|Mark Hyman Rapaport, MD
Welcome to the first edition of Brain Waves , our newest publication from the Department of Psychiatry and Behavioral Sciences. The intent of our newsletter is to provide timely updates about exciting advances occurring at Emory and to highlight the wonderful people who make up our department and service line. Our department is one of the most highly ranked departments of psychiatry in US News and World Report and also in federal funds. We are responsible for all of the psychiatric care in the Emory Healthcare system as well being a significant provider of care at Grady Memorial Hospital and the Atlanta VAMC. We are very proud of who we are and very excited about where we are going. Work by our researchers is leading to new breakthroughs in the areas of treatment refractory depression, posttraumatic stress disorder, the treatment of anxiety disorders and the biology of fear. We are the largest psychiatric and behavioral sciences training program in the State of Georgia and one of the largest in the southeastern United States and we are pleased that our graduates provide outstanding care for many individuals. We are committed to providing care to the disenfranchised, our veterans as well as the larger Atlanta and Georgia community.
I am very excited about where our department is going. Emory University and the Woodruff Health Sciences have committed to the development of the Brain Health Initiative that will facilitate the integration of the research, clinical, and training missions of not only the Departments of Psychiatry and Behavioral Sciences and the Department of Neurology, but eventually all individuals interested in brain health. The first step of this will be the movement of the outpatient programs of the Department of Psychiatry and Neurology into a new building located within 2 miles of the Emory Campus (Executive Park). Simultaneously with this wonderful commitment to resources to brain health, Woodruff Health Sciences is committed to the development on the Wesley Woods campus of a truly integrated academic and psychiatric inpatient program! Over the next year, we will be opening a new state-of-the –art adult inpatient facility and a newly renovated geriatric inpatient unit. We are excited about new partnerships we are forming within the State of Georgia and look forward to many collaborations locally, nationally, and internationally.
You will enjoy this first edition of Brain Waves and learn a little about one of our amazing senior investigators, Andy Miller, our tremendous program at the Emory Autism Center and a little about our training program. Please be sure to explore some of the links that talk about the important research that we are doing here at Emory. Thanks again for joining us.
Linking Inflammation and Depression
Too much of a good thing can be bad. Consider inflammation. It's fundamental for our very survival, priming our bodies to fight off infection and repair tissue damage. If it becomes chronic, however, inflammation can lead to a host of problems, including depression.
Dr. Andrew Miller, William P. Timmie Professor of Psychiatry and Behavioral Sciences and Director of Psychiatric Oncology at the Winship Cancer Institute, is studying that link between chronic inflammation and depression in both medically healthy and medically ill – specifically cancer – patients. By working to uncover the specific mechanisms and pathways behind chronic inflammation, Miller hopes to fashion novel therapies to treat depression.
|Andrew Miller MD
One area of research focuses on cytokines, chemicals produced by the body to mediate inflammation. "Cytokines get into the brain and interact with virtually every physiologic pathway that we know is relevant to the symptoms of depression, including neurotransmitters, growth factors involved with the development of new neurons and circuits and hormonal pathways involved with emotion regulation," says Miller.
So Miller and his team tested a drug, infliximab, that blocks one of the key cytokines on medically healthy treatment-resistant depressed patients. At first glance, the results were disappointing, revealing no difference between patients who received the infliximab (an anti-inflammatory drug typically used to treat rheumatoid arthritis or inflammatory bowel disease) and those who received placebo.
But Miller then looked at the participants' baseline inflammation and discovered that those with high levels of inflammation – CPR (c-reactive protein) greater than 5 mg/L – exhibited an antidepressant response to the anti-inflammatory drug.
"This suggests that cytokines at high levels can play a key role in depression and blocking them can treat depression in certain patients," says Miller. "These results could have huge implications. We have a situation where, on the basis of a simple, widely available blood test for inflammation - CRP, we can determine a subgroup of patients up front who might respond to a specific therapy that blocks inflammation."
For more information on Miller's research, visit psychiatry.emory.edu/PROGRAMS/mindbody.
— Martha Nolan McKenzie
The Emory Autism Center
|Children at play at the Walden Early Childhood Center
When it comes to the treatment of ASD (Autism Spectrum Disorder), since 1991, the Emory Autism Center has been unique in the state and nation in that we have a renowned preschool program, a program that provides training for teachers and others who work with school age children, and have one of the only inclusive programs for adults with Autism Spectrum Disorder in the Southeast.
Early autism intervention is the focus of Walden, a laboratory preschool, that includes children with autism alongside their typically developing peers. Research is aimed at evaluating the efficacy of providing optimal social input at very young ages (12 months until kindergarten) using behavioral techniques within natural preschool activities. Individualized clinical care is also available to children with autism who come from other states and countries. This groundbreaking treatment approach has been replicated through multidisciplinary professional training on campus, in other sites (Arizona, California, Texas), and through collaboration with Georgia Department of Education on a federally funded – teacher training - project. See more at: psychiatry.emory.edu/PROGRAMS/autism/Childhood
The Monarch Program is a highly-successful, inclusion-based, technical and consultative training program that works with schools, families and agencies to improve programming in the areas of education, transition and behavior for Kdg-12th grade students throughout the State of GA. Since 1993, Monarch has positively affected thousands of students with ASD and their families in public/private schools, as well as collaborating with autism-related organizations in an effort to improve outcomes and enrich opportunities in the school and community for children with ASD. See more at: psychiatry.emory.edu/PROGRAMS/autism/Monarch
The philosophy of the EAC Adult Program is based firmly on the fundamental principle guiding all programs at EAC: that persons with ASD belong in their home communities, interacting with typical members of the community in ways that promote dignity, productivity and happiness. The EAC Adult Program provides innovative and diverse programs to address the burgeoning demand for services for adults with autism spectrum disorders (ASD), including a psychopharmacology clinic, individual and family psychotherapy, social skills and leisure skills interventions, and behavior analysis to address individual challenging behaviors. We welcome all inquiries, and invite interested people to see more at: psychiatry.emory.edu/PROGRAMS/autism/Adult