2009 NARSAD Young Investigator Grant: Neural Markers of Treatment Response in Late-life Generalized Anxiety Disorder

Carmen Andreescu, M.D., an Assistant Professor in the Department of Psychiatry at the University of Pittsburgh School of Medicine, is exploring the neural basis of generalized anxiety disorder (GAD). Although the most prevalent anxiety disorder in the elderly—more prevalent than depression—GAD has been the least studied, least understood and probably least treated mental disorder in this population. Even when treated, a persistent problem with GAD is the high rate of post-treatment relapse.

Dr. Andreescu is seeking to identify neural markers of treatment response in late-life GAD. Combining the use of neuroimaging methods with clinical and neuropsychological assessments and treatment interventions, she wants to pinpoint the biological sources of poor treatment response and of variability in treatment response.

In her 2009 NARSAD Young Investigator Grant project, Dr. Andreescu administered the antidepressant citalopram (Celexa®) to a group of previously untreated elderly GAD patients. Post-treatment brain scans revealed significant changes in the neural networks involved in emotion regulation, including greater prefrontal connectivity. (The prefrontal cortex regulates complex cognitive, emotional and behavioral functioning.)

Based on their preliminary observations, Dr. Andreescu and her team are currently designing follow-up studies to identify how these neurobiological profiles can guide more personalized treatment strategies that would target the high relapse rates following pharmacotherapy and could circumvent the mediocre response to psychotherapy in patients with GAD.

Dr. Andreescu is a graduate of the Carol Davila University of Medicine and Pharmacy in Bucharest, Romania. After a residency in clinical psychiatry, Dr. Andreescu was a fellow in geriatric psychiatry at the Western Psychiatric Institute and Clinic at the University of Pittsburgh Medical Center before her faculty appointment at the university.

“The NARSAD Young Investigator Grant from the Brain and Behavior Foundation gave me the opportunity to conduct a study in the novel and rather high-risk area of neural markers of treatment response. Our research team was able to obtain critical pilot data that will permit us to apply for additional grant funding. The results from the project provide a platform for future research aimed at improving treatment options for patients with severe anxiety.”

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