David Rosenberg, M.D.
An ABC cameraman tapes Dr. Rosenberg for an upcoming segment on "20/20."
Dr. Rosenberg, right, explains his research to "20/20" anchor David Muir.
A crew from ABC’s “20/20” was on campus June 10 to interview and tape David Rosenberg, M.D., who leads a team of researchers that recently discovered that the chemical glutamate plays a major role in children with obsessive-compulsive disorder.
Dr. Rosenberg, the Miriam L. Hamburger Endowed Chair of Child Psychiatry and professor of Psychiatry with the School of Medicine, was interviewed by ABC’s David Muir. The news anchor also interviewed one of Dr. Rosenberg’s OCD patients who recently turned 18. Dr. Rosenberg has been treating the patient since she was 11. He said that her condition has “dramatically changed” and the young lady no longer requires medication for her OCD.
The interviews took place at Children’s Hospital of Michigan.
The program, a one-hour special on childhood OCD, is scheduled to air in mid-July, followed by segments on “ABC World News Tonight” and “Primetime.”
Dr. Rosenberg, in collaboration with researchers at the University of Michigan, Children’s Hospital of Michigan and University of Toronto/ Hospital for Sick Kids, recently discovered that the chemical glutamate plays a key role in children with OCD. That finding could open the gates to additional research into new treatments for OCD.
A debilitating neuropsychiatric condition, OCD affects approximately 1 percent to 3 percent of the population worldwide. As many as 80 percent of all OCD cases begin in childhood and adolescence.
“What we are doing is beginning to elevate child psychiatry to a level comparable to traditional pediatric medicine and neurology in that we now have a firm basis in the brain anatomy, chemistry and physiology, and, therefore, a better scientific underpinning for what we do, just like for other chronic medical illnesses like diabetes,” Dr. Rosenberg said. “The brain's a lot more complicated in many ways, but the principles are same. So we now know that childhood OCD is a brain disease and this knowledge may help defeat some of the stigma and prejudice children with psychiatric illness face, like more difficulty getting insurance to pay for their treatment, having people say, ‘It's all in your head,’ when, in fact, these are brain illnesses that can be helped with proper treatment.
“Even the most imaginative science fiction writer could not have dreamed of the powerful tools we use routinely to look at the child's brain,” he added. “With magnetic resonance imaging, we can take a completely noninvasive biopsy of the child brain's anatomy, chemistry and physiology with great power and precision -- but with no shots, needles or radiation. We take this brain biopsy without doing surgery.”
Dr. Rosenberg’s study found that children with OCD had abnormal glutamate levels in key brain regions that were reversible with effective treatment.
“Since our initial findings at Wayne State University, basic neuroscience, genetic, brain imaging and novel treatment development studies all converged to show that glutamate has a key role in OCD,” Dr. Rosenberg said. “If we think of serotonin as analogous to light that lets us see in the dark, glutamate is the brain's light switch or brain modulator which helps turn serotonin and other chemicals off and on.”
School of Medicine researchers, along with Gregory Hanna, M.D., of the University of Michigan and researchers at the University of Toronto/Hospital for Sick Kids in Toronto, Ontario, have a longstanding collaboration and recently published the first OCD study combining brain imaging and genetics studies in the same children with OCD in the March 2009 issue of the journal Brain Imaging and Behavior. All brain images and blood samples were collected at Wayne State with blood samples genetically analyzed in Drs. James Kennedy and Paul Arnold’s laboratory at the University of Toronto and Hospital for Sick Kids.
The studies found significant associations between glutamate receptor and transporter genes and abnormal brain volumes in brain regions implicated in OCD such as the thalamus (“grand central station” in the brain), caudate nucleus (the brain's “secretary”), anterior cingulate cortex (the brain's arousal center) and orbital prefrontal cortex (the brain's “executive decision maker”).
Based in part on initial findings at the School of Medicine showing glutamate abnormalities in OCD, new treatment approaches using glutamate modulator drugs such as riluzole, which is used for treating Lou Gehring’s disease, and others have been used in adults and children with OCD. Initial studies have shown great promise, and studies using riluzole are being conducted by the National Institute of Mental Health in children with OCD. The trial is ongoing and results are unavailable.
“This study at NIMH demonstrates how work first done at Wayne State University not only has scientific implications but has key translational relevance in bringing work from the bench to the bedside with potential clinical ramifications,” Dr. Rosenberg said. Wayne State University, the University of Michigan and the University of Toronto/Hospital for Sick Kids in Toronto have recently submitted a Collaborative R01 grant to NIMH that is being considered for funding. Wayne State University is the lead site and coordinating center on this application.
Collaborators on the project include Frank P. MacMaster, Ph.D., Yousha Mirza, M.D., Phillip Easter, research assistant, and Michelle Rose, research assistant, of Wayne State University and The Children’s Hospital of Michigan; Gregory Hanna, M.D., University of Michigan; Paul Daniel Arnold, M.D., Hospital of Sick Kids and the University of Toronto; and Margaret A. Richter, M.D.,Tricia Sicard, research assistant, Eliza Burroughs, research assistant, and James Kennedy, M.D., University of Toronto.