Carolyn I. Rodriguez

Last updated
Carolyn Rodriguez
Carolyn Rodriguez at World Economic Forum.jpg
Rodriguez speaks at the World Economic Forum in 2019
Bornc. 1981 (age 42–43)
San Juan, Puerto Rico
Alma mater Harvard University
Known forDiscovering therapeutic potential of Ketamine in treating OCD
Scientific career
FieldsNeuroscience, psychiatry
InstitutionsStanford University

Carolyn I. Rodriguez is a Puerto Rican psychiatrist, neuroscientist, and clinical researcher developing treatments for obsessive compulsive disorder as well as mapping circuit dysfunction in the human brain. Rodriguez holds appointments in both clinical and academic departments at Stanford University. Rodriguez is a Clinical Lab Director at the Stanford Center for Cognitive and Neurobiological Imaging, an associate professor and Associate Chair of Psychiatry and Behavioral Sciences, and a Director of several specialized translational research programs.

Contents

Early life and education

Rodriguez was born in San Juan, Puerto Rico. [1] She moved to Boston for her undergraduate degree in Computer Science at Harvard University. [1] After graduating in 1996, Rodriguez stayed in Boston to pursue her MD-PhD training within the Harvard-MIT Health Sciences and Technology program where she conducted research in Neuroscience and completed her MD training at Harvard Medical School. [1] During her PhD, Rodriguez was mentored by Susan Dymecki where she developed an innovative genetic technology to map the development of the Precerebellar System in rodents. [2] Her technology has been cited hundreds of times and is now widely used many researchers in neuroscience. [3]

Rodriguez moved to New York City to complete her internship, residency, and postdoctoral training at Columbia University Medical Center-NYSPI. [1] In 2005, Rodriguez completed her Internship in Pediatrics and in 2008, she completed her Residency in both Pediatrics and Psychiatry. [1] Rodriguez narrowed her clinical and research focus towards understand and treating patients with Obsessive–compulsive disorder. [4] When she first treated a patient with OCD, she was taken aback by how disabling the disease was and she became frustrated by both the lack of treatments and the long time course before existing treatments begin to relieve patients symptoms. [4] She became motivated to help patients with OCD by exploring avenues to innovate treatments that have rapid effects on patients. [4]

Rodriguez continued on to Fellowship training at Columbia under the mentorship of Helen Blair Simpson. [5] Rodriguez explored the rapid therapeutic effects of Ketamine as a treatment for OCD. [3] Rodriguez was recruited to Stanford University in 2015. [1]

Tool development for precerebellar afferent system ontogeny

During her graduate studies, Rodriguez wanted to test the hypothesis that precerebellar neurons originate from the dorsal neuroepithelium, but she needed a tool to do so. [6] To determine the origins of the precerebellar neurons, Rodriguez developed a genetic tool, using flip-recombinase, that allowed for irreversible fluorescent tagging of descendent cells from a specific progenitor. [6] Applying this tool. Rodriguez localized the origins of the precerebellar neurons to Wnt1 expressing dorsal neural progenitors. [6] She later improved the efficacy of her tool by creating an enhanced version, called FLPe, that had 10 fold improved activity compared to the previous iteration. [6] Using FLPe, Rodriguez was able to determine molecular differences in the primordial cell population that gave rise to unique subsystems of cerebellar cells, suggesting that differentiation may occur even earlier than originally appreciated. [6] Rodriguez's genetic tool development and novel findings were published in Neuron in 2000 and have been cited numerous times due to their utility in neuronal fate mapping. [7]

Obsessive-compulsive disorder and hoarding disorder

Rodriguez published a case study exploring the difficulty in diagnosing and treating an individual with signs of both OCD and schizophrenia, and she displayed the efficacy of treating OCD with glutamate modulators posing future questions about their longitudinal use in treating OCD. [8]

Rodriguez and her colleagues tested a novel glutamate modulator, minocycline, to assess its potential for relief of OCD symptoms as an alternative to SSRIs. [9] They found that minocycline might ameliorate early onset OCD and improve symptoms of primary hoarding, and their results overall suggest that further studies are warranted to explore minocycline as a therapeutic agent for early-onset OCD. [9] In 2015, Rodriguez published a groundbreaking paper in Neurospychopharmacology highlighting the therapeutic potential of a different glutamate modulating compound, Ketamine, in treating OCD. [10] They found significant decreases in obsessions that lasted for more than one week. [10] Rodriuguez's study was the first randomized controlled trial to show that modulating glutamate signalling could have rapid and long-lasting therapeutic effects for patients with OCD. [10]

Rodriguez also discovered abnormally high rates of Hoarding Disorder (HD) in the population of individuals in New York seeking help from Eviction Intervention Services. [11] Her findings highlighted the potential of treating HD in reducing homelessness in New York and Rodriguez began to explore new and improved treatments for HD. [11] In a case report, she assessed the use of methylphenidate, an amphetamine, in treating HD and it showed improvements in some individuals suggesting further research into applying amphetamine compounds in a clinical setting for HD. [12]

Career and research

In 2015, Rodriguez joined the faculty at Stanford University as an Assistant Professor of Psychiatry and Behavioral Sciences and a member of the Wu Tsai Neurosciences Institute. [13] Rodriguez was also appointed the Director of the Stanford Hoarding Disorders Research Program, the Director of the Translational OCD Research Program, and the Director of the Translational Therapeutics Lab, which is also the Rodriguez Lab. [14] Rodriguez's lab focuses on understanding the neurobiological mechanisms of emotion and behavior in order to develop rapid acting therapeutics for mental illnesses. [15] They focus on drug discovery and participate in clinical trials to test mechanisms and efficacy of their compounds and treatments in the human brain. [15] The main illness that the lab focuses on currently is OCD, they also work on Hoarding Disorder and Posttraumatic Stress Disorder. [15]

Rodriguez also provides clinical mental health care for veterans as a consultation liaison psychiatrist. [1] In 2018, Rodriguez was promoted to Associate Chair of Inclusion and Diversity at Stanford Medical School in the Department of Psychiatry and Behavioral Sciences, and she took on the role of Clinical Lab Director at the Stanford Center for Cognitive and Neurobiological Imaging. [14]

Glutamate modulation as a treatment for OCD

Following Rodriguez's successful postdoctoral work at Columbia elucidating the therapeutic potential of Ketamine in treating OCD, Rodriguez continued to pursue a further understanding of this therapeutic avenue and ways to improve its efficacy in patients. To assess the neurochemical effects of Ketamine, Rodriguez and her colleagues used proton magnetic resonance spectroscopy. [16] They found that subjects treated with Ketamine had higher GABA levels than controls, and these findings support data showing that patients with OCD have decreased GABAergic activity. [16] Their finding pointed to a novel mechanism of ketamine action and underlying GABA abnormality in patients with OCD. [16]

While Ketamine was effective in ameliorating symptoms, its side effects include nausea and dissociation, so Rodriguez and her colleagues sought to find another glutamate modulatory compound to treat OCD with fewer side effects. [17] They found that Rapastinel, a NMDAR glycine-site partial agonist, showed similar improvements in obsessions associated with OCD while accompanied by fewer side effects compared to ketamine treatment. [17] Though the short term effects were positive, it did not have long lasting effects like ketamine thus calling for further developments in therapeutics. [17]

To explore underlying mechanisms of Ketamine's actions and find ways to reduce the dissociative effects of Ketamine, Rodriguez and her team tested opioid receptor antagonism as a means to reduce dissociations in patients. [18] They surprisingly found that opioid signalling plays an important role in mediating ketamines acute anti-depressant effects but does not seem to play as dominant a role in mediating the dissociative effects. [18]

Advocacy

Rodriguez is a past Chair of the American College of Neuropsychopharmacology Underrepresented Minority Task Force. [19]

Rodriguez also advocates for equity, inclusion, and diversity in science and medicine. She recently[ when? ] co-authored an article in the Harvard Business Review [19] discussing the barriers that women face in medicine and that broader diversity can improve innovative potential. [19] She also helps to outline critical yet simple steps that can be achieved quickly to begin to make changes to improve the numbers of women in leadership positions in medicine and academia. [19]

As a writer for the Huffington Post, Rodriguez has written articles educating the public about the importance of research and how they can get involved in advancing research towards treating and curing mental illnesses like OCD. [20] Her writing has also created an avenue for public awareness of the stages of ketamine research for use in mental illness. [21]

Awards and honors

Select publications

Related Research Articles

<span class="mw-page-title-main">Obsessive–compulsive personality disorder</span> Personality disorder involving orderliness

Obsessive–compulsive personality disorder (OCPD) is a cluster C personality disorder marked by a spectrum of obsessions with rules, lists, schedules, and order, among other things. Symptoms are usually present by the time a person reaches adulthood, and are visible in a variety of situations. The cause of OCPD is thought to involve a combination of genetic and environmental factors, namely problems with attachment.

<span class="mw-page-title-main">Hoarding disorder</span> Behavioral pattern

Hoarding disorder (HD) or Plyushkin's disorder, is a mental disorder characterised by persistent difficulty in parting with possessions and engaging in excessive acquisition of items that are not needed or for which no space is available. This results in severely cluttered living spaces, distress, and impairment in personal, family, social, educational, occupational, or other important areas of functioning. Excessive acquisition is characterized by repetitive urges or behaviours related to amassing or buying property. Difficulty discarding possessions is characterized by a perceived need to save items and distress associated with discarding them. Accumulation of possessions results in living spaces becoming cluttered to the point that their use or safety is compromised. It is recognised by the eleventh revision of the International Classification of Diseases (ICD-11) and the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5).

<span class="mw-page-title-main">Hoarding</span> Intentional accumulation of items for later use

Hoarding is the act of engaging in excessive acquisition of items that are not needed or for which no space is available.

<span class="mw-page-title-main">Clomipramine</span> Antidepressant

Clomipramine, sold under the brand name Anafranil among others, is a tricyclic antidepressant (TCA). It is used in the treatment of various conditions, most-notably obsessive–compulsive disorder but also many other disorders, including panic disorder, major depressive disorder, trichotilomania, body dysmorphic disorder and chronic pain. It has also been notably used to treat premature ejaculation and the cataplexy associated with narcolepsy.

Impulse-control disorder (ICD) is a class of psychiatric disorders characterized by impulsivity – failure to resist a temptation, an urge, or an impulse; or having the inability to not speak on a thought. Many psychiatric disorders feature impulsivity, including substance-related disorders, behavioral addictions, attention deficit hyperactivity disorder, autism spectrum disorder, fetal alcohol spectrum disorders, antisocial personality disorder, borderline personality disorder, conduct disorder and some mood disorders.

<span class="mw-page-title-main">Excoriation disorder</span> Medical condition

Excoriation disorder, more commonly known as dermatillomania, is a mental disorder on the obsessive–compulsive spectrum that is characterized by the repeated urge or impulse to pick at one's own skin, to the extent that either psychological or physical damage is caused.

The obsessive–compulsive spectrum is a model of medical classification where various psychiatric, neurological and/or medical conditions are described as existing on a spectrum of conditions related to obsessive–compulsive disorder (OCD). "The disorders are thought to lie on a spectrum from impulsive to compulsive where impulsivity is said to persist due to deficits in the ability to inhibit repetitive behavior with known negative consequences, while compulsivity persists as a consequence of deficits in recognizing completion of tasks." OCD is a mental disorder characterized by obsessions and/or compulsions. An obsession is defined as "a recurring thought, image, or urge that the individual cannot control". Compulsion can be described as a "ritualistic behavior that the person feels compelled to perform". The model suggests that many conditions overlap with OCD in symptomatic profile, demographics, family history, neurobiology, comorbidity, clinical course and response to various pharmacotherapies. Conditions described as being on the spectrum are sometimes referred to as obsessive–compulsive spectrum disorders.

<span class="mw-page-title-main">Olanzapine/fluoxetine</span> Antidepressant medication

Olanzapine/fluoxetine is a fixed-dose combination medication containing olanzapine (Zyprexa), an atypical antipsychotic, and fluoxetine (Prozac), a selective serotonin reuptake inhibitor (SSRI). Olanzapine/fluoxetine is primarily used to treat the depressive episodes of bipolar I disorder as well as treatment-resistant depression.

Exposure therapy is a technique in behavior therapy to treat anxiety disorders.

<span class="mw-page-title-main">Obsessive–compulsive disorder</span> Mental and behavioral disorder

Obsessive–compulsive disorder (OCD) is a mental and behavioral disorder in which an individual has intrusive thoughts and feels the need to perform certain routines (compulsions) repeatedly to relieve the distress caused by the obsession, to the extent where it impairs general function.

The biology of obsessive–compulsive disorder (OCD) refers biologically based theories about the mechanism of OCD. Cognitive models generally fall into the category of executive dysfunction or modulatory control. Neuroanatomically, functional and structural neuroimaging studies implicate the prefrontal cortex (PFC), basal ganglia (BG), insula, and posterior cingulate cortex (PCC). Genetic and neurochemical studies implicate glutamate and monoamine neurotransmitters, especially serotonin and dopamine.

The cause of obsessive–compulsive disorder is understood mainly through identifying biological risk factors that lead to obsessive–compulsive disorder (OCD) symptomology. The leading hypotheses propose the involvement of the orbitofrontal cortex, basal ganglia, and/or the limbic system, with discoveries being made in the fields of neuroanatomy, neurochemistry, neuroimmunology, neurogenetics, and neuroethology.

The delayed-maturation theory of obsessive–compulsive disorder suggests that obsessive–compulsive disorder (OCD) can be caused by delayed maturation of the frontal striatal circuitry or parts of the brain that make up the frontal cortex, striatum, or integrating circuits. Some researchers suspect that variations in the volume of specific brain structures can be observed in children that have OCD. It has not been determined if delayed-maturation of this frontal circuitry contributes to the development of OCD or if OCD is the ailment that inhibits normal growth of structures in the frontal striatal, frontal cortex, or striatum. However, the use of neuroimaging has equipped researchers with evidence of some brain structures that are consistently less adequate and less matured in patients diagnosed with OCD in comparison to brains without OCD. More specifically, structures such as the caudate nucleus, volumes of gray matter, white matter, and the cingulate have been identified as being less developed in people with OCD in comparison to individuals that do not have OCD. However, the cortex volume of the operculum (brain) is larger and OCD patients are also reported to have larger temporal lobe volumes; which has been identified in some women patients with OCD. Further research is needed to determine the effect of these structural size differences on the onset and degree of OCD and the maturation of specific brain structures.

The University of Florida Obsessive–Compulsive Disorder Program is a treatment and research clinic in the Department of Psychiatry at the University of Florida. The clinic is located in Gainesville, Florida.

Joseph Zohar is the director of Psychiatry and the Anxiety and Obsessive Compulsive Clinic at the Sheba Medical Center in Tel HaShomer and professor of psychiatry at Tel Aviv University, Israel. He is the founder of the World Council on Anxiety as well as the Israeli Consortium on PTSD. He currently leads the chief installation of the Israeli Defense Force for the treatment of PTSD. He is a member of the executive committee of the European College of Neuropsychopharmacology, of which he is a former president, and chairman of the Expert Platform on Mental Health.

Jonathan Stuart Abramowitz is an American clinical psychologist and Professor in the Department of Psychology and Neuroscience at the University of North Carolina at Chapel Hill (UNC-CH). He is an expert on obsessive-compulsive disorder (OCD) and anxiety disorders whose work is highly cited. He maintains a research lab and currently serves as the Director of the UNC-CH Clinical Psychology PhD Program. Abramowitz approaches the understanding and treatment of psychological problems from a cognitive-behavioral perspective.

The Dimensional Obsessive-Compulsive Scale (DOCS) is a 20-item self-report instrument that assesses the severity of Obsessive-Compulsive Disorder (OCD) symptoms along four empirically supported theme-based dimensions: (a) contamination, (b) responsibility for harm and mistakes, (c) incompleteness/symmetry, and (d) unacceptable (taboo) thoughts. The scale was developed in 2010 by a team of experts on OCD led by Jonathan Abramowitz, PhD to improve upon existing OCD measures and advance the assessment and understanding of OCD. The DOCS contains four subscales that have been shown to have good reliability, validity, diagnostic sensitivity, and sensitivity to treatment effects in a variety of settings cross-culturally and in different languages. As such, the DOCS meets the needs of clinicians and researchers who wish to measure current OCD symptoms or assess changes in symptoms over time.

Association splitting is a self-help technique for people with obsessive-compulsive disorder (OCD).

References

  1. 1 2 3 4 5 6 7 8 9 10 11 "Carolyn Rodriguez | Stanford Medicine Profiles". med.stanford.edu. Retrieved April 27, 2020.
  2. ↑ "Student Trainees". The Harvard/MIT MD-PhD Program. Retrieved April 25, 2020.
  3. 1 2 "Carolyn Rodriguez and Todd Gould receive SOBP 2017 A.E. Bennett Research Award". EurekAlert!. Retrieved April 27, 2020.
  4. 1 2 3 University, © Stanford; Stanford; California 94305 (September 28, 2018). "Carolyn Rodriguez". Wu Tsai Neurosciences Institute. Retrieved April 27, 2020.{{cite web}}: CS1 maint: numeric names: authors list (link)
  5. ↑ "Helen Blair Simpson, MD, PhD". Graduate School of Arts and Sciences. August 1, 2018. Retrieved April 27, 2020.
  6. 1 2 3 4 5 "Innovating genetic technology to map the origin of the precerebellar system". www.elibrary.ru. Retrieved April 27, 2020.
  7. ↑ Rodriguez, Carolyn I.; Dymecki, Susan M. (September 1, 2000). "Origin of the Precerebellar System". Neuron. 27 (3): 475–486. doi: 10.1016/S0896-6273(00)00059-3 . ISSN   0896-6273. PMID   11055431. S2CID   18729111.
  8. ↑ Rodriguez, Carolyn I.; Corcoran, Cheryl; Simpson, Helen Blair (July 1, 2010). "Diagnosis and Treatment of a Patient With Both Psychotic and Obsessive-Compulsive Symptoms". American Journal of Psychiatry. 167 (7): 754–761. doi:10.1176/appi.ajp.2009.09070997. ISSN   0002-953X. PMC   3859191 . PMID   20595428.
  9. 1 2 Rodriguez, Carolyn I.; Bender, James; Marcus, Sue M.; Snape, Michael; Rynn, Moira; Simpson, Helen Blair (September 2010). "Minocycline Augmentation of Pharmacotherapy in Obsessive-Compulsive Disorder: An Open-Label Trial". The Journal of Clinical Psychiatry. 71 (9): 1247–1249. doi:10.4088/JCP.09l05805blu. ISSN   0160-6689. PMC   3923525 . PMID   20923629.
  10. 1 2 3 Rodriguez, Carolyn I.; Kegeles, Lawrence S.; Levinson, Amanda; Feng, Tianshu; Marcus, Sue M.; Vermes, Donna; Flood, Pamela; Simpson, Helen B. (November 2013). "Randomized Controlled Crossover Trial of Ketamine in Obsessive-Compulsive Disorder: Proof-of-Concept". Neuropsychopharmacology. 38 (12): 2475–2483. doi:10.1038/npp.2013.150. ISSN   1740-634X. PMC   3799067 . PMID   23783065.
  11. 1 2 Rodriguez, Carolyn I.; Herman, Dan; Alcon, Jehanny; Chen, Shaofu; Tannen, Audrey; Essock, Susan; Simpson, Helen Blair (January 2012). "Prevalence of Hoarding Disorder in Individuals at Potential Risk of Eviction in New York City". The Journal of Nervous and Mental Disease. 200 (1): 91–94. doi:10.1097/NMD.0b013e31823f678b. ISSN   0022-3018. PMC   3833068 . PMID   22210369.
  12. ↑ Rodriguez, Carolyn I.; Bender, James; Morrison, Samantha; Mehendru, Raveen; Tolin, David; Simpson, Helen Blair (June 2013). "Does Extended Release Methylphenidate Help Adults with Hoarding Disorder? A Case Series". Journal of Clinical Psychopharmacology. 33 (3): 444–447. doi:10.1097/JCP.0b013e318290115e. ISSN   0271-0749. PMC   4003908 . PMID   23609401.
  13. ↑ "Carolyn Rodriguez and Todd Gould receive SOBP 2017 A.E. Bennett Research Award". EurekAlert!. Retrieved April 27, 2020.
  14. 1 2 "Carolyn Rodriguez's Profile | Stanford Profiles". profiles.stanford.edu. Retrieved April 27, 2020.
  15. 1 2 3 "About". Rodriguez Lab. Retrieved April 27, 2020.
  16. 1 2 3 Rodriguez, Carolyn I.; Kegeles, Lawrence S.; Levinson, Amanda; Ogden, R. Todd; Mao, Xiangling; Milak, Matthew S.; Vermes, Donna; Xie, Shan; Hunter, Liane; Flood, Pamela; Moore, Holly (August 30, 2015). "In vivo effects of ketamine on glutamate-glutamine and gamma-aminobutyric acid in obsessive-compulsive disorder: Proof of concept". Psychiatry Research: Neuroimaging. 233 (2): 141–147. doi:10.1016/j.pscychresns.2015.06.001. ISSN   0925-4927. PMC   4715460 . PMID   26104826.
  17. 1 2 3 Rodriguez, Carolyn I.; Zwerling, Jordana; Kalanthroff, Eyal; Shen, Hanyang; Filippou, Maria; Jo, Booil; Simpson, Helen Blair; Burch, Ronald M.; Moskal, Joseph R. (December 1, 2016). "Effect of a Novel NMDA Receptor Modulator, Rapastinel (formerly GLYX-13) in OCD: Proof-of-Concept". The American Journal of Psychiatry. 173 (12): 1239–1241. doi:10.1176/appi.ajp.2016.16080868. ISSN   0002-953X. PMC   5304999 . PMID   27903098.
  18. 1 2 Williams, Nolan R.; Heifets, Boris D.; Blasey, Christine; Sudheimer, Keith; Pannu, Jaspreet; Pankow, Heather; Hawkins, Jessica; Birnbaum, Justin; Lyons, David M.; Rodriguez, Carolyn I.; Schatzberg, Alan F. (August 29, 2018). "Attenuation of Antidepressant Effects of Ketamine by Opioid Receptor Antagonism". American Journal of Psychiatry. 175 (12): 1205–1215. doi:10.1176/appi.ajp.2018.18020138. ISSN   0002-953X. PMC   6395554 . PMID   30153752.
  19. 1 2 3 4 Mangurian, Christina; Linos, Eleni; Sarkar, Urmimala; Rodriguez, Carolyn; Reshma Jagsi (June 19, 2018). "What's Holding Women in Medicine Back from Leadership". Harvard Business Review. ISSN   0017-8012 . Retrieved April 27, 2020.
  20. ↑ Rodriguez, Carolyn; M.D.; Ph.D.; University, ContributorAssistant Professor at Stanford (December 7, 2017). "How We Can Discover New Treatments for Mental Health". HuffPost. Retrieved April 27, 2020.{{cite web}}: |first4= has generic name (help)
  21. ↑ "Ketamine's Rapid Effects in Depression and OCD: Cause for Hope and Caution". HuffPost. March 24, 2014. Retrieved April 27, 2020.
  22. ↑ "President Donald J. Trump Announces Recipients of the Presidential Early Career Award for Scientists and Engineers". whitehouse.gov . Retrieved April 27, 2020– via National Archives.
  23. ↑ "Eva King Killam Previous Award Winners". ACNP. Retrieved April 27, 2020.
  24. ↑ "A.E. Bennett Research Award – Basic | Society of Biological Psychiatry" . Retrieved April 27, 2020.
  25. ↑ "Past Klerman & Freedman Prizewinners". Brain & Behavior Research Foundation. April 11, 2017. Retrieved April 27, 2020.
  26. ↑ "How Early BBRF Grants Helped Place Two Young Investigators on the Path to Major Career Success". Brain & Behavior Research Foundation. April 6, 2020. Retrieved April 27, 2020.
  27. 1 2 3 4 5 6 7 8 9 10 11 "Publications". Rodriguez Lab. Retrieved April 27, 2020.
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