack impact.  Although the group effect was not the driver of the benefits seen, learning mindfulness in a group setting may moderate these effects.

Q: How do you hope your research impacts the populations you study?

RW: Many people with migraine have depression, experience pain catastrophizing (during and in-between attacks), and live with significant disability (migraine is the second leading cause of disability worldwide!) so mindfulness could have a major public health impact. I hope our research provides evidence-based non-drug options for patients and providers of migraine. I hope our research changes the way researchers in the field study migraine, with a lens at also targeting and treating the inter-ictal (e.g., between migraine attacks) impact of migraine. I hope our research brings attention to the importance of considering disability as a primary outcome in migraine clinical trials. I am also hopeful that through targeting patients of diverse backgrounds, our research can be generalizable to all patients with migraine.

Q: Can you tell me a bit about what you’re working on currently?

RW: I currently have several large projects I’m working on. I’m excited to announce I just received R01 funding to evaluate online mindfulness in patients with migraine, with the entire study conducted remotely, which allows for national recruitment.  If effective in this in this large scale study, we then plan to assess implementation strategies so that patients of all backgrounds with migraine can access an evidence-based non-drug treatment to target the significant disability of migraine. I am also working on a multi-site R01 study evaluating telephone and video-delivery of mindfulness-based cognitive therapy in patient with migraine and depression. I am also finishing a study where we have been working to understand the genetic underpinnings of the gender differences in cluster headache. We conducted this study in the setting of a large family reunion (pre-pandemic!) and are excited to finish analyzing our results.  This study could help us understand the genetics behind the headaches we often diagnose based on clinical phenotype.

Q: How does an integrative lens inform how you treat and empower patients and providers?

RW: Patients want the story behind their illness to be heard. So many patients also want to find ways to tap into the natural healing of the body to treat their illnesses.  I find an integrative approach allows me to listen fully to patients, and work with them to find the ways they are most interested in to target their illness, taking full advantage of the value of healthy lifestyles on overall health impact.

Q: Anything else you’d like to add?

RW: Conducting clinical research is a team effort, no one can do it alone, and no one can learn how to do it alone. I am so incredibly grateful for the training and mentorship that I received through the Osher Center. I would not be on this path without the incredible support and guidance of so many inspiring people. When I recently received my R01, I did some digging and discovered that there are only 10 physician (MD) scientists in the US right now with R01 (or R01 equivalent) funding in Headache Medicine.  I’m proud of the training and support I received at Osher to make this possible. I also recognize how important it is that we continue to work to improve the pipeline to increase opportunities for people of all backgrounds to conduct clinical research so we can target and improve the care for all our patients.

Rebecca E. Wells, MD, MPH

Dr. Rebecca Erwin Wells is an Associate Professor in Neurology at Atrium Health Wake Forest Baptist in Winston-Salem, NC, USA and Wake Forest University School of Medicine. She founded and directs their Comprehensive Headache Program and serves as Associate Director of Clinical Research at their Center for Integrative Medicine.

She graduated with highest honors from UNC-Chapel Hill, received her MD from East Carolina-Brody School of Medicine, then completed Internship and Neurology residency at University of Virginia. After residency, she completed the Osher Center’s 3-year research fellowship in Integrative Medicine while also obtaining a Master’s in Public Health from Harvard School of Public Health. She went on to a second fellowship in Headache Medicine at Harvard’s John R. Graham Headache Center.

Dr. Wells has been a “Best Doctor of America” since 2015. She is Vice President of the Southern Headache Society and on the Board of Directors of the American Headache Society. She has served as Co-Chair of the Diversity, Equity, and Inclusion Taskforce for the American Headache Society. She received the American Headache Society Early Career Lecture Award for her research on the patient voice in migraine and the American Academy of Neurology’s Wolff-Graham award for recognition of her outstanding achievements in headache/facial pain research.

Her research investigates the mechanisms and efficacy of mind/body treatments for headache, which often receives media attention, including interviews with Time magazine, NPR, BBC News, Boston Globe, and Prevention magazine. She presents to national and international audiences as an expert in headache, mind/body, and integrative medicine. She has received funding from NIH, National Headache Foundation, and American Pain Society for her research. As a trained mindfulness meditation instructor, she has led mindfulness sessions virtually with worldwide participants during the pandemic.