McLean Hospital 115 Mill Street Belmont, MA 02478
Martin Teicher, MD, PhD, has been director of the Developmental Biopsychiatry Research Program at McLean Hospital since 1988. He was director of the former Developmental Psychopharmacology Laboratory (now the Laboratory of Developmental Neuropharmacology), and is currently an associate professor of psychiatry at Harvard Medical School.
Dr. Teicher is a member of the editorial board of the Journal of Child and Adolescent Psychopharmacology, Current Pediatric Reviews, and Current Psychosomatic Medicine. He is a member of the Scientific Advisory Council of the Juvenile Bipolar Research Foundation, and has been part of Harvard University’s Brain Development Working Group. He has served on or chaired numerous review committees for the National Institutes of Health, published more than 150 articles, and has received numerous honors.
Dr. Teicher’s Developmental Biopsychiatry Research Program was founded in 1988 with the aim of improving the lives of children, adolescents, and adults by exploring the cause of psychiatric disorders that arise during development, and by creating medical devices for their assessment. Dr. Teicher is particularly focused on the enduring effects of childhood maltreatment.
Research reveals a strong link between physical, sexual, and emotional maltreatment and bullying, and depression, anxiety, post-traumatic stress, and substance abuse. Research pioneered by Dr. Teicher’s lab shows that childhood maltreatment alters brain structure and function, depending on the type of abuse and the stage of development.
The lab’s research goals include identifying sensitive periods when brain regions are maximally vulnerable to early life stress and associated with greatest risk for mental illness, assessing whether alterations in brain structure can predict future risk for substance abuse, and evaluating novel treatments—including sensory enrichment, brain exercises, acupressure, and mindfulness—for ADHD, depression, and learning disorders,.
In collaboration with Kwang-Soo Kim, PhD, Bruce M. Cohen, MD, PhD, and Debkanya Datta, PhD, skin samples are being collected from adults with ADHD and from siblings or close family relatives without psychiatric disorders. These samples are transformed into induced pluripotent stem cells and the lab is then comparing the rate of development, metabolic activity, and neurochemistry of the neurons derived from these stem cells in subjects with ADHD versus their unaffected relatives.
In collaboration with Karlen Lyons-Ruth (Cambridge Health Alliance) and Ellen Grant (Boston Children’s Hospital), Dr. Teicher’s group is assessing the effects of childhood maltreatment on brain structure and function and correlating these changes with alterations in maternal behavior and maternal stress response in mothers of newborns. They are also studying the impact of maternal behavior and stress reactivity on infant attachment, infant stress response, and amygdala development and connectivity at 1 year of age.
In collaboration with Kerry J. Ressler, MD, PhD, and Marisa M. Silveri, PhD, the lab is assessing whether the association between exposure to childhood abuse and affective dysregulation is mediated by epigenetic modifications to stress response genes, neurotrophic factor genes, emergence of neuroinflammation, or sleep disruption.
Prior research in Dr. Teicher’s laboratory has shown that exposure to childhood abuse affects the development of cortical regions and pathways that register and convey the adverse experience. Hence, exposure to verbal abuse is associated with alterations in auditory cortex and language pathways. In contrast, visually witnessing domestic violence is associated with alterations in the visual cortex and in the pathway that connects the visual cortex and limbic system. Dr. Teicher and his staff now are using evoked potentials to delineate the association between exposure to abuse and electrophysiological response to stimuli in visual, auditory, and olfactory systems, and on sympathetic versus parasympathetic response to a social stressor.
Dr. Teicher is collaborating with Dr. Demitri Papolus (Juvenile Bipolar Research Foundation) in a double-blind randomized control trial assessing the safety and efficacy of intranasal ketamine in the treatment of children and adolescents with treatment-refractory bipolar disorder. Studies in adults have reported that intravenous ketamine can immediately attenuate symptoms of depression and suicidality. Interestingly, children tolerate ketamine better than adults and open label use by Dr. Papolus has provided preliminary evidence for both rapid benefits and sustained efficacy with dosing every 2-4 days, providing the impetus for this formal controlled trial.
A primary focus in the lab is to identify stages of development when exposure to childhood maltreatment maximally affects regional anatomy or brain network architecture, and to ascertain whether genetic factors alter the timing or duration of these sensitive periods.
A parallel aim is to identify sensitive periods when exposure to childhood maltreatment maximally increases the risk for major depression and to correlate vulnerability to depression with the vulnerability of specific brain regions.
Dr. Teicher has identified in cross-sectional studies regional brain abnormalities in the cerebellar vermis and anterior cingulate associated with increased risk for drug and alcohol abuse. The lab is assessing longitudinally whether alterations in these regions predict future risk for drug abuse in maltreated youth.
Two studies are underway to assess whether non-pharmacological treatments for ADHD can produce sustained improvement. In the first study, a sensory enrichment protocol designed to enhance neurogenesis will be compared to treatment using ‘hemi-sync’ sounds and music to synchronize brain activity into a pattern designed to markedly enhance focus, concentration, and attention. The second study will evaluate efficacy of ‘brain balance exercises’ designed to increase hemispheric integration and right hemisphere function. Subjects can either be unmedicated or can remain on their prescribed medications during the course of the study, except on pre- and post-treatment test days and pre- and post-treatment MRI scanning days. The Quotient ADHD System developed in the laboratory to provide objective measures of hyperactivity, inattention, and impulsivity will be used as a primary outcome measure. Neuroimaging will be used to evaluate treatment effects on regional blood flow and resting-state functional connectivity.
The lab is testing the hypothesis that the integrated Learning Enhancement Acupressure Program (developed by Charles T. Krebs, PhD), a non-invasive approach combining Western and Eastern techniques to resynchronizing brain function, can enhance spelling ability and the capacity to visualize in poor spellers with good reading skills.
Induced pluripotent stem cells are being used through collaboration with Drs. Kim and Cohen to evaluate the differences in neuronal sensitivity to stress hormones in susceptible versus resilient subjects with childhood abuse.
Teicher MH, Anderson CM, Polcari A. Childhood maltreatment is associated with reduced volume in the hippocampal subfields CA3, dentate gyrus, and subiculum. Proceedings of the National Academy of Sciences of the United States of America. 2012;109(9):E563-72.
Teicher MH, Samson JA. Childhood maltreatment and psychopathology: A case for ecophenotypic variants as clinically and neurobiologically distinct subtypes. The American Journal of Psychiatry. 2013;170(10):1114-33.
Teicher MH, Anderson CM, Ohashi K, Polcari A. Childhood maltreatment: altered network centrality of cingulate, precuneus, temporal pole and insula. Biological Psychiatry. 2014;76(4):297-305.
Belmont campus - Service Building, Room 139