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Innovative Research

Military service membersHome Base Program clinicians and researchers are engaged in exciting national research to develop better understanding and treatment of post traumatic stress (PTSD) and traumatic brain injury (TBI). This research may lead to new breakthroughs in treatment for these “invisible wounds of war" and help to improve the lives of service members,  veterans, and their families.

Research Underway at Home Base

Home Base Program clinicians are researching new therapies to better diagnose and treat Post Traumatic Stress (PTSD) and Traumatic Brain Injury (TBI). Your Home Base clinician can discuss possible research studies with you. If you are interested, they will work with you to see which study would be the best fit for you.*

Home Base affiliated research studies at Massachusetts General Hospital and Spaulding Rehabilitation Hospital include:

  • Medication and evidence-based psychotherapy to reduce symptoms of PTSD
  • Evaluating telemedicine couples therapy to treat PTSD symptoms and improve relationships
  • Using certain medications to influence and weaken traumatic memories
  • Using sophisticated brain imaging to monitor blood flow in the brains of individuals with TBI or combat stress

For general questions about research at Home Base, contact Rebecca Zakarian at rzakarian@partners.org,  (617) 643-8973

*Compensation for time and travel may be available.

Did You Serve in Iraq or Afghanistan?

  Do you:

  • have trouble sleeping or have nightmares?
  • feel anxious, jumpy or on alert?
  • feel irritable -- or feel numb?

If you answered "yes" to ANY of these questions, you may be eligible for a Home Base research study of Post Traumatic Stress. Participants receive therapy or study medication at no cost.

To learn more about the study, listen to this WBUR radio story, entitled: New PTSD Study Offering Hope To Veterans. For information call 1-617-726-1579 or email mghvets@mgh.harvard.edu.

All inquiries are kept confidential. Compensation up to $375 provided for study participants.

Studies Seeking Participants

Randomized controlled trial of sertraline, PE and their combination in OEF/OIF/OND with PTSD (PROGrESS)

What: This study is comparing 3 treatments for posttraumatic stress disorder, each shown to be effective for PTSD. The treatments are a talk therapy (Prolonged Exposure; PE), a medication (sertraline), and the combination of the two.
When: 12 weeks of treatment, followed by 12 weeks of less frequent visits and a 1-year follow-up visit
Who: OEF/OIF/OND veterans or active duty service members who have had combat-related posttraumatic stress symptoms for at least three months
Compensation: Individuals receive $50 for each assessment, for up to $300. Individuals receive an additional $800 if they choose to do the optional fMRI scan that occurs in Ann Arbor, MI.
Where: Massachusetts General Hospital (Boston, MA)
Contact: Benjamin Kovachy, bkovachy@partners.org, 617-726-0666; Andrew Rogers, arogers@partners.org, 617-726-1579


A Brain Activity Study in People with Posttraumatic Stress Disorder (PTSD)

What: This study uses fMRI and PET scans to examine brain activity in individuals who have PTSD and to predict their response to cognitive behavioral therapy
When: One fMRI scan before therapy and two optional PET scans before and after therapy
Who: Participants must be ready to receive cognitive behavioral therapy through Dr. Naomi Simon’s clinic at the Massachusetts General Hospital
Compensation: $50 for the fMRI scan and $75 for each optional PET scan
Where: The Massachusetts General Hospital (Charlestown, MA)
Contact: Lisa M. Shin, PhD: lshin@partners.org or (617) 726-8120


Optimizing the Treatment of Complicated Grief

What: This study is comparing four treatments for complicated grief. The treatments are a talk therapy for complicated grief (CGT) and a medication (citalopram), CGT and a pill placebo, citalopram alone, or pill placebo alone.
When: 16 to 20 weeks of treatment with 3 months of follow-up treatment and a 6-month follow up visit
Who: Individuals who lost a loved one over 6 months ago and are feeling stuck in their grief
Compensation: $110-200
Where: Massachusetts General Hospital (Boston, MA)
Contact: Arielle Horenstein, ahorenstein@partners.org, 617-726-4585


Impact of Transcranial Direct Current Stimulation on Memory: A Pilot Research Study

What: The research study examines the benefits of transcranial direct current stimulation on memory
When: 3 visits that last approximately 2 hours each, that are scheduled at least 48 hours apart, at times that are convenient for the participant
Who: 2 groups: one group of individuals who are 19 years or older and had a traumatic brain injury at least 1 year ago; and one group of individuals who are 19 years or older who have not had a traumatic brain injury
Compensation: $25 grocery card at the end of each of the 3 study visits
Where: Spaulding Rehabilitation Hospital (Charlestown, MA)
Contact: Therese O’Neil-Pirozzi, 617-373-5750, t.oneil-pirozzi@neu.edu


Cognitive Processing Therapy for PTSD with Co-morbid Mild Traumatic Brain Injury

What: This research will examine potential differences between individuals diagnosed with PTSD plus mild traumatic brain injury compared to individuals diagnosed with PTSD only in their response to a type of talk therapy called cognitive processing therapy (CPT).
When: 12 weeks of treatment at the Home Base Program, a 6-month follow-up, and completing a MRI, clinical symptom scales, and neurocognitive assessments
Who: OEF/OIF/OND veterans 50 years or younger who have been diagnosed with PTD and who do or do not have mild traumatic brain injury
Compensation: up to $300
Where: Massachusetts General Hospital (Boston, MA)
Contact: Karen Chen, kchen15@partners.org, 617-724-2767


Neural Mechanisms of Fear Extinction Across Anxiety Disorders

What: Study Description: The purpose of this research study is to find out more about how the human brain forms and stores emotional memory. In particular, we would like to understand how human beings learn not to fear. We hope this study will help us understand why people with anxiety disorders cannot control unwanted fear. If eligible for this study, you will have two fMRI scans, during which you will perform some small tasks, such as finger tapping, while the MRI makes detailed pictures (images) of your brain.
When: 3 separate visits for a total of 7 hours
Who: You may be eligible if:
o You are currently suffering from generalized social anxiety disorder, panic disorder, or a specific phobia.
o You are between 18 and 65 years of age.
o You are right-handed.
o You have normal (or corrected) vision.
o You have been on stable psychotropic medications for at least 8 weeks and are not currently taking benzodiazepines.
o You do not have any metal in your body.
Compensation: Up to $230
Where: Massachusetts General Hospital, Charlestown Navy Yard
Contact: Allie Campbell, (617) 726-3508, acampbell7@partners.org

Jerry Rosenbaum

Scientific Council for Research

Dr. Jerrold F. Rosenbaum, Psychiatrist-in-Chief at the Massachusetts General Hospital and Stanley Cobb Professor of Psychiatry at Harvard Medical School, is the head of the Home Base Program’s scientific council for research.

Dr. Rosenbaum is recognized as one of the world’s authorities on mood and anxiety disorders. His research contributions include extensive leadership in the development of new therapies, the design and implementation of trials to develop innovative treatments for major depression, treatment resistant depression, and panic disorder, studies of psychopathology including comorbidity and subtypes, and studies of longitudinal course and outcomes of those disorders.

At Mass General, Dr. Rosenbaum directs a department of more than 600 clinicians, researchers, and trainees, named by U.S. News and World Report as the #1 Department of Psychiatry in the United States for 16 of the last 18 years.  Also at Mass General – the largest hospital based research institution in the world, with over 700 million dollars per year of research funding –  he served as Chair of the hospital’s Executive Committee on Research.  His clinical and consulting practice specializes in treatment resistant mood and anxiety disorders, and he consults extensively to colleagues on management of these conditions.

Dr. Rosenbaum was the 2007 recipient of the C. Charles Burlingame Award given annually for lifetime achievement in psychiatric research and education by the Institute of Living in Hartford, CT, and the 2011 Massachusetts Association of Mental Health Friend and Leader Award.  He served as President and the Chairman of the Board of the Anxiety and Depression Association of America and is Chair of the Scientific Council and on the Board of Directors for the American Foundation for Suicide Prevention. He also serves on the MGH Board of Trustees. He and colleagues have recently founded a venture, PsyBrain, for the discovery and development of novel therapeutics for psychiatric disorders.

Dr. Rosenbaum received his undergraduate degree from Yale College and his medical degree from Yale School of Medicine.  He completed his residency and fellowship in Psychiatry at Mass General, Harvard Medical School.

Spotlight on Research

Understanding the Neural Mechanisms of Fear Extinction

Mohammed R Milad, Ph.D. is an Associate Professor of Psychiatry at Harvard Medical School and a Research Scientist at the Department of Psychiatry at Massachusetts General Hospital (MGH). He serves as the Director of the Behavioral Neuroscience Program within MGH.

The Laboratory for Behavioral Neuroscience is focused on understanding the neural mechanisms of fear extinction using classical fear conditioning. Ongoing projects involve studies in human patients as well a rodent model of fear extinction. Functional MRI and psychophysiological tools are employed in humans to examine the role of limbic circuits in conditioned fear in various patient populations including PTSD, OCD, and schizophrenia, as well as the influence of sex and gonadal hormones on these circuits. Animal models are then used to examine the influence of the estrus cycle and gonadal hormones on fear extinction. These basic research efforts are actively being translated to test novel therapeutic agents to block reconsolidation of conditioned fear.

Dr. Milad earned his Ph.D. in Behavioral Neuroscience and his post-doctoral training at MGH and HMS. He has received the Positive Neuroscience Award from the Templeton Foundation and was named a Kavli Fellow by the National Academy of Sciences. He served as an Institute of Medicine committee member, focusing on the improvement of treatment and diagnosis for PTSD.  Dr. Milad’s research has been supported by NIMH, DOD, and NARSAD.

Blocking Memories of Fear

 Scott P. Orr, Ph.D. is an Associate Professor of Psychology in Psychiatry at Harvard Medical School and Massachusetts General Hospital. He is also the associate director of the Post Traumatic Stress Disorder and Psychophysiology Laboratory at MGH.

Dr. Orr and colleagues have developed and implemented a methodology for testing the efficacy of different drugs and behavioral interventions for blocking re-consolidation of fear memories. Drugs that are able to block memory re-consolidation offer a potential treatment for the traumatic memories associated with PTSD. This methodology is designed to be used with healthy individuals, so as to expedite finding an effective intervention. Clinical trials that rely on enrolling patients with PTSD are difficult and often extend over years in order to recruit an adequate number of individuals to provide reliable results. To date, propranolol, a beta-adrenergic blocker, and a modified extinction procedure that have been tested and both failed to produce an effect on re-consolidation blockade. Dr. Orr’s lab is currently testing mifepristone, a synthetic steroid, and preparing to test oxytocin. The goal of this work is to find a drug or behavioral intervention that is capable of blocking or reducing the re-consolidation of conditioned fear memories. Once an effective intervention has been identified, the work can then move to a clinical trial that will test the intervention in individuals with PTSD.

Dr. Orr received his Ph.D. in Psychology from Dartmouth College in 1982 and has published over 125 reports of original research. Dr. Orr’s work has been published in numerous psychology and psychiatry scientific journals. For more information on Dr. Orr's work and research, email scott_orr@hms.harvard.edu

Harnessing New Brain Cells to Regulate Fear

Amar ResearchAmar Sahay, Ph.D, is an Assistant Professor of Psychiatry at Harvard Medical School, Massachusetts General Hospital, Center for Regenerative Medicine, and Principal faculty at the Harvard Stem Cell Institute. His primary research interests include how neurogenesis in the adult brain affect cognition and mood and how perturbations in neural circuits may contribute to psychiatric disorders.

The Sahay lab is interested in understanding how new brain cells can be harnessed to regulate fear. Recent studies have overturned the century old dogma that the adult brain cannot generate new brain cells. Remarkably, stem cells in a part of the brain called the “hippocampus” that is essential for formation of new memories of places and events generates new brain cells every day. The Sahay Lab recently proposed that the overgeneralization of fear seen in patients with PTSD may arise from an inability of the hippocampus to distinguish between similar places or features and this results in the retrieval of previously experienced aversive or traumatic memories. Importantly, their work has shown that stimulating the capacity to make new brain cells in rodents dampens overgeneralization of fear. The Sahay Lab is currently exploring (i) how these new brain cells exert their effects on regulation of fear, (ii) how stress, a known risk factor for PTSD, affects brain circuits underlying fear generalization, and (iii) how genes modulate overgeneralization of fear. Since the brain circuits of the hippocampus of mice and men are similar. The hope is that these studies will lead to new therapeutic strategies for treating overgeneralization of fear in patients with PTSD. 

To learn more about his research studies visit http://www.sahaylab.com/

Identifying Predictors of Suicide and Trauma-Related Outcomes

 Dr. Jordan Smoller is Associate Chief for Research for the MGH Department of Psychiatry and Director of Psychiatric Genetics. He is Professor of Psychiatry at Harvard Medical School and Professor in the Department of Epidemiology at the Harvard School of Public Health in Boston.  He is Director of the Psychiatric and Neurodevelopmental Genetics Unit in the MGH Center for Human Genetics Research. Dr. Smoller also serves as co-director of the Genetics and Genomics Unit of the MGH Clinical Research Program and co-Director of the Partners HealthCare Biobank at MGH.

The focus of Dr. Smoller’s research interests has been the identification of genetic and environmental determinants of childhood and adult psychiatric disorders.  He has had a leading role in genetic and biomarker studies in the Army Study To Assess Risk and Resilience in Servicemembers (Army STARRS) in effort to identify predictors of suicide and trauma-related outcomes. Dr. Smoller and colleagues have also been studying genetic predictors of treatment response and the ways in which advances in genetics may impact clinical practice. He is an author of more than 200 scientific publications as well as The Other Side of Normal (HarperCollins/William Morrow, 2012).

Dr. Smoller earned his undergraduate degree at Harvard University and his medical degree at Harvard Medical School.  After completing residency training in psychiatry at McLean Hospital, Dr. Smoller received masters and doctoral degrees in epidemiology at the Harvard School of Public Health.

Developing New Treatments for TBI

Ross Zafonte, DO is the Clinical and Research Leader for Traumatic Brain Injury at the Red Sox Foundation and Massachusetts General Hospital Home Base Program. He is the Earle P. and Ida S. Charlton Chairman of the Department of Physical Medicine and Rehabilitation at Harvard Medical School, vice president of Medical Affairs at Spaulding Rehabilitation Hospital, and Chief of Physical Medicine and Rehabilitation at MGH.

The goal of Dr. Zafonte’s work is to understand and develop novel prognostic techniques for TBI. Accordingly, he has been involved in trying to define clinical prognostic variables in TBI and have employed the laboratory to understand factors that may impact the recovery process. This line of research has evolved from prospective clinical observational data to laboratory work attempting to define biological-based differences in the recovery process from TBI. The findings from this work have noted population-based recovery differences based on duration of posttraumatic amnesia and imaging data. This work is now seeking to establish biomarkers that can be employed in the acute and post-acute phases of recovery from TBI.

Dr. Zafonte’s work has also sought to understand the role of novel pharmacotherapeutics in the post-acute and rehabilitation time periods. This work has progressed from small clinical trials to a laboratory effort attempting to understand both the harmful and the facilitative aspects of medications frequently prescribed to persons with TBI. The findings of this work have helped to establish concerns with the chronic administration of some atypical antipsychotics to those with TBI.  Dr. Zafonte’s team is seeking now to to further understand the role of dopaminergic and cholinergic systems after TBI and are presently pursuing novel laser based treatments.

Research at Massachusetts General Hospital and Spaulding

Massachusetts General Hospital (MGH) and Spaulding Rehabilitation Hospital doctors and researchers are working to develop better treatments for post traumatic stress disorder (PTSD) and traumatic brain injury (TBI). This research may lead to new breakthroughs in treatment for these conditions and help to improve the lives of service members and veterans.

MGH has a long tradition of being a leader in medical discoveries. In 1846, MGH was the first hospital to use anesthesia for surgery.  In 2008, MGH developed a device—the size of a credit card—to detect small amounts of cancer cells in the blood stream.

Every day, researchers at MGH take basic scientific discoveries and transform clinical patient care. Almost every treatment, test, drug, or medical device used today is the result of research and the willingness of individuals to participate in order to advance medical care for others.

Facts About Research at Home Base, MGH and Spaulding

Five important facts about research at Home Base, Massachusetts General Hospital and Spaulding Rehabilitation Hospital:

  1. Your participation in research is 100% voluntary. The choice is completely up to you. No patient is ever required to participate in clinical research.

  2. There are many benefits to participating in Home Base research. Your research team includes doctors and other health care professionals who are familiar with the most advanced treatments.
    1. You may have access to study medications and/or therapy that are not widely accessible, at no cost.
    2. You can learn more about your condition and how to manage it..
    3. You will be helping others by contributing to our knowledge and helping identify new treatments for PTSD & TBI.

  3. Research participation will not affect your ability to get care at Home Base. Your care at Home Base will not be impacted if you decide not to participate in a research study. If you do decide to participate in a research study, and give consent, your Home Base clinician will be aware of your research participation and will help to coordinate your treatment.

  4. All MGH research is rigorously scrutinized. Home Base researchers are required to have their studies approved by an Institutional Review Board (IRB). The IRB is composed of scientific experts, clinicians, and community members. The IRB review everything about the study before it begins, including its scientific merit, safety of participants, and ethical considerations.

  5. There are risks to every study. There is no guarantee that the treatment will make you better. Some medications may have side effects. Psychotherapies can temporarily increase distress. We will not hide those risks from you. The Home Base research team will talk about any possible risks with you, and if your symptoms get worse, you can be removed from the study. The Home Base clinical team can then develop a different treatment plan for you.