VISN 4 MIRECC Newsflash
A dozen novel genetic loci linked to opioid use disorder revealed in Million Veteran Program analysis
Findings could help reduce stigma and improve treatments
Researchers at the VISN 4 MIRECC have identified 14 genetic loci for opioid use disorder (OUD), 12 of which are novel discoveries. The team also found genetic correlations between OUD and 127 traits, including psychiatric disorders such as major depressive disorder and other substance use disorders.
The findings were recently published by Philadelphia-based investigators Rachel Kember, Ph.D., Emily Hartwell, Ph.D., Kyle Kampman, M.D., and Henry Kranzler, M.D., along with other colleagues, in Nature Neuroscience.
Although twin and family studies place the heritability of OUD at roughly 50%, past genome-wide association studies (GWAS) of OUD, often based on limited sample sizes, have struggled to uncover many significant genetic associations. These latest discoveries were possible thanks to the size of VA’s Million Veteran Program (MVP), which is the world’s largest genomic database linked to a health care system and electronic medical record. The cross-ancestry meta-analysis of OUD included 425,944 individuals—the largest single-sample GWAS of OUD to date. The MVP database continues to grow; in August 2022, VA announced that the program had surpassed 900,000 enrolled Veterans.
“A deeper understanding of the genetics underlying this disorder is essential to addressing the national opioid crisis,” said Dr. Kranzler. “OUD is a heritable brain disease and expanding our knowledge of its biological basis could help to change attitudes and guide improvements in its prevention, diagnosis, and treatment.”
This project is an excellent example of the VISN 4 MIRECC’s focus on Precision Mental Health Care. Through the application of “big data,” including genetic information, researchers aim to gain a better understanding of common diseases affecting mental health. Multiple VISN 4 MIRECC investigators are currently engaged in MVP research projects, including genetic studies of suicide risk and substance use disorders.
This study was supported by awards from VA’s Biomedical Laboratory and Clinical Science Research and Development Services, the VISN 4 MIRECC, NIAAA, and NIDA.
MEET THE FELLOWS
Charles Bennett, Ph.D.
Dr. Bennett, joining us in Pittsburgh, will be exploring dimensional approaches to investigating latent factors common to mood and psychotic disorders, with an interest in longitudinal prediction of treatment outcome. He is interested in the role of eHealth to redress barriers to care and augment evidence-based practices, and he also hopes to increase his expertise with statistical methodology (e.g., machine learning).
Dr. Bennett hails from Franklin, Pa. He earned his Ph.D. in clinical psychology from the University of North Texas (with a minor in statistics) and did his internship with the Stony Brook University Consortium Internship Program.
Christine So, Ph.D.
Dr. So, joining us in Philadelphia, is focused on sleep and circadian rhythm disruptions in mental health. As a fellow, she will be examining how these disturbances contribute to PTSD symptoms, as well as the relevance of behavioral sleep medicine interventions.
Originally from Baltimore, Md., Dr. So holds a Ph.D. in clinical psychology from the University of Houston and completed her clinical internship at the UPMC Western Psychiatric Hospital. During graduate school, she completed a clinical practicum at the Michael E. DeBakey VA Medical Center in Houston, working with the PTSD clinical team as well as with a research team investigating transdiagnostic treatments for anxiety. Prior to graduate school, she was a research associate at Walter Reed Army Institute of Research in the Sleep Research Center and Military Psychiatry Branch.
Mark C. Thomas, Ph.D.
Dr. Thomas, joining us in Pittsburgh, is interested in the impact of health behaviors on mood disorders and cardiovascular disease risk, particularly hypertension and obesity. Currently, he is interested in researching how CPAP use may (or may not) enhance weight loss and improve depressive symptoms in Veterans with obstructive sleep apnea participating in the MOVE! weight loss intervention.
A Pittsburgh native, Dr. Thomas earned his Ph.D. in clinical psychology from the University of Pittsburgh. Prior to joining VA, he completed inpatient and outpatient rotations in assessing and treating insomnia and mood disorders in medical populations (e.g., heart failure, solid organ transplant). He also has experience assessing mood and health behaviors via self-report and ambulatory monitoring in the context of cardiovascular disease risk factors.
EXPERTS IN THE NEWS
Steven Sayers, Ph.D., director of VA’s Coaching Into Care and Philadelphia’s Advanced Fellowship in Mental Illness Research and Treatment (Psychology track), discussed PTSD resources for family and loved ones on the VA podcast, PTSD Bytes (June).
David Oslin, M.D.’s Precision Medicine in Mental Health (PRIME) Care study, whose main outcomes were published in JAMA in July, has been featured by the Philadelphia Inquirer, WNYC’s Science Friday, Medpage Today, Healthline, Discover Magazine, The Hill, The Pharmaceutical Journal, LabPulse, The BMJ, Medscape, TODAY.com, and U.S. Medicine.
An editorial published by Henry Kranzler, M.D. and Emily Hartwell, Ph.D. in JAMA Psychiatry about historical and current interest in the use of hallucinogens to treat alcohol use disorder was mentioned by Live Science, Medpage Today, Medscape, and Everyday Health (August).
Dr. Kranzler also did a Q&A with the Philadelphia Inquirer about genetics and alcohol use disorder (August). He also commented to Everyday Health about medications used to treat alcohol use disorder (September).
Philip Gehrman, Ph.D. spoke to the New York Times for a story about tips for sleeping better in the summer heat (July) and another about whether people can become dependent on melatonin supplements (September).
Swathi Gujral, Ph.D. and colleagues at the University of Pittsburgh coauthored a paper in JAMA Psychiatry that concluded that regular activity routines for older adults are associated with better cognitive performance. The results were covered by HCP Live, MarthaStewart.com, The Times of India, the New York Post, and HealthDay (September).
Kyle Kampman, M.D. was mentioned in a Philadelphia Inquirer story about research he is conducting with Penn colleagues on “add-on” treatments that may help patients being treated for opioid use disorder stay on their medications (September).
Recorded Webinar: Measurement Based Care
Earlier this year the VISN 4 MIRECC, in partnership with the VA Employee Education System and OMHSP’s Measurement Based Care in Mental Health Initiative, Northeast Program Evaluation Center (NEPEC), sponsored two popular events entitled Measurement Based Care (MBC): Using Patient Reported Outcome Measures (PROMs) to Enhance Mental Health Care. VA employees can now access a recording of the conference in the Talent Management System (TMS) anytime. CEUs are available. Click here for access. [VA intranet only].
Save the Date: PADRECC/MIRECC Symposium on Neurodegenerative Diseases
The Philadelphia PADRECC and VISN 4 MIRECC are co-hosting a webinar:
Lifestyle Interventions to Promote Brain Health in Neuropsychiatric Disorders
March 22, 2023, 11:00am – 3:00am ET
Registration information to follow.
New Patient Education Video: Pharmacogenetics and Mental Health
As part of our thematic focus on Precision Mental Health Care, our MIRECC has produced a new 3.5-minute video geared toward educating patients: Pharmacogenetics and Mental Health: Do My Genes Influence My Response to Medications? Check it out on the VHA YouTube channel.
Sarah Forster, Ph.D. and Steven Forman, M.D., Ph.D. received a National Institutes of Health (NIH) Small Business Innovative Research (SBIR) Phase 1 Award in collaboration with Behaivior, LLC. Their project, Modeling Physiology and Behavior of Veterans to Avert Opioid Related Mortality Through Timely Intervention, has been funded with a subaward through the Veterans Health Foundation (VHF).
The aim of this project is to evaluate and refine Behaivior, LLC’s proprietary predictive algorithm forecasting opioid relapse risk through remote collection of physiological, behavioral, and self-report metrics. Veterans with Opioid Use Disorder will be asked to participate in data collection via a consumer-grade wearable device and Behaivior, LLC’s mobile health app (Recovery) over a four week period. Information about potential high risk states may additionally be shared with each Veteran’s treatment team for further action.
Tighe CA, Buysse DJ, Weiner DK, Beehler GP, Forman DE. Prevalence, impact, and trajectories of sleep disturbance in cardiac rehabilitation: A narrative review and suggestions for evaluation and treatment. Journal of Cardiopulmonary Rehabilitation and Prevention. May 2022. [link]
Kapman AD, Tipnis U, Beckham JC, Kimbrel NA, Oslin DW, McMahon BH, the MVP Suicide Exemplar Group. Continuous-time probabilistic model for longitudinal electronic health records. Journal of Biomedical Informatics. June 2022. [link]
Khazanov GK, Morris PE, Beed A, Jager-Hyman S, Myhre K, McKay JR, Feinn RS, Boland EM, Thase ME. Do financial incentives increase mental health treatment engagement? A meta-analysis. Journal of Consulting and Clinical Psychology. June 2022. [link]
Bramoweth AD. Patience required: Increasing sleep duration in the months to years following CBT-I. Journal of Clinical Sleep Medicine. July 2022. [link]
Mavandadi S, Wetherell JL, Barker MD, Steadman-Wood PL, Harrington PJ, Karel MJ. Home-based primary care-mental health integration in the Veterans Health Administration: An updated evaluation of practice patterns. Psychological Services. September 2022. [link]
Remmert JE, Guzman G, Mavandadi S, Oslin DW. Racial disparities in prescription of antidepressants among U.S. Veterans referred to behavioral health care. Psychiatric Services. September 2022. [link]
Peeples AD, Muralidharan A, McCarthy S, Goldberg R, Kuykendall L, Vineyard N, Chinman M. Barriers and enablers to implementing Peer Specialists in Veterans Health Administration Primary Care: A qualitative study. Journal of General Internal Medicine. September 2022. [link]
Gancz NN, Forster SE. Threats to external validity in the neuroprediction of substance use treatment outcomes. American Journal of Drug and Alcohol Abuse. September 2022. [link]