Director Eva Redei, PhD, joined the Asher Center in 1996 as the Dunbar Scholar and was invested as the first David Lawrence Stein Professor of Psychiatry in October of 2001. The goal of her research is to better understand, and thus ultimately to influence or control, individual vulnerabilities to stress. This work is based on the hypothesis that increased vulnerability to stress contributes to the pathology of depression, perhaps even as a causal mechanism. Dr. Redei’s team has discovered and characterized a peptide that seems to inhibit both the hormonal and behavioral manifestations of stress. This has been widely recognized as a major finding in understanding the neurobiology of depression in that one of the most consistent neuroendocrine findings in serious depression is hypercortisolemia. Using animal models and state of the art molecular techniques, this laboratory is studying the neurobiological mechanisms that are likely to be implicated in human depression. Dr. Revskoy, who joined the Asher Center in 1996 as a member of the Laboratory of Neurobiology and Genetics of Stress and Depression, has been the recipient of a prestigious NARSAD Young Investigator Award. He has received National Institutes of Health (NIH) funding to investigate whether a depressive state in cancer patients can result in higher vulnerability of their immune system to the genotoxic effects of chemo- and radiation therapy—a result that would worsen the prognosis of the disease. Director Margarita Dubocovich, PhD, has been on the faculty of the Department of Molecular Pharmacology and Biological Chemistry since 1982. Her joint appointment with the Department of Psychiatry and Behavioral Sciences began in 1999. Her area of interest is to elucidate the mechanism of action of the hormone melatonin and its functional interaction with dopamine. Current studies in her laboratory include:
- Dunbar Scholar Jelena Radulovic, MD, PhD, joined the Asher Center in 2004. She studies the genes and signalling pathways involved in the consolidation of long-term memories, in particular memories of aversive events associated with distinctive environments. The long-term goal of Dr. Radulovic’s research is to understand the molecular mechanisms underlying regulation (acquisition and extinction) of fear responses and establish the effects of stressful experiences on these processes. The work pursues the hypothesis that disruption of molecular processes within the hippocampal brain area results in abnormal fear resembling symptoms of anxiety disorders. Her current research predominantly fosuses on the characterization of the roles of the hippocampal serine/threonine kinases cyclin-dependent kinase 5 (Cdk5) and extracellular signal-regulated kinases (Erk 1/2) in memory formation.
Tightly regulated Cdk5 activity is critical for the normal brain development, whereas deregulation of this kinase has been strongly implicated in the pathophysiology of Alzheimer’s and other neurodegenerative diseases. Dr. Radulovic demonstrated for the first time that Cdk5 and its neuronal co-activator p35 within the cholinergic septo-hippocampal system are required for memory consolidation of context-dependent conditioned but not for the formation of short-term memory. Analysis of different mouse strains revealed a conserved role of Cdk5/p35 in associative learning, however, the regulation of baseline and inducible Cdk5 gene expression was strain-specific and probably dependent on Sp transcription factor levels. Thus, although hyperactivation of Cdk5 might contribute to neurodegenerative processes leading to dementia, regulated activity of this kinase in the adult non-demented brain represents an important biochemical step for memory formation. The regulation of septo-hippocampal Cdk5 activity by upstream activators is currently investigated.
Erk-1/2 has been considered to be one of the core signalling pathways involved in memory consolidation. Dr. Radulovic studied in detail the regulation of Erk-1/2 activity and phosphorylation by upstream kinases as well as the activation of downstream Erk-1/2 substrates during fear conditioning and stress-enhanced fear conditioning. She demonstrated cytoplasmic interactions between Erk-1/2 an Elk-1 followed by nuclear translocation of their substrate p90Rsk-1 but not Elk-1 in hippocampal pyramidal neurons. This pattern was specific for the hippocampal area and contrasted findings from other regions such as the basolateral and central amygdala, demonstrating nuclear localization of Erk-1/2 and Elk-1. It has been assumed that the mitogen activated and extracellular signal-regulated kinase (Mek) is the main activator of Erk-1/2. Unexpectedly, it was observed that cAMP-dependent protein kinase (PKA) and protein kinase C (PKC) but not Mek are the major regulators of hippocampal Erk-1/2 phosphorylation during fear conditioning. Notably, a Mek-dependent Erk-1/2 activation after stress-enhanced fear conditioning that was triggered by hippocampal CRF2 receptors. The role of the described mechanisms in fear extinction has been studied.
The clinical component of the Asher Center was established in 1995 as a joint program with Northwestern Medical Faculty Foundation. Asher Center clinicians have served more than 2,500 individual patients since the center was established. The Mood Disorders Specialty Diagnosis and Treatment Program is a subspecialty program providing diagnosis and ongoing care, as well as consultation/second opinions in the area of depressive disorders. Emphasis is on diagnosis, psychopharmacological management, education, and supportive management. Treatment is individually tailored to each patient's needs. Indicated psychotherapeutic management will either be handled by Asher Center clinicians or arrangements made for referral to other clinicians. Clinical research is considered a core function of this program. There is a regular, systematic utilization of state of the art quantitative rating instruments. Clinical research instruments routinely used in the monitoring of patients seen in this program include the Montgomery Asberg Depression Rating Scale (MADRS) and the Hamilton Depression Rating Scale (28 item). The center's database contains basic epidemiological, demographic, and clinical characterization of more than 1,500 patients currently being seen. This information includes, at intake: past psychiatric and medical history, age at onset, and rating instruments (see above); and at follow-up, current treatments, MADRS, change in or addition to psychiatric and/or non-psychiatric medical diagnosis.
Faculty and staff are closely related to the Department's Behavioral Pharmacology Program.
Medical Director and Psychiatrist, Asher Depression Center,
Director, Northwestern Behavioral Pharmacology Program
Associate Professor, Department of Psychiatry and Behavioral Sciences
Dr. William Gilmer is medical director of the Asher Center Clinical Program and an associate professor in the Feinberg School of Medicine's Department of Psychiatry and Behavioral Sciences. He received his medical degree from the University of Iowa Medical College and completed his psychiatric residency training from Rush Presbyterian-St. Luke’s Medical Center in Chicago. He joined the faculty of Northwestern's Feinberg School in 1994. Dr. Gilmer is the director of Northwestern Behavioral Pharmacology Program. His clinical and research interests include the investigation of new pharmacological agents, mood disorder phenomenology, predictors of bipolar spectrum disorders, and various factors influencing the course of mood disorders. Dr. Gilmer is the director of the Northwestern University Regional Center for the STAR*D (Sequenced Treatment Alternatives to Relieve Depression) study, a national, multi-site study designed to systematically evaluate the various treatment options in patients with major depressive disorders and assess clinical benefit, side-effect burden, and patient acceptability. He is an active educator at the Feinberg School where he teaches a psychiatry residency course on biological psychiatry. He also is a frequently invited lecturer on topics related to mood disorders and psychopharmacology. In February of 2004, the National Alliance for the Mentally Ill named Dr. Gilmer as the John Davis Young Clinical Researcher of the Year.
Assistant Professor
Department of Psychiatry and Behavioral Sciences Dr. Pedro Dago is the medical director of the Psychiatric Emergency Service at Northwestern Memorial Hospital and an assistant professor in the Department of Psychiatry and Behavioral Sciences. He joined the faculty in 1997 after completing a two-year clinical research fellowship at Columbia-Presbyterian Hospital in New York City. During his fellowship training he gained considerable experience in the design and implementation of medication trials in mood and anxiety disorders. He completed his residency at the New York State Psychiatric Institute in 1994. He graduated with honors from the University of Illinois School of Medicine. Dr. Dago is board certified and specializes in the psychopharmacology of mood, anxiety, and psychotic disorders. In addition to his clinical duties, Dr. Dago is also an investigator in industry-sponsored medication trials. He teaches the Advanced Psychopharmacology course to psychiatric residents and is frequently invited to speak on topics related to psychopharmacology. Chief, Division of Psychology
Professor, Department of Psychiatry and Behavioral Sciences Dr. Mark Reinecke is chief of the Division of Psychology in the Department of Psychiatry and Behavioral Sciences at the Feinberg School. He joined the faculty at Northwestern in 2001, having previously been at the University of Chicago Medical School. He is a nationally recognized expert in depression treatment and research with special expertise in Cognitive Behavioral Therapy. He heads the Northwestern site for the National Institute of Mental Health–funded multi-site Treatment for Adolescents with Depression Study (TADS).
Director, Consultation Liaison Psychiatry
Northwestern Memorial Hospital
Assistant Professor, Department of Psychiatry and Behavioral Sciences Dr. Joshua Straus is attending psychiatrist for the Asher Center of the Northwestern Medical Faculty Foundation and the Division Director of Psychosomatic Medicine. He joined the faculty of the Feinberg School in July 1995. He completed a fellowship in Consultation and Liaison Psychiatry at Rush-Presbyterian St. Luke's Medical Center following a residency in Psychiatry at the Medical College of Wisconsin. Dr. Straus also has completed a full internship in Internal Medicine at Northwestern University's medical school. He is a graduate of the University of Chicago Pritzker School of Medicine. He is board-certified in general psychiatry and psychosomatic medicine and a fellow of both the American Psychiatric Association and the Academy of Psychosomatic Medicine. He has interests in research and treatment of depression and other mood disorders. As psychiatric consultant to the Heart Failure Program at Northwestern Memorial Hospital, Dr. Straus has a special interest in the relationships between heart disease, stroke, and disorders of mood and anxiety. He headed the Northwestern site for the SADHART Program, a national, multi-site treatment study of major depression. He is also involved in the joint initiatives with neurology, neurosurgery, and psychiatry in the Feinberg Neurosciences Center. Dr. Straus has been an integral member of the Helping Obtain Palliative Excellence in Oncology (HOPE) Research program, directed by David Cella, PhD. Research is presently underway in collaboration with the Robert H. Lurie Comprehensive Cancer Center of Northwestern University and the Center for Outcomes Research and Education to establish the prevalence of mental distress (depression and anxiety especially), fatigue, anorexia, and pain in patients with cancer. A series of psychopharmacology trials for cancer patients with depression are planned. He received the 1999 Richard C. Marohn Teacher of the Year Award in Psychiatry and the Second Place 1997 Dorfman Journal Paper Award from the Academy of Psychosomatic Medicine.
Sequenced Treatment Alternatives to Relieve Depression (STAR*D) This study focuses on patients with Major Depressive Disorder, presenting for treatment in general psychiatry settings, who do not respond satisfactorily to initial treatment with a selective serotonin reuptake inhibitor (SSRI). At present, there are virtually no controlled data to guide the clinician’s decision regarding which of several treatments to employ next. This study is designed to systematically evaluate the various treatment options in such patients and to assess clinical benefit, side-effect burden, and patient acceptability.
Treatment for Adolescents with Depression Study (TADS)
A clinical trial of 439 adolescents with major depression has found a combination of medication and psychotherapy to be the most effective treatment. Funded by the NIH's National Institute of Mental Health (NIMH), the study compared cognitive-behavioral therapy (CBT) with fluoxetine, currently the only antidepressant approved by the Food and Drug Administration for use in children and adolescents.
Center for Drug Discovery and Chemical Biology Center for Sleep and Circadian Biology Cognitive Neurology and Alzheimer's Disease Center (was Center for Behavioral and Cognitive Neurology) Feinberg Clinical Neuroscience Research Institution Northwestern University Institute for Neuroscience
You have entered a Web site that describes the Asher Center for the Study and Treatment of Depressive Disorders. If you are seeking immediate help for treatment of depression, we recommend that you contact your clinician, physician, or your nearest emergency room.
This Web site is not set up to provide help or advice to individuals about their depression, nor to family members or friends of individuals with depression. It does not provide a chat room and individual queries will not receive a response. Any message posted on this Web site is not confidential. This Web site is created solely for the purposes of providing background information about the Asher Center.
If you are interested in getting general information about depression, you can visit the following Web site: http://www.nimh.nih.gov/healthinformation/depressionmenu.cfm
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