slide1 l.
Download
Skip this Video
Loading SlideShow in 5 Seconds..
Thomas R. Insel, M.D. Director, NIMH 9/29/10 PowerPoint Presentation
Download Presentation
Thomas R. Insel, M.D. Director, NIMH 9/29/10

Loading in 2 Seconds...

play fullscreen
1 / 18

Thomas R. Insel, M.D. Director, NIMH 9/29/10 - PowerPoint PPT Presentation


  • 198 Views
  • Uploaded on

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.

loader
I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
capcha
Download Presentation

PowerPoint Slideshow about 'Thomas R. Insel, M.D. Director, NIMH 9/29/10' - trilby


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.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript
slide1

Neuroscience Research: Challenges and Opportunities

Thomas R. Insel, M.D.

Director, NIMH

9/29/10

slide4

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)

slide5

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)

slide6

Disruptive Innovations

In Mental Health

Mental disorders are brain disorders.

Mental disorders are developmental disorders.

human neuroimaging seeing the connections
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

slide8

Depression is a Brain Disorder

Hopelessness, helplessness, suicidal thoughts, anorexia, loss of libido, sleep disturbance

Insel, Sci Am, 2010

slide9

OCD is a Brain Disorder

Recurrent unwanted thoughts (obsesssions) and/or repetitive behaviors (compulsions)

Insel, Sci Am, 2010

slide10

PTSD is a Brain Disorder

Flashbacks, bad dreams, insomnia, frightening thoughts, avoidance, guilt, depression, hyperarousal

Insel, Sci Am, 2010

slide11

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

moving the bar for antidepressants
Moving the Bar for Antidepressants

18 pts with TRD

Ketamine 0.5mg/kg

vs Placebo

given IV single dose

1 week apart

slide13

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

slide14

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

slide15

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

slide16

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

slide17

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