LOS ANGELES TIMES (California) 05 December 10 Hartford Hospital Doing Research With Snakes And Volunteers - Study Looks At A Drug's Role In Banishing Subjects' Fears (William Weir)
For most of her life, Joan Lewis was terrified of snakes.
But that was a few weeks ago, before staring at photos of snakes while lying in an MRI machine during a psychotherapy session that ended with her holding a snake, and taking a drug (or a placebo; she doesn't know which) traditionally used to treat tuberculosis. Now the 63-year-old Newington resident can take her hobby of metal-detecting into the woods for the first time.
It was all part of an ongoing study at Hartford Hospital designed to get a better sense of how fears develop in the brain, and how the brain banishes those fears. The research team also hopes to get a better sense of how the drug d-cycloserine works on the brain.
D-cycloserine has been used to treat tuberculosis for decades but only for the past 10 years or so have researchers known of its effectiveness in conquering phobias.
It affects the part of the brain called the amygdala, which develops new fears and banishes old ones. Specifically, it makes the amygdala more receptive to neurotransmitters so that lessons from psychotherapy are absorbed faster and more deeply.
Exactly how it works, though, is still a mystery. That's what researchers Andrea Nave, David Tolin, and Michael Stevens hope to find out.
"How does the brain banish the fear? We don't really know that," says Stevens, director of the Institute of Living's clinical neuroscience and development laboratory. "It's the first time anyone has ever approached it with this level of thoughtfulness — what's working, and why is it working?"
That's where Lewis comes in. She's one of six people who have signed up for the study. Besides Lewis, two have completed it and the others are partway through. The study began about two months ago. Altogether, 20 subjects are needed for the study, which is expected to be completed by next spring. Half will take the medication and the other half will take placebos. They receive $50 stipends, but Lewis said the real incentive was the chance to conquer her lifelong fear of snakes.
Besides the initial meeting to determine the subject's eligibility, the study is done in three parts. First, subjects lie in an MRI for about 40 minutes while they look at snakes. That gives researchers a sense of how their brain reacts to snakes. The second meeting is a psychotherapy session in which subjects sit in a room with a real snake. Ideally, it ends with the subject holding the snake.
For Lewis, it took 90 minutes to get to that point. Much of that session was terrifying, Lewis said. She started at first as far away from the snake as possible, slowly being coaxed closer to it. Eventually, she held Princess, a 3-year-old corn snake kept in an aquarium at the Institute of Living.
"I wouldn't say I love all snakes now," she said, "but I actually felt motherly when I held it."
The last part of the study is another session in the MRI, identical to the first. That way, the researchers can compare the snake-fearing brain to the snake-friendly brain.
So why snakes? Nave, a clinical research assistant who led the study, said it's one of the easiest of all the phobias to expose subjects to in an MRI. Tolin, director of the anxiety disorders center, added that he hates spiders.
Because it's so early in the study, the researchers don't know how much of a role d-cycloserine played in Lewis' new phobia-free status. They expect to finish the study, and use the results to apply to the National Institutes of Health for a grant to conduct a large-scale study on the drug's effects on phobias.
Anyone interested in taking part in the study should call Andrea Nave at 860-545-7670.
Study Looks At A Drug's Role In Banishing Subjects' Fears

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