One Mind for Research

12 11 2012

Today I want to give you an opportunity to watch and hear a series of fascinating lectures and interviews that were conducted as part of the “One Mind for Research”, an extraordinary event took place in Boston last year. This event  brought together researchers, health advocates and politicians to mount a concerted challenge to solving what has been called the final frontier of medicine: the human brain.

Among other things you can find lectures by Steven E. Hyman, MD  “Imagining the Future: A 10-Year Plan for Neuroscience”; by Kevin Kit Parker, PhD that talked about Traumatic Brain Injury on the Battlefield; and by Husseini Manji, MD, that claims that “Serious Neuropsychiatric Diseases Can Be Tackled Through An Innovative, Accelerated, Collaborative Effort”. Furthermore, you can enjoy interesting interviews with Thomas Insel, MD, the Director of the National Institute of Mental Health (NIMH); Steven E. Hyman, MD from Harvard University and many other interesting researchers.





The Healing Power of Music

6 10 2012

Here is a very interesting lecture by Dr. Gupta about a subject that I am not quite familiar with: Music Therapy. While I love and appreciate good music, I did not realize the significant effect of music in treatment and rehabilitation processes. I think that some of you will find it interesting and helpful:

Violinist Robert Vijay Gupta joined the Los Angeles Philharmonic at the age of 19. He made his solo debut, at age 11, with the Israel Philharmonic under Zubin Mehta. He has a Master’s in music from Yale. But his undergraduate degree? Pre-med. As an undergrad, Gupta was part of several research projects in neuro- and neurodegenerative biology. He held Research Assistant positions at CUNY Hunter College in New York City, where he worked on spinal cord neuronal regeneration, and at the Harvard Institutes of Medicine Center for Neurologic Diseases, where he studied the biochemical pathology of Parkinson’s disease.

Gupta is passionate about education and outreach, both as a musician and as an activist for mental health issues. He has the privilege of working with Nathaniel Ayers, the brilliant, schizophrenic musician featured in “The Soloist,” as his violin teacher.

Dr. Robert Vijay Gupta





“Understanding of mental illness as a neurodevelopmental disorder is key”

3 10 2012

“[Mental illnesses] are brain disorders and by that I don’t mean you have a tumor or a lesion but that they are disorders of circuits. These are brain circuit problems. It’s is not a question of behavior but of the genetics of the organ, the brain in this case”.

“The brain is incredibly resilient… behavior is the last thing to go,” says Dr. Insel. Trying to treat a mental disorder by addressing behavior is difficult and not the most effective method. By that time, the illness is already in Stage IV of its development and symptoms have begun to show, the brain has already been deeply impacted. The warning signs of an impending illness (stage II) have already passed and the first episodes have already occurred (stage III). As with heart disease, if you wait until the last thing happens—a heart attack in the case of heart disease—outcomes aren’t good.

“….Studies are being made and research is being conducted that allows for more accurate images of the brain that in turn have allowed us to examine the different levels of an illness. Instead of addressing merely the behavioral manifestations of the brain disorder, we can hopefully begin to address the illness in the prodromal, or beginning, stages. Looking at the behavioral symptoms is still important but we need to find out what’s going on at the level of physiology, at the level of cells and genes and molecules, to get a much more comprehensive picture”.

New techniques such as diffusion spectrum imaging have allowed scientists to begin to map the neural fiber pathways of the brain. While these methods are still in their infancy they show promise. They allow us to decode the “bowl of spaghetti”. With the new technologies we can now begin to see into that mass in the middle. We hope that by the end of this year we will be able to tell what the actual connectivity is between two parts of the brain. Ultimately being able to discover what is exactly different between individuals with depression and individuals with schizophrenia, what part of the brain changes with treatment.

“For the first time we can begin to say, ‘So this is what depression looks like… these are the parts of the brain that are involved in PTSD or the parts that are involved in OCD  or schizophrenia.’”

“The understanding of mental illness as a neurodevelopmental disorder is key. Continued research on the early stages of the development of mental illness will result in treatments that can truly begin to address the core of the problem rather than focusing on mitigating the visible expressions of the illness”.

“Research into the circuits of the brain is not the only thing to be done. It’s not just a matter of getting clearer pictures of the brain, identifying the neurons, cells and structures in the brain. Evidence has continued to show one thing, over and over: “If you look at those things that help to build resilience… one of the best is simply by getting families involved.” It’s not just all the brain talk that’s important, it’s the human talk too”.

These very important and exciting things were said by Dr. Thomas Insel, Head of the National Institute of Mental Health (USA). Now I hope to hear the same thing from policy makers in Israel…

To read the full article enter:

http://www.nami.org/Template.cfm?Section=About_Research&template=/ContentManagement/ContentDisplay.cfm&ContentID=142938

And a related article by Insel:

http://www.nimh.nih.gov/about/director/2012/words-matter.shtml?utm_source=govdelivery&utm_medium=email&utm_campaign=govdelivery





The neural mechanisms beneath social and emotional intelligence and the sins of the education system

14 05 2012

Please check out this  fascinating talk by Dr. Daniel J. Siegel! Dr. Daniel Siegel explores the neural mechanisms beneath social and emotional intelligence and how these can be cultivated through reflective practices that focus on the inner nature of the mind.
Daniel is a child psychiatrist, educator, and author of Mindsight, The Mindful Brain, Parenting from the Inside Out, and The Developing Mind. He is the Founding Editor of the Norton Professional Series on Interpersonal Neurobiology, co-director of the UCLA Mindful Awareness Research Center, and executive director of the Mindsight Institute.

Enjoy!

Amir

 

 





Is there an identity crisis in psychiatry and how can Neurosciences help?

20 04 2012

Following my previous posts about neurosciences here is [another] great post by NIMH director entitled: The Future of Psychiatry (= Clinical Neuroscience). What do you think?

Thomas Insel

Last week a short piece in the British medical journal, The Lancet, described an “identity crisis” in psychiatry. In the U.K., the number of medical students choosing psychiatry has dropped more than 50 percent since 2009 and over the past decade the number of psychiatrists has dropped by 26 percent while the number of physicians overall has increased more than 31 percent. Ninety-five percent of posts for junior physicians across all specialties are generally filled; but psychiatry posts, as of last summer, were running more than one third unfilled.

Tom Brown, Assistant Registrar of Recruitment at the Royal College of Psychiatrists, U.K., told The Lancet: “Common perceptions within the medical profession include the view that psychiatry is just not scientific enough, is too remote from the rest of medicine, is often viewed negatively by other medical professionals, and is a specialty too often characterised by difficult doctor-patient relationships and limited success rates of therapeutic interventions.”

Meanwhile, psychiatry in the U.S. is undergoing a quiet resurgence which appears to run counter to the British experience. This might not have been apparent last month at match day, the day when medical students match with their post-graduate residencies. Match day is always a moment to track the popularity of different medical specialties. This year, slightly less than 4 percent of graduating students chose psychiatry, which is a bit lower than recent years. But this number hides an extraordinary trend: psychiatry has become the hot specialty for MD-PhD students who want to do research.

The number of MD-PhD students choosing psychiatry has more than doubled in the past decade. This year, 50 percent of the students who matched with the Yale psychiatry residency were MD-PhDs. At Columbia, 20 percent of psychiatric residents in recent years have been MD-PhDs. In other psychiatry residency programs, while the number of applicants has not increased, the number of MD-PhDs has. Why is this important? Getting into an MD-PhD training program is even more competitive than getting into medical school. The training includes intensive research experience, and many (but not all) graduates go on to do independent research either in the clinic or in a laboratory setting. In the past, most of these elite students have chosen a medical specialty such as oncology or a high paying surgical specialty such as ophthalmology.

Why are they now selecting psychiatry? I asked this question at Brain Camp a couple weeks ago. Each year, NIMH runs a 4-day intensive Brain Camp for some of the top physicians in their second year of psychiatric residency training. The faculty, including Nobel laureates and other distinguished scientists, describe recent insights from neuroscience relevant to the problems facing psychiatric residents. The residents, who are still at a very early stage of their training, are challenged with charting the future of psychiatry. The result is one of the most inspiring 4 days of the year for all of us who attend.

This year, 11 of the 17 psychiatric residents at Brain Camp were MD-PhDs. Many had been neuroscience majors in college, had published high impact papers in medical school, and were continuing to do research during their clinical training. Prior to residency, all 17 were medical students who had been at the top of their class and could have gone into any specialty. When I asked them why they had chosen psychiatry instead of another specialty, I heard various reasons but they all agreed that psychiatry is the specialty where they can have the greatest impact. To paraphrase, one student said, “The questions are profound, the patients are fascinating, and the tools are finally available to make unprecedented progress.” Another told me confidently, “This is the place to make a mark.”

These brilliant young scientists have mostly come from a neuroscience background. They are but a few of the gifted and committed trainees currently in the pipeline who have been attracted to psychiatry in the U.S. They see psychiatry as the natural application of their interest in how the brain works. They want to transform psychiatry into clinical neuroscience, not with less of a commitment to clinical excellence but with a great commitment to developing a new scientific basis for clinical care. This year Brain Camp was largely focused on neuromodulation—using cognitive training and repetitive transcranial magnetic stimulation (rTMS)—to alter symptoms of depression and anxiety by modulating specific brain circuits. For this new generation, psychiatry already is clinical neuroscience.

So maybe there is an identity crisis for psychiatry in the U.S. as well as the U.K. But the U.S. version seems filled with hope and excitement, with many of the best and brightest now deciding that they can bring new approaches to help people challenged by mental illness.

References

Lancet. 2012 Apr 7;379(9823):1274.