MIRECC / CoE

VISN 4 MIRECC Newsflash

Winter 2019

The mystery of nightmares: can in-home sleep monitoring offer clues?

We know that nightmares, one of the defining features of PTSD, are associated with poor clinical outcomes and increased risk of suicide in Veterans. However, despite an urgent need to reduce this burden, the underlying physiological changes accompanying trauma nightmares are poorly understood, and there are no clear evidence-based recommendations for their treatment. Katherine E. Miller, Ph.D. of the VISN 4 MIRECC Philadelphia site will be exploring some of these unanswered questions through a new CSR&D Career Development Award-funded project, Characterization of Sleep with Trauma-Nightmares Using Ambulatory Sleep Measurement.

A significant barrier to investigating this topic has been that current assessment procedures—mainly in-laboratory sleep studies—don’t often capture nightmares, so our knowledge of phenotypic markers and their response to treatment is limited. Dr. Miller’s study will employ innovative mattress-based actigraphy technology to conduct extended, in-home sleep monitoring to capture the physiological parameters associated with Veterans’ nightmare reports. She will then assess how these features are altered throughout a cognitive-behavioral nightmare treatment. This project supports the VISN 4 MIRECC’s research focus on Measurement-Based/Precision Mental Health Care by increasing our understanding of trauma nightmare pathophysiology and advancing strategies for personalizing symptom management in Veterans.

Despite their prevalence, nightmares remain a bit of a mystery. We know that many Veterans report them and that they cause significant distress. However, as providers, we can get stuck trying to figure out the best approach for care. To improve our treatment options, we first need to know more about what is going on. My hope is that we will gain some insight by going to the source of when and where a nightmare occurs." —KATHERINE E. MILLER, PH.D.

Michael Thase, M.D. was elected to the Academy of Master Clinicians [external] at the University of Pennsylvania, the highest clinical honor for a Penn physician (December). Master Clinicians “develop and implement innovative programs focusing on career mentoring for medical students, professionalism, promoting and enhancing a culture of clinical excellence at Penn Medicine, promoting wellness and reducing burnout, and exploring barriers to providing exceptional patient care.”

Swathi Gujral, Ph.D. received a MIRECC Pilot Project Award for her project, Neurobiological Correlates of Physical Activity and Cardiorespiratory Fitness: Role in Predicting Treatment Response in a Pharmacotherapy Trial for Treatment-Resistant Late-Life Depression.

Subhajit Chakravorty, M.D.’s National Science Foundation-funded study, Implementation of a Biometric Data Software Platform to Augment Mental Health Treatment, was mentioned in a profile of Philadelphia-based startup NeuroFlow in the Philadelphia Citizen [external]. The article notes that results of the pilot project at the Cpl. Michael J. Crescenz VA Medical Center could lead to funding to expand the project to other VA sites around the country.

Coaching into Care, Steven Sayers, Ph.D. and Tanya Hess, Ph.D. were featured in a post on VAntage Point, the official blog of the VA, about a letter of gratitude written by a family member of a Veteran.

Michael Thase, M.D. was quoted on TODAY.com about common misconceptions about psychiatric medications (external) and about borderline personality disorder (external). He did a Q & A with MD Magazine [external] about cariprazine and current bipolar therapies and was quoted in SELF magazine [external] about antipsychotic medication before and during pregnancy.

David Oslin, M.D.’s PRIME Care study was featured in a post on VA INSIDER, the official blog for VA employees [VA intranet only].

Chinman M, Gellad WF, McCarthy S, Gordon AJ, et al. Protocol for Evaluating the Nationwide Implementation of the VA Stratification Tool for Opioid Risk Management (STORM). Implementation Science. January 2019. PMID: 30658658 [external]  

Greden JF, Parikh SV, Rothschild AJ, Thase ME, et al. Impact of Pharmacogenetics on Clinical Outcomes in Major Depressive Disorder in the GUIDED Trial: A Large, Patient- and Rater-Blinded, Randomized, Controlled Study. Journal of Psychiatric Research. January 2019. PMID: 30677646 [external]  

Achtyes ED, Ben-Zeev D, Rotondi AJ, et al. Off-Hours Use of a Smartphone Intervention to Extend Support for Individuals with Schizophrenia Spectrum Disorders Recently Discharged from a Psychiatric Hospital. Schizophrenia Research. PMID: 30551981 [external] 

Vickers-Smith R, Kranzler HR, Justice AC, Tate JP. Longitudinal Drinking Patterns and Their Clinical Correlates in Million Veteran Program Participants. Alcoholism: Clinical and Experimental Research. PMID: 30592535  [external]

Precision Medicine in Mental Health Care: Can Pharmacogenomic Testing Improve Antidepressant Outcomes?

This virtual conference led by Michael Thase, M.D. will review the current gaps in antidepressant prescribing and examine whether systematic use of pharmacogenomics testing can improve treatment outcomes.

Date: Thursday, March 7, 2019 (1:00 p.m. – 2:00 p.m. ET)

11^th PADRECC/MIRECC Symposium on Neurodegenerative Diseases

Updates on the psychiatric and cognitive complications of Parkinson’s Disease and Dementia with Lewy Bodies

Date: Friday, March 29, 2019 (9:00 a.m. – 3:30 p.m. ET)

Location: Corporal Michael J. Crescenz VA Medical Center (Philadelphia)

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