Author Interviews, Bipolar Disorder, Infections, Johns Hopkins, Mental Health Research, Microbiome, Schizophrenia / 05.05.2016 Interview with: Emily G. Severance, Ph.D Stanley Division of Developmental Neurovirology Department of Pediatrics Johns Hopkins University School of Medicine Baltimore, MD What is the background for this study? What are the main findings? Dr. Severance: This research stems in part from anecdotal dialogues that we had with people with psychiatric disorders and their families, and repeatedly the issue of yeast infections came up. We found that Candida overgrowth was more prevalent in people with mental illness compared to those without psychiatric disorders and the patterns that we observed occurred in a surprisingly sex-specific manner.  The levels of IgG antibodies directed against the Candida albicans were elevated in males with schizophrenia and bipolar disorder compared to controls. In females, there were no differences in antibody levels between these groups, but in women with mental illness who had high amounts of these antibodies, we found significant memory deficits compared to those without evidence of past infection. (more…)
Author Interviews, Depression, JAMA / 04.05.2016 Interview with: Dipl.-Psych. R. Redlich Neuroimaging Group Klinik und Poliklinik für Psychiatrie und Psychotherapie Westfaelische Wilhelms-Universitaet Muenster What is the background for this study? Response: Electroconvulsive therapy (ECT) is one of the most effective treatments for severe depression. The ability to advise psychiatrists and patients accurately regarding the chances of successful ECT is of considerable value, particularly since ECT is a demanding procedure and, despite having relatively few side effects, has a profound impact on patients. Therefore, the present study sought to predict ECT response in a psychiatric sample by using a combination of structural Magnetic Resonance Imaging data and machine-learning techniques. (more…)
Alzheimer's - Dementia, Author Interviews, Depression, Lancet / 02.05.2016 Interview with: Saira Saeed Mirza, MD, PhD Department of Epidemiology Erasmus MC, Rotterdam What is the background for this study? What are the main findings? Dr. Mirza: Depressive symptoms appearing in late-life have been extensively studied for their relationship with dementia. They not only very frequently occur in demented patients, but also predict dementia. In this context, depressive symptoms have largely been assessed at a single time point only. However, depression is a disorder which remits and relapses, and symptoms do not remain same over the years. Given this pattern of disease progression, it is more important to study the course of depression over time in relation to long-term health outcomes such as dementia, rather than assessing it at a single time-point, which will neglect the course of depression. This is important as people follow different courses of depression, and different courses of depression might carry different risks of dementia. When we studied the course of depressive symptoms over 11 years in community dwelling older adults in Rotterdam, and the subsequent risks of dementia, we observed that only those who had increasing or worsening depressive symptoms were at a higher risk of dementia. In this group of people, about one in five persons developed dementia. Interestingly, people suffering from high depressive symptoms at a single time point were not at a higher dementia risk than those without depressive symptoms. (more…)
Author Interviews, Brain Injury, JAMA, Pediatrics / 02.05.2016 Interview with: Zachary Y. Kerr, PhD, MPH Sports Injury Epidemiologist Director, NCAA Injury Surveillance Program Datalys Center for Sports Injury Research and Prevention Indianapolis, IN 46202 What is the background for this study? What are the main findings? Dr. Kerr: A 2013 Institutes of Medicine report called for more research on concussion in athletes aged 5-21 years.  Although there is much research on the incidence of concussion across this age span, there is less related to outcomes such as symptoms and return to play time, let along comparisons by age. In examining sport-related concussions that occurred in youth, high school, and college football, we found differences in the symptomatology and return to play time of concussed players.  For example, the odds of return to play time being under 24 hours was higher in youth than in college.  Also, over 40% of all concussions were returned to play in 2 weeks or more. (more…)
Author Interviews, Depression, Mental Health Research, OBGYNE, Pediatrics, Pharmacology / 02.05.2016 Interview with: Heli Malm, MD, PhD Specialist in Obstetrics and Gynecology Teratology Information Service Helsinki University and Helsinki University Hospital What is the background for this study? What are the main findings? Dr. Malm: Animal studies have demonstrated that exposure to SSRIs during early brain development can result in depression-like behavior in adolescence. Today 6% of pregnant women in the US and 4% in Finland are on selective serotonin reuptake inhibitors (SSRIs) at some stage of pregnancy. SSRIs pass the placenta but no prior studies have followed children beyond childhood to monitor the development of depressive disorders, which typically emerge after puberty onset. Results on autism spectrum disorders (ASD) and attention-deficit/hyperactivity disorders (ADHD) have been conflicting. The study material is based on national register data from Finland. We investigated offspring psychiatric diagnoses, including depression, anxiety, ASD, and ADHD, of nearly 16,000 mothers who had used SSRIs during pregnancy between 1996 and 2010. Children in this cohort ranged in age from 0 to 15 years old. Because maternal psychiatric illness can affect offspring neurodevelopment in the absence of SSRIs, primary comparisons were made between offspring of the SSRI group and offspring of mothers with a psychiatric disorder diagnosis but no antidepressant use. Children exposed to SSRIs during gestation were diagnosed with depression at an increasing rate after age 12, reaching a cumulative incidence of 8.2% by age 15, compared to 1.9% in the group of children exposed to maternal psychiatric illness but no antidepressants. Rates of anxiety, autism spectrum disorder (ASD), and attention-deficit/hyperactivity disorder (ADHD) diagnoses did not differ significantly between the two groups. (more…)
Alzheimer's - Dementia, Author Interviews, Dermatology / 01.05.2016 Interview with: Alexander Egeberg, MD PhD National Allergy Research Centre, Departments of Dermato-Allergology and Cardiology Herlev and Gentofte University Hospital University of Copenhagen Hellerup, Denmark What is the background for this study? What are the main findings? Dr. Egeberg: Certain proteins and inflammatory processes have been found in increased levels in the skin of patients with rosacea, and these have also been linked to dementia, in particular Alzheimer's disease. While this may be one potential explanation, we cannot say for sure that this is the cause. Our team have recently shown a link between rosacea and other neurological diseases, and single-case reports have previously described a possible association between rosacea and Alzheimers disease. However, this is the first comprehensive investigation of Alzheimer's disease in a large population of patients with rosacea. We found a slightly increased risk of dementia, in particular Alzheimer's disease in patients with rosacea. (more…)
Author Interviews, Autism, Pediatrics, Toxin Research / 01.05.2016 Interview with: Steven Daniel Hicks, M.D., Ph.D. Penn State Hershey Medical Group Hope Drive, Pediatrics Hershey, PA 17033 What is the background for this study? What are the main findings? Dr. Hicks:  This research was inspired by results of the CHARGE study (examining environmental influences on autism) which showed that specific pesticides (including pyrethroids) increased the risk of autism and developmental delay, particularly when mothers were exposed in the 3rdtrimester. We recognized that the department of health sprayed pyrethroids from airplanes in a specific area near our regional medical center every summer to combat mosquito borne illnesses. We asked whether children from those areas had increased rates of autism and developmental delay. We found that they were about 25% more likely to be diagnosed with a developmental disorder at our medical center than children from control regions without aerial spraying of pyrethroids. (more…)
Author Interviews, Cancer Research, JAMA, Karolinski Institute, Mental Health Research / 28.04.2016 Interview with: Donghao Lu MD, PhD candidate Department of Medical Epidemiology & Biostatistics, Karolinska Institutet Stockholm What is the background for this study? What are the main findings? Dr. Lu: Psychiatric comorbidities are common among cancer patients. However, whether or not there is already increased risk of psychiatric disorders during the diagnostic workup leading to a cancer diagnosis was largely unknown. We found that, among cancer patients, the risks for several common and potentially stress-related mental disorders, including depression, anxiety, substance abuse, somatoform/conversion disorder and stress reaction/adjustment disorder started to increase from ten months before cancer diagnosis, peaked during the first week after diagnosis, compared to cancer-free individuals in Sweden. (more…)
Author Interviews, Cognitive Issues, JAMA / 28.04.2016 Interview with: Babak Hooshmand, MD, PhD, MPH Center for Alzheimer Research–Aging Research Center Karolinska Institutet Stockholm University, Stockholm, Sweden Department of Neurology, Klinikum Augsburg Augsburg, Germany What is the background for this study? What are the main findings?  Dr. Hooshmand: Low and subnormal levels of vitamin B12 as well as high levels of homocysteine (a vascular risk factor and neurotoxic amino-acid associated with B12 deficiency) are common conditions in the elderly and are associated with a variety of disorders, including cardiovascular and cerebrovascular conditions. Our study showed that over 6-year of follow-up, both low vitamin B12 status and high homocysteine levels are associated with accelerated brain atrophy in older adults, which precedes clinical dementia. (more…)
Alzheimer's - Dementia, Author Interviews, Biomarkers / 27.04.2016 Interview with: Dr Anne Poljak Leader of the Proteomics Group Centre for Healthy Brain Ageing (CHeBA) UNSW, Australia What is the background for this study?  Dr Poljak: Amyloid-beta (Aβ) peptides are found in abundance in the plaque particles which build up in the Alzheimer’s brain and small blood vessels of the brain, and are therefore considered hallmark features of Alzheimer’s disease. However they are also found in blood which is a convenient body fluid for sampling purposes. We therefore wished to assay them in plasma samples from one of our longitudinal population based studies of older age individuals (70 – 90 years) – the Centre for Healthy Brain Ageing’s Sydney Memory and Ageing Study. Other research groups had previously measured these peptides in plasma, but there was controversy in the area because of differences in outcomes across laboratories. So one of the main questions was whether plasma levels of Aβ peptides have any relationship with what is happening in the brain, or are they a red-herring? We wanted to see how the levels we found would compare with the findings of others in relation to Alzheimer’s disease and mild cognitive impairment. A further question was how our plasma levels would relate to other clinical measures including cognition and brain volumetrics. One of the precautions we took was to use an assay kit with very well characterized antibodies, so we could be confident that our method was specific for the two full length Aβ peptides (Ab1-40 and Ab1-42). (more…)
Author Interviews, Brain Injury, Exercise - Fitness / 26.04.2016 Interview with: Jaclyn B. Caccese MS The University of Delaware PhD Candidate Biomechanics and Movement Science What is the background for this study? Response: Recently, there has been increased concern regarding the adverse effects of repetitively heading soccer balls on brain function. While some studies have shown impaired balance and vision, it is unclear if these deficits are acute or chronic adaptations. Therefore, the purpose of this study was to identify changes in postural control and vestibular/ocular motor function immediately following an acute bout of 12 purposeful soccer headers. What are the main findings? Response: The main finding of this study was that women's soccer players showed an increase in sway velocity, but no other changes in balance or vestibular/ocular motor function were identified. (more…)
Aging, Author Interviews, Mental Health Research / 25.04.2016 Interview with: Dr. Jesus Bertran-Gonzalez, Clem Jones Centre for Ageing Dementia Research, Queensland Brain Institute University of Queensland Brisbane Australia What is the background for this study? Response: It has long been recognized that elderly people often show behavioural inflexibility, for example they may have difficulties in finding alternative routes to reach a previously known place in neighbourhoods that have changed, or they may find it difficult to remember new episodes in their life, as opposed to very old ones. The question that we wanted to address in this study is how this memory rigidity in old individuals affects their goal-directed performance, as this can directly impair their capacity to adjust their behaviour to new demands in the environment. Specifically, we wanted to investigate the changes in the brain that occur with normal ageing that have these negative effects on adaptation, and that can potentially keep old people from achieving their needs. (more…)
Author Interviews, Cognitive Issues, Heart Disease, JAMA / 22.04.2016 Interview with: Thomas H. Marwick, MBBS, PhD, MPH Baker IDI Heart and Diabetes Institute Melbourne, Australia What is the background for this study? What are the main findings? Dr. Marwick: Readmission for heart failure (HF) remains common and the risk of this remains hard to predict. It's possible that existing risk scores don't cover all important patient features. We confirmed that cognitive impairment was an unmeasured contributor and incorporated this measurement in a prediction model. The resulting model was the most reliable reported to date and could be used to identify patients who need the closest follow up to avoid readmission. (more…)
Author Interviews, Schizophrenia, Smoking / 20.04.2016 Interview with: Stéphane Potvin, PhD Associate professor, Department of Psychiatry Eli Lilly Chair in Schizophrenia Research University of Montreal What is the background for this study? What are the main findings? Dr. Potvin:  Life expectancy is substantially reduced in schizophrenia, and one of the main factors contributing to this is the high prevalence of cigarette smoking in these patients. The leading hypothesis for cigarette smoking in schizophrenia is the self-medication hypothesis. Although some empirical results show that nicotine improves cognitive performance in schizophrenia, some authors have criticized the self-medication hypothesis for its implied (and unintented) justification of cigarette smoking in schizophrenia. About a decade ago, it has been hypothesized that cigarette smoking may be more reinforcing in schizophrenia patients, due to biological dysfunctions common to schizophrenia and tobacco use disorder. However, that model had not been formally tested. Based on recent findings showing that cigarette cravings are increased in schizophrenia smokers, compared to smokers with no comorbid psychiatric disorder, we performed a neuroimaging study on cigarette cravings in schizophrenia. Unless we are wrong, this was most probably the first study to do so. We found that relative to control smokers, smokers with schizophrenia had increased activations of the ventro-medial prefrontal cortex in response to pleasant images of cigarette. What is is interesting is that the ventro-medial prefrontal cortex is one of the core regions of the brain reward system, which mediated the reinforcing effects of several psycho-active substances, including tobacco. As such, our results tend to confirm the assumption that cigarette might be more reinforcing in schizophrenia smokers. (more…)
Alzheimer's - Dementia, Author Interviews, JAMA, UCSF / 20.04.2016 Interview with: Jennifer S. Yokoyama, PhD Assistant Professor, Memory and Aging Center University of California, San Francisco What is the background for this study? Dr. Yokoyama: Alzheimer’s disease is a common neurodegenerative disease that occurs in older adults. Clinically, Alzheimer’s disease is primarily associated with changes in cognition (e.g., declines in memory, language and visuospatial functioning). Pathologically, Alzheimer’s disease is associated with misfolded amyloid beta and tau proteins and can only be definitively diagnosed at autopsy. It has long been appreciated that there is a link between the immune system and Alzheimer’s disease, and there are multiple sources of evidence that suggest that immune activity may be increased in patients with Alzheimer’s. Although there is strong evidence for an association between immune activity and Alzheimer’s disease there has always been a chicken-egg problem because we don’t know whether the Alzheimer’s disease process triggers the immune response or whether altered immune function promotes the Alzheimer’s disease process. Genetic information can offer important clues about the role of the immune system in Alzheimer’s disease. Each person has a unique genetic fingerprint, and different combinations of gene changes (“variants”) put individuals at higher or lower risk for different diseases. Genetic data enables us to test whether having a certain genetic variant puts people at greater risk for both Alzheimer’s disease and autoimmune diseases, immune system diseases in which the immune system is overactive (e.g., Crohn's disease, ulcerative colitis, rheumatoid arthritis, type 1 diabetes, Celiac's disease, and psoriasis). Rather than only responding to foreign objects such as bacteria and viruses, in autoimmune diseases the immune system also responds to the body’s own material, which do not ordinarily create an immune response, thereby leading to symptoms associated with higher levels of inflammation and other long-term problems. A variant that increases risk for both Alzheimer’s disease and autoimmune diseases would suggest a common biological pathway. What are the main findings? Dr. Yokoyama: In our study we tested whether there are genetic variants that put people at increased risk for both Alzheimer's disease and autoimmune diseases. We found eight genetic variants that influence people’s risk for both Alzheimer's disease and autoimmune disease. Some of these variants were associated with lower risk of autoimmune disease and Alzheimer’s disease, but two variants were associated with greater risk for both.   (more…)
Author Interviews, Brain Injury, Neurological Disorders / 13.04.2016 Interview with: Thomas A. Buckley Ed.D Assistant Professor Kinesiology & Applied Physiology 144 Human Performance Lab College of Health Sciences University of Delaware What is the background for this study? What are the main findings? Dr. Buckley: The most recent international consensus statement recommends 24 - 48 hours of cognitive and physical rest in the immediate aftermath of a concussion; however, our clinical experience was that patients who were "shut down" for a few days did worse than patients who were allowed to be out and about as tolerated by symptoms.  This was a retrospective study (chart review) comparing symptom reporting among patients who were shut down for 24 hours and those who were not. The main finding of the study was the addition of a day of cognitive and physical rest (i.e., 'shut down") did not improve symptom recovery recovery.  In fact, we were surprised to see that the non-rest group was symptom free 1.3 days sooner than the rest group and this was statistically significant. (more…)
Alzheimer's - Dementia, Author Interviews / 12.04.2016 Interview with: Dr. Sven Joubert, PhD Département de psychologie, Université de Montréal Centre de recherche Institut universitaire de gériatrie de Montréal (CRIUGM) Montréal, Canada What is the background for this study? What are the main findings? Dr. Joubert: Difficulties in recognizing familiar people in Alzheimer's disease have typically been attributed to the underlying memory impairment. There is evidence however that people with Alzheimer's disease also have difficulties in visual perception. The aim of this study was to determine if people with Alzheimer's were specifically impaired at face perception. In the current study, people with Alzheimer's along with healthy seniors were asked to process pictures of faces and cars at both upright and inverted orientation. Results showed that persons with Alzheimer's disease had a reduced face inversion effect, in other words they had a disproportionate impairment in processing upright relative to inverted faces. This reduced inversion effect in Alzheimer's disease, which was specific to faces, may reflect a reduced ability in "holistic" processing of faces, in other words the ability to form intergrated and individualized representations of faces based on their local features. (more…)
Author Interviews, Autism, Brigham & Women's - Harvard, PLoS / 09.04.2016 Interview with: Ya Wen PhD TRANSCEND Research, Neurology Department Massachusetts General Hospital, Charlestown, Massachusetts, Harvard Medical School, Harvard University, Boston, Massachusetts Higher Synthesis Foundation, Cambridge, Massachusetts What is the background for this study? Dr. Ya Wen: At the time of this study (December 2014), the SFARI (Simons Foundation Autism Research Initiative) Gene-Human Gene Module recorded 667 human genes implicated as relevant to Autism spectrum disorders (ASDs). Now the number is close to 800. We sought to address the challenge of making sense of this large list of genes by identifying coherent underlying biological mechanisms that link groups of these genes together. To do this, we used information from several existing and well established databases and created a “demographics” of autism genes and pathways. What are the main findings? Dr. Ya Wen: From these hundreds of autism genes, we first found the relatively most important pathways, and then we generated a pathway network by mapping the pathway-pathway interactions into an Autism Pathway Network. Our systems analyses of this network converged upon an important role in autism pathophysiology for two pathways: MAPK signaling and calcium signaling, and specifically the process where they overlap, “calcium-protein kinase C-Ras-Raf-MAPK/ERK”. Our study also illuminated genetic relationships between autism and several other kinds of illness, including cancer, metabolic and heart diseases. Many of the significant genes and pathways were associated with vulnerability in the processing of challenging environmental influences. (more…)
Author Interviews, Mental Health Research, NYU, PLoS, PTSD / 06.04.2016 Interview with: Glenn Saxe, MD Arnold Simon Professor of Child and Adolescent Psychiatry and Chair, Department of Child and Adolescent Psychiatry NYU Langone’s Child Study Center Dr. Saxe’s bio page What is the background for this approach? What are the main advantages and drawbacks to the CS-CN method in psychiatry research? Dr. Saxe: Psychiatric disorders are complex and, in all likelihood, emerge and are sustained over time because they form what is called a complex system, involving the interaction between a great many variables of different types (e.g. molecules, neurons, brain circuits, developmental, social variables). There is a strong literature on complex systems in other fields that show remarkably similar properties between vastly different types of systems. Unfortunately, data methods used in research in psychiatry are not designed to ‘see’ the possible complex systems nature of a psychiatric disorder. Our method is designed to identify networks of variables related to psychiatric disorders that, together, have properties of complex systems. If such a system is identified, it may reveal new ways to treat these disorders. (more…)
Author Interviews, Cognitive Issues, Dental Research / 06.04.2016 Interview with: Elham Emami, DDS, MSc, PhD Director , Oral Health and Rehabilitation Research Unit & Associate Professor Faculty of Dental Medicine & School of Public Health Université de Montréal Adjunct Professor McGill University What is the background for this study? What are the main findings? Dr. Emami: Over the past 20 years, scientific evidence has shown that oral and general health are closely linked. Recently, studies have shown that there is also a link between the number of teeth an older person has and his/her cognitive status. We carried out a meta-analysis using the data from these latter studies. Our results indicate that, taking into account socioeconomic differences and other potential confounding variables, a person with less than 20 teeth has a 20% greater risk of having cognitive decline (HR= 1.26, 95% CI = 1.14 to 1.40) and dementia (HR = 1.22, 95% CI = 1.04 to 1.43) than someone who has 20 or more teeth. (more…)
Author Interviews, Brain Injury / 01.04.2016 Interview with: Dr. David W. Lawrence, MD Department of Family & Community Medicine St Michael's Hospital, University of Toronto Toronto, Ontario, Canada What is the background for this study? What are the main findings? Dr. Lawrence: The risk of all-cause injury and concussion for NFL athletes is significant. There has been a lot of discussion recently about this risk of injury in the NFL and general player safety, particularly regarding concussions. The first step in improving player safety and lowering that risk is to identify the factors affecting injury rates. Once we can answer those questions, we can begin to modify player exposure. (more…)
Author Interviews, Diabetes, Mental Health Research, OBGYNE / 30.03.2016 Interview with: Eyal Sheiner, MD,PhD Department of Obstetrics and Gynecology Soroka University Medical Center Beer-Sheva Israel What is the background for this study? What are the main findings? Dr. Sheiner: The reported rates of gestational diabetes mellitus (GDM) are constantly escalating and little is known about the long term complications in the offspring. Evidence from the field of epigenetics strongly advocated the need for research on the neuropsychiatric impact of being exposed prenatally to GDM. In our study, in utero exposure to  gestational diabetes mellitus was found to be an independent risk factor for long term neuropsychiatric morbidity of the offspring. (more…)
AHA Journals, Author Interviews, Heart Disease, PTSD / 27.03.2016 Interview with: S. Marlene Grenon, MDCM, MMSc, FRCSC Associate Professor of Surgery Division of Vascular and Endovascular Surgery University of California, San Francisco Veterans Affairs Medical Center- Surgical Services San Francisco, CA What is the background for this study? What are the main findings? Dr. Grenon: In this study, we investigated the impact of PTSD on endothelial function using flow-mediated brachial artery vasodilation. After adjustments for different risk factors and comorbidities, we found that patients with PTSD had worse endothelial function. (more…)
Author Interviews, Genetic Research, JAMA, Schizophrenia / 26.03.2016 Interview with: S. Hong Lee, PhD Queensland Brain Institute, The University of Queensland, Brisbane School of Environmental and Rural Science, University of New England, Armidale Australia What is the background for this study? What are the main findings? Response: Previous studies reported increased risk of schizophrenia (SCZ) in offspring associated with both early and delayed parental age. However, it remains unclear if the risk to the child is due to psychosocial factors associated with parental age or if those at higher risk for schizophrenia tend to have children at an earlier or later age. We found evidence for a significant overlap between genetic factors associated with risk of schizophrenia and genetic factors associated with Age at First Birth (AFB). We observed a U-shaped relationship between schizophrenia risk and maternal AFB, consistent with the previously reported relationship between schizophrenia risk in offspring and maternal age when not adjusted for age of the father. (more…)
Author Interviews, Depression / 21.03.2016 Interview with: Theodore Henderson, MD, PhD Neuroluminance Ketamine Infusion Centers What is the background for this study? What are the main findings? Dr. Henderson: Depression is a widespread problem. Psychotropic medications or therapy are the standard treatments, but they are often disappointing. Some studies have shown that the response rate to antidepressant medications is only 12-17% better than placebo response rate. Newer non-pharmacetical treatments, like transcranial magnetic stimulation, appear to have only a 50% response rate at best. The seminal study by Berman and colleagues in 2000 showed that sub-anesthetic dose infusions of the anesthetic, ketamine, produced a rapid antidepressant response. Many clinics across the United States focus on these rapid effects. Our clinic has been treating patients with treatment-resistant depression (defined as failing five or more antidepressants) for over three years. Our response rate is 80% based on multiple depression rating scales. We report here on 100 of the over 300 patients in our clinic who agreed to share their data in a research study. We treated patients with ketamine infusions no more frequently than once per week, unlike the clinical studies and many other ketamine clinics. We found our patients did equally well or better and received fewer treatments. The neurobiology of ketamine and its mechanism of action hold the key. Ketamine is a potent activator of the growth factor, brain derived neurotrophic factor (BDNF). This growth factor reverses the damage that depression causes to the brain – loss of synapses, dearborization of dendrites, and neuronal death. Ketamine’s ability to activate BDNF over time is responsible for a persistent antidepressant effect upon the brain. (more…)