MGH McLean Adult Psychiatry Residency Program

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.

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.

In June, the Class of 2013 presented their work in the annual Senior Talks Symposium at McLean and MGH. At McLean, residents discussed the process of disruption and repair, identifying with patients, and the importance of screening and intervention for public health. Two complementary talks addressed the importance of peer education, and the value of peer support during residency. The talks in the Ether Dome at MGH ranged from a philosophical analysis of autonomy to neuroimaging in mouse models. Residents presented on complicating factors such as sociocultural issues, comorbidity, and trauma and their impact on public health.

Speakers are listed below.

• Benjamin Herbstman, M.D., M.H.S. - "Healing through Disruption and Repair"
• Christopher Keary, M.D. - "The Resident as Teacher: Experiences designing a resident teaching curriculum"
• Brian Hurley, M.D., M.B.A. - "Transforming the World by Providing Care to Patients who Use Substances"
• Ying Wang, M.D. - "Parallel Journeys - Learning and Growing Alongside My Patients"
• Lazaro Zayas, M.D. and Jonathan Moran, M.D., M.B.A. - "Are we all imbalanced? Attempting to achieve well-being in residency: Getting by with a little help from our friends"

• John Taylor, M.D., M.B.A. - "The Burden of Psychiatric Illness in High Utilizers of Healthcare Resources"
• Justin Chen, M.D. - "Toward suicide prevention in East Asia: A sociocultural, historical, and legal perspective"
• Avi Gerstenblith, M.D. - "Reflections"
• Michael Halassa, M.D., Ph.D. - "Why Psychiatry?"
• Amanda Green, M.D. - "Autonomy"
• Oriana Vesga Lopez, M.D. - "Remembering and working through"
• Elizabeth Levey, M.D. - "From the Ashes of Disaster: Growing up in Liberia"
• Leah Bauer, M.D. - "Three Extraordinary Women and What They’ve Taught Me about Life and Doctoring"

As Boston recovers from Monday's bombing at the finish line of the Boston Marathon, mental health specialists from around the city are advocating attention be paid to the psychological, as well as the physical trauma of this event. Children in particular are at risk, and may need help from parents and teachers in processing the events.

Drs. Eugene Beresin of the MGH and Michael Leslie of McLean Hospital were both quoted in a recent article in the Boston Globe. Speaking of the need for witnesses and victims of the bombing to regain a sense of safety and security in their lives, Leslie advocates “Activities which are grounding, which they are able to participate in in a mindful way, which help them realize they are currently safe, and they don’t need to be in a constant state of dread.”

Our hearts go out to all of the victims of this tragedy. We hope that MGH, McLean, and all of Boston's hospitals can continue to provide the exceptional care that will help the victims and this city to heal.

Read the full article in the Globe hereSource: Boston Globe, April 17, 2013

Milissa Kaufman, MD, PhD, will begin her role as Associate Training Directors of the MGH/McLean Psychiatry Residency later this month. Kaufman, who currently serves as the director of the Hill Center for Women at McLean Hospital, will continue to fulfill both roles.