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Treating OCD In Kids

WSU pediatric study is breakthrough
in obsessive-compulsive disorder.

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May 21 . 2009

JN

ayne State University
medical researchers
recently discovered a
chemical that plays a major role in
children with obsessive-compulsive
disorder (OCD).
David Rosenberg,
M.D., the Miriam
L. Hamburger
Endowed Chair of
Child Psychiatry and
professor of psychia-
try in the School of
Medicine
at Detroit-
Dr. Rosenberg
based WSU, collabo-
rated with research-
ers at the University of Michigan in
Ann Arbor, Children's Hospital of
Michigan in Detroit and University of
Toronto/Hospital for Sick Kids. This
international team discovered that the
chemical, glutamate, plays a key role in
children with OCD.
OCD is a debilitating neuropsychi-
atric condition that affects approxi-
mately 1 to 3 percent of the population
worldwide. As many as 80 percent of
all OCD cases begin in childhood and
adolescence.
In Rosenberg's study, 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," said Rosenberg. "If
we think of serotonin as analogous to
light that lets us see in the dark, gluta-
mate is the brain's light switch or brain
modulator, which helps turn serotonin
and other chemicals off and on."

Collaborative Effort
Wayne State's researchers, along with
Gregory Hanna, M.D., of the University
of Michigan and researchers at the
University of Toronto/Hospital for Sick
Kids, have a longstanding collabora-
tion. They recently published in the
March 2009 issue of the journal Brain
Imaging and Behavior the first OCD
study combining brain imaging and
genetics studies in the same children
with OCD.
This work showing glutamate

abnormalities in OCD has significant
treatment implications. Based in part
on initial findings at Wayne State
showing glutamate abnormalities in
OCD, new treatment approaches using
glutamate modulator drugs such as
riluzole, which is currently 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 stud-
ies using riluzole are currently being
conducted by the National Institute
of Mental Health (NIMH) in children
with OCD. The trial is ongoing and
results are currently unavailable.
"This study at NIMH demonstrates
how work first done at Wayne State
University not only has scientific
implications, but also has key 'trans-
lationar relevance in bringing work
from the bench to the bedside with
potential clinical ramifications',' said
Rosenberg.
Wayne State University, the University
of Michigan and the University of
Toronto/Hospital for Sick Kids have
recently submitted a Collaborative RO1
grant to NIMH, which is being consid-
ered for funding. Wayne State University
is the lead site and coordinating center
on this application.
A second paper was recently pub-
lished online and will be available in
the May issue of Psychiatry Research:
Neuroimaging by the same team of
researchers. This paper continues
the team's study of pediatric OCD
patients. It is the first published report
examining the relationship between
genetic variation and a neurochemical
phenotype in OCD. This study found
that there is a significant association
between variation in a key glutamate
receptor gene and glutamate levels in
the brain's arousal center, the anterior
cingulate cortex. No association was
found between genetic markers and
brain imaging measures in brain
regions not implicated in the pathol-
ogy of OCD.
Along with Rosenberg, local col-
laborators on the projects include
Frank P. MacMaster, Yousha Mirza,
Phillip Easter and Michelle Rose of
Wayne State University and Children's
Hospital of Michigan; and Gregory
Hanna, University of Michigan. _