Serge A Mitelman, MD

Dr. Mitelman’s neuroimaging research has contributed to the scientific literature on schizophrenia, with inter alia findings of the widespread (rather than localized) abnormalities in white matter integrity that appear nonprogressive with the exception of patients with poor functional outcome (who showed progressive changes in the corpus callosum); posteriorization of gray matter deficits with poor outcome in schizophrenia; signs of premature aging in gray matter of patients with schizophrenia – more pronounced in its most severe Kraepelinian subtype (characterized by very poor outcome and chronic institutionalization). He also explored differential patterns of regional intercorrelations among gray and white matter structures using both structural MRI and 18F-FDG positron emission tomography in schizophrenia and healthy subjects, with the emphasis on the cortex and several nuclei of the thalamus previously implicated in schizophrenia. His multimodal studies using diffusion tensor imaging, 18F-fallypride and 18F-fluorodeoxyglucose positron emission tomography suggested a role of dopaminergic modulation in axonal myelination and by extension a role of primary dopaminergic abnormalities in white matter pathology widely documented in schizophrenia by previous diffusion tensor imaging investigations; a possible role of dopaminergic system in neurovascular coupling in healthy subjects and in metabolic abnormalities in the gray matter in schizophrenia; increased energetic expenditures in connection with lower white matter fractional anisotropy (reflective of myelin abnormalities) in schizophrenia. First direct transdiagnostic comparisons yielded support for diametrically opposed and similarly distributed structural changes in both gray and white matter in subjects with schizophrenia and autism (buttressing a prominent evolutionary model of their reciprocal relationship as trade-off diseases of social brain); and found increased white matter metabolism in both schizophrenia and autism proposing that this may be a common feature of all neurodevelopmental and neurodegenerative disorders. These latter studies were summarized in a recently published review of transdiagnostic neuroimaging in psychiatric disorders and support a hypothesis of diametrically opposite placement of psychotic and autistic disorders along the same cognitive spectrum. Ongoing research investigates the role of dopamine receptors and their abnormalities in cognitive functions in healthy and schizophrenia subjects, in particular verbal fluency, reading and attention. Dr. Mitelman is also the site principal investigator at Elmhurst Hospital Center for a series of interrelated studies employing artificial intelligence and machine learning methodology to evaluate and modify emotional responses elicited in clinicians by experimental exposure to suicidality.