Alzheimer's - Dementia, Author Interviews, Biomarkers / 27.04.2016

MedicalResearch.com Interview with: Dr Anne Poljak Leader of the Proteomics Group Centre for Healthy Brain Ageing (CHeBA) UNSW, Australia  MedicalResearch.com: 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

MedicalResearch.com Interview with: Jaclyn B. Caccese MS The University of Delaware PhD Candidate Biomechanics and Movement Science  MedicalResearch.com: 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. MedicalResearch.com: 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

MedicalResearch.com Interview with: Dr. Jesus Bertran-Gonzalez, Clem Jones Centre for Ageing Dementia Research, Queensland Brain Institute University of Queensland Brisbane Australia MedicalResearch.com: 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

MedicalResearch.com Interview with: Thomas H. Marwick, MBBS, PhD, MPH Baker IDI Heart and Diabetes Institute Melbourne, Australia MedicalResearch.com: 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

MedicalResearch.com Interview with: Stéphane Potvin, PhD Associate professor, Department of Psychiatry Eli Lilly Chair in Schizophrenia Research University of Montreal MedicalResearch.com: 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

MedicalResearch.com Interview with: Jennifer S. Yokoyama, PhD Assistant Professor, Memory and Aging Center University of California, San Francisco MedicalResearch.com: 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. MedicalResearch.com: 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

MedicalResearch.com Interview with: Thomas A. Buckley Ed.D Assistant Professor Kinesiology & Applied Physiology 144 Human Performance Lab College of Health Sciences University of Delaware MedicalResearch.com: 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

MedicalResearch.com Interview with: Dr. Sven Joubert, PhD Département de psychologie, Université de Montréal Centre de recherche Institut universitaire de gériatrie de Montréal (CRIUGM) Montréal, Canada MedicalResearch.com: 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

MedicalResearch.com 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 MedicalResearch.com: 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. MedicalResearch.com: 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

MedicalResearch.com 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   MedicalResearch.com: 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

MedicalResearch.com 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 MedicalResearch.com: 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

MedicalResearch.com Interview with: Dr. David W. Lawrence, MD Department of Family & Community Medicine St Michael's Hospital, University of Toronto Toronto, Ontario, Canada MedicalResearch.com: 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

MedicalResearch.com Interview with: Eyal Sheiner, MD,PhD Department of Obstetrics and Gynecology Soroka University Medical Center Beer-Sheva Israel   MedicalResearch.com: 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

MedicalResearch.com 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   MedicalResearch.com: 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

MedicalResearch.com 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  MedicalResearch.com: 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

MedicalResearch.com Interview with: Theodore Henderson, MD, PhD Neuroluminance Ketamine Infusion Centers MedicalResearch.com: 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…)
Author Interviews, Depression, Omega-3 Fatty Acids / 19.03.2016

MedicalResearch.com Interview with: Dr. Roel JT Mocking Program for Mood Disorders Department of Psychiatry Academic Medical Center University of Amsterdam, The Netherlands  MedicalResearch.com: What is the background for this study? Response: Omega-3 polyunsaturated fatty acid supplementation (popularly referred to as fish oil) is being promoted as (add-on) treatment for depression. Thus far, many studies have been performed that tested the effects of omega-3 fatty acids in depression. In order to overcome differences between these results of individual studies, a meta-analysis can be performed. A meta-analysis pools the results of all individual studies, and thereby provides a more definitive conclusion regarding the effect of omega-3 fatty acids in depression. Moreover, using the differences between the individual studies, a meta-analysis can point to factors that are associated with a better effect of the supplementation, for example supplementation dose or duration. There have been meta-analyses performed previously, but they seemed to contain several inconsistencies. For example, they accidentally included the same study two or three times, which results in errors. In addition, these meta-analyses did not only include studies performed in patients with the psychiatric disorder "major depressive episode", but also subjects from the general population with less severe depressive complaints. This makes it more difficult to interpret the results. Therefore, we performed a meta-analysis that included only studies performed in patients with major depressive disorder, and corrected errors from earlier meta-analyses. (more…)
Author Interviews, Mental Health Research, PTSD / 18.03.2016

MedicalResearch.com Interview with: Donna L. Littlewood PhD Student School of Psychological Sciences University of Manchester, UK MedicalResearch.com: What is the background for this study? What are the main findings? Response: Every year over 800,000 people die by suicide, and for every individual’s death, it is estimated that another 20 people will make a suicide attempt. Therefore, to be able to prevent suicide, we need to understand the different factors that can combine to make an individual think about ending their own life. Recent research indicates that nightmares are associated with suicidal thoughts and behaviours, and that this association is independent of other related suicide risk factors, such as, depression and PTSD. However, it is now important for research to examine the mechanisms that underpin this association, as this information will support the development of clinical interventions to prevent subsequent suicide attempts and deaths (more…)
Alzheimer's - Dementia, Author Interviews, Depression, JAMA, UCSF / 18.03.2016

MedicalResearch.com Interview with: Allison R. Kaup, PhD Assistant Adjunct Professor, UCSF Department of Psychiatry Clinical Research Psychologist / Clinical Neuropsychologist and Kristine Yaffe MD Professor of Psychiatry, Neurology and Epidemiology Chief of Geriatric Psychiatry and Director of the Memory Evaluation Clinic San Francisco VA Medical Center  MedicalResearch.com: What is the background for this study? Response: Previous research has shown that older adults with depression are more likely to develop dementia.  But, most studies have only examined an older adult’s depressive symptoms at one point in time.  This is an important limitation because we know that depressive symptoms change over time and that older adults show different patterns of depressive symptoms over time.  For the present study, older adults were followed for several years.  We assessed what patterns of depressive symptoms they tended to have during the early years of the study, and then investigated whether these different patterns were associated with who developed dementia during the later years of the study. MedicalResearch.com: What are the main findings? Response: Older adults in this study tended to show one of 3 different patterns of depressive symptoms.  Most tended to have few, if any, symptoms over time.  Some tended to have a moderate level of depressive symptoms at the beginning of the study, which increased over time.  And others tended to have a high level of depressive symptoms at the beginning of the study, which increased over time. We found that older adults with the high-and-increasing depressive symptoms pattern were almost twice as likely to develop dementia than those with minimal symptoms, even when accounting for other important factors.  While older adults with the moderate-and-increasing depressive symptom pattern were also somewhat more likely to develop dementia, this association was not as strong and did not hold up in our statistical models when we accounted for what individuals’ cognitive functioning was like during the early years of the study. (more…)
AHA Journals, Author Interviews, Cognitive Issues, Heart Disease / 18.03.2016

MedicalResearch.com Interview with: Hannah Gardener, ScD Department of Neurology, Miller School of Medicine University of Miami Miami, FL MedicalResearch.com: What is the background for this study? Response: At the beginning of the study, 1,033 participants in the Northern Manhattan Study (average age 72; 65 percent Hispanic, 19 percent black and 16 percent white), were categorized using the American Heart Association’s “Life’s Simple Seven®” definition of cardiovascular health, which includes tobacco avoidance, ideal levels of weight, physical activity, healthy diet, blood pressure, cholesterol and glucose. The participants were tested for memory, thinking and brain processing speed. Brain processing speed measures how quickly a person is able to perform tasks that require focused attention. Approximately six years later, 722 participants repeated the cognitive testing, which allowed us to measure performance over time. The cardiovascular health factors, which have been shown to predict risk of stroke and myocardial infarction, were then examined in relation to cognitive performance and impairment over time. (more…)
Author Interviews, BMJ, Karolinski Institute, Mental Health Research, Schizophrenia / 16.03.2016

MedicalResearch.com Interview with: Anna-Clara Hollander PhD Division of Social Medicine, Department of Public Health Sciences Karolinska Institutet, Stockholm, Sweden. MedicalResearch.com: What is the background for this study? What are the main findings? Response: The humanitarian crises in Europe, the Middle East, north Africa, and central Asia have led to more displaced people, asylum seekers, and refugees worldwide than at any time since the second world war. Refugees are known to be at an increased risk of mental health problems, such as post-traumatic stress disorder and other common mental disorders, compared to non-refugee migrants, but little is known about their risk of psychosis. The aim of the study was to determine the risk of schizophrenia and other non-affective psychotic disorders among refugees, compared to non-refugee migrants, and the general Swedish population. We used a linked national register data to examine more than 1.3 million people in Sweden, and tracked diagnoses of non-affective psychotic disorders among the population. The cohort included people born to two Swedish-born parents, refugees, and non-refugee migrants from the four major refugee generating regions: the Middle East and north Africa, sub-Saharan Africa, Asia, Eastern Europe and Russia. Results showed 3,704 cases of non-affective psychotic disorders during the 8.9 million person years of follow up. Refugees granted asylum were on average 66% more likely to develop schizophrenia or another non-affective psychotic disorder than non-refugee migrants. In addition, they were up to 3.6 times more likely to do so than the Swedish-born population. Incidence rates for non-affective psychosis were 385 per million in those born in Sweden, 804 per million in non-refugee migrants, and 1264 per million in refugees. The increased rate in refugees was significant for all areas of origin except sub-Saharan Africa, for whom rates in both groups were similarly high relative to the Swedish-born population. One possible explanation is that a larger proportion of sub-Saharan Africa immigrants will have been exposed to deleterious psychosocial adversities before emigration, irrespective of refugee status. Alternatively post-migratory factors, such as discrimination, racism, and social exclusion may explain these high rates. Overall, our findings are consistent with the hypothesis that increased risk of non-affective psychotic disorders among immigrants is due to a higher frequency of exposure to social adversity before migration, including the effects of war, violence, or persecution. (more…)
Abuse and Neglect, Autism, Depression / 14.03.2016

MedicalResearch.com Interview with: Dr. Rebecca A. Charlton PhD Senior Lecturer in Psychology; Undergraduate Admissions Tutor Department of Psychology Goldsmiths, University of London New Cross London, UK MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Charlton: Although Autism Spectrum Disorders are classified as developmental disorders, they last throughout life. Autism Spectrum Disorders were first identified in the 1940s, but it was only from the 1960s onwards that awareness of the condition began to increase. Initial research into Autism focused on the area of greatest need, i.e. childhood and education. Only now that those individuals first diagnosed with Autism are reaching old age are studies able to examine what happens in late-life. Although there are an increasing number of older adults with a diagnosis of Autism Spectrum Disorders, it is often difficult to identify individuals willing to participate in research. One alternative is to explore Autism traits in the general population, this is known as the Broad Autism Phenotype (BAP). These BAP traits occur in relatives of those with Autism and in the general population. By examining the BAP in community-dwelling older adults, we can begin to understand whether these traits confer additional risk to in ageing. MedicalResearch.com: What did you do in the study? What are the main findings? Dr. Charlton: Adults aged over 60 years old were recruited to take part in the study. They completed questionnaires reporting on presences of  Broad Autism Phenotype traits, executive functions (the ability to plan and organise behaviour), mood (depression and anxiety), and social support. Of the 66 individuals who participated, 20 individuals reported significant BAP traits – classified as the  Broad Autism Phenotype group. Individuals in the BAP group reported more problems with executive functions, higher rates of depression and anxiety, and less social support than those in the non-BAP group. Further analyses demonstrated that having  Broad Autism Phenotype traits was the factor that most explained presence of depression and anxiety symptoms among these older adults. (more…)
Alzheimer's - Dementia, Author Interviews, Exercise - Fitness, Lifestyle & Health / 14.03.2016

MedicalResearch.com Interview with: Cyrus A. Raji, MD, PhD Resident in Diagnostic Radiology UCLA Health System  MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Raji: The purpose of this study was to investigate the relationship between caloric expenditure from leisure physical activities (15 different ones were assessed from walking to gardening to dancing to swimming etc.). Increased caloric expenditure from these physical activities were related to larger gray matter volumes in key brain areas for memory and learning (hippocampus, precuneus) that are also affected by Alzheimer's. These findings were demonstrated in 876 persons who had MRI scans and caloric expenditure assessed. Five years after the scan a subset of 326 persons from the larger group of 876 were followed cognitively and it was found that those with larger gray matter volumes associated with physical activity in the orbital frontal cortex and precuneus had a 2 fold reduction in the risk for cognitive decline to mild cognitive impairment and Alzheimer's dementia.  (more…)
Author Interviews, Brain Injury, Pediatrics / 10.03.2016

MedicalResearch.com Interview with: Roger Zemek, MD, FRCPC Associate Professor, Dept of Pediatrics and Emergency Medicine, Clinical Research Chair in Pediatric Concussion, University of Ottawa Director, Clinical Research Unit, Children’s Hospital of Eastern Ontario Ottawa, ON MedicalResearch.com: What is the background for this study? Dr. Zemek: The number of concussions have dramatically increased over the past decade.  Not only are children and adolescents are at highest risk for getting concussions, they also take longer to recover.  As part of our background work, our team performed a systematic review (published in JAMA Pediatrics) confirming that validated, easy-to-use prognosticators did not exist for clinicians to identify children with concussion who are at the highest risk for persistent post-concussive symptoms (PPCS) and sequelae. MedicalResearch.com: What are the main findings? Dr. Zemek: In this, the largest concussion study in the world to-date, we derived and validated in a large, diverse cohort of children a clinical risk score that is significantly superior to clinicians’ ability to predict future PPCS at the time of ED presentation. Multivariate analysis revealed that age group, female sex, past history of migraine, prior concussion with symptom duration of >1 week, ED presentation with “answering questions slowly”, 4 or more errors on BESS Tandem stance, and the initial symptoms of headache, noise sensitivity and fatigue were all clinically significant and strongly associated with PCS at 1-month. We assigned points based on the adjusted multivariate odds ratio, and the rule incorporating patient demographic factors, past history, early cognitive deficits, balance (an physical exam finding), and early symptoms.  The rule has a maximum of 12 points.  We selected two cut-off points in order to yield three clinically relevant (low, intermediate and high risk) categories for the development of PPCS at one month. (more…)
Anesthesiology, Author Interviews, Cognitive Issues, Surgical Research / 09.03.2016

MedicalResearch.com Interview with: Unni Dokkedal, M.P.H. Unit of Epidemiology, Biostatistics, and Biodemography University of Southern Denmark MedicalResearch: What is the background for this study?  Response: Early (seven days) postoperative cognitive impairment is common in adult surgical patients of all ages, but elderly patients are at higher risk for this complication. Previous studies have shown that these impairments are detectable up to three months after surgery in patients older than 60 years. Furthermore, the condition may persist for longer than six months in some patients with potential long-term implications of the surgery leading to impaired quality of life and increased mortality risk. We wanted to investigate the contribution of surgery, anesthesia, preexisting conditions and other factors on the postoperative cognitive functioning of elderly patients. MedicalResearch:  What are the main findings? Response: For a sample of 4,299 middle-aged twins younger than 70 years and 4,204 elderly twins over 70 years, all of whom were residents of Denmark, medical records were reviewed from 1977 and until the accomplishment of cognitive tests in the period from 1995 to 2001. Results from five cognitive tests were compared in twins exposed to surgery, classified as major, minor, hip and knee replacement, or other, with those of a reference group without surgery. A statistically significant lower composite cognitive score was found in twins with at least one major surgery compared with the reference group (mean difference, −0.27; 95% CI, −0.48 to −0.06), which is a negligible effect size. None of the other groups differed from the reference group except the knee and hip replacement group that tended to have higher cognitive scores (mean difference, 0.35; 95% CI, −0.18 to 0.87).To consider genetic and shared environmental confounding and to take preoperative cognition into account, intrapair analyses were performed in same-sexed pairs in whom one had a history of major surgery and the other no surgery. No difference was found in the intra-pair analysis. The results suggest that preoperative cognitive functioning and underlying diseases were more important for cognitive functioning in mid- and late life than surgery and anesthesia. (more…)
Author Interviews, Brain Injury, Genetic Research / 09.03.2016

MedicalResearch.com Interview with: Dr. Jane McDevitt Temple University in Philadelphia MedicalResearch.com: What is the background for this study? Dr. McDevitt: During a head impact there is a mechanical load that causes acceleration and deceleration forces on the brain within the cranium. The acceleration and deceleration causes stress to the neurons and initiates a neurometabolic cascade, where excitatory neurotransmitters such as glutamate are released and depolarize the cell.  This triggers protein channels to open and allow ions into and out of the cell.  Increases in calcium persist longer and have greater magnitude of imbalance than any other ionic disturbance. One channel responsible for allowing calcium into the cell is r-type voltage-gated calcium channel.  One of the main proteins within this voltage-gated calcium channel is the CACNA1E protein produced by the CACNA1E gene. This protein forms the external pore and contains a pair of glutamate residues that are required for calcium selectivity.   It is also responsible for modulating neuronal firing patterns. A variation within this gene (i.e,CACNA1E ) that regulates expression levels of CACNA1E could be associated with how an athlete recovers following a concussion injury. Upwards of 20% of the concussed population fall into the prolonged recovery category, which puts these athletes at risk for returning to play quicker than they should. Variation in recovery depends on extrinsic factors like magnitude of impact, and sport, or intrinsic factors like age or sex. One intrinsic factor that has not been definitively parsed out is genetic variation. Recovery is likely to be influenced by genetics because genes determine the structure and function of proteins involved in the cell’s resistance and response to mechanical stress. Due to CACNA1E’s relationship to calcium influx regulation, a single nucleotide polymorphism (SNP) could modify the expression level of the protein responsible for regulating calcium. Altered protein levels could lead to athlete’s responding to concussive injuries differently. The main objective of this study was to examine the association between CACNA1E SNPs with concussion recovery in athletes. (more…)
Author Interviews, Cannabis, Lancet, Mental Health Research / 08.03.2016

MedicalResearch.com Interview with: Dr Sagnik Bhattacharyya Reader in Translational Neuroscience and Psychiatry Institute of Psychiatry, Psychology & Neuroscience, KCL Consultant Psychiatrist, Early Intervention Pathway Director, Maudsley Early Intervention in Dual Diagnosis clinic Psychosis Clinical Academic Group, South London & Maudsley NHS Foundation Trust King’s Health Partners  MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Bhattacharyya: Cannabis is the most commonly used illicit drug in the world and its use has been linked to the onset of psychotic disorders such as schizophrenia. Whilst a lot of research has investigated the association between cannabis use and the development of psychosis, there is less clarity regarding the consequences of continued cannabis use in those with an established psychotic disorder. We therefore pooled together all available evidence from studies that specifically looked at the effects of cannabis use on outcome following the onset of psychosis. Based on data from more than 16000 patients with a first episode or more established psychosis, our results show that continued cannabis use is consistently associated with poor outcome in the form of more relapses (as indexed by psychiatric hospitalisation), longer hospitalisations and increased positive symptoms. However, outcomes were not as bad if cannabis use was discontinued following the onset of psychosis. (more…)
Author Interviews, Cannabis, Mental Health Research / 06.03.2016

MedicalResearch.com Interview with: Dr. Rashmi Patel MA (Cantab) MA BM BCh PGDip (Oxon) MRCPsych Clinical Lecturer in General Psychiatry Kings College London MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Patel: Previous studies suggest that cannabis use is associated with an increased risk of developing a psychotic disorder but, until now, little was known about the effects of cannabis on people with an established psychotic disorder. Using novel text mining techniques, we investigated the association of cannabis use with the clinical outcomes of over 2,000 people following their first episode of psychosis. We found that cannabis use was associated with significantly poorer clinical outcomes including a 50% increased frequency of hospital admission and 35 additional days spent in hospital in the 5 years after first receiving treatment. We also found that the poor outcomes associated with cannabis use may be linked to antipsychotic treatment failure. (more…)