1 / 18

Thomas R. Insel, M.D. Director, NIMH 9/29/10

Neuroscience Research: Challenges and Opportunities. Thomas R. Insel, M.D. Director, NIMH 9/29/10. Mental Disorders are Chronic and Disabling. WHO 2008. Mental Disorders are Chronic and Disabling. WHO 2008. Mental Disorders: Mortality.

trilby
Download Presentation

Thomas R. Insel, M.D. Director, NIMH 9/29/10

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Neuroscience Research: Challenges and Opportunities Thomas R. Insel, M.D. Director, NIMH 9/29/10

  2. Mental Disorders are Chronic and Disabling WHO 2008

  3. Mental Disorders are Chronic and Disabling WHO 2008

  4. Mental Disorders: Mortality • Over 34,000 suicides per year in the U.S. (CDC, 2007) • - 90% related to mental illness • For context: • 18,000 homicides • 33,000 traffic fatalities Life expectancy: 56 years (Colton & Mandersheid, 2006)

  5. The Five Most Costly Conditions Not Counted: $193B - lost earnings $24B – SSI/SSDI $57.5 billion, ranking mental health expenditures the third most costly and equal to that of cancer Costs of: Incarceration Homelessness School/Home care Total > $317B/yr (Insel 2008)

  6. Disruptive Innovations In Mental Health Mental disorders are brain disorders. Mental disorders are developmental disorders.

  7. Human Neuroimaging:Seeing the Connections Functional Connectivity Molecular Imaging Structural Connectivity Temporal Connectivity EEG fMRI Multimodal Integration New Molecular Imaging New knowledge of human brain function in health, disorders & across lifespan

  8. Depression is a Brain Disorder Hopelessness, helplessness, suicidal thoughts, anorexia, loss of libido, sleep disturbance Insel, Sci Am, 2010

  9. OCD is a Brain Disorder Recurrent unwanted thoughts (obsesssions) and/or repetitive behaviors (compulsions) Insel, Sci Am, 2010

  10. PTSD is a Brain Disorder Flashbacks, bad dreams, insomnia, frightening thoughts, avoidance, guilt, depression, hyperarousal Insel, Sci Am, 2010

  11. PF MCC MF PCC MCC CBT MEDS PF P PCC Meds Cg25 BS Defining Depression Circuits Response Pathways Cognition (attention-appraisal-action) hc Par40 PM6 PF9/46 Mood state thal mF9/10 na-vst Self-awareness insight pACC24 amg mb-vta oF11 Salience Motivation sACC25 a-ins hth bstem Interoception (drive-autonomic-circadian) Br Med Bul 65:193-207, 2003 Arch Gen Psych 61:34-41-2004

  12. Moving the Bar for Antidepressants 18 pts with TRD Ketamine 0.5mg/kg vs Placebo given IV single dose 1 week apart

  13. Large Small • Neurobiological parameters may be valuable predictors of treatment response, possibly explaining more variation than common subdiagnostic classifications Effect sizes: Predictors of antidepressant response to ketamine at 230 min

  14. Abnormal Amygdala-Prefrontal Effective Connectivity to Happy Faces Differentiates Bipolar from Major Depression Jorge Renner Cardoso de Almeida, Amelia Versace, Andrea Mechelli, Stefanie Hassel, Karina Quevedo, David Jerome Kupfer, and Mary Louise Phillips

  15. STAGE 1 Biosignatures Initiative: EMBARC Enrolled N=400 Establishing Moderators/Mediators for a Biosignature of Antidepressant Response in Clinical Care (EMBARC) P.I.s: MadhukarTrivedi and Myrna Weissman Sites: Columbia, MGH, U Mich, UTSW Randomized Treat with Citalopram n=200 Treat with Placebo n=200 Responder n=90 Non-Responders n=70 Responders n=60 Non-Responders n=100 Clinical assess. Genetics/Epigen. Cognition Imaging qEEG STAGE 2 Switched to Citalopram n=50 Continue Citalopram n=90 Switch to Buspirone SR n=70 Continue Placebo n=60 Predictors of response Early surrogates Predictors of adverse events

  16. Stem Cells Transcript profiles Proteomics Optical imaging Databases Electrode arrays Zebrafish Imaging ChR-2 Databases GWAS Sequencing Transgenics Epigenetics Databases Sensors Eye gaze Cognitive Tools Epidemiology Web 2.0 Knowledge management From Description to Mechanism: 2010 Molecule Cell System Individual Social

  17. Translating Neuroscience to Health Preventive interventions Personalized care Genes Cells Systems Individual Social Molecular diagnostics Discovery Technologies Proteomics Neuroimaging Pathophysiology Clinical genomics Dissemination Access Coordination Translating Research to Practice Strategic prevention Cure Therapeutics Next-Gen Clin Trials Early Interventions POC Dx Biodiagnostics Treatment of core pathology Diagnosis by symptoms Treatment of episode

  18. Paving the Way for Prevention, Recovery, and Cure www.nimh.nih.gov

More Related