McLean Hospital 115 Mill Street Belmont, MA 02478
Kerry J. Ressler, MD, PhD, arrived at McLean in August as Chief Scientific Officer and the inaugural chief of McLean’s new Center of Excellence in Depression and Anxiety Disorders. He also holds the James and Patricia Poitras Endowed Chair in Psychiatry, thanks to a generous gift from longtime donors Patricia and James Poitras.
Dr. Ressler’s research examines how fear works in the mammalian brain, with implications for treating and preventing fear-based disorders such as post-traumatic stress disorder (PTSD), phobic disorders, and panic disorders. His lab, which was formerly based at Emory University School of Medicine, is now up and running at McLean. Horizons recently sat down with Dr. Ressler to talk about his work at McLean.
Horizons: Tell us about your two administrative roles.
Dr. Ressler: As Chief Scientific Officer, my job is to help broaden McLean’s research focus. One of the first things I saw when I arrived is that the hospital has world-class research in many areas, as well as world-class clinical care. But for many years, the two were relatively separate. We need a much better understanding of the neurobiology and the psychology of our patients. One of my central goals is to improve communication among clinicians and researchers and enable more research that brings together these two worlds.
Horizons: And your role as division chief?
Dr. Ressler: By grouping clinical units and programs into divisions, or Centers of Excellence as we call them, we’re better able to integrate the hospital’s treatment, research, and educational activities within a broad domain, such as depression and anxiety disorders.
For example, McLean routinely collects similar quantitative data on different units throughout the division. With proper consent from patients, we can combine this data with biological data to give us insight into many things, including which treatments are working and which are not. Units that share patient populations can use their combined knowledge to improve programs and processes not only within units, but across them as well.
Horizons: What are some of the ways you’d like to leverage the divisional structure to enhance work on anxiety and depression?
Dr. Ressler: We have one of the largest neurotherapeutics services (electroconvulsive therapy [ECT] and transcranial magnetic stimulation [TMS]) in the country and yet the scientific community has little understanding of how a treatment like ECT changes the biology of the body and the brain over time. If we can help the neurotherapeutics team create a better infrastructure for collecting data, we can learn a lot.
Similarly, our researchers can help other programs collect more patient data to answer questions like: how are things changing on a symptom, psychological, and biological level pre- and post-treatment? How is the expression of different genes changing, and how is that affected by illness and recovery? How do genes put someone at increased risk for anxiety and depression? How does the brain change after effective treatment?
At the research level, there is a lot of overlap among labs and ways to further the discussions among our basic science researchers, clinicians, and clinical researchers focusing on questions of emotion regulation, emotion processing, and depression and anxiety symptoms.
In the spring of 2016, we are going to invite presentations from each of the division’s units to get a better sense of each unit’s specialty, their patients, treatment approaches, and research questions. Eventually, I’d like to see more collaborative research across individual units.
Horizons: What role does philanthropy play in the division?
Dr. Ressler: Federal research dollars are increasingly scarce. Although there’s great interest at the federal level in translational research—bringing knowledge from the lab into practice to identify better treatments—there are very few mechanisms to fund these approaches. That’s because often in the grant review process, you’ll have an expert in human clinical trials, an expert in imaging, an expert in animal models—but rarely do they see eye to eye.
Philanthropy can be helpful in providing seed funding to get new ideas of the ground until they can be supported by federal grants. Philanthropy also can fund cutting-edge approaches—especially where we’re trying to span the basic science to the clinical science, or bridge across divisions such as depression and addiction or depression and eating disorders, as examples.
Horizons: What are you most excited about for the months and years ahead?
Dr. Ressler: At the basic science level, I am most excited about the burgeoning opportunities to gain a much more comprehensive understanding of certain basic behaviors by targeting specific circuits within the brain and combining genetic, epigenetic, physiological, and behavioral information.
At the translational neuroscience level, it’s bringing the fruits of some of these technologies to bear in identifying new interventions and therapeutics, based on our improved understanding of the biology of the brain and psychiatric disorders.
And at the clinical level, it’s the integration of much broader ways to collect data to understand our patients, beyond patient self-reports and interviews. There is a huge new array of wearable devices, voice and facial recognition approaches, and other methods to capture ‘big data’ related to patients’ behaviors. In deploying these tools, we will have more powerful ways to understand illnesses, develop more effective treatments, and offer more targeted care.