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Clinical Research

Our current research interest is focused in two topics:

1. Treatment Resistant Depression (TRD)

2. Transcranial Direct Current Stimulation (tDCS)

These studies will be performed in mental health centers in Israel.

 

Treatment resistant depression (TRD) is a common mental health problem that has a critical impact on the quality of life and well-being of the depressed patients, and posing a great toll on their family members as well. Recently, a promising treatment strategy in the treatment of TRD is starting to evolve. This treatment strategy is administration of intravenous ketamine infusion which induces a rapid improvement of depressive symptoms. A setback of this treatment strategy is that its effect is transient, and there is a usually a relapse within a week or less. Moreover, not all patients will respond to well to this strategy, and depressive symptoms will not be alleviated. Other studies that employed this treatment strategy have shown improvement at one week of treatment, but did not follow up the results beyond that time frame. The suggested underlying mechanism for the antidepressive effect of ketamine applications is that ketamine induces an increase in the expression and activity of brain-derived neurotrophic factor (BDNF). We are currently exploring novel therapeutic approaches to tackle the setbacks of this therapeutic strategy. Furthermore, we are exploring new techniques that will make this treatment more feasible in an ambulatory setting.

 

Transcranial direct current stimulation (tDCS) is an evolving therapeutic tool in neuropsychiatric disorders such as chronic pain, fibromyalgia, after stroke rehabilitation, and in psychiatry it was investigated for major depressive disorder. However, in spite of some encouraging results, the overall efficacy of this treatment strategy in psychiatry is not yet clear. One of the reasons for the ambiguity of tDCS efficacy is largely due to the lack of knowledge of the underlying mechanisms, especially with regard to its plasticity effects. Furthermore, the optimal montages of the electrodes positioning is not completely understood. We would like to investigate the use of tDCS as a therapeutic tool for various clinical diagnoses, not only depression, based on our current understanding of altered brain activity in the various pathological clinical conditions. This type of studies will enhance our comprehension of the mechanisms underlying various psychiatric disorders as well as the mechanisms underlying tDCS plasticity modifications. Furthermore, on the clinical level it will enable us to better optimize the tDCS treatment strategy for a number of pathological psychiatric conditions.  

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