Putting Their Heads Together

Bradley Peterson, MD, answers questions about how CHLA intends to revolutionize the study of the young, developing mind.

Bradley Peterson, MD, was named the inaugural director of the Institute for the Developing Mind (IDM) at The Saban Research Institute of Children’s Hospital Los Angeles in July 2014. He joined CHLA after spending 13 years at Columbia University, most recently as the director of the Center for Developmental Neuropsychiatry at the Columbia University Medical Center. Peterson’s vast experience as a scientist, physician, teacher and mentor provides the Institute with the transformative leadership necessary to establish a comprehensive program of interdisciplinary research, education, training and clinical services for childhood neurodevelopmental problems at CHLA.

Peterson’s own research has used brain-imaging technologies to understand the origins of neurodevelopmental disorders, and to map the complex pathways between the genetic and environmental influences that can trigger their onset or progression. We talked with him about his vision for the IDM.

Q: Why did you decide to come to The Saban Research Institute of CHLA?

A: I came to CHLA because of the prospect that the IDM will redefine the process for scientific discovery in childhood neuropsychiatric disorders. This new process will involve scientists and clinicians with diverse backgrounds and expertise—geneticists, molecular and cellular biologists, systems neuroscientists and brain imaging specialists, behavioral and cognitive neuroscientists, clinical trial specialists and expert clinicians—all coming together to tackle highly focused questions in a coordinated way. This integration of scientific questions and expertise will allow us to understand the causes of these devastating illnesses much more deeply and more quickly than would be possible with the old way of doing science, in which investigators work in the relative isolation of their own laboratories. Many institutions talk about conducting science in this new way, but they don’t really do it. It was the institutional commitment to this revolutionary process of scientific discovery that ultimately convinced me to make the move.

Q: Why is this important?

A: To understand how a deeper understanding of the mind, brain and behavior comes from a collective understanding at different levels of investigation, it may help to consider what we have learned over many decades about one of the most important capacities of mind and brain: learning itself. At the level of observable behavior, for example, we know a lot about reinforcement processes—reward, punishment, incentive and motivation—that create and sustain patterns of learned behavior. At this level of investigation, scientists understand in a fairly sophisticated way why people do things—even things we aren’t fully aware of doing, like when we act out of unconscious habit.

Researchers can then use brain imaging to identify the changes in neural activity and brain structure that support such learned behaviors. In turn, these changes can be understood at other levels by basic scientists who study the changes in the structure and function of neurons; and at still other levels by scientists who study the molecules that induce those neuronal changes.

The result—a more comprehensive understanding of the cause of neuropsychiatric illnesses—will speed the development of truly rational preventions and therapeutic interventions, reducing the suffering of millions of children and their families.

Q: Most of the brain-imaging studies published to date are interpretations based on correlations, but demonstrate flimsy causal relationships.

A: That’s correct. Just because two things are correlated doesn’t mean that either one of those things causes the other. We must work to design and implement imaging studies that allow us to identify what is truly causing a disorder and how treatments are actually working in the brain—what is placing us at risk for getting sick and what is protecting us from illness. How do we prove that these things are either making us vulnerable to becoming ill or conferring resilience?

A major component of my own work uses imaging to help identify features of the brain that diagnose illness more accurately, in order to better plan treatments and monitor treatment results. These were the promises of brain imaging when the field first began, and now is the time to fulfill those promises. That ability is within our reach.

We have the potential to use cutting-edge MRI technology to identify disorders that are very difficult to diagnose definitively, particularly early in the course of illness. If we can realize that potential, bring it into clinical practice and then disseminate that ability, my professional life will have been worth living.