We are engaged in multiple translational projects involving mouse and human studies that are linked so as to establish a structure that allows the testing of multiple hypothesized targets and drugs based on mechanism. To accomplish this, basic neuroscientists are partnering with clinical researchers and using what we understand from animal studies about the brain circuits that underlie anxiety and repetitive behaviors to make strategic hypotheses about what types of treatments might work in our patients. We then test those treatments in our patients. What we are learning from our patients, we then feed back to the basic scientists. So it is a back and forth, bi-directional translation from basic science to clinical research and from clinical research back to basic science, with the goal being to advance what we know about mechanisms, as well as to develop new treatments for people suffering from anxiety disorders.
The following is a selection of current and completed research projects funded by the Youth Anxiety Center
TRANSLATING SCIENCE INTO BETTER TREATMENTS
Identification of “sensitive period” for fear regulation-Investigator(s): Francis Lee, MD, PhD, Charles Glatt, PhD, BJ Casey, PhD
There is a period during adolescence when there is a peak in the emergence of mental illness, in particular, anxiety disorders. By understanding “sensitive periods” of development when the brain is especially receptive to the environment, we may be able to understand shifts and early closures of these windows and potentially expand them behaviorally and/or pharmacologically.
Examining what causes pathological anxiety in humans
*DTI and resting state fMRI data from individuals with and without OCD-Investigators: Rachel Marsh PhD, X He, PhD
This research uses two specific types of neuroimaging, Diffusion Tensor Imaging (DTI) and resting state imaging, and compares results between non-OCD subjects, OCD subjects not on medication and OCD patients on medication. Ultimately these studies may identify bio signatures of OCD that could become targets for new treatment development.
Developing new treatments
There is a compelling need for alternative pharmacological treatments in adolescents with OCD. In this pilot proposal, we will evaluate the feasibility/tolerability, and preliminary efficacy of ketamine as a rapid treatment for OCD symptoms in adolescents with OCD.
Investigating how and for whom our treatments work
Developing treatment-specific biomarkers for OCD-Investigators: Shannon Bennett, PhD, John Walkup, MD, Anne Marie Albano, PhD and Francis Lee, PhD, MD
The first-line psychotherapy for OCD is cognitive-behavioral therapy consisting of exposure and response prevention. However, some individuals are not helped by this treatment or experience only a minimal reduction in symptoms. This study examines the effectiveness of exposure therapy across development in an effort to identify potential bio-behavioral marker(s) of exposure therapy outcome in childhood anxiety disorder. A treatment-specific biological marker (biomarker) could assist clinicians by identifying individuals for whom alternative treatment is necessary, personalizing medical care and maximizing resource allocation.
A test of a potential biomarker for exposure therapy outcome across development in anxious youth-Investigators: Michael Wheaton, PhD
Anxiety disorders typically begin in childhood or adolescence, have a high lifetime prevalence, and when inadequately treated become chronic. Exposure therapy for anxiety and related disorders is an intervention with proven efficacy, yet for a significant percentage of treated individuals is not sufficient to achieve remission. The aim of this study is to expand our understanding of developmental differences in extinction learning and explore the potential impact on the efficacy of exposure therapy across development.
TRANSLATING SCIENCE INTO BETTER SERVICES
A public health perspective on anxiety disorders in youth and young adulthood: phenomenology, course and treatment-Investigators: Cristiane Duarte PhD and Mark Olfson, MD
With the goal of generating novel findings of the highest public health significance for young adults with anxiety disorders, we are conducting secondary data analyses of population-based, longitudinal datasets. Specifically, we are focused on elucidating (a) the phenomenology and course of anxiety disorders in young adulthood, and (b) patterns of mental health treatment, given the substantial disparities in care observed among young adults.
* Denotes previously funded and completed projects.
All other projects listed are currently funded by the Youth Anxiety Center.