Exploring the Origins of Resilience

July 1, 2019
Dani Dumitriu, MD, PhD defines resilience as “an active coping mechanism.”

The word resilience has many definitions: hardiness, elasticity, adaptability, flexibility. Dani Dumitriu, MD, PhD defines it as “an active coping mechanism.” A pediatrician and neuroscientist, Dr. Dumitriu has thought about resilience a lot—what it means to have it, and the consequences of lacking it. She recently joined the Department of Pediatrics to conduct research through her newly established DOOR laboratory, devoted to understanding the Developmental Origins Of Resilience. Her ultimate goal is to design interventions that prevent disease by increasing resilience.

The main question currently addressed in Dr. Dumitriu’s research is why some individuals are resilient to stress while others develop stress-induced pathology. When people experience stress in the form of major life changes or traumatic events, especially in early childhood, they are at increased risk not just of mental health diseases, but also of stroke, diabetes, autoimmune diseases, and many other diseases later in life. “In response to stress, the body undergoes subtle changes at early time points in development, which act as a prelude to negative impacts on many, many different organ systems throughout the life of the individual,” she says.

Through animal studies she is hoping to understand the connectivity pattern of the brains of individuals who are resilient to stress. “This is analogous to looking at wiring diagrams inside a computer, to try to trace things back and forth to see what is connected to what to make it tick,” she says. “I'm interested in differences in the preexisting wiring diagram of susceptible versus resilient individuals—the wiring diagram before they ever encounter a stressor.”

In animals that are susceptible to stress, she has identified a brain circuit connecting the prefrontal cortex to the amygdala that is hyper-activated. “When we block this circuit during the stress encounter, we can actually shift the population toward resilience,” she says. “In the next phase we're going to ask why those neurons are hyperconnected—what are their upstream partners, and how do those connections get set up during development? If we can find these little trigger points, perhaps we can, with very subtle interventions during development, shift the balance of how these circuits are made by tipping them in favor of resiliency patterns.”

Her eventual goal is what Dr. Dumitriu calls “developmental neuroprevention,” methods to monitor these circuits noninvasively in children, especially in at-risk populations, and interventional techniques that shift these circuits toward resilience.She adds, “By creating tools that enhance resiliency, I hope to help children lead happier, healthier, and longer lives.”

Over the past century, medicine has experienced a revolution in uncovering principles of pathophysiology, Dr. Dumitriu says. “This gave us a solid basic science understanding of the biological mechanisms underlying disease and enabled us to create many amazing treatments. Now we need increased focus on, and funding for, studies of the basic mechanisms of health, which will give us the foundation for disease prevention. My research is helping build that foundation, which will hopefully ultimately translate into a revolution in prevention.”