CNCS Center for Nonlinear and Complex Systems
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Andrew D Krystal, Professor of Psychiatry and Behavioral Sciences

Contact Info:
Office Location:  54221 Hosp South
Office Phone:  (919) 681-8742, (919) 684-2057
Email Address: send me a message
Web Page:  http://faculty.duhs.duke.edu/faculty/info?pid=1061

Teaching (Fall 2013):

  • BSP 301B.16, RESEARCH IN BSP Synopsis
    TBA, 12:00 AM-11:59 PM
  • BSP 301B.16-S, RESEARCH IN BSP Synopsis
    TBA, 12:00 AM-11:59 PM
Education:

M.D.Duke University1987
Research Interests:

My research is focused on better understanding the pathophysiology of sleep disorders and mood disorders and developing improved treatments for these conditions. My primary research tools are: electroencepahlography (EEG), polysomnography (PSG), computer signal analysis and modeling, functional magnetic resonance imaging (fMRI), and positron emission tomograophy (PET). Nearly all of my projects have been carried out with humans, however, projects are ongoing with gene knock-out models in mice, and lemurs in collaboration with the Duke Primate Center. A few representative current studies are: 1) Defining physiologic (EEG, PSG, PET, fMRI) correlates of sleep complaints and subtyping insomnia on the basis of the associated pathophysiology, 2) Studying the relationship of EEG data recorded during non-REM sleep, daytime function, and insomnia treatment response, 3) Developing new pharmacologic and non-pharmacologic treatments for insomnia, 4) Studying the relationship of natural sleep and hibernation-like phenomena (torpor), 5) Predicting depression treatment response on the basis of pre-treatment EEG and structural MRI data.

Keywords:

Electroencephalography • Anesthesia, General • Electroconvulsive Therapy • Practice Guidelines • Anti-Anxiety Agents, Benzodiazepine • Signal Processing, Computer-Assisted • Electromagnetic Fields • Models, Biological • Electrocardiography • Affect • Nonlinear Dynamics • Insomnia • Sleep Disorders • Neurobiology • Psychopharmacology • Sleepiness • Neuroimaging • Circadian Rhythm • Models, Neurological

Representative Publications   (More Publications)

  1. J Singh, CA Zarate Jr, AD Krystal, Case report: Successful riluzole augmentation therapy in treatment-resistant bipolar depression following the development of rash with lamotrigine., Psychopharmacology, vol. 173 no. 1-2 (April, 2004), pp. 227-8, ISSN 0033-3158 [doi]
  2. S Ancoli-Israel, RM Benca, JD Edinger, AD Krystal, W Mendelson, H Moldofsky, J Petrie, T Roth, JK Walsh, J Winkelman, Special Issues Board Panel Members, Panel discussion: changing how we think about insomnia., The Journal of clinical psychiatry, vol. 65 Suppl 8 (2004), pp. 44-6, ISSN 0160-6689
  3. AD Krystal, The changing perspective on chronic insomnia management., The Journal of clinical psychiatry, vol. 65 Suppl 8 (2004), pp. 20-5, ISSN 0160-6689  [abs]
  4. AD Krystal, JK Walsh, E Laska, J Caron, DA Amato, TC Wessel, T Roth, Sustained efficacy of eszopiclone over 6 months of nightly treatment: results of a randomized, double-blind, placebo-controlled study in adults with chronic insomnia., Sleep, vol. 26 no. 7 (November, 2003), pp. 793-9, ISSN 0161-8105  [abs]
  5. JD Edinger, AD Krystal, Subtyping primary insomnia: is sleep state misperception a distinct clinical entity?, Sleep medicine reviews, vol. 7 no. 3 (June, 2003), pp. 203-14, ISSN 1087-0792  [abs]
  6. AD Krystal, Insomnia in women., Clinical cornerstone, vol. 5 no. 3 (2003), pp. 41-50, ISSN 1098-3597  [abs]
  7. AD Krystal, RD Weiner, MD Dean, VH Lindahl, LA Tramontozzi 3rd, G Falcone, CE Coffey, Comparison of seizure duration, ictal EEG, and cognitive effects of ketamine and methohexital anesthesia with ECT., The Journal of neuropsychiatry and clinical neurosciences, vol. 15 no. 1 (2003), pp. 27-34, ISSN 0895-0172  [abs]
  8. AD Krystal, JD Edinger, WK Wohlgemuth, GR Marsh, NREM sleep EEG frequency spectral correlates of sleep complaints in primary insomnia subtypes., Sleep, vol. 25 no. 6 (September, 2002), pp. 630-40, ISSN 0161-8105  [abs]
  9. Prado R, West M, Krystal AD  Multichannel electroencephalographic analyses via dynamic regression models with time-varying lag-lead structure J. Royal Statistical Society C-APP Part I. 2001;50: 95-109.
  10. AD Krystal, T Holsinger, RD Weiner, CE Coffey, Prediction of the utility of a switch from unilateral to bilateral ECT in the elderly using treatment 2 ictal EEG indices., The journal of ECT, vol. 16 no. 4 (December, 2000), pp. 327-37, ISSN 1095-0680  [abs]
  11. AD Krystal, RD Weiner, V Lindahl, R Massie, The development and retrospective testing of an electroencephalographic seizure quality-based stimulus dosing paradigm with ECT., The journal of ECT, vol. 16 no. 4 (December, 2000), pp. 338-49, ISSN 1095-0680  [abs]
  12. AD Krystal, MD Dean, RD Weiner, LA Tramontozzi 3rd, KM Connor, VH Lindahl, RW Massie, ECT stimulus intensity: are present ECT devices too limited?, The American journal of psychiatry, vol. 157 no. 6 (June, 2000), pp. 963-7, ISSN 0002-953X  [abs]
  13. AD Krystal, M West, R Prado, H Greenside, S Zoldi, RD Weiner, EEG effects of ECT: implications for rTMS., Depression and anxiety, vol. 12 no. 3 (2000), pp. 157-65, ISSN 1091-4269 [doi]  [abs]
  14. SM Zoldi, A Krystal, HS Greenside, Stationarity and redundancy of multichannel EEG data recorded during generalized tonic-clonic seizures., Brain topography, vol. 12 no. 3 (2000), pp. 187-200, ISSN 0896-0267  [abs]
  15. AD Krystal, R Prado, M West, New methods of time series analysis of non-stationary EEG data: eigenstructure decompositions of time varying autoregressions., Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology, vol. 110 no. 12 (December, 1999), pp. 2197-206, ISSN 1388-2457  [abs]
  16. GM Asnis, A Chakraburtty, EA DuBoff, A Krystal, PD Londborg, R Rosenberg, B Roth-Schechter, MB Scharf, JK Walsh, Zolpidem for persistent insomnia in SSRI-treated depressed patients., The Journal of clinical psychiatry, vol. 60 no. 10 (October, 1999), pp. 668-76, ISSN 0160-6689  [abs]
  17. AD Krystal, RD Weiner, EEG correlates of the response to ECT: a possible antidepressant role of brain-derived neurotrophic factor., The journal of ECT, vol. 15 no. 1 (March, 1999), pp. 27-38, ISSN 1095-0680  [abs]
  18. West, M. Prado, R. and Krystal, A.  Evaluation and comparison of EEG traces: Latent structure in non-staionary time series.  Journal of the American Statistical Association, 94:375-387, 1999.
  19. AD Krystal, HS Greenside, Low-dimensional chaos in bipolar disorder?, Archives of general psychiatry, vol. 55 no. 3 (March, 1998), pp. 275-6, ISSN 0003-990X
  20. AD Krystal, BV Watts, RD Weiner, S Moore, DC Steffens, V Lindahl, The use of flumazenil in the anxious and benzodiazepine-dependent ECT patient., The journal of ECT, vol. 14 no. 1 (March, 1998), pp. 5-14, ISSN 1095-0680  [abs]
  21. Krystal AD. The clinical utility of ictal EEG seizure adequacy models. Psychiatric Annals 1:30- 35, 1998.
  22. Krystal, A.D., (member of the U.S. Modafinil in Narcolepsy Study Group). HLA-DQB1*0602 homozygosity increases relative risk for narcolepsy but not disease severity in two ethnic groups. Tissue Antigens 51:96-100, 1998.
  23. Krystal, A.D., (member of the U.S. Modafinil in Narcolepsy Study Group). Randomized trial of modafinil for the treatment of pathological somnolence in narcolepsy. Annals of Neurology 43:88-97, 1998.
  24. Krystal, A.D., Edinger, J., Wohlgemuth, W., Marsh, G.R. Sleep in peri-menopausal and post- menopausal women. Sleep Medicine Reviews, 2:243-253, 1998.
  25. Krystal, A.D., Zoldi, S., Greenside, H., Prado, R., West, M., Weiner, R. The effects of ECT on the EEG: implicatons for rTMS. Progress in Neuro-Psychopharmacology & Biological Psychiatry, in press.
  26. AD Krystal, CE Coffey, RD Weiner, T Holsinger, Changes in seizure threshold over the course of electroconvulsive therapy affect therapeutic response and are detected by ictal EEG ratings., The Journal of neuropsychiatry and clinical neurosciences, vol. 10 no. 2 (1998), pp. 178-86, ISSN 0895-0172  [abs]
  27. AD Krystal, C Zaidman, HS Greenside, RD Weiner, CE Coffey, The largest Lyapunov exponent of the EEG during ECT seizures as a measure of ECT seizure adequacy., Electroencephalography and clinical neurophysiology, vol. 103 no. 6 (December, 1997), pp. 599-606, ISSN 0013-4694  [abs]
  28. Edinger, J.D., Fins, A.I., Goeke, J.M., McMillan, D.K., Gersh, T.L., Krystal, A.D., McCall, W.V. The empirical identification of insomnia subtypes: A cluster analytic approach. Sleep (in press).
  29. Krystal, A.D. The clinical utility of ictal EEG seizure adequacy models. Psychiatric Annals, 1:30-35, 1998.
  30. Krystal, A.D., Coffey, C.E. Neuropsychiatric considerations in the use of Electroconvulsive Therapy. Journal of Neuropsychiatry and Clinical Neurosciences 9:283-292, 1997.
  31. Krystal, A.D., Greenside, H.S. Low Dimensional Chaos in Bipolar Disorders? (Letter to the Editor) Arch. Gen. Psychiatry (in press).
  32. Krystal, A.D., Zaidman, C., Greenside, H.S., Weiner, R.D., Coffey, C.E. The largest Lyapunov exponent of the EEG during ECT seizures as a measure of therapeutic adequacy. Electroencephalography and Clinical Neurophysiology 103:599-606, 1997.
  33. AD Krystal, CE Coffey, Neuropsychiatric considerations in the use of electroconvulsive therapy., The Journal of neuropsychiatry and clinical neurosciences, vol. 9 no. 2 (1997), pp. 283-92, ISSN 0895-0172  [abs]
  34. AD Krystal, HS Greenside, RD Weiner, D Gassert, A comparison of EEG signal dynamics in waking, after anesthesia induction and during electroconvulsive therapy seizures., Electroencephalography and clinical neurophysiology, vol. 99 no. 2 (August, 1996), pp. 129-40, ISSN 0013-4694  [abs]
  35. JD Edinger, AI Fins, JM Goeke, DK McMillan, TL Gersh, AD Krystal, WV McCall, The empirical identification of insomnia subtypes: a cluster analytic approach., Sleep, vol. 19 no. 5 (June, 1996), pp. 398-411, ISSN 0161-8105  [abs]
  36. AD Krystal, RD Weiner, CE Coffey, WV McCall, Effect of ECT treatment number on the ictal EEG., Psychiatry research, vol. 62 no. 2 (May, 1996), pp. 179-89, ISSN 0165-1781  [abs]
  37. AD Krystal, RD Weiner, D Gassert, WV McCall, CE Coffey, T Sibert, T Holsinger, The relative ability of three ictal EEG frequency bands to differentiate ECT seizures on the basis of electrode placement, stimulus intensity, and therapeutic response., Convulsive therapy, vol. 12 no. 1 (March, 1996), pp. 13-24, ISSN 0749-8055  [abs]
  38. Krystal, A.D., Coffey, C.E., Weiner, R.D., Holsinger, T. Changes in seizure threshold over the ECTcourse affect therapeutic response and are detected by ictal EEG ratings.
  39. Krystal, A.D., Greenside, H.S., Weiner, R.D., Gassert, D. A comparison of EEG signal dynamics in waking, after anesthesia induction and during ECT seizures. Electroencephalography and Clinical Neurophysiology 99:129-140, 1996.
  40. AD Krystal, RD Weiner, ECT seizure duration: reliability of manual and computer-automated determinations., Convulsive therapy, vol. 11 no. 3 (September, 1995), pp. 158-69, ISSN 0749-8055  [abs]
  41. CE Coffey, J Lucke, RD Weiner, AD Krystal, M Aque, Seizure threshold in electroconvulsive therapy (ECT) II. The anticonvulsant effect of ECT., Biological psychiatry, vol. 37 no. 11 (June, 1995), pp. 777-88, ISSN 0006-3223 [doi]  [abs]
  42. CE Coffey, J Lucke, RD Weiner, AD Krystal, M Aque, Seizure threshold in electroconvulsive therapy: I. Initial seizure threshold., Biological psychiatry, vol. 37 no. 10 (May, 1995), pp. 713-20, ISSN 0006-3223 [doi]  [abs]
  43. JD Edinger, CW Erwin, AI Fins, GR Marsh, AD Krystal, Ambulatory cassette polysomnography: findings from a large cohort of drug-free insomnia patients., Journal of clinical neurophysiology : official publication of the American Electroencephalographic Society, vol. 12 no. 3 (May, 1995), pp. 302-9, ISSN 0736-0258  [abs]
  44. Krystal, A.D., Weiner, R.D., Coffey, C.E. The ictal EEG as a marker of adequate stimulus intensity with unilateral ECT. J. Neuropsychiatr. and Clin. Neurosciences 7:295-303, 1995.
  45. AD Krystal, RD Weiner, CE Coffey, The ictal EEG as a marker of adequate stimulus intensity with unilateral ECT., The Journal of neuropsychiatry and clinical neurosciences, vol. 7 no. 3 (1995), pp. 295-303, ISSN 0895-0172  [abs]
  46. AD Krystal, RD Weiner, ECT seizure therapeutic adequacy., Convulsive therapy, vol. 10 no. 2 (June, 1994), pp. 153-64, ISSN 0749-8055  [abs]
  47. Krystal AD, Weiner RD, McCall WV, Shelp F, Arias R, Smith P: The effects of ECT stimulus dose and electrode placement on the ictal electroencehpalogram: An intraindividual crossover study. Biological Psychiatry 34: 759-767, 1993.
  48. Krystal AD, Weiner RD: Low frequency ictal EEG activity and ECT therapeutic impact. Convulsive Therapy 9: 220-224, 1993.
  49. McCall WV, Edinger JD, Krystal AD, Marsh GR: Ambulatory polysomnogrophic differences in healthy and insomniac older men. Ambulatory monitoring 6: 135-140, 1993.
  50. Weiner RD, Krystal AD: EEG monitoring of ECT seizures. In (ed Coffey CE), The Clinical Science of Electroconvulsive Therapy. Washington DC: American Psychiatric Press, Inc., pp 93-109, 1993.
  51. RD Weiner, AD Krystal, The present use of electroconvulsive therapy., Annual review of medicine, vol. 45 (1994), pp. 273-81, ISSN 0066-4219 [doi]  [abs]
  52. AD Krystal, RD Weiner, WV McCall, FE Shelp, R Arias, P Smith, The effects of ECT stimulus dose and electrode placement on the ictal electroencephalogram: an intraindividual crossover study., Biological psychiatry, vol. 34 no. 11 (December, 1993), pp. 759-67, ISSN 0006-3223  [abs]
  53. AD Krystal, RD Weiner, CE Coffey, P Smith, R Arias, E Moffett, EEG evidence of more "intense" seizure activity with bilateral ECT., Biological psychiatry, vol. 31 no. 6 (March, 1992), pp. 617-21, ISSN 0006-3223
  54. WV McCall, CW Erwin, JD Edinger, AD Krystal, GR Marsh, Ambulatory polysomnography: technical aspects and normative values., Journal of clinical neurophysiology : official publication of the American Electroencephalographic Society, vol. 9 no. 1 (January, 1992), pp. 68-77, ISSN 0736-0258  [abs]
  55. RD Weiner, AD Krystal, CE Coffey, P Smith, The electrophysiology of ECT: relevance to mechanism of action., Clinical neuropharmacology, vol. 15 Suppl 1 Pt A (1992), pp. 671A-672A, ISSN 0362-5664
  56. RD Weiner, CE Coffey, AD Krystal, The monitoring and management of electrically induced seizures., The Psychiatric clinics of North America, vol. 14 no. 4 (December, 1991), pp. 845-69, ISSN 0193-953X  [abs]
  57. AD Krystal, JP McEvoy, Shared features of neuroleptic malignant syndrome and alcohol abuse complications., The Journal of clinical psychiatry, vol. 51 no. 12 (December, 1990), pp. 523, ISSN 0160-6689
  58. A Krystal, KR Krishnan, M Raitiere, R Poland, JC Ritchie, NR Dunnick, K Hanada, CB Nemeroff, Differential diagnosis and pathophysiology of Cushing's syndrome and primary affective disorder., The Journal of neuropsychiatry and clinical neurosciences, vol. 2 no. 1 (1990), pp. 34-43, ISSN 0895-0172  [abs]