Howard Fields, MD, PhD
Professor Emeritus
Neurology
School of Medicine
Howard Fields received his MD and PhD in Neuroscience at Stanford in 1965-66. After Internal Medicine training at Bellevue Hospital in New York, he spent three years as a research neurologist at Walter Reed Army Institute of Research. Following clinical training in neurology at the Boston City Hospital Service of Harvard Medical School in 1972, he joined the faculty of the University of California San Francisco.
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Fields major interests are in nervous system mechanisms of pain and substance abuse with a focus on how endogenous opioids contribute to these mechanisms. He was a founder of the UCSF pain management center and has made major contributions to understanding and treating neuropathic pain. His group was the first to demonstrate the clinical effectiveness of opioids for neuropathic pain and of topical lidocaine for post-herpetic neuralgia. In laboratory studies he discovered and elucidated a pain modulating neural circuit that is required for opioids to produce analgesia. He also discovered that placebo analgesia is blocked by an opioid antagonist. Recently, his laboratory has discovered nerve cells in the striatum that selectively encode the magnitude of a reward. They have also shown how the neurotransmitter dopamine contributes to motivation and reward based choice. Current work is focused on the neurobiology of opioid reward.
Awards
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- Mitchell Max Award for Neuropathic Pain Research, American Academy of Neurology, 2012
- Founder's Award, American Academy of Pain Medicine, 2012
- American Academy of Arts and Sciences, 2010
- Raymond D. Adams Lecture, American Neurological Association, 2006
- Cotzias Lecture, American Academy of Neurology, 2000
- Institute of Medicine, 1997
- Kerr Award, American Pain Society, 1997
- Bristol Myers Award for Pain Research, 1988-1993
Education & Training
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- PhD Neuroscience Stanford University 1966
- MD Medicine Stanford University 1965
Grants and Projects
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Publications (103)
Top publication keywords:
DopamineRewardPainEnkephalin, Ala(2)-MePhe(4)-Gly(5)-Receptors, Opioid, kappaVentral Tegmental AreaAnalgesics, OpioidPain PerceptionReceptors, Opioid, deltaCuesConditioning, OperantMesencephalonReceptors, Opioid, muNucleus AccumbensNeurons
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International Association for the Study of Pain publications over the 50-year span.
Pain 2023 Davis KD, Basbaum AI, Bushnell MC, Yarnitsky D, Fields HL -
A deeper dive into top-down control of pain and itch.
Brain : a journal of neurology 2022 Fields HL -
Optimal opioid treatment requires a consensual approach.
Pain 2022 Fields HL, Darnall BD -
Optimal opioid treatment requires a consensual approach.
Pain 2022 Yamaguchi S, Terahara T, Okawa K, Inakura H -
Pain modulates dopamine neurons via a spinal-parabrachial-mesencephalic circuit.
Nature neuroscience 2021 Yang H, de Jong JW, Cerniauskas I, Peck JR, Lim BK, Gong H, Fields HL, Lammel S
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Onset hyperalgesia and offset analgesia: Transient increases or decreases of noxious thermal stimulus intensity robustly modulate subsequent perceived pain intensity.
PloS one 2020 Alter BJ, Aung MS, Strigo IA, Fields HL -
A Midbrain Circuit that Mediates Headache Aversiveness in Rats.
Cell reports 2019 Waung MW, Margolis EB, Charbit AR, Fields HL -
How expectations influence pain.
Pain 2018 Fields HL -
Two delta opioid receptor subtypes are functional in single ventral tegmental area neurons, and can interact with the mu opioid receptor.
Neuropharmacology 2017 Margolis EB, Fujita W, Devi LA, Fields HL -
Cortico-Accumbens Regulation of Approach-Avoidance Behavior Is Modified by Experience and Chronic Pain.
Cell reports 2017 Schwartz N, Miller C, Fields HL -
Mu Opioid Receptor Actions in the Lateral Habenula.
PloS one 2016 Margolis EB, Fields HL -
Ventral Pallidum Neurons Encode Incentive Value and Promote Cue-Elicited Instrumental Actions.
Neuron 2016 Richard JM, Ambroggi F, Janak PH, Fields HL -
Mu-opioid receptor activation in the medial shell of nucleus accumbens promotes alcohol consumption, self-administration and cue-induced reinstatement.
Neuropharmacology 2016 Richard JM, Fields HL -
Alterations in the rostral ventromedial medulla after the selective ablation of μ-opioid receptor expressing neurons.
Pain 2016 Harasawa I, Johansen JP, Fields HL, Porreca F, Meng ID -
Endogenous opioid activity in the anterior cingulate cortex is required for relief of pain.
The Journal of neuroscience : the official journal of the Society for Neuroscience 2015 Navratilova E, Xie JY, Meske D, Qu C, Morimura K, Okun A, Arakawa N, Ossipov M, Fields HL, Porreca F -
Understanding opioid reward.
Trends in neurosciences 2015 Fields HL, Margolis EB -
Direct bidirectional μ-opioid control of midbrain dopamine neurons.
The Journal of neuroscience : the official journal of the Society for Neuroscience 2014 Margolis EB, Hjelmstad GO, Fujita W, Fields HL -
Neuroscience. More pain; less gain.
Science (New York, N.Y.) 2014 Fields HL -
Parceling human accumbens into putative core and shell dissociates encoding of values for reward and pain.
The Journal of neuroscience : the official journal of the Society for Neuroscience 2013 Baliki MN, Mansour A, Baria AT, Huang L, Berger SE, Fields HL, Apkarian AV -
Capturing the aversive state of cephalic pain preclinically.
Annals of neurology 2013 De Felice M, Eyde N, Dodick D, Dussor GO, Ossipov MH, Fields HL, Porreca F -
Intra-VTA deltorphin, but not DPDPE, induces place preference in ethanol-drinking rats: distinct DOR-1 and DOR-2 mechanisms control ethanol consumption and reward.
Alcoholism, clinical and experimental research 2013 Mitchell JM, Margolis EB, Coker AR, Allen DC, Fields HL -
Catechol-O-methyltransferase genotype modulates opioid release in decision circuitry.
Clinical and translational science 2013 Mitchell JM, O'Neil JP, Jagust WJ, Fields HL -
Opioid modulation of ventral pallidal afferents to ventral tegmental area neurons.
The Journal of neuroscience : the official journal of the Society for Neuroscience 2013 Hjelmstad GO, Xia Y, Margolis EB, Fields HL -
Pain relief produces negative reinforcement through activation of mesolimbic reward-valuation circuitry.
Proceedings of the National Academy of Sciences of the United States of America 2012 Navratilova E, Xie JY, Okun A, Qu C, Eyde N, Ci S, Ossipov MH, King T, Fields HL, Porreca F -
Ventral tegmental area glutamate neurons: electrophysiological properties and projections.
The Journal of neuroscience : the official journal of the Society for Neuroscience 2012 Hnasko TS, Hjelmstad GO, Fields HL, Edwards RH -
Identification of rat ventral tegmental area GABAergic neurons.
PloS one 2012 Margolis EB, Toy B, Himmels P, Morales M, Fields HL -
Dopamine, corticostriatal connectivity, and intertemporal choice.
The Journal of neuroscience : the official journal of the Society for Neuroscience 2012 Kayser AS, Allen DC, Navarro-Cebrian A, Mitchell JM, Fields HL -
Corticostriatal functional connectivity predicts transition to chronic back pain.
Nature neuroscience 2012 Baliki MN, Petre B, Torbey S, Herrmann KM, Huang L, Schnitzer TJ, Fields HL, Apkarian AV -
Alcohol self-administration, anxiety, and cortisol levels predict changes in delta opioid receptor function in the ventral tegmental area.
Behavioral neuroscience 2012 Mitchell JM, Margolis EB, Coker AR, Fields HL -
Varenicline decreases alcohol consumption in heavy-drinking smokers.
Psychopharmacology 2012 Mitchell JM, Teague CH, Kayser AS, Bartlett SE, Fields HL -
Pain and the primary somatosensory cortex.
Pain 2012 Fields HL -
Alcohol consumption induces endogenous opioid release in the human orbitofrontal cortex and nucleus accumbens.
Science translational medicine 2012 Mitchell JM, O'Neil JP, Janabi M, Marks SM, Jagust WJ, Fields HL -
Prefrontal cortex mediates extinction of responding by two distinct neural mechanisms in accumbens shell.
The Journal of neuroscience : the official journal of the Society for Neuroscience 2012 Ghazizadeh A, Ambroggi F, Odean N, Fields HL -
Engagement of descending inhibition from the rostral ventromedial medulla protects against chronic neuropathic pain.
Pain 2011 De Felice M, Sanoja R, Wang R, Vera-Portocarrero L, Oyarzo J, King T, Ossipov MH, Vanderah TW, Lai J, Dussor GO, Fields HL, Price TJ, Porreca F -
A novel opioid receptor-mediated enhancement of GABAA receptor function induced by stress in ventral tegmental area neurons.
The Journal of physiology 2011 Margolis EB, Mitchell JM, Hjelmstad GO, Fields HL -
Nucleus accumbens medium spiny neurons target non-dopaminergic neurons in the ventral tegmental area.
The Journal of neuroscience : the official journal of the Society for Neuroscience 2011 Xia Y, Driscoll JR, Wilbrecht L, Margolis EB, Fields HL, Hjelmstad GO -
Interaction between family history of alcoholism and Locus of Control in the opioid regulation of impulsive responding under the influence of alcohol.
Alcoholism, clinical and experimental research 2011 Altamirano LJ, Fields HL, D'Esposito M, Boettiger CA -
Roles of nucleus accumbens core and shell in incentive-cue responding and behavioral inhibition.
The Journal of neuroscience : the official journal of the Society for Neuroscience 2011 Ambroggi F, Ghazizadeh A, Nicola SM, Fields HL -
Lesion of the rostral anterior cingulate cortex eliminates the aversiveness of spontaneous neuropathic pain following partial or complete axotomy.
Pain 2011 Qu C, King T, Okun A, Lai J, Fields HL, Porreca F -
The doctor's dilemma: opiate analgesics and chronic pain.
Neuron 2011 Fields HL -
Ask the experts: What has the establishment of multidisciplinary pain centers done to improve the management of chronic pain conditions?
Pain management 2011 Fields HL -
Reliability in the identification of midbrain dopamine neurons.
PloS one 2010 Margolis EB, Coker AR, Driscoll JR, Lemaître AI, Fields HL -
Isolating event-related neuronal responses by deconvolution.
Journal of neurophysiology 2010 Ghazizadeh A, Fields HL, Ambroggi F -
Reply: Is reflex sympathetic dystrophy/complex regional pain syndrome type I a small-fiber neuropathy?
Annals of neurology 2010 Oaklander AL, Fields HL -
Predicting value of pain and analgesia: nucleus accumbens response to noxious stimuli changes in the presence of chronic pain.
Neuron 2010 Baliki MN, Geha PY, Fields HL, Apkarian AV -
A pause in nucleus accumbens neuron firing is required to initiate and maintain feeding.
The Journal of neuroscience : the official journal of the Society for Neuroscience 2010 Krause M, German PW, Taha SA, Fields HL -
Unmasking the tonic-aversive state in neuropathic pain.
Nature neuroscience 2009 King T, Vera-Portocarrero L, Gutierrez T, Vanderah TW, Dussor G, Lai J, Fields HL, Porreca F -
Is reflex sympathetic dystrophy/complex regional pain syndrome type I a small-fiber neuropathy?
Annals of neurology 2009 Oaklander AL, Fields HL -
The rostromedial tegmental nucleus (RMTg), a GABAergic afferent to midbrain dopamine neurons, encodes aversive stimuli and inhibits motor responses.
Neuron 2009 Jhou TC, Fields HL, Baxter MG, Saper CB, Holland PC -
Now or Later? An fMRI study of the effects of endogenous opioid blockade on a decision-making network.
Pharmacology, biochemistry, and behavior 2009 Boettiger CA, Kelley EA, Mitchell JM, D'Esposito M, Fields HL -
Delta-opioid receptor expression in the ventral tegmental area protects against elevated alcohol consumption.
The Journal of neuroscience : the official journal of the Society for Neuroscience 2008 Margolis EB, Fields HL, Hjelmstad GO, Mitchell JM -
Naltrexone aversion and treatment efficacy are greatest in humans and rats that actively consume high levels of alcohol.
Neurobiology of disease 2008 Mitchell JM, Bergren LJ, Chen KS, Rowbotham MC, Fields HL -
Midbrain dopamine neurons: projection target determines action potential duration and dopamine D(2) receptor inhibition.
The Journal of neuroscience : the official journal of the Society for Neuroscience 2008 Margolis EB, Mitchell JM, Ishikawa J, Hjelmstad GO, Fields HL -
Basolateral amygdala neurons facilitate reward-seeking behavior by exciting nucleus accumbens neurons.
Neuron 2008 Ambroggi F, Ishikawa A, Fields HL, Nicola SM -
Dorsomedial prefrontal cortex contribution to behavioral and nucleus accumbens neuronal responses to incentive cues.
The Journal of neuroscience : the official journal of the Society for Neuroscience 2008 Ishikawa A, Ambroggi F, Nicola SM, Fields HL -
Immediate reward bias in humans: fronto-parietal networks and a role for the catechol-O-methyltransferase 158(Val/Val) genotype.
The Journal of neuroscience : the official journal of the Society for Neuroscience 2007 Boettiger CA, Mitchell JM, Tavares VC, Robertson M, Joslyn G, D'Esposito M, Fields HL -
Cue-evoked encoding of movement planning and execution in the rat nucleus accumbens.
The Journal of physiology 2007 Taha SA, Nicola SM, Fields HL -
Understanding how opioids contribute to reward and analgesia.
Regional anesthesia and pain medicine 2007 Fields HL -
Should we be reluctant to prescribe opioids for chronic non-malignant pain?
Pain 2007 Fields HL -
The Asp40 mu-opioid receptor allele does not predict naltrexone treatment efficacy in heavy drinkers.
Journal of clinical psychopharmacology 2007 Mitchell JM, Fields HL, White RL, Meadoff TM, Joslyn G, Rowbotham MC -
Ventral tegmental area neurons in learned appetitive behavior and positive reinforcement.
Annual review of neuroscience 2007 Fields HL, Hjelmstad GO, Margolis EB, Nicola SM -
Cholecystokinin is necessary for the expression of morphine conditioned place preference.
Pharmacology, biochemistry, and behavior 2006 Mitchell JM, Bergren LJ, Chen KS, Fields HL -
How prior reward experience biases exploratory movements: a probabilistic model.
Journal of neurophysiology 2006 German PW, Fields HL -
Rat nucleus accumbens neurons persistently encode locations associated with morphine reward.
Journal of neurophysiology 2006 German PW, Fields HL -
Endogenous opioid blockade and impulsive responding in alcoholics and healthy controls.
Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology 2006 Mitchell JM, Tavares VC, Fields HL, D'Esposito M, Boettiger CA -
The ventral tegmental area revisited: is there an electrophysiological marker for dopaminergic neurons?
The Journal of physiology 2006 Margolis EB, Lock H, Hjelmstad GO, Fields HL -
Endogenous opioids encode relative taste preference.
The European journal of neuroscience 2006 Taha SA, Norsted E, Lee LS, Lang PD, Lee BS, Woolley JD, Fields HL -
Isolating the modulatory effect of expectation on pain transmission: a functional magnetic resonance imaging study.
The Journal of neuroscience : the official journal of the Society for Neuroscience 2006 Keltner JR, Furst A, Fan C, Redfern R, Inglis B, Fields HL -
Orexin A in the VTA is critical for the induction of synaptic plasticity and behavioral sensitization to cocaine.
Neuron 2006 Borgland SL, Taha SA, Sarti F, Fields HL, Bonci A -
Kappa opioids selectively control dopaminergic neurons projecting to the prefrontal cortex.
Proceedings of the National Academy of Sciences of the United States of America 2006 Margolis EB, Lock H, Chefer VI, Shippenberg TS, Hjelmstad GO, Fields HL -
Inhibitions of nucleus accumbens neurons encode a gating signal for reward-directed behavior.
The Journal of neuroscience : the official journal of the Society for Neuroscience 2006 Taha SA, Fields HL -
Impulsive responding in alcoholics.
Alcoholism, clinical and experimental research 2005 Mitchell JM, Fields HL, D'Esposito M, Boettiger CA -
Treatment response in antidepressant-naïve postherpetic neuralgia patients: double-blind, randomized trial.
The journal of pain 2005 Rowbotham MC, Reisner LA, Davies PS, Fields HL -
A single injection of the kappa opioid antagonist norbinaltorphimine increases ethanol consumption in rats.
Psychopharmacology 2005 Mitchell JM, Liang MT, Fields HL -
Fibromyalgia from the perspective of neuropathic pain.
The Journal of rheumatology. Supplement 2005 Dworkin RH, Fields HL -
Encoding of palatability and appetitive behaviors by distinct neuronal populations in the nucleus accumbens.
The Journal of neuroscience : the official journal of the Society for Neuroscience 2005 Taha SA, Fields HL -
Both kappa and mu opioid agonists inhibit glutamatergic input to ventral tegmental area neurons.
Journal of neurophysiology 2004 Margolis EB, Hjelmstad GO, Bonci A, Fields HL -
Dissociation of the role of nucleus accumbens dopamine in responding to reward-predictive cues and waiting for reward.
Behavioural brain research 2004 Wakabayashi KT, Fields HL, Nicola SM -
Contrasting effects of dopamine and glutamate receptor antagonist injection in the nucleus accumbens suggest a neural mechanism underlying cue-evoked goal-directed behavior.
The European journal of neuroscience 2004 Yun IA, Nicola SM, Fields HL -
State-dependent opioid control of pain.
Nature reviews. Neuroscience 2004 Fields H -
A single cocaine exposure enhances both opioid reward and aversion through a ventral tegmental area-dependent mechanism.
Proceedings of the National Academy of Sciences of the United States of America 2004 Kim JA, Pollak KA, Hjelmstad GO, Fields HL -
The ventral tegmental area is required for the behavioral and nucleus accumbens neuronal firing responses to incentive cues.
The Journal of neuroscience : the official journal of the Society for Neuroscience 2004 Yun IA, Wakabayashi KT, Fields HL, Nicola SM -
Glutamatergic activation of anterior cingulate cortex produces an aversive teaching signal.
Nature neuroscience 2004 Johansen JP, Fields HL -
Local application of the cannabinoid receptor agonist, WIN 55,212-2, to spinal trigeminal nucleus caudalis differentially affects nociceptive and non-nociceptive neurons.
Pain 2004 Papanastassiou AM, Fields HL, Meng ID -
Cue-evoked firing of nucleus accumbens neurons encodes motivational significance during a discriminative stimulus task.
Journal of neurophysiology 2003 Nicola SM, Yun IA, Wakabayashi KT, Fields HL -
Firing of nucleus accumbens neurons during the consummatory phase of a discriminative stimulus task depends on previous reward predictive cues.
Journal of neurophysiology 2003 Nicola SM, Yun IA, Wakabayashi KT, Fields HL -
Peptidergic nociceptors of both trigeminal and dorsal root ganglia express serotonin 1D receptors: implications for the selective antimigraine action of triptans.
The Journal of neuroscience : the official journal of the Society for Neuroscience 2003 Potrebic S, Ahn AH, Skinner K, Fields HL, Basbaum AI -
Kappa-opioid agonists directly inhibit midbrain dopaminergic neurons.
The Journal of neuroscience : the official journal of the Society for Neuroscience 2003 Margolis EB, Hjelmstad GO, Bonci A, Fields HL -
Kappa opioid receptor activation in the nucleus accumbens inhibits glutamate and GABA release through different mechanisms.
Journal of neurophysiology 2003 Hjelmstad GO, Fields HL -
Capsaicin evoked pain and allodynia in post-herpetic neuralgia.
Pain 2000 Petersen KL, Fields HL, Brennum J, Sandroni P, Rowbotham MC -
Pain: an unpleasant topic.
Pain 1999 Fields HL -
Comments on Thurston and Randich.
Pain 1996 Fields HL, Heinricher MM -
Do benzodiazepines have a role in chronic pain management?
Pain 1994 Dellemijn PLI, Fields HL -
Activity of nociceptive modulatory neurons in the rostral ventromedial medulla associated with volume expansion-induced antinociception.
Pain 1993 Morgan MM, Fields HL -
Treatment of inflammatory, neuropathic and sympathetically maintained pain in a patient with Sjögren's syndrome.
Pain 1992 Galer BS, Rowbotham MC, Miller KV, Walton A, Fields HL -
Post-herpetic neuralgia: the relation of pain complaint, sensory disturbance, and skin temperature.
Pain 1989 Rowbotham MC, Fields HL -
Topical lidocaine reduces pain in post-herpetic neuralgia.
Pain 1989 Rowbotham MC, Fields HL -
Can opiates relieve neuropathic pain?
Pain 1988 Fields HL -
Sources of variability in the sensation of pain.
Pain 1988 Fields HL -
Synergy between the antinociceptive effects of intrathecal clonidine and systemic morphine in the rat.
Pain 1988 Drasner K, Fields HL -
Potentiation of morphine antinociception by monoamine reuptake inhibitors in the rat spinal cord.
Pain 1985 Taiwo YO, Fabian A, Pazoles CJ, Fields HL -
Naloxone fails to antagonize nitrous oxide analgesia for clinical pain.
Pain 1982 Levine JD, Gordon NC, Fields HL -
Analgesic responses to morphine and placebo in individuals with postoperative pain.
Pain 1981 Levine JD, Gordon NC, Smith R, Fields HL