Joel Bregman, MD Email: jbregman@nshs.edu

During the past decade, our understanding of autism and related neurodevelopmental conditions (autism spectrum disorders – ASD) has expanded significantly. Although once thought to be rare (affecting only 1 in 10,000 children), autism is now acknowledged to be present in approximately 1 in 150 children. The reasons for this dramatic increase in prevalence are not entirely understood, but largely reflect a greater appreciation of the genetic and phenotypic heterogeneity of the autism spectrum. The core clinical features of ASD (serious qualitative impairment in social understanding, reciprocity, and communication) are manifest across a broad range of intellectual, linguistic, and behavioral profiles. This complexity creates special challenges for investigators and clinicians who strive to identify etiological factors, define the neurobiology, and characterize the range of clinical expressions of ASD in an effort to develop effective educational and treatment programs.

In the service of these goals, the Autism Research Program is trans-disciplinary and translational in it approach, integrating the efforts of several key professional disciplines in the discovery of linkages between specific causative factors, (genetics, neurobiology), characteristic clinical presentations, and differential responses to treatment. Psychopharmacological, brain imaging, genetics, and immunological studies are conducted by investigators of the Autism Research Program (based within The Center for Translational Psychiatry) in collaboration with colleagues from the FIMR Centers for Genomics and Human Genetics and Autoimmune and Musculoskeletal Disorders, and from Hofstra University. Clinical and biological assessments are conducted in the General Clinical Research Center (GCRC) and database management and biostatistical analyses are performed with the support of the Bioinformatics and Biostatistics Programs of the FIMR. The Autism Research Program also works collaboratively with the Fay J. Lindner Center for Autism of Advantage Care/AHRC (an affiliate of NSLIJHS) in providing opportunities for research participation to the many families receiving clinical services at the Center. Dr. Bregman serves as Director of Clinical Research for the Lindner Center (which houses a state-of-the-art audiovisual recording and analysis laboratory) and also provides clinical services at the Center (assessments and treatment). 

During the past 6 years, the Autism Research Program has gained national recognition within the autism research community, joining with the Seaver Center of Mt. Sinai School of Medicine to form the Greater New York Autism Research Center of Excellence, an NIH-funded STAART program, and serving as a participating site in the Autism Clinical Trials Network of Autism Speaks. The investigators of the Research Program have contributed to the development of clinical medication trial protocols, achieving very high participant enrollment figures, and actively participating in the analysis, interpretation, and publication of study findings.

Current projects:

• An Open-label & Randomized, Double-blind Placebo-Controlled Study of Pharmacokinetics, Safety, Efficacy & Tolerability of Memantine in Pediatric Patients With Autism and an Open-label Extension Study of the Safety &Tolerability of Memantine in Pediatric Patients with Autism

• Risperidone in the Treatment of Children and Adolescents With Autistic Disorder: A Double-Blind, Placebo-Controlled Study of Efficacy and Safety Followed by an Open-Label Extension Study of Safety

• Neuroimaging of Executive Functions & Emotion Recognition in Autism

Recently completed projects:

• Citalopram in Children with Autism Spectrum Disorders and High Levels of Repetitive Behavior

• Randomized, Double-blind, Multicenter Study of Fluoxetine in Autism Spectrum Disorders

• Multicenter, Double-Blind, Randomized, Placebo-Controlled Study of Aripiprazole in Autism

• Gray & White Matter Microstructure In ASD:  A Voxel-Based Diffusion Tensor Imaging Study

• Dense Mapping of Candidate Regions Linked to Autistic Disorder

Planned and proposed studies:

• Genetic, Immune and Androgenic Risk Factors for Autism and Related Neurodevelopmental Disorders

• Nicotinic Receptor Treatment in Autism: Placebo-Controlled Pilot Trial Targeting Impairments in Executive Functions & Core Social and Behavioral Features

Select publications:

King, B.H., Hollander, E., Sikich, L., McCracken, J.T., Scahill, L., Bregman, J.D., Donnelly, C.L., Anagnostou, E., Dukes, K., Sullivan, L., Hirtz, D., Wagner, A., Ritz, L. Lack of efficacy of citalopram in children with autism spectrum disorders and high levels of repetitive behavior: citalopram ineffective in children with autism. Archives of General Psychiatry, 66:583-90, 2009.

Bregman, J.D. Pervasive Developmental Disorder-Not Otherwise Specified. In Textbook of Autism Spectrum Disorder, In Press, American Psychiatric Publishing, Inc., In press.

Bregman, J. The Developmental Disabilities-Introduction. In: Developmental Disabilities From Childhood through Adulthood: What Works In Community Settings, In Press, Johns Hopkins Press

Sebat, J., Lakshmi, B., Malhotra, D., Troge, J., Lese-Martin, C., Walsh, T., Yamrom, B., Yoon, S., Krasnitz, A., Kendall, J., Leotta, A., Pai, D., Zhang, R., Lee, Y. H., Hicks, J., Spence, S. J., Lee, A. T., Puura, K., Lehtimaki, T., Ledbetter, D., Gregersen, P. K., Bregman, J., Sutcliffe, J. S., Jobanputra, V., Chung, W., Warburton, D., King, M. C., Skuse, D., Geschwind, D. H., Gilliam, T. C., Ye, K., Wigler, M (2007). "Strong association of de novo copy number mutations with autism." Science 316(5823): 445-9.

Recent research poster presentations:

White Matter Abnormalities in High Functioning Autism Spectrum Disorder: A Combined Voxelwise and Tractography Analyses, Annual Meeting of the American Society of Neuroradiology, New Orleans, June, 2008, Ashtari, Bregman, Nichols, et al.

Gray Matter Abnormalities in Youth with ASB (High Functioning Autism And Asperger Syndrome) Using A Novel Method Of Diffusion Based Morphometry, International Meeting for Autism Research (IMFAR), Seattle, WA, May 2007, Ashtari, Bregman, Nichols, et al.