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Director:
Manuel Tancer, MD
9B UHC
Phone: 313.577.0215
The
Neuropsychiatric Research Unit is a new inpatient/outpatient research
unit located at 5V DRH. It has six inpatient beds and 4 outpatient beds/
procedure rooms, and is capable of supporting state-of-the-art clinical
research studies. The NRU also includes an on site laboratory for sample
preparation and storage. The unit is staffed by a research coordinator,
psychiatric research nurses, research assistants, an occupational
therapist, a social worker, a pharmacy technician, sleep research
technicians, and is under the overall Scientific and Medical
Directorship of Husseini K. Manji, MD. The sleep research component is
under the Directorship of Tom Roth Ph.D., Tim Roehrs, Ph.D., and Suzanne
Woodward, Ph.D. The Research Unit is particularly well suited for the
study of the underlying biologic basis of the major mental illnesses,
and for the development of innovative treatment strategies.
Nature
of Scientific Investigations that can be undertaken at the NRU:
- Molecular,
Cellular and Biochemical: Various biochemical processes can be
investigated in patients at different illness stages and in response
to treatments. These biochemical measures include hormones,
neurotransmitters, and second messenger systems, gene expression,
and other cellular elements known to be critical for normal neuronal
functioning. The NRU is capable of supporting such studies in CSF,
plasma, urine, and peripheral circulating blood cells.
- Physiological:
The NRU is capable of supporting state of the art sleep research
studies, ambulatory EEG and activity monitoring, and it is
anticipated that in the not too distant future, studies of autonomic
function (e.g. sympathetic nerve firing activity).
Because
of the unique nature of the NRU, many complex studies can be performed
in patients longitudinally, often following an adequate medication
washout period. To facilitate this, a number of psychotropic medications
(including antidepressants, antipsychotics, mood-stabilizers, and
anxiolytics) have been formulated in identical blinded capsules.
Some
examples of the type of research paradigms which can undertaken in the
NRU include the following:
- Investigation
of new neuropharmacological agents, and characterizing determinants
of treatment response. By investigating the genetic /
biochemical /physiological determinants of treatment response, it
may be possible to eventually predict with a greater degree of
certainty which medication is best suited to each patient’s
individual condition, thereby greatly improving the delivery of
effective treatments.
- Investigation
of abnormalities in the Sleep/Wake and Circadian cycle in various
disorders and during various treatment stages. Baseline
circadian and/or sleep-wake cycle alterations can be studied, and
these can be monitored longitudinally as indices of not only the
underlying illness pathophysiology, but also as predictors of
treatment response, resistance, or relapse. With the growing body of
evidence identifying various "clock genes", such
sophisticated polysomnographic studies in combination with genetic
studies may also lend themselves to the more precise
genotyping/phenotyping of various neuropsychiatric disorders which
have considerable phenomenologic and symptom cluster overlap.
- Investigation
of the responses to traditional and new neuropharmacologic agents
with respect to timing of administration. It may be possible to
exploit human circadian rhythms for therapeutic purposes, for
example, by administering medications during certain stages of
sleep. In NRU, it is possible to monitor the patients’ sleep
stages (using sleep EEG instrumentation), and administer medications
through an intravenous line.
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