Dr. Judith Rapoport, chief of NIMH’s Child Psychiatry Branch, speaks at Natcher Bldg.
NIMH’s Intramural Research Program is one of its “brightest jewels,” institute director Dr. Thomas Insel recently told a consortium
of advocacy group leaders representing
patients with mental disorders
and their families. “It’s our venture space, our incubator, our place to experiment on things that might take a lot more time and investment
if done in a university setting.”
Insel and researchers from several of NIMH’s 22 intramural labs and branches spoke at a meeting of the NIMH Alliance for Research Progress held at Natcher Conference Center.
“We start with brilliant and dedicated
scientists,” added Dr. Richard Nakamura, scientific director, Division of NIMH Intramural
Research. “We support ideas and principal investigators, not projects. We allow risk taking, failure and recovery from failure. We permit PIs to drastically change their research directions
when the science requires it and we try to ensure that they have the freedom to choose the best scientific directions.”
One such example is the Child Psychiatry Branch, which began focusing on children’s brain development in 1989, using magnetic resonance imaging (MRI), a technique that provides
images of the brain’s structure.
“This all started with a terribly simple-minded idea—that a very large fraction of serious psychiatric
disorders are related to neurodevelopment
and that we first needed to learn more about normal brain development,” said CPB chief Dr. Judith Rapoport.
Hundreds of children, as young as age 5, were recruited, to return every 2 years for a brain scan. By following the same children in longitudinal
studies as they matured, scientists were able to track brain development in healthy kids as well as in children with psychiatric disorders such as ADHD and schizophrenia.
Studying the same children over an extended period of time, Rapoport and colleagues including
Dr. Jay Giedd and Dr. Philip Shaw, were able to observe changes in the children’s brains related to mental disorders. Previous studies using cross-sectional data comparing different
children at different ages had only allowed researchers to make inferences about development.
Now for the first time, the researchers were able to detect abnormal patterns of structural
growth that actually predated any of the disorder symptoms.
In the case of children with attention deficit disorder, brain imaging studies revealed that though the brain continues to mature in a normal
pattern, growth of some parts of the cortex
is delayed up to 3 years. This provided clues as to why some children eventually grow out of ADHD.
The research also showed that the delayed pattern
of maturation observed in ADHD is far different
than that seen in other developmental brain disorders like autism, in which the number
of certain brain structures peaks at a much earlier-than-normal age. These findings suggest that the biological origins of autism likely precede
the end of the first year of life, when rapid overgrowth of brain structures begins.
Rapoport’s imaging studies revealed information
about other pediatric mental disorders. Despite evidence of some overlap in symptoms and genetics, pediatric bipolar disorder and childhood-onset schizophrenia likely do not stem from the same underlying illness process, as previously suspected.
After many years of piecing together clues revealing certain mysteries of the brain, Rapoport
is more excited than ever about her team’s findings. “I still pinch myself that I’m going to work at the job that I have every day,” said Rapoport, who recently received the $50,000 Mind of America Scientific Research Award from the National Alliance on Mental Illness for her years of accomplishment in the NIMH intramural program.
As data from the intramural studies accumulate from more than 6,000 MRI scans of 2,000 children
and teens, scientists at NIMH are moving closer to understanding how the brain develops,
where and when the circuitry and systems go awry and how to begin to construct paths to treatment and intervention.