MGHPGR: Structural Neuroimaging of Brain Circuits
Structural Neuroimaging of Brain Circuits: Some implications in Treating Psychiatric Conditions with Neuromodulation Approaches - Could Research Domain Criteria (RDoC) and Diagnostic and Statistical Manual of Mental Disorders (DSM) approaches be Integrated?
Modern neuroscience has produced a paradigm shift in biomedical sciences with important implications for psychiatry. In the 1990s, a new hypothesis was formulated, namely that psychiatric disorders are associated with altered brain circuitries and thus could be viewed as disorders of brain connectivity. In this paradigm, brain circuitries are considered putative biomarkers (or endophenotypes) in psychiatric disorders. The neural systems approach in psychiatric clinical research aims to identify well-understood neural systems in psychiatric conditions and to determine whether these neural systems are correlated with specific behaviors as well as with specific genotypes. These three issues can be addressed currently with the aid of neuroimaging in clinical psychiatric studies. Although it is not yet feasible for a diagnosis in psychiatry to be addressed at a brain circuitry level, neurocircuitry has become a major emphasis in psychiatric research. This is reflected clearly in the RDoC (Research Domain Criteria) framework, which integrates multiple levels of information in different domains of human biology and functioning – from genes to behavior – to investigate mental health and dysfunction. Although it is not a diagnostic instrument, the RDoC could be of great use to psychiatrists in enhancing their understanding of the behavioral dimensions in which a given patient may be strong or weak. A clinician psychiatrist or psychotherapist could use this information to sharpen and tailor a therapeutic intervention for a patient. Thus, the utilization of dimensional tools (such as the RDoC) and categorical tools (such as the Diagnostic and Statistical Manual of Mental Disorders-5 or DSM-5) could be complementary and mutually reinforcing to benefit the patient. Using neuroimaging, we can identify brain circuits and stimulate them using transcranial magnetic stimulation (TMS) or deep brain stimulation (DBS) aimed at modulating their activity (neuromodulation) to treat psychiatric conditions such as refractory depression or obsessive-compulsive disorder (OCD).
This program is intended for: Psychiatrists, Psychologists, Fellows, Residents, Interns and Nurses
At the end of this presentation participants will be able to:
- Discuss the fundamental aspects of the Research Domain Criteria, RDoC, its strengths and weaknesses, how it relates to the DSM-5 approach, and how is it contextualized in modern neuroscience.
- Describe neural systems neuroanatomy and brain circuits, i.e. how brain circuits are related to the RDoC framework and how are they visualized and delineated structurally using neuroimaging.
- Describe the concept of neuromodulation and the use of transcranial magnetic stimulation (TMS) and deep brain stimulation (DBS) in treating psychiatric disorders.
- 1.00 AMA PRA Category 1 Credit™
This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of McLean Hospital and Massachusetts General Hospital. McLean Hospital is accredited by the ACCME to provide continuing medical education for physicians.
McLean Hospital designates this Enduring activity for a maximum of 1.00 AMA PRA Category 1 Credit™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
- 1.00 Nursing Contact Hours
Massachusetts General Laws, Chapter 13, sections 13, 14, 14A, 15 and 15D and Chapter 112, sections 74 through 81C authorize the Board of Registration in Nursing to regulate nursing practice and education.
This program meets the requirements of the Massachusetts Board of Registration in Nursing (244 CMR 5.00) for 1.00 contact hours of nursing continuing education credit. Advance practice nurses, please note: Educational activities which meet the requirements of the ACCME (such as this activity) count towards 50% of the nursing requirement for ANCC accreditation.
- 1.00 Participation
This course allows other providers to claim a Participation Certificate upon successful completion of this course.
Participation Certificates will specify the title, location, type of activity, date of activity, and number of AMA PRA Category 1 Credit™ associated with the activity. Providers should check with their regulatory agencies to determine ways in which AMA PRA Category 1 Credit™ may or may not fulfill continuing education requirements. Providers should also consider saving copies of brochures, agenda, and other supporting documents.
- 1.00 Psychologists CE Credit
The Massachusetts General Hospital Department of Psychiatry is approved by the American Psychological Association to sponsor continuing education for psychologists. The Massachusetts General Hospital Department of Psychiatry maintains responsibility for this program and its content.
This offering meets the criteria for 1.00 Continuing Education (CE) credits per presentation for psychologists.
Dr. Makris has the following financial relationships:
Stock Ownership - Amarin Corporation
Consultation - INRIA - Institut National de Recherche en informatique et en Automatique
Advisor - ULL - Instituto Universitario de Neurociencia
Research Scholar - FULLBRIGHT
Fellowship - HWK - Hanse-Wissenschaftskolleg