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Teresa R Franklin

Adjunct Associate Professor of Psychiatry
Member, David J. Mahoney Institute of Neurological Sciences, University of Pennsylvania, Philadelphia, PA
Member, Center for Functional Neuroimaging, University of Pennsylvania School of Medicine, Philadelphia, PA
Member, Penn Medicine Neuroscience Center, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
Department: Psychiatry

Contact information
Treatment Research Center/Center for the Studies of Addictions
Brain and Behavioral Vulnerabilities Laboratory
3535 Market Street
Philadelphia, PA 19104
B.S. (Chemistry/Biology)
Lycoming College, 1986.
Ph.D. (Neuroscience)
MCP Hahnemann University , 1999.
Post-Graduate Training
Postdoctoral Fellow, Center for the Studies of Addiction, Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, PA , 1999-2002.
Cognitive Neuroscience Fellow, Department of Cognitive Neuroscience, Dartmouth College, Hanover, NH, 2001-2001.
Research Associate, Center for the Studies of Addiction, Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, PA, 2002-2002.
Leading Success Program, Office of Organization Effectiveness , Perelman School of Medicine at the University of Pennsylvania , 2015-2016.
Permanent link
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Description of Research Expertise

As an Addiction’s Researcher, a key goal of mine is to characterize pharmaco-responsive endophenotypes in smokers to aid them in achieving successful smoking cessation. There are two major factors that motivate relapse to smoking: a) craving induced my pharmacological withdrawal from nicotine and b) craving elicited by exposure to smoking reminders (smoking cues). We hypothesize that there is inter-individual variability in the relative contribution of withdrawal- and smoking cue-induced craving to relapse. In our lab we focus on cue-vulnerable subtypes of smokers – and pharmacotherapies that reduce relapse rates in these subtypes. The tools I am using to identify the subtypes are a) appetitive smoking cue videos in a withdrawal vs sated neuroimaging paradigm, b) the quantitative neuroimaging technique of continuous arterial spin labeled (CASL) perfusion fMRI, c) GABA B agonists such as baclofen, d) the partial nicotinic agonist and FDA-approved agent, varenicline, e) behavioral probes that predict relapse, f) treatment outcome measures, g) objective measures of smoking behavior, and h) a candidate gene approach of functional polymorphisms involved in smoking behavior. We have published and replicated our findings showing that genetic variance in the dopamine transporter (DAT) modulates brain and behavioral responses during smoking cue exposure. We are currently exploring the interaction between the DAT and other dopaminergic regulating molecules, which have been shown to be involved in reward and smoking cue responsivity.Further exploration into the characterization of phenotypes in smokers includes the study of sex and hormonal influences on smoking behavior. We also are examining the brain and behavioral responses to smoking cues in smokers with co-morbidities such as Obesity, Attention Deficit Hyperactivity Disorder (ADHD), anxiety disorder, and marijuana addiction. For example, varenicline, which has positive effects on cognition may provide dual benefit to ADHD smokers by improving attention and focus, while also aiding in smoking cessation. We also have evincing data that varenicline, which is known to reduce withdrawal and the reinforcement received from smoking, also blocks subjective craving and the reward-related neural ‘signature’ of smoking cue exposure, while also blunting smoking cue-induced craving. Our unique perfusion fMRI paradigm allowed us to deduce the mechanisms underlying varenicline’s effectiveness. Further, we have evidence that both marijuana cues and smoking cues activate the same reward-related brain circuitry, suggesting that medications that might aid smokers may also aid marijuana-dependent cigarette smokers. Evidence suggests that an anxiety-prone cue-vulnerable subtype will respond to baclofen, which we have shown has efficacy in a smoking reduction study and blunts both brain activity in reward-related neural activity in the brain in ‘at rest’ and during smoking cue exposure.

Additional studies include the use of the imaging technique, single photon emission computed tomography (SPECT), and the DAT-specific radiotracer, TRODAT to examine whether the DAT-mediated effects on smoking cue reactivity are due to less available or less functional DATs.

Ultimately, the goal for contemporary medicine is to establish brain/behavioral/genetic endophenotypes of medication response, so that treatment strategies can be tailored to manage individual vulnerabilities to aid in conquering this devastating and difficult to treat addiction.

Selected Publications

Dumais Kelly M, Franklin Teresa R, Jagannathan Kanchana, Hager Nathan, Gawrysiak Michael, Betts Jennifer, Farmer Stacey, Guthier Emily, Pater Heather, Janes Amy C, Wetherill Reagan R: Multi-site exploration of sex differences in brain reactivity to smoking cues: Consensus across sites and methodologies. Drug and Alcohol Dependence 178: 469-476, Sep 2017.

Wetherill Reagan R, Franklin Teresa R, Allen Sharon S: Ovarian hormones, menstrual cycle phase, and smoking: a review with recommendations for future studies. Current Addiction Reports 3(1): 1-8, Mar 2016.

Wetherill Reagan R, Jagannathan Kanchana, Hager Nathan, Maron Melanie, Franklin Teresa R: Influence of menstrual cycle phase on resting-state functional connectivity in naturally cycling, cigarette-dependent women. Biology of Sex Differences 7: 24, 2016.

Wetherill Reagan R, Jagannathan Kanchana, Hager Nathan, Childress Anna Rose, Franklin Teresa R: Sex differences in associations between cannabis craving and neural responses to cannabis cues: Implications for treatment. Experimental and Clinical Psychopharmacology 23(4): 238-46, Aug 2015.

Franklin Teresa R, Jagannathan Kanchana, Wetherill Reagan R, Johnson Barbara, Kelly Shannon, Langguth Jamison, Mumma Joel, Childress Anna Rose: Influence of menstrual cycle phase on neural and craving responses to appetitive smoking cues in naturally cycling females. Nicotine & Tobacco Research 17(4): 390-7, Apr 2015.

Wetherill, R.R., Jagannathan, K., Shin, J., Franklin, T.R.: Sex Differences in Resting State Neural Networks of Nicotine-Dependent Cigarette Smokers. Addictive Behaviors 39(4): 789-792, Apr 2014.

Franklin, T.R., Wang, Z., Suh, J.J., Hazan, R., Cruz, J., Li, Y., Goldman, M., Detre, J.A., O'Brien, C.P., Childress, A.R.: Effects of varenicline on smoking cue-triggered neural and craving responses. Archives of General Psychiatry 68(5): 516-526, 2011.

Franklin, T.R., Wang, Z., Sciortino, N., Harper, D., Li, Y., Hakun, J., Kildea, S., Kampman, K., Ehrman, R., Detre, J.A., O'Brien, C.P., Childress, A.R.: Modulation of resting brain cerebral blood flow by the GABA B agonist, baclofen: A longitudinal perfusion fMRI study. Drug and Alcohol Dependence 117(2-3): 176-183, 2011.

Franklin, T.R., Harper, D., Kampman, K., Kildea-McCrea, S., Jens, W., Lynch, K.G., O'Brien, C.P., Childress, A.R.: The GABA B agonist baclofen reduces cigarette consumption in a preliminary double-blind placebo-controlled smoking reduction study. Drug and Alcohol Dependence 103(1-2): 30-36, 2009.

Franklin, T.R., Allen, S.S.: Influence of menstrual cycle phase on smoking cessation treatment outcome: a hypothesis regarding the discordant findings in the literature. Addiction 104(11): 1941-1942, 2009.

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Last updated: 10/10/2023
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