Neuropsychiatric Research Unit Services

The Neuropsychiatric Research Unit is a new inpatient/outpatient research unit located at 5V DRH. It has six inpatient beds and 4 outpatient beds/ procedure rooms, and is capable of supporting state-of-the-art clinical research studies. The NRU also includes an on site laboratory for sample preparation and storage. The unit is staffed by a research coordinator, psychiatric research nurses, research assistants, an occupational therapist, a social worker, a pharmacy technician, sleep research technicians, and is under the overall Scientific and Medical Directorship of Husseini K. Manji, MD. The sleep research component is under the Directorship of Tom Roth Ph.D., Tim Roehrs, Ph.D., and Suzanne Woodward, Ph.D. The Research Unit is particularly well suited for the study of the underlying biologic basis of the major mental illnesses, and for the development of innovative treatment strategies.

Nature of Scientific Investigations that can be undertaken at the NRU:

Molecular, Cellular and Biochemical: Various biochemical processes can be investigated in patients at different illness stages and in response to treatments. These biochemical measures include hormones, neurotransmitters, and second messenger systems, gene expression, and other cellular elements known to be critical for normal neuronal functioning. The NRU is capable of supporting such studies in CSF, plasma, urine, and peripheral circulating blood cells.
Physiological: The NRU is capable of supporting state of the art sleep research studies, ambulatory EEG and activity monitoring, and it is anticipated that in the not too distant future, studies of autonomic function (e.g. sympathetic nerve firing activity).

Because of the unique nature of the NRU, many complex studies can be performed in patients longitudinally, often following an adequate medication washout period. To facilitate this, a number of psychotropic medications (including antidepressants, antipsychotics, mood-stabilizers, and anxiolytics) have been formulated in identical blinded capsules.

Some examples of the type of research paradigms which can undertaken in the NRU include the following:

Investigation of new neuropharmacological agents, and characterizing determinants of treatment response. By investigating the genetic / biochemical /physiological determinants of treatment response, it may be possible to eventually predict with a greater degree of certainty which medication is best suited to each patient’s individual condition, thereby greatly improving the delivery of effective treatments.
Investigation of abnormalities in the Sleep/Wake and Circadian cycle in various disorders and during various treatment stages. Baseline circadian and/or sleep-wake cycle alterations can be studied, and these can be monitored longitudinally as indices of not only the underlying illness pathophysiology, but also as predictors of treatment response, resistance, or relapse. With the growing body of evidence identifying various "clock genes", such sophisticated polysomnographic studies in combination with genetic studies may also lend themselves to the more precise genotyping/phenotyping of various neuropsychiatric disorders which have considerable phenomenologic and symptom cluster overlap.
Investigation of the responses to traditional and new neuropharmacologic agents with respect to timing of administration. It may be possible to exploit human circadian rhythms for therapeutic purposes, for example, by administering medications during certain stages of sleep. In NRU, it is possible to monitor the patients’ sleep stages (using sleep EEG instrumentation), and administer medications through an intravenous line.

Manuel Tancer, M.D.
Director
9B UHC
Phone: (313) 577-0215