1. Neuroendocrine Regulation
The focus of these studies is the control of limbic-hypothalamic-pituitary-adrenal function. The basic strategy derives from the role of limbic brain sites in controlling emotions as well as pituitary function. The project includes studies of basic human neuroendocrine physiology, e.g., threshold adrenocortical sensitivity to ACTH, methodology of the CRF stimulation test, fast feedback of cortisol on ACTH secretion, bioactivity of dexamethasone metabolies. Clinical disorders studied are depression, Alzheimer's disease, mania and post-traumatic stress disorder. New techniques of unmasking the brain and pituitary from glucocorticoid feedback are employed to obtain direct information on the activity of neural components of the LHPA axis.
2. Depression in Late Life
I am director of the MHCRC for depression in late life. This multidisciplinary center facilitates research and research training in mood disorders for a wide range of faculty investigators. Core projects of the Center include a longitudinal study of course of illness in relation to psychosocial, MRI, clinical and neuroendocrine variables. A major hypothese is that late onset depressions result from cerebrovascular disease.
3. Neurobiology and Phenomenology of Mania and Depression
A neurobiologic model of mania and depression (Carroll/Klein model) is being studies with newly designed clinical assessment instruments. Validation studies are in progress. A collaborative study with Frackowiack's group in UK is commencing to correlate the clinical symptom clusters with PET scan findings.