Thursday, November 13, 2014

Conference review: ECNP congress 2014

I recently attended the European College of Neuropsychopharmacology (ECNP) congress 2014. I was doubly fortunate in that (a). I received a travel grant to this congress, which (b). was happening in Berlin, the home of an old friend. In so many words, the ECNP congress discusses the use of brain science to better understand and treat disorder of the brain.

It's very easy to get lost at a Congress (compared to a conference)-the scope of a large subject can leave one drowning in a sea of breadth, presenting at sessions where no one knows much about what any other speaker is talking about. What's neat about ECNP is they divide sessions into tracks-preclinical research, clinical research, clinical treatment etc. and within this the sessions have well-defined titles that still allow for multidisciplinary input. 

I was presenting a poster with colleagues at Dept of Psychiatry in UCC concerning the effects of ketamine on treatment resistant depression. We classified this as people with major depression who had failed to respond to two or more adequate trials of antidepressants. We also looked at brain-derived neurotropic factor (BDNF)-a substance involved in the production of brain cells. BDNF was reduced in people with treatment resistant depression compared to healthy controls, as has been shown before. What was interesting was that BDNF increased in depressed people, but it was delayed compared to a rapid improvement in feelings of depression. What was more, this effect did not seem to persist after multiple infusions, even though multiple infusions maintained a reduction in depressive symptoms.

The topic of depression and ketamine was pretty hot at the congress-there was a brainstorming session on this topic that was well attended despite a start time of 7.45 (in comparison, a session the previous day on getting ERC grants didn't seem so well attended{!!!!}). The ketamine session was more focussed on whether ketamine is really ready for clinical use; there was a lot of focus on the clear impact on symptoms in treatment-resistant depression, as well as possible risk factors-a problematic aspect being a dearth of evidence on the long-term effects of ketamine therapy. There was a lot of (too much) anecdotal evidence at the discussion-what would be great in the long run would be to develop some kind of decision tree clinicians could use to decide whether ketamine use can be recommended and when to cease its use, although in the absence of long-term evidence such work may be preliminary. Although ketamine may improve BDNF, I shouldn't make it sound as though other drugs can't impact on the development of brain cells-there was a poster from Portugal indicating that anti-psychotics can enhance the growth of brain cells in rodents-although this effect is present for some of these drugs but not others.

On the topic of depression, there was a nice psychology talk from Catherine Harmer suggesting that changes in processing of emotional stimuli may change following treatment with drugs such as NRI's (norepinephrine reuptake inhibitors-these increase the level of norepinephrine in the synapse by preventing reuptake back into the cell). Interestingly, these changes in information processing seem to occur prior to the improvement of symptoms, suggesting that this cognitive effect could underpin the subsequent emotional effect.

Other highlights included a keynote speech from Karl "Future Nobel Laureate" Deisseroth, having a chat about how he invented optigenetics and CLARITY. There was also an interesting session on the neurobiology of ADHD-there seems to be quite a lot of work going on across Europe looking at how genetics may explain changes in the structure of the brain associated with ADHD (as well as other disorders)-I asked one of the speakers at a later session if there had been much work along these lines using fMRI during sustained attention to look at the function of brain structures during performance of the types of tasks impaired by ADHD-apparently there may be a gap in the literature there...

You can download our posters from this congress and other posters from the Dept of Psychiatry here

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