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Ihori Kobayashi has been involved in research on posttraumatic stress disorder (PTSD) since the beginning of her doctoral training at Kent State University. Her clinical research interests include roles of sleep in the development of and recovery from PTSD, and nocturnal autonomic nervous system activity in PTSD and resilience. In addition, working in collaboration with a basic scientist, she started a mouse sleep study to examine sex differences in posttraumatic sleep. This study provided her with an opportunity to learn animal sleep study methodology and lay a foundation for developing an interdisciplinary research program. Her current project aims to examine whether blocking the orexin (hypotretin) system enhances sleep’s benefits to therapeutic exposure for PTSD. Her long-term goal is to develop an interdisciplinary research program to elucidate neurophysiological mechanisms that underlie sleep’s contributions to therapeutic processes and incorporate this knowledge into PTSD treatment strategies.
Describe your research interests and how you chose this area of research.
My research focuses on sleep aspects of posttraumatic stress disorder (PTSD). I use both clinical methods and animal models to elucidate sleep’s role in the development of and recovery from PTSD. Topics of projects I have been working on include roles of sleep in exposure-based treatment of PTSD, pharmacological augmentation of exposure-based treatment of PTSD through sleep, sex differences in sleep after trauma exposure, and impacts of PTSD on nocturnal autonomic nervous system activity.
I initially chose to study PTSD during my undergraduate studies because of my interests in women’s issues such as violence against women. Learning that violence against women had limited recognition and support in my home country, Japan despite its profound impact on women’s lives led to my decision to study clinical psychology focusing on PTSD to help women struggling with the consequence of violence. My specific interest in sleep aspects of PTSD developed during my graduate training. I learned about a theory that abnormal consolidation of traumatic memory underlies the development of PTSD. As sleep is involved in memory consolidation, I wondered if sleep is connected to PTSD. Sleep disturbance is a commonly reported symptom of PTSD. Research has shown that sleep disturbances prior to and soon after trauma predicted the development of PTSD. Sleep has also been implicated in learning processes involved in adaptive processing of trauma memories. These findings increased my confidence that elucidating the role of sleep in the development of and recovery from PTSD would contribute to the advancement of PTSD treatment.
How does GHUCCTS help you to achieve your research goals and advance your career in clinical and translational research? How will the CTSA program help to advance knowledge and treatments for patients with the disease(s) you study?
The GHUCCTS KL2 award is providing me with resources to conduct a clinical trial to examine whether blocking the orexin system enhances therapeutic benefits of exposure-based treatment for PTSD through improving sleep. The KL2 award also gives me training opportunities to acquire new knowledge and research skills in neuroscience. Both research and training opportunities will help me to develop my independent translational research program encompassing both clinical and animal studies to elucidate neural mechanisms underlying sleep’s role in PTSD and develop novel strategies to improve treatment of PTSD.
Why is it important to have both disciplinary and ethnic/cultural diversity in medical research? How does diversity contribute to your research? How does diversity enhance scientific discovery?
PTSD is a complex condition as both psychosocial and biological factors contribute to its development, maintenance, and recovery. Treatment strategies that focus on either psychological or biological targets alone have shown limited success. To improve treatment for PTSD, it is important for researchers from diverse disciplines to work together to develop more comprehensive intervention strategies. I work with researchers from various fields including psychology, psychiatry, and physiology to understand various factors influencing sleep in PTSD and develop novel strategies to treat PTSD.
Many research projects I have been involved in included African Americans living in stressful urban neighborhoods as research participants. One of those projects recently found that neighborhood distress was associated with reduced nocturnal blood pressure dipping, a risk factor for cardiovascular disease. It is an example of why inclusion of ethnically/culturally/socioeconomically diverse groups in research can help researchers and clinicians recognize unique challenges patients from minority groups face and ensure that research findings are applicable to the improvement of health of people from various backgrounds.
How does clinical translational research benefit our communities, both directly and indirectly?
The research program I am developing with the support from the GHUCCTS KL2 award encompasses both clinical and animal research. Clinical research is important as it is able to show whether certain treatment approaches are effective in treating target conditions. However, clinical research alone is often not able to provide all information we need to develop or improve treatment strategies. For example, my clinical study aims to examine whether a dual orexin receptor antagonist, suvorexant, would enhance therapeutic effects of exposure-based treatment for PTSD through improving sleep. Although this clinical study would provide extremely useful clinical information, it does not allow for directly manipulating specific neural circuities to determine mechanisms underlying the hypothesized effects. After receiving training in animal research methodology, I plan to conduct animal research to elucidate neural mechanisms underlying the hypothesized effects of orexin antagonist on sleep and PTSD symptoms. Information to be obtained from both clinical and animal studies would reciprocally stimulate further research to refine the intervention strategy as well as to develop novel treatment approaches.
Details regarding my project can found here: https://clinicaltrials.gov/show/NCT02849548
September 15, 2016