Medical Student Research Fellowship for Summer 2007

Mentor: Bryon Adinoff, M.D.
Department: Psychiatry
Room number: FL500
Mail Code: 8564
Phone number: 214-645-6975
E-mail: bryon.adinoff@utsouthwestern.edu
Project title: Stress, HPA Axis Dysfunction, and Relapse in Alcoholism

Human subjects IRB approved project number (where applicable): 012007-023

Animal subjects IRB approved project number (where applicable):

Project Type (patient-based research, animal-based research, or basic research; this characterization is only to permit a general classification for grouping similar types of projects)

Brief Description of Project:

Both trauma and chronic alcohol use produce persistent disturbances in the HPA axis response to stress. Suppression of adrenocortical glucocorticoid release, in particular, is identified as a key component of this altered stress response. The chronic use of alcohol may also impair the stress-induced release of neurosteroids, compounds that directly modulate GABAergic activity. Thus, diminished glucocorticoid and neurosteroid responsiveness during abstinence may impair the central nervous system's (CNS) ability to mount an appropriate response to environmental stressors, thus heightening the probability of relapse. In the proposed study, the investigators will expand upon their extensive work on stress, HPA axis disturbances, and substance use disorders to directly assess the contribution of trauma, stress, and alcohol use upon pituitary-adrenocortical functioning in alcohol-dependent subjects. The relative contribution of adrenocortical disruption and episodic stress to drinking behavior will then be prospectively determined over the next six months.
Methods: One hundred treatment-seeking, one-month abstinent, alcohol-dependent subjects will be studied. Standardized assessments will be used to assess childhood, adolescent, and adult trauma as well as recent (six months) stress. Pituitary-adrenal (including ACTH, cortisol, and neurostoids) provocation to both neuroendocrine (ovine corticotropin releasing hormone, oCRH, and cosyntropin) and experiential (public speaking) challenges will be assessed. Drinking behavior will be determined for six months following the initial assessment. fMRI studies of subjects during a stress paradigm will also be obtained.

Previous Research Activities or Publications with Medical Students:

I have worked with several pre-med students, pre-graduate, post-graduate, and fellow trainees over a period of several years. However, I have not had the pleasure, to date, or working with a medical student. I am therefore very excited about having the opportunity to work with Elizabeth Hardin this summer. I am certain that this will be a productive experience for her.

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