Bio

Bio


Postdoctoral researcher at the Biobehavioral Pediatric Pain (BPP) Lab, Department of Anesthesiology, Perioperative, and Pain Medicine since October 2017, under supervision of Laura Simons. My PhD research focused on Cognitive Neuroscience and Metabolic Pediatrics (Jan 2011-April 2014, Maastricht University, Netherlands, under supervision of Bernadette Jansma and Estela Rubio-Gozalbo). After my PhD, I started my first postdoc at Maastricht University, at the Department of Cognitive Neuroscience and the Department of Rehabilitation Medicine, under supervision of Amanda Kaas and Jeroen de Jong. My main research interests include (pediatric) chronic pain, psychosocial and sensory aspects of (chronic) pain, and pain rehabilitation.

Professional Education


  • Bachelor of Science, Maastricht University (2008)
  • Master of Science, Maastricht University (2010)
  • Doctor of Philosophy, Maastricht University (2014)

Stanford Advisors


Research & Scholarship

Current Research and Scholarly Interests


My main research interests include (pediatric) chronic pain, psychosocial and sensory aspects of (chronic) pain, and pain rehabilitation. My main focus is on using neuroimaging techniques -both functional and structural MRI- combined with self-reports and sensory testing to unravel underlying mechanisms of pain rehabilitation treatment. I am interested both in adult chronic pain, as well as pediatric chronic pain and parental influences on treatment responses.

Publications

All Publications


  • Pain neuroscience education on YouTube PEERJ Heathcote, L. C., Pate, J. W., Park, A. L., Leake, H. B., Moseley, G., Kronman, C. A., Fischer, M., Timmers, I., Simons, L. E. 2019; 7: e6603

    Abstract

    The Internet in general, and YouTube in particular, is now one of the most popular sources of health-related information. Pain neuroscience education has become a primary tool for managing persistent pain, based in part on the discovery that information about pain can change pain. Our objective was to examine the availability, characteristics, and content of YouTube videos that address the neuroscience of pain.We conducted a systematic review of videos on YouTube using the search terms "pain education", "what is pain", and "pain brain" in January 2018. Videos were included if they were in English, were under 10 minutes long, and included information on the neuroscience of pain. Videos were coded for (i) descriptive characteristics (e.g., number of views, duration on YouTube), (ii) source and style, (iii) whether or not they addressed seven pre-determined target concepts of pain neuroscience education (e.g., 'Pain is not an accurate marker of tissue state'), and (iv) how engaging they were.We found 106 unique videos that met the inclusion criteria. The videos ranged from having four views to over five million views (Mdn = 1,163 views), with the three most highly viewed videos accounting for 75% of the total views. Animated videos were much more highly viewed than non-animated videos. Only a small number of videos had been posted by a clearly-identifiable reputable source such as an academic or medical institution (10%), although a number of videos were posted by healthcare professionals and professional medical societies. For a small number of videos (7%), the source was unclear. We found 17 videos that addressed at least one target concept of pain neuroscience science education, only nine of which were considered to be at least somewhat engaging. The target concept 'Pain is a brain output' was considered to be well addressed by the most videos (N = 11), followed by 'Pain is a protector' (N = 10). We found only one video that adequately addressed all seven target concepts of pain neuroscience education.YouTube contains a variety of videos that practitioners, patients, and families may view to access pain neuroscience education information. A small portion of these videos addressed one or more target concepts of pain neuroscience education in an engaging manner. It is yet to be determined to what extent patients are able to learn information from these videos, to what extent the videos promote behavior change, and thus to what extent the videos may be useful for clinical practice.

    View details for PubMedID 30923652

  • Is Empathy for Pain Unique in Its Neural Correlates? A Meta-Analysis of Neuroimaging Studies of Empathy FRONTIERS IN BEHAVIORAL NEUROSCIENCE Timmers, I., Park, A. L., Fischer, M. D., Kronman, C. A., Heathcote, L. C., Hernandez, J., Simons, L. E. 2018; 12
  • Precipitating events in child and adolescent chronic musculoskeletal pain. Pain reports Becker, A. J., Heathcote, L. C., Timmers, I., Simons, L. E. 2018; 3 (Suppl 1): e665

    Abstract

    Introduction: The epidemiology of chronic pain in youth has been increasingly documented over the past decade. However, the precipitating events associated with the onset of pediatric chronic pain are not well studied.Objectives: Understanding the events that precede the onset of pain, and are reported by patients as germane to the early stages of their pain, may add one piece to the puzzle of the causal etiology of pediatric chronic pain disorders.Methods: We conducted a retrospective chart review of 320 young people attending a tertiary care chronic pain clinic with musculoskeletal chronic pain.Results: Approximately two-thirds of patients reported a precipitating event for their pain; injury was the most commonly reported event, followed by a chronic disease, then an infection or illness. Surgery was the least commonly reported event. About one-third of patients did not report any precipitating event for their pain. Patients with neuropathic pain were even more likely to report a precipitating event compared to those with localized and diffuse musculoskeletal pain. Patients with localized musculoskeletal pain and neuropathic pain were most likely to report an injury, whereas patients with diffuse musculoskeletal pain were most likely to report a chronic disease. We found little to no evidence that the presence or type of precipitating event was associated with patients' psychological or physical functioning.Conclusion: This study adds to the epidemiological evidence base for pediatric chronic pain disorders.

    View details for PubMedID 30324167

  • Fear of pain and cortisol reactivity predict the strength of stress-induced hypoalgesia EUROPEAN JOURNAL OF PAIN Timmers, I., Kaas, A. L., Quaedflieg, C. M., Biggs, E. E., Smeets, T., de Jong, J. R. 2018; 22 (7): 1291–1303

    Abstract

    Acute stress can have an effect on pain sensitivity, yet the direction of the effect - whether it is hypoalgesic or hyperalgesic - is mixed across studies. Moreover, which part of the stress response influences pain sensitivity is still unclear. In the current experimental study, we aim to examine the effect of acute stress on heat pain thresholds and pain tolerance levels in healthy participants, while taking into account individual differences in stress responses.Forty-two healthy participants were randomly assigned to either a well-validated stress paradigm: the Maastricht Acute Stress Task (MAST; combining physical and psychological stressors) or to a nonstressful version of the task. Heat pain thresholds and tolerance levels were assessed at three times: prior to the MAST, immediately after the MAST during the presumed sympatho-adrenal medullary (SAM) response, and 15 min after MAST to cover the presumed hypothalamus-pituitary-adrenal (HPA) axis response. Stress responses were assessed both subjectively and physiologically.We observed that the acute stress induction led to increased heat pain thresholds, an effect that was present only in participants showing a cortisol response following stress induction and only in the presumed HPA axis time window. The strength of this hypoalgesic effect was further predicted by the change in cortisol and by fear of pain levels.Our findings indicate that the HPA axis - and not the autonomic - stress response specifically underlies this stress-induced hypoalgesic effect, having important implications for clinical states with HPA axis dysfunctions.This experimental study shows that an acute stress induction - that combines physical and psychological stressors - increases heat pain thresholds, but not tolerance in healthy participants. Furthermore, the magnitude of this stress-induced hypoalgesic effect is predicted by cortisol reactivity and fear of pain, revealing specific involvement of the HPA axis stress system and interactions with pain-related psychosocial aspects.

    View details for PubMedID 29577522

  • Atypical White Matter Connectivity in Dyslexic Readers of a Fairly Transparent Orthography FRONTIERS IN PSYCHOLOGY Zaric, G., Timmers, I., Gerretsen, P., Gonzalez, G., Tijms, J., van der Molen, M. W., Blomert, L., Bonte, M. 2018; 9