Author Interviews, Biomarkers, Brain Injury, JAMA / 21.11.2017

MedicalResearch.com Interview with: Dr. Steven D. Hicks,  M.D., Ph.D Penn State Health MedicalResearch.com: What is the background for this study? What are the main findings? Response: Previous research has shown that small epigenetic molecules called microRNAs are altered in the blood after a traumatic brain injury. Our own pilot research showed that microRNAs were also changed in the saliva after brain injury and that some of these changes mirrored changes in cerebrospinal fluid. In this study we investigated whether salivary microRNA patterns after a concussion could be used to predict the duration and character of symptoms one month after injury. We found that levels of five microRNAs predicted presence of symptoms one month later with greater accuracy (~85%) than standard surveys of symptom burden (~65%). Interestingly, one of the predictive salivary microRNAs (miR-320c) targets pathways involved in synaptic plasticity and was significantly correlated with attention difficulties one month after concussive injury.   (more…)
Author Interviews, JAMA, Mental Health Research, Pediatrics / 21.11.2017

MedicalResearch.com Interview with: Julie M. Zito, PhD Professor of Pharmacy and Psychiatry University of Maryland, Baltimore Pharmaceutical Health Services Department Baltimore, MD 21201  MedicalResearch.com: What is the background for this study? What are the main findings? Response: The growth of antipsychotic use in children, mainly for the treatment of behavior, has been of increasing concern in recent years. Clinical safety issues (Burcu et al. 2017) and government reports on overuse in the treatment of poor and foster care children (GAO, 2017; 2012) motivated our assessment of peer review programs. These programs are a relatively new approach to Medicaid oversight intended to monitor and assure clinical appropriateness of second generation antipsychotics in children. Critically important is the fact that most antipsychotic use is for child behavioral problems which are off-label conditions, i.e. without sufficient evidence of effectiveness or safety. (more…)
Author Interviews, Education, JAMA, Karolinski Institute, Mental Health Research / 16.11.2017

MedicalResearch.com Interview with: Ana Pérez-Vigil MD Department of Clinical Neuroscience Child and Adolescent Psychiatry Research Center Karolinska Institutet MedicalResearch.com: What is the background for this study? Response: Everyone who regularly works with persons who have obsessive-compulsive disorder (OCD) has seen that their patients often struggle with school work. It is not uncommon for these individuals to have poor school attendance and severe patients can be out of the education system altogether. This applies to persons of all ages, from school children to young adults who may be at university. On the other hand there is a group of patients who, against all odds, working 10 times as hard as everybody else, manage to stay in education and eventually get a degree. So we have long suspected that OCD has a detrimental impact on the person’s education, with all the consequences that this entails (worse chances to enter the labour market and have a high paid job). But we did not really know to what extent OCD impacts education. So we wanted to know what is the actual impact of OCD on educational attainment using objectively collected information from the unique Swedish national registers. Previous work had been primarily based on small clinical samples from specialist clinics, using either self or parent report and cross-sectional designs. Previous work also tended not to control for important confounders such as psychiatric comorbidity or familial factors (genetic and environmental factors that could explain both OCD and the outcomes of interest). (more…)
Author Interviews, Cognitive Issues, Compliance, HIV, JAMA / 16.11.2017

MedicalResearch.com Interview with: Ryan Sanford, MEng Department of Neurology and Neurosurgery Montreal Neurological Institute McGill University, Montréal, Québec, Canada   MedicalResearch.com: What is the background for this study? What are the main findings? Response: With the introduction of combination antiretroviral therapy (cART) the outlook for HIV+ individuals has dramatically shifted from a fatal disease to a chronic manageable condition. However, HIV-associated neurocognitive disorders are still prevalent. The etiology of this dysfunction remains unknown. Previous work has reported progressive brain atrophy in HIV+ individuals with advanced disease and poor viral suppression, but it is unclear whether stable treatment and effective viral suppression can mitigate the progression of brain atrophy. To examine this issue, we followed well-treated HIV+ individuals with good viral suppression and well-matched controls, and assessed whether ongoing brain atrophy occurs over time. The main finding in this study was the HIV+ participants had reduced brain volumes and poorer cognitive performance compared to the control group, but the changes in brain volumes and cognitive performance were similar between the groups. (more…)
Alzheimer's - Dementia, Author Interviews, NYU, Obstructive Sleep Apnea / 15.11.2017

MedicalResearch.com Interview with: Ricardo S Osorio MD Center for Brain Health Department of Psychiatry Center of Excellence on Brain Aging NYU Langone Medical Center New York, NY 10016, USA  MedicalResearch.com: What is the background for this study? What are the main findings? Response: This was a study that was performed in a group of healthy normal elderly from the community that volunteered for studies on memory and aging. The main findings were that sleep apnea was very common, in almost all cases undiagnosed, and that it was associated with a longitudinal increase in amyloid burden which is considered one of the hallmark lesions of Alzheimer's disease (more…)
Author Interviews, Autism, Genetic Research, Nature / 12.11.2017

MedicalResearch.com Interview with: Woo-Yang Kim, Ph.D Associate Professor Department of Developmental Neuroscience Munroe-Meyer Institute University of Nebraska Medical Center Omaha, NE 68198-5960 MedicalResearch.com: What is the background for this study? What are the main findings? Response:  Autism impairs the ability of individuals to communicate and interact with others. About 75 percent of individuals with autism also have intellectual disability, which is characterized by significant limitations in cognitive functions and adaptive behaviors. While autism and intellectual disability are currently defined using behavioral criteria, little is known about the neuropathogenesis of these conditions. Recent genetic studies have reported that haploinsufficiency of ARID1B causes autism and intellectual disability. However, the neurobiological function of ARID1B during brain development is unknown. Our study investigated the neurobiological role of the gene in brain development. Using genetically-modified mice, we found that Arid1b haploinsufficiency leads to an excitation-inhibition imbalance by reducing the number of GABAergic interneurons in the cerebral cortex. Furthermore, we showed that treatment with a GABAA-receptor positive allosteric modulator rescues ASD-like behavior and cognitive dysfunction in Arid1b-haploinsufficient mice, suggesting an association between lower numbers of GABAergic interneurons and behavioral outcomes. Our findings suggest a pathogenic mechanism for Autism Spectrum Disorder and intellectual disability. (more…)
Author Interviews, Biomarkers, Brain Injury, Lancet / 09.11.2017

MedicalResearch.com Interview with: Prof.dr. J van der Naalt PhD Department of Neurology University Medical Center Groningen Groningen, The Netherlands MedicalResearch.com: What is the background for this study? What are the main findings? Response: Mild traumatic brain injury occurs frequently and is one of the leading cause of morbidity in adults worldwide. It is a major social-economic problem with one in three patients had persistent complaints several months after injury that interfere with resumption of daily activities and work. One of the most important questions concerns the finding that some patients recover without complaints and others do not after sustaining a mild traumatic brain injury. In a follow-up study with more than 1000 participants we found that personality factors are a major factor in the recovery process. In particular coping, that is the way patients adapt to persistent complaints, is important next to emotional distress and impact of the injury. In an add-on study with fMRI we found that in the early phase after injury, the interaction between specific brain networks was temporarily changed. However, when regarding persistent posttraumatic complaints , specific personality characteristics significantly determine long term outcome. (more…)
Author Interviews, HIV, Mental Health Research, Pediatrics / 08.11.2017

MedicalResearch.com Interview with: Marcin Jankiewicz  University of Cape Town Cape Town, South AfricaMarcin Jankiewicz  University of Cape Town Cape Town, South Africa  MedicalResearch.com: What is the background for this study? Response: The Children with HIV Early Antiretroviral (CHER) trial, conducted in Cape Town and Soweto, was designed when there was uncertainty whether to start antiretroviral therapy (ART) as soon as HIV was diagnosed (below 12 weeks of age) or to wait until there was evidence of immuno-compromise and disease progression. Also, there were concerns about maintaining adherence, long-term toxicity and also resistance in the setting of few antiretroviral options. Early outcomes showed a decreased risk in childhood mortality in the early treatment arms compared to deferred treatment, becoming standard of care globally. The CHER cohort is one of the largest and best documented of children receiving ART within the first year of life. Also, age- and community-matched HIV exposed uninfected (HEU) and HIV unexposed (HU) uninfected infants were enrolled in parallel for a linked vaccine study. We therefore had an amazing opportunity to link with a neurodevelopmental sub-study in participants from Cape Town and apply sophisticated neuroimaging modalities that could link with clinical, virological and immunological characteristics. (more…)
Author Interviews, Depression, Kidney Disease, UT Southwestern / 08.11.2017

MedicalResearch.com Interview with: Dr. Susan Hedayati MD Yin Quan-Yuen Distinguished Professorship in Nephrology University of Texas Southwestern Dallas, Texas MedicalResearch.com: What is the background for this study? What are the main findings? Response: We previously showed that Major Depression is associated with a significantly higher risk of death, dialysis initiation, and hospitalization among patients with Chronic Kidney Disease (CKD). Now we show that a common antidepressant medication, a selective serotonin reuptake inhibitors (SSRI), sertraline, does not improve depression in this patient population, a chronically ill group that is not only at significantly increased risk for developing depression but also its serious complications. (more…)
Author Interviews, Autism, Pharmacology / 07.11.2017

MedicalResearch.com Interview with: Dr. Mark E. Gurney, PhD MBA Chairman & CEO, Tetra Discovery Partners Inc. MedicalResearch.com: What is the background for this study? What are the main findings? Response: Fragile X is a genetic condition. Affected patients display a range of behavioral and other symptoms, including seizures, sleep disorders, anxiety, irritability, hyperactivity, autism, mild-to-severe cognitive impairment and intellectual disability. BPN14770 is a novel therapeutic agent that selectively inhibits phosphodiesterase-4D (PDE4D). Inhibition of PDE4 has been validated as a treatment strategy by many research groups in the Fragile X field, but non-selective PDE4 inhibitors have been associated with significant GI side-effects that have limited those drugs’ use. As a selective inhibitor, such side-effects were not seen for BPN14770 in a Phase 1 clinical trial in healthy young and elderly adults. In the current study, daily treatment of Fragile X knock-out (FXS) mice with BPN14770 showed a reduction in hyperarousal, improved social interactions and natural behaviors, and changes in nerve structure in the prefrontal cortex of the brain, the portion of that brain associated with cognition. Moreover, the drug’s benefit persisted for two weeks after all drug was cleared from the mice. At the same time, the behavior of normal mice treated with the drug remained unchanged. Examination of neurons from the prefrontal cortex of the treated FXS mice showed an improvement in dendritic spine morphology. (more…)
Author Interviews, Heart Disease, JAMA, Mental Health Research / 07.11.2017

MedicalResearch.com Interview with: Dr. Keun-Hwa Jung MD PhD Program in Neuroscience, Neuroscience Research Institute of SNUMRC College of Medicine Seoul National University First author: Dr. Woo-Jin Lee MD Department of Neurology Seoul National University Hospital Seoul, South Korea  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Cerebral white matter hyperintensity is a prevalent consequence of brain aging process and associated with various complications. One of the main mechanisms underlying the progression of white matter hyperintensity is chronic dysfunction of the glymphatic system which maintains metabolic homeostasis in brain. Glymphatic system is the route where the cerebrospinal fluid enters into the brain parenchyma and is cleared out with soluble wastes to the perivascular space of the cerebral small veins, peri-meningeal lymphatic vessels, deep cervical lymph nodes, and finally to the right atrium. Although the integrity of the glymphatic system is dependent on the adequate drainage of cerebral veins and lymphatics to the downstream chamber, the right atrium, the impact of hemodynamic changes in right-sided cardiac chambers on the development of white matter hyperintensity have not been elucidated. (more…)
Alzheimer's - Dementia, Author Interviews, Cognitive Issues, Genetic Research, Nature / 07.11.2017

MedicalResearch.com Interview with: Dr Miguel Chillon PhD Department of Biochemistry and Molecular Biology Universitat Autonoma Barcelona Spain MedicalResearch.com: What is the background for this study? What are the main findings? Response: Klotho is a protein with an anti-aging and neuroprotective role. Recent studies show it prevents the development of cognitive problems associated with aging and Alzheimer's disease. Klotho works mainly by inhibiting the insulin / IGF-1 signaling pathway and decreasing the damage caused by oxidative stress in the brain. One of the latest results revealed that the concentration of Klotho in cerebrospinal fluid is significantly lower in Alzheimer's patients than in human controls of the same age; and it is lower in the elderly with respect to young adults. Our study used a gene therapy strategy to introduce the Klotho gene into the Central Nervous System of adult animals. With just a single injection of the Klotho gene, young adult animals were protected over time from the cognitive decline associated with aging in old animals. These exciting results pave the way to further advances in research and the development of a neuroprotective therapy based on Klotho. (more…)
Alzheimer's - Dementia, Author Interviews, Johns Hopkins, Memory, Mental Health Research / 04.11.2017

MedicalResearch.com Interview with: Keenan A. Walker, PhD Johns Hopkins University School of Medicine Baltimore, MD MedicalResearch.com: What is the background for this study? What are the main findings? Response: There is quite a bit of evidence linking immune function with dementia. For example, several of the risk genes for Alzheimer’s disease are known to play a key role in immune functioning and the regulation of inflammation. We conducted the current study to determine whether systemic inflammation earlier in life might be a risk factor for neurodegeneration decades later. This long temporal window allows us to get closer to understanding causality. That is, which comes first – systemic inflammation or brain volume loss. Using a large community sample, we found that individuals with higher levels of blood inflammatory markers during midlife tended to have smaller brain volumes in select regions and reduced memory ability as older adults. We found the strongest associations between systemic inflammation and brain volume loss in brain regions most vulnerable Alzheimer’s disease. (more…)
Author Interviews, Cannabis, Cognitive Issues, HIV / 03.11.2017

MedicalResearch.com Interview with: Richard Saitz, MD, MPH, FACP, DFASAM Department of Community Health Sciences Boston University School of Public Health Clinical Addiction Research and Education (CARE) Unit Section of General Internal Medicine, Department of Medicin Boston University School of Medicine and Boston Medical Center Boston , Massachusetts MedicalResearch.com: What is the background for this study? What are the main findings? Response: Many people living with HIV infection use alcohol and other drugs including marijuana. People with HIV infection are also susceptible to cognitive dysfunction from many causes from HIV infection itself to aging. The main findings were that among people with HIV and substance use disorder, lifetime marijuana and alcohol use were not associated with cognitive dysfunction, likely due to competing risks.  But current marijuana use was associated with cognitive dysfunction. (more…)
Author Interviews, Mental Health Research, Nature / 30.10.2017

MedicalResearch.com Interview with: Hyun Ji Noh PhD Computational Scientist, Medical and Population Genetics Broad Institute of MIT and Harvard MedicalResearch.com: What is the background for this study? What are the main findings? Response: Obsessive-compulsive disorder (OCD) is a debilitating neuropsychiatric disorder, characterized by intrusive thoughts and repetitive behaviors. OCD is estimated to affect roughly 80 million people worldwide, but its neurobiology remains poorly understood. To understand the disorder’s underpinnings, we searched for genetic mutations that are associated with OCD. For this, we first identified 608 genes that were most likely to be important  in OCD - some that have previously been identified in OCD-like behaviors in dogs and mice, and others in human autism, which also involves repetitive behaviors. We compared these genes in 592 people with OCD and 560 people without OCD, and found that 4 of these genes were significantly different between people with and without OCD: NRXN1, HTR2A, CTTNBP2 and REEP3. All of these four genes have important functions in the brain. Specifically, we found that the variants in NRXN1 are likely to change its ability to bind other synaptic proteins. Synaptic proteins link neurons together, and are critical for transmitting signals through the brain. We also found that the variants in CTTNBP2 and REEP3 don’t actually change the proteins made by these genes, but instead probably affect gene regulation (for example, how much of the protein is made). These ‘regulatory’ variants disrupt the binding of transcription factors (proteins that regulate expression of genes in the body) near the gene. (more…)
Author Interviews, Brain Injury, Exercise - Fitness / 30.10.2017

MedicalResearch.com Interview with: Michael D. Cusimano MD, FRCSC, DABNS, FACS, PhD, MHPE Adjunct Scientist in the Keenan Research Centre of the Li Ka Shing Knowledge Institute of St. Michael's Hospital Division of Neurosurgery, St. Michael\'s Hospital Professor of Neurosurgery, Education and Public Health University of Toronto MedicalResearch.com: What is the background for this study? Response: Baseball is played by millions annually and is traditionally seen as a low risk sport for head injury when compared to sports like American Football, Ice Hockey and Rugby. Over 6 million children and youth are enrolled in formal baseball or softball leagues annually. (more…)
Author Interviews, Cognitive Issues, Heart Disease / 26.10.2017

MedicalResearch.com Interview with: Dr. Leif Friberg MD, PhD Associate professor in cardiology Karolinska Institute Friberg Resarch Stockholm, Sweden  MedicalResearch.com: What is the background for this study? What are the main findings? Response: I have been doing research on atrial fibrillation and stroke risk for many years and knew that the very common heart arrhythmia is associated with a 40% increased risk of dementia. Considering that that 12-15% of 75 years olds have this arrhythmia, and even more at higher ages, the problem is significant to say the least. The mechanism behind stroke in atrial fibrillation is that blood clots are formed in the heart. When these are dislodged they travel with the blood stream and may get stuck in the narrow vessels of the brain where they stop blood flow causing brain infarction or stroke. Oral anticoagulant drugs like warfarin or the newer so called NOAC (new oral anticoagulant) drugs are highly efficient in preventing formation of these large blood clots and offer at least 70% risk reduction. Now, blood clots come in different sizes. There are also microscopic clots that do not cause symptoms of stroke but all the same eat away at the brain at a slow but steady pace. Imaging studies shows this after only a few months or even weeks of atrial fibrillation. Our hypothesis was therefore: If anticoagulants are so effective in protecting against large clots, will they not help against the small ones too? (more…)
AACR, Alzheimer's - Dementia, Author Interviews, Cancer Research, Cognitive Issues, Colon Cancer, UCSF / 24.10.2017

MedicalResearch.com Interview with: Yingjia Chen, M.Sc, MPH, Ph.D. Postdoctoral Fellow University of California, San Francisco  MedicalResearch.com: What is the background for this study? Response: Both colon cancer and dementia are prevalent among the elderly and have a high risk of co-occurrence. Previous studies found that patients with dementia were treated less aggressively. In this study, we hypothesized that presence of pre-existing dementia was associated with worse survival for stage III colon cancer patients, and that post-operative chemotherapy was on the causal pathway. (more…)
Author Interviews, Brain Injury, Exercise - Fitness, Pediatrics / 21.10.2017

MedicalResearch.com Interview with: Jingzhen (Ginger) Yang, PhD, MPH Principal Investigator Associate Professor, Center for Injury Research and Policy The Research Institute at Nationwide Children’s Hospital Dept. of Pediatrics, College of Medicine, The Ohio State University Columbus, Ohio 43205  MedicalResearch.com: What is the background for this study? Response: From 2009-2014, all 50 states and the District of Columbia passed their state TBI laws, more commonly known as concussion laws, to mitigate severe consequences of concussions. These laws often include 3 core components: (1) mandatory removal from play following actual or suspected concussions, (2) requirements to receive clearance to return to play from a licensed health professional, and (3) education of coaches, parents, and athletes regarding concussion symptoms and signs. Our study aimed to evaluate whether the laws achieve the intended impact. MedicalResearch.com: What are the main findings? Response: The main findings showed that:
  • The rates of new and recurrent concussions initially increase significantly after a law goes into effect. This is likely due to more people – athletes, athletic trainers, coaches, and parents – becoming aware of the signs and symptoms of concussion and actually reporting a potential or actual concussion. Lack of knowledge about concussion signs and symptoms may have resulted in underreporting of concussions during the prelaw period. This trend is consistent across sports in our study and other studies looking at youth sports-related concussions.
  • The rate of recurrent concussions shows a significant decline approximately 2 ½ years after the law is in place. This demonstrates that the laws are having an impact. One of the core function of these laws is to reduce the immediate risk of health consequences caused by continued play with concussion or returning to play too soon without full recovery. The decline in recurrent concussion rates in our study is likely the results of the laws requirements of mandatory removal from play or permission requirements to return to play.
  • Football had the highest average annual concussion rate, followed by girls’ soccer and boys’ wrestling. Males had a higher average annual concussion rate than females. However, when comparing the rates in gender comparable sports (basketball, soccer, baseball/softball), females had almost double the annual rate of concussions as males. These results are consistent with findings from other studies. It is possible that girls have higher risk of concussions than boys or are more likely to report injuries. Future studies are needed to look specifically at these disparities.
(more…)
Author Interviews, Mental Health Research, Pain Research / 20.10.2017

MedicalResearch.com Interview with: Fu-Chi Yang, M.D., Ph.D.Assistant Professor Department of Neurology, Tri-Service General Hospital National Defense Medical Center Taipei, Taiwan MedicalResearch.com: What is the background for this study? What are the main findings? Response: Migraineurs are likely to suffer from comorbid depression and anxiety. Furthermore, increased migraine frequency is associated with an increased risk of mood/anxiety disorders. It is not distinguished by grouping frequency of migraine attacks, whether it is associated with severity scores of depression and anxiety. Thus, we evaluated the relationship between severity of depression/anxiety and migraine frequency We mainly found that the severity of depression (BDI and HADS-depression scores) and anxiety (HADS anxiety score) were related to migraine frequency, after adjusting confounding factors. (more…)
Author Interviews, Autism, Pediatrics, Race/Ethnic Diversity / 17.10.2017

MedicalResearch.com Interview with: Maureen Durkin, PhD, DrPH Professor and Interim Chair Department of Population Health Sciences University of Wisconsin School of Medicine and Public Health Madison, WI  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Previous studies of the prevalence of autism spectrum disorder (ASD) among children in the U.S. have found two consistent patterns.  One is a higher prevalence among white non-Hispanic children than among black non-Hispanic or Hispanic children.  The other is a positive socioeconomic gradient, meaning that ASD prevalence in the U.S. is found to increase with increasing income and other indicators of socioeconomic status. One of the findings of this new study is that the racial and ethnic differences in autism spectrum disorder prevalence are not explained by socioeconomic factors, because even after adjusting for socioeconomic factors, ASD prevalence was found to be significantly lower in black and Hispanic children than in white non-Hispanic children.  Another finding is that the gap in ASD prevalence between children of high and low socioeconomic status did not change over time between 2002 and 2010, though the overall prevalence of ASD more than doubled during this period. (more…)
Author Interviews, Depression, Diabetes, JAMA, Pediatrics, Pharmacology / 17.10.2017

MedicalResearch.com Interview with: Mehmet Burcu, PhD, MS Department of Pharmaceutical Health Services Research University of Maryland, Baltimore  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Antidepressants are one of the most commonly used psychotropic medication classes in U.S. youth, with serotonin reuptake inhibitors representing a large majority of total antidepressant use in youth. The most interesting finding was that the current use of serotonin reuptake inhibitors in youth was associated with an increased risk of type 2 diabetes mellitus, and this increased risk intensified further with the increasing duration of use and with the increasing dose. A secondary analysis also revealed that the risk of incident type 2 diabetes was most apparent in youth who used serotonin reuptake inhibitors for longer durations AND in greater daily doses. (more…)
Alzheimer's - Dementia, Author Interviews, Biomarkers, JAMA, Personalized Medicine / 17.10.2017

MedicalResearch.com Interview with: Ingrid S. van Maurik, MSc Department of Neurology and Alzheimer Center Department of Epidemiology and Biostatistics Amsterdam Neuroscience VU University Medical Center Amsterdam, the Netherlands MedicalResearch.com: What is the background for this study? What are the main findings? Response: CSF and MRI biomarkers are increasingly used in clinical practice, but their diagnostic and prognostic value is not perfect. Furthermore, criteria do not specify how to deal with conflicting or borderline results, or how to take patient characteristics into account. Therefore, optimal use of these biomarkers in clinical practice remains challenging. As part of the ABIDE project, we constructed biomarker-based prognostic models (CSF, MRI and combined) that enable prediction of future Alzheimer’s disease, or any type of dementia, in individual patients with mild cognitive impairment. When using these models, any value can be entered for the variables, resulting in personalized probabilities with confidence intervals. (more…)
Author Interviews, PTSD, Technology / 17.10.2017

MedicalResearch.com Interview with: Dr. Gale Lucas, PhD Director of Research USC Institute for Creative Technologies Playa Vista, CA   MedicalResearch.com: What is the background for this study? What are the main findings? Response: A common barrier to healthcare for psychiatric conditions is the stigma associated with these disorders. Perceived stigma prevents many from reporting their symptoms. Stigma is a particularly pervasive problem among military service members, preventing them from reporting symptoms of combat-related conditions like posttraumatic stress disorder (PTSD). This put them at risk for having their symptoms go untreated, with possible disastrous outcomes including suicide attempts. We envisioned a technology system – a virtual human interviewer – whereby military service members can get feedback about their risk for PTSD in a safe place without stigma. Indeed, our prior research has shown that, because its “just a computer” (therefore safe and anonymous), this virtual human interviewer helps people to feel safe discussing sensitive issues like mental health symptoms. In this follow-up research project (published in Frontiers), we sought to demonstrate the value of this kind of virtual human interviewer specifically for encouraging reporting of PTSD symptoms among service members. Specifically, we were interested in comparing the willingness of service members to report symptoms of PTSD to our virtual human interviewer, compared to the gold standard of the Post Deployment Health Assessment (PDHA). We wanted to isolate the effect of anonymity, separating it from “relational factors” that the virtual human interviewer uses to encourage service members to open up. Indeed, before asking these same questions as on the PDHA to capture PTSD symptoms, the system engages in social dialogue, which build rapport with users. The system asks “get to know you questions,” and throughout the interview, engage in active listening with responses such as nods, smiles, saying “uh huh,” and other encouraging phrases like “that’s great.” (more…)
Author Interviews, Autism, BMJ, Nutrition / 14.10.2017

MedicalResearch.com Interview with: Elizabeth DeVilbiss, PhD MPH Dornsife School of Public Health Drexel University MedicalResearch.com: What is the background for this study? What are the main findings? Response: Unfortunately, not much is known about how diet during pregnancy affects autism risk.  There have been studies in recent years about varied aspects of diet during pregnancy and autism risk involving multivitamins, iron, folic acid, vitamin D, and more, but the evidence is still inconclusive. After adjusting for several potentially influencing factors in both mothers and children, we found that multivitamin use, with or without additional iron and/or folic acid, was associated with a lower likelihood of child autism spectrum disorder with intellectual disability relative to mothers who did not use folic acid, iron, and multivitamins. (more…)
Author Interviews, Mental Health Research, Pharmacology, Psychological Science / 10.10.2017

MedicalResearch.com Interview with: Vanda Faria PhD Department of Psychology Uppsala, Sweden  MedicalResearch.com: What is the background for this study? What are the main findings? Response: It has been debated whether selective serotonin reuptake inhibitors (SSRIs), which are commonly prescribed for depression and anxiety, are more effective than placebo. Concerns have been raised that the beneficial effects of SSRIs, as measured in double-blind clinical trials, may be explained by expectancies (a crucial placebo mechanism) rather than the biochemical compound. But no study has tested experimentally the extent to which the SSRI treatment effect can be influenced by expectancies induced by verbal suggestions. We compared the efficacy of overt vs. covert administration of an SSRI (escitalopram) in patients with social anxiety disorder. Rather than comparing the SSRI with placebo, we compared it with itself while manipulating the patients’ expectations of improvement. This was achieved by informing one group correctly about the SSRI and its effectiveness (overt group) whereas the comparison (covert) group received incorrect information. By use of a cover story, the covert group was led to believe they were treated with a so called “active placebo”, an ineffective neurokinin-1 antagonist yielding similar side effects as the SSRI but lacking anxiety-reducing properties. But the treatment, dosage and duration was in fact identical in both groups. Results showed that overt outperformed covert SSRI treatment, as the number of treatment responders was more than three times higher on the main clinical outcome measure when correct information was given. Using neuroimaging (fMRI) we also noted differences between the overt and covert SSRI groups on objective brain activity measures. There were differences between the groups e.g. with regard to activation of the posterior cingulate cortex with treatment, and the functional coupling between this region and the amygdala which is a brain region crucially involved in fear and anxiety. The fMRI  results may reflect the interaction between cognition and emotion as the brain changes differently with treatment pending on the expectations of improvement. (more…)
Alzheimer's - Dementia, Author Interviews, Medical Imaging, MRI / 06.10.2017

MedicalResearch.com Interview with: Dr. Sanja Josef Golubic, dr. sc Department of Physics, Faculty of Science University of Zagreb, Croatia MedicalResearch.com: What is the background for this study? Response: Our study was aimed to search the topological biomarker of Alzheimer’s disease. A recent evidences suggest that the decades long progression of brain degeneration that is irreversible by the stage of symptomatic Alzheimer’s disease, may account for failures to develop successful disease-modifying therapies. Currently, there is a pressing worldwide search for a marker of very early, possibly reversible, pathological changes related to Alzheimer’s disease in still cognitively intact individuals, that could provide a critical opportunity for evolving of efficient therapeutic interventions. Three years ago we reported the discovery of the novel, fast brain pathway specialized for rapid processing of the simple tones. We named it gating loop. Gating loop directly links auditory brain areas to prefrontal brain area. We have also noticed the high sensitivity of the gating loop processing on AD pathology. It was inspiration to focus our Alzheimer’s disease biomarker search in the direction of prefrontal brain activation during listening of simple tones. (more…)
Author Interviews, Cost of Health Care, JAMA, PTSD / 06.10.2017

MedicalResearch.com Interview with: Gregory H. Cohen, MPhil, MSW Statistical Analyst Department of Epidemiology School of Public Health Boston University  MedicalResearch.com: What is the background for this study? What are the main findings? Response: We simulated a stepped care case-finding approach to the treatment of posttraumatic stress in New York City, in the aftermath of Hurricane Sandy. Stepped care includes an initial triage screening step which identifies whether a presenting individual is in need of Cognitive Behavioral Therapy, or can be adequately treated at a lower level of care. Our simulation suggests that a stepped care approach to treating symptoms of posttraumatic stress in the aftermath of a hurricane is superior to care as usual in terms of reach and treatment-effectiveness, while being cost-effective. (more…)
Author Interviews, Education, Gender Differences, Mental Health Research, Sexual Health, Social Issues / 03.10.2017

MedicalResearch.com Interview with: Oliver Ferlatte PhD Men's Health Research Program University of British Columbia Vancouver , British Columbia , Canada MedicalResearch.com: What is the background for this study? Response: Suicide, like many other health inequities, is unevenly distributed among the population, with marginalized groups being most affected. In Canada, suicide has been found to particularly affect gay and bisexual men, aboriginal people and people living in rural and remote communities. While the populations affected by suicide are not mutually exclusive – for example someone can be a bisexual Aboriginal man living in a remote community – much of the suicide prevention literature tends to treat these groups as such. Moreso, very little attention is given in suicide prevention research to diversity within groups: for example, we know very little about which gay and bisexual men are most at risk of attempting suicide. This situation creates a vacuum of knowledge about suicide among gay and bisexual and deprives us of critical information for the development of effective suicide prevention activities. We therefore investigated in a survey of Canadian gay and bisexual men (Sex Now Survey), which gay and bisexual men are at increased risk of reporting a recent suicide attempt. The large sample of gay and bisexual men with 8493 participants allows for this unique analysis focused on the multiple, intersecting identities of the survey participants. (more…)