Clinical Psychobiology
Jack M. Gorman, M.D.,
Director
Anissa Abi-Dargham, M.D., Psychiatrist
II
Dolores Malaspina, M.D., Psychiatrist
II
Laszlo A. Papp, M.D., Psychiatrist
II
Xavier Amador, Ph.D., Research
Scientist IV
Jeremy Coplan, M.D., Psychiatrist
I
The Anxiety Disorders Research Program within the Department of Clinical Psychobiology, under the leadership of Drs. Laszlo Papp, Jeremy Coplan, and Jack Gorman, has expanded significantly during the reporting period. The research team received several new grants, added new staff, and developed a series of collaborative projects. Current performance sites for the Anxiety Program include the Biological Studies Unit (BSU) at PI, the Phobia Clinic of North-Shore LIJ Health System, neuroscience laboratories of NYU, outpatient clinics of the Cornell campus, and animal facilities of Downstate Medical Center, in addition to several clinical departments and basic laboratories within PI and New York Presbyterian Hospital.
Aided by the recently awarded "Core Grants for Enhancing Neuroscience Translation" grant (CoGent) to Dr. Gorman, the BSU core (core Principal Investigator, Dr. Papp) is able to support a series of pilot projects in addition to providing logistical support to its core grants in mood and anxiety disorders. BSU infrastructure support includes the maintenance of five subject rooms, an examination room and two control rooms on the third floor of PI, the availability of state-of- the-art psychophysiology equipment such as a fully functional respiratory laboratory, ambulatory monitors of cardio-pulmonary functions, and all the facilities needed for collecting and storing biological specimens.
Treatment Studies
Our NIMH Multicenter Panic Treatment project (Principal Investigator, Dr. Gorman), investigating the long-term effects of a treatment paradigm consisting of cognitive behavioral therapy (CBT) followed by maintenance CBT, no treatment or a medication algorithm, is in its second phase. Our four-year, Late-life Anxiety Treatment project (Principal Investigator, Dr. Papp), also sponsored by NIMH, using CBT for elderly anxious patients who remain symptomatic in spite of pharmacotherapy, has been completed this year. One of the most consistent findings of these treatment trials is that cognitive behavioral therapies represent a powerful alternative to pharmacological interventions and in many instances should be the preferred approach over medications. Dr. Papp received an Independent Investigator award from NARSAD to study treatment strategies for elderly patients who suffer from co-morbid anxiety and depression. Again, a first-line CBT approach followed by a medication algorithm seems most promising in this population. Dr. Marc Kleber received PIRSG funding to examine the relationship among personality, life events, and relapse in patients with panic disorder. Dr. Jan Mohlman, a fellow in geriatrics, is studying the efficacy of CBT augmented with learning aids in anxious older adults and the impact of executive dysfunction on therapy outcome.
An NIMH-sponsored longitudinal treatment study of panic disorder (Principal Investigator, Dr. Gorman) is underway to examine the predictors and psychophysiological concomitants of relapse following successful treatment. We have reported the benefits and risks of nefazodone treatment in panic disorder (Principal Investigator, Dr. Papp) and are in the middle of a promising trial of venlafaxine in late-life anxiety disorders (Principal Investigator, Dr. Papp). The efficacy of citalopram will be tested for Irritable Bowel Syndrome (Principal Investigator, Dr. Coplan).
Neuroimaging/Neurobiology
In collaboration with the Division of Functional Brain Mapping, Drs. Justine Kent and Jeremy Coplan have been investigating potential abnormalities of cerebral blood flow in panic disorder. They are also using neuroreceptor imaging techniques to study the serotonin system in social anxiety and generalized anxiety disorders. Dr. David Gutman, a first year fellow, in collaboration with Dr. Joy Hirsch, is piloting a cognitive stimulus for a fMRI study of neural networks involved in fear and anxiety and, with the help of Dr. Elizabeth Phelps, he is evaluating the role of fear conditioning in the pathophysiology of anxiety disorders. Dr. Sanjay Mathew, an incoming fellow, has begun a primate neuroimaging study with Dr. Coplan. His PIRSG-funded study measures differences in hippocampal and other brain region function between adversely and non-stressfully reared monkeys. The role of the thyroid system in depression is the subject of an ongoing NIH study (Principal Investigator, Dr. Gorman). Drs. Gorman and Gregory Sullivan are examining the relationship of a thyroid transport protein to brain thyroid hormone levels and HPA hormone activity. Dr. Sullivan, working with Dr. Joseph LeDoux at NYU, developed a novel model of anxious behavior in the rat. He presented his work at the annual meeting of the American College of Neuropsychopharmacology this year. Dr. Jeremy Coplan took on new responsibilities at SUNY Downstate but continued his exciting work at the BSU. He received NIH funding to study adverse early rearing and glutamatergic function in non-human primates and continues his investigations of the effects of novel compounds on differentially reared groups of monkeys. Dr. Janet Fairbanks continued her work with children of patients with anxiety disorders. Her complex behavioral paradigms are combined with sophisticated tests of respiratory function.
K Awards from NIMH provided continued support to Drs. Gorman, Papp, and Fairbanks and a new, two-year Junior Faculty Research Award was granted to Dr. Gregory Sullivan. Dr Justine Kent was this year's recipient of the ACNP/ADAA Career Development Award.
The Schizophrenia Research program under the direction of Drs. Jack Gorman, Dolores Malaspina, and Anissa Abi-Dargham continued its growth this year. The research in schizophrenia is supported in part by two large Centers, the NIMH-funded MHCRC in Schizophrenia Studies and the Lieber Center for Schizophrenia Research, both headed by Dr. Gorman.
Diagnosis and Treatment (Drs. Amador, Bruder, Harkavy Friedman, and Printz)
Drs. David Printz and Laurie Stricks continue the growth and development of the Bipolar Disorders Research Clinic (BDRC). The BDRC conducted several research projects this year including a collaboration with Dr. Martha Morrell of the Columbia Epilepsy Center looking at the impact of anti-convulsants on the neuroendocrine and reproductive functioning in bipolar women. The BDRC also conducted outpatient industry-sponsored clinical trials with olanzapine and ziprasadone. The Schizophrenia Research Clinic (SRC) run by Drs. Anissa-Abi-Dargham and Roberto Gil, supported by the Lieber Center continued its growth with implementation of an "umbrella" research protocol which provides standard research assessments for all clinic patients, thus reducing duplication of effort by other SRC studies. SRC patients participated in a wide variety of research, including PET and SPECT studies.
Brain Imaging (Drs. Laruelle, Abi-Dargham, Kegeles, and Malaspina)
In 2000, the Brain Imaging Research Core of the MHCRC continued its progress on developing new imaging technologies for use in schizophrenia research. Dr. Anissa Abi-Dargham and colleagues published a study looking at 13 medication-free subjects with schizophrenia (five of which were neuroleptic naive) and nine match controls and found a small but significant increase in D1 receptor binding in both the dorsolateral prefrontal cortex (DLPFC) and the midbrain. This study was conducted using a new PET ligand NNC-112 that was developed by the Lieber Center PET chemistry laboratory.
Neurodevelopmental and Genetic Epidemiology (Drs. Susser, Brown, and Malaspina)
Dr. Dolores Malaspina continues her work on the Jerusalem Perination Cohort Study in Schizphrenia. During this year, the NIMH awarded Dr. Malaspina a supplement to the JPCSS grant to collect genetic material from the schizophrenia subjects in the cohort. Dr. Malaspina and colleagues also presented findings from the JPCSS of a relationship between father's age at conception and risk for schizophrenia in his offspring. Dr. Alan Brown was the lead author on a paper showing that in a rubella-exposed cohort, cohort subjects had a markedly increased risk of schizophrenia spectrum disorders and the rubella-exposed subjects who developed schizophrenia spectrum psychosis (SSP) had a decline in IQ from childhood to adolescence and increased premorbid neuromotor and behavioral abnormalities when compared to cohort members without SSP.
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Dr. Jack
Gorman presenting at the Psychiatric Institute Annual Scientific
Conference
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Dr. Anissa Abi-Dargham
conferring with
Dr. Roberto Gil
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