School of Medicine

Wayne State University School of Medicine
Study of brain networks shows why children with obsessive-compulsive disorder might not be able to 'move on'
In Headlines on March 26, 2015
Vaibhav Diwadkar, Ph.D.

Vaibhav Diwadkar, Ph.D.

David Rosenberg, M.D.

David Rosenberg, M.D.

A new study by scientists at the Wayne State University School of Medicine sheds significant light on our understanding of how brain networks contribute to obsessive-compulsive disorder in youth. Led by David Rosenberg, M.D., and Vaibhav Diwadkar, Ph.D., of the Department of Psychiatry and Behavioral Neurosciences, the research demonstrates that communication between some of the brain’s most important centers is impaired in the disorder.

The study included youth with a diagnosis of OCD and a comparison group free of psychiatric illness. The investigators used functional magnetic resonance imaging, or fMRI, to collect brain responses while participants engaged in a basic working memory task. The difficulty of the task was varied to evoke activity in a core brain sub-network. This sub-network is responsible for implementing complex processes such as cognitive control. Then, using sophisticated network analyses, the investigators quantified differences in brain network function between the two groups.

“Most fundamentally, we show that the dorsal anterior cingulate cortex, a key region of the brain associated with cognitive control, exerts exaggerated brain network effects in OCD,” said Dr. Diwadkar, an associate professor. “This result provides a putative scientific framework for what clinicians have noted about OCD-related behaviors. These network-based effects have been suggested, but not explicitly demonstrated before in brain imaging data in the disorder. Our studies are perfectly aligned with the renewed emphasis of the National Institute of Mental Health to discover mechanisms of neuropsychiatric disease in the brain. If you can discover a reliable mechanism underlying disease, you have the promise of improved pathways toward treatment.”

The results are highly consistent with observations in the clinic, said Dr. Rosenberg, who is a professor and the department’s chair. “Children with OCD are beset by preoccupations and can’t easily move on from certain tasks and behaviors. As all complex behavior arises from brain networks, being trapped in this mode must arise from impaired brain network interactions in OCD. In our previous studies we had focused on assessing the structure and the neurochemistry of the anterior cingulate. We had long suspected that brain network interactions originating in this region are impaired in the disorder. But this is the first study to clearly demonstrate this.”

The full paper, “Dysfunctional activation and brain network profiles in youth with obsessive-compulsive disorder: a focus on the dorsal anterior cingulate during working memory,” appears in a special issue of the journal Frontiers in Human Neuroscience, and is available to the public on line at the journal’s website. The special issue is devoted to the use of complex techniques to map psychopathology in the brain, a question of increased interest in the field, and a focus of research in the WSU Department of Psychiatry and Behavioral Neurosciences.

The reported work is part of a large multi-center project funded by the National Institutes of Mental Health. The project is coordinated by Wayne State University, and in addition to Drs. Rosenberg and Diwadkar, involves Gregory Hanna, M.D. (University of Michigan), and Paul Arnold, M.D., Ph.D. (University of Toronto). “This is the second successful collaborative R01 led by WSU, and includes new and highly innovative directions in fMRI research made possible by our superlative in-house expertise here,” Dr. Rosenberg said.

The paper complements WSU’s OCD research most recently featured in a May 2014 episode of ABC News’ ongoing series on the disorder featured on “20/20.” “The new results in the paper makes their focus on our work here even more compelling,” Dr. Rosenberg added.

The investigative team will soon combine complex imaging techniques with genetic mapping to identify complex neurobiological mechanisms that contribute to OCD and obsessive-compulsive behaviors. The doctors said the NIMH is focused on identifying biological mechanisms underlying neuropsychiatric disease. “We are fully seized of this initiative and our collective efforts are aligned in that direction.”

The work was supported by the National Institute of Mental Health (MH059299), the Children’s Hospital of Michigan Foundation, the Prechter World Bipolar Foundation, the Lycaki-Young Fund from the State of Michigan, the Miriam Hamburger Endowed Chair of Child Psychiatry, the Paul and Anita Strauss Endowment, the Donald and Mary Kosch Foundation, The Mark M. Cohen Neuroscience Research Fund, Detroit Wayne County Health Authority and Gateway Community Health.
Dr. Smitherman elected president of Wayne County Medical Society of Southeast Michigan
In Headlines on March 24, 2015
Herbert Smitherman Jr., M.D. M.P.H.

Herbert Smitherman Jr., M.D. M.P.H.

A Wayne State University School of Medicine dean has been named president of the Wayne County Medical Society of Southeast Michigan.

Herbert Smitherman Jr., M.D., M.P.H., F.A.C.P., will be sworn in as the society’s 132nd president during a May 16 reception and dinner at the Detroit Golf Club.

“I believe it a privilege, and I am honored to have been elected by my peers to assume the role of president of the Wayne County Medical Society of Southeast Michigan,” said Dr. Smitherman, assistant dean for Community and Urban Health for the School of Medicine, and associate professor of the school’s Department of Internal Medicine and the Barbara Ann Karmanos Cancer Institute. “I look at my role and responsibility as president as a willingness to be accountable for the well-being of our profession, and to help continue to build the organizational capacity required for both the current and the next generation of physicians to be successful.”

The society represents approximately 3,500 physicians who live and work in Wayne County.

A resident of Detroit, Dr. Smitherman has been a member of the WSU faculty for 25 years. He also serves as president and chief elected officer of the Health Centers Detroit Foundation Inc., which operates three health centers in the city as Health Centers Detroit Medical Group, and lobbies for quality health care for all. As a Federally Qualified Health Center look-alike, Health Centers Detroit Medical Group provides care in medically underserved areas.

Dr. Smitherman has committed more than two decades to providing quality medical care to underserved populations. In 2007, he and four co-authors published “Taking Care of the Uninsured: A Path to Reform,” which detailed the 10-year path of the Voices of Detroit Initiative. The project, launched in 1998 with a $5 million grant from the W.K. Kellogg Foundation, sought to ease the strain on emergency rooms used by the uninsured as primary care facilities by providing access to true primary care. Originally tasked with addressing the primary care needs of 27,500 patients, the initiative surpassed that goal by assisting 33,093 uninsured Detroit residents. The number represents slightly more than 13.8 percent of the city’s uninsured residents. A majority of those cared for under the initiative were African-American (92.4 percent). Fifty-seven percent of enrollees were women and 69 percent were single.

In 2008, the WSU Center for Peace and Conflict Studies honored Dr. Smitherman with its annual Peacemaker Award. The center recognized him for “monumental achievements and contributions to multicultural awareness and constructive conflict resolution.” The Michigan State Medical Society, in 2009, gave him its Community Service Award for his efforts to battle health care disparities.

This month, Michigan Gov. Rick Snyder selected Dr. Smitherman to serve as a member of the state’s new Human Trafficking Commission, which will work to protect Michigan residents from human trafficking, fight repeat violations and improve survivor support services.

Dr. Smitherman served as co-chairman of the $16.2 million “Fighting D in the D, text4health” initiative launched in 2012 by the Southeast Michigan Beacon Community. That program used mobile phone text messaging to engage diabetic patients to take better control of the self-management of their condition.

He has spoken nationally on health care disparities and has been invited to the White House to speak on that issue and others. In 2008, U.S. Rep. John Conyers recommended Dr. Smitherman be appointed U.S. Surgeon General to then President-elect Barack Obama.

“The presidency is ultimately about service and commitment to the larger community of physicians,” Dr. Smitherman said. “To achieve this goal, I will need the assistance of all physicians throughout the county and will be reaching out to each and every one of you asking for that assistance. Our profession has many new challenges on the horizon that we will have to navigate. However, if we are to be successful, it will only happen through working together. So please come to the installation gala at the Detroit Golf Club on May 16 so we can start this journey of commitment to our profession together.”

The inaugural gala fundraiser, at which Dr. Smitherman will be sworn in, begins with a reception at 6 p.m., followed by a 7 p.m. dinner. For more information, contact Karen Carter at 313-874-1360, ext. 303.

WSU medical students push legislators for GME funding, tougher vaccination waiver language
In Headlines on March 23, 2015
WSU medical students hear from a state representative in Lansing on March 10.

WSU medical students hear from a state representative in Lansing on March 10.

Medical students wait for their next meeting with a state senator in the capital building in Lansing.

Medical students wait for their next meeting with a state senator in the capital building in Lansing.

Forty first- and second-year Wayne State University medical students met with dozens of state representatives and state senators, and Nick Lyon, the director of the Michigan Department of Community Health, during a March 10 “advocacy day” in Lansing.

The students discussed with legislators the continued need for child vaccinations and support for state funding of graduate medical education, said Doug Skrzyniarz, associate vice president of Government Affairs for the Wayne State University School of Medicine and leader of the school of medicine’s Medicine and Political Action in the Community student organization.

“I am so proud of the work the students did,” Skrzyniarz said. “They exemplify why we are a unique medical school by their commitment to the community and public health.”

The students spoke with lawmakers about MI-Docs, a state graduate medical education pilot program. MI-Docs is charged with developing a new plan for GME that will produce new physicians in medical specialties most needed in underserved communities across the state, identify strategies to keep these physicians in the state post-residency, integrate and plan for new clinical delivery models that focus on patient-centered care and care quality, and leverage and coordinate resources between health care organizations, higher education and public health entities.

Established in 2014, MI-Docs is a consortium of medical schools of Central Michigan University, Michigan State University, University of Michigan, Wayne State University and Western Michigan University. The organization is collaborating with the Michigan Department of Community Health to produce a comprehensive statewide workforce analysis. This analysis will provide the Legislature and the governor with data on where health care provider shortages exist and in what specialties. The report, expected to be released in late summer or early fall, will be used to develop a statewide plan on creating and expanding existing residency programs to address clinical access needs.

Medical student Rick Smith said he found the lawmakers he spoke with supportive of the MI-Docs plan, and interested in greater detail.

The students also educated the lawmakers on the importance of childhood vaccinations in the face of a growing wave of parents who refuse to have their children vaccinated, and asked that they support legislation limiting vaccination waivers in the state.

Included in the information the students provided are the facts that in Michigan parents can opt out of vaccinating their children for medical, religious or any other reason. Michigan is now the fourth-worst state in terms of vaccination waiver rates. An outbreak of pertussis, or whooping cough, that began in October 2014 has affected at least 90 children in 19 schools in Grand Traverse County. Health officials believe lack of vaccinations against the disease led to the spread.

Class of 2015 celebrates 97.5 percent residency rate at Match Day
In Headlines on March 20, 2015
From left, La Tonya, Nejlah and David Clark celebrate on Match Day.

From left, La Tonya, Nejlah and David Clark celebrate on Match Day.

Michael Song shows off his Match Day letter announcing his move to California.

Michael Song shows off his Match Day letter announcing his move to California.

Marianne Mousigian smiles big after learning where she will train after graduation.

Marianne Mousigian smiles big after learning where she will train after graduation.

Students shouted and cheered after opening Match Day letters.

Students shouted and cheered after opening Match Day letters.

Students used pins to mark where their residency would be in the United States.

Students used pins to mark where their residency would be in the United States.

(Click here for more Match Day photos).

Leading up to Friday, Detroit native and Wayne State University School of Medicine medical student Nejlah Clark had puzzling dreams about Match Day, the annual event for senior medical students in the United States that simultaneously reveals and celebrates where their post-graduation residency training will take place. One night, she dreamed it was her stepmother La Tonya Clark who matched – into a surgery residency in Phoenix. Another night, she dreamed she opened the envelope containing what was supposed to be her assignment for the next three to seven years. The only text on it was, mysteriously, the number nine.

“The least I can say is, yeah, I’m nervous,” said Clark, who attended the University of Nevada at Las Vegas on a college basketball scholarship. In her family, “I’m the first college graduate, and the first doctor.”

By noon, the Clarks, including Nejlah’s father David, were elated. “She got the field she wanted,” he said, smiling as he put down the letter.

Nejlah is headed to an Emergency Medicine residency at Newark Beth Israel Medical Center. “I feel so excited. I’m ready to bring it on, New Jersey,” said Clark, who had applied to several residencies in Michigan and out of state. “I didn’t see this coming. A total shocker.”

Friday’s event at the MGM Grand Detroit Hotel’s Grand Ballroom mimicked others like it going on at the same time across the country. In Detroit, nearly 900 students, faculty, staff and family counted down the seconds before their sons, daughters, wives, husbands and siblings opened envelopes containing their residency assignment. Minutes before the countdown to noon, thin cream envelopes were placed in the hands of the 283 senior students who make up the Class of 2015, waiting with 18,447 allopathic (M.D.) medical school seniors across the United States.

At WSU, 97.5 percent of students matched into residencies, higher than this year’s national match rate of 95.7 percent.

The letter – some excitedly ripped apart in less than a second, others slowly and painstakingly unfolded – included the institution name, location and their chosen specialty.

“Match Day is the culmination of four years of study and months of an intense process leading up to this moment. Students have applied to hospitals and residency programs, selecting the field of medicine they hope to work in and the city they hope to live in,” said Lisa MacLean, M.D., assistant dean of Student Affairs and Career Development and the event emcee. “I congratulate you now as you enter this next chapter of your life. I ask you to be open to whatever life brings you and to embrace every moment.”

Match Day is organized by the National Resident Matching Program, a private non-profit corporation established in 1952 to provide a uniform date of appointment to positions of graduate medical education in the United States.

A whopping 49.6 percent, or 157 students, of WSU’s Class of 2015, are staying in Michigan, Dr. MacLean told the crowd, great news for a state with a projected physician shortage, as studies show that residents who train in Michigan often remain here for the majority of their careers. Another 39.9 percent will enter primary care residencies.

“We are extremely proud of the foundation we have built for you at the School of Medicine,” Vice Dean for Medical Education Maryjean Schenk, M.D., M.P.H., said. “When you match into a residency program, the program director recognizes your potential to excel in your chosen specialty and to become an awesome practicing physician who provides outstanding care to their patients.”

Thirty-nine students matched with their soon-to-be alma mater, earning residencies in the programs solely- or co-sponsored by WSU. Thirty-two students matched to residencies with Henry Ford Health System, 18 to William Beaumont Hospital and 14 to the University of Michigan Health System. WSU students are also headed to programs at St. John Hospital, St. Mary Mercy Hospital, Michigan State University and more.

Students moving out of state after graduating in May will practice medicine in 34 U.S. states and Canada, at 92 hospitals, universities and medical centers, including the Mayo School of Graduate Medical Education in Arizona, Florida and Minnesota; McGill University in Quebec, Canada; Vanderbilt University Medical Center in Tennessee; Rutgers New Jersey Medical Center; and more. Among states, Illinois will have 23 WSU medical students in residencies beginning this June, with 19 students going to Ohio, 16 to California, 11 to Texas, 10 to New York and nine going to Florida.

Combined, 58,443 applicants from the U.S., Canada and other countries applied for 30,212 U.S. residency positions.

Internal Medicine residencies were the most popular clinical discipline at WSU this year, with 58 students entering such programs, up from 45 students in 2014. Michael Song is among them. He is headed to San Diego, where he will study at Scripps Clinics/Green Hospital. The training program was his No. 1 pick when ranking the programs with which he interviewed.

“I was cautiously optimistic,” said Song, who brought his father, Wenwei Song, to Match Day. Wenwei shared that he was excited and proud of his son’s efforts. “Always. Not only today.”

Another 31 students will enter Emergency Medicine programs and 30 will enter Family Medicine. Thirty students will participate in a transitional year before beginning their specialty training, including Dearborn native Marianne Mousigian, who will train for one year at Oakwood Hospital in Taylor before beginning a Physical Medicine and Rehabilitation residency with the University of Michigan Health System.

“Having this be the culmination of four years of hard work? It’s kind of amazing, and a blessing to be around friends who have been through so much together,” she said. “’I’m all smiles,’ is a good way to put it.”

Other chosen specialties include pediatrics, child neurology, dermatology, radiation oncology, urology, vascular surgery and more.

Before the matches were revealed, several awards honoring students and faculty were announced. The awards list included:

Medical Alumni Senior Scholarship Award: Jeremy Farida and Derek Wood

Robert J. Sokol, M.D., Medical Alumni Association Endowed Prize: Stephanie Lazar

Class of 2015 Academic Achievement Awards: Freshman year, Jonathan Arcobello; sophomore year, Derek Wood; junior year, Bianca Jiddou, Devin Mangold and Alexander Tapper; senior year, David Bergman and Jasmine Omar

Elvis Smith Alford, M.D., and Nellie Corbin Alford Memorial Award: David Bergman

Marjorie Edwards Prize for Scholarship and Community Service: Joi Moore

Herbert Mendelson Enthusiasm for Medicine Endowed Scholarship: David Coleman

Leonard Tow Humanism in Medicine Award (Faculty): Mary Morreale, M.D.

Leonard Tow Humanism in Medicine Award (Student): Matt Falkiewicz

Voluntary Faculty Awards: Ronald Cheek, M.D., and Sean Drake, M.D.

Distinguished Service Awards: Jacob Price, Cletus Stanton, Lauren Robinson, Sameen Farooq, Adhnan Mohamed, Jonathan Wong, Lindsey Aurora, Christopher Sy, Matthew Falkiewicz, Hieu Nguyen, Sarah Gorgis, Carolyn Chan, Allen Kadado, Christine Kang, Osamuedemen Iyoha, Mansoor Siddiqui and Alexander Lee

Class Marshal: Barbara Bosch, M.D.

Penfil-Tischler Award (tie): Ali Sobh and Sameen Farooq

WSU neurologist, DMC nurse establish Detroit Brain Aneurysm Support Group
In Headlines on March 20, 2015

Partnering with the Joe Niekro Foundation for the last year, Sandra Narayanan M.D., F.A.H.A., assistant professor of Neurosurgery and Neurology for the Wayne State University School of Medicine, and Carol Wynn M.S.N., NP-C., a Detroit Medical Center nurse and neuroendovascular nurse practitioner with the Wayne State University Physician Group Department of Neurosurgery, have established the Detroit Brain Aneurysm Support Group.

The support group held its first meeting March 16, attracting 17 members, some of which traveled more than 120 miles to take part.

The group meets the third Monday of the month from 6 to 8 p.m. at Harper University Hospital, 3990 John R, Detroit, in Hospitality Suite 2. Meetings are conducted by an aneurysm, arteriovenous malformation or hemorrhagic stroke survivor/facilitator. Physicians, caregivers, survivors and family members are welcome to attend.

Joe Niekro was a pitcher for the Detroit Tigers and several other teams. He died of an aneurysmal subarachnoid hemorrhage in 2006. His daughter, Natalie Niekro, started the JNF in 2007 to promote brain aneurysm awareness, support and research.

For more information, email kimberly@joeniekrofoundation.org.

National association, CDC release water safety policy written by WSU public health student
In Headlines on March 18, 2015
Samantha Iovan

Samantha Iovan

The National Association of County and City Health Officials is calling for an increased focus on improved recreational water safety in support of a policy written by Wayne State University graduate student Samantha Iovan, who was part of the organization’s first class of Public Health Policy and Practice Scholars last year.

(Read the statement here).

"Having my policy statement approved by the board of directors was an incredible accomplishment. I know that the work I’ve done will help inform the decisions of local health departments across the country on recreational water issues, such as aquatic venue monitoring, recreational water illness and water testing guidelines,” said Iovan, a master’s of public health degree student in the Department of Family Medicine and Public Health Sciences.

NACCHO, the national organization representing local public health departments across the United States, approved Statement of Policy 15-01 in February, calling for a renewed focus on improving recreational water safety. The Statement of Policy, released in March by NACCHO and the U.S. Centers for Disease Control and Prevention, includes recommendations for improvements in regulatory oversight, water testing, funding, training, community education and communication between partners, as well as comprehensive justification for the recommendations.

The competitive NACCHO scholar program is a practical, tele-based opportunity for graduate-level students to impact public health locally. NACCHO’s members are the 2,800 local health departments across the United States.

“It was great to be able to reach out to public health experts across the country for support and guidance,” Iovan said. “My experience was enlightening. As soon as I was accepted into the program, I began working on projects that were of high priority at NACCHO. As the environmental health policy scholar, I discussed the need for policy statements on water quality and safety with the environmental health director, and began work on framing three separate policy statements to inform local health departments on water issues. Prior to my internship, I didn’t know anything about writing policy statements. I began researching policy statements and discussing points of importance with the environmental health committee, which provided many suggestions.”

She is now working on two policy statements regarding sustainable water use and water quality.

“The development and dissemination of public health policy maximizes the potential to improve population health outcomes. Congratulations to Samantha for being involved in the effort to develop a policy in concert with a national team of experts on such an important topic,” said WSU Program Director Kimberly Campbell-Voytal, Ph.D., M.S.N. “I also salute Dr. Dana Rice’s leadership in identifying quality learning opportunities that expose students to ‘real-world’ practice. These experiences are often game-changers for a student’s professional development.”

Iovan received academic credit for completing a minimum of 100 hours of public health policy and practice experience with specific assigned tasks.

“The development of public health policy integrates both the art and science of public health. Her practicum experience allowed her the opportunity to bring science to bear on the problem of recreational water quality – a topic of national and local importance. The goal of the practicum is to provide opportunities for students like Samantha to work on important public health issues and the quality of her work exemplifies the type of products our M.P.H. students produce. Samantha represents the kind of future leader in public health that we seek to prepare,” said Dana Rice, Dr.PH, the program’s practicum director.

Iovan is in the final year of the public health program. She expects to graduate in August.

Older Articles