Severe mental illness (SMI) refers to mental disorders that result in significant functional impairment (e.g., schizophrenia and bipolar disorder). In this episode, we bring you Part 1 of our conversation with Lisa Eyler, Ph.D., about inflammation in individuals with SMI, how inflammation is associated with accelerated aging and other health problems, and the clinical utility of functional magnetic resonance imaging (fMRI) in this population. We also contrast the approaches of the Diagnostic and Statistical Manual of Mental Disorders – Fifth Edition (DSM-5) and the Research Domain Criteria (RDoC).
A pdf of the transcript for this episode is available here.
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Show Notes (with time stamps)
- Dr. Eyler’s elevator pitch for her research program (1:53)
- Definitions of severe/serious mental illness (SMI) (1:53)
- Similarities between mood disorders and psychotic disorders, including symptomatology, functional impairment, and genetic risk (3:57)
- Comparing the diagnostic approaches of the DSM-5 and the RDoC (5:55)
- RDoC research framework (9:01)
- Classification system of RDoC (10:24)
- Accelerated aging in SMI (11:31)
- Inflammation, SMI, and accelerated aging (15:34)
- Potential underlying mechanisms of inflammation in cognitive aging (19:29)
- Measuring inflammation with neuroimaging? (21:40)
- The effects of exercise on neuroinflammation (25:09)
- Is the mechanism for neuroinflammation similar across neurological conditions? (28:00)
- The role of the healthcare system in SMI and accelerated aging (30:04)
- Case study that examined a high-functioning woman with schizophrenia (32:25)
- The optimal research approach to examining the heterogeneity of SMI (35:19)
- Functional magnetic resonance imaging (fMRI) in SMI (37:25)
- Accurately interpreting fMRI data (42:09)
- The clinical utility of fMRI (47:56)
- Comparing the sensitivity and specificity of a biological biomarker and self-reported symptoms in the diagnosis of psychiatric disorders (55:34)
Dr. Lisa Eyler is a Professor in the University of California San Diego (UCSD) Department of Psychiatry, co-director of the Neuroimaging Unit of the San Diego VA Mental Illness, Research and Education and Clinical Center (MIRECC), and a steering committee member of UCSD’s Center for Healthy Aging. Dr. Eyler’s research focuses on understanding individual differences in cognitive and emotional functioning using neurobiological measures including structural and functional brain imaging. In particular, she has examined the relationship between cognitive deficits in schizophrenia and abnormalities of brain function and how these relationships may change with age. She completed an NIMH-funded R01 project that examined whether brain structure and function appear to age more rapidly among individuals with bipolar disorder and how this related to increasing cognitive deficits with age. An ongoing longitudinal study investigates how blood-based inflammatory markers and mood variability relate to short- and long-term cognitive changes in bipolar disorder. Dr. Eyler is also a co-investigator on a grant examining accelerated biological and inflammatory aging in schizophrenia. Additionally, she serves as a co-investigator in the Autism Center of Excellence at UCSD studying how neuroimaging measures in infants and toddlers at risk for autism can be used to predict language outcomes. She is a licensed clinical psychologist with training in neuropsychological and diagnostic assessment.
Dev, S. I., Moore, R. C., Soontornniyomkij, B., Achim, C. L., Jeste, D. V., & Eyler, L. T. (2017). Peripheral inflammation related to lower fMRI activation during a working memory task and resting functional connectivity among older adults: a preliminary study. Int J Geriatr Psychiatry, 32(3), 341-349.
Dev, S. I., Nguyen, T. T., McKenna, B. S., Sutherland, A. N., Bartsch, H., Theilmann, R. J., et al. (2017). Steeper Slope of Age-Related Changes in White Matter Microstructure and Processing Speed in Bipolar Disorder. Am J Geriatr Psychiatry, 25(7), 744-752.
Lee, E. E., Eyler, L. T., Wolkowitz, O. M., Martin, A. S., Reuter, C., Kraemer, H., et al. (2016). Elevated plasma F2-isoprostane levels in schizophrenia. Schizophr Res, 176(2-3), 320-326.
Lee, E. E., Liu, J., Tu, X., Palmer, B. W., Eyler, L. T., & Jeste, D. V. (2018). A widening longevity gap between people with schizophrenia and general population: A literature review and call for action. Schizophr Res, 196, 9-13.
Moore, R. C., Eyler, L. T., Mausbach, B. T., Zlatar, Z. Z., Thompson, W. K., Peavy, G., et al. (2015). Complex interplay between health and successful aging: role of perceived stress, resilience, and social support. Am J Geriatr Psychiatry, 23(6), 622-632.
Nguyen, T. T., Eyler, L. T., & Jeste, D. V. (2018). Systemic Biomarkers of Accelerated Aging in Schizophrenia: A Critical Review and Future Directions. Schizophr Bull, 44(2), 398-408.
Nguyen, T. T., Kovacevic, S., Dev, S. I., Lu, K., Liu, T. T., & Eyler, L. T. (2017). Dynamic functional connectivity in bipolar disorder is associated with executive function and processing speed: A preliminary study. Neuropsychology, 31(1), 73-83.
Palmer, B. W., Moore, R. C., Eyler, L. T., Pinto, L. L., Saks, E. R., & Jeste, D. V. (2018a). Avoidance of accelerated aging in schizophrenia?: Clinical and biological characterization of an exceptionally high functioning individual. Schizophr Res, 196, 45-52.
Palmer, B. W., Moore, R. C., Eyler, L. T., Pinto, L. L., Saks, E. R., & Jeste, D. V. (2018b). Avoidance of accelerated aging in schizophrenia?: Clinical and biological characterization of an exceptionally high functioning individual. Schizophr Res, 196, 45-52.