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On May 7 th the Emory University Graduate Students in Psychology and Neuroscience (GSPN) hosted a colloquium talk given by Vijay Mittal , assistant Professor of Psychology and Neuroscience at the University of Colorado at Boulder. In the talk, titled “Translational Clinical Science in the Psychosis Prodrome: From Biomarkers to Early Identification and Intervention,” Dr. Mittal, who received his Ph.D. from Emory, discussed some of his research on the prodrome for schizophrenia. 1 Dr. Vijay Mittal The prodrome for schizophrenia is a collection of neurological and psychological symptoms that can indicate risk for developing schizophrenia (as has been discussed previously on this blog) prior to the development of clinically relevant symptoms. Research on the prodrome is gaining much attention and funding because it could lead to a better understanding of how schizophrenia develops and better ways to intervene prior to its onset. Mittal began his talk with a background on the schizoph...

By Jalayne J. Arias, JD, MA Jalayne J. Arias is the Associate Director of the NeuroEthics Program and Assistant Professional Staff in the Department of Bioethics at the Cleveland Clinic. Ms. Arias’ work incorporates empirical and conceptual projects addressing critical legal and ethical issues inherent in diagnosing, treating, and researching Alzheimer’s disease and other neurodegenerative conditions. Most recently, she served as the principal investigator for the study Stakeholders’ Perspectives on Preclinical Alzheimer’s Diagnosis: Patients, Families and Care Givers . Her recent publication, Confidentiality in preclinical Alzheimer disease studies (Neurology), addresses confidentiality concerns relevant to biomarker testing in Alzheimer’s. In 2007, Dr. Dubois and co-authors introduced the concept of prodromal Alzheimer’s disease in their Lancet article revising diagnostic criteria. In 2011, the National Institutes of Aging and the Alzheimer’s Association supported a series of...

Autism Spectrum Disorder (ASD) is a complex disorder typically characterized by social impairment and communication deficits, and most recently the CDC has estimated that 1 in 88 American children are affected by a form of ASD. 1 A reliable diagnosis for autism can be offered at 24 months, but most children are diagnosed later after attending school. For the first Neuroethics journal club of the spring semester, ILA graduate student and Neuroethics Scholar Jennifer Sarrett led a discussion on a new technology that could offer preclinical risk assessment in children as young as 2 months. Even though children and adults with autism exhibit a wide variety of individual and unique symptoms, a common attribute of those diagnosed with autism is a deficit in the ability to make eye contact. In a paper published in Nature late last year, researchers from the Marcus Autism Center and Emory University School of Medicine used special eye-tracking equipment to measure eye fixation in children on...

By Elaine Walker, Ph.D., Sandy Goulding, MPH, MA., Arthur Ryan, MA., Carrie Holtzman, MA., Allison MacDonald, MA. Elaine Walker is Samuel Candler Dobbs Professor of Psychology and Neuroscience in the Department of Psychology at Emory University .  She leads a research laboratory that is funded by the National Institute of Mental Health  to study risk factors for major mental illness.  Her research is focused on child and adolescent development and the brain changes that are associated with adolescence. The identification of risk factors for illness is receiving increased attention in all fields of medicine, especially cardiology, oncology, neurology and psychiatry.  There are three potential benefits to identifying risk factors. The first is to reduce morbidity by reducing risk exposure. The second is to enhance opportunities for targeting preventive treatment toward those who are most likely to benefit. Finally, the identification of risk factors can shed light o...

Psychotic disorders like schizophrenia affect about 5% of people and often result in life-long disability. Identifying at-risk individuals and predicting disease onset are crucial, and present a challenge to the development of preventative treatments. Understanding the biological mechanisms underlying psychosis are also extremely important in identifying risk factors and designing treatments. Because psychotic disorders are so disabling and usually irreversible, research interests in this field have shifted toward prevention and early intervention. Subtle pre-clinical deficits in psychosocial and neurocognitive functioning have been reported for many years and are now being extensively studied. Elucidating this pre-illness state, known as the “prodromal” period, is one area of research for Dr. Elaine Walker, the Samuel Candler Dobbs Professor of Psychology and Neuroscience at Emory University. Dr. Walker spoke at the Frontiers in Neuroscience Seminar Series on Friday, January 27 th , ...

Prophylactic medicine is the new medicine. The primary ethical issue brought up by the paper revolves around the notion of diagnostic testing. Everyone wants to try and catch the disease early so that we can come up with treatment options and help them salvage whatever quality of life they have left. The problem arises because these tests are not perfect. They sometimes miss the targets, leading to false negatives. They also sometimes hit targets that aren’t actually targets, leading to false positives. In both cases, there could be catastrophic consequences. It’s usually one or the other though. So when the condition is more dangerous than the treatment, it’s important to minimize the false negatives, such as in the case of cancers. When the treatment is more dangerous than the condition, however, it’s important to minimize the false positives, such as for hypercoagulability. In the case of schizophrenia, it appears that the symptoms of the condition outweigh the commitment and side-e...

David Dobbs describes new developments in schizophrenia research, prodromal schizophrenia, and potential new treatments for the disorder in “The Making of a Troubled Mind”. He cites several recent advancements in researchers’ understanding of the disease and indicates that targeting GABA receptors is a promising pharmacological therapy. Like many psychiatric and medical diseases, schizophrenia presents itself in various subtle ways before it may be clinically recognized and diagnosable. This is because the mechanisms behind the disease—dysfunctional pyramidal and chandelier cell structure and activity, at least in part—are present throughout a person’s life but only start causing significant, noticeable problems in adolescence. Pre-clinical signs of schizophrenia may include paranoia, cognitive impairments, hallucinations or “peculiar” thoughts. Dobbs mentions a survey to assess a young person’s risk of developing schizophrenia—the Structured Interview for Prodromal Syndrome. It has sh...

In the last decade, there has been a push to develop and characterize a diagnosis for adolescents at high-risk for schizophrenia, called prodromal risk syndrome. 1 The Personal Assessment and Crisis Evaluation (PACE) clinic in Melbourne, Australia, was first to develop a classification of prodromal syndromes. 2 The disease of schizophrenia is most typically diagnosed in early adulthood, when most schizophrenics experience their first psychotic break, therefore, early intervention tactics are aimed at adolescents. This is one of the reasons that the PACE clinic is located in a shopping mall. 3 On the other side of the globe, the North American Prodrome Longitudinal Study (NAPLS) has been developing and improving methods to reliably diagnose individuals in the prodrome stage. Once identified, they offer these individuals psychotherapy, family therapy, drugs, or cognitive training to hopefully lessen the progression of symptoms. Their method of assessment scores symptoms including ...

John Forbes Nash Jr. was a brilliant mathematician at Massachusetts Institute of Technology when in 1959 he began to exhibit extreme paranoia and erratic behavior. Later that year, he would check into a mental hospital where he would be diagnosed with schizophrenia. Although over 50 years have passed since that time, schizophrenia has no cure, no well-defined cause, and no means of prevention. Schizophrenia is debilitating and extremely costly, not only to patients and their families, but also to society at large. Approximately 1% of the world's population will be diagnosed with schizophrenia within their lifetime. Recent research has focused on identifying individuals at the highest risk before the full onset of psychosis, but these efforts have proven highly controversial due to ethical concerns. The North American Prodrome Longitudinal Study (NAPLS) has championed efforts to characterize the schizophrenia prodrome, which is defined as early symptoms of the disease that may be...