Brian A Fallon, MD, MPH

A primary focus is on the pathophysiologic mechanisms and treatment underlying persistent cognitive impairment, fatigue, and pain among patients with histories of Lyme or other Tick borne diseases. This interest leads to collaborative studies involving proteomics, genomics, neuroimaging, cognitive remediation, treatment trials, and the search for more sensitive and specific diagnostic biomarkers. This expertise has also led to new projects in psychiatry, such a a NARSAD funded study of the role of ceftriaxone (an IV antibiotic) as a treatment for patients with refractory psychoses, examining improvement clinically and in glutamatergic change using MR Spectroscopy. Dr. Fallon is also a leader in the area of somatoform disorders, particularly the pharmacotherapy of hypochondriasis and is currently conducting both treatment and functional neuroimaging studies in these areas and serves as an advisor to the Anxiety and Obsessional Disorders DSM-V workgroup.

Primary areas of research include:

1. Diagnostic and treatment studies of neurologic and chronic Lyme disease, using neuroimaging to identify markers of neuroinflammation
2. Clinical research neuroimaging and treatment trials of hypochondriasis
3. Studies of immune markers in patients with somatic symptoms.

Lyme-Related Research

1. SPECT imaging of Lyme disease vs Depression vs Healthy controls. This study aims to determine whether brain SPECT imaging when used clinically and assessed blind to diagnosis can help in the differential diagnosis of Lyme disease.
2. Laboratory testing for Lyme disease. This study aims to contrast the sensitivity and specificity of different lab tests at different commercial and specialty labs to determine the value of these tests in the diagnosis of patients with chronic Lyme disease.
3. Proteomics in Lyme Disease. This study is a collaborative project between investigators at the NIH, UMDNJ, the Department of Energy, and us at Columbia. The aim is to identify unique proteins among patients with chronic Lyme disease as a device to identify better diagnostic tools and biomarkers of treatment response.
4. Immune Complexes in Lyme Disease. This study aims to identify Bb-specific immune complexes in the CSF of patients with Chronic Lyme disease vs masked controls.
5. Tick studies. This project being conducted by Dr. Tokarz aims to identify novel organisms with ticks that may be agents of human disease. This research is being conducted collaboratively with Dr. Ian Lipkin of the Greene Infectious Disease Lab at the Columbia University Mailman School of Public Health.

Somatoform Disorders Research

1. Dual-site treatment Study of hypochondriasis using Fluoxetine vs Placebo vs CBT vs CBT and Fluoxetine. This study aims to determine which is the most effective treatment both short- and long-term for patients with excessive illness fears.
2. fMRI Study of Hypochondriasis vs OCD vs Healthy Controls. This study aims to compare the neural activation patterns of patients vs healthy controls when exposed to a virtual reality cognitive task that teases out implicit vs explicit memory challenges. Conducted by Dr. Kelli Harding in collaboration with Dr. Bard Peterson.

Psychosis-Related Research

1. Study of efficacy of 8 weeks of IV ceftriaxone for patients with refractory psychosis. This study aims to determine in a double-blind placebo-controlled fashion whether the IV antibiotic ceftriaxone would be effective for patients who have not responded well to typical or atypical antipsychotic medications.
2. Because the primary hypothesis underlying the study above relates to ceftriaxone's unique impact on GLT1 (glutamate transporter), we are also conducting MR Spectroscopy on these patients before and after treatment to see if there is within subject change in response to ceftriaxone that can be measured by MR Spectroscopy. Conducted in collaboration with Dr. Kegeles, Peterson, and Shungu.

Future Studies

1. PET receptor studies of markers of microglial activation.