Dr. McIntosh[/caption]
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.
Dr. Aaronson[/caption]
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.
Dr. Calati[/caption]
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.
Tine Vertommen[/caption]
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.
MedicalResearch.com Interview with: [caption id="attachment_33404" align="alignleft" width="107"] Dr. Guodong Liu[/caption] Guodong Liu, PhD Assistant Professor Division of Health Services and Behavioral Research Department of Public Health Sciences, A210 Penn State University College of Medicine Hershey, PA 17033 MedicalResearch.com: What is the background for this study? What are the main findings? Response: Adolescents with autism spectrum disorder (ASD) use emergency...
Dr. Richard Kryscio[/caption]
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).
Dr. Ullrich[/caption]
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.
Dr. Blayne Welk[/caption]
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.
Dr. Lumey[/caption]
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.
Dr. Hsu[/caption]
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.
Dr. Hilal Maradit Kremers[/caption]
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.
Dr. Taveras[/caption]
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.
Dr. Emma van Bussel[/caption]
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.
Dr. Guido Frank[/caption]
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.
Dr. Dobscha[/caption]
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.
Dr. Signy Sheldon[/caption]
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.
Dr. Emil Coccaro[/caption]
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.
Dr. Charvet[/caption]
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.
Dr. Petr Novak[/caption]
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.
Dr. Maxwell[/caption]
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).
Ernst L Noordraven[/caption]
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).
Dr. Ariela Orkaby[/caption]
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.