Dr. Karen Parker, director of the Social Neurosciences Research Program at Stanford University
(25 mins) Dr. Parker is an Associate Professor of Psychiatry and Behavioral Sciences at Stanford University where she directs the Social Neurosciences Research Program as its principal investigator. Her research expertise is the biology of social functioning, with a particular interest in oxytocin and vasopressin signaling pathways. Her preclinical research program focuses on developing novel animal models; her clinical research program encompasses biomarker discovery and therapeutic testing in patients with neurodevelopmental and neuropsychiatric disorders. She serves on the Editorial Board of Psychoneuroendocrinology, the scientific advisory board for the Stanford Autism Center at Packard Children’s Hospital, and on various national (e.g., NIH and NSF) and international (e.g., Medical Research Council) grant review committees. She discusses her research into the biological role of socialization, how her work may eventually lead to easier autism diagnoses, and the challenges to the scientific research community.
For more information about Dr. Parker’s work, visit: parkerlab.stanford.edu
And take a look at this recent article about the Parker Lab’s research by clicking here.
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Meeting Dr. Karen Parker
HACKIE REITMAN, M.D. (HR): Hi, I’m Dr. Hackie Reitman, welcome to another episode of Exploring Different Brains. Today we have coming to us all the way from California, where she’s at Stanford University of all places doing amazing autism research, Karen Parker, welcome! How are you Dr. Parker?
KAREN PARKER Ph.D. (KP): Thank you, it’s a pleasure to be with you.
HR: Why don’t you give a proper introduction to you, because in reading about you, you have a million different awards, you are doing a million different things, you’re all over the place, you’ve got a bunch of kids and dogs at home. I don’t know how you are doing everything.
KP: (Laughs.) I think I’m going to hire you to be my PR person, Hackie (Laughs.) Um alright well so, I run what I think of as a Translational Social Neuroscience Research Program which basically means we’re interested in the biology of social functioning, and we do this in different species and we translate those fundamental insights we learn about the biology of social behavior to inform us about the development of new biologically-based diagnostic tools and then also new medications to improve social abilities in various patient populations with a specific focus on autism.
HR: How did you get in to that?
KP: That’s a good question. So, In graduate school, I was really interested in social behavior, and my PhD advisor studied these little rodents called “voles” that look like mice, and right around that time, there was all this work being done on these two hormones oxytocin and vasopressin, which we know were critically involved in social behavior and so I joined her lab to be able to study these molecules in this little mouse-like species.
The Intersection of Biology and Socialization
HR: So, you’re basically, you chose to go with the intersection of science and biology and socialization.
KP: And you know, I actually thought about going to medical school, so, that was like, in grad, you know like an undergrad, I was having this, you know, sort of crisis. Do I go to medical school or do I do a PhD? And what’s sort of interesting is, I picked the PhD route, but here I am now in a medical school working with patients, so you know I sort of came full circle.
HR: You know, it’s amazing to me is I learn more in this brain milieu that more and more with our overall health, I’m finding the most underrated thing is socialization and you were smart enough to perceive that because people think that’s just an extra added attraction but it is absolutely essential as all the studies show.
KP: Yeah, I agree. I mean if you think about humans, we’re an intensely social species and, you know, we experience social interactions as rewarding from infancy, and because those interactions are rewarding, we learn these critical life skills that are responsible for our very survival and well-being, and so, you know, because we’re so social, it’s really interesting when we start thinking about, you know, depression or anxiety or even addiction. A lot of what we think of as, you know, mental Illnesses, often result from like the loss of a loved one, for instance, and so for me it’s, you know, it’s a really interesting ability to think about how humans evolved, how other mammals evolved and that’s against the fabric of social behavior.
HR: You know, I saw a Ted Talk once about the study–they did a 75-year longitudinal study at Harvard on factors affecting the health and longevity and happiness of families and people they followed for 75 years which was amazing.
HR: And then was sure it was gonna show that the main thing was genetics, or cancer, heart attacks. You know, something very scientific and biological. They found out beyond the shadow of a doubt with blue, everything out of the water was strong social relationships. If you have strong social relationships, you have less cancer, less heart disease, less diabetes, less Alzheimer’s, less dementia. You live 20 years longer and happier and it’s, I don’t know why it’s so understated in our society.
KP: I agree with you, I think we’re trying to work hard to change that.
HR: How much do you feel of socialization is nature vs nurture?
KP: It’s a good question. I mean, the way I think about that is it’s always both, right? Because what we have is you have your own, you know, genetic background, and the environment is always acting on that, right? And the environment includes being in your mother’s womb, you know, so all of the, it’s the placental biology, it’s the hormones that are released during gestation up to, you know, what are your parents like? What’s your social interactions like? Who are your siblings, right? Are you born as the first born or are you middle born or the last born child? And so, where do you grow up? You know, are you in a urban or rural setting. I think you know all of those things interact and so it’s really hard to disentangle them.
Biological Links to Social Behavior
HR: I know that in our autism world, social challenges are right up there on the list, I mean it’s tough to get out of your comfort zone and make social connections.
KP: Yeah. I think that was why I was so attracted to autism because, you know, my hope was that by understanding the biology of social behavior, we might be able to help individuals who felt, you know, that they had social challenges.
HR: So what have been some of the big biological links to social behavior that you’ve unearthed and you’re aware of now.
KP: Yeah, well what was interesting is back several decades ago, there were these two hormones: Vasopressin and oxytocin. And oxytocin’s implicated in maternal care, lactation, uterine contractions. And vasopressin was actually more implicated in pair bond formation on males and their paternal care. And autism as you know, is a male biased disorder, you know, where you might even have four males to every one females that are diagnosed, And so, I got really interested in asking: how could this biology influence our understanding of autism? And so, we’ve been, and I guess the other thing to say is most people, if they’re thinking about the biology, have been looking in blood samples, and one thing that we started doing because autism, you know, it involves your social cognition which is obviously generated by your brain, we were interested in looking at a fluid that was closer to the brain. So, we’ve been studying something called cerebral spinal fluid, and what we were able to show is in some of the animals we study, and some of the children we have been studying, that they have much lower vasopressin levels in spinal fluid, but not in blood. You don’t see any differences in blood and that the lower your spinal fluid levels of vasopressin the greater your social challenges are.
HR: Wow, I was completely ignorant of that. And cerebral spinal fluid is yielding a lot of secrets lately, isn’t it?
KP: It is, and I think part of the reason we started doing the work we were doing was we saw that you could, you know, in neurology, there’s been tremendous progress and looking in spinal fluid for like multiple sclerosis, or various forms of dementia. And so we were able, when people were going and taking spinal fluid anyway for a clinical reason we were able is what I call piggy-backing onto the clinical indication, and I was, Stanford’s a pretty small place, you get to know everybody and so I was able to get all of my friends on different medical services to help recruit patients that again were already undergoing a lumbar puncture for some other reason. Um and so, it felt like a, you know, there were lots of people involved and so, you know, finding what we found was, you know, scientifically really exciting, but it was also a real big pay-off because we had so many people involved in the effort to get us the samples.
HR: Now, oxytocin, um my limited understanding of oxytocin is you make a lot of it when you give somebody a hug, (Laugh.) And that, mothers when they give birth, it’s off the charts.
HR: And it doesn’t seem to be the kind of thing that you can get over the internet.
KP: Well, there’s some interesting studies where they, you know, show trying to give social support by text message, or, if you’re able to hear somebody’s voice, or give them a hug, and more of these pro-social hormones are released, you know, when you hear somebody’s voice or when you give somebody a hug, probably not surprisingly than when you see it on a text. And so, I think that also has a lot of interesting ramifications for, you know “Loneliness.” If so much of the communication is by text message and Emails that you sort of wonder if we’re moving further and further away from, you know, this really close interpersonal bonds that you, you know, were mentioning with that Harvard longevity study.
Improving Autism Diagnoses
HR: What are some of the benefits would you say if we can, If we can get such things on genetic testing versus other types of testing versus the way they diagnose now. And this gets us into a very very controversial area, but, I was wondering what your thoughts might be?
KP: Um, well, I mean I think think the thing that I would first say is that, you know, currently we first diagnose autism behaviorally and because behavior is a snapshot in time, right? If you bring a child in and they’re having a really challenging day, what does that test look like, right? Versus if they’re not. Different clinicians perceive behavior differently and there’s very long clinic wait times currently to get in to these specialty behavioral clinics. A lot of the rest of medicine, you know, if we think that there is, you know, you’re experiencing a health condition, we diagnose you based on the biology, right? And we currently don’t do that almost any brain disorder except for maybe epilepsy, right? And there’s neurological conditions that we can now diagnose biologically. So, I think moving toward a biological diagnosis would be useful for a few different reasons. One would be that you might have higher yield of the number of patients you could serve, it might be more objective, I think for a very long time, people have been suspected that there are subtypes of autism right? There’s that saying that “If you met one person with autism, you’ve met one person with autism” and so, currently we think of this as a “spectrum” and you know, it very likely is a spectrum. But, you know, somebody who has an IQ of 50 who head bangs and hand flaps and has epilepsy, and sensory challenges to me seems like a very different kid then somebody who doesn’t have any intellectual disabilities capable of working a job, doesn’t have epilepsy, maybe has a lot of areas of strength like they’re extremely gifted mathematically or musically, and maybe they have some social challenges, right? And so I think if we could come up with a way of biologically contextualizing these differences, it would lead to I think a deeper understanding of maybe what autism is.
HR: And what are some of the comorbidities you’re seeing?
KP: So, I mean about you know 30% of kids have seizure disorders, you know, and again these estimates vary by the study, but, Upwards of 80%-90% of kids have comorbidity disorders. There’s kids who has sensory disorders, there’s also genetic conditions that are associated with autism in some people, but not in others. And so, I think that really complicates the picture tremendously because it’s what we call such a heterogeneous condition.
HR: We here at different brains.org, we feel that we would hope for a world to get rid of a lot of the stigma associated with all these different labels and also to help each individual maximize their potential for happiness, health, productivity, and everything somebody would want. As you know, it can get very controversial, Especially in today’s atmosphere, when you talk about improving someone’s potential versus getting into the quote trying to cure, say, autism and I know that you are of the opinion that you want to help maximize everyone’s maximum potential and help them in any way you can.
HR: But I don’t want to put words in your mouth let me hear you.
KP: No, actually that’s absolutely true. You know and I think that sometimes I’ll get contacted by people saying I don’t want you to cure me and I always say I’m not trying to [laughs] you know, it’s a lot of people can say that you know, I mean I’ve met a lot of children who can articulate, you know on suffering. I really wish I could have friends and so for it’s really about thinking about I love the way that you frame that about improving somebody’s potential and every person no matter who they are, you know, deserves to have a life that they can fulfill their potential and that’s different for everybody and I strongly agree with your statement about that and I think, you know, the neurodiversity movement is doing very very good things in recognizing precisely what you just stated.
The Roadblocks to Research
HR: What would you say is the biggest roadblock to your work?
KP: Okay. I will be completely honest with you. The biggest road block is how broken the funding model is in academic medicine. The number one broken thing. So, you know, the way science happens in academic medical schools, as you probably well know, is that scientists, you know, you basically pay your salary, you pay the salary of everybody in your lab, and then you write a grant that’s very long and takes weeks and weeks of your time, and then you get it reviewed and then you have to resubmit it and then you get the money two years later with a 20% cut, so you have to do 100% of the work on 80% of the budget, and what I find so, and it’s also been incredibly. So the federal government with a few exceptions doesn’t want to be funding extremely innovative work and so when we submit federal grants they have to be massively de-risked and we’re not given the money to take a moonshot, you know, nobody gives us the rocket fuel to take the moonshot for the science that’s the most impactful, and I think that’s the number one challenge. Most of the best scientists in the world that I know spend well over half of their time trying to raise money for the research that they want to do and that’s why we do not have more progress sadly in almost any area of brain health.
HR: And sadly, it also means a corollary to that that you touched on is if I’m going to apply for a grant, first of all I have to give it a label, and second of all, I got to make it in something with some of the Graham Works already been done so that you take us something like Alzheimer’s. Barking up the wrong tree for a hundred years with this, I mean, it’s just we are not getting anywhere with it and it’s going to take a fresh approach. I know my friend Ken Dychtwald at age wave–he’s the CEO of age wave–is really pushing for a whole new approach to Alzheimer’s and dementia and the same thing in autism if we keep, you know, just keep plowing the same thing and then that’s what happens. Not good.
KP: The biggest discoveries that my lab has made has been with philanthropy. It’s been people coming in and saying I believe in what you’re doing I’m going to give you a unrestricted funds to follow what you need to do, and I know it’s high risk but it’s high-reward, and at one of my funny agencies there’s a guy named Jim Simons who started Renaissance Technologies, he’s a big hedge-fund guy, and he really believed in funding the team. I mean this is what industry does. We fund the team in the idea. You don’t have to have done the work to get the funding after the fact, and so I think he’s really revolutionized in many ways aspects of the autism field and so, you know, you put the team together, you write the grant, you get the money with, you know, maybe four to six months rather than two years, and you know, I think about any disease I care about having to wait two years for the scientists to get the money to start the study. You know, versus if you could get at the money tomorrow in two years you’d be halfway to making really important progress so I think that’s probably the number one reason that, for me, as a biomedical researcher it’s it’s the biggest challenge I face on a daily basis.
HR: And in addition to that, as someone who just looks in from the outside, I got to speak out at the Aspen Institute. Now, I’m the least qualified guy up here, but let me say, you heard from the University of Pittsburgh about how this diet, this very good diet rewired the brains of these people with autism, and I sent you an email later from another University the same diet, they got a grant to show it does good in someone who’s progressive toward dementia. Okay, so guess what? It’s good for all of our brains, but why do we have to repeat it over here and keep it over there and we’re all fighting for the same pot of money. It’s got to be different and that’s just from an outsider.
KP: Well, and I think the other tricky part is that the way that science is rewarded and how we get promoted, you know, so we get, you know, there’s the recognition of how much money did you raise and are you the first or the last author on the scientific publication, and you know if you’ve spent all this time to get this hard-earned grant money and you spend 60% of your time, let’s say doing it maybe 70% do you want to hand the information over to one of your competitors, right? Do you want to share your data if you spent ten years collecting this valuable patient population and somebody across the, you know, the country comes up with a good idea and it would take them a fraction of the time to ask it in your patients, but so the incentives are absolutely not set up for idea sharing or resource sharing or anything else and I think the way the funding model could help change those dynamics or how universities reward people for tenure, you know could be, did you work productively on a team? Did you share your resources? Did you get the most out of the resources you had? And I think until the incentive structure for tenure changes to match the data sharing and things that you’re talking about were always going to have that mismatch and I think that that diminishes our ability to Progress as a Field, as well.
HR: Hey, I agree with you. Something has to change because the status quo is not our friend.
KP: [Laughs] No, I agree whole-heartedly with you. I’ll be thinking about you the next time I write a grant.
New Advancements in Research
HR: [Laughs] Are there any topics we have not covered that you would like to talk about?
KP: Well I guess the one that was really exciting, probably the most exciting thing that came out of our group this year was, you know, I told you we did that work on Vasopressin being low in spinal fluid and we just published a treatment trial this past year showing that we could give Vasopressin, and this was in children, to increase their social abilities. It was a gold standard, what we called double blind randomized placebo-controlled trial and what was exciting to me about that work was that we were able to show that people unaware if a child was on the drug or not. So both the parents, the clinicians, and then the children themselves, they basically had some computerized tasks about social abilities and on all of those different outcome measures we saw an improvement when we gave Vasopressin to these kids and so that was really exciting for me because we could see an alteration in the biology and in a very simplistic way of thinking about it, we’re replacing it and then we see this increase in social abilities and so, you know, to your point about increasing potential that that might just be to other things that we do for people with autism if that that’s something that they feel that they would like as a, you know, as a way to increase potential.
HR: Wow. That is tremendously exciting. That’s really that’s really at the intersection of socialization and biology. Wow!
KP: Yeah. And we had people, I could send you, there was this Stanford medicine magazine long-form article on the work that we did. It’s available, you know, readily on the internet. I think it’s even on my lab page and what was interesting was when one of the dads was interviewed who had a child in our treatment trial, and he said my kid went out for the first time ever and started talking to somebody at the grocery story. He said he was just gob-smacked by it, you know, he’d never seen it before and so I thought that was really interesting because you think of the trillions of social events that somebody has in a week, right? The micro, you know, the eye contact, the smile, all of those things if you thought about them add up to the trillions of social event over even just the first you know couple years of of development and you think that if there’s a medication that might help kids become slightly more socially motivated that you know what we think of as something that just happens implicitly for most of us, it could be a real game-changer in terms of like you said enhancing their socialization.
HR: Well Karen that is all amazing stuff you really really educated us.
KP: Thank you.
HR: How can our audience learn more about you?
KP: I have a lab website and that’s probably the best way to learn and it also has interviews and it has videos of me giving talks and all of our research publications are on the lab website.
HR: Dr. Karen Parker of Stanford University, thank you so much for taking the time to be with us on this episode of Exploring Different Brains
KP: It’s a pleasure to be here.