AHA Journals, Author Interviews, Heart Disease, Mental Health Research / 04.04.2017

MedicalResearch.com Interview with: Alessandro Paoletti Perini, MD, PhD and Valentina Kutyifa MD, PhD University of Rochester Medical Center Heart Research Follow-Up Program Rochester, New York, 14642 MedicalResearch.com: What is the background for this study? What are the main findings? Response: The present study is a pre-specified sub-study of the Multicenter Automatic Defibrillator Implantation Trial – Reduce Inappropriate Therapy (MADIT-RIT), which was published on the New England Journal of Medicine in 2012. The main trial showed that innovative ICD programming was associated with reduction in inappropriate ICD therapy and mortality. In the present investigation we focused on the detrimental effects that ICD firings, either appropriate or inappropriate, may have on patients’ psychological well-being. We observed that multiple appropriate and inappropriate shocks are associated with increased levels of ICD-related anxiety, a specific kind of psychological disorder which affects patients implanted with an ICD. Multiple appropriate ATP were also proved associated with higher anxiety, although not as much as shocks. On the other hand, we did not find a significant association with anxiety for multiple inappropriate ATP. (more…)
Author Interviews, Cannabis, Mental Health Research, Pediatrics / 04.04.2017

MedicalResearch.com Interview with: James McIntosh PhD Economics Department Concordia University Montreal, Quebec, Canada. MedicalResearch.com: What is the background for this study Response: Marijuana is about to become legal in Canada. Consequently, an analysis of its effects on users is a high priority. This issue has been explored by Canadian researchers to some extent but there are gaps in what is known about the effects of using marijuana. Most of the Canadian studies focus on youth or adolescent use. This is clearly important but adult use is as well. Establishing the link between early usage and the effects of use over an individual’s lifetime was a major objective of the study. (more…)
Author Interviews, Depression / 04.04.2017

MedicalResearch.com Interview with: Scott T. Aaronson, M.D Psychiatrist, The Retreat at Sheppard Pratt Director of Clinical Research Sheppard Pratt Health System Baltimore, MD MedicalResearch.com: What is the background for this study? What are the main findings? Response: This study is the largest ever conducted on patients with severe, chronic depression, a group typically ignored by clinical research in psychiatry. We looked at individuals who, on average, had received 8 unsuccessful treatment interventions in the past. These individuals were split into two groups and examined over five years. One group was given proven anti-depressant treatments (medications, psychotherapy, and/or electroconvulsive therapy (ECT)), and one group was given both anti-depressant treatments and VNS Therapy—an implantable, pacemaker-like device that stimulates the vagus nerve, which regulates mood in the brain. • The study found that 67.9% of the VNS therapy group responded to treatment, compared to 40.9% of patients receiving treatment as usual. Importantly, the VNS therapy group reported responses earlier in treatment, and responses were sustained longer than those receiving treatment as usual. • VNS therapy improved treatment effect in individuals whether they had unipolar or bipolar disorder, and whether or not they had responded to ECT in the past. (more…)
Author Interviews, Cancer Research, Mental Health Research / 03.04.2017

MedicalResearch.com Interview with: Raffaella Calati, Psy.D., Ph.D. University of Montpellier INSERM U 1061: Neuropsychiatry: Epidemiological and Clinical Research Department of Emergency Psychiatry and Post Acute Care Lapeyronie Hospital, Centre Hospitalier Universitaire Montpellier, France MedicalResearch.com: What is the background for this study? What are the main findings? Response: A number of previous original studies investigated suicidal thoughts and behaviours in cancer patients, finding them to be higher than those in the general population. However, to our knowledge, we performed the first meta-analysis on this link, pooling all the published data to calculate the size of this increased risk. Our main finding is an increased suicide risk in patients with cancer compared to individuals without it. It should be underlined that the analyses presented are the first stage in our work, since at the moment we are analyzing a higher number of studies and we are planning to control for confounders, not considered in our first analyses. This means that the exact strength of this association will be more precisely known. (more…)
Abuse and Neglect, Author Interviews, BMJ, Exercise - Fitness, Mental Health Research / 02.04.2017

MedicalResearch.com Interview with: Tine Vertommen, Criminologist Faculty of Medicine and Health Sciences Universiteitsplein 1 Antwerp, Belgium MedicalResearch.com: What is the background for this study? What are the main findings? Response: A recent prevalence study into interpersonal violence against child athletes in the Netherlands and Belgium showed that 6% experienced severe sexual violence, 8% experienced severe physical violence, and 9% of respondents experienced severe psychological violence in sport (Vertommen et al., 2016). While general literature has repeatedly shown that exposure to interpersonal violence during childhood is associated with mental health problems in adulthood, this relationship has not yet been demonstrated in (former) athletes. Thus, the objective of the current study is to assess the long-term consequences of these experiences on adult mental health and quality of life. (more…)
Accidents & Violence, Author Interviews, Autism, Columbia / 22.03.2017

MedicalResearch.com Interview with: Joseph Guan MPH Candidate in Epidemiology, Certificate in Chronic Diseases Epidemiology Columbia University Mailman School of Public Health MedicalResearch.com: What is the background for this study? What are the main findings? Response: The prevalence of autism has been increasing especially in the past two decades. With an estimate of more than 3.5 million people living with autism in the US, approximately 500,000 of them are children under 15 years old. Current studies show that males are approximately four times as likely than females to be diagnosed with autism. There is also evidence that people with autism are at a heightened risk of injury. However, the research on the relationship between autism and injury is understudied. We found that 28% of deaths in individuals with autism were due to injury, compared to 7% of deaths in the general population. Injury deaths in individuals with autism occurred at a much younger age (29.1 years) on average compared to injury deaths in the general population (54.7 years). Our study show that drowning was the leading cause of injury death among individuals with autism, followed by suffocation and asphyxiation. Children under the age of 15 years were 160 times more likely to die from drowning. (more…)
Aging, Alzheimer's - Dementia, Author Interviews, JAMA, Supplements / 21.03.2017

MedicalResearch.com Interview with: Richard J. Kryscio, Ph.D. Statistics and Chair, Biostatistics and Sanders-Brown Center on Aging Sanders-Brown Center on Aging University of Kentucky  MedicalResearch.com: What is the background for this study? Response: At the time the trial was initiated (2002), there was ample evidence that oxidative stress is an important mechanism in brain aging. Research showed that protein oxidation is linked to the brain’s response to the abnormal proteins seen in Alzheimer disease (amyloid beta plaques in particular) leading to inflammation, DNA repair problems, reduced energy production, and other cellular changes that are identified mechanisms in the Alzheimer brain. Both vitamin E and selenium are antioxidants. Antioxidants, either through food or supplements, are believed to reduce oxidative stress throughout the body. In the brain, they may reduce the formation of amyloid beta plaques, reduce brain inflammation, and improve other brain processes. Studies in humans support these hypotheses. The Rotterdam study in the Netherlands, as an example, showed that initial blood levels of vitamin E could predict dementia risk. Those people with higher vitamin E levels were 25% less likely to develop dementia. Also, selenium deficiency results in cognitive difficulties and several population-based studies have shown an association between selenium level and cognitive decline (lower selenium levels are linked to thinking changes in the elderly). (more…)
Author Interviews, Mental Health Research / 21.03.2017

MedicalResearch.com Interview with: Dr. Melanie Ullrich PhD Universität Würzburg Physiologisches Institut Würzburg MedicalResearch.com: What is the background for this study? Response: Shortly after the first description of SPRED proteins in 2001, their in vivo functions, especially that of SPRED2, were completely unexplored. Thus we generated a mouse model which lacks functional SPRED2 expression. In our previous study, we identified SPRED2 as a critical regulator of stress hormone release from the hypothalamic-pituitary-adrenal (HPA) axis. In SPRED2 KO mice levels of corticotropin-releasing hormone, adrenocorticotropic hormone, and corticosterone are elevated, a feature often associated with obsessive-compulsive disorders (OCD) in humans. In fact SPRED2 KO mice showed clear signs of OCD-like behavior demonstrated by excessive self-grooming up to the level of self-inflicted lesions. Treatment with the selective serotonin reuptake inhibitor (SSRI) fluoxetine alleviated excessive grooming, confirming the OCD-like nature of the disease. Therefore, the first main finding of our study is that mutations in the SPRED2 gene have to be considered as a possible risk factor for the development of OCD-like diseases. (more…)
Author Interviews, JAMA, Mental Health Research, Urology / 21.03.2017

MedicalResearch.com Interview with: Blayne Welk, MD, FRCSC Assistant Professor of Surgery Western University MedicalResearch.com: What is the background for this study? What are the main findings? Response: Concerns have been raised by regulatory agencies and patients about possible serious psychiatric side effects associated with the use of 5 alpha reductase inhibitors. These medications can be used for both enlarged prostates and alopecia. We used administrative data to assess for potential psychiatric side effects associated with finasteride and dutasteride usage in older men with benign prostatic enlargement. In our study we found that there was no increased risk of suicide associated with the use of these medications. However, there was a small increase in both self-harm and new onset depression associated with the use of 5 alpha reductase inhibitors. (more…)
Author Interviews, JAMA, Mental Health Research / 19.03.2017

MedicalResearch.com Interview with: Florian Walter MSc Centre for Mental Health and Safety University of Manchester, Manchester, England Dr Roger Webb PhD and Reader in Mental Health Epidemiology Senior Postgraduate Research Tutor Division of Psychology and Mental Health Faculty of Biology, Medicine and Health The University of Manchester MedicalResearch.com: What is the background for this study? Response: Mental disorders are associated with an elevated risk of premature mortality, and risk is especially heightened soon after discharge from inpatient psychiatric services. Previous studies have focused on single causes of death, whereas our study considered a comprehensive array of cause-specific mortality outcomes. We analysed over 1.7 million Danish residents in our national interlinked registry study, which was conducted collaboratively by the Centre of Mental Health and Safety, University of Manchester, UK and the National Centre for Register-based Research, Aarhus University, Denmark. We compared the risk of dying from specific natural and unnatural causes of death among patients following their first discharge from inpatient psychiatric care versus people not admitted. (more…)
Author Interviews, Columbia, Global Health, Schizophrenia / 16.03.2017

MedicalResearch.com Interview with: L. H. Lumey, MD, PhD Professor of Epidemiology Mailman School of Public Health Columbia University MedicalResearch.com: What is the background for this study? What are the main findings? Response: The Chinese Great Leap Forward Famine in 1959-1961 is the largest famine in human history. Earlier studies have reported that overweight, type 2 diabetes, hyperglycemia, the metabolic syndrome and schizophrenia were more common among adults who were exposed to the famine. Our re-analysis of all previous studies shows no increases in diabetes, high blood pressure and other chronic conditions among famine births except for schizophrenia. (more…)
Author Interviews, Brain Injury, Exercise - Fitness, Gender Differences, Mental Health Research / 16.03.2017

MedicalResearch.com Interview with: Wellington K. Hsu, MD Clifford C. Raisbeck, MD, Professor of Orthopaedic Surgery Associate Professor of Orthopaedic Surgery Northwestern University Chicago, IL MedicalResearch.com: What is the background for this study? What are the main findings? Response: Concussions remains a significant problem in youth sports. The recent enactment of Traumatic brain injury laws have certainly heightened awareness regarding this problem. Our study looked at publicly available data regarding diagnosis of concussion in high school athletes. We found that females are more likely to be diagnosed with a concussion than males. We also concluded that girl soccer players and boys football players are at highest risk for a diagnosis of concussion. Since the neck meant of the Traumatic brain injury state laws, the diagnosis of concussion in this patient group increased significantly past decade. (more…)
Author Interviews, Depression, Mayo Clinic / 15.03.2017

MedicalResearch.com Interview with: Hilal Maradit Kremers, M.D. M.Sc.  Associate Professor of Epidemiology Mayo Clinic College of Medicine  MedicalResearch.com: What is the background for this study? Response: Depression and mood disorders are common comorbidities in patients undergoing total hip and total knee arthroplasty.  Based on previous research, there is evidence to suggest presence of depression in arthroplasty patients is associated with worse functional and clinical outcomes, such as complications, readmissions and mortality.  Although the mechanisms are poorly understood, it is important to identify strategies to effectively manage perioperative depression in an effort to improve arthroplasty outcomes.  One potential strategy is effective medical treatment of underlying depression which can potentially improve depression symptoms, thereby surgical outcomes. (more…)
Author Interviews, Education, Mental Health Research, Pediatrics, Sleep Disorders / 11.03.2017

MedicalResearch.com Interview with: Dr. Elsie M. Taveras, MD MPH Chief, Division of General Pediatrics Director, Pediatric Population Health Management Director, Raising Healthy Hearts Clinic MassGeneral Hospital for Children MedicalResearch.com: What are the primary findings of this study and why are they important? Response: The primary findings of this study are that children who get an insufficient amount of sleep in their preschool and early school age years have a higher risk of poor neurobehavioral functioning as reported by their mothers and independently by their teachers at age 7. These behaviors included poorer executive function and more hyperactivity/inattention, emotional symptoms, conduct problems, and peer relationship problems. (more…)
Addiction, Author Interviews, Mental Health Research / 10.03.2017

MedicalResearch.com Interview with: Carl Stevenson, PhD Assistant Professor of Neuroscience BSc Animal Science Admissions Tutor Local Group Rep, British Neuroscience Association School of Biosciences University of Nottingham Loughborough, UK MedicalResearch.com: What is the background for this study? What are the main findings? Response: Anxiety-related and substance abuse disorders can be serious forms of mental illness that are not always treated effectively by psychological therapies or medications. One strategy to enhance their treatment is to boost the effects of psychological therapy by combining it with medication. This study reviewed the literature on the effects of cannabidiol, a chemical found in the cannabis plant, in preclinical models of these disorders. Cannabidiol is safe to use in humans and doesn’t cause the ‘high’ associated with cannabis. This means that cannabidiol might be useful for treating certain symptoms without the unwanted side effects linked to medical cannabis. Our review confirmed that cannabidiol reduces fear and anxiety in various preclinical models, when given on its own or in conjunction with behavioural interventions that model psychological treatment for anxiety-related disorders. This could show that exploring the option of cbd for anxiety could be a step forward in treating the condition. Our review suggested that it can also reduce relapse in some preclinical models of addiction, although research looking at the effects of cannabidiol in substance abuse disorders is still in its infancy. (more…)
Aging, Alzheimer's - Dementia, Author Interviews, PLoS / 04.03.2017

MedicalResearch.com Interview with: Emma van Bussel MD, MSc Academic Medical Center | University of Amsterdam Amsterdam | The Netherlands  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Dementia forms a high social and economic burden on society. Since there is a growing number of older people, the occurrence of dementia is expected to increase over the years to come. For future planning of care, it is important to have reliable predictions on new dementia cases for the population at large. Studies in Western countries suggested that the incidence per 1000 person years is declining. We studied the incidence trend of dementia in the Netherlands in primary care registry data, in a population of over 800,000 older people (60 years and over) for the years 1992 to 2014. Our results indicate a small increase of 2.1% (95% CI 0.5% to 3.8%) per year in dementia incidence over the past decades. The trend did not change in the years after 2003, when a national program was developed to support dementia care and research, compared to the years prior to 2003. (more…)
Author Interviews, Eating Disorders / 04.03.2017

MedicalResearch.com Interview with: Guido K.W. Frank, M.D., FAED Associate Professor of Psychiatry and Neuroscience Associate Director, Eating Disorder Program Director, Developmental Brain Research Program Pediatric Mental Health Institute | Children’s Hospital | University of Colorado Anschutz Medical Campus Colorado MedicalResearch.com: What is the background for this study? Response: Anorexia nervosa is an eating disorder that primarily affects young females and is associated with high mortality. The diagnostic criteria include restriction of energy intake that leads to significantly low body weight and an intense fear of gaining weight or becoming fat. The etiology of anorexia nervosa is complex, and only recently have we begun to better understand its underlying neurobiology. Brain scans of anorexia nervosa patients have implicated brain reward circuits in the disease, brain regions that govern food intake. On the other hand, how much we eat also affects over time reward system response and eating too much or too little has important implications on brain reward function. Previous studies from our lab as well as basic science research suggest that underweight is associated with heightened reward system response. In this study wanted to test whether we would find heightened brain activity in adolescents with anorexia nervosa and whether this would normalize once the patient regained weight. (more…)
Author Interviews, Electronic Records, Mental Health Research / 04.03.2017

MedicalResearch.com Interview with: Steven K. Dobscha, M.D. Professor, Department of Psychiatry, OHSU Director, VAPORHCS Center to Improve Veteran Involvement in Care Oregon Health & Science University MedicalResearch.com: What is the background for this study?  Response: Several health care systems across the United States now offer patients online access to all of their clinical notes (sometimes referred to as progress notes) through electronic health record portals; this type of access has been referred to as OpenNotes (see www.opennotes.org for more information on the national OpenNotes initiative). Veterans have been able to use OpenNotes in the Veterans Health Care (VHA) system since 2013. However, some individuals have expressed concern that online access to clinical notes related to mental health could cause some patient harms. We are conducting a VA-funded research project with several objectives: 1) to examine benefits and unintended negative consequences of OpenNotes use as perceived by veterans receiving VHA mental health care and by VHA mental health clinicians, and 2) to develop and evaluate brief web-based courses designed to help veterans and clinicians use OpenNotes in ways that optimize Veteran-clinician collaboration and minimize unintended consequences. (more…)
Author Interviews, Memory / 04.03.2017

MedicalResearch.com Interview with: Signy Sheldon, PhD Assistant Professor Department of Psychology McGill University Montreal, QC, CAN MedicalResearch.com: What is the background for this study? Response: It is clear to most people that emotion and memory are strongly linked - thinking about our past experiences is often accompanied with a strong feelings, sometimes good and sometimes bad. In psychological research, many investigations have looked at how emotional memories are remembered differently than non-emotional memories. A lot of this research has found that the valence of a memory, whether it is positive or negative, will impact how detailed a past event can be recalled. Much less research as looked at how the emotions we feel at the time of remembering can also influence the way that memory is recalled. This is a very important area of research. If emotions during remembering can influence what memories are accessed and how we experience these memories, this would suggest that our memories are tagged and organized according to emotions. In this study, we looked at how different aspects of emotion can affect the types of past experiences we bring to mind to further investigate how emotions direct memory retrieval. To do this, we had participants listen to unfamiliar excerpts of music that ranged in both memory valence (positive and negative) and arousal (high or low levels). To each piece of music, participants were asked to think of a past memory and then describe their experience of that event they were remembering. (more…)
Addiction, Alcohol, Author Interviews, Cannabis, Mental Health Research / 03.03.2017

MedicalResearch.com Interview with: Emil F. Coccaro, M.D. Ellen C. Manning Professor Department of Psychiatry and Behavioral Neuroscience The University of Chicago Chicago, Illinois 60637 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Aggressive behavior and drug use have been related for years but this study shows people with problematic aggression (Intermittent Explosive Disorder: IED) are in fact at risk for developing alcohol, tobacco, and cannabis use disorders and that the onset of problematic aggression (IED) begins before the onset of the drug use. The increased risk for alcohol use disorder was nearly six-fold higher, the increased risk for cannabis use disorder was seven-fold higher, and the increased risk for tobacco use disorder  was four-fold higher. In addition, the presence of IED increased the severity of the substance use disorder. (more…)
Author Interviews, BMJ, Environmental Risks, Mental Health Research, Pediatrics, Toxin Research / 02.03.2017

MedicalResearch.com Interview with: Professor Jean-Francois Viel Department of Epidemiology and Public Health University Hospital Rennes, France MedicalResearch.com: What is the background for this study? What are the main findings? Response: The use of pyrethroid insecticides has increased substantially throughout the world over the past several decades, replacing organophosphate and carbamate insecticides, because of their chemical potency against many pests, their relatively low mammalian toxicity and their favorable environmental profiles. However, despite the neurotoxicity of these insecticides at high doses, the potential impact of environmental exposure to pyrethroid insecticides on child neurodevelopment has only just started to receive attention. Using a longitudinal design (PELAGIE mother-child cohort), we were able to assess pyrethroid exposure (trough urine concentrations) both prenatally and during childhood (at 6 years of age). We showed that increased prenatal concentrations of one pyrethroid metabolite (cis-DCCA, a metabolite of permethrin, cypermethrin and cyfluthrin) were associated with internalising difficulties (children showing behaviours that are inhibited and over-controlled). Moreover, for childhood 3-PBA (a common metabolite of up to 20 synthetic pyrethroid insecticides) concentrations, a positive association was observed with externalising difficulties (children showing behaviours that are under-controlled and having generally a more challenging temperament). (more…)
Author Interviews, Cognitive Issues, Multiple Sclerosis, NYU / 01.03.2017

MedicalResearch.com Interview with: Leigh E. Charvet, PhD Associate Professor, Department of Neurology Department of Neurology New York University Langone Medical Center New York, NY MedicalResearch.com: What is the background for transcranial direct current stimulation? What are the main findings of this study in multiple sclerosis patients? Response: The application of tDCS is a relatively recent therapeutic development that utilizes low amplitude direct currents to induce changes in cortical excitability. When paired with a rehabilitation activity, it may improve learning rates and outcomes. Multiple repeated sessions are needed for both tDCS and cognitive training sessions to see a benefit. Because it is not feasible to have participants come to clinic daily for treatments, we developed a method to deliver tDCS paired with cognitive training (using computer-based training games) to patients at home. Our protocol uses a telemedicine platform with videoconferencing to assist study participants with all the procedures and to ensure safety and consistency across treatment sessions. When testing our methods, we enrolled 25 participants with multiple sclerosis (MS) completed 10 sessions of tDCS (2.0 mA x 20 minutes, dorsolateral prefrontal cortex, left anodal) using the remotely-supervised telerehabilitation protocol. This group was compared to n=20 MS participants who completed 10 sessions of cognitive training only (also through remote supervision). We administered cognitive testing measures at baseline and study end. We found that both the tDCS and cognitive training only group had similar and slight improvements on composites of standard neuropsychological measures and basic attention. However, the tDCS group had a significantly greater gain on computer-based measures of complex attention and on a measure of intra-individual variability in response times. (more…)
Alzheimer's - Dementia, Author Interviews, Lancet, Vaccine Studies / 01.03.2017

MedicalResearch.com Interview with: Petr Novak, MD, PhD AXON Neuroscience Bratislava, Slovakia MedicalResearch.com: What is the background for this study? Response: Alzheimer’s disease is a complex, multifactorial disorder, with many-faceted neuropathology. A hallmark finding is the co-existence of neurofibrillary pathology (such as neurofibrillary tangles) composed of tau protein, and amyloid-β pathology (plaques) [1]. Neurofibrillary pathology is closely correlated with cognitive impairment in Alzheimer’s disease [2], while support for the role amyloid in the disease pathogenesis comes from the ability of certain mutations to induce AD in an autosomal-dominant fashion [3]. The field has explored various anti-amyloid therapies to great extent, and continues to do so with undiminished effort [4]; meanwhile, there is a noticeable paucity of investigated therapies aimed at neurofibrillary tau protein pathology, despite the ability of tau protein dysfunction to cause a multitude of neurodegenerative disorders, collectively named “tauopathies” [5]. AADvac1 is the first tau-targeted immunotherapy investigated in humans [6], a pioneering effort to target the component of AD neuropathology that is proximal to neuronal damage and cognitive loss, and thus to halt or slow the progression of Alzheimer’s disease. (more…)
ADHD, Author Interviews, Lancet, MRI, Neurological Disorders / 01.03.2017

MedicalResearch.com Interview with: M. (Martine) Hoogman PhD. Postdoc and PI of ENIGMA-ADHD Radboud universitair medisch centrum Department of Human Genetics Nijmegen, The Netherlands MedicalResearch.com: What is the background for this study? What are the main findings? Response: There are many neuro-imaging studies aimed at investigating structural brain changes related to ADHD, but the results are often inconclusive. There are two main reasons for this: 1) the small sample size of the studies and 2) the heterogeneous methods used. We tried to address these issues by forming an international collaboration to provide a sample size sufficient to detect even small effects in volume differences. And in addition, we analyzed all the raw scans again using homogenized methods. There are data of more than 1700 patients (aged 4-63 years of age) and more than 1500 healthy controls in our dataset, coming from 23 sites around the world. We studied the possible volume differences between cases and controls of 7 subcortical regions and intracranial volume by performing mega- and meta-analysis. (more…)
Author Interviews, Mental Health Research, Pediatrics, Social Issues, Stroke / 28.02.2017

MedicalResearch.com Interview with: Emily C. Maxwell, Ph.D. Pediatric Neuropsychology Bugher Fellow Division of Neurology Instructor | Department of Pediatrics University of Colorado School of Medicine Aurora, CO 80045  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Previous research has found increased psychological problems and significantly higher rates of psychiatric disorders after pediatric stroke. However, past studies have mainly used global indices, without comparison to age-based norms. Thus, little is known about the discrete symptomatology exhibited by these children and how discrepant these symptoms may be from normative expectations. At the University of Colorado Denver and Children’s Hospital Colorado, we studied 50 patients who suffered an arterial ischemic stroke during childhood. The parents of these patients completed the Child Behavior Checklist, a questionnaire assessing emotional and behavioral problems. We found that children with stroke had higher symptoms of depression, anxiety, physical complaints, and behavioral difficulties compared to a normative sample of same-aged peers. Additionally, levels of anxiety were higher in children who had a stroke at an early age (before 6 years of age) compared to children who had a stroke at a later age (after 10 years of age). (more…)
Author Interviews, Compliance, Lancet, Mental Health Research, Schizophrenia / 27.02.2017

MedicalResearch.com Interview with: Ernst L Noordraven MSc, PhD student Department of Psychiatry Epidemiological and Social Psychiatric Research institute Erasmus University Medical Center Rotterdam Netherlands MedicalResearch.com: What is the background for this study? What are the main findings? Response: Provision of financial incentives is a promising intervention for improving adherence in patients taking antipsychotic medication. We aimed to assess the effectiveness of this intervention for improving adherence to antipsychotic depot medication in patients with psychotic disorders, irrespective of their previous compliance. Our 12-month randomized controlled trial showed that financial incentives improved adherence to antipsychotic depot medications in patients with psychotic disorders, regardless of their level of compliance at study entrance. Patients received either treatment as usual plus a financial reward for each depot of medication received (€30 per month if fully compliant; intervention group) or treatment as usual alone (control group). Based on the use of depot registrations from 155 patients (92%), the adjusted difference in adherence was 14·9% (95% CI 8·9–20·9%; p<0·0001) in favour of the intervention group. Our study is also the first to demonstrate that the effects on medication adherence persist after monetary rewards are discontinued, for at least a 6-month follow-up period (adjusted difference 6·5%, 95% CI 2·0–10·9; p=0·047). (more…)
ASCO, Author Interviews, Cognitive Issues, Endocrinology, Journal Clinical Oncology, Prostate Cancer, Testosterone / 27.02.2017

MedicalResearch.com Interview with: Farzin Khosrow-Khavar, M.Sc. Ph.D. Candidate Department of Epidemiology, Biostatistics and Occupational Health, McGill University Center for Clinical Epidemiology - Jewish General Hospital Montreal, QC  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Previous studies have shown an association between androgen deprivation therapy (ADT) and risk of dementia and Alzheimer’s disease. However, these studies had methodological limitations that may account for this positive association. Using appropriate study design and methodology, we found no association between androgen deprivation therapy and risk of dementia (including Alzheimer’s disease) in patients with prostate cancer. These results were consistent by cumulative duration of  androgen deprivation therapy use and by ADT modality. (more…)
Alzheimer's - Dementia, Author Interviews, Brigham & Women's - Harvard, Geriatrics, Heart Disease, Stroke / 26.02.2017

MedicalResearch.com Interview with: Ariela Orkaby, MD, MPH Geriatrics & Preventive Cardiology Associate Epidemiologist Division of Aging, Brigham and Women's Hospital Instructor in Medicine, Harvard Medical School MedicalResearch.com: What is the background for this study? What are the main findings? Response: Atrial Fibrillation is a common heart rhythm that affects 1 in 25 adults over age 60 and 1 in 10 adults over age 80. The feared consequence of atrial fibrillation is stroke, leading to the prescription of blood thinning medications (anticoagulants such as warfarin) to prevent strokes. However, there is an underutilization of these life-saving medications in older adults, and particularly in those who have dementia. In part, this is due to a lack of research and inclusion of older adults with dementia in prior studies. In this study, we used clinical Veterans Administration data, linked to Medicare, to follow 2,572 individuals over age 65 who had atrial fibrillation and until a diagnosis of dementia. The average age was 80 years, and 99% were male. We found that only 16% remained on warfarin. We used statistical methods to account for reasons why a patient would or would not be treated with warfarin and found that those who continued to take warfarin had a significantly lower risk of stroke (HR 0.74, 95% Confidence interval 0.54- 0.99, p=0.47) and death (HR 0.72, 95% CI 0.60-0.87, p<0.01) compared to those who did not continue to take warfarin, without an increased risk of bleeding. (more…)
Alzheimer's - Dementia, Author Interviews, Neurology, Sleep Disorders / 25.02.2017

MedicalResearch.com Interview with: Dr. Matthew P. Pase Sidney Sax NHMRC Fellow, Department of Neurology Boston University School of Medicine Investigator, Framingham Heart Study; Senior Research Fellow, Swinburne University of Technology. Boston MA 02118 MedicalResearch.com: What is the background for this study? Response: Sleep disturbances are common in dementia. However, most studies have focused on patients who already have dementia and so it is unclear whether disturbed sleep is a symptom or a cause of dementia. We studied 2,457 older participants enrolled in the Framingham Heart Study, a large group of adults sampled from the community in Framingham, Massachusetts. We asked participants to indicate how long they typically slept each night. Participants were then observed for the following 10-years to determine who developed dementia, including dementia due to Alzheimer’s disease. Over the 10 years, we observed 234 cases of dementia. Information on sleep duration was then examined with respect to the risk of developing dementia. (more…)