MGH McLean Adult Psychiatry Residency Program

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McLean Hospital researchers are reporting that xenon gas, used in humans for anesthesia and diagnostic imaging, has the potential to be a treatment for post-traumatic stress disorder (PTSD) and other memory-related disorders.

“In our study, we found that xenon gas has the capability of reducing memories of traumatic events,” said Edward G. Meloni, PhD, assistant psychologist at McLean Hospital and an assistant professor of Psychiatry at Harvard Medical School. “It’s an exciting breakthrough, as this has the potential to be a new treatment for individuals suffering from PTSD.”

In the study, published in the a recent issue of PLOS ONE, Meloni, and Marc J. Kaufman, PhD, director of the McLean Hospital Translational Imaging Laboratory, examined whether a low concentration of xenon gas could interfere with a process called reconsolidation – a state in which reactivated memories become susceptible to modification. "We know from previous research that each time an emotional memory is recalled, the brain actually restores it as if it were a new memory. With this knowledge, we decided to see whether we could alter the process by introducing xenon gas immediately after a fear memory was reactivated,” explained Meloni.

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Michael Rohan, a physicist at McLean Hospital’s Brain Imaging Center, demonstrated the low-field magnetic stimulation (LFMS) device he developed.

Individuals with major depressive disorder or bipolar disorder who receive low-field magnetic stimulation (LFMS) show immediate and substantial mood improvement, McLean Hospital researchers report in the Aug. 1 issue of Biological Psychiatry.

“LFMS is unlike any current treatment. It uses magnetic fields that are a fraction of the strength but at a higher frequency than the electromagnetic fields used in TMS [transcranial magnetic stimulation] and ECT [electroconvulsive therapy],” explained first author Harvard Medical School.

According to Rohan, although other brain stimulation treatments like ECT and TMS are often effective for the treatment of depression, they typically take longer to impact mood, and ECT is associated with side effects such as memory loss. Similarly, while antidepressant medications can be highly effective for treating depression, it can take between four to six weeks before mood changes are detected.

“Importantly, LFMS appears to have an immediate effect on mood and thus has the potential to provide relief in emergency situations,” explained Rohan, who first reported the potential use of LFMS to treat depression in a groundbreaking study in 2004. “In addition to providing quick relief from symptoms, the other exciting piece about LFMS is that no side effects have been observed.”

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National Depression Screening Day has been taking place since 1991 and is designed to screen those who may be suffering from depression but not know it. Participants fill out an anonymous questionnaire and, depending on their answers, are referred to mental health professionals for follow-up.

The screenings are given at colleges, workplaces, community-based organizations and military installations and will be available on line at the organization’s special web site, www.HelpYourselfHelpOthers.org. The website also lists local sites where screenings will be given.

A study done in 2009 showed that depression screenings are effective in connecting at-risk individuals with treatment. It showed that 55 percent of those who completed the screening online and who agreed to take part in a follow-up survey sought depression treatment within three months.

While McLean has held screening events in the past, this is the first time the hospital will be co-sponsoring the national event and will publicizing it via social media, including Facebook and Twitter.

The questionnaire allows individuals to screen themselves, in an anonymous way, for mood and anxiety disorders, eating disorders and alcohol use disorders. The online screenings provide an assessment of the user’s mental health, information on whether the user’s results are consistent with a mental health disorder, an overview of signs and symptoms of treatable disorders and help getting access to local treatment options.

More than 700 colleges and over 300 community-based organizations participate, resulting in more than 120,000 screenings each year.

If you or a loved one is experiencing suicidal thoughts, please reach out to the National Suicide Prevention Lifeline at 1.800.273.TALK (8255) or a mental health professional.

Article content sourced from a McLean Hospital press release. Image source: Recovery Friendly Taos.

Image Source: drjanet.tv

A gene essential for normal brain development, and also linked to autism spectrum disorders, plays a critical role in addiction-related behaviors, according to Harvard Medical School investigators at McLean Hospital.

“Chronic exposure to drugs of abuse causes changes in the brain that could underlie the transition from casual drug use to addiction. By discovering the brain molecules that control the development of drug addiction, we hope to identify new treatment approaches,” Cowan said.

The Cowan lab team, led by Laura Smith, HMS research fellow in psychiatry at McLean, used animal models to show that the fragile X mental retardation protein, or FMRP, plays a critical role in the development of addiction-related behaviors.

[The findings were published in the latest issue of the neuroscience journal Neuron. (more…)

Joan Camprodon, MD, MPH, PhD (Class of 2012), demonstrates the use of TMS on Amanda Arulpragasam, MGH Research Assistant

For patients suffering from depression, the Massachusetts General Hospital Department of Psychiatry now offers another treatment option – a new clinic based in Charlestown that uses transcranial magnetic stimulation (TMS). The clinic is part of a broader effort that includes a research enterprise program, both led by Joan Camprodon, MD, MPH, PhD, (Class of 2012) director of the Laboratory for Neuropsychiatry and Neuromodulation at Mass General. Dr. Camprodon’s team aims to understand how the brain’s structure and function affect disease and how interventions such as TMS can change the mechanisms that contribute to disease.

During a TMS procedure, focused magnetic impulses are directed to the brain. The electrical currents produced stimulate nerve cells involved in mood regulation that may be underactive in diseases such as depression. By restoring the equilibrium, TMS helps reset this imbalance of chemicals. from a diseased brain to a healthy one.

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The Jonathan F. Borus Outstanding Early Career Educator Award in medical student education has been awarded since 2011 to a junior faculty member at Harvard Medical School who has demonstrated exceptional promise, initiative and commitment in the area of psychiatric education. The award is named in honor of Jonathan F. Borus MD, the Stanley Cobb Distinguished Professor of Psychiatry, Emeritus Chair of Psychiatry at the Brigham and Women’s and Faulkner Hospitals, Director of Medical Education at BWH and Co-Chair of the Partners Education Committee, who has exerted a major and lasting impact on psychiatric undergraduate and graduate education. In addition to being a master educator and educational leader, Borus is known widely for his generous mentorship and outspoken advocacy for generations of trainees who themselves have made important contributions to medical education.

Joseph Stoklosa (pictured above, Class of 2011), psychiatrist in charge of McLean’s Psychotic Disorders Unit, has been selected by the Harvard Medical School (HMS) Psychiatry Executive Committee as the 2014 co-recipient of the Jonathan F. Borus Early Outstanding Early Educator Award.

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Oligodendrocytes (green) wrap electrical insulation called myelin around axons (purple). Image courtesy of Alan Hoofring, Medical Arts Design Section, NIH.

Schizophrenia is one of the most disabling of all psychiatric illnesses. Sadly, it affects is about 1% of the global population and often strikes early in life.

Many studies have looked into causes and potential interventions, and it has been long known that genetic factors play a role in determining the risk of developing schizophrenia. However, recent work has shown that there no single gene or small number of genes explains much of the risk for illness. Instead, groups of genes interact to create the illness.

In a new paper published in PLOS ONE (DOI: 10.1371/journal.pone.0089441), MGH/McLean Adult Psychiatry Residency Program faculty Bruce M. Cohen, MD, PhD, Dost Ongur, MD, PhD (Class of 2004), and Jordan W. Smoller, MD, ScD, report promising evidence on what one of those important groups of genes may be.

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Harvard researcher David Ludwig has linked low blood glucose levels with high activation of the nucleus accumbens, a brain region specifically involved in reward and craving, known addictive behaviors. Using fMRI analysis, his team found that the glycemic load of foods, not caloric intake, significantly alters brain function, promoting hunger and overeating, behaviors related to substance abuse and dependence.

Read the full article on the Harvard Medical School website.

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Does religious belief have anything to do with psychiatric treatment outcomes? Recent research by David Rosmarin of McLean Hospital suggests that the level of a patient's belief in God may have influence on the likelihood of treatment response.

By asking 159 patients in a day-treatment program the question "To what extent do you believe in God or a Higher Power?" Rosmarin found that those who answered "Very" or "Moderately" were more likely to respond to treatment than patients who expressed lesser religious belief. This relationship is believed to be mediated by a greater expectancy of treatment success: greater belief in God was correlated to greater belief in credibility of treatment and expectation of treatment efficacy.

Further reading available here. The published journal article can be found here.

A. Edin Evins, MD, Director of Center for Addiction Medicine at MGH and Staci Gruber, PhD, Director of the Cognitive and Clinical Neuroimaging Core at McLean Hospital, were quoted in a recent New York Times article concerning recent changes in the legality of marijuana.

Speaking about the potential risks involved in Washington and Colorado's recent legalization of marijuana for public use, Dr. Evins warned that “Before we unleash the powers of the marketplace to woo people to use this addictive substance, we need to better understand who is at risk. Once moneyed interests are involved, this trend will be difficult to reverse."

Dr. Gruber addressed the dangers of marijuana use in teens and young adults, whose brains are still developing. “The frontal cortex is the last part of the brain to come online, and the most important,” said Dr. Gruber. “Early exposure perhaps changes the trajectory of brain development, such that ability to perform complex executive function tasks is compromised.”

The full story, which appeared in the January 8, 2013 edition of the NY Times, is available here.