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  2. Pauline Maki

Pauline Maki PhD

Pauline Maki
Designation
  • Professor of Psychiatry and Psychology
  • Director of Women’s Mental Health Research Program
  • Senior Director of Research, Center for Research on Women and Gender
Contact Information
  • pmaki1@uic.edu
  • (312) 996-6941
  • Neuropsychiatric Institute (NPI)
    Department of Psychiatry (MC 913)
    912 S. Wood St.
    Chicago IL 60612
  • Room #:328
Website

For over 20 years, Dr. Pauline M. Maki has led a program of NIH-funded research focused on the role of sex steroid hormones on cognition, mood, brain function (neuroimaging) and stress responsivity in women. Women’s cognitive abilities, mood, and response to stress can be affected by changes in sex hormones, like estrogen, including changes that occur during the menopausal transition, during pregnancy, and across the menstrual cycle.  In particular, the goal of her work is to improve the lives of women by identifying factors that alter their risk of cognitive decline and affective disorders. Dr. Maki received her Ph.D. in experimental psychology from the University of Minnesota in 1994. She received post-graduate training at the Johns Hopkins University School of Medicine in the dementias of aging and at the National Institute on Aging in neuroimaging. In 1999, she joined the Intramural Research Program of the National Institute on Aging. In 2002, she joined the faculty at the University of Illinois at Chicago.

Menopause

Dr. Maki is best known for her contributions to the field of menopause and cognition. A central focus of her research has been the effects of hormone therapy (HT) and alternative treatments for menopausal symptoms on cognition, mood, and brain function in women. Professor Maki’s primary contribution to clinical practice is her research on the risks and benefits of HT on cognition and brain function. Epidemiological studies demonstrate that women who used HT had a 39% reduced risk of Alzheimer’s disease compared to women who had not used HT. In contrast, the Women’s Health Initiative (WHI) demonstrated a doubling of dementia risk in women aged 65 years and older who were randomized to combined estrogen plus progestin treatment. It was unclear if the WHI findings generalized to younger women and to other HT regimens. Clinically this is important because: a) two-thirds of Alzheimer’s patients are women, b) 80% of women experience vasomotor symptoms (VMS; hot flashes and night sweats), c) most women who initiate HT do so at around age 50 (20+ years younger than women in the WHI), and d) non-hormonal therapies have limited efficacy in treating VMS.

Dr. Maki’s clinical studies demonstrated that the effects of HT on cognition and brain function depend on both the timing of initiation and the use of progestins. With respect to timing, later use but not early use is harmful. With respect to progestins, the addition of medroxyprogesterone acetate, which used to be the most widely used progestin in the US, is harmful. As a member of the expert panels contributing to national and international practice guidelines, she has incorporated these findings into the position statements of the North American Menopause Society (NAMS) and the International Menopause Society (IMS), as well as the Global Consensus Statement issued by multiple women’s health organizations. Dr. Maki’s leadership in this area is recognized by her serving as President of NAMS in 2014 and 2015.  She is a frequent national and international speaker on this topic. In 2016 alone she was keynote speaker at the Royal College of Obstetrics and Gynecology in London, the Nordic Federation on Obstetrics and Gynecology in Helsinki, the South African Menopause Society in Cape Town, and the International Menopause Society in Prague, Czech Republic.

Currently, Dr. Maki is funded by NIH to examine the role of vasomotor symptoms on cognition and brain function, as her pilot work showed that physiological hot flashes (measured with ambulatory skin conductance monitors) are associated with memory deficits, ischemic brain lesions, and functional alterations in the brain at rest (RF1 AG053504-01). She is also funded by the NIH to examine the role of an anesthesia procedure, Stellate Ganglion Blockade (SGB), as an effective non-hormonal treatment for vasomotor symptoms and related memory problems (R01 AG049924).

HIV/AIDS

Dr. Maki’s research on women’s cognitive health and mood extends to the study of women with HIV and she is credited with the seminal study of cognitive function in women with HIV. She is the immediate past-Head of the Neurocognitive Working Group (NCWG) of the Women’s Interagency HIV Study (WIHS), the largest study of the natural and treated history of HIV in women in the U.S. In that role, she directed the implementation of the largest longitudinal study of cognitive function in HIV-infected women and HIV-uninfected controls (n=~1521). Her NIH-funded work in the Women’s Interagency HIV Study (WIHS) revealed a significant and prominent deficit in verbal memory in HIV-infected women compared to at-risk HIV-uninfected women, a pattern that appears to differ from that of HIV-infected men. Other NIH-funded work demonstrated that substance use and mental health factors contribute to verbal memory declines in HIV-infected women, effects that are mediated by the prefrontal cortex. This work points to a unique pattern of cognitive dysfunction in HIV-infected women, one that is largely influenced by mental health factors. In addition to her work within WIHS, Dr. Maki also serves as the Leader of the Special Emphasis Area on HIV and Aging Group for the Chicago Developmental Center for AIDS Research.

PREGNANCY & POSTPARUM

Dr. Maki has successfully built a collaboration with the Department of Obstetrics and Gynecology to address disparities in the screening and treatment of mental health disorders of pregnant and postpartum women. She has pursued innovative approaches to fill in gaps in depression screening by creating a research infrastructure that involves undergraduate research assistants who screen for perinatal depression during routine clinic visits. With input from monthly meetings with clinical staff from Psychiatry and OB-GYN, she is addressing barriers to treatment through efforts such as delivery of cognitive behavior therapy (CBT) via the web.  

Throughout her career, Dr. Maki has made mentorship a priority at the undergraduate, graduate, and assistant professor levels. Currently in her lab, she has 11 undergraduate research volunteers. As a UIC Honors College Fellow, she also mentors honors college undergraduates. In 2015 she was honored with the first Capstone Mentor of the Year award from the Honors College. At UIC she has held many leadership positions in mentorship, including serving as the Program Director for the NIH-funded K12 grant Building Interdisciplinary Research Careers in Women’s Health (BIRCWH), serving as the College of Medicine (COM) Representative to Provost’s Mentorship Training Workshop, and serving on the COM Mentorship Planning Task Force. Additionally, in the last two years she served as primary mentor for four assistant professors on funded HIV studies and four individual K awardees in women’s health. Annually, she teaches Introduction to Behavioral Neuroscience to undergraduate students. She serves on the Executive Committee for the Graduate Program in Neuroscience and mentors graduate students in that program, as well as in the Behavioral Neuroscience Division of the Department of Psychology (2 current; 5 past).

  • psychiatry

    Women, cognition, mood, stress, HIV, Alzheimer’s disease, perinatal depression and anxiety, mentorship

  • Women’s Interagency HIV Study

  • Enhancing Perinatal Mental Health: Perinatal Mental Health Clinical Research Registry & Gut Microbiome

  • Stellate Ganglion Blockade for the Management of Vasomotor Symptoms

  • Menopausal Vasomotor Symptoms and Brain Aging in Women

  • Effects of Glucocorticoids on Cognition in HIV-Infected Women

  • Maki PM, Rubin LH, Savarese A, Drogos L, Shulman LP, Banuvar S, Walega DR. Stellate ganglion blockade and verbal memory in midlife women: Evidence from a randomized trial. Maturitas. 2016 Oct 31;92:123-9. PMID: 27621249

    Sundermann EE, Biegon A, Rubin LH, Lipton RB, Mowrey W, Landau S, & Maki PM for the Alzheimer’s Disease Neuroimaging Initiative. Better verbal memory in women than men in MCI despite similar levels of hippocampal atrophy. Neurology. 2016 Apr 12;86(15):1368-76. PMCID: PMC4831033

    Sundermann EE, Biegon A, Rubin LH, Lipton RB, Landau S, Maki PM. Does the female advantage in verbal memory contribute to underestimating Alzheimer’s disease pathology in women versus men? Journal of Alzheimer's Disease. 2017 Jan 1(Preprint):1-1. PMCID: PMC4831033

    Harlow SD, Gass M, Hall JE, Lobo R, Maki P, Rebar RW, Sherman S, Sluss PM, De Villiers TJ. Executive summary of the Stages of Reproductive Aging Workshop+ 10: addressing the unfinished agenda of staging reproductive aging. Climacteric. 2012 Apr 1;15(2):105-14. PMCID: PMC3319184

    Maki PM, Rubin LH, Fornelli D, Drogos L, Banuvar S, Shulman LP, Geller SE. Effects of botanicals and combined hormone therapy on cognition in postmenopausal women. Menopause. 2009 Nov-Dec;16(6):1167-77. PMCID: PMC2783198.

    Maki PM, Drogos LL, Rubin LH, Banuvar S, Shulman LP, Geller SE. Objective hot flashes are negatively related to verbal memory performance in midlife women. Menopause. 2008 Sep-Oct;15(5):848-56. PMCID: PMC2783198.

    Maki PM, Gast MJ, Vieweg AJ, Burriss SW, Yaffe K. Hormone therapy in menopausal women with cognitive complaints: a randomized, double-blind trial. Neurology. 2007 Sep 25;69(13):1322-30. PMID: 17893293

    Resnick SM, Maki PM, Rapp SR, Espeland MA, Brunner R, Coker LH, Granek IA, Hogan P, Ockene JK, Shumaker SA; Women’s Health Initiative Study of Cognitive Aging Investigators. Effects of combination estrogen plus progestin hormone treatment on cognition and affect. J Clin Endocrinol Metab. 2006 May;91(5):1802-10. PMID: 16522699

    Maki PM, Zonderman AB, Resnick SM. Enhanced verbal memory in nondemented elderly women receiving hormone-replacement therapy. Am J Psychiatry. 2001 Feb;158(2):227-33. PMID: 11156805

    Maki PM, Resnick SM. Longitudinal effects of estrogen replacement therapy on PET cerebral blood flow and cognition. Neurobiol Aging. 2000 Mar-Apr;21(2):373-83. PMID: 10867223

Title Description Investigator(s) Category Status
Effects of Glucocorticoids on Cognitive Functioning in HIV-infected Women NIMH -- R01 MH113512 This R01 grant examines the effects of low-dose hydrocortisone (LDH) on cognition in HIV+ women with the goal to identify and assess an adjunctive therapy for the treatment of cognitive dysfunction in HIV+ women. This study is funded by the National Institute on Mental Health. Women's Mental Health Research Program On-going
Enhancing Perinatal Mental Health: A Feasibility Study of a Collaborative, Translational Research Approach The project goals include: (1) Piloting a randomized controlled trial of a provider training program to improve screening, assessment, and referral procedures for perinatal depression and anxiety disorders during clinical visits; and (2) Establishing an enduring database linking perinatal depression and anxiety diagnoses, medical records, and a biorepository of blood samples from routine perina Women's Mental Health Research Program On-going
Human Microbiome and Perinatal Depression NICHD – R03 HD095056 Women's Mental Health Research Program On-going
Implementation of an Evidence-Based E-Health Intervention for Perinatal Depression NCATS - UL1TR002003 This project aims to implement a validated computerized adaptive testing (CAT) to assess perinatal mental health into routine clinical care, as well as testing the feasibility and acceptability of an online intervention (Sunnyside for Moms) to prevent and treat perinatal depression. Women's Mental Health Research Program On-going
Menopausal Vasomotor Symptoms and Brain Aging in Women NIA - RF1 AG053504 This multi-year R01 equivalent grant examines the relationship between vasomotor symptoms, the cardinal symptom of menopause, and structural and functional integrity of the brain and cognitive function. This study is funded by the National Institute on Aging. Women's Mental Health Research Program On-going
Should sex-based norms be the norm?: Understanding how the female advantage in verbal memory may impact the diagnosis and trajectory of Alzheimer’s Disease NIA – P30 AG010161-28 Women's Mental Health Research Program On-going
Stellate Ganglion Blockade for the Management of Vasomotor Symptoms NIA - R01 AG049924 This multi-year grant supports a randomized, sham-controlled clinical trial of stellate ganglion blockade on vasomotor symptoms in midlife women. Secondary outcomes include cognition, mood, brain imaging outcomes, and autonomic nervous system activity. This study is funded by the National Institute on Aging. Women's Mental Health Research Program On-going
WIHS: Women’s Interagency HIV Study Neurocognitive Research in Women’s Interagency HIV Study (WIHS), Chicago Consortium This is an ongoing program of research to investigate the predictors of neurocognitive function and HIV Associated Neurocognitive Disorders (HAND) in HIV-infected women in the Women’ Women's Mental Health Research Program On-going
A Feasibility Study of an Intervention to Improve Mother-Infant Synchrony and Emotion Regulation, and the Contributing Role of Oxytocin The primary aim of this pilot study is to demonstrate feasibility of recruitment and retention of women with psychosocial adversities into an intervention study designed to enhance mother-infant synchrony through the use of an auditory, tactile, visual, and vestibular intervention (ATVV). Women's Mental Health Research Program Completed
Botanical Menopausal Therapies Mechanisms of CNS Action This Career Award grant examined the mechanisms by which phytoestrogens and botanical therapies for menopausal symptoms affect CNS function. This study was funded by the National Center for Complementary & Alternative Medicine (NCCAM) from 2004-2009 (K01 AT002321). Women's Mental Health Research Program Completed
Brain Aging in HIV-infected Women: The Role of Reproductive Aging and Cardiovascular Risk Factors This Creative and Novel Ideas in HIV Research (CNIHR) grant aims to examine the effects of chronological aging, reproductive aging (i.e., menopause), and subclinical vascular risk factors on brain integrity in midlife HIV-infected women, compared to HIV-uninfected women. Women's Mental Health Research Program Completed
Cognitive Neuropsychology of HIV and Drug Abuse This is an ongoing program of theory driven research to investigate the unique and additive effects of HIV and substance dependence on selected neurocognitive functions with neuroanatomical and functional significance for neuroAIDS research. Dr. Women's Mental Health Research Program Completed
Cognitive Neuropsychology of HIV and Drug Abuse - Potential Age Effects This goal of this administrative supplement is to investigate effects of HIV serostatus on memory and executive function among a sample of older HIV+ and HIV- cocaine dependent women. This study is funded by the National Institute on Drug Abuse (NIDA - R01 DA012828-14S1). Women's Mental Health Research Program Completed
Effects of Botanicals on Cognition in Midlife Women The goal of this study was to compare the effects of standard hormone therapy, Trifolium pratense and Cimicifuga racemosa on brain function in midlife women. This study was funded by the National Center for Complementary & Alternative Medicine (NCCAM) from 2004-2006 (R21 AT001868). Women's Mental Health Research Program Completed
Effects of Estradiol and Phytoestrogens on Stress Responsivity This study was a randomized, placebo-controlled trial comparing estradiol and soy supplements to placebo for the treatment of daily anxiety, stress responsivity, objective hot flashes, and cognition in perimenopausal women. Women's Mental Health Research Program Completed
Effects of Sex Steroid Hormones on Cognition and Brain Function The goal of this project was to gain insight into the effects of sex steroid hormones on cognitive function involving three primary lines of research: 1) sex differences in cognitive function; 2) changes in cognition in relation to natural fluctuations in endogenous hormones; and 3) changes in cognition associated with exogenous hormone intervention. Women's Mental Health Research Program Completed
Effects of Stress and Stress Hormones on Cognition in HIV-infected Women The goal of this mentored award is to develop a program of research that addresses the role of stress and stress hormones on cognitive dysfunction among HIV+ women. This study is funded by the National Institute of Mental Health (NIMH - K01 MH098798). Women's Mental Health Research Program Completed
Healthy Behaviors in Women - Illinois MotherCare Project The goal of this project was to develop, implement, evaluate and disseminate a model for integration of mental health and healthy eating into perinatal care clinic settings. Among the health issues linked closely with depression and posing substantial risks to women and their offspring, the most central is disordered eating. Women's Mental Health Research Program Completed
Impact of Cocaine on Brain Neurochemistry, Functional Connectivity and Cognition in HIV The overall aim of this study is to investigate the impact of cocaine abuse on brain neurochemistry, functional connectivity, and cognition in HIV+ individuals. The general goal is to characterize the effects of cocaine abuse on brain neurochemistry, as well as functional connectivity in neural circuitry involved in reward/cognition in HIV+ individuals. Women's Mental Health Research Program Completed
InterAgency Agreement with HFS The goal of this grant was to: 1) Deliver workshops on screening, assessment, and treatment of perinatal mental health issues across Illinois; 2) Maintain a national consultation service for providers with questions of perinatal mental health, and; 3) Create a perinatal mental health protocol, medication chart and provider tool kit. Women's Mental Health Research Program Completed
Sex Differences in Cognitive Response to a Hydrocortisone Challenge in HIV This pharmacologic challenge explores the impact of hydrocortisone, a glucocorticoid, on cognition and immune response in HIV+ men and women. This study is funded by the National Institute of Mental Health (NIMH - R21 MH099978). Women's Mental Health Research Program Completed
The Center for Dietary Supplemental Research - Botanical Dietary Supplements for Women’s Health The initial efforts of this study were to investigate the clinical safety and efficacy of botanicals used to treat women's health with particular emphasis on therapies for menopause. Women's Mental Health Research Program Completed
The Science of Thermoregulation and Vasomotor Symptoms: Possible New Targets for Treatment The purpose of this 2-day conference was to bring together diverse key researchers and menopause clinicians to review recent scientific advances in our understanding of 1) the mechanisms underlying hot flashes and night sweats; 2) the efficacy of nonhormonal treatments for these symptoms. Women's Mental Health Research Program Completed
Women’s Interagency HIV Study (WIHS), Chicago Consortium The WIHS is a multi-site prospective epidemiology cohort study of women who either are infected with HIV or are at increased risk for acquiring HIV infection. The Chicago Consortium is a clinical research site. Women's Mental Health Research Program Completed