Nicholas Ara Mischel

Verified

Nicholas verified their affiliation via an institutional email.

Learn more

Verified

Nicholas verified their affiliation via an institutional email.

Learn more

• Doctor of Medicine and Philosophy - Physiology
• Professor (Assistant) at Wayne State University

Background In people with substance use disorders (SUDs), stress-exposure can impair executive function, and increase craving and likelihood of drug-use recurrence. Research shows that acute stressors increase drug-seeking behavior; however, mechanisms underlying this effect are incompletely understood. The Competing Neurobehavioral Decisions Syste...

Background Ketamine has demonstrated efficacy in treating depression unresponsive to traditional interventions and is increasingly utilized in psychiatric practice. However, limited information is available regarding effectiveness in patients with psychiatric comorbidity. The aim of this study is to compare the response of ketamine treatment for de...

“Having a seizure” usually implies a generalized tonic-clonic seizure (GTCS) event as an “epileptic” or “grand mal” seizure. These are very impressive, dramatic, and frightening experiences. One GTCS event causes lasting damage only very rarely. For clinicians, the focus is on recognition and assessment to prevent further events from occurring in u...

Background Chronic low back pain is a debilitating condition that impacts millions of individuals around the world, and also has an enormous economic impact. The impact of chronic pain does not only involve physical health, but can also play a detrimental role in a patient's mental health. Consequently, it is critical to approach these patients wit...

The rostral ventrolateral medulla (RVLM) is an important brain region involved in both resting and reflex regulation of the sympathetic nervous system. Anatomical evidence suggests that as a bilateral structure, each RVLM innervates sympathetic preganglionic neurons on both sides of the spinal cord. However, the functional importance of ipsilateral...

Physiological and psychological stressors can exert wide-ranging effects on the human brain and behavior. Research has improved understanding of how the sympatho-adreno-medullary (SAM) and hypothalamic-pituitary-adrenocortical (HPA) axes respond to stressors and the differential responses that occur depending on stressor type. Although the physiolo...

Introduction About one third of patients with major depressive disorder (MDD) have treatment resistant depression (TRD). The difficulty of treating TRD especially in those with suicidal ideation and psychotic features demands treatments that are fast-acting, safe, and effective. Limited access, lack of viable options, and incomplete characterizatio...

Repetitive transcranial magnetic stimulation (rTMS) is an effective treatment for depression. As the left prefrontal cortex activity is linked to depression, rTMS induces blood flow in the left dorsolateral prefrontal cortex. We used rTMS in a middle-aged male patient with depression who had discontinued psychostimulant medication over a 12-month p...

Purpose/background: Subanesthetic dosing of intravenous ketamine has shown to be an effective treatment for patients with major depressive disorder. It is unknown whether sympathetic response is related to treatment outcomes. The purpose of this study is to evaluate sympathetic response to ketamine infusions as it relates to treatment outcomes. M...

Background: Mood disorders are a leading cause of morbidity. Many patients experience treatment-resistant depression (TRD), and suicide rates are rising. Faster-acting and more effective antidepressant medications are needed. Four decades of research has transformed the use of ketamine from an anesthetic to an outpatient treatment for major depres...

Background: Behavioral and psychological symptoms of dementia (BPSD) are challenging to recognize and treat effectively. Despite very effective nonpharmacologic strategies, there are cases where severe BPSD may require biological intervention. The purpose of this review was to clarify safe and evidence-based use of pharmacological agents based on...

The incidence of Alzheimer’s type dementia (DAT) in the United States is expected to rise from 5.2 million in 2010 to approximately 13.8 million by 2050 (1, 2). Worldwide, major neurocognitive disorders may increase in cost from $604 billion USD to $818 billion USD (3, 4). A majority of these patients may have behavioral and psychological symptoms...

The U.S. is currently facing an unprecedented epidemic of opioid-related deaths. Despite the efficacy of the current treatments for opioid use disorder (OUD), including psychosocial interventions and medication-assisted therapy (MAT), many patients remain treatment-resistant and at high risk for overdose. A potential augmentation strategy includes...

INTRODUCTION Autoimmune encephalitis (AE) is an inflammatory condition which may present with encephalopathy, including psychiatric symptoms of psychosis and catatonia. When catatonia becomes life-threatening or refractory to medication, electroconvulsive therapy (ECT) should be considered. This case series represents a compilation of patient care...

INTRODUCTION Autoimmune encephalitis (AE) is an inflammatory condition which may present with encephalopathy, including psychiatric symptoms of psychosis and catatonia. When catatonia becomes life-threatening or refractory to medication, electroconvulsive therapy (ECT) should be considered. This case series represents a compilation of patient care...

Background: The development of new-generation antidepressants comes at a time of great clinical need when the global burden of depression, suicide, and other psychiatric conditions continues to increase. Our current treatment armamentarium is limited by the time delay needed for antidepressant effects and the significant number of patients who do...

Schizophrenia is a psychiatric illness with a prevalence of 1.4 to 1.6 per 1000 persons in the United States. Studies show the prevalence of cognitive deficits in patients with schizophrenia, spanning multiple domains, such as working memory, processing speed, and verbal memory. Treatment modalities that have tried to address cognitive deficits in...

The development of new generation antidepressants comes at a time of great clinical need when the global burden of depression, suicide, and other psychiatric conditions continues to increase. Our current treatment armamentarium is limited by the time delay needed for antidepressant effects and the significant number of patients who do not show an a...

Abstract: Behavioral and psychological symptoms of dementia (BPSD) are a challenging cluster of symptoms to recognize and treat effectively when managing patients with major neurocognitive disorders. Despite the increasing implementation of very effective nonpharmacologic interventions such as physical activity, psychotherapies, and sleep-wake hygi...

Depression is the leading cause of disability in individuals aged 15-44, resulting in about 400 million disability days per year. The total economic burden is estimated to be $26.1 billion in direct medical costs. Electroconvulsive therapy (ECT) is the gold-standard treatment for major depressive disorder (MDD) and is currently regarded as the most...

Patients were screened for inclusion at the ECT clinical evaluation. Ten participants were randomized into two groups and instructed to self-administer bupropion XL 300mg 4-5 hours prior to the first or second session. Clinical evaluators and the ECT procedure team were kept blind to group designation. Seizure threshold was determined at the first...

Suicide is believed to be the second leading cause of death among Americans aged 15 to 34 years and is the 10th leading cause among Americans of all ages. For every suicide completed in the United States, there are approximately 25 failed attempts, and the estimated societal cost of suicide is more than 50 billion dollars. In addition, rural areas...

More people die as a result of physical inactivity than any other preventable risk factor including smoking, high cholesterol, and obesity. Cardiovascular disease, the number one cause of death in the United States, tops the list of inactivity-related diseases. Nevertheless, the vast majority of Americans continue to make lifestyle choices that are...

The RVLM contains neurons that regulate blood pressure and exhibit (in)activity‐dependent neuroplasticity. Previous studies have found that sedentary animals have enhanced responses to direct activation of RVLM neurons that regulate sympathetic nervous activity (SNA). We hypothesized that sedentary animals have heightened sympathoexcitation due to...

Increased activity of the sympathetic nervous system is thought to play a role in the development and progression of cardiovascular disease. Recent work has shown that physical inactivity versus activity alters neuronal structure in brain regions associated with cardiovascular regulation. Our physiological studies suggest that neurons in the rostra...

Blood pressure regulation relies on neurons in the RVLM and is influenced by regular physical activity. We hypothesized that the morphology of RVLM neurons differs in active vs inactive rats. Rats were housed with and without running wheels for 12 weeks and then cholera toxin B subunit (CTB) was injected into cord segment T10. Double immunoperoxida...

Overactivity of the sympathetic nervous system (SNS) is a hallmark of many cardiovascular diseases. It is also well-known that physical inactivity independently contributes to cardiovascular diseases, likely in part via increased SNS activity. Recent work from our laboratory has demonstrated increased SNS responses in sedentary animals following ei...

The rostral ventrolateral medulla (RVLM) contains neurons critical for cardiovascular regulation. Functional plasticity in RVLM neurons may contribute to increased sympathoexcitation in disease states. Here, we aimed to define morphological differences in RVLM cardiovascular neurons in sedentary vs physically active rats, hypothesizing that increas...

Individuals who lead a sedentary lifestyle are at increased risk of cardiovascular disease. C1 neurons in the rostral ventrolateral medulla (RVLM) express tyrosine hydroxylase (TH) and are important in blood pressure regulation. We have hypothesized that the RVLM undergoes neuroplastic changes that increase sympathoexcitation in sedentary (SED) ver...

The negative effects of sympathetic overactivity on long-term cardiovascular health are becoming increasingly clear. Moreover, recent work done in animal models of cardiovascular disease suggests that sympathetic tone to the splanchnic vasculature may play an important role in the development and maintenance of these disease states. Work from our l...

Under acute and chronic conditions, the sympathetic nervous system can be activated in a differential and even selective manner. Activation of the rostral ventrolateral medulla (RVLM) has been implicated in differential control of sympathetic outputs based on evidence primarily in the cat. Although several studies indicate that differential control...

Spinally‐projecting neurons in the rostral ventrolateral medulla (RVLM) are important in blood pressure regulation. Functional and anatomical studies suggest that N‐methyl‐D‐aspartate receptors (NMDARs) are located in the RVLM and play important roles in cardiovascular reflexes. Since NMDARs are also associated with neuroplasticity, we determined t...

The SIN3 histone deacetylase complex plays a central role in regulation of intracellular metabolism via repression of genes involved in cytosolic and mitochondrial energy-generating pathways. Cytochemical studies of cell culture derived from D. Melanogaster revealed that loss of SIN3 resulted in the buildup of material that fluoresced in the green...