Research StudiesActive Research Studies Prevalence of Thalamocortical Dysrhythmia in a General Psychiatric Population Research Studies Under Development Electrophysiologic Markers of Depression in an Adolescent Population Planned Research Studies Early Separation of Parents and their Newborns Reunited when the Children are of School Age
Active Research Studies
Prevalence of Thalamocortical Dysrhythmia in a General Psychiatric Population The presence of abnormal slow wave activity in the thalamus has been demonstrated and associated with a variety of neuropsychiatric conditions including OCD, depression, and schizoaffective disorder. The MIPC is in the process of publishing studies of schizoaffective disorders and OCD cases showing symptoms that are associated with the thalamic abnormality. This has the potential to offer a major detection and discrimination capability with respect to severe mental illness of all major types. One limitation of the thalmocortical dysrhythmia studies is their reliance on the magnetoencephalogram (MEG). Because there are few enough MEGs available in research institutions, much less in general clinical practice, we are comparing the effectiveness of scalp EEG abnormalities to MEG source localization. If, in fact, the inexpensive software methods of QEEG is sufficiently accurate to localize the source of the abnormality, this could make the diagnostic search and discrimination of psychiatirc abnormalities much more practical. A new cohort of psychotic patients consisting primarily of those diagnosed as schizophrenic, but also including depressive psychoses and alcoholic psychoses was analyzed. The clustering algorithm described above held up in this new cohort of patients. It was of great interest that the alcoholic and depressive psychoses were found in each of the six clusters along with the schizophrenics. It would appear from this study that some of the electrophysiologic characteristics of psychoses are consistent across the board and are not restricted to the group of schizophrenias. This study was not financially supported by MIPC.
A cohort of prodromal cases is being obtained, evaluated, and followed. We are searching for pathophysiologic markers that precede decompensation. Data obtained in New Zealand and Australia indicate that the early detection of prodromal symptoms treated with low-dose neuroleptic drugs can prevent the onset of psychotic disorders. This extremely important finding needs to be replicated in a larger cohort and in different genetic pools as well. While the Center has raised funds to initiate this study, funds are needed to complete the study. Should the psychopharmaological approach to prevention of adolescent onset of psychosis be successful, the second task of this program will be to implement a similar study using non-medication interventions. The third hypothesis to be tested in the overall prodromal study program is the efficacy of combined therapeutic approaches:
Individuals determined to be at high-risk for psychosis (because of a positive family history) will be evaluated for biomarkers. In addition, age, sex, and ethnic matched low-risk controls (with no family history), will also be screened. All subjects are followed-up clinically every two months for signs of illness. On an annual basis, all biological evaluations are repeated. Those who develop a psychotic illness after a two-year period will be compared with those who do not. It is hoped that this study will determine whether changes in brain structure and function occur in a prodromal phase prior to the onset of illness.
Subtyping of Chronic Schizophrenia Electrophysiologic studies of chronic schizophrenia found that they could be clustered into six groups. One group was more responsive to haloperidol, and a second to risperidone. These datea are being reanalyzed with 3D source localization to determine the source of the scalp abnormalities. It is expected that this clustering algorithm will contribute to a biologic classification of the schizophrenia. A new cohort of psychotic patients consisting primarily of those diagnosed as schizophrenic, but also including depressive psychoses and alcoholic psychoses was analyzed. The clustering algorithm described above held up in this new cohort of patients. It was of great interest that the alcoholic and depressive psychoses were found in each of the six clusters along with the schizophrenics. It would appear from this study that some of the electrophysiologic characteristics of psychoses are consistent across the board and are not restricted to the group of schizophrenias. This study was not financially supported by MIPC.
Israeli Draftee (First-break Schizophrenia) The MIPC has obtained the funds to make electrophysiologic equipment available to our Tel Aviv research associates in order to add electrophysiology and three-dimensional source localization to their current program. They will study Army draftees who decompensated shortly after having been medically cleared as fit to serve. Equipment has been purchased by MIPC and shipped to Tel Aviv to begin to collect data. Data collection was started in March 2006.
External Counter Pulsation in Dementia A study has been started in Germany on the effect of external counter pulsation on Alzheimer patients. Hopefully, this study will demonstrate the safety and possible effectiveness of the intervention in a dementia population. The MIPC wants to utilize the techniques in vascular dementia, which group is the most likely to benefit.
Dr. Jan Volavka has devoted much of his professional career to the study of aggression. Recently, he and Stephen Ginsberg have been utilizing a mouse model of aggression. The MIPC has raised money to support a genetic analysis of the mice who show this behavior.
Whenever protocols have been attempted concerning the early detection and identification of individuals at risk for psychiatric disorders, there are ethical questions as to whether the identification may constitute labeling and lead to stigma.
Research Studies Under Development
Electrophysiologic Markers of Depression in an Adolescent Population Permission is being sought to screen high school students to identify those who may be at risk for depression. The problem of early detection of adolescent onset of depression is inadequately met by present resources, techniques, and approaches.
Permission is being sought to screen high school students for prodromal symptoms associated with higher risk for psychotic decompensation. This study will supplement the prodromal study that is ongoing.
Planned Research Studies
Early Separation of Parents and their Newborns Reunited when the Children are of School Age This is a study of school age Chinese children reunited with their biologic mothers after having been sent away shortly after birth. The separation, while voluntary on the part of their mother, was nevertheless a source of trauma for the child. A variety of developmental, cognitive, and physiologic variables will be studied as a function of infant age at the time of separation.
The Effect of Prenatal Stress on the Offspring A large group of pregnant Turkish women were victims of an earthquake some years ago. The fetal age at the time of the stress is easily determined. We propose to study these preteens in terms of developmental lags and/or abnormalities correlated to fetal age at the time of the stress.
Post-Traumatic Stress Disorder: Moderating the Effects of Terror Several programs are under development. The tragic events of 9/11, the war in Iraq, and the increasing frequency of global terrorism have caused many people to experience a post traumatic stress disorder. Traumas of this severity have had a detrimental effect on the emotional and functional stability of many people. In the long-term, prevention is the only answer. Over the short-term, there are a number of tools that we are developing to help rehabilitate victims of this disorder. Close to home, we are experienced in moderating the effects of New Yorkers, post 9/11. And we are eager to help in the rehabilitation of our home-coming soldiers, as well as help implement prevention programs for our troops in the field. The first is being developed at the request of Russia, which had had extensive exposure to terrorism in the last few years. In 2002, some 50 Chechen rebels seized a Moscow theater, taking about 800 hostages. After a three-day siege, Russian forces stormed the building using gas, killing most of the rebels and 120 hostages. Last September, schoolchildren at Beslan's Middle School No. 1 and their teachers and parents were held captive for three days by terrorists. At least 340 people were killed, half of them children, and 700 injured when a bomb was detonated, causing the gymnasium roof to collapse and sparking a firefight. Valery N. Krasnov, M.D., director of the Moscow Research Institute of Psychiatry and president of the Russian Society of Psychiatrists, asked Cancro, "as one of the leaders in modern psychiatry and spychosocial rehabilitation," to help initiate a trans-insititutional center of psychological and psychiatric care fot he victims of terrorist attacks and other emergencies. An affiliation is being arranged with the Moscow Research Institute to create a Center for Stress Disorders. The goal is to establish an ongoing partnership that will lead to the development of common approaches to treatment and rehabilitation of victims of terrorist attacks and other emergencies. Included in the partnership will be development of cross-cultural assessment and intervention tools, training of specialists, development of educational materials, and joint scientific research. |