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Since 2002, Dr. Pauline Maki and the researchers in the Women’s Mental Health Research Program (WMHRP) at UIC have developed a program of NIH-funded research on women’s mental and cognitive health throughout their lifespan. Early research focused on the role of sex steroid hormones on cognitive aging, mood, brain function and stress responsivity in healthy women. This research was extended to the study of women with HIV and led to ground-breaking work with the Women’s Interagency HIV Study (WIHS). Descriptions of previously funded research studies led by Women’s Mental Health Research Program’s Principal Investigators (PIs) or Co-Investigators (Co-Is) and some of the resulting publications are available at the following tabs:
Our research with HIV+ women has been aimed at understanding how different female-specific risk factors contribute to their cognitive and mental health. Studying HIV+ women is particularly important given that these women may be at greater risk for cognitive deficits/declines due to issues of underserved communities including poverty, low literacy levels, low educational attainment, substance abuse, mental health issues. In our Neurology publication (Maki, Rubin, et al. 2014), we demonstrated that HIV-infected women show a prominent deficit in verbal learning and memory and attention compared to at-risk HIV-uninfected (HIV-) women. Across multiple studies we have identified certain factors that are differentially associated with verbal learning and memory in HIV-infected compared to HIV-uninfected women including crack/cocaine use, menopausal anxiety, insulin resistance, and perceived stress. We have also shown that post-traumatic stress was associated with worse scores on tests of verbal learning, memory, and psychomotor speed, and our structural and functional imaging studies suggest that the prefrontal cortex plays a critical role in stress-related memory impairments in HIV+ women.
Using data from the WIHS, this project will examine the potential role of glucorticoid receptor biology as a contributor to psychological risk factors and cognitive function in HIV positive women, as compared to HIV negative women
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).
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).
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).
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. Maki is the PI of an exploratory pilot study that investigates the effects of menstrual cycle fluctuations on HIV-associated neurocognitive impairment in cocaine users. This study is funded by the National Institute on Drug Abuse (NIDA - R01 DA012828).
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. As a past head of the Neurocognitive Working Group (NCWG) of the Women’s Interagency HIV Study (WIHS), Dr. Pauline Maki directed the implementation of the largest longitudinal study of cognitive function in HIV-infected women and HIV-uninfected controls. Dr. Leah Rubin has worked to develop and apply sophisticated statistical approaches to elucidate the association between HIV status and cognition in women as well as identify risk factors for cognitive difficulties. These risk factors have including menopause, drug abuse, COMT, liver function, insulin resistance, C-C chemokine receptor type 2 (CCR2) on monocyte subsets, and age-related glucocorticoid resistance. The WIHS is primarily funded by the National Institute of Allergy and Infectious Diseases (NIAID - U01 AI034993).
Other WMHRP studies led by Dr. Maki within the WIHS cohort include:
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).
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. This study is jointly funded by the NIH, the NIH-supported Centers for Aids Research (CFAR) and the International AIDS Society (IAS).
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. This study is funded by the National Institute on Aging (NIA - R21 AG048176).
This training grant sought to identify genetic predictors of cognitive performance and brain dysfunction in HIV. The general aim of the study was to characterize the effect of a common polymorphism of the catechol- O-methyl transferase (COMT) gene, Val158Met, on cognition and brain function in midlife women with HIV. This study was funded by the National Institute of Mental Health (NIMH) from 2008-2011 (F31 MH083537).
For the past 20 years, Dr. Pauline Maki has led a program of NIH-funded research on cognition and brain function in aging women. This program examines the role of menopause, vasomotor symptoms (VMS), and hormonal fluctuations on neuropsychological test performance and functional and structural neuroimaging outcomes.
In the past decade, our understanding of the role of menopause stage and menopausal symptoms on cognitive function has greatly expanded. There is now increasing evidence from large-scale prospective studies that women both report increased memory complaints and perform worse on memory tests during the menopausal transition. Dr. Maki’s work demonstrates a significant relationship between subjective memory complaints and objective memory declines, and also shows considerable individual differences in this relationship, with some women reporting few memory complaints and performing well on memory tests, and others having significant complaints and significant impairment. Dr. Maki’s work has contributed to the understanding of the factors underlying these changes in memory. Although there is strong evidence that the vasomotor symptoms (VMS) women report are unrelated to memory performance, Dr. Maki and collaborators discovered that physiologic VMS, as measured with ambulatory skin conductance monitors, bear a strong relationship with memory performance. Women under-report physiological hot flashes by about 45%, so measuring physiologic VMS with monitors appears to be critical in unmasking the relationship between VMS and memory.
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. This study was funded by the National Institute on Aging (NIA) from 2014-2016 (R13 AG048700-01).
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. This study was funded by the National Institute of Mental Health (NIMH) from 2009-2015 (R01 MH083782).
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).
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).
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. Additional studies addressed mechanisms of action, identification of active compounds, and characterization of metabolism, bioavailability and pharmacokinetics of active species contained in these botanicals.This study was funded by the National Center for Complementary & Alternative Medicine (NCCAM) from 1999-2004 (P50 AT000155).
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. This study was funded by the National Institute on Aging (NIA) from 2001-2002 (Z01 AG000192-02).
The Women’s Mental Health Research Program has worked collaboratively with researchers and clinicians in OB/GYN to increase provider and systems capacity to detect, diagnose and treat perinatal anxiety and depressive disorders in our patients. The majority of women who receive perinatal care at the University of Illinois Hospital and Health Sciences System are low-income minorities and these women have significantly higher rates of perinatal depression compared to the rest of the population (Bennett et al., 2004). Our previous longitudinal work with pregnant women at UIC found that 39% of the women had depression at preconception, 36% during pregnancy, and 33% in the postpartum period (Rubin et al., 2011). The intended outcome of our perinatal mental health research is to increase awareness, reduce stigma and connect women to the care they need.
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). The second goal of this study is to demonstrate intervention fidelity of mothers applying the ATVV twice-daily with their baby for 4-weeks. This study is funded by the UIC College of Nursing, Internal Research Support Program.
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. The project proposed to (1) develop a self-care tool and guided self-care process for women with perinatal depression and/or eating problems; (2) incorporate this self-care tool and process, along with evidence-based treatments, into a stepped-care disease management model that coordinates mental health care with prenatal care. This study was funded by the Health Resources and Services Administration (HRSA), Maternal and Child Health Bureau (MCHB) from 2009-2012 (H59MC09957).
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. This study was funded by the Illinois Department of Healthcare and Family Services from 2011-2012.
*References
Bennett, H.A., et al., Prevalence of depression during pregnancy: systematic review. Obstet Gynecol, 2004. 103(4): p. 698-709.
Rubin, L.H., et al., Perinatal depressive symptoms in HIV-infected versus HIV-uninfected women: a prospective study from preconception to postpartum. J Womens Health (Larchmt), 2011. 20(9): p. 1287-95.