Walter Zieglgänsberger receives Sertürner Award for his lifetime achievements
Acknowledgement for outstanding achievements in pain research
Prof. Dr. med. Dr. h.c. Walter Zieglgänsberger, emeritus professor at the Max Planck Institute of Psychiatry, received the Sertürner Award for his lifetime achievements on May 22, 2014. Therewith, the Sertürner Society acknowledged his extraordinary scientific achievements in the field of pain research.
Walter Zieglgänsberger pioneered in the field of pain medicine. His aim was to render findings from basic science also useful for therapeutic applications. In general, his translational research is characterized by a multidisciplinary collaboration to overcome the compartmentalization within science. Thereby, he established the term “memory of pain”. Interrupted by clinical training and some research periods abroad, he performed most of his work at the Max Planck Institute (MPI) of Psychiatry in Munich. Inspired by the close proximity of high level neurobiology and psychiatry, he developed his ideas and new therapeutic concepts in close cooperation with the clinics of the Ludwig Maximilians University (LMU) and the Technical University (TU) in Munich.
Advances in electrophysiological, molecular and cellular biological techniques have profoundly changed the face of pain research in recent years. At the beginning of Walter Zieglgänsberger´s scientific career, the perception of pain was thought to be transduced by a more or less rigid signaling mechanism and patients suffering from chronic pain but showing no signs of organic disease were referred to psychiatric treatment. Not to mention that glutamate was almost exclusively known as a soup spice at that time. Glutamate, which has come a long way from a soup spice to a most prominent excitatory neurotransmitter in the mammalian central nervous system involved in learning and memory, was always in the focus of his research. Today, no one questions the central nervous system being a highly dynamic and adaptive network. There is no single switch turning pain on or off but pain signal transduction presents a rather plastic process. Activity-dependent forms of synaptic plasticity and memory storage in brain structures such as the amygdala and the hippocampus are crucial for the integration and control of emotional and autonomic behavior such as fear and anxiety. The influence of emotional and cognitive input and feedback from different brain areas makes pain not only a perception, but an experience. It is to be expected that conventional analgesics often show only limited therapeutic value in the treatment of this multitude of dynamic changes that operate to produce the symptoms. Chronic pain appears as the dark side of neuronal plasticity. Persistent pain syndromes offer no biological advantage and cause suffering and distress followed by anxiety and depression.
Already the early experimental work of Walter Zieglgänsberger where he studied the plethora of different neurotransmitters and neuromodulators involved in signaling processes at spinofugal projection neurons offered new gateways to novel therapeutic approaches. The development of continuous epidural or intrathecal application of minute amounts of opioids was one of his first therapeutically relevant implementations. After several years of basic research, he could apply this newly designed procedure on patients for the first time. “In a first trial in 1978, we injected a small amount of an opioid agonist close to the spine of a cancer patient suffering from excruciating pain. I will never forget the moment, when this patient reported a clear lowering of his pain level, stood up and walked along the corridor”, recounts Walter Zieglgänsberger. “Today, this procedure is clinical standard.”
Owing to Walter Zieglgänsberger, we now know about the phenomenon of “memory of pain”, as an experience–based adaptation of expectancies originating from molecular modifications in neurons. The memory of pain can lead to pain perception even in the absence of the primary cause. In such cases, the pain itself becomes a disease. The memory of pain can be more damaging than its initial experience.
Patients suffering from chronic pain are constantly afraid of reoccurring pain. This fear and the resulting stress become the main symptom of chronic pain. Previously, these symptoms were considered as mere reactions to pain but are now seen as an essential component of pain processing. The patient’s personal attitude and genetic background play a key role therein. As an existing memory of pain can’t simply be erased, the therapeutic concepts developed by Walter Zieglgänsberger aim at reprogramming the memory of pain by combining pharmacological and psychological interventions. In what he called the Re-Learning Process, patients have to perform tasks which they could not do anymore due to the pain. In this way, the patients experience that performing these activities now is inducing no or remarkably less pain. These new experiences overwrite the previous negative adaptation of expectancies and modify a dysfunctional cognition.
In the quest to understand neuronal signaling in chronic pain states, there is clear evidence that stress and the memory of pain involve the remodeling of spines in projecting neurons. It is widely accepted that dendritic regression and a loss of dendritic spines are accompanied by deficits in synaptic plasticity and memory and that stress and chronic pain induce dendritic spine loss in various brain regions.
Born 1940 in Landshut, Germany, Walter Zieglgänsberger studied medicine at the LMU Munich followed by his doctoral thesis in 1967 at the MPI of Psychiatry. After having received his license for practicing medicine in 1971, he focused on neurobiological basic research at the MPI of Psychiatry. In 1976 he qualified as a professor in the fields of physiology and pharmacology and became a medical specialist for pharmacology and toxicology. After a research period at the AVD Center for Behavioral Neurobiology, The Salk Institute in La Jolla, California, he additionally became a medical specialist for clinical pharmacology. From 1979 until 1983, Walter Zieglgänsberger worked in several laboratories in Europe and the US. Since having been appointed as a professor at the LMU Munich in 1984 and the accompanying return to Munich, he was head of the research group “Clinical Neuropharmacology” at the MPI of Psychiatry. Despite becoming an emeritus professor in 2005, Walter Zieglgänsberger still gives numerous talks and organizes workshops, supervises doctoral students and participates in high level medical commissions and societies.
Honors and Awards
Walter Zieglgänsberger received several honors for his outstanding scientific achievements, including the German Prize for Pain Research and Pain Therapy, the German Pain Award and the Galenus v. Pergamon Award for enlightening the mechanism of action of acamprosate, a substance used for treating alcohol dependence. In 2012, he was awarded an honorary doctorate by the TU Munich.