[John] I’m John Paradis senior editor and writer for the VA New
England healthcare system And I’m here at the Jamaica Plain campus of the VA
Boston healthcare system, and I’m with Dr. Mark Logue He’s an Army veteran and a statistician with the US Department of
Veterans Affairs and the National Center for PTSD here at the VA Boston healthcare system his research interests include the
genetics of brain disorders such as PTSD, and Alzheimer’s disease, and anxiety. He’s also an associate professor of psychiatry
at the Boston University School of Medicine He has published works
in dozens of academic journals Some of his research involves the
VA’s Million Veteran Program. Mark, welcome to our program. [Mark] Hi, glad to be here. [John] Mark, well, why don’t we we start off
by if you could talk about your service in the United States Army. [Mark] Great. So, right after high school, I was looking for
someplace, some way to pay for college so I thought it would be
good to join the Army Reserves, and I signed up and did basic training
and then partway through my Sophomore year at University of Oregon, my reserve unit got called up
because of Operation Desert Shield and I actually went to Germany
for three months. I worked in medical supply
and I worked in medical supply in Germany helping get
a hospital ready for casualties that would be sent back and after three months, I was discharged
and went back to my reserve unit. [John] And your time in in Germany,
in Stuttgart in particular, during Desert Storm, Desert Shield with that, what did that involve
and what did that include [Mark] So, we were really
at that point trying to, the effort was to increase
the capacity of the hospital, so they were taking rooms that were
just on the campus and on the base used for other things
and and bringing in beds and trying to set it up to
just increase the capacity. So I worked on that primarily,
and then for a little bit of that time I actually worked in a warehouse in
Permasens near the French border as well. Again, just trying to help process
the medical supplies coming in, just in case there were a lot of casualties
in Desert Storm, Desert Shield. [John] And then you came back home
to the Pacific Northwest, you remained in the
Army Reserves, you separated in what year? [Mark] Uh, I can’t remember
when I was officially done, but then I moved from Oregon
to Iowa to do graduate work [John] Okay, so early 90s timeframe [Mark] Yeah, mid 90s [John] And what piqued your interest in going into this
academic career field that you’re in? [Mark] So I my undergraduate degree
was in mathematics and statistics seemed to be a good way to apply
those mathematics to real-world problems, so I like that it that had applicability
and it helped me understand what I read in the newspaper
and it helped me deal with real data and maybe address real
problems like health issues and things that I thought just math theory won’t let you do. [John] Sure. Was your time in the army,
was there kind of any any linkage to to what you’re pursuing at the time with your medical kind of a medical field
and medical corps background or? [Mark] You know that may have played a role
primarily, it helped me get through college. So it allowed me to be able to keep working on my degree. [John] Sure. That’s important. [Mark] But I don’t think… I initially didn’t start
working in PTSD. I started working more in
general anxiety disorders, and when I moved to Boston,
I started working in Alzheimer disease, and then I made connections with a few
people at the National Center for PTSD here and we started working on a genetic study for PTSD they had data
and they needed help analyzing it. I think that paper
was very successful and it just snowballed from there and I became
more and more involved in PTSD research. [John] So your work is on genetics, particularly as it applies to those three areas
PTSD, Alzheimers, and anxiety? [Mark] Yeah, mostly my work focuses around there. So we studied the genetics at multiple different levels. So there’s there’s the genetics, genetic variants you
inherit from your parents. That’s one level of genetics; then we also look in the cells and look at what genes are turned
off and on in the blood and brain tissue so we’re looking at multiple levels of what’s
happening with the genes of the genetics. [John] What’s the potential impact from the work that you’re doing in the work
with the team here at VA Boston with veterans [Mark] So, there there’s
one level when we’re talking about things you
inherit from your parents and that might be useful for identifying
people at increased risk for forgetting. PTSD, or Alzheimer’s, or age-related disorders. There’s another level when
you’re talking about studying the the epigenetics or
the gene expression, is that that’s measuring
something that’s going on potentially right then in the person
and so that gives the possibility of doing diagnostics if at some point
based on on these genetic assays. Also there there may be genetics may have implications
for treatment so, they’re there cancer drugs
right now that are targeted for cancer cells that have
a specific genetic profile and maybe someday if people
have a certain kind of PTSD or depression We can find the
best drug for them quicker or the best method for treatment. [John] So a lot of veterans certainly know the US Department of
Veterans Affairs for our health care, right and in the
clinical care that we provide. But the research arm
of the VA is, is known throughout the world as as a leading
cutting edge with a lot of the research. Is that also applied
in this in this area? As far as the PTS work
that’s being done within the VA. [Mark] Yeah. I certainly knew research
was going on at the VA but didn’t know
until I joined how extensive that was and and how much impact it has I mean, it’s it’s impressive. So there there are many different
research groups across the country, there’s also the big genetic push
within the VA right now as sort of embodied in the Million Veterans Program. Which is an amazing project where hundreds of thousands of veterans
have volunteered to submit DNA samples and also to allow those to be studied by
researchers like me have those samples linked to their medical records and fill out surveys and
health questionnaires that can be examined and so we can look for genetic
effects for these disorders and and it’s Amazing in that it’s it’s one of the
largest bio banks of its kind in the world there are there only
a few others like the Thousand Genomes Project and well not UK biobank, sorry not
Thousand Genomes, UK biobank and a few other projects that are
that are on the same scale. There’s a few more coming online, but it’s it’s really impressive to have this
resource built up within the VA system and, and allow us to do genetic studies on things
that are of particular interest to veterans [John] How does a veteran get? Get involved with a million veteran program, and
and how does that work as far as the process? [Mark] So I’ve never been involved in collection,
but as I understand it there are collection arms at many VA’s across the country
and desks out or you might see a sign for MVP And there are people
out there to talk to you and and and help you sort of navigate joining and it just involves taking a blood sample,
which gets sent to the data to a core laboratory that’s here
at the Boston VA and Filling out consent forms and questionnaires about prior studies and then then that data is amassed and people like me who have
an approved project who have got a grant submitted to study
something specific and in the MVP dataset can can access it. [John] Is there anything
that you’ve seen so far with? within your work
within a scope of work that You can share or anything that
is compelling at the moment [Mark] So my project is has mostly just got started in the last year.
So we’re still collating all the data from
the medical records particularly my projects to look at Alzheimer disease genes than the known risk variance
from from other things and look to see if
the impact of those genes is modulated or changed by exposure to
head injuries and TBI’s or combat stress. So it’s looking at if Alzheimer disease risk is
increased by interactions between those genes
and severe combat stress. And We don’t have results yet. We’re; when you’re working with data
like this, you have to… a lot of our data comes
from the medical record. And that involves actually
going through the medical record in an automated way
because you can’t read through 500,000 peoples medical
record and decide this person has Alzheimer disease. This person doesn’t individually, you have to come up with some
computer algorithm to decide who has Alzheimer disease, who’s has mild cognitive
impairment, who has some other kind of dementia, and and validate that, show that your your algorithm
is working very well and so we’re in that stage
where we’re developing that and we’ve just got a few preliminary
diagnosis now with with MCI, Mild Cognitive Impairment,
so a precursor stage to Alzheimer disease and these, the Alzheimer disease genes and
at least we’re showing so far that the known Alzheimer
disease genes are increasing risk for mild cognitive
impairment in the veterans. [John] So for the post 9/11 generation, certainly traumatic brain injury
is one of the signature injuries and wounds of war for the Iraq Afghanistan veterans a lot of the research you’re doing
is looking at kind of the intersections if you will between traumatic brain injury, PTS and anxiety disorders, depression, how they
all possibly connect and [Mark] Yeah, that’s that’s the goal like Now we’re of course mostly
looking at older veterans if we’re looking for things
like Alzheimer disease but hopefully we things
we find in those veterans will help the younger
veterans that are Maybe new to the VA system now [John] For the Million Veteran Program
is that apply to to veterans of
of all errors and in generations? [Mark] Yeah, I think all veterans
receiving care at the VA system are eligible to join MVP and I think there’s a
pilot program and push now to expand
beyond that to veterans who who aren’t specifically
getting care at the VA Right now older veterans
are over-represented in the MVP which is in some ways
good for my research looking at Alzheimer
disease and dementia but In other ways we’d like
to see the younger veterans too and I think there’s
a push to get them enrolled as well and
the more different kinds of people you can see in the
bio bank, you know The more you’re sure that
your results are representative. [John] So you work in in
arguably the research hub for the US Department of
Veterans Affairs, you know, VA Boston, believed as more
research of any VA Medical Center
across the country How does that make you feel
when you come into work every day knowing that
you’re coming into a place that You have have
colleagues that are working towards the
same common purpose to help veterans and it
may not be seen immediately from some of the work
that you’ve described but Longitudinally, over time, hoping to see the reaping
the benefits of the good work that you’re doing. [Mark] I I think this is just a great environment to do research. It’s it’s amazing how many
different things are going on here and the opportunities
for somebody like me that’s looking for for a new say data to examine You know, I was
immediately, you know people were knocking on
my door when I showed up and Asked me if I wanted to
be involved in studies, and if I had tried
this new kind of data, And so there’s just so many
opportunities to get involved which I thought was exciting. We’ve got the MVP, a lot of the the
leadership is here, and as I said, the
core lab is downstairs. There’s also the PTSD
brain bank is here. A lot of some of those
people right down the hall from my office which
has led to other opportunities. So the research community
and the opportunities are great. It’s also I think very interesting to be Housed at the VA and
coming in every day you see veterans in the
lobby and in the in the elevator and I think that’s Motivating compared to being
just in your university office all day and only seeing other researchers. We see people we’re trying to help on the elevator and the cafeteria
when we’re having lunch so it I think that’s actually
been another good Reason I’m happy that I
came to the VA to do research. [John] Can you describe some
of the collaboration work with with the VA here in Boston? You’re on the faculty at Boston University, some of the other organizations,
agencies, academic affiliations, and how that all plays into the
research work that you do here. [Mark] Yeah, so I came from Boston University
School of Medicine and then Joined this full-time and still
keep an affiliation there. The work I do here is
primarily with people in the National Center for PTSD
behavioral sciences division. But we have collaborations
with other VA centers that the Track study for which studies, it’s a neuroimaging study of veterans with TBI (traumatic
brain injury) so that’s just downstairs so we do a lot of work with them
and looking at at the veterans with TBI and neuroimaging and There’s also as I mentioned
the PTSD brain bank, we have a project collaborating
with them and then there’s MVP. So there’s My work reaches out to a lot
of other groups within the VA. Then there’s also a large genomics effort that’s
going on in the world sort of spearheaded by a group called the Psychiatric Genomics Consortium. And there’s a PTSD group within
that consortium that’s getting together tens of thousands of
samples outside the VA system of just general population samples, and trying to get
large-scale analyses of PTSD cases and controls there
to try to find PTSD genes, and we’re involved in that as well. Some of the studies I’m involved in, I work to try to make sure
veterans are represented in that consortium and that veteran
data is being analyzed, and incorporating in the models
being developed by those, those groups. [John] With all the work that you do
here I imagine you get a lot of visitors *laugh* [Mark] I actually end up traveling
more than I get visitors. [John] Do you? [Mark] Yeah, I’m off
meeting with people from Duke to talk about
neuro-imaging and, Emory to talk about epigenetic effects and, I’m off at conferences quite a bit
and those are good places for these For these large-scale collaborative
efforts, there’s meetings before a lot of
research conferences to get all the people together
and try to do work. So So, yeah I’m out and about quite a bit meeting
with these groups and getting my results. [John] Would you say there
is great interest right now in academia to look at these
areas of interest: PTS and TBI and in the gene research that [Mark] Absolutely. So, I got involved in this I think around 2014-2015 and the growths been exponential
in the amount there wasn’t a genome-wide Association scan for for PTSD genes
before our paper came out at that stage, and I think
since then there’s been like seven. Including the the one from
the Million Veterans Program, which was the biggest so far. So it all kind of kicked
off and snowballed and then the working groups started
forming pretty much right after that. So it’s it’s a a lot of active collaborations going on now
in this area and TBI especially as well. [John] So I think for us as veterans
that’s really reassuring to know that our nation has
taken such great interest in this you know for all those of
us that have served that there are folks very
smart intelligent people that are looking at all the different consequences from war with the hope and goal the result that
it’ll improve care and our quality of life, so we all live long long good lives. That must make you feel great If from a from an Army soldier and now
working for the for the federal VA. [Mark] Oh, thank you, you know
that’s great to hear. I’m you know, I you write papers and you
work away on this stuff and you know, that’s the ultimate
goal and the hope is that someday the work you’re
doing will have an impact and will be translatable to care in the hospital or lead to new knowledge
about brain circuits or molecular pathways that allow
a new drug to to hit the market and I think that’s what we’re
all hoping to achieve. [John] So this comes full circle from the
time you left high school [Mark] Yeah, it was it wasn’t a planned path, but in some ways it does seem like like I’ve come back around. I was working in medical supply you know, I was supporting soldiers on the front
line or you know trying to and that was my goal
in that job and then now I’m at the VA in some ways still trying to support soldiers
maybe even some of the same ones And help make their lives better and make things easier. It wasn’t the plan but it in some ways it felt like Coming back to the VA,
I had a sense of the bureaucracy, and being in the military, and the
government, and the culture a a little bit which which made it feel a bit like a homecoming in some ways. [John] Yeah. Sure. Sure You know and I think also I ask every veteran this question is: Some of those early
formative years that you’ve had, I’m certain in the army have had impact on you now, you know as far as just
very basic things that we all learn through our military service. Discipline, right? Accountability, being on time How has all those things worked for you throughout your career? I mean, going certainly in a Ph.D program, that takes an enormous
amount of dedication and incredible amount of
discipline I would imagine? [Mark] I think some of the things you
mentioned definitely. The accountability, being
on time, that’s sort of just the sense that you’re don’t have a normal job and that your actions have consequences, so you just need to get the job done. That’s the goal that sense definitely stuck with me in many ways. And in other odd little ways, you know, there in basic training you’re trained to check your
dog tags and your rifle moving, before you move
from one place to the next I still you know before I leave work Check my ID and my cell phone in my
pocket, you know as I’m leaving the door I’m like, “okay, I’ve got to do the check.” [John] I do the same thing [Mark] you do too? So definitely there’s my military experiences have shaped my, my life in all sorts of ways. Not to mention just the the great impact of
the support for my education and, The college afterwards that well that was a game changer. [John] So for the veterans that are out there or folks
that are still active duty or serving, looking at a post career with the VA, how does that look and what advice could you offer
folks as they’re looking at perhaps going into the
research arm of the VA? [Mark] I just I can’t say I had a plan to end
up where I am today, so I don’t, I don’t think I’m good at
telling people how to plan but I think it’s good just
to never stop learning. I think look for opportunities to
do new things, to try new things, and to challenge yourself
whether that’s a college, or just going to the local library, or going and finding out, you know what new restaurants are in your town? Just being out in the world and and trying
new things and getting out there leads to opportunities you never knew were possible. [John] Dr. Mark Logue, thank you for the
important work that you’re doing VA statistician here at the
VA Boston healthcare system. On behalf of New England Veteran and the
VA New England Health Care System, thanks for all the work that you’re doing. [Mark] Oh, thanks for having me, this was really fun.