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Rita Goldstein

  • PROFESSOR Psychiatry
  • PROFESSOR Neuroscience
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Education

  • BA, Tel Aviv University
    Psychology

  • Internship, Long Island Jewish Medical Center
    Clinical Neuropsychology

  • PhD, University of Miami
    Health Clinical Psychology

  • Post-doc fellow, Brookhaven National Laboratory
    Neuroimaging in addiction

Biography

    Dr. Goldstein is a Professor of Psychiatry with a secondary appointment in the Department of Neuroscience at the Icahn School of Medicine in NY. Dr. Goldstein is chief of the Brain Imaging Core (BIC) at ISMMS; she also directs the NARC (Neuropsychoimaging of Addiction and Related Conditions) research group that uses multimodality functional neuroimaging methods to explore the neurobiological basis of impaired cognitive and emotional functioning in human drug addiction and other disorders of self-control. An important application of this research is to facilitate the development of intervention modalities that would improve treatment outcome in drug addiction and other chronically relapsing disorders of self-regulation.

    Nationally and internationally known for her neuroimaging and neuropsychological studies in drug addiction, Dr. Goldstein formulated a theoretical model known as Impaired Response Inhibition and Salience Attribution (iRISA). The model uses multiple neuroimaging modalities—including MRI, EEG/ERP, PET and neuropsychological tests—to explore the neurobiological underpinnings of iRISA in drug addiction and related conditions. Her work has contributed to the development of relevant machine-learning algorithms for innovative analyses applied to this multidimensional data set.

    Dr. Goldstein’s interests also include pharmacological fMRI, including administering oral methylphenidate to cocaine addicted individuals to improve self-control, neurofeedback such as Brain Computer Interface, and brain stimulation with Transcranial Magnetic Stimulation. She has also been exploring the contribution of individual differences, including polymorphisms in monoaminergic genes, to addiction and aggression, with a focus on the neural mechanisms underlying reinforcement learning and extinction, choice and decision-making, and self-awareness and insight into severity of illness.

    Dr. Goldstein received her B.A. degree (double major in Psychology and French), cum laude, from Tel Aviv University, Israel, in 1992. She received her Ph.D. degree in Health Clinical Psychology, with award of academic merit, from the University of Miami, FL, in 1999, after completing a yearlong internship in clinical neuropsychology at the Long Island Jewish Medical Center, NY. She then completed her post-doctorate training on a fellowship on Brain Imaging and Alcohol Abuse from the National Institutes of Health, under the mentorship of Nora D. Volkow (director of NIDA). Dr. Goldstein received her license in clinical psychology in 2002. Dr. Goldstein became Assistant Scientist at the medical research department at Brookhaven National Laboratory in 2002, advancing to the Associate position in 2004, and to a Scientist position in 2006; tenure was awarded in 2008. Dr. Goldstein moved to the Icahn School of Medicine in January 2013. Dr. Goldstein is also an affiliate in the departments of psychology and biomedical engineering at State University of New York at Stony Brook. She has authored or co-authored numerous well-cited peer-reviewed manuscripts and book chapters, focusing on the role of the prefrontal cortex in addiction. She became member of the American College of Neuropsychopharmacology (ACNP) in January 2010, receiving the prestigious Joel Elkes Research Award in 2012 and the Jacob P. Waletzky Award in 2013. Goldstein’s research has been independently funded by several federal and private agencies (including NIDA, NIMH, and National Alliance for Research on Schizophrenia and Depression).

Awards

  • 2013 -
    Jacob P. Waletzky Award
    SfN

  • 2012 -
    Joel Elkes Research Award
    American College of Neuropsychopharmacology (ACNP)

  • 2012 -
    Outstanding Alumni Award
    Department of Psychology, University of Miami, FL

  • 2010 -
    Nominated as Member
    American College of Neuropsychopharmacology (ACNP)

  • 2009 -
    Outstanding Mentor Award
    Brookhaven National Laboratory

  • 2005 -
    Woman of the Year in Science
    Brookhaven Town

  • 2003 - 2005
    Young Investigator Award
    National Alliance for Research on Schizophrenia And Depression (NARSAD)

  • 2002 - 2007
    Mentored Patient-Oriented Research Career Development Award
    NIDA

Research

Main Accomplishments

Theoretical

·      In 2002, formulation of a theoretical model, the iRISA (Impaired Response Inhibition and Salience Attribution) postulating that drug addicted individuals disproportionately attribute salience, or value, to their drug of choice at the expense of other potential reward, with a concomitant decrease in the ability to inhibit drug use (published in Am J Psychiatry, within the 50 most-frequently cited AJP articles, cited since >800 times).

·      In 2009, formulation of a hypothesis that, instead of lying or being in denial (as commonly perceived), drug addicted individuals suffer from impaired self-awareness/insight into illness (a term previously reserved to describe “classical” psychiatric and neurological disorders, for the first time applied to drug addiction). This novel hypothesis was highlighted at SfN (symposium in 2008 and published in TiCS 2009); supporting experimental results are now published (Brain 2010 & 2012, JAMA Psychiatry in press).

·      Exploration of a novel hypothesis that Brain Computer Interface (to date mostlyused to substitute for loss of normal neuromuscular outputs by enabling interaction with environment through brain signals) can be used to reduce strong emotional responses (e.g., craving) in psychopathology (e.g., addiction). Collaboration with Wodsworth Center in Albany is ongoing, an F32 received (see Education below).

·      Among the first to use fMRI to study reward extinction retention in addiction in humans (completed R21DA02062); to date studies of reward extinction used animal models, in humans fMRI is used to study fear extinction in PTSD.

Intervention

·      Methylphenidate has all but been abandoned in the treatment of cocaine addiction (as a stand-alone did not decrease drug use). Our pharmacological fMRI results suggest that methylphenidate normalizes prefrontal cortical function and connectivity as associated with reduced impulsivity and enhanced sustained motivation in cocaine addicted individuals (PNAS 2010, Translational Psychiatry 2012, Cerebral Cortex 2012, JAMA Psychiatry 2013).

·      Pharmacogenetics (i.e., adapting pharmacological interventions based on targeted genes)? Genetic contributions have to be more fully incorporated in intervention efforts. Note our publications focusing on the MAOA in aggression (J Neurosci 2008 and featured by the Society for Nuclear Medicine; see also a manuscript in Arch Gen Psychiatry 2011), and other targeted genes (PER2, DAT, DRD4, SERT; results of DAT published in J Neurosci 2013).

Technical

·      Since 2002, we used multiple neuroimaging techniques (fMRI, PET, EEG/ERP) and neuropsychological tests to explore the neurobiological underpinnings of iRISA in cocaine addiction and related disorders (Intermittent Explosive Behavior).

·      Collaboration with computer scientists (first at Stony Brook University now with IBM) proved invaluable in developing and applying machine learning algorithms to explore our multidimensional data set.

·      Design of novel behavioral probes: drug fluency, drug Stroop, drug choice; and questionnaires: STRAP-R.

Training and education

·      Sponsor of post-doc individual fellowships (1F32DA030017, Moeller PI and 1F32DA033088, Parvaz PI).

·      Examples of other significant achievements by trainees: Moeller (post-doc): NIDA Director’s Travel Award to CPDD, 2013 and Travel Award to ACNP, 2013; Konova (graduate student): Winner, 2012 Basic Psychological Science Research Grant, APAGS and 2013 Distinguished Travel Award, Graduate Student Organization SUNY SB; Beebe-Wang (high school student): Intel semi-finalist 1/13; Wu (high school student): 2013 Neuroscience Research Finalist, American Academy of Neurology.

Knowledge dissemination

·      Lecturer (2008-2011, to state and federal judges, lawyers, probation officers, etc.), the neuroscience and law series, sponsored by the Catherine T. and John D. MacArthur FoundationLaw & Neuroscience Project, the Gruter Institute for Law and Behavioral Research, and the Federal Judicial Center/National Judicial College

Links

NARC: http://icahn.mssm.edu/research/programs/narc/about-us

Waletzky Award: http://www.sfn.org/Awards-and-Funding/Individual-Prizes-and-Fellowships/Outstanding-Research-and-Career-Awards/Jacob-P-Waletzky-Award

General

My primary research interest lies in studying the interplay between the cognitive-emotional-behavioral and neurobiological changes that accompany drug addiction with the goal of understanding the mechanisms that underlie the recurring nature of addiction to drugs (intoxication, withdrawal, craving, relapse). In this study of the brain-behavior mechanisms that underlie drug addiction, I place a special emphasis on the role of the prefrontal cortex and the mesocortical and mesolimbic dopamine brain circuits in the impaired ability to change ongoing behavior (willed-behavior) in response to an emotionally salient feedback. This intricate study of the interaction between brain and behavior incorporates the interrelated yet distinct research disciplines of neuroimaging, cognitive neuroscience, and neuropsychology. My research embraces this multidisciplinary approach, translating into patient-oriented clinical research settings the principles of non-invasive techniques to measure brain function such as fMRI, PET, ERP recordings, and neuropsychology.

 

Related tools/goals: pharmacological fMRI and PET-MRI-ERP validation studies/simultaneous recordings; computer science/machine learning; genetic contributions and other predispositions (environmental and developmental) to disorders of control; neurorehabilitation to enhance behavioral control using cognitive-behavioral exercises, neurofeedback (e.g., using Brain Computer Interface), and/or brain stimulation (e.g., with TMS); neural mechanisms underlying reinforcement learning and extinction, choice and decision-making, and self-awareness and insight into severity of illness in addiction and other disorders of inhibitory control (including Intermittent Explosive Disorder).

Publications

Konova AB, Moeller SJ, Tomasi D, Volkow ND, Goldstein RZ. Effects of methylphenidate on resting-state functional connectivity of the mesocorticolimbic dopamine pathways in cocaine addiction. JAMA psychiatry (Chicago, Ill.) 2013 Aug; 70(8).

Moeller SJ, Parvaz MA, Shumay E, Beebe-Wang N, Konova AB, Alia-Klein N, Volkow ND, Goldstein RZ. Gene x abstinence effects on drug cue reactivity in addiction: multimodal evidence. The Journal of neuroscience : the official journal of the Society for Neuroscience 2013 Jun; 33(24).

Goldstein RZ, Volkow ND. Dysfunction of the prefrontal cortex in addiction: neuroimaging findings and clinical implications. Nature reviews. Neuroscience 2011 Nov; 12(11).

Volkow ND, Tomasi D, Wang GJ, Fowler JS, Telang F, Goldstein RZ, Alia-Klein N, Woicik P, Wong C, Logan J, Millard J, Alexoff D. Positive emotionality is associated with baseline metabolism in orbitofrontal cortex and in regions of the default network. Molecular psychiatry 2011 Aug; 16(8).

Alia-Klein N, Parvaz MA, Woicik PA, Konova AB, Maloney T, Shumay E, Wang R, Telang F, Biegon A, Wang GJ, Fowler JS, Tomasi D, Volkow ND, Goldstein RZ. Gene x disease interaction on orbitofrontal gray matter in cocaine addiction. Archives of general psychiatry 2011 Mar; 68(3).

Volkow ND, Baler RD, Goldstein RZ. Addiction: pulling at the neural threads of social behaviors. Neuron 2011 Feb; 69(4).

Volkow ND, Wang GJ, Newcorn JH, Kollins SH, Wigal TL, Telang F, Fowler JS, Goldstein RZ, Klein N, Logan J, Wong C, Swanson JM. Motivation deficit in ADHD is associated with dysfunction of the dopamine reward pathway. Molecular psychiatry 2011 Nov; 16(11).

Goldstein RZ, Woicik PA, Maloney T, Tomasi D, Alia-Klein N, Shan J, Honorio J, Samaras D, Wang R, Telang F, Wang GJ, Volkow ND. Oral methylphenidate normalizes cingulate activity in cocaine addiction during a salient cognitive task. Proceedings of the National Academy of Sciences of the United States of America 2010 Sep; 107(38).

Goldstein RZ, Craig AD, Bechara A, Garavan H, Childress AR, Paulus MP, Volkow ND. The neurocircuitry of impaired insight in drug addiction. Trends in cognitive sciences 2009 Sep; 13(9).

Goldstein RZ, Alia-Klein N, Tomasi D, Carrillo JH, Maloney T, Woicik PA, Wang R, Telang F, Volkow ND. Anterior cingulate cortex hypoactivations to an emotionally salient task in cocaine addiction. Proceedings of the National Academy of Sciences of the United States of America 2009 Jun; 106(23).

Goldstein RZ, Tomasi D, Alia-Klein N, Honorio Carrillo J, Maloney T, Woicik PA, Wang R, Telang F, Volkow ND. Dopaminergic response to drug words in cocaine addiction. The Journal of neuroscience : the official journal of the Society for Neuroscience 2009 May; 29(18).

Alia-Klein N, Goldstein RZ, Kriplani A, Logan J, Tomasi D, Williams B, Telang F, Shumay E, Biegon A, Craig IW, Henn F, Wang GJ, Volkow ND, Fowler JS. Brain monoamine oxidase A activity predicts trait aggression. The Journal of neuroscience : the official journal of the Society for Neuroscience 2008 May; 28(19).

Goldstein RZ, Alia-Klein N, Tomasi D, Zhang L, Cottone LA, Maloney T, Telang F, Caparelli EC, Chang L, Ernst T, Samaras D, Squires NK, Volkow ND. Is decreased prefrontal cortical sensitivity to monetary reward associated with impaired motivation and self-control in cocaine addiction?. The American journal of psychiatry 2007 Jan; 164(1).

Goldstein RZ, Volkow ND. Drug addiction and its underlying neurobiological basis: neuroimaging evidence for the involvement of the frontal cortex. The American journal of psychiatry 2002 Oct; 159(10).

Industry Relationships

Physicians and scientists on the faculty of the Icahn School of Medicine at Mount Sinai often interact with pharmaceutical, device and biotechnology companies to improve patient care, develop new therapies and achieve scientific breakthroughs. In order to promote an ethical and transparent environment for conducting research, providing clinical care and teaching, Mount Sinai requires that salaried faculty inform the School of their relationships with such companies.

Dr. Goldstein did not report having any of the following types of financial relationships with industry during 2013 and/or 2014: consulting, scientific advisory board, industry-sponsored lectures, service on Board of Directors, participation on industry-sponsored committees, equity ownership valued at greater than 5% of a publicly traded company or any value in a privately held company. Please note that this information may differ from information posted on corporate sites due to timing or classification differences.

Mount Sinai's faculty policies relating to faculty collaboration with industry are posted on our website at http://icahn.mssm.edu/about-us/services-and-resources/faculty-resources/handbooks-and-policies/faculty-handbook. Patients may wish to ask their physician about the activities they perform for companies.

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