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- Honorary Professor
- Restorative Dental Sciences
- Eastman Dental Institute
- Faculty of Medical Sciences
Professor Joanna M. Zakrzewska BDS, MB BChir, MD, FDSRCS, FFDRCSI, FFPM RCA, FHEA
After obtaining dental (Kings College, London), medical (University of Cambridge ) degrees Joanna Zakrzewska underwent specialist training in oral medicine. Initially specialised in oral cancer screening programs in industry and then set up and ran for ten years the first oral and dental clinic for patients with HIV and AIDS. Joanna Zakrzewska went on to specialize in orofacial pain. After gaining an MD on trigeminal neuralgia she transferred to an academic post at Queen Mary’s Dental School, London were she ran the oral medicine department for ten years. She was awarded a personal chair in pain in relation to oral medicine and became the first non-anaesthetist fellow of the Faculty of Pain Medicine. In 2007 Joanna Zakrzewska moved to University College London Hospitals NHS Foundation Trust, to set up and now lead the largest multidisciplinary facial pain unit in the UK. The unit sees over 700 new patients a year and over 1,500 follow ups and runs an evidence based, patient centred service. Supervising an interdisciplinary PhD on visualisation of pain through photography has led to further post doctoral funding to develop the generated pain cards into tools that can be used in pain consultations to improve communication. She has written 4 books on orofacial pain including one for patients, 19 chapters and over 100 papers. Her main area of research is in trigeminal neuralgia and she is a Trustee and head of medical advisory board for the Trigeminal Neuralgia Association UK, a support group for patients. Currently she is chief investigator of an international trial of a new drug for trigeminal neuralgia, contributes to a USA based genetics study of the condition and is aiming to set up a national centre for this rare and potentially devastating disease. She lectures extensively both nationally and internationally and has played a prominent role in the International Association for the Study of Pain’s global campaign to increase awareness of orofacial pain.
My research on orofacial pain and particularly trigeminal neuralgia is clinically based and I am working not only with multidisciplinary teams at UCLH, London but also with teams nationally and internationally.
The following are my current key areas of research :
i. Clinical trials in trigeminal neuralgia TN
I helped to conceive a novel design and then was chief investigator on a multicentre, multinational (3 UK and 11 international centres) phase IIa study to evaluate the safety and efficacy of CNV1014802, the first new drug for trigeminal neuralgia Detailstails on http://clinicaltrials.gov/ and NIHR CRN Portfolio - UKCRN ID 11675 – 3. The protocol was published prior to closure of the trial. The trial is now closed having achieved its planned recruitment target. We included a genetics study to determine if non response was due to genetic causes.
I previously ran a RCT for use of lamotrigine and an open label study on leviteracetam. We had to abandon an RCT on the use of low dose intravenous immunoglublin, IVG.
I currently have ethics approval for a natural history cohort study of TN with 190 recruited patients. This will provide for the first time prospective data on patients treated medically and surgically using validated outcome measures. This is part of a collaboration with a research group in Leeds who have got funding from their BHRC in order to prepare a grant application to the NIHR. Contributing genetic material to a USA study looking for the potential genetic cause of TN.Our international taskforce has published European and American guidelines on management of TN based on best evidence currently available and we update our review in Clinical Evidence.
ii. Surgical management of trigeminal neuralgia
Weundertook a Cochrane systematic review of surgical management of TN. We have reported the largest UK series of independently assessed microvascular decompression procedures. For this study we used a patient centred approach, described our methodology in a separate study and provided a template for future collection of data. We have now proposed and published a scoring system for improving the quality of reporting of surgical outcomes in TN.
vi.Visualisation of pain through photographic images –face2face, Pain: speaking the threshold
An innovative project with the Slade at UCL is using images created by patients and an artist to improve our understanding of pain, its communication and progress through management. I was second supervisor for Deborah Padfield’s PhD, a photographic artist and artist in residence at UCLH. We have now received further three years post doctoral funding. With historians from Birkbeck we took part in the Wellcome Collection day on Pain and its meanings with subsequent interviews on several BBC channels. Our own public exhibitions as well as participation in UCLH open day and PainLess exhibition at the Science museum enabled thousands of people to increase their awareness of pain and its enormous burden to society.
I am an enthusiastic committed teacher who takes pride in her teaching. Not only do I want to teach effectively but I also wish to understand the basis of educational theory. I was one of the first in the dental school to gain HFEA membership and assisted 4 others (through seminars which also encouraged the spread of good practice) to gain membership. I insist that my juniors take up training in learning and teaching as part of their normal pattern of career development. Effective professional practise entails lifelong learning so I regularly read educational journals and books, am a member of medical educational societies such as ASME and AMME, participate in staff development, maintain a teaching portfolio, reflect on my teaching and publish in peer reviewed journals.
I aim to inspire students by example and show especially our undergraduate students how theoretical teaching is put into clinical practise which includes bringing patients to lectures and using evidence based medicine at the chair side. The advent of HIV/AIDS led to a need to train not just undergraduates but also the teaching staff both medical and dental. I established a teaching package for consultants and students which I then trialled at the University of Perambuco in Brazil.Further developments included a course on oral awareness developed with Dr H. Fry , now Head of Education at Imperial College, for medical undergraduates which we hope other medical schools will adopt . I have now taken up the challenge of increasing the teaching of Pain at all levels of the medical and dental curricula. I introduced a special thread on pain in the new 1999 dental curriculum and would like to introduce it into the medical curriculum.
I take the training of my junior staff seriously and in order to understand better the problems they are facing I undertook a UK wide study into the training of oral medicine and I was chair of the Speciality Training Committee for the Additional Dental Specialties in the London Deanery for a term of five years.