MGH McLean Adult Psychiatry Residency Program

It is my pleasure to welcome Kerry J. Ressler, MD, PhD, to the McLean community. Dr. Ressler will assume the roles of Chief Scientific Officer and Chief of the Depression and Anxiety Disorders Division, effective August 1, 2015. He will also hold the Patricia and James Poitras Endowed Chair in Psychiatry at McLean Hospital, thanks to a generous gift from longtime hospital supporters Patricia and James Poitras.

As McLean’s Chief Scientific Officer, Dr. Ressler will oversee the hospital’s comprehensive research enterprise, enhancing the breadth and depth of the scientific portfolio, promoting research collaborations, and advancing a vision for improved lab facilities. As McLean’s inaugural Chief of the Depression and Anxiety Disorders Division, he will work to improve communication across clinical operations, while working with researchers with an interest in depression and anxiety to identify greater opportunities to collaborate with their colleagues throughout the hospital and across translational and clinical research programs. A formal Division launch event will be planned for the fall.

Dr. Ressler, a Howard Hughes Medical Institute investigator, comes to Belmont from the Emory University School of Medicine and Yerkes Research Center in Atlanta where, since 2001, he has been investigating the molecular and cellular mechanisms of fear learning and the process of extinction of fear. The primary objective of his work is to use the power of molecular genetics to understand the molecular biology, neural circuitry and behavioral biology of fear and recovery from fear in animal models and human patients.

Also a practicing psychiatrist, Dr. Ressler’s primary interest is in translational and clinical research on fear-related psychiatric disorders, with a focus on post-traumatic stress disorder (PTSD). His hope is that understanding how fear works in the mammalian brain in a laboratory setting will someday translate into improved treatment and prevention for disorders such as PTSD, phobias, panic and other anxiety disorders.

In addition to Dr. Ressler’s clinical and research work, his academic qualifications are broad, numerous and well recognized. He has more than 200 peer-reviewed publications, including a number of articles in high-profile journals including Nature, Cell, Nature Neuroscience, Neuron, and the Journal of the American Medical Association.

Dr. Ressler is President-Elect of the Society for Biological Psychiatry and Chair of the Scientific Advisory Board of the Anxiety and Depression Association of America. He is also a member of the Institute of Medicine, a Fellow of the American College of Neuropsychopharmacology, and a member of the Board of Scientific Counselors for the National Institute of Mental Health. He has served on numerous NIH study sections and serves on the editorial boards of several journals, including Biological Psychiatry and Neuropsychopharmacology, and Depression and Anxiety.

Dr. Ressler holds a degree in molecular biology from the Massachusetts Institute of Technology and earned his PhD in neuroscience from Harvard University and his medical degree from Harvard Medical School. He completed his residency training at Emory University School of Medicine in Atlanta, Georgia. As a faculty member at Emory, he was previously Interim Director of the Emory Medical Scientist Training Program (MSTP), a member of the Executive Committee of the Emory Neuroscience Graduate Program, and Director of the Emory Psychiatry Residency Research Program.

As we welcome Dr. Ressler, I would also like to take a moment to thank Joseph Coyle, MD, for serving as our first CSO. His leadership has provided critical support and mentorship for young researchers and has helped us to recruit and retain future generations of leaders in the field. Although he is stepping down as CSO, Dr. Coyle will continue to be an active member of our research community, leading the Molecular Psychiatry Research Laboratory and holding the Eben S. Draper Chair in Psychiatry and Neuroscience at Harvard Medical School.

Please join me in welcoming Dr. Ressler to McLean and thanking Dr. Coyle for his leadership within our research community. A welcome reception for Dr. Ressler will be planned for this fall.

Scott L. Rauch, MD

Dr. Rauch's letter was originally published in the August 3rd edition of the McLean News

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.

President Obama's announcement of the BRAIN Initiative earlier this year brought public attention to key the questions of cognitive neuroscience, understand how brain activity leads to perception, decision making and behavior; and ultimately, use this knowledge to provide more effective treatments for debilitating diseases.

A new paper published in the current issue of Neuron, McLean Hospital and Harvard Medical School researchers report that increased activity in the medial prefrontal cortex (mPFC) of the brain is linked to decreased activity in the amygdala, the portion of the brain used in the creation of memories of events that scared those exposed.

According to author Vadim Bolshakov, PhD, director of the Cellular Neurobiology Laboratory at McLean and professor at Harvard Medical School, this finding is significant in that it could lead to better methods to prevent PTSD.

"A single exposure to something traumatic or scary can be enough to create a fear memory--causing someone to expect and be afraid in similar situations in the future," said Bolshakov. "What we're seeing is that we may one day be able to prevent those fear memories."

Bolshakov and his colleagues tested their theory using animal models. Dividing the mice into two groups, some were taught to fear an auditory stimulus while in others fear memory was extinguished Increased activation of mPFC in extinguished animals led to inhibition of the amygdala and significant decreases in fear responses.

"For example, if a sound ended with an extremely loud shriek, a subject would come to expect that scary noise at the end of the sound," explained Bolshakov. "What we found was when we suppressed the fear memory by decreasing activity in the amygdala, the subjects were not afraid of the end of the auditory stimulus any longer."

Bolshakov notes that this work could have serious implications for the treatment of a number of conditions including PTSD.

"While there is still a great deal of research that needs to be done before our work can be translated to clinical trials, what we are showing has the potential to ensure that individuals exposed to trauma were not haunted by the conditions surrounding their initial stressor."

Adapted from a McLean Hospital news release.

The MGH/McLean Adult Psychiatry Residency is committed to fostering the research aspirations of promising psychiatric scientists. While our NIMH-funded Research Concentration Program provides support to residents during clinical training, a critical time for a researcher's career is immediately following their residency, before they have received extramural funding (e.g. a NIH Career Development, or K, Award). But as a newly announced fellowship shows, this crucial "bridge" period is increasingly well-supported by a range of opportunities for MGH/McLean residents.

On November 18th, the Stanley Center for Psychiatric Research, which is part of the Broad Institute of Harvard and MIT, announced a new post-graduate residency research fellowship exclusively available to MGH/McLean residents. The Stanley Center Fellowship for Psychiatric Genetics and Neuroscience will provide one to two years of post-residency salary support, representing at least 70% effort, for recently graduated residents beginning careers in psychiatric research. The effort represents a new partnership between the residency and the Stanley Center, which is directed by Steve Hyman, MD, a former McLean resident who later served as head of NIMH and then Harvard Provost, before taking on the Stanley Center post. Read the full announcement for this award here.

This new fellowship joins a host of other research opportunities available to MGH/McLean residents during their PGY5 and PGY6 years. (more…)

Joseph T. Coyle, MD, will assume the role of Chief Scientific Officer (CSO) for McLean Hospital, effective immediately. In this newly created position, Dr. Coyle will play the principal leadership role with regard to McLean’s research mission. Dr. Coyle’s leadership experience and extensive academic accomplishments make him a superb choice to serve as the CSO. His leadership will help to provide critical support and mentorship for young researchers, and enable us to even more effectively recruit and retain tomorrow’s leaders in psychiatry and neuroscience research. Importantly, the CSO will also oversee research administration at McLean, working closely with Director, Raquel Espinosa, and play a critical role at the interface with Partners Health Care and Harvard Medical School, along with McLean's CAO, Shelly Greenfield, MD, MPH.

A recently published study by Dost Ongur, MD, PhD, Co-Director for the Research Concentration Program, Clinical Director of the Psychotic Disorders Division at McLean Hospital, and an Assistant Professor at Harvard Medical School, has found abnormalities in the myelin in the brain's white matter.

The research used two types of brain imaging: magnetic resonance spectroscopy, which measures the levels of particular chemicals in the brain; and magnetization transfer imaging, which detects changes in the level of myelin in the brain's white matter. Using these techniques, Dr. Ongur found evidence of abnormalities in both myelin and axons (nerve cell projections) in patients with schizophrenia, a serious psychiatric disorder. More specifically, they found reduced myelination of white matter pathways in people with schizophrenia, and also abnormal spread of a type of small molecule (called N-acetylaspartate) thought to be mainly contained within nerve cells.

"The notion that the brain in schizophrenia is characterized by abnormalities in connections between distant brain regions is not new, and imaging studies using diffusion tensor imaging have long suggested that the white matter where these connections travel is abnormal in this condition,"  Dr. Dost Ongur said in a journal news release. "However, we have not had the tools to determine whether the abnormalities are in axons, or the myelin sheath around the axons, or both."

Click here to read the full article in U.S. News and World Report.

Click here for the abstract of the article in Biological Psychiatry.

Researchers at Harvard Medical School have identified two pairs of dopaminergic neurons with links to the fly brain's central complex, suggesting that important components of aggression-related behaviors may be processed there."This is the first research to identify single dopaminergic neurons that modulate a complex behavior—aggression—in fruit flies,” said Edward Kravitz, George Packer Berry Professor of Neurobiology at HMS and lead author of the study.

Read the full story here. Source: HMS News, April 18, 2013

George Church, the Robert Winthrop Professor of Genetics at Harvard Medical School, is one of the key researchers behind the next big project in neuroscience: The Brain Activity Map. The project, which has been compared in scope to that of the Human Genome Project, aims to provide scientists with a full map of the brain's functions and connections.

Church sat recently for an interview on the project, its applications, and his own role. The full interview can be found here. Source: HMS News February 20, 2013.

A new study has found that participating in an eight-week meditation training program can have measurable effects on how the brain functions even when someone is not actively meditating. In their report in the November issue of Frontiers in Human Neuroscience, investigators at Harvard Medical School-affiliated Massachusetts General Hospital (MGH), Boston University (BU), and several other research centers also found differences in those effects based on the specific type of meditation practiced.

“The two different types of meditation training our study participants completed yielded some differences in the response of the amygdala — a part of the brain known for decades to be important for emotion — to images with emotional content,” says Gaëlle Desbordes, a research fellow at the Athinoula A. Martinos Center for Biomedical Imaging at MGH and at the BU Center for Computational Neuroscience and Neural Technology, corresponding author of the report. “This is the first time that meditation training has been shown to affect emotional processing in the brain outside of a meditative state.”

Source: Harvard Gazette, November 15, 2012

Read the full story here

The December 12th event featured talks from leaders in psychiatry and neuroscience research, including a keynote presentation from Steve Hyman, former head of the National Institute for Mental Health, and currently Director of the Stanley Center for Psychiatric Research at the Broad Institute of Harvard and MIT).

A poster session featured work from current RCP residents and allow faculty, residents, and visiting applicants to share their thoughts and experience with the wide ranging possibilities for research in the Boston neuroscience and psychiatric communities.

• 10:30 - 11:00 | Coffee & Pastries
• 11:00 - 11:15 | Introductory remarks – Jerrold Rosenbaum & Scott Rauch
• 11:15 - 11:30 | Overview of the RCP – Justin Baker, Dost Ongur, and John Denninger
• 11:30 - 12:00 | Keynote Presentation – Steve Hyman
• 12:00 - 12:15 | Lunch Buffet
• 12:15 - 01:45 | Selected Scientific Presentations - Faculty
• 01:45 - 02:00 | Closing Remarks - Maurizio Fava & Shelly Greenfield
• 02:00 - 03:00 | Poster Session - Residents of the MGH/McLean RCP

Pictured: Claire Brickell discusses the topic of free will in the context of psychodynamic psychotherapy.

Over the past two weeks, the Class of 2012 presented their work in the annual Senior Talks Symposium at McLean and MGH. Topics during week one covered a wide range and included a discussion of evil and psychopathy, group psychotherapy for patients with psychotic disorders, the neural correlates of emotional experiences in depression, and the epigenetics of schizophrenia. Week two featured a discussion of combined neuromodulation and neuroimaging, the psychodynamics of psychopharmacology, and the rise of "Bath Salts" as a new illicit drug. The full schedule is listed below.

Wednesday, June 6, 2012 McLean, de Marneffe, Room 132

• 1:00 – Jeff DeVido, M.D. – The Question of Evil
• 1:30 – Karen Adler, M.D. – From object to subject: The role of the patient's experience of the therapist's subjectivity as a catalyst for change
• 2:00 – Ellen House, M.D. – A Safe Arena: Group Psychotherapy and Psychosis
• 2:30 – Chris Tangren, M.D. – The Couch and the Anchor: The Use of Metaphors in Psychotherapy
• 3:30 – Brad Ruzicka, M.D. Ph.D. – Nature, Nurture, and Chromatin Structure
• 4:00 – Claire Brickell, M.D. – Psychotherapy and Free Will
• 4:30 – Sharmin Ghaznavi, M.D., Ph.D. – Neural Evidence for the Struggle To Feel Good in Major Depression

Wednesday, June 13, 2012 MGH, Haber Auditorium

• 1:00 – Brian Schulman, M.D. – The Psychodynamics of Psychopharmacology
• 1:30 – Amelia Dubovsky, M.D. – A Brief History of Graduate Medical Education: the Birth of Duty Hours
• 2:00 – Hannah Brown, M.D. –Bath Salts: The Rise of a New Drug
• 2:30 – Joan Camprodon, M.D., M.P.H., Ph.D. – Simultaneous combination of TMS and fMRI: a window into mechanisms of neuropsychiatric disease and recovery
• 3:15 – Argo Caminis, M.D. – At the Couch-side: Teaching for Medical Students and Junior Residents in Inpatient Psychiatry
• 3:45 – Nicole Christian, M.D. – Traditional Mental Health Care in a Post-Conflict Society
• 4:15 – Kelly Irwin, M.D. – Is everyone having a baby? Or is it just me?

Michael Halassa, Class of 2013, recently published a first author paper in Nature Neuroscience, describing work he carried out at MIT in the lab of Christopher Moore, now at Brown University.  By selective optical control of thalamic activity, Mike and colleagues demonstrated that sleep spindles can be causally generated with millisecond precision to understand their role in physiology and behavior. The work was carried out while Mike was a PGY1 and PGY2 in the Research Concentration Program.

Mike was also recently awarded a NIH pathway to independence career award (K99/R00) through the National Institute of Neurological Disorders and Stroke, the first time such an award has been obtained by a current MGH/McLean resident.