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Paul E Holtzheimer, MD, MS

Title(s):
Associate Professor of Psychiatry
Associate Professor of Surgery

Additional Titles/Positions/Affiliations:
Deputy Director for Research, National Center for PTSD
Staff Physician, White River Junction VAMC
Staff Physician, Dartmouth-Hitchcock Medical Center

Department(s):
Psychiatry
Surgery

Education:
1990-1995 Pacific Lutheran University, Tacoma, WA.
B.S., Biology, summa cum laude.
B.A., Psychology and Philosophy, summa cum laude.
- Honors in Philosophy.
- Honors in the Integrated Studies Program.
1995-1999 Dartmouth Medical School, Hanover, NH.
M.D., with honors.
2005-2008 Emory University, Atlanta, GA.
M.S., Clinical Research.

Programs:
Program in Experimental and Molecular Medicine

Contact Information:

Dartmouth-Hitchcock Medical Center
5D
One Medical Center Drive
Lebanon NH 03756

Phone: 802-296-513
Email: Paul.E.Holtzheimer@hitchcock.org


Professional Interests:

Dr. Holtzheimer’s research program at Dartmouth is focused on the neurobiology and treatment of mood disorders, anxiety disorders and posttraumatic stress disorder. Current methodologies include functional and structural neuroimaging (including EEG) and focal neuromodulation techniques such as transcranial magnetic stimulation and deep brain stimulation.

Rotations and Thesis Projects:

Rotations are available in the lab. Most projects will be focused on brain imaging research (structural MRI, resting state functional MRI, diffusion imaging, EEG).

Grant Information:

ACTIVE
NARSAD/BBRF Independent Investigator Award (Holtzheimer)

09/01/2016-08/31/2019
Neural Markers of Antidepressant Response to Dorsolateral versus Medial Prefrontal Transcranial Magnetic Stimulation

Using dense-array electroencephalography and specific behavioral tasks, this project will assess the neurobiological and antidepressant effects of dorsolateral (DLPFC) versus medial prefrontal (MPFC) cortical transcranial magnetic stimulation (TMS) in patients with treatment-resistant depression. Specifically, the effects of DLPFC and MPFC TMS on the cognitive control network and the default mode network will be assessed and correlated with their respective antidepressant efficacy.

Diamond Interdisciplinary Grant (DHMC Neurology)(Bujarski/Holtzheimer)

07/01/2016-09/30/2019
Efficacy and Safety of Low Frequency Transcranial Magnetic Stimulation (LF TMS) for Medication-Resistant Depression in Patients with Temporal Lobe Epilepsy

This project will assess the feasibility, safety and efficacy of right 1 Hz transcranial magnetic stimulation applied to the right dorsolateral prefrontal cortex as a treatment for depression in patients with temporal lobe epilepsy. Additionally, resting state functional magnetic resonance imaging and 256-channel EEG will be collected pre- and post-treatment to evaluate for biomarkers of treatment response and elucidate the mechanism of this intervention in these patients.

NIMH R01 MH 059282 (Haxby)

09/15/16-06/30/21
Functional Anatomic Studies or Self-Affect: A Multimodal Approach

This project will use recently developed applications of network analysis to assess resting state connectivity in brain circuitry and its relation to self-affect and health-relevant outcomes in healthy controls. The guiding hypothesis of this research is that individual differences in the integrity of these networks can predict individual differences in vulnerability to stress and their relation to self-affect.

NIMH/NCCIH 1UG3AT009758-01 (MPI: Rosen, Martino)

09/20/17-08/15/19
Engaging Veterans Seeking Service-Connection Payments in Pain Treatment

We propose to test the effectiveness and cost- effectiveness of Screening, Brief Intervention and Referral to Treatment for pain Management (SBIRT-PM), designed to reduce pain and reduce risky substance use, in part by helping Veterans get comprehensive pain treatment. The study will involve a 2-year period to arrange for clinicians at a single site to counsel Veterans throughout New England by phone with SBIRT-PM as part of a clinical trial, and a 4-year period to conduct the trial and disseminate its findings.

NIMH 1RF1MH117813-01 (PI: Roskies)

09/29/18-09/28/22
Assessing the Effects of Deep Brain Stimulation on Agency

This project will develop a scale to measure personal agency and will be used to assess for potential changes in agency in patients undergoing deep brain stimulation for neuropsychiatric conditions.

PENDING
NIMH R01MH120126-01 (PI: L. Williams; Site PI: Holtzheimer)

7/19-6/24
Mechanistic circuit markers of transcranial magnetic stimulation outcomes in pharmacoresistant depression

This study will assess fMRI biomarkers (task and resting state) for response to transcranial magnetic stimulation for depression in Veterans.

VA CSR&D I01CX002088 (MPI: Holtzheimer/A. Etkin)

10/19-9/24
Assessing an electroencephalography (EEG) biomarker of response to transcranial magnetic stimulation for major depression

This study will assess EEG biomarkers of response to transcranial magnetic stimulation for depression in Veterans.

NINDS (MPI: G. Wylie/Holtzheimer)

4/20-3/24
Understanding the relationship between depression and fatigue in TBI

This study will assess the functional neuroanatomy of cognitive fatigue in patients with moderate-severe TBI and the moderating effect of comorbid depression. An exploratory aim will test transcranial magnetic stimulation as a treatment for cognitive fatigue and/or depression in TBI patients.

Biography:

Paul Holtzheimer, MD, is the Deputy Director for Research at the National Center for Posttraumatic Stress Disorder, Executive Division. He is an Associate Professor of Psychiatry and Surgery at the Geisel School of Medicine at Dartmouth, and a staff psychiatrist at Dartmouth-Hitchcock Medical Center and the White River Junction VA Medical Center.

Dr. Holtzheimer’s clinical and research interests include developing better interventions for PTSD and related disorders, especially for patients with treatment-resistant and comorbid illness. He has expertise in brain imaging and brain stimulation therapies (including transcranial magnetic stimulation, electroconvulsive therapy, vagus nerve stimulation, and deep brain stimulation). A primary aim of his research program is to better understand the neural circuitry of treatment-resistant mood and anxiety disorders (especially PTSD), and to use this information to develop and advance novel treatment approaches, with a particular emphasis on focal brain stimulation therapies.

Dr. Holtzheimer is an author on approximately 100 publications in psychiatry, neurology, neurosurgery and neuroimaging. He serves on the Council of the Society of Biological Psychiatry and on the Board of Directors for the Anxiety and Depression Association of America, the New Hampshire chapter of the American Foundation for Suicide Prevention, and the Veterans Education and Research Association of Northern New England.

Mentoring Information:

2006-2007 Karim Gokal, MD, PGY-2, Primary mentor, Psychiatry Research Elective, Emory University
2007-2009 Marie Walters, Co-mentor, Undergraduate Honors Thesis, Emory University
2007-2009 R. Cameron Craddock, Co-mentor, Biomedical Engineering Graduate Student, Georgia Institute of Technology
2007-2010 Jared Moreines, Primary mentor, Undergraduate Honors Thesis, Emory University
2009-2012 Alexandre Franco, PhD, Co-mentor, Post-doctoral fellowship, Department of Psychiatry, Emory University
2009-2012 Callie McGrath, Co-mentor for PhD, Neuroscience Graduate Thesis, Emory University
2009-2013 KiSueng Choi, MS, PhD Co-mentor for PhD, Biomedical Engineering Graduate Student, Georgia Institute of Technology
2011-2013 Lisa Lambert, MD, Research Mentor, White River Junction VAMC/Geisel School of Medicine at Dartmouth
2011-present Wilder Doucette, MD/PhD, Secondary research mentor, Psychiatry Research Track, Geisel School of Medicine at Dartmouth
2011-present Natalie Riblet, MD, Co-mentor, Geisel School of Medicine at Dartmouth
2012-present Christopher Abbott, MD/MS, External mentor, University of New Mexico School of Medicine
2012-2015 Sibylle Delaloye, MD, Primary mentor, Psychiatry Research Track, Geisel School of Medicine at Dartmouth
2013-present Crystal Lantrip, PhD, Primary mentor Geisel School of Medicine at Dartmouth
2014-2015 Britta Carroll, Undergraduate thesis advisor, Dartmouth College
2014-2015 Alex Nourishad, Research advisor, Geisel School of Medicine at Dartmouth
2014-2016 Katie Billings, Research advisor, Presidential Scholars, Dartmouth College
2014-2017 Carey Allmendinger, Primary research mentor , Program in Experimental and Molecular Medicine (PhD program), Geisel School of Medicine at Dartmouth
2014-2018 Jeffrey Reed, DO, Secondary research advisor, Psychiatry Research Track, Geisel School of Medicine at Dartmouth
2015-2018 Nicole Smith, MD, Research Mentor, Psychiatry Research Track, Geisel School of Medicine at Dartmouth
2016-2017 Nicole Ross, DO, Primary research mentor, Department of Psychiatry, Geisel School of Medicine at Dartmouth
2017-present Lauren Sippel, PhD, Primary research mentor, Department of Psychiatry, Geisel School of Medicine at Dartmouth; National Center for PTSD
2017-present Sanne van Rooij, PhD Co-mentor, Department of Psychiatry and Behavioral Science, Emory University
2017-present Susan Conroy, MD, Co-mentor, Department of Psychiatry, Indiana University School of Medicine
2017-present James Rustad, MD, Primary research mentor, White River Junction VAMC; Department of Psychiatry, Geisel School of Medicine at Dartmouth
2018-present Crystal Noller, PhD, Primary research co-mentor, White River Junction VAMC; Department of Psychiatry, Geisel School of Medicine at Dartmouth/Dartmouth-Hitchcock Medical Center


Selected Publications:

 

  • Lantrip C, Delaloye S, Baird L, Dreyer-Oren S, Brady RE, Roth RM, Gunning F, Holtzheimer P. Effects of Left Versus Right Dorsolateral Prefrontal Cortex Repetitive Transcranial Magnetic Stimulation on Affective Flexibility in Healthy Women: A Pilot Study. Cogn Behav Neurol. 2019 Jun;32(2):69-75. (view details on MedLine)

  • Philip NS, Aiken EE, Kelley ME, Burch W, Waterman L, Holtzheimer PE. Synchronized transcranial magnetic stimulation for posttraumatic stress disorder and comorbid major depression. Brain Stimul. 2019 Sep - Oct;12(5):1335-1337. (view details on MedLine)

  • Tsai J, Huang M, Wilkinson ST, Edelen C, Rosenheck RA, Holtzheimer PE. A Measure to Assess Perceptions and Knowledge About Electroconvulsive Therapy: Development and Psychometric Properties. J ECT. 2019 Jun 11; doi: 10.1097/YCT.0000000000000609. Epub 2019 Jun 11. (view details on MedLine)

  • Almiron Bonnin DA, Holtzheimer PE, Knight J Electroconvulsive Therapy in Recurrent Oligodendroglioma After Resection. J ECT. 2019 Sep;35(3):e33-e34. (view details on MedLine)

  • Huckins JF, daSilva AW, Wang R, Wang W, Hedlund EL, Murphy EI, Lopez RB, Rogers C, Holtzheimer PE, Kelley WM, Heatherton TF, Wagner DD, Haxby JV, Campbell AT. Fusing Mobile Phone Sensing and Brain Imaging to Assess Depression in College Students. Front Neurosci. 2019;13:248. (view details on MedLine)

  • Wilkinson ST, Holtzheimer PE, Gao S, Kirwin DS, Price RB. Leveraging Neuroplasticity to Enhance Adaptive Learning: The Potential for Synergistic Somatic-Behavioral Treatment Combinations to Improve Clinical Outcomes in Depression. Biol Psychiatry. 2019 Mar 15;85(6):454-465. (view details on MedLine)

  • Sippel LM, Holtzheimer PE, Friedman MJ, Schnurr PP. Defining Treatment-Resistant Posttraumatic Stress Disorder: A Framework for Future Research. Biol Psychiatry. 2018 Sep 1;84(5):e37-e41. (view details on MedLine)

  • Kavanaugh BC, Aaronson ST, Clarke GN, Holtzheimer PE, Johnson CW, McDonald WM, Schneider MB, Carpenter LL Neurocognitive Effects of Repetitive Transcranial Magnetic Stimulation With a 2-Coil Device in Treatment-Resistant Major Depressive Disorder. J ECT. 2018 Dec;34(4):258-265. (view details on MedLine)

  • Holtzheimer PE. Defining Mechanisms of Transcranial Magnetic Stimulation as a Treatment for Depression Through Neuroimaging: Progress and Challenges. Biol Psychiatry Cogn Neurosci Neuroimaging. 2018 Mar;3(3):201-202. (view details on MedLine)

  • Holtzheimer PE, Husain MM, Lisanby SH, Taylor SF, Whitworth LA, McClintock S, Slavin KV, Berman J, McKhann GM, Patil PG, Rittberg BR, Abosch A, Pandurangi AK, Holloway KL, Lam RW, Honey CR, Neimat JS, Henderson JM, DeBattista C, Rothschild AJ, et al. Subcallosal cingulate deep brain stimulation for treatment-resistant depression: a multisite, randomised, sham-controlled trial. Lancet Psychiatry. 2017 Nov;4(11):839-849. (view details on MedLine)