Author Interviews, Depression, Genetic Research, JAMA / 19.04.2019

MedicalResearch.com Interview with: Dr Kimberley Kendall MBBCh Wellcome Trust Clinical Research Fellow Professor James Walters MRC Centre for Neuropsychiatric Genetics and Genomics Professor, Division of Psychological Medicine and Clinical Neurosciences Cardiff University   MedicalResearch.com: What is the background for this study? Response: Copy number variants (CNVs) are the deletion or duplication of large sections of DNA. Large, rare CNVs have been shown to increase the risk of neurodevelopmental disorders including autism spectrum disorder (ASD), intellectual disability (ID), attention deficit/hyperactivity disorder (ADHD) and schizophrenia. However, the impact of these CNVs on risk of depression was unclear from the existing literature. (more…)
Author Interviews, Brain Injury, Stem Cells, Surgical Research, University of Pittsburgh / 18.04.2019

MedicalResearch.com Interview with: Dr. David Okonkwo, M.D., Ph.D., Professor of Neurological surgery Director of the Neurotrauma Clinical Trials Center University of Pittsburgh Dr. Okonkwo discusses the results from the STEMTRA Phase 2 trial evaluating the efficacy and safety of SB623 in patients with chronic motor deficit from traumatic brain injury. The results were presented at the American Association of Neurological Surgeons (AANS), April 2019 MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Traumatic brain injury (TBI) is a major cause of death and disability in the US and around the globe. The effects of TBI are often long-lasting, with more than one-third of severe TBI patients displaying a neuromotor abnormality on physical examination 2 years following injury and, yet, there are no effective treatments. The public health implications are staggering: there are approximately 1.4 million new cases of TBI in the US annually, resulting in over 50,000 deaths and 80,000 disabilities; over 5 million Americans currently suffer from long-term disability caused by TBI. A successful neuroregenerative or neurorestorative therapy, such as stem cell implantation, would have significant impact. (more…)
Author Interviews, Memory, NIH, Sleep Disorders / 17.04.2019

MedicalResearch.com Interview with: Leonardo G. Cohen, M.D., Ph.D., Senior Investigator Marlene Bönstrup, M.D., Postdoctoral fellow in  Dr. Cohen's lab NIH's National Institute of Neurological Disorders and Stroke MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Learning a new skill is typically divided into online (during practice) and offline (after practice has ended) components. Particularly motor skill learning occurs to a considerable degree offline, meaning that performance further improves even after practice has ended. A single practice session itself however, is typically divided into short (level of seconds) periods of practice and rest. In this study, we set out to investigate the contribution of those short periods of practice and rest to the learning during a practice session (i.e. online learning). We found that during early motor skill learning, when most of the total learning occurs, performance improvements actually precipitate during short periods of rest whereas during practice periods, performance mostly stagnated. We found a signature of neural activity predictive of those performance improvements during rest: The lower the beta rhythmic activity in the parietofrontal regions of the brain during those short periods of rest, the higher were participant’s performance jumps.  (more…)
Addiction, Author Interviews, Education, Mental Health Research / 16.04.2019

MedicalResearch.com Interview with: Lina Begdache, PhD, RDN, CDN, CNS-S, FAND Assistant Professor Health and Wellness Studies Department GW 15 Decker School of Nursing Binghamton University  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: College students engage in activities such as binge drinking, abuse of ADHD medications as "study drugs" or use of illicit drugs during a critical brain developmental window that supports maturation of the brain (the prefrontal cortex) necessary for emotional control, cognitive functions and regulation of impulsive behaviors. These activities not only affect brain function, thus mental health and cognitive functions, but may dampen brain development with potential long-lasting effects. As for findings, we were able to identify neurobehavioral patterns that associate with mental wellbeing and mental distress in young adults. Based on evidence from the literature, we constructed conceptual models that describe how one behavior may lead to another until virtuous or vicious cycles set-in.  (more…)
Author Interviews, Depression, Mental Health Research, Vanderbilt / 16.04.2019

MedicalResearch.com Interview with: Lauren Gaydosh, PhD Assistant Professor Center for Medicine, Health, and Society Public Policy Studies Vanderbilt University  MedicalResearch.com: What is the background for this study?   Response: Several years ago, life expectancy at birth in the United States declined, and this decline has continued every year since. Part of the cause underlying this decline is that midlife mortality – deaths among those 45-54 – has been rising. This increase in midlife mortality has been attributed by some to the “deaths of despair” – a cluster of causes of death including suicide, drug overdose, and alcohol-related disease - and has been most pronounced among middle-aged white adults with a HS degree or less. In our research, we wanted to better understand the indicators of despair that would be predictive of these causes of death. Things like depression, substance use, and suicidal ideation. And study them in individuals before the period of elevated risk of death – in other words, before they reached middle age. Our goal was to evaluate whether these markers of despair were rising for a younger cohort, and whether this pattern was isolated to white adults with low education. (more…)
Author Interviews, Cognitive Issues, Memory, University Texas / 16.04.2019

MedicalResearch.com Interview with: Dr. Sandra Bond Chapman PhD Founder and Chief Director, Center for BrainHealth, Co-Leader, The BrainHealth Project University of Texas, Dallas MedicalResearch.com: What is the background for this study? Response: Finding effective treatments to reverse or slow rates of cognitive decline for those at risk for developing dementia is one of the most important and urgent challenges of the 21st century. Brain stimulation is gaining attention as a viable intervention to increase neuroplasticity when used in isolation or when combined with cognitive training regimens. Given the growing evidence that certain cognitive training protocols, such as SMART, benefit people with Mild Cognitive Impairment (MCI), a population that is vulnerable to Alzheimer’s disease, we were interested in exploring whether we could further increase the gains from cognitive training (i.e., SMART) when the training was preceded by brain stimulation using tDCS.  (more…)
Aging, Author Interviews, Cognitive Issues, Lifestyle & Health / 13.04.2019

MedicalResearch.com Interview with: Carla R. Schubert, MS Researcher,  EpiSense Research Program Dept. of Ophthalmology & Visual Sciences School of Medicine and Public Health University of Wisconsin Madison, WI  53726-2336  MedicalResearch.com: What is the background for this study? Response: Mildlife is an important time-period for health later in life and also when declines in sensory and cognitive functions may begin to occur. Hearing, vision and smell impairments have been associated with cognitive impairments in older adults and with worse cognitive function in middle-aged adults.  These associations may be reflecting the close integration of sensory and cognitive systems as both require good brain function. (more…)
Author Interviews, Cognitive Issues, Environmental Risks, Pediatrics, Toxin Research / 12.04.2019

MedicalResearch.com Interview with: Edson R. Severnini PhD Assistant Professor Of Economics And Public Policy Carnegie Mellon University MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Although lead has been banned from gasoline, paint, and other substances in the United States and many other countries around the world, the legacy of lead use is a critical environmental and public health issue. Surface soil contamination, in particular, has been long recognized as an important pathway of human lead exposure, and is now a worldwide health concern. This study estimates the causal effects of exposure to lead in topsoil on cognitive ability among 5-year-old children. We draw on individual level data from the 2000 U.S. Census, and USGS data on lead in topsoil covering a broad set of counties across the United States. We find that higher lead in topsoil increases considerably the probability of 5-year-old boys experiencing cognitive difficulties such as learning, remembering, concentrating, or making decisions. Living in counties with topsoil lead concentration above the national median roughly doubles the probability of 5-year-old boys having cognitive difficulties. This harmful effect does not seem to extend to 5-year-old girls, potentially due to the natural protection of estrogen.  (more…)
Alzheimer's - Dementia, Author Interviews, Merck, NEJM / 10.04.2019

MedicalResearch.com Interview with: Michael F. Egan, MDVice President,  NeuroscienceGlobal Clinical DevelopmentMerck Research LaboratoriesNorth Wales, PAMichael F. Egan, MD Vice President,  Neuroscience Global Clinical Development Merck Research Laboratories North Wales, PA  MedicalResearch.com: What is the background for this study?   Response: Alzheimer’s disease (AD) appears to be due to the gradual accumulation of amyloid over many years (the “amyloid hypothesis”). At some point, it is thought that amyloid triggers abnormalities in tau, which then forms deposits within neurons and leads to progressive neurodegeneration. Amyloid is made up of  a small, sticky peptide, Abeta, which is produced when the enzyme BACE cleaves a large protein called APP.  In our trial, we tested whether a potent BACE inhibitor, verubecestat, could slow disease progression in subjects with early AD (or prodromal AD) by blocking formation of Abeta.  A previous trial in subjects with dementia due to AD failed to find evidence of efficacy. One possible reason for this failure is that subjects had too much amyloid in their brain already. (more…)
Author Interviews, Depression, Exercise - Fitness, JAMA, Parkinson's / 10.04.2019

MedicalResearch.com Interview with: Dr. Jojo Kwok  R.N., BN(Hons), MPH, Ph.D. School of Nursing, Li Ka Shing Faculty of Medicine The University of Hong Kong MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Before the study, we knew that mind-body exercises such as yoga and stretching improves the physical health of patients with Parkinson’s disease (PD), however the benefits to their mental health was not known. This study concludes that mindfulness yoga alleviates psychological distress, improves spiritual well-being and quality of life, not to mention motor symptoms and mobility. When it comes to managing the stress and symptoms of Parkinson Disease, what is exciting, is that yoga has now been proven to be a better strategy than just stretching. Yoga draws together body, mind and spirit through mindful practice of 1) yoga posture, 2) breathing and 3) meditation. These form the three core components of our Mindfulness Yoga Program. Mindfulness is non-judgemental awareness of the present moment - of one’s physical sensations and thoughts, be they positive or negative. By adopting a mind-body approach, patients are much better positioned to reframe their illness journey than through physical training alone. By learning to relate non-judgmentally to their physical symptoms and emotions, they develop new coping skills that cultivate openness, acceptance and resilience to these symptoms. They feel better.  (more…)
Author Interviews, Autism, Occupational Health / 08.04.2019

MedicalResearch.com Interview with: Ginny Russell, PhD College of Medicine and Health, University of Exeter Medical School University of Exeter Exeter United Kingdom  MedicalResearch.com: What is the background for this study? What are the main findings? Response: The study was done to find out what autistic adults could tell us about their own abilities. They told us about their abilities and how these abilities had helped them in their everyday lives: at work, in their relationships with other people, and at home. Hyper focus, attention to detail, and the ability to remember were the abilities that autistic people said benefitted them most often. But autistic adults who were interviewed said although their autistic traits were sometimes helpful, at other times they hindered their progress. So the same trait might be useful in some circumstances and unhelpful in other situations. For example, hypersensitivity led one person to enjoy nature, but was difficult to cope with in crowded streets. The study highlights this interchangeability. (more…)
ADHD, Author Interviews, JAMA, OBGYNE, Pediatrics, Pharmacology / 08.04.2019

MedicalResearch.com Interview with: Dr. Angela Lupattelli, PhD School of Pharmacy University of Oslo MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Between 1-4% of pregnant women take at least once a benzodiazepine and/or a z-hypnotic medication during the course of gestation. These medications are generally used intermittently in pregnancy, mainly for treatment of anxiety disorders and sleeping problems, which are not uncommon conditions among pregnant women. However, data regarding the safety of benzodiazepine and/or a z-hypnotic in pregnancy on child longer-term development are sparse. For instance, studies on child motor skills are only available up to toddler age, and little is known in relation to other child developmental domains. So, there is an urgent need to better understand whether prenatal use of benzodiazepine and/or a z-hypnotic medication may pose detrimental longer-term child risks. (more…)
Addiction, Author Interviews, Mental Health Research, Occupational Health, Social Issues / 08.04.2019

MedicalResearch.com Interview with: Hefei Wen, PhD Assistant Professor, Department of Health Management & Policy University of Kentucky College of Public Health MedicalResearch.com: What is the background for this study? Response: Work requirements condition Medicaid eligibility on completing a specified number of hours of employment, work search, job training, or community service. Little is known about how behavioral health and other chronic health conditions intersect with employment status among Medicaid enrollees who may be subject to work requirements. (more…)
Author Interviews, Diabetes, Genetic Research, JAMA, Mental Health Research, Schizophrenia / 03.04.2019

MedicalResearch.com Interview with: Prof Sabine Bahn MD PhD MRCPsych FRSB Cambridge Centre for Neuropsychiatric Research Jakub Tomasik, PhD Department of Chemical Engineering and Biotechnology University of Cambridge   MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Schizophrenia patients are at increased risk of impaired glucose metabolism, yet the comorbidity between the two conditions cannot be fully explained by known risk factors such as obesity, smoking, stress or antipsychotic medication. Previous family and genome-wide studies have suggested that the co-occurrence between schizophrenia and impaired glucose metabolism might be due to shared genetic factors, as exemplified by increased risk of diabetes in first-degree relatives of schizophrenia patients, but the biological mechanisms underlying this association remain unknown. We examined the association between insulin resistance, schizophrenia polygenic risk and response to treatment in 58 drug-naive schizophrenia patients and 58 matched healthy individuals while controlling for a range of demographic (age, gender, body mass index), lifestyle (smoking, alcohol and cannabis use) and clinical (psychopathology scores, treatment drug) factors. We found that insulin resistance, a key feature contributing to the development of type 2 diabetes, significantly correlated with schizophrenia polygenic risk score in patients, with higher genetic risk of schizophrenia associated with increased insulin resistance. Furthermore, we found that patients with higher insulin resistance were more likely to switch medication during the first year of treatment, which implies lower clinical response.  (more…)
Accidents & Violence, Alzheimer's - Dementia, Author Interviews, JAMA, Mental Health Research / 28.03.2019

MedicalResearch.com Interview with: Madeleine Liljegren, MD Division of Oncology and Pathology Department of Clinical Sciences Lund University Lund, Sweden MedicalResearch.com: What is the background for this study? What are the main findings? Response: We know from former studies including patients with a clinical diagnosis of dementia, that criminal and socially inappropriate behaviors can be signs of dementia, sometimes even the first signs of a neurodegenerative disorder. We wanted to study this relatively large (n=220) cohort of neuropathologically verified Alzheimer disease (AD) and frontotemporal dementia (FTD) patients, who had been followed clinically by specialists in cognitive medicine or geriatric psychiatry during their disease period, to see if we could confirm results from previous studies. In this paper, we further wanted to study potential differences regarding protein pathology and criminal behavior in frontotemporal dementia patients. This has, to our knowledge, never been done before. (more…)
Author Interviews, Environmental Risks, JAMA, Mental Health Research, Pediatrics / 28.03.2019

MedicalResearch.com Interview with: “air pollution, beijing” by 大杨 is licensed under CC BY 2.0Joanne B. Newbury, PhD ESRC Postdoctoral Fellow King’s College London Social, Genetic & Developmental Psychiatry Centre Institute of Psychiatry, Psychology & Neuroscience London, United Kingdom MedicalResearch.com: What is the background for this study? Response: Urban living is one of the most well-established risk factors for adult psychotic disorders such as schizophrenia. However, less is known about the role of the urban environment in subclinical psychotic experiences in childhood and adolescence, such as hearing voices and extreme paranoia. These early psychotic experiences are a developmental risk factor for adult psychotic disorders and a range of other serious mental health problems such as depression and anxiety. It is therefore important that we understand what factors might contribute to the development of early psychotic experiences so that we might be able to intervene and prevent their onset and progression. In a cohort of over 2000 UK-born children (The Environmental Risk Longitudinal Twin Study), we have previously shown that subclinical psychotic experiences are also around twice as common among children and teenagers raised in urban versus rural settings. We have also shown that this appears to be partly explained by social features in urban neighbourhoods such as higher crime levels and lower levels of social cohesion. However, no studies have examined the potential link between air pollution and psychotic experiences. This is despite air pollution being a major health problem worldwide (particularly in cities), and despite emerging evidence linking air pollution to the brain.  (more…)
Author Interviews, Cannabis, JAMA, Mental Health Research, OBGYNE / 28.03.2019

MedicalResearch.com Interview with: Jeremy Fine B.A. in Philosophy, Neuroscience, and Psychology Washington University in St. Louis, Class of 201 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Alongside increasingly permissive marijuana use attitudes and laws, the prevalence of marijuana use among pregnant mothers has increased substantially (by 75% between 2002 and 2016), with some evidence that pregnant women may be using cannabis to combat pregnancy-related nausea. Our data came from the Adolescent Brain Cognitive Development (ABCD) Study, which included over 4,000 subjects with data on maternal marijuana use during pregnancy. Our main finding was that the children of mothers who used marijuana after learning they were pregnant had a small but significant increase in risk for psychosis in their future. (more…)
Author Interviews, Autism, Social Issues, University of Pittsburgh, Vaccine Studies / 26.03.2019

MedicalResearch.com Interview with: Beth Hoffman, B.Sc., graduate student University of Pittsburgh Graduate School of Public Health Research Assistant, University of Pittsburgh Center for Research on Media, Technology and Health MedicalResearch.com: What is the background for this study? What are the main findings? Response: Vaccine refusal is a public health crisis - low vaccination rates are leading to outbreaks of deadly vaccine-preventable diseases. In 2017, Kids Plus Pediatrics, a Pittsburgh-based pediatric practice, posted a video on its Facebook pagef eaturing its practitioners encouraging HPV vaccination to prevent cancer. Nearly a month after the video posted, it caught the attention of multiple anti-vaccination groups and, in an eight-day period, garnered thousands of anti-vaccination comments. Our team analyzed the profiles of a randomly selected sample of 197 commenters in the hopes that this crisis may be stemmed if we can better understand and communicate with vaccine-hesitant parents. We determined that, although Kids Plus Pediatrics is an independent practice caring for patients in the Pittsburgh region, the commenters in the sample were spread across 36 states and eight countries. By delving into the messages that each commenter had publicly posted in the previous two years, we also found that they clustered into four distinct subgroups:
  • “trust,” which emphasized suspicion of the scientific community and concerns about personal liberty;
  • “alternatives,” which focused on chemicals in vaccines and the use of homeopathic remedies instead of vaccination;
  • “safety,” which focused on perceived risks and concerns about vaccination being immoral; and
  • “conspiracy,” which suggested that the government and other entities hide information that this subgroup believes to be facts, including that the polio virus does not exist. 
(more…)
Author Interviews, Depression, Dermatology / 24.03.2019

MedicalResearch.com Interview with: Dr. Jonathan L. Silverberg MD PhD MPH Assistant Professor in Dermatology Medical Social Sciences and Preventive Medicine Northwestern, Chicago, Illinois MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Atopic Dermatitis is characterized by chronic and often severe and debilitating itch, skin pain, sleep disturbances, skin lesions and multiple comorbid health conditions. The signs, symptoms and comorbidities of atopic dermatitis can lead to significant psychosocial distress and mental health burden We performed a cross-sectional, population-based study of 2893 US adults. We found that adults with atopic dermatitis had more severe symptoms scores for anxiety and depression (Hospital Anxiety and Depression anxiety). Adults with atopic dermatitis also had higher prevalences of anxiety and depression. Mean symptom scores and prevalences of anxiety and depression were even higher in adults with moderate and severe atopic dermatitis compared to those with mild atopic dermatitis. All respondents with severe PO-SCORAD, POEM and PO-SCORAD-itch scores had elevated anxiety and depression scores. Many adults with atopic dermatitis that had elevated anxiety and depression scores reported no diagnosis of anxiety or depression.  (more…)
Author Interviews, Infections, Schizophrenia / 21.03.2019

MedicalResearch.com Interview with: Dr. Ed Breitschwerdt, DVM, DACVIM Melanie S. Steele Distinguished Professor of Internal Medicine NC State MedicalResearch.com: What is the background for this case report?  Can you briefly explain the signs/symptoms of a Bartonella infection? Response: Bartonella henselae is a bacteria most commonly associated with cat scratch disease, which until recently was thought to be a short-lived (or self-limiting) infection. There are now at least 40 different known species of Bartonella, 13 of which have been found to infect human beings. The ability to find and diagnose Bartonella infection in animals and humans – it is notorious for “hiding” in the linings of blood vessels – has led to its identification in patients with a host of chronic illnesses ranging from migraines to seizures to rheumatoid illnesses, some of which the medical community previously hadn’t been able to attribute to a specific cause. Evolving data suggests a role for these bacteria in a spectrum of cardiovascular, neurological and rheumatological diseases. Specific symptoms or diseases that have been reported with neurobartonellosis previously include encephalitis, headaches, migraines, demyelinating polyneuropathy, neuroretinitis and transverse myelitis. Documentation of Bartonella henselae blood stream infection in a boy diagnosed with Schizophrenia and Pediatric Acute-onset Neuropsychiatric Syndrome (PANS) extends the spectrum of symptomatology associated with neurobartonellosis. (more…)
Author Interviews, Gender Differences, Mental Health Research, OBGYNE, Psychological Science / 20.03.2019

MedicalResearch.com Interview with Haley Kranstuber Horstman, Ph.D. Department of Communication University of Missouri MedicalResearch.com: What is the background for this study? Response: Miscarriage is a prevalent health concern, with one in five pregnancies ending in miscarriage, which is a pregnancy loss before 20 weeks’ gestation. Past research has shown that women who have miscarried often suffer mental health effects such as heightened grief, depression, loneliness, and suicidality. Although much of the research on coping with miscarriage has focused on women’s health, many miscarriages occur within romantic relationships and affect the non-miscarrying partner as well. Women in heterosexual marriages report that their husband is often their top support-provider. Past research has shown that husbands suffer with mental health effects after a miscarriage, sometimes for even longer than their wives, but are not often supported in their grief because miscarriage is a “woman’s issue” and they feel uncomfortable talking about it. (more…)
Author Interviews, Depression, Nutrition, Supplements, Weight Research / 08.03.2019

MedicalResearch.com Interview with: Prof. Marjolein Visser PhD Professor of Healthy Aging Head section Nutrition and Health Department of Health Sciences, Vrije Universiteit Amsterdam Amsterdam Public Health research institute MedicalResearch.com: What is the background for this study? What are the main findings? Response: More than 40 million Europeans experience a major depressive disorder. One in ten men, and one in five women suffer from clinical depression at least once during their lifetime. Depression is one of the most prevalent and disabling disorders in the EU. Given the increasing prevalence of depression, more people are actively searching for ways to decrease their risk through lifestyle modification, but are often overwhelmed by confusing and contradictory information. The MooDFOOD prevention trial is the largest randomized clinical trial to study the effects of nutritional strategies on the prevention of major depressive disorder. Over 1000 overweight or obese participants identified as being at elevated risk for depression but who were not currently depressed, from four European countries -the Netherlands, the United Kingdom, Germany and Spain, took part in the study. Participants were randomized to either take nutritional supplements containing folic acid, vitamin D, zinc, selenium or to a pill placebo, and half of participants also received a behavioral lifestyle intervention intended to change dietary behaviors and patterns. (more…)
Alzheimer's - Dementia, Author Interviews, BMJ, Hormone Therapy / 07.03.2019

MedicalResearch.com Interview with: Tomi Mikkola MD Associate Professor Helsinki University Hospital Department of Obstetrics and Gynecology Helsinki, Finland MedicalResearch.com: What is the background for this study? What are the main findings? Response: In Finland we have perhaps the most comprehensive and reliable medical registers in the world. Thus, with my research group I have conducted various large studies evaluating association of postmenopausal hormone therapy use and various major diseases (see e.g. the references in the B;MJ paper). There has been various smaller studies indicating that hormone therapy might be protective for all kinds of dementias, also Alzheimer’s disease. However, we have quite recently shown that hormone therapy seems to lower the mortality risk of vascular dementia but not Alzheimer’s disease (Mikkola TS et al. J Clin Endocrinol Metab 2017;102:870-7). Now in this upcoming BMJ-paper we report in a very large case-control study (83 688 women with Alzheimer’s disease and same number of control women without the disease) that systemic hormone therapy was associated with a 9-17% increased risk of Alzheimer’s disease. Furthermore, this risk increase is particularly in women using hormone therapy long, for more than 10 years. This was somewhat surprising finding, but it underlines the fact that mechanisms behind Alzheimer’s disease are likely quite different than in vascular dementia, where the risk factors are similar as in cardiovascular disease. We have also shown how hormone therapy protects against cardiovascular disease, particularly in women who initiate hormone therapy soon after menopause. (more…)
Author Interviews, Depression, OBGYNE, Weight Research / 05.03.2019

MedicalResearch.com Interview with: Jun Ma, MD, PhD, FAHA, FABMR Professor and Associate Head of Research Department of Medicine Director, Center for Health Behavior Research The University of Illinois at Chicago MedicalResearch.com: What is the background for this study? What are the main findings? Response: Obesity and depression are major public health problems. Obesity affects 40% of United States (US) adults. About 20% in US women and 13% in men experience major depressive disorder at some point in their lifetime and, additionally, many adults have elevated depressive symptoms that do not meet clinical diagnostic criteria but can nevertheless negatively affect their health and quality of life. Obesity and depression share common risk factors, such as poor diet and lack of exercise, and cause other health problems, such as diabetes and cardiovascular disease. People with obesity are at increased risk of being depressed and, likewise, people with depression are at increased risk of being obese. Consequently, obesity and depression often co-occur. To date, there has been no integrated therapy to effectively treat patients affected by both conditions at the same time. The RAINBOW randomized clinical trial addressed this gap. The main finding from the trial is that, among adult patients with obesity and depression, a collaborative care intervention integrating behavioral weight loss treatment, problem-solving therapy, and as-needed antidepressant medications significantly improve weight loss and depressive symptoms over one year compared with usual care, which patients received through their primary care physicians.  (more…)
Author Interviews, Brigham & Women's - Harvard, Health Care Systems, JAMA, Mental Health Research / 04.03.2019

MedicalResearch.com Interview with: Mark S. Bauer, M.D. Professor of Psychiatry, Emeritus Harvard Medical School Center for Healthcare Organization and Implementation Research VA Boston Healthcare System-152M Boston, MA 02130 MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Collaborative Chronic Care Models (CCMs) have extensive evidence for their effectiveness in a wide variety of mental health conditions.  CCMs are frameworks of care that include several or all of the following six elements:  work role redesign for anticipatory, continuous care; self-management support for individuals in treatment; provider decision support; information system support for population-based and measurement-guided care; linkage to community resources; and organization and leadership support. However, evidence for Collaborative Chronic Care Model effectiveness comes almost exclusively from highly structured clinical trials.  Little is known about whether CCMs can be implemented in general clinical practice settings, and the implementation evidence that does exist derives primarily from studies of the CCM used in primary care settings to treat depression. We conducted a randomized, stepped wedge implementation trial using implementation facilitation to establish CCMs in general mental health teams in nine US Department of Veterans Affairs medical centers. We found that establishing Collaborative Chronic Care Models was associated with reduced mental health hospitalization rates and, for individuals with complex clinical presentations, improvements in mental health status.  Additionally, standardized assessment of team clinicians indicated that facilitation improved clinician role clarity and increased focus on team goals. (more…)
Author Interviews, Cognitive Issues, Education, Social Issues / 04.03.2019

MedicalResearch.com Interview with: Marja Aartsen, PhD Research professor at NOVA Norwegian Social Research / OsloMet Oslo Metropolitan University MedicalResearch.com: What is the background for this study? What are the main findings? Response: Our study is part of a larger project “Life course influences on health trajectories at older age” conducted at the University of Geneva, of which dr. Stéphane Cullati is the principle investigator (see for more information on the project https://cigev.unige.ch/index.php?cID=887). The aim of that research project is to examine in what way retrospective life course precursors from childhood to late adulthood have long-term impacts on current health trajectories at older age. A number of studies in this project are now published among which our study on childhood conditions and cognitive functioning and cognitive decline in later life. In our research, we were particularly interested in the origins of cognitive decline in later life.  Studies among children show that the childhood is an important phase in the development of the brain. Growing up in environments in which people are cognitively stimulated stimulates the brain to develop more complex neuronal networks and larger brain reserves, which may compensate for the neuronal losses that occur when people get older. This effect is long visible, even at old age as a number of important studies recently provided quite solid evidence for the beneficial effect of advantaged childhood conditions on level of cognitive functioning in later life. However, not many studies investigated the relation between childhood conditions and the speed of cognitive decline in later life. Those that did found inconsistent results. We reasoned that part of the inconsistencies in study findings might stem from differences in the analytical approach (not sensitive enough), too little cognitive change because of a short follow-up, too young people, or too small sample (all causing too little power to find statistically significant effects) or differences in the measurement of the childhood conditions. To overcome these potential limitations, we used a large study sample with long follow-up, used a multidimensional measurement of childhood condition, and applied a powerful analytical technique.  (more…)
Author Interviews, Cognitive Issues, Heart Disease, JAMA, Stroke / 04.03.2019

MedicalResearch.com Interview with: Sarah Parish, MSc, DPhil Professor of Medical Statistics and Epidemiology MRC Population Health Research Unit Nuffield Department of Population Health University of Oxford MedicalResearch.com: What is the background for this study? Response: Acquiring reliable randomized evidence of the effects of cardiovascular interventions on cognitive decline is a priority. In this secondary analysis of 3 randomized intervention trials of cardiovascular event prevention, including 45 029 participants undergoing cognitive testing, we estimated the association of the avoidance of vascular events with differences in cognitive function in order to understand whether reports of non-significant results exclude worthwhile benefit.  (more…)
Alzheimer's - Dementia, Author Interviews, JAMA, Pharmacology, University of Pittsburgh / 01.03.2019

MedicalResearch.com Interview with: Alvaro San-Juan-Rodriguez, PharmD Pharmacoeconomics, Outcomes and Pharmacoanalytics Research Fellow Pharmacy and Therapeutics School of Pharmacy University of Pittsburgh MedicalResearch.com: What are the main findings? Response: Currently, there are 4 antidementia drugs approved by the FDA for the treatment of Alzheimer’s disease, including 3 acetylcholinesterase inhibitors (AChEIs)—donepezil, rivastigmine, and galantamine—and the N-methyl-D-aspartic receptor antagonist memantine. On the one hand, evidence about the effect of these drugs at delaying nursing home admission is still sparse and conflicting. On the other, all these antidementia medications have been associated with several cardiovascular side effects, such as bradycardia, ventricular tachycardia, syncope, QT interval prolongation, atrioventricular block or even myocardial infarction. In this study, we aimed to compare time to nursing home admission and time to cardiovascular side effects across all drug therapies available for the treatment of Alzheimer’s disease. In doing so, we used 2006-2014 medical and pharmacy claims data from Medicare Part D beneficiaries with a new diagnosis Alzheimer’s disease who initiated antidementia drug therapy. (more…)
Author Interviews, JAMA, Mental Health Research, Pharmacology / 01.03.2019

MedicalResearch.com Interview with: Kuan-Pin Su, MD, PhD China Medical University Taichung, Taiwan MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Delirium, also known as acute confusional state, is a serious disturbance in mental abilities that results in confused thinking and reduced awareness of the environment. Delirium can often be traced to one or more contributing factors, such as a severe or chronic illness, changes in metabolic balance (such as low sodium), medication, infection, surgery, or alcohol or drug intoxication or withdrawal. It’s critically important to identify and treat delirium because some of the contributing factors could be life-threatening. However, there is no sufficient evidence for choice of medication to treat or prevent the symptoms of delirium. A recent paper, Association of Delirium Response and Safety of Pharmacological Interventions for the Management and Prevention of Delirium A Network Meta-analysis, published in JAMA Psychiatry provides important findings of this missing piece in that important clinical uncertainty. The leading author, Professor Kuan-Pin Su, at the China Medical University in Taichung, Taiwan, concludes the main finding about treatment/prevention of delirium: “In this report, we found that the combination of haloperidol and lorazepam demonstrated the best option for treatment of delirium, while ramelteon for prevention against delirium.  (more…)
Author Interviews, JAMA, Karolinski Institute, Pharmacology, Schizophrenia / 24.02.2019

MedicalResearch.com Interview with: Jari Tiihonen, MD, PhD Professor, Department of Clinical Neuroscience Karolinska Institutet Stockholm, Sweden  MedicalResearch.com: What is the background for this study? Response: The effectiveness of antipsychotic combination therapy in schizophrenia relapse prevention is controversial, and use of multiple agents is generally believed to impair physical well-being. But the evidence for this are weak and antipsychotic polypharmacy is widely used. (more…)