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Events at the Centre for Affective Disorders

The Centre for Affective Disorders holds a variety of lectures, workshops and conferences:

You are invited to the Centre for Affective Disorders guest lecture:

New Mothers' thoughts of infant related harm and their relation to OCD

By Dr. Nichole Fairbrother

Assistant Professor, UBC Department of Psychiatry and the Island Medical Program

Location: Seminar Room 1

When: 8th February 2018 at 4.30pm 

Chair: Professor Allan Young

Centre for Affective Disorders 

Abstract

Obsessive compulsive disorder (OCD) is an anxiety-related mental health condition characterized by obsessions (recurrent, unwanted and distressing thoughts, images, or impulses) and compulsions (repetitive mental or behavioural acts engaged in, in order to decrease the distress associated with the obsessions), and high levels of distress and impairment. OCD is the only anxiety or anxiety related condition for which there is evidence of an increased risk of onset and/or exacerbation during the perinatal period. The risk appears greatest during the early postpartum. OCD when it occurs postpartum (ppOCD), is characterized by unwanted, intrusive thoughts, images or impulses of harm coming to or of harming one’s infant. In this study, participants (N = 580) were pregnant women, living in the province of British Columbia, Canada at the time or recruitment, and fluent in English. Women were recruited in pregnancy and were administered a semi-structured diagnostic interview to assess OCD in the third trimester of pregnancy, and at approximately 8-weeks and 5-months postpartum. In pregnancy, 4.3% of participants reported symptoms meeting full diagnostic criteria for OCD. In the first 5-months postpartum, 14.8% reported symptoms meeting full diagnostic criteria for OCD. The incidence of OCD in the postpartum period was 9.2%. Findings from this study add important information to our understanding of the prevalence and incidence of OCD in the perinatal period.

Biography 

Dr. Nichole Fairbrother is an assistant professor with the UBC Department of Psychiatry and the Island Medical Program. She received her Ph.D. in clinical psychology from the University of British Columbia in 2002, and subsequently completed a post-doctoral fellowship in women’s reproductive health through the Child and Family Research Institute and the UBC Department of Health Care and Epidemiology. In addition to her position with the UBC Department of Psychiatry, Dr. Fairbrother also holds appointments with the UBC School of Population and Public Health (SPPH), the University of Victoria’s (UVic) Department of Psychology, and the UVic Division of Medical Sciences (DMS). Via BC Women’s Hospital and Health Centre, Dr. Fairbrother is a member of the BC Hospital Research Institute (BCHRI), and the Women’s Health Research Institute (WHRI). Dr. Fairbrother’s research is in the area of reproductive mental health with an emphasis on perinatal anxiety disorders and epidemiology. Her current research projects include a large-scale study of maternal postpartum thoughts of infant-related harm and their relation to postpartum obsessive compulsive disorder (ppOCD) and harsh parenting, and a study of a new measure of fear of childbirth. She is currently in the planning stages for two randomized controlled trials of online CBT for perinatal anxiety - specific phobia, fear of childbirth, and ppOCD.

Contact: caroline.loveland@kcl.ac.uk / 020 7848 0088 

 

New Advances in Transcranial Magnetic Stimulation (TMS)

By Professor Mark S. George

Director, Brain Stimulation Laboratory (BSL), Distinguished Professor of Psychiatry, Radiology and Neurosciences

Layton McCurdy Endowed Chair, Medical University of South Carolina, Charleston, SC, USA

Location: Seminar Room 5, IoPPN

When: 9th February 2018 at 4pm 

Chair: Professor Allan Young

Centre for Affective Disorders 

Abstract

In 1985, Prof. Tony Barker brought a new machine he had made from Sheffield to London and demonstrated at Queen Square that one could non-invasively and rather painlessly cause the thumb to move by using brief yet powerful magnetic fields to induce neuronal depolarizations in the motor cortex (transcranial magnetic stimulation TMS). In 1994 researchers began exploring whether repeated daily subconvulsive stimulation of the prefrontal cortex for several weeks with TMS might treat depression. The US FDA approved this indication 10 years ago (October, 2008).

This lecture will review some of the more interesting new advances with TMS, focused largely on using it to treat depression. Topics to be covered will include but not be limited to – EEG phase synchronization of pulses, advanced brain imaging studies to determine the best location for stimulation, accelerated protocols, putative biomarkers of response, and when to give up on a patient and declare them a TMS non-responder.

Biography 

Dr. George first studied the relationship between mind and brain, or brain/behavior relationships while an undergraduate philosophy student at Davidson College in North Carolina. He has continued this interest throughout his career with a focus on using brain imaging and brain stimulation to understand mood regulating circuits and how they go awry in depression and then using this knowledge to devise new brain stimulation treatments.

He received his medical degree from the Medical University of South Carolina in Charleston in 1985, where he continued with dual residencies in both neurology and psychiatry. He is board certified in both areas. Following his residency training he worked for one year (1990-91) with Professor Michael Trimble as a Visiting Research Fellow in the Raymond Way Neuropsychiatry Research Group at the Institute of Neurology, Queen Square, London, England. He then moved to Washington, DC, working with Dr. Robert Post in the Biological Psychiatry Branch of the Intramural National Institute of Mental Health (NIMH).  During his 4 years at NIMH he was one of the first to use functional imaging (particularly oxygen PET) and discovered that specific brain regions change activity during normal emotions. This led to work using imaging to understand brain changes that occur in depression and mania. This imaging work directly led to using a non-invasive brain stimulation method, transcranial magnetic stimulation (TMS), as a probe of neuronal circuits regulating mood, and to clinical trials using TMS as an antidepressant. In 1993 while at the NIMH, he discovered that daily prefrontal rTMS over several weeks could treat depression and ever since he has worked to grow the science of TMS, both in terms of how it works in the brain, and in critically evaluating its therapeutic applications, especially in the area of treating depression. In 1998 he and the group at MUSC showed that one could actually non-invasively stimulate the brain with TMS inside an MRI scanner, effectively pushing and pulling brain circuits in awake alert adults, while imaging the activity in the brain. He also helped pioneer another new treatment for chronic treatment resistant depression, cervical vagus nerve stimulation (VNS). This was FDA approved in 2006.

He is a world expert in brain stimulation, and depression, and is the editor-in-chief of a new journal he launched with Elsevier in 2008 called, Brain Stimulation: Basic, Translation and Clinical Research in Neuromodulation. He is on several editorial review boards and NIH study sections, has published over 500 scientific articles or book chapters, and has written or edited 6 books.

Contact: caroline.loveland@kcl.ac.uk / 020 7848 0088 

 

Quake Brain – The mental health effects of a prolonged earthquake sequence

By Professor Richard Porter 

Professor of Psychiatry, Department of Psychological Medicine, University of Otago, Christchurch, New Zealand

Location: Small Lecture Theatre

When: 15th March 2018 at 3pm 

Chair: Professor Allan Young

Centre for Affective Disorders 

Abstract

In September 2010, Christchurch in New Zealand experienced the beginning of an earthquake sequence which ultimately led to 185 deaths, the destruction of large parts of the city and more than 10,000 aftershocks including three which caused further significant injury and damage. Several studies were conducted to evaluate the effects of this sequence on mental health and brain function.

This talk will present data from three main groups of studies. In the first, in a longitudinal cohort study of 1,000 people born in 1977 approximately half lived outside Christchurch at the start of the earthquake series. This gave a unique opportunity to compare the groups exposed and not exposed to these events. Secondly, a series of aspects of mental health data which is routinely collected in New Zealand was examined for changes pre and post-earthquake sequence.

Thirdly, we assessed the cognitive function and emotional processing of a group of people exposed but resilient people, who had undergone very significant stressful experiences during the earthquakes, with control subjects who had been tested on equivalent tasks prior to the earthquakes. The data suggests that although the exposed but resilient people had no significant mental health diagnoses, they did have significant differences in emotional processing and neuropsychological function compared with unexposed people.

Biography 

Richard Porter is Professor and head of the Department of Psychological Medicine, University of Otago, Christchurch and a Consultant Psychiatrist in a service for adults with intellectual disability. He also works in an ECT service and sees many patients with treatment resistant mood disorder. He trained in psychiatry in Newcastle-Upon-Tyne where his clinical training focussed on the treatment of resistant mood disorders. Recently his research has focused on neuropsychological impairment in depression and bipolar disorder and the relevance of this to treatment. Events in Christchurch have also led to an interest in PTSD. He is Deputy Editor of ANZJP.

Contact: caroline.loveland@kcl.ac.uk / 020 7848 0088 

 


Previous Events

 

 

 


The Centre for Affective Disorders holds a variety of lectures, workshops and conferences:

The Quality of Mercy

By Dr. Daniel Hall-Flavin 

Associate Professor of Psychiatry at the Mayo Clinic College of Medicine

Location: Small Lecture Theatre

When: 4th April 2017, 2.30pm

Chair: Professor Allan Young

Centre for Affective Disorders 

Abstract

Pressures on physicians and other health professionals in the practice of medicine have been associated with patient dissatisfaction,  physician burnout and negative impacts on physician health, most tragically suicide. This lecture cites as its primary texts excerpts from Shakespeare's "The Quality of Mercy" and "The Tempest" to support the thesis that the concept of mercy can be conceived of as bi-directional. It hypothesizes that the application of the components of mercy in routine practice can improve physician satisfaction and presence, as well as patient satisfaction in the clinical encounter. It further speculates that presence, compassion, and empathy are facilitated by physician comfort with their own vulnerabilities in a scalar fashion; these are important elements of mercy which improve clinical communications and its downstream benefits.

Biography 

Dr. Hall-Flavin is a St. Louis native and a graduate of the University of Missouri School of Medicine in Kansas City.  He has specialized in the field of Addiction Psychiatry and has served on the medical faculties of Cornell University, The George Washington University, and the New York Medical College, and is currently an Associate Professor of Psychiatry at the Mayo Clinic College of Medicine.  He has served as the Medical Director of the National Council on Alcoholism and Drug Dependence from 1986 to 2000.  He has had research interests in pharmacogenomics, the interface between addiction and its mood-related comorbidities,  and in bioethics and the Medical Humanities.   He is currently a MSc candidate in the Medical Humanities at Kings College in London and has been an academic visitor at the Uehiro Center for Practical Ethics at Oxford University.

 

The Future of Neuromodulation in the Treatment of Depression

By Dr. Jeff Daskalakis 

Professor of Psychiatry, Chief of the CAMH Mood and Anxiety Division and Temerty Chair in Therapeutic Brain Intervention, Canada

Location: Small Lecture Theatre

When: 14th March 2017, 4pm

Chair: Professor Cynthia Fu

Centre for Affective Disorders 

Abstract

Repetitive transcranial magnetic stimulation (rTMS), magnetic seizure therapy (MST), electroconvulsive therapy (ECT) and deep brain stimulation (DBS) are effective in treatment resistant depression (TRD). Dysfunctional cortical inhibition has been postulated as a mechanism underlying TRD. Cortical inhibition (CI) refers to the neurophysiological process in which GABA inhibitory interneurons attenuate cortical pyramidal activity. TMS combined with EMG or EEG represents a unique experimental modality used to directly index CI in the motor and prefrontal cortex, respectively. It has been demonstrated that treatment with electroconvulsive therapy (ECT) is associated with enhanced CI. In this presentation, data will be presented reviewing the therapeutic efficacy of these novel treatment approaches and data will also be demonstrated linking CI to the treatment response of these novel therapeutic approaches. Such findings will be expanded and discussed in relation to identification of biomarkers in predicting TRD response to novel brain stimulation therapies. 

Biography 

Dr. Jeff Daskalakis is a Professor of Psychiatry, Chief of the CAMH Mood and Anxiety Division and Temerty Chair in Therapeutic Brain Intervention. The Temerty centre uses brain stimulation to treat severe mental illness (e.g., depression, schizophrenia and obsessive compulsive disorder) and also studies important brain mechanisms such as plasticity to understand how these treatments work. He has received several national and international awards and distinctions, he holds national and international peer-reviewed funding, he is a editor for several key journals in the field (e.g. Clinical Neurophysiology, Biological Psychiatry) and he has over 260 peer-reviewed publications.

 

DEPRESSION: THE NEXT FRONTIER IN GLOBAL MENTAL HEALTH RESEARCH?

By Associate Professor Abebaw Fekadu MD, PhD

Associate Professor of Psychiatry at Addis Ababa University & Visiting Senior Lecturer at King’s College London, UK. 

Location: Robin Murray A, IoPPN

When: 30th January 201, 4pm

Chair: Professor Anthony Cleare

Centre for Affective Disorders 

Abstract

The aim of this talk is to offer what I think to be a reasoned reflection of the importance of depression for global mental health research, particularly for the provision of integrated mental healthcare in Low to Medium Income Countries (LMICs).  In this context the challenges of conducting research in depression and the way forward will be discussed. I believe the current construct of depression is not helping with patient care in LMICs and only concerted, multi-disciplinary, international studies could address the challenges meaningfully. 

Biography 

Abebaw Fekadu is Associate Professor of psychiatry at Addis Ababa University and a visiting senior lecturer at King’s College London, UK. He is Center Leader of the World Bank African Center of Excellence in Therapeutic Discovery (CDT-Africa) at Addis Ababa University and an African Research Leader (the Medical Research Council/DfID, UK).

Having trained at the Affective Disorders Unit under Professors Anthony Cleare, Peter McGuffin and Anne Farmer, his research interest has naturally been in mood disorders. His current work focuses on developing evidence for integrating mental healthcare into primary care and detection of depression. He is a fellow of the Ethiopian Academy of Sciences. He serves in various committees, for example in the WHO, National Commission for NCD, and the Lancet Commission for the Future of Health in Africa

Something old, something new, something borrowed, not so blue

By Professor Michael Berk, MD, PhD

NHMRC Senior Principal research Fellow, Alfred Deakin Chair of Psychiatry at Deakin University and Barwon Health, Australia

Location: Small Lecture Theatre, IoPPN

When: 5th December 2016, 3pm

Chair: Professor Allan Young

Director, Centre for Affective Disorders 

Abstract

The path to novel therapy development has been fraught and complex, with little success of late. This lecture presents data on alternate paths to therapy development. There is abundant evidence that inflammatory and oxidative processes, altered neurogenesis and mitochondrial dysfunction play a role in the genesis and neuroprogression of mood and psychotic disorders. There is evidence of increased inflammatory activity, oxidative stress, mitochondrial dysfunction as well as altered neurogenesis in most major neuropsychiatric disorders. The consequences of inflammatory and oxidative stress include lipid peroxidation, DNA fragmentation, telomere shortening, protein carbonylation, reduced neurogenesis and an increased vulnerability to apoptosis. Inflammatory and oxidative stress can lead to decreased BDNF and other trophic factors. In sum, these processes can further damage neurocircuitry and may lead to progression of these disorders, suggesting an entirely new range of therapeutic possibilities. Many of these are repurposed, and hence have established tolerability and safety profiles. The agent for which the largest amount of data is currently available is N-acetylcysteine. Positive placebo controlled data is currently available in schizophrenia, bipolar disorder, depression, smoking cessation, cannabis abuse, obsessive compulsive disorder and autism. Agents targeting inflammatory pathways additionally show promise. These include aspirin, minocycline, infliximab, celecoxib and statins, with largest current database for the latter two. Mitochondrial dysfunction also offers druggable targets. Lastly, some agents such as aspirin may have as preventive potential as part of integrated preventive programs targeting non-communicable disorders. These findings not only offer the promise of novel treatments, but serve as proof of principle of the role of inflammation and oxidative stress in the pathophysiology of major psychiatric disorders.

Biography 

Professor Michael Berk is currently a NHMRC Senior Principal research Fellow, and is Alfred Deakin Chair of Psychiatry at Deakin University and Barwon Health, where he heads the IMPACT Strategic Research Centre. He also is an Honorary Professorial Research fellow in the Department of Psychiatry, the Florey Institute for Neuroscience and Mental Health and Orygen Youth Health at Melbourne University, as well as in the School of Public Health and Preventive Medicine at Monash University. He is past president of the International Society for Bipolar disorders and the Australasian Society or Bipolar and Depressive Disorders. He is an ISI highly cited researcher who has published over 800 papers predominantly in mood disorders. His major interests are in the discovery and implementation of novel therapies, and risk factors and prevention of psychiatric disorders. He is the recipient of a number of national and international awards including the Brain and behaviour Foundation Colvin prize, and holds grants from the National Institutes of Health (US), Simon Autism Foundation, NHMRC CRE and project grants, Beyondblue and Stanley Medical Research Institute and is a lead investigator in a Collaborative Research Centre. 

Contact: caroline.loveland@kcl.ac.uk / 020 7848 0088 

Circadian disruption and psychiatric disorders: implications for treatment

By Professor Anna Wirz-Justice 

Professor emeritus, Centre for Chronobiology, Psychiatric University Clinics Basel, Switzerland

Location: Robin Murray A, IoPPN

When: 13th December 2016, 3pm

Chair: Prof David Veale 

Centre for Anxiety Disorders & Trauma  

Abstract

The biological clock plays an enormously important part in our daily lives: it regulates the optimal timing of sleep and wake, cognitive function, mood and alertness, hormonal patterns, and gene expression - to name but a few of an entire host of biochemical, physiological, and psychological functions. Temporal coordination is required for health and wellbeing, when it goes wrong, the first signs are sleep disturbances and daytime sleepiness, mood and behavioural problems. Adequate synchronisation of body clocks requires sufficient light during the day and darkness at night; our modern civilisation disturbs these circadian and seasonal rhythms with artificial light at odd times of day, shift work, transmeridian travel. The first clinical application of this research was light as a treatment for winter depression (SAD). Many other psychiatric disorders evince circadian disruption: light, “darkness”, melatonin, and wake therapy (sleep deprivation) provide non-pharmacological adjunct treatment modalities that are still insufficiently known and used in clinical practice.

www.chronobiology.ch         

www.cet.org 

Chronotherapeutics for Affective Disorders. A Clinician's Manual for Light and Wake Therapy.  AWirz-Justice, F Benedetti, M Terman. 2nd, revised edition 2013, S.Karger Basel

Biography

Anna Wirz-Justice is emeritus Professor at the University of Basel Psychiatric Clinics, where she founded the Centre for Chronobiology, specialising in diagnosis and treatment of circadian and seasonal disorders, as well as basic psychophysiological research on human circadian rhythms, sleep, mood, and performance. She introduced light therapy for winter depression to Europe, and extended the application of light to other illnesses, from non-seasonal affective disorder to Alzheimer’s Disease and sleep disturbances. Her present interest is the translation of research findings into architectural use of (day)light to influence wellbeing and health.     

Inflammation in depression and on the mechanism of action of psychotropic drugs

By Dr. Livia A. Carvalho

Lecturer in Neuropsychopharmacology, Department of Clinical Pharmacology, William Harvey Research Institute

Location: Small Lecture Theatre, IoPPN

When: 19th January 2017, 3pm

Chair: Prof Allan Young 

Centre for Affective Disorders 

Abstract

Despite the costs to the NHS of treatment for clinical depression of ~£48.6bn1 and over 57 million antidepressants prescriptions in 2014 morbidity of depression persists. About a third of all patients do not respond to the most widely used antidepressants that act on the monaminergic system. I will call this “treatment-resistance”. There are many definitions of treatment-resistance but I consider it to be a continuum of which non-response to a single treatment is the least restrictive definition. Many people with depression experience poor long-term outcomes including chronic depression, suicide, substance abuse and somatic illnesses. In order to address this clinical need, we need to understand the biology behind treatment-resistance and more about the mechanisms of action of antidepressants. Knowledge of these pathways could significantly influence treatment decisions and provide alternative molecular targets for potential new antidepressant agents. Research shows that inflammation in patients with depression may define a subgroup of patients with a worse course of the disorder i.e higher physical and mental comorbid conditions, recurrent episodes, or unresponsive to antidepressants. In this talk, I will discuss epidemiological, clinical and experimental evidence of this association, provide potential mechanisms, and discuss future directions. 

Biography

Since my MSc and PhD in Neuroscience and Pharmacology, my work has concentrated on understanding the neuroendocrine and immune effects of antidepressants. I use clinical and experimental models to further understand whether biological mediators of stress, such as cortisol and inflammation are part of the mechanism of action of psychotropic drugs. I am also interested in understanding the molecular pathways by which drugs that modulate stress-related systems improve cognitive and behavior with the view of identifying new targets for treatment. During my early post-doc years at the Institute of Psychiatry, KCL, I was one of the first to show that the immune system is activated in treatment-resistant depressed patients. Experimentally, using whole blood and adult stem cells I showed antidepressants have anti-inflammatory properties such as improving steroid receptor function which leads to increased neuronal differentiation. Building from my previous work, a collaboration was developed with Prof. H. Drexhage and the department of Psychiatry in The Netherlands. In this collaboration we worked on isolated monocytes. I was capable of dissecting in more detail the molecular machinery associated with inflammation in treatment-resistant depression, and tie the inflammatory disturbances to a particular cellular source. Having access to drug-free patients through this collaboration meant that immune disturbances could be analyzed without the impact of current medications. These patients started a clinical trial and thus for the first time we analyzed whether inflammation was a target of antidepressants. Working on a strictly clinically characterized patient sample showed how immune markers are capable of predicting response to antidepressants and are a target for antidepressant treatment. This work was funded by the European Union and by an ECNP Young Investigator Award to myself. In 2012, I moved to UCL with Prof. Andrew Steptoe where investigated whether drugs that modulate the stress response system such as antidepressants and beta-blockers modulated stress-induced inflammation. We also evaluated the impact of normalizing the stress response as a prevention strategy for inflammatory illnesses such as heart disease and arthritis. I have further characterized inflamed depressed patients and showed that inflammation is more frequently associated to a more severe course of the disorder such as in those unresponsive to antidepressants, in people with comorbid conditions, older people, who had a younger age of onset, and who present recurrent episodes. Since 2016 I am a lecturer at the Dept. of Clinical Pharmacology Queen Mary University.

http://www.whri.qmul.ac.uk/staff-all/staff-research/629-dr-livia-a-carvalho

Contact: caroline.loveland@kcl.ac.uk / 020 7848 0088 

Towards a theoretical frame work for today’s functional MRS

By Dr Paul G Mullins

Reader in Neuroimaging and Director Bangor Imaging Centre, School of Psychology, Bangor University, Bangor, Gwynedd, United Kingdom.

Location: Robin Murray B, IoPPN

When: 23rd November 2016, 3pm

Chair: Dr James Stone

Centre for Affective Disorders 

Abstract

Functional magnetic resonance spectroscopy (fMRS) is not a new technique. Based on the same principles as in vivo MRS, fMRS collects multiple spectra in a dynamic series to study metabolite concentration changes during brain function. Originally used to measure changes associated with energy usage and lactate metabolism in response to prolonged neural stimulation, fMRS had limited application.  Recently however, fMRS has also been shown to be able to measure changes in neurotransmitters over very short time scales - seconds rather than minutes - and can be combined with other measures of neural activity such as EEG and BOLD to offer complimentary multi-modal imaging capabilities (Apšvalka, Gadie, Clemence, & Mullins, 2015; Lally et al., 2014).  Direct measurement of neurotransmitter and neurometabolite changes allows fundamental questions to be addressed regarding the excitatory, inhibitory and metabolic processes underlying neural activity. However, before we can properly address these questions, some theoretical understanding of the process we may be able to measure, and how they may be reflected in MRS measures needs to be properly developed.  In this discussion I will attempt to highlight some of the major questions, and offer a few suggestions as to what fMRS may be able to tell us about neural activity.

Biography

Currently the Director of the Bangor Imaging Centre in the School of Psychology home to a research dedicated 3T whole body MRI system used for functional and structural imaging studies.  Liaising with researchers from the College of Health and Behavioral Sciences on study design, data acquisition and processing and resources available to help with their research questions, in a world-class center for neuroimaging research in North Wales. 
Dr Mullins is actively involved in pursuing my own research using magnetic resonance spectroscopy (MRS) to measure neurochemistry in central nervous system function and disorders.  In particular projects are aimed at measuring neurotransmitter (Glutamate, Glutamine and GABA) changes and relationships in response to external and internal stimuli, and in patients with chronic pain.  Recently work has focused on the simultaneous acquisition of MRS and EEG data to better elucidate the neurochemical correlates of neuronal activity.
Dr Mullins Teaching activities include coordination of the MSc in Neuroimaging, and lecturer for the “Introduction to Neuroimaging” and “Advanced Techniques in Neuroimaging” modules.  He has recently supervised 3 PhD students to completion, has co-supervision of 4 others, and generally several MSc students’ neuroimaging research projects. 
Dr Mullins is also actively involved in collaborative researcher with colleagues in the USA, Ireland and the UK.  

Contact: caroline.loveland@kcl.ac.uk / 020 7848 0088 

Studies of erythropoietin to target cognitive dysfunction in mood disorders: key findings and methodological implications

Speaker: Dr Kamilla Woznica Miskowiak

Neurocognition and Emotion in Affective Disorders (NEAD) Group Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet

Location:  Small Lecture Theatre, Institute of Psychiatry, Psychology & Neuroscience, Denmark Hill

When: Thursday 17th November 2016, 3pm  

Abstract

Cognitive dysfunction is an emerging treatment target in depression and bipolar disorder but there are no available cognition treatments with reliable, enduring effects. Impaired neuroplasticity is a putative neurobiological pathway underlying cognitive deficits and mood symptoms in these disorders. Novel treatments with rapid and enduring effects on neuroplasticity therefore hold great promise for targeting both cognition and mood symptoms in these patients. Recent evidence from preclinical and human proof-of-concept studies points to erythropoietin (EPO) as one of the most promising candidate treatments to reduce deficits in neuroplasticity and cognitive dysfunction in mood disorders. Based on this we conducted two randomized, double-blind, placebo-controlled studies of the effects of EPO on cognitive deficits and mood symptoms in depression and bipolar disorder and the underlying neuroanatomical mechanisms of the effects. This research has implications beyond EPO, highlighting some key methodological challenges in the field and their possible solutions.

Biography

My research bridges the areas of neuropsychology, psychiatry and neuroscience and aims to develop new biological and psychological treatments targeting cognitive dysfunction in depression and bipolar disorder and to delineate with neuroimaging and neuropsychological tests the mechanisms of established and novel candidate treatments. I also use the unique Danish registers to study the effects of genetic risk of affective disorder on neural and behavioural measures of cognitive function, emotional processing and emotion regulation in healthy twins with an affected or healthy co-twin (high- versus low-risk). This will create new insights into illness etiology and may aid earlier detection and correct treatment in the future.

I have a degree in clinical psychology from University of Copenhagen with my dissertation on multidisciplinary research on depression, which received the university gold medal, and an MSc (with Distinction) and a PhD (DPhil) from University of Oxford in experimental psychology and psychiatry. I currently work as a senior research psychologist at the Psychiatric Center Copenhagen, Copenhagen University Hospital, conducting a number of clinical and experimental studies in patients with affective disorders using clinical ratings, neurocognitive testing and functional magnetic resonance imaging (fMRI). Alongside my research I have received training in and worked with cognitive behavioural therapy of patients with depression or bipolar disorder and have qualified as clinical psychologist in 2011.

I collaborate with groups at University of Oxford in the United Kingdom, the Max Planck Institute in Germany and University of Pittsburgh in the United States of America. I also have a small group, Neurocognition and Emotion in Affective Disorders (NEAD) Group (http://www.neadgroup.org/) at the Psychiatric Centre Copenhagen. The team consists of two PhD students, four research assistants and two postgraduate students whom I teach and supervise in clinical ratings, neuropsychological testing and collection of fMRI data.

 Contact: caroline.loveland@kcl.ac.uk / 020 7848 0088 

Measuring the mind: Detecting cognitive deficits and measuring cognitive change

By John Harrison, MD, PhD

Associate Professor with the Alzheimer Center at the VUmc in Amsterdam, Honorary Professor at the West London Mental Health Trust, and Principal Consultant at Metis Cognition Ltd

Location: Robin Murray A, IoPPN, Ground Floor, East Wing

When: 20th September 2016, 3pm

Chair: Professor Allan Young

Director, Centre for Affective Disorders 

Abstract

Since the early 1990s the assessment of cognition for new chemical entities for psychiatric and neurological diseases has been mandated for safety purposes. Cognition assessment has also played a significant role in determining efficacy, especially for disorders such as Alzheimer’s disease, and more recently indications such as schizophrenia and depression. The selected outcome measures have typically been borrowed from clinical psychology, or in the case of Alzheimer’s disease, through the use of measures generally regarded as being unfit for purpose.

In this presentation I will critically review the current state of cognitive assessment in drug development and especially for the indications of schizophrenia, depression and Alzheimer’s disease (AD). I will contrast the success achieved in assessing cognition in depression with the lack of efficacy evidence seen in schizophrenia and AD. I will suggest and offer support for the view that cognition is most efficiently assessed when specific cognitive domains are targeted and tests are selected according to best practice, specifically according to requirements of acceptable reliability, validity and sensitivity.

Biography

John Harrison is an Associate Professor with the Alzheimer Center at the VUmc in Amsterdam, Honorary Professor at the West London Mental Health Trust, and Principal Consultant at Metis Cognition Ltd.  Metis is an applied psychology practice established to advise with the selection and successful integration of cognitive testing into therapeutic development programs.  Metis provide consultancy to more than 40 companies involved in the development of new drugs for indications including Alzheimer’s disease, depression, schizophrenia and Parkinson’s disease.

John has previously served as Head of Neuropsychology at CeNeS Pharmaceuticals (1997-2000), Principal Consultant of CPC Pharma Services (2000-2007) and as Principal Scientist at CogState Ltd. (2007-2011).  He has trained and presented on CNS outcome measures at more than 250 meetings at locations in Europe, Asia, Australia, Canada, the United States and South America.   He speaks on the use of cognitive testing at various international meetings, including the American Alzheimer’s Association roundtable events, the European Task Force for Alzheimer’s disease and the THINC Cognition in Depression initiative, which he co-chairs.  He is also a member of the EPAD cognition group (http://ep-ad.org/).  John holds Chartered Psychologist and Associate Fellow status with the British Psychological Society, and Chartered Scientist status with the UK Science Council.  He has authored/co-authored more than 60 books and scientific articles, including a popular neuroscience book ‘Synaesthesia: The Strangest Thing’.

Weblinks:

http://www.linkedin.com/in/drjohnharrison

http://open.academia.edu/JohnHarrison

Contact: caroline.loveland@kcl.ac.uk / 020 7848 0088 

The Quest for Innovation in Psychiatry: A Personal Perspective

By Dr Norman Rosenthal 

Clinical Professor of Psychiatry at Georgetown University Medical School, Washington D.C 

Location: Wolfson Lecture Theatre, IoPPN

When: 18th October 2016, 3pm

Chair: Professor Allan Young

Director, Centre for Affective Disorders 

Abstract

Drawing on almost four decades of psychiatric research experience Dr Rosenthal will discuss the elements required for innovation including the value of "taking a flyer," a bold, high-risk, high-yield step that can significantly advance a field. He will refer specifically to his work with seasonal affective disorder and light therapy, Transcendental Meditation for post-traumatic stress disorder, and Botox for depression. 

Biography

Dr Norman Rosenthal is a Clinical Professor of Psychiatry at Georgetown University Medical School in Washington D.C. A highly cited researcher, he has published more than 200 scholarly papers. He was the first physician to describe and name Seasonal Affective Disorder (SAD) and pioneered the use of light therapy as a treatment. More recently he has researched the use of Botox for Depression and Transcendental Meditation for Post Traumatic Stress Disorder. He has authored or co-authored 9 popular books, including several best sellers. His most recent book, Super Mind, reached number one in the Washington Post best sellers list.

Contact: caroline.loveland@kcl.ac.uk / 020 7848 0088

Perspectives of tDCS in the treatment of affective disorders

Location:  The Small Lecture Theatre, Institute of Psychiatry, Psychology & Neuroscience, Denmark Hill

When: Thursday 16th June, 12.30pm  

By Andre Russowsky Brunoni, MD, PhD

Service of Interdisciplinary Neuromodulation, University of São Paulo, São Paulo, Brasil

Chair: Professor Cindy Fu

Professor in Affective Neuroscience, UEL & Honorary Consultant South London & Maudsley Hospital

Abstract

Dr. Brunoni will discuss the perspectives of using tDCS in mood disorders. He will start with an overview of the technique, followed by the results of recent randomised clinical trials and meta-analyses investigating tDCS efficacy in depression. He will then move to discuss how to optimize the technique and the perspectives of future, upcoming basic, translational and clinical tDCS studies in depression. Dr. Brunoni will also present some of the work he has carried on in his laboratory at the University of São Paulo.

Biography

Dr. Brunoni has an international recognition in the use of non-invasive brain stimulation (NIBS) tools such as transcranial direct current stimulation and transcranial magnetic stimulation in the treatment of psychiatric disorders. He has published over 120 international, peer-reviewed papers. Dr Brunoni’s research activities focus on clinical and translational research of NIBS treatments in psychiatry, including the identification of several biomarkers (psychological, neuropsychological, neurophysiological, genetics and neuroimaging) that can predict response and unveil mechanisms of action. 

Contact: caroline.loveland@kcl.ac.uk / 020 7848 0088 

You are invited to the Centre for Affective Disorders guest seminar:

CfAD is delighted to present two internationally renowned scientists presenting an afternoon of insights into mood disorders. Prof Trisha Suppes will present an update on DSM-5. Dr Kamilla Woznica Miskowiak will explore erythropoietin and its potential treatment implications in cognitive dysfunction.  

Chair: Prof Allan Young

Location:  The small lecture theatre, Institute of Psychiatry, Psychology & Neuroscience, Denmark Hill

When: Thursday 23rd June, 3pm  

DSM-5 Update on Changes: Strengths and limitations for Bipolar Disorders

Speaker: Trisha Suppes, M.D., Ph.D.

Professor of Psychiatry and Behavioral Science at Stanford University School of Medicine, and Director of the Bipolar and Depression Research Program at the VA Palo Alto Health Care System in Palo Alto, California

Abstract

In this talk updates to the American Psychiatric Association DSM-5 on Bipolar and Related Disorders will be presented.  In particular, background on DSM-5 principles and goals will be briefly reviewed, followed by some of the highlights and changes in DSM-5 for bipolar disorders.  Some of the changes that will be discussed include changes to Criteria A for mania and hypomania with the addition of increased energy or activity to changes in mood.  The new Mixed Features Specifier providing a bridge across Major Depressive and Bipolar Disorders will be reviewed including recent findings that led to this Specifier and limitations as it is currently defined.  The importance of changes to bipolar disorders otherwise specified will be discussed.  Background to these changes, and in particular evidence and committee considerations will be reviewed. While changes in DSM-5 represent a step forward, where this breaks down or is limited will also be considered.

Biography

Prof Suppes areas of expertise and research include long-term treatment strategies for bipolar disorder and treatment of bipolar and major depression. She also has interest in the use of complementary medicine for the management of mood disorders. Among her research on mood disorders, Dr. Suppes’ work on lithium discontinuation in the early 1990s changed the way psychiatrists approach the treatment of bipolar disorder leading to the recommendation for patients with bipolar I disorder ongoing treatment is appropriate.  More recent work on mixed hypomania contributed to the changes in DSM-5 on mixed states.       

Dr. Suppes currently serves as the Treasurer and Secretary for the International Society for Bipolar Disorders.  Dr. Suppes was a member of Mood Disorders workgroup and chair of the Bipolar Disorders subcommittee of the APA Diagnostic and Statistical Manual for Mental Disorders 5 (DSM-5).  She also served as co-chair of the Department of Veterans’ Affairs/Department of Defense work group on treatment guidelines for bipolar disorder.  Additionally, she is a member of the Scientific Advisory Board of the Depression and Bipolar Support Alliance and several editorial boards.  She has authored or co-authored over 200 peer-reviewed articles.

Before moving to Stanford in June 2008, Dr. Suppes was the Director of the Bipolar Disorders Research Program at UT Southwestern Medical Center at Dallas.  Dr. Suppes earned her BA in human biology at Stanford University in Stanford, California, her Ph.D.in anatomy/physiology at the University of California at Los Angeles, and her M.D. at Dartmouth Medical School in Hanover, New Hampshire. After graduating, she completed her residency in adult psychiatry at McLean Hospital at Harvard Medical School in Belmont, Massachusetts. Her postdoctoral fellowship in neurology was conducted at Stanford University School of Medicine, and her clinical fellowship in psychiatry was conducted at McLean Hospital at the Harvard Medical School in Boston, Massachusetts.  She also completed a fellowship in neuroscience at Harvard Medical School. 

 

Mountain High Valley Low

Location:  The Small Lecture Theatre, Institute of Psychiatry, Psychology & Neuroscience, Denmark Hill

When: Thursday 2nd June, 3pm  

By The Wishbone Theatre Company

Chair: Professor Allan Young

This is the story of Josie, a passionate cyclist and self-confessed ‘image nerd’, who’s looking for love and connection. Josie is also affected by bipolar disorder. She aims to manage her illness by committing herself to long-distance cycling sportives instead of relying on medication. While Josie rides through the English countryside, she journeys across the landscape of her mind. Things may not go to plan….

Mountain High Valley Low blends live pedalling action and an immersive soundtrack by Conor OB. A simple yet emotionally rewarding mini-show (15 minutes), of sound and live performance.

Wishbone collaborated with clinicians, careworkers and people affected by bipolar disorder at the South London and Maudsley Trust to create Josie’s fictional journey. The project started life as a pop-up performance in East London cycling cafes and then played at Southbank Centre for both Changing Minds and Women of the World festivals, 2016.

After the performance there will be a panel discussion and an interactive Q&A session. 

About Wishbone Theatre

Fresh Theatre, From Scratch. Initiated in 2001, Wishbone is a creative partnership between theatre-makers Karen Glossop and Paul Murray. Our mission is to make theatre that is as accessible as it is inventive. We’ve won a Total Theatre Award for Artistic Ambition, and have appeared in the Edinburgh Fringe Festival, the London International Mime Festival, the Prague Fringe Festival, the Ruhrfestspiele Recklinghausen, and at other UK venues such as BAC and Southbank Centre.http://www.wishbonetheatre.co.uk/  

Contact: caroline.loveland@kcl.ac.uk / 020 7848 0088

Neuroprotective effects of Li? Food for thought

Location:  The Wolfson lecture theatre, Institute of Psychiatry, Psychology & Neuroscience, Denmark Hill

When: Friday 13th May, 3pm  

Speaker: Prof Tomas Hajek

Department of Psychiatry, Dalhousie University, Halifax, Canada, National Institute of Mental Health, Klecany, Czech Republic

Abstract 

Background: There is a growing body of pre-clinical evidence suggesting that Li may protect neurons from a range of neurotoxic insults, hence the term neuroprotective effects. Does Li have similar effects also in human subjects?

Methods: I will summarize our neuroimaging studies investigating the association between Li treatment and brain structure, and will review the available literature on neuroprotective effects of Li in human subjects, including brain imaging data, pharmacoepidemiological, case control and cohort studies investigating the association between Li treatment and risk of dementia, as well as treatment trials studying the disease modifying effects of Li in Alzheimer dementia and amnestic mild cognitive impairment.

Results: There is level I evidence for positive association between Li treatment and brain gray matter volume, which is one of the most replicated neuroimaging findings. This effect of Li occurs regardless of mood state, diagnostic subtype, presence or absence of concomitant medications, even in subjects with episodes of BD while on Li. Cohort studies suggest an association between lithium treatment and reduction in the risk or severity of dementia. In addition, lithium showed evidence for positive effects on cognitive functions and biomarkers in amnestic mild cognitive impairment (aMCI, 1 study) and Alzheimer dementia (2 studies), even with doses lower than those used for mood stabilisation.

Conclusions: Despite the wide range of supporting evidence, the neuroprotective properties of Li are mostly unknown outside of the mood disorders field and there is little ongoing research into these effects. In the absence of disease modifying treatments for any neurodegenerative disorders, we cannot afford to ignore this robust and replicated evidence base. All we are saying is give Li a chance!

Biography

Tomas Hajek received his M.D. (1999) and Ph.D. in neuroscience (2003) from Charles University, Prague, Czech Republic. He trained in psychiatry and in 2003 was awarded a clinical research fellowship in mood disorders with Dr. Alda at Dalhousie University, Halifax, Canada. In 2005, Dr. Hajek joined the Department of Psychiatry, Dalhousie University as an Assistant Professor, in 2009 became an Associate Professor and in 2015 a Full Professor of Psychiatry. He works at the Mood Disorders Clinic at Dalhousie University, Halifax, Canada and as a senior researcher in National Institute of Mental Health, Czech Republic. Dr. Hajek`s main research interest lies in investigating effects of various clinical variables, including genetic predisposition, illness burden, comorbid metabolic disorders and exposure to medications on brain structure in patients with bipolar disorders. To this goal, he has been performing magnetic resonance imaging studies in both affected and unaffected relatives of bipolar probands. In addition Dr. Hajek collaborates with the International Group for Study of Lithium Treated Patients on a multicentre project investigating neuroprotective effects of lithium. Dr. Hajek is a recipient of the Dalhousie Clinical Research Scholarship and his research has been supported by grants from Canadian Institutes of Health Research, National Alliance for Research on Schizophrenia and Depression (USA), Nova Scotia Health Research Foundation, Ministry of Health of the Czech Republic. Dr. Hajek received fellowships or travel scholarships from the American Psychiatric Association, World Psychiatric Association, International Society for Affective disorders. He has taught continuous medical education courses for several international organizations, including Neuroscience School of Advanced Studies, Italy, Vienna School of Clinical Research, Austria, Academia Medica Pragensis, Czech Republic. He has published over 60 in extenso papers in journals including Molecular Psychiatry, American Journal of Psychiatry, Biological Psychiatry, Neuropsychopharmacology, Schizophrenia Bulletin and over 50 abstracts.

For details please see: Research Gate Tomas Hajek (https://www.researchgate.net/profile/Tomas_Hajek2/stats/?ev=prf_stats) 

Contact: caroline.loveland@kcl.ac.uk / 020 7848 0088

Studies of erythropoietin to target cognitive dysfunction in mood disorders: key findings and methodological implications

Location:  The small lecture theatre, Institute of Psychiatry, Psychology & Neuroscience, Denmark Hill

When: Thursday 23rd June, 3pm  

Speaker: Dr Kamilla Woznica Miskowiak

Neurocognition and Emotion in Affective Disorders (NEAD) Group Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet

Abstract

Cognitive dysfunction is an emerging treatment target in depression and bipolar disorder but there are no available cognition treatments with reliable, enduring effects. Impaired neuroplasticity is a putative neurobiological pathway underlying cognitive deficits and mood symptoms in these disorders. Novel treatments with rapid and enduring effects on neuroplasticity therefore hold great promise for targeting both cognition and mood symptoms in these patients. Recent evidence from preclinical and human proof-of-concept studies points to erythropoietin (EPO) as one of the most promising candidate treatments to reduce deficits in neuroplasticity and cognitive dysfunction in mood disorders. Based on this we conducted two randomized, double-blind, placebo-controlled studies of the effects of EPO on cognitive deficits and mood symptoms in depression and bipolar disorder and the underlying neuroanatomical mechanisms of the effects. This research has implications beyond EPO, highlighting some key methodological challenges in the field and their possible solutions.

Biography

My research bridges the areas of neuropsychology, psychiatry and neuroscience and aims to develop new biological and psychological treatments targeting cognitive dysfunction in depression and bipolar disorder and to delineate with neuroimaging and neuropsychological tests the mechanisms of established and novel candidate treatments. I also use the unique Danish registers to study the effects of genetic risk of affective disorder on neural and behavioural measures of cognitive function, emotional processing and emotion regulation in healthy twins with an affected or healthy co-twin (high- versus low-risk). This will create new insights into illness etiology and may aid earlier detection and correct treatment in the future.

I have a degree in clinical psychology from University of Copenhagen with my dissertation on multidisciplinary research on depression, which received the university gold medal, and an MSc (with Distinction) and a PhD (DPhil) from University of Oxford in experimental psychology and psychiatry. I currently work as a senior research psychologist at the Psychiatric Center Copenhagen, Copenhagen University Hospital, conducting a number of clinical and experimental studies in patients with affective disorders using clinical ratings, neurocognitive testing and functional magnetic resonance imaging (fMRI). Alongside my research I have received training in and worked with cognitive behavioural therapy of patients with depression or bipolar disorder and have qualified as clinical psychologist in 2011.

I collaborate with groups at University of Oxford in the United Kingdom, the Max Planck Institute in Germany and University of Pittsburgh in the United States of America. I also have a small group, Neurocognition and Emotion in Affective Disorders (NEAD) Group (http://www.neadgroup.org/) at the Psychiatric Centre Copenhagen. The team consists of two PhD students, four research assistants and two postgraduate students whom I teach and supervise in clinical ratings, neuropsychological testing and collection of fMRI data.

 Contact: caroline.loveland@kcl.ac.uk / 020 7848 0088

Translational Research in Treatment-Resistant Mood Disorder

Location:  Small lecture theatre, Institute of Psychiatry, Psychology & Neuroscience, Denmark Hill

When: 7th April 2016 at 2pm

Speaker: Prof Douglas Steele MD, PhD, MRC Psych

Professor of Neuroimaging and Honorary Consultant Psychiatrist at the Advanced Interventions Service

Abstract 

Due to a tendency for an early age of onset and chronicity, psychiatric disorders are the leading cause of years-of-life-lived-with-disability worldwide, with depressive disorders being the single biggest contributor to chronic disability.  Antidepressant medications were mostly discovered around 1960. More recent developments such as the SSRIs are no more effective than original antidepressants.   In 2016, after more than half a century, we still do not understand how antidepressants cause remission from depression, let alone why so many patients  do  not  respond  to  treatments and  remain  chronically  ill  and  disabled.    Better understanding of brain function using translational approaches appears crucial.   In this presentation I will focus on two publications: one I published last year and the other I have just had had accepted for publication, both in Brain.

In 1991, largely on the basis of animal model studies of human illness, Deakin & Graeff published ‘5-HT and mechanisms of defence’ which has been cited over 600 times and recently discussed (Deakin, 2014, ‘The origins of ‘5-HT and mechanisms of defence’ by Deakin and Graeff: A personal perspective’, Journal of Psychopharmacology).   However, despite the original article being highly cited, there have been few attempts at testing the theory in humans and none using instrumental learning tasks during fMRI in patients with treatment-resistant depression.  In 2015 I published a test of Deakin & Graeff’s predictions using fMRI (Johnston B, et al, 2015, Brain).  The findings strongly supported most of Deakin& Graeff’s predictions, extending this to treatment-resistant mood disorder.

The clinical service I currently work in uses anterior cingulotomy as a treatment of last resort, in highly treatment-resistant patients who want the procedure and can provide sustained informed consent, as independently verified by the CQC. Lesions are made in the white matter deep to the anterior mid-cingulate cortex (aMCC).  Depending on the historical papers one reads, the procedure was originally developed to treat intractable pain with an early study by Foltz &  White  (1962)  noting  that  patients  with  comorbid  anxiety  and/or  mood  disorder appeared to have the best outcomes.  Reasons for the original selection of the brain region appear obscure and the treatment is now justified on entirely empirical, clinical grounds. In a recently accepted manuscript (Tolomeo S, et al, 2016, Brain), I argue that the aMCC has a causal role in negative affect and cognitive control.  It is plausible that lesions made within a brain region associated with the subjective experience of negative affect and pain may be therapeutic for some patients with otherwise intractable mood, anxiety and pain syndromes.

I will finish by combining ideas from both studies, suggesting implications for future translational mood disorder research.

Biography

My clinical and research interests are predominately in treatment-resistant mood disorder but also increasingly in substance misuse. I have a relatively unique background in medicine and the physical sciences that puts me in a position to deliver fully on the translational interface between these disciplines.

I began by studying theoretical physics (BSc Hons, Strathclyde University) then obtained a PhD in physics with a joint physiology-physics study at Glasgow University.  I subsequently worked for a few years in NHS medical physics and industry, before moving to Edinburgh University to study medicine (MB, ChB).  I specialised in psychiatry (MD, MRCPsych) and worked as a Lecturer in psychiatry at Edinburgh University for 3 years.  In 2004 I moved to Aberdeen University for 5 years as Senior Lecturer in psychiatry and worked as a CMHT Honorary Consultant Psychiatrist.

In 2009 I moved to Dundee University as Professor of Neuroimaging and Honorary Consultant Psychiatrist at the Advanced Interventions Service, a tertiary (second opinion) and quaternary (neurosurgical) service for treatment-resistant depression and OCD. I have recently become Co-Director of the Clinical Research Imaging Centre at Ninewells Hospital and also Dundee PI for a multicentre Wellcome Trust funded Strategic Award, Stratifying Resilience and Depression Longitudinally (STRADL), which aims to scan 1000 subjects in Dundee alone (3000 total).

I specialise academically in translational neuroimaging based studies of various psychiatric disorders, particularly focusing on mood disorder using fMRI.  In some studies I have used computational modelling techniques to test various hypotheses, in others I have used machine learning to make clinical predictions about individual patients.

Stressed, tired and emotional: imaging the hippocampus

Location:  Seminar Room 1, Institute of Psychiatry, Psychology & Neuroscience, Denmark Hill

When: 11th February 2016 at 12.30pm 

Speaker: Dr Cathy Symonds   

NIHR Academic Clinical Lecturer in Old Age Psychiatry at University of Manchester, Neuroscience & Psychiatry Unit

Abstract 

The hippocampus lies at the heart of the limbic system and plays a pivotal role in neurocognition and affective disorders.  It also has a major role in endocrine regulation of the hypothalamic pituitary adrenal (HPA) axis.  This particular role is pertinent to affective disorders, as well as many other disease states.  Acute and chronic dysregulation of the HPA axis is associated with cognitive impairment, although previously research has focussed on so-called ‘cold’ cognitions, rather than emotional memory. 

Using novel pharmacodynamic function MRI techniques, we demonstrated the real time, acute, non-genomic effects of hydrocortisone on the hippocampus for the first time in humans.  In addition, to the endocrine role of the hippocampus, the role of emotional memory in treatment resistant depression was also investigated using a novel emotional memory task.

Finally, it is discussed how looking at the hippocampus as a structure for emotional and endocrine regulation will inform future research.

Biography

Originally from Glasgow, Dr Cathy Symonds studied medicine at Newcastle University.  She was first introduced to psychiatric research as an intercalating medical student.  She was supervised by Prof Allan H Young examining the relationship between cortisol and cognition across the menstrual cycle in healthy women.  This led to an interest in the interplay between emotion, cognition and hormones that has lasted her entire career.

Cathy gained the MRCP before moving to Manchester as an Academic Clinical Fellow in psychiatry working with Prof Ian Anderson and Prof Bill Deakin, learning innovative neuroimaging techniques including pharmacodynamic functional MRI and working clinically in the specialist affective disorders service.  She also worked with Prof Rebecca Elliott to produce novel emotional memory tasks.  Cathy used these techniques as part of her PhD where she was the PI of a mechanistic sub-study of the ADD study (efficacy of metyrapone in treatment resistant depression).

Currently, she is an NIHR clinical lecturer in old age psychiatry, bringing together her interests in depression, cognition and physical health.

Is depression caused by a hyperactive habenula?

Location:  Robin Murray A, Institute of Psychiatry, Psychology & Neuroscience, Denmark Hill

When: 22nd October 2015, 3pm

Speaker: Dr Jonathan Roiser   

Reader (Associate Professor) at the UCL Institute of Cognitive Neuroscience (ICN), London

Abstract 

A decade of research has revealed a key role for the habenula, a small structure adjacent to the thalamus, in the brain's processing of aversive stimuli. Not only does the habenula respond to such stimuli, it also inhibits midbrain dopamine neuron firing and its stimulation can drive conditioned place avoidance. Based on these findings, many investigators have suggested that habenula hyperactivity may play a role in depression, and this hypothesis is supported by work in animal models. However, the habenula hyperactivity hypothesis of depression has yet to be tested directly in humans, possibly due to the habenula's small size, which makes its measurement challenging. 

I will present two studies, both of which use a basic computational approach to examine the role of the habenula in humans, and whether it is hyperactive in depression. The first study (Lawson et al 2014, PNAS) showed that in healthy volunteers the habenula responds to aversively conditioned stimuli in a manner consistent with learning. As initially neutral cues became increasingly associated with painful electric shocks, habenula activation increased significantly. The second study showed a similar pattern in an independent sample of healthy volunteers. However, in unmedicated depressed patients habenula activation significantly decreased in response to increasing association with shocks, contradicting the hypothesis. Habenula resting-state perfusion and volume were similar between the groups, though the latter correlated negatively with anhedonic symptoms. These data suggest that the habenula does function abnormally in depression, but that the simple hyperactivity hypothesis is incorrect. 

Biography

Jonathan Roiser is Reader (Associate Professor) at the UCL Institute of Cognitive Neuroscience (ICN), London, where he directs the Cognitive Neuropsychiatry group, and a Wellcome Trust Senior Investigator. His research aims to understand the neurobiological basis of psychiatric symptoms, combining behavioural and psychopharmacological approaches with neuroimaging techniques and computational analysis. His current research focuses on understanding motivational dysfunction in depression. He studied Natural Sciences at Trinity College, Cambridge, as an undergraduate and remained there for his doctorate in the Department of Psychiatry, including a year spent at the National Institute of Mental Health (NIMH), USA. Following a post-doctoral appointment at the UCL Institute of Neurology he was appointed to his current faculty position at the ICN. He was the recipient of the 2013 British Psychological Society’s Spearman Medal and the 2013 British Association for Psychopharmacology’s Senior Psychopharmacology Award. His work has been funded by the Medical Research Council, the British Academy, the Brain and Behavior Research Foundation and the Wellcome Trust. He founded and co-directs two PhD schemes: the UCL-NIMH Joint Doctoral Training Program in Neuroscience (since 2008); and the UCL 4-year PhD Programme in Mental Health (since 2011).

 

Contact: caroline.loveland@kcl.ac.uk / 020 7848 0088

Exploring the causal brain-behaviour relationship: insights from non-invasive brain stimulation

Location:  Small Lecture Theatre, Institute of Psychiatry, Psychology & Neuroscience, Denmark Hill

When: 29th June, 3pm

Speaker: Dr Gorana Pobric 

Institute of Health and Wellbeing, College of Medical, Veterinary and Life Sciences University of Glasgow

Abstract 

In this talk, I will demonstrate that non-invasive brain stimulation provides valuable insight into normal perceptual and cognitive processing, as well as its breakdown in neurodegenerative and mental health conditions. In the first part of the talk I will focus on the neural basis of conceptual knowledge and what we have learned from transcranial magnetic stimulation (TMS). It has been argued that conceptual knowledge stems from the joint action of multiple modality-specific association cortices (the "distributed" theory). However, parallel studies of semantic dementia, rTMS in normal participants and neuroimaging indicate that the anterior temporal lobes (ATL) play an important role in semantic cognition. Based on TMS studies, I will argue that conceptual knowledge is the result of a hub-and-spoke combination of information. The spokes are the modality-specific association areas supporting sensory, verbal, and motor input, while the anterior temporal lobes act as a modality-invariant hub.  In the second part, I will address the role of the middle temporal (MT+) region in global motion processing in patients with schizophrenia and healthy participants. We studied the causal involvement of area MT+ in an optic flow paradigm. Schizophrenic patients showed a significantly reduced bias in trajectory perception for global motion processing. Secondly we explored the effects of non-invasive transcranial electric stimulation (TES) over the MT+ region. We found that cathodal and random noise (HF-RNS) stimulation had opposite effects on trajectory perception in the global optic flow condition. While HF-RNS stimulation reduced the bias of trajectory perception, cathodal stimulation increased it.  Using HF-RNS stimulation over MT+ we demonstrate that the behavioural pattern seen in patients with schizophrenia can be mirrored in healthy participants 

Biography

Dr Pobric is a lecturer at the University of Manchester. After graduating in Neurosciences form the University of Toronto, she received a PhD in Cognitive Neuroscience form SISSA, Italy. During her Marie Curie Fellowship, she worked on visual word recognition and interhemispheric integration at the ICN, UCL with Michal Lavidor (Bar Illan University, Israel) and Vincent Walsh, UCL. In 2006, she joined Neuroscience and Aphasia Research Unit at the University of Manchester. In her own research Dr Pobric uses imaging and brain stimulation to investigate neural basis of semantic cognition, gestures, and perceptual priming.

Contact: caroline.loveland@kcl.ac.uk / 020 7848 0088

 

Molecular mechanisms linking brain response to peripheral inflammation 

 

Location:  Small Lecture Theatre, Institute of Psychiatry, Psychology & Neuroscience, Denmark Hill

When: 27th November 2014, 2pm

Speaker: Professor Jonathan Cavanagh

Institute of Health and Wellbeing, College of Medical, Veterinary and Life Sciences University of Glasgow

Abstract

There is increasingly compelling evidence supporting an association between inflammation and mood disorder.  However, the mechanisms underpinning this relationship remain unclear. 

This presentation will provide data showing that proinflammatory cytokines (e.g. TNFα) increase the activity and availability of the serotonin transporter (SERT). We tested the hypothesis that peripheral antagonism of cytokines (TNFα) will down-regulate SERT availability in the brain. In an initial proof of concept study, we showed that SERT availability was reduced following 4 weeks of the human monoclonal drug Adalimumab in patients with rheumatoid arthritis. We replicated this with another drug (Etancercept) in a different clinical population (Psoriatic Arthritis). 

In addition, preclinical data will be discussed exploring possible molecular mechanisms linking peripheral and brain immune responses, with a particular emphasis on chemokines.  

 

Prof Cavanagh qualified in Medicine at Glasgow, then post grad and doctoral studies in Edinburgh. Currently professor of psychiatry in Glasgow and runs a translational research programme from molecular techniques in preclinical models to human neuroimaging with an inter-disciplinary team understanding the role of immune molecular mechanisms in serious mental disorder. Key questions are focused on determining the role of cytokine and chemokine biology in the pathophysiology of neuropsychiatric disorders. The current focus is on the mechanisms linking peripheral immune markers to brain responses.  

 

Investigating neuropsychological mechanisms in depression

Location: Wolfson Lecture Theatre, Institute of Psychiatry, Psychology and Neuroscience

When: 1st December 2014, 2pm

Speaker: Dr Emma Robinson

Reader in Psychopharmacology, School of Physiology and Pharmacology, Faculty of Medical and Veterinary Sciences Business Fellow

Abstract: Major depressive disorder usually presents as a complex mixture of emotional, cognitive and somatic symptoms.  Current treatments include both pharmacological and psychological approaches and success rates are often comparable for mild to moderate illness.  However, a significant proportion of patients fail to respond and the disease can develop in a very severe and debilitating, treatment resistant disorder.  Despite the availability of drug treatments for more than 60 years and extensive clinical and pre-clinical research, the underlying biology of depression remain elusive.  Our work focuses on the use of animals to investigate the neurobiology of depression and studies to try to understand the processes which lead to the development and perpetuation of the disease.  We have recently been working to develop and validate novel methods to study cognitive affective behaviours in animals.

Activation & Genes in Bipolar Disorder:

Recent Advances in Understanding 

September 19th 2014

Location: Wolfson Lecture Theatre, Institute of Psychiatry, Psychology & Neuroscience, Denmark Hill

When: 19th September 2014 / 08.30 to 1pm 

Contact: caroline.loveland@kcl.ac.uk / 020 7848 0088

This event will bring together leading experts from Europe, the USA and Australia.  Professor Jan Scott (University of Newcastle) will review the definition, measurement and central role of activation in mania and bipolar disorders.  Professor Ian Hickie (Brain and Mind Institute, University of Sydney) will review motor activation and subjective energy as a core construct in mood disorders and discuss evidence from clinical and twin studies.  Prof Kathleen Merikangas (National Institute of Mental health, Washington D.C., will review activation as a key feature of mania and draw on her work from general population and family studies.  Dr Gerome Breen (MRC-SDGP, KCL) will review recent genetic findings and the implications of these for this area.

 

  • Programme: A full list of topics and speaker profiles is available here.

CfAD Launch Day | January 31 2014

 

Location: Wolfson Lecture Theatre, Institute of Psychiatry, Psychology & Neuroscience, Denmark Hill

When: 31st January 2014 / 09:00 to 17:00 

Contact: caroline.loveland@kcl.ac.uk / 020 7848 0088

 

Affective or Mood Disorders represent one of the greatest challenges in medicine today. This group of illnesses may occur at any age, in any demographic group and is associated with one of the heaviest cost burdens both to the individual and to society. 

Affective disorders are common and overlap with other psychiatric disorders and physical ill-health. Knowledge of this key area is important for all practising health care professionals, policy makers and health service managers.

The Centre for Affective Disorders Launch Day offers all health professionals interested in affective disorders the opportunity to meet the new CfAD team, clinicians from the tertiary South London and Maudsley NHS Foundation Trust Affective Disorders Service and like-minded colleagues.  

It also offers a forum to learn about the most recent advances in Affective Disorders, to hear news from front line primary care and to learn from the patient perspective of clinical care.  

 

  • Programme: A full list of topics and speaker profiles is available here.
  • Cost: £5 including refreshments and lunch
  • Online Booking : Please use the King's Estore to book your ticket. 

Lunch Time Talk

27th September 2013, 12.30pm, Seminar Room 4

Anne Duffy, MD, MSc, FRCPC CAIP  Professor Youth Mental Health, Department of Psychiatry, Mathison Centre for Mental Health Research and Education, Canada                         

Prof Duffy presented "Staging models of bipolar disorder - how can they inform diagnosis and treatment?"

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