National Center for Complementary and Alternative Medicine (NCCAM)

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NCCAM’s FY 2012 Funding Priorities and Research Focus

The National Center for Complementary and Alternative Medicine (NCCAM) at the National Institutes of Health (NIH) funds and conducts research to help answer important scientific and public health questions about complementary health approaches. NCCAM works to determine what is promising, what helps and why, what doesn’t work, and what is safe.

NCCAM’s Funding Priorities

This graphic depicts two priority areas covering what NCCAM studies[1]: mind and body practices (acupuncture, massage, meditatino, spinal manipulation, deep-breathing exercises, hypnotherapy, qi gong, tai chi, etc.) and natural products (herbs, botanicals, dietary supplements, probiotics, etc.).  Six important questions about complementary health approaches include: pain; interactions and safety; biological effects; mechanisms; healthy behaviors; and symptoms.

1Exploring the Science of Complementary and Alternative Medicine: NCCAM Third Strategic Plan 2011–2015 (1.7MB PDF)

Setting Funding Priorities

The field of complementary health encompasses a large and diverse array of practices, products, and disciplines. To best focus its research investment, NCCAM adopted a strategic plan in 2011 that outlined a framework of factors for setting research priorities including

  • Scientific promise
  • Amenability to rigorous scientific study
  • Potential to change health practices
  • Relationship to real world use.

NCCAM’s Grant Portfolio

Fiscal year 2012 was the first full year in which NCCAM’s most recent strategic plan was in place, reflecting the framework for priority setting. The grants awarded in 2012 demonstrate a diverse and robust research portfolio designed to address significant public health needs.

NCCAM’s Budget at NIH

NIH is the Nation’s medical research agency and is the largest source of funding for medical research in the world. In FY 2012, the entire NIH budget was approximately $30.9 billion. NCCAM’s overall budget that same year was about $128 million, or 0.4 percent of the total NIH budget (46KB PDF) [NIH].

NCCAM’s Key Areas of Research

Pain Research: Employing Mind and Body Approaches

A major focus for NCCAM is research related to chronic pain, an enormous public health problem that affects 100 million Americans and costs up to $635 billion per year in treatments and lost productivity.2 Current drug-based treatment options are only partially effective and can have serious side effects. Thus, NCCAM’s research exploring nonpharmacologic approaches, such as mind and body practices, that may help in treating chronic pain is a top priority. In fact, about 30 percent of our cumulative portfolio supports research in pain. We are playing a key role not only in determining the value of nonpharmacologic approaches and self-management strategies, but also understanding the neuroscience of pain.

  • NCCAM plays a leadership role in the Trans-NIH Pain Consortium and our scientific staff is co-chairing the Research Task Force on Research Standards for Chronic Low Back Pain, which is developing recommendations for core measures of back pain for use in clinical research to help advance the field.
  • NCCAM has also embarked on an initiative to stimulate research on the use of complementary approaches for pain and symptom management in military and veteran populations. This effort encourages collaboration among NCCAM-funded researchers, other NIH institutes and centers, and researchers at the Departments of Defense and Veterans Affairs.
  • NCCAM’s new intramural research program, launched in July 2012 and based on the NIH campus, focuses on the role of the brain in perceiving, modifying, and managing pain, with the long-term goal of improving clinical management of chronic pain through the integration of pharmacological and nonpharmacologic approaches. The program will investigate the role of the brain in pain processing and control, and how factors such as emotion, attention, environment, and genetics affect pain perception. Complementary health practices often used to control pain, such as meditation and yoga, will also be studied.

Natural Product Research: Investigating Safety and Mechanisms

Research on the safety of natural products is another major priority for NCCAM, given the widespread availability and use of these products by the public. An area of particular need is better scientific information about interactions between natural products and drugs. Well-documented examples include interactions involving St. John’s wort or grapefruit juice. Each has an ability to decrease or increase the blood concentration of various prescription medications. In 2012, NCCAM held a workshop entitled “Dietary Supplement-Drug Interactions,” which explored the state of research on natural product-drug interactions and available technologies needed to conduct rigorous research on them. NCCAM has begun a phased initiative, which will take advantage of recent advances in genomic and proteomic technologies to systematically screen for potential adverse and beneficial natural product-drug interactions.

NCCAM is also delving into the biology of small molecules and understanding how diets rich in fruits and vegetables positively affect health. And, as our understanding of the human microbiome continues to expand, we are exploring the promise of probiotics by examining the mechanisms by which probiotics may impact health.

Recent Research From NCCAM

These recent research highlights represent just a few of the thousands of articles in the peer-reviewed literature that have been published by NCCAM grantees [PubMed]. To see additional posted research results, visit nccam.nih.gov/research/results.

A young African-American woman meditates next to a pool.

According to a recent study, meditation may have effects on the brain, enhancing how the brain responds to anxiety and stress. And these effects may persist, so that even when someone is not meditating they may still benefit.3

An older african american woman.

Hypnosis significantly improved hot flashes in a group of postmenopausal women in a recent study. These findings suggest that hypnosis may be a safe nonpharmacologic approach for postmenopausal women who experience symptoms.4

Doctor speaking to elderly man.

A recent study showed that dietary patterns may be able to help prevent cognitive decline in older people, potentially leading to a better quality of life for millions of older Americans.5

A doctor performing acupuncture on a man's back.

A study employing individual patient data meta-analyses provides evidence that acupuncture may be helpful for chronic pain. The study showed that effects of acupuncture may be attributable to factors such as patient’s belief in the treatment, placebo and other context effects, as well as locations of specific needling points or depth of needling.6

Looking Ahead: NCCAM Research in Progress

A doctor prepares a man for insertion into a CAT scan machine.

NCCAM’s Division of Intramural Research is using sophisticated neuroimaging to explore how chronic pain produces changes in the brain that can modify how the brain reacts to pain medications like opioids and to evaluate the utility of nonpharmacologic approaches, such as yoga and meditation for pain management.

Person standing on a weight scale.

With obesity a growing national health crisis and costs mounting to $147 billion a year, can an approach like mindfulness-based stress reduction help prevent childhood obesity and support healthy eating and behavior change?7

Woman holds her back in pain.

Lower back pain affects 80 percent of Americans at some point in their lives and is a leading form of disability. Researchers are seeking to understand what role nonpharmacologic approaches, such as manipulative and body-based interventions, play in managing symptoms.8

To stay up to date on NCCAM’s research:

 


 

2Relieving Pain in America: A Blueprint for Transforming Prevention, Care, Education, and Research, Institute of Medicine, June 2011. Back

3 Desbordes G, Negi LT, Pace TWW, et al. Effects of mindful-attention and compassion meditation training on amygdala response to emotional stimuli in an ordinary, non-meditative state. Frontiers in Human Neuroscience. 2012;6:292. www.ncbi.nlm.nih.gov/pubmed/23125828 Back

4 Elkins GR, Fisher WI, Johnson AK, et al. Clinical hypnosis in the treatment of postmenopausal hot flashes: a randomized controlled trial. Menopause: The Journal of the North American Menopause Society. October 22, 2012 [Epub ahead of print]. www.ncbi.nlm.nih.gov/pubmed/23096250 Back

5 Bowman GL, Silbert LC, Howieson D, et al. Nutrient biomarker patterns, cognitive function, and MRI measures of brain aging. Neurology. 2012;78(4):241-249. www.ncbi.nlm.nih.gov/pubmed/22205763 Back

6 Vickers AJ, Cronin AM, Maschino AC, et al. Acupuncture for chronic pain: individual patient data meta-analysis. Archives of Internal Medicine. 2012;172(19):1444-1453. www.ncbi.nlm.nih.gov/pubmed/22965186 Back

7 Chaplin, Tara; Yale University; Preventing Childhood Obesity Through a Family-Based Mindfulness Intervention; projectreporter.nih.gov/project_info_description.cfm?aid=8512273&icde=16677968&ddparam=&ddvalue=&ddsub=&cr=63&csb=default&cs=ASC Back

8 Bishop, Mark; University of Florida; Central Mechanisms of Body Based Interventions for Musculoskeletal Low Back Pain; projectreporter.nih.gov/project_info_description.cfm?aid=8455718&icde=16677968&ddparam=&ddvalue=&ddsub=&cr=33&csb=default&cs=ASC Back

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