Oxley College of Health Sciences

TU, LIBR partnership at the forefront of mental health research 

The Laureate Institute for Brain Research opened its doors 10 years ago to address one of Oklahoma’s worst health factors, mental health. As scientists and researchers discover the ways in which a person’s mental health is directly linked to their overall physical condition, LIBR, in collaboration with The University of Tulsa, is using new neuroscience tools and resources to answer old questions about Oklahoma’s health crisis.

LIBR
Director Martin Paulus

LIBR was founded by the William K. Warren Foundation when then scientific director Wayne Drevets and five other colleagues from the National Institutes of Health in Washington, D.C., transferred to Tulsa in 2009. Today, the organization includes seven principal investigators (PI) who are faculty within TU’s Oxley College of Health Sciences and have tenure track or tenure appointments in the OU-TU School of Community Medicine. The goal then and now is to conduct neuroscience-based research that will improve the diagnosis or prognosis of individuals with mental illness. LIBR Director Martin Paulus said the institute strives to respect the dignity of each patient while leveraging leading talent and technology to discover the causes of and cures for disorders related to mood, anxiety, eating and memory. “We’re trying to use neuroscience to find better ways to develop mental health interventions,” he said.

T-1000

When Paulus joined the LIBR staff in 2014, he set a goal to create a large data set that would allow researchers to investigate mental health prognosis and diagnosis through behavioral processes, neuroimaging, neuromodulation, psychophysiology and bioassays. LIBR’s largest research project, the Tulsa 1000 (T-1000) study, began recruiting participants with mood, anxiety, eating and substance disorders to complete more than 24 hours of baseline testing. The 1,000th and final individual was enrolled in 2018 with the goal of determining whether neuroscience-based measures can be used to predict outcomes in patients with mental illness.
Data Analytics Lead Rayus Kuplicki (B.S. ’09, M.S. ’11, Ph.D. ’14) has been heavily involved in the technical setup and analysis of T-1000 since its inception. He said the standardization of this initial data collection at the institute is critical for quality research. “My work has made it possible to take raw data from thousands of participants and compute the quantifiable traits that we compare across groups,” he explained.

LIBR
TU graduate student Bart Ford

Data analysis of T-1000 participants continues and has generated more than 40 scientific papers, currently in progress. TU graduate students in the areas of psychology, engineering and biology contribute to T-1000 research through subsets of data analysis. Biology doctoral student Bart Ford is collaborating with LIBR PI Jonathan Savitz to examine the link between latent viruses and depression. “It is well established that early life stress and childhood trauma increase the risk of physical and mental health problems later in life, but the biological mechanisms by which this occurs are not well understood,” Ford said. “Dr. Savitz and I wondered if people who experience childhood abuse and neglect are perhaps more vulnerable to a common latent herpes virus called cytomegalovirus (CMV).”

The virus is usually harmless in otherwise healthy individuals but can weaken the immune system over time. Savitz and Ford studied a group of individuals with major depressive disorder and found that higher levels of self-reported childhood abuse and neglect were associated with a greater likelihood of testing positive for CMV. They then used the T-1000 cohort to replicate the study and discovered the same results with similar effects in size. The findings were published in the prestigious “JAMA Psychiatry” journal earlier this year.
“We interpret this to mean that the stress of abuse and neglect during development may render a person susceptible to a CMV infection,” Ford stated. “This could suggest CMV contributes to later life health problems that are often seen in survivors of abuse.”

According to Savitz and Ford, T-1000 is beneficial in understanding the biological causes, mechanisms and outcomes of mental health disorders, and consequently, can help identify therapeutic targets that will lead to treatments of the sources and after-effects of mental illness.

ABCD

In addition to T-1000, another primary project ongoing at LIBR is the Adolescent Brain Cognitive Development (ABCD) initiative, a study of more than 11,878 children, ages 9 and 10, at 21 different sites nationwide. LIBR researchers have conducted detailed assessments of 743 of the participants. Follow-up visits and scans will continue for 10 years to examine the course of wellness and mental illness during the second decade of life when mental health disorders tend to emerge. One of the first papers the data generated in 2018 was accepted to the journal “NeuroImage” and entitled “Screen media activity and brain structure in youth: Evidence for diverse structural correlation networks from the ABCD study.”

TU Tough

LIBR
Professor Robin Aupperle

Robin Aupperle is another LIBR PI and assistant professor of community medicine who uses neuroscience and psychological research to improve mental health and gain insight into the causes of anxiety, depression and trauma. She is interested in identifying factors that support resilience to college-related stress and strategies to optimize a student’s psychological well-being. Paulus said meta-analyses show one in three students will develop significant anxiety and depression during their first year of college — a major reason why some students choose to drop out of school. That’s why Aupperle developed the four-week TU Tough program that teaches the skills and mindset necessary for mental toughness to effectively respond to stressful or challenging situations. “This is the idea that our abilities are not set in stone — that we can learn, improve and adapt,” she explained. “Likewise, our ability to be resilient in the face of stress is not hard-wired but can be built and strengthened through practicing certain skills as we seek out and face challenges.”

Aupperle is a mentor to graduate students such as TU clinical psychology Ph.D. student Tim McDermott. His predoctoral training grant application to the National Institute of Mental Health received a qualifying score for funding, which will support McDermott’s research to study the brain circuits underlying people’s ability to manage their emotional reactions. Understanding the brain circuits involved in the processing and regulating of emotions could potentially inform future anxiety and depression treatments. “We will examine whether individuals can learn to regulate their prefrontal cortex activation during emotional processing in response to feedback about their brain activation during functional magnetic resonance imaging (fMRI) scanning,” he said.

As an assistant in the TU Tough project, McDermott has led lectures in TU Tough modules and supervised small group leaders during breakout discussions. He also has managed data processing and analysis for fMRI neuroimaging scans performed before and after TU Tough treatment. Prepared by lead author Elisabeth Akeman (BS ’15) as well as Aupperle and McDermott, a recently published manuscript in the journal “Depression and Anxiety” reports findings from the first two cohorts of TU Tough. The research shows students who complete the program (compared to those who did not) experienced lower rates of self-reported stress and depression symptoms throughout their first semester of college, particularly as measured during finals week. Aupperle explained TU Tough is a strong example of LIBR research that can improve the overall mental health of Oklahomans. “By taking measures to improve resilience to stress and mental health among TU students, we are benefiting the community in general,” she said. “Supporting the health and well-being of our students is the equivalent to supporting the health and well-being of our community.”

LIBR
TU graduate student McKenna Pierson

Other ongoing treatment studies at LIBR use behavioral activation or cognitive behavioral therapy (as part of ongoing studies in Aupperle’s lab) or novel intervention approaches such as the Float Clinic and Research Center led by PI Justin Feinstein. His studies use flotation as an intervention approach to mental illness, providing patients with a way to disconnect with the world and reconnect with signals firing in their bodies. His research was featured on the CBS This Morning’s “Pay Attention” series in 2018.

TU and LIBR’s unique partnership

Paulus is pleased with the substantial data collection, analyses and treatment LIBR has been able to provide to residents within its first decade. Although Oklahoma has a long way to go in improving its overall mental health, he explained LIBR intends to serve as the starting point for large sets of basic health information that support a biotech approach to mental health treatment and diagnosis. “We want to know how far we can develop, how advanced is our research and can we potentially establish startups that can be developed into effective treatments and commercial products,” Paulus said. In one example, LIBR Chief Technology Officer and physicist Jerzy Bodurka, created a way to use a real-time MRI to train a specific part of the brain to give instant feedback on if the training is effective. Paulus explained the training has reduced levels of depression in research participants, and Bodurka now is developing a turnkey system that will allow for scalability of the intervention at any site with MRI imaging capabilities.

LIBRBehind every principal or associate investigator stands a team of student researchers eager to get involved, serving as valuable assets for LIBR’s mission. When asked if TU depends on LIBR or if LIBR relies on TU, Paulus said the partnership is unique in that it is based on both concepts; while the institute focuses on quality research, TU is a generator of knowledge. “TU’s primary mission is teaching, but the goal of our faculty is to be top-level researchers,” Paulus said. “The research provides training opportunities for students, and we couldn’t train them if we didn’t have this relationship with TU.”

Close ties to LIBR are an incentive for students, especially those at the graduate level, to choose TU for advanced experience in their field of research. Students are invited to participate in rotations through the institute and contribute to the facility’s mental health mission. Although LIBR’s primary method of research is brain imaging, Paulus said there will be opportunities for additional biology-based research in the future as researchers pursue exciting advancements into the new decade.

Robinson receives NATA scholarship

Round-offs, back handsprings and cartwheels — Katelyn Robinson grew up on gymnastics. With every twist and turn, she witnessed others’ injuries and made it her mission to study athletic training.

Robinson is a National Athletic Trainer’s Association Research and Education Foundation scholarship awardee. The number of scholarships NATA awards varies annually from 50 to 75 recipients with the amount of the award currently at $2,300 per scholarship.

Her love for athletic training started as early as the eighth-grade when she attended an athletic training day. While attending Oklahoma State University for her undergraduate degree, she interned with the football and wrestling teams.

The “golden” experience

 Robinson with Dean of Oxley College of Health Sciences, Robin Ploeger
Robinson with Dean of Oxley College of Health Sciences, Robin Ploeger

Robinson is a Tulsa native who chose The University of Tulsa to pursue her education in athletic training.

I have always dreamed about going to TU for athletic training,” said Robinson.

Seeing how passionate TU is about giving their students opportunities and teaching is really incredible to me,” explains Robinson.

The athletic training program at TU is accredited by the Commission on Accreditation of Athletic Training Education. The program was the first accredited athletic training program in Oklahoma and involves an extensive core of academic study combined with in-depth clinical rotations.

We are very proud of Katelyn for earning recognition through the NATA Foundation scholarship,” said Ron Walker associate dean of the Oxley College of Health Sciences.

Walker explained: “She is certainly a very deserving recipient who represents our athletic training program and TU very well because of her experiences and enthusiasm for the athletic training profession.”

Sideline support

For some, sprains, cuts and gruesome injuries make heads turn right away, but Robinson doesn’t bat an eye “You have to be that person that they look to in the situation that to them is the end of the world,” she said.

Robinson volunteered with the Student Leadership Council at TU to help coordinate the Big XII wrestling tournament in Tulsa.

In the master’s program, Oxley College of Health Sciences students are required to assist professional athletic trainers during sport seasons. Robinson has assisted Tulsa-area high schools and the TU Men’s soccer team. This fall, she will be on the sideline assisting the Golden Hurricane football team.

I have loved that relationship with the athletes from the moment they stepped foot on campus through any injuries and battles that they had and watching them play the sport they love,” said Robinson.

The NATA Foundation’s work benefits every athletic trainer and every group associated with the profession, as well as the physically active community at large.

The scholarship was presented during the NATA Clinical Symposia in Las Vegas on June 25.

The requirements for the NATA Research and Education Foundation scholarship are:

  • Be enrolled in a CAATE accredited entry-level master’s program that concludes with a master’s degree;
  • Have a cumulative overall grade-point average of at least 3.2 (based on a 4.0 maximum) for the last 40 credits of his/her undergraduate courses and ALL of his/her entry-level master’s courses including the fall of 2019;
  • Have one academic year in master’s program remaining OR is graduating in spring 2020 and intends to pursue an advanced degree in domains of athletic training.