Hospital del Mar Research Institute Hospital del Mar Research Institute



"Neuropsychiatry and Neuromodulation: a dimensional circuit-centered paradigm and its therapeutic implications"

Sala Charles Darwin (PRBB) a les 12:00 hores

En el marc de les sessions del Programa de Neurociències, el proper 2 d'octubre a les 12:00 hores tindrà lloc a la Sala Charles Darwin (Plaça interior del PRBB) la sessió que porta per títol "Neuropsychiatry and Neuromodulation: a dimensional circuit-centered paradigm and its therapeutic implications" impartida pel Dr. Joan A Camprodon, del Laboratory for Neuropsychiatry and Neuromodulation & TMS clinical service, Division of Neuropsychiatry, Massachusetts General Hospital, Harvard Medical School. Boston, MA (USA).

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A major paradigm shift has changed the clinical neurosciences, and particularly Psychiatry, in the last 15 years. A wealth of basic research has dramatically advanced our understanding of the anatomy and physiology of brain networks, and the mechanisms by which they process cognition, behavior and emotion. This “circuit revolution” has had major clinical impact, transforming our understanding of psychiatric pathophysiology from neurochemical models (i.e. neurotransmitter imbalances) to a systems neuroscience understanding of how maladaptive information processing within neural circuits lead to symptoms and syndromes. This new paradigm is relevant not only because it changes how we think about mechanism of disease, but also because, in a practical and clinically-relevant manner, has introduced new treatments (i.e. brain stimulation) that use device-based strategies to therapeutically modulate disease-relevant dysregulated circuits.

Neuropsychiatry has traditionally been defined as the clinical subspecialty that cares for patients with neurological disorders presenting with psychiatric symptoms. Given the anatomical, physiological, psychodynamic and overall clinical complexity of these cases, Neuropsychiatry draws from the traditional tools of both psychiatry and neurology. While this classical description still holds, we propose a broader definition not based on what patients we see, but on how we see them: Neuropsychiatry uses a circuit-centered, dimensional approach to the anamnesis, examination, case formulation, differential diagnosis and treatment planning of patients affected by disorders of cognition, behavior and affect. This focus on circuits and clinical dimensions requires a sophisticated systems neuroscience understanding of brain network function and pathophysiology. Beyond these basic science challenges, a number of translational opportunities emerge to develop practical tools to support clinical decision-making (e.g. biomarkers and predictors or response) and to identify therapeutic targets as the basis to develop novel treatments.

In this talk we will examine the neurobiological and clinical paradigm of this circuit-centered definition of Neuropsychiatry. We will then focus on neuromodulation therapies and present recent research from our group studying the mechanisms of action of Electroconvulsive Therapy and Transcranial Magnetic Stimulation, highlighting translational applications for the discovery of predictors of response and the development of individualized treatment strategies.

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