As a principal investigator and Director of Native American Research and the Electroencephalography Core for LIBR, Dr. Evan White, Ph.D. dedicates much of his professional effort to working with American Indian communities to advance mental health. The focus of his work is employing clinical neuroscience to improve mental health outcomes among AI communities—in particular, his research looks at two things: cultural engagement and the role it may play in providing protection against poor mental health outcomes; he also works to identify the signatures of those cultural protective factors that may enhance culturally informed prevention and intervention efforts.
How does your work help advance health equity? What are you seeing in the American Indian communities? In the scope of mental health studies, our work is very much in the early stages. Unfortunately, many mental health disparities among American Indian (AI) populations remain and are potentially even growing. We have not observed changes in health disparities attributable to the research we’re doing; however, this work is advancing health equity in important ways. Native populations are vastly underrepresented in clinical neuroscience research, particularly as a population of focus. We are working to remedy this by placing AI communities at the center of our clinical-cultural neuroscience research, and by building community partnerships to collaborate in our research process. The broader goal is to incorporate principles from community-engaged research methods (Community-Based Participatory Research/CBPR in particular) whenever possible. It’s important to note that this endeavor is not unique to our research, and encouragingly, our research is informed by a substantial and growing body of health equity researchers who champion community-grounded health equity research. What are your research goals, purpose and aim? My research aims to establish and advance a neuroscientific understanding of cultural factors that are protective against poor mental health among American Indians (AI) utilizing a strength-based framework. My goal is to integrate clinical and cultural neuroscience to identify modifiable factors as candidate treatment targets for mental health intervention and prevention. We are working to establish a clinical-cultural-neuroscience framework in which mental health intervention and prevention efforts are culturally grounded, community-engaged, and guided by neuroscience. You are an enrolled member of the Absentee Shawnee Tribe of Oklahoma. Does your identity as a tribal member inspire you to research minority health, health disparities, and health equity? Improving the health and wellbeing of the populations we serve is a motivation many researchers share, and my commitment to helping the community I come from is no exception. However, my motivation extends to other communities and populations that also experience disparities and it is my hope that our work can make a meaningful impact at home and more broadly. In the scientific and medical communities, it is a well-known fact that minority communities are disproportionately impacted by mental health risk factors and, as a result, mental health conditions. Like many native people, I have seen first-hand the impacts of suicide, substance misuse, and addiction. As health disparities researchers we can play an important role in helping to address these conditions. On a positive note, I have also seen the incredible strengths and resilience of Native people and communities rooted in relationships and traditional cultural practices and values. I believe this is a critically important area for mental health disparities research – a community-grounded understanding of treating and preventing disparate mental health conditions which leverages and elevates the strengths that exist within communities. Are there any studies you’re recruiting for right now? What type of volunteers do you need? Are volunteers paid, and what’s involved in being a volunteer? We are always interested in people willing to participate in our research studies. Individuals who participate are compensated for their time and can expect to answer questions related to their health and general life experiences. If individuals qualify for one of our studies based on a variety of factors, they may be contacted to complete some additional protocols that include interviews, computer tasks and even brain scanning. This is a big question: How do we encourage the next generation of scientists? I know that for me, I received encouragement to pursue my passion from supportive mentors, training programs, colleagues, and family and friends outside of academia. The support I am given helps me find ways to encourage the next generation of scientists. We need to engage students with hands-on research opportunities early in their training—and not just data collection and curation—but also with idea development, generating research questions, analytic training, and opportunities to share and present findings with a broad audience. Providing training like this in an inclusive and growth-oriented environment allows trainees to explore and develop their own passions for research. We have created these experiences at LIBR in recent years with the LIBR Accelerated Summer Research Internship and Diversity, Research, and Mental Health Neuroscience (DReaM-Neuro) fellowship programs.
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Dr. Salvador Guinjoan is a Principal Investigator at LIBR and Research Associate Professor at The University of Tulsa. He is working on the definition of neurobiological signatures of transdiagnostic clinical manifestations (especially rumination, a well-known adverse prognostic factor in a variety of psychiatric conditions), with the purpose of attaining a better definition of both 1) disease processes which transcend current psychiatric diagnostic categories, and 2) prognosis and prediction of response to treatment, especially in the mood and anxiety disorders. To this end, he is studying a large sample of healthy participants and patients with nonpsychotic disorders (T1000). He is also helping to define experiments that characterize -and modulate- structural and functional brain circuits in such disorders, with the ultimate goal of providing the treating clinician with diagnostic and prognostic tools based upon quantifiable neurobiological variables.
What is your research study about? We are using a new technique called low-intensity focused ultrasound, which allows us to modulate the activity of small and well-defined areas in the brain using a non-invasive brain scan. Our goal is to define brain circuits that sub-serve our behaviors, thoughts, and emotions. In particular, we are interested in modulating brain connections involved in rumination. Rumination is a repetitive pattern of thinking, primarily self-relevant negative thoughts and memories. Rumination is associated with more difficult treatment of depression. If we were able to resolve it, in theory, we could also improve the prognosis of depression in general. What is focused ultrasound? Focused ultrasound is a novel technique to influence the activity (or the structure) of areas anywhere in the brain, in a non-invasive, painless, and safe way. We are only using low-intensity focused ultrasound, which modulates brain activity for a relatively short period of time. Alternatively, when used with high intensity in a neurosurgery setting, focused ultrasound can produce well-defined, circumscribed lesions in circuits that have been demonstrated to improve neurological conditions such as Parkinson’s disease and essential tremor, which might be useful in psychiatric conditions such as obsessive-compulsive disorder and major depression. Low-intensity and high-intensity ranges are well-defined and, in fact, use different devices. Again, we only use low-intensity focused ultrasound. How is the study being conducted? Participants in the study undergo an initial eligibility evaluation. Eligible participants include healthy, unmedicated persons, as well as persons with depression and varying degrees of rumination as one of the symptoms of their depression. The initial evaluation includes measuring a series of clinical variables and obtaining brain images with a magnetic resonance (MRI) scanner. Subjects return for two more visits, in which each participant undergoes either low-intensity focused ultrasound of connections between two areas of the brain, or a sham procedure (neither the participant nor the clinical rater know which kind of procedure occurs in each visit). Immediately after low-intensity focused ultrasound or sham, the person is asked to complete questionnaires about the extent of their ruminations, and how they feel in general. We also obtain measures of cardiac and skin regulation, and another series of brain images. What is the potential importance of this study? The goal of the study is to define if the brain connections targeted with low-intensity focused ultrasound are the cause of rumination. This is why we need to obtain information about both the symptom itself and the brain activity. If we confirm a relationship between certain brain connections and the production of rumination, this would pave the way to a clinical trial. This trial, performed in a clinical setting, would confirm that we can actually help patients with depression to become less ruminative. For this, we could use focused ultrasound or other forms of neuromodulation. The most important thing is characterizing the brain region involved in the symptom, rather than which tool we use to alter its function. Are you looking for participants? If so, who is the ideal candidate? Yes, we are actively recruiting participants. This is a pilot study, meaning we plan to recruit a relatively small number of participants. Currently, there are just 20 slots remaining. Any person with active depression who is not pregnant or actively using drugs, and who can be scanned, is eligible to participate. Persons who either very ruminative or not ruminative are eligible, as we need to know if there is a difference between the two. A small proportion of those 20 slots will be reserved for persons with no known psychiatric conditions, so healthy adults are also eligible to participate. What does participation in the study involve? And will I be paid? The study consists of a total of five visits. Visit 1 is for clinical evaluation and brain images. Visits 2 and 4, which occur about two weeks apart, are for assessing the effect of low-intensity focused ultrasound in comparison with sham stimulation. Between those visits, Visit 3 is short and basically used to see how the participant is doing after the first treatment (be it active or sham). Visit 5 is an opportunity to wrap up the study, in which we again check on the general mental status and brain structure. All participants will be paid for their time spent in the study. |
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