Author Interviews, JAMA, PTSD / 08.10.2015

Kathryn Magruder, Ph.D., M.P.H. Johnson Veterans Affairs Medical Center Charleston, S.C.MedicalResearch.com Interview with: Kathryn Magruder, Ph.D., M.P.H. Johnson Veterans Affairs Medical Center Charleston, S.C. Medical Research: What is the background for this study? What are the main findings? Dr. Magruder: There has been lots of attention and concern over PTSD in your younger veterans — both male and female -- and in male Vietnam veterans.  Too often the women who served during the Vietnam Era have been largely overlooked.  We felt like we owed it to them to understand better their responses to their wartime experiences — even if 40 years later.  It’s never too late to do the right thing! Our main finding is that the women who served in Vietnam had high prevalence of PTSD (20% lifetime, 16% current) and this was not attributable to cases that had developed prior to entering the military.  This was higher than the women who served near Vietnam or in the United States.  When we looked at their reported experiences during the Vietnam Era, the women who were in Vietnam reported higher levels of exposure to all of the items on our scale.  It was these experiences — especially sexual harassment, performance pressures, and experiences with triage and death — that explained their higher levels of PTSD. (more…)
Author Interviews, JAMA, Mental Health Research, Surgical Research / 08.10.2015

Dr. Junaid A. Bhatti MBBS PhD Sunnybrook Health Sciences Centre Toronto, ONMedicalResearch.com Interview with: Dr. Junaid A. Bhatti MBBS PhD Sunnybrook Health Sciences Centre Toronto, ON Medical Research: What is the background for this study? What are the main findings? Dr. Bhatti:  Bariatric surgery remains an important option for morbidly obese patients where other obesity management options fail. It is a safe procedure with mortality risk not higher than any other major procedure of this type. Some studies report that some patients may experience psychological stress following surgery. Studies on the long-term outcomes noted that there was a higher suicide risk in bariatric patients as compared to the general population. It was not clear whether these risks increased following surgery. In this study, we used the data of bariatric patients from Ontario who underwent surgery between 2006 and 2011. We assessed their emergency room visits three years before and three years following surgery. We looked into whether these patients had significantly more visits related to suicide attempts before compared to post surgery period. Overall, about 111 patients (1%) of the cohort had suicide attempts during follow-up. What we saw is that suicide risk increased by 50% following surgery than before surgery period. The risks were higher, but not significantly higher than others, if they were 35 years or older or from low-income or rural settings. The emergency services utilization of suicide attempts following surgery was more intense for the visits before surgery. (more…)
Author Interviews, Brain Injury, NEJM / 07.10.2015

Prof. Peter JD Andrews Honorary Professor Department of Anaesthesia University of EdinburghMedicalResearch.com Interview with: Prof. Peter JD Andrews Honorary Professor Department of Anaesthesia University of Edinburgh  Medical Research: What is the background for this study? Prof. Andrews: Therapeutic hypothermia has shown considerable promise as a neuro-protective intervention in many species and models of cerebral injury in the laboratory. Clinical trials after neonatal hypoxic ischemic encephalopathy and cardiac arrest (global cereal ischemia) show signal of benefit. The outcome after traumatic brain injury (TBI) has not improved in the last 20 years. Clinical trials of prophylactic therapeutic hypothermia for neuroprotection after traumatic brain injury show a mixed outcome, however, the larger trials are all neutral or have a trend toward harm. Because traumatic brain injury is a heterogeneous pathology it has been suggest that the therapeutic hypothermia intervention should be adjusted according to response of a biomarker, to maximize benefit and limit any harms. The EUROTHERM3235Trial was a trial of therapeutic hypothermia to reduce brain swelling after traumatic brain injury. Brain swelling was measured by an intracranial pressure (ICP) probe directly inserted into the brain. Medical Research: What are the main findings? Prof. Andrews: Hypothermia successfully reduced intracranial pressure, but did not improve outcomes compared to standard care alone, with more than a third achieving a good outcome in the standard care group and one a quarter in the hypothermia group. (more…)
Author Interviews, Eating Disorders, Microbiome / 06.10.2015

Dr. Ian Carroll, PhD Professor of medicine UNC Center for Gastrointestinal Biology and DiseaseMedicalResearch.com Interview with: Dr. Ian Carroll, PhD Professor of medicine UNC Center for Gastrointestinal Biology and Disease  Medical Research: What is the background for this study? What are the main findings? Dr. Carroll: Anorexia nervosa (AN) is a severe psychiatric disorder characterized by extreme weight dysregulation and presents with high rates of comorbid anxiety.Anorexia nervosa carries the highest mortality rate of all psychiatric illnesses and relapse is frequent. Although a prime contributor, genetic factors do not fully account for the etiology ofAnorexia nervosa, and non-genetic factors that contribute to the onset and persistence of this disease warrant investigation. Compelling evidence that the intestinal microbiota regulates adiposity and metabolism, and more recently, anxiety behavior, provides a strong rationale for exploring the role of this complex microbial community in the onset, maintenance of, and recovery from Anorexia nervosa. Our study provides evidence of an intestinal dysbiosis in AN and an association between mood and the enteric microbiota in this patient population. (more…)
Author Interviews, Mental Health Research / 04.10.2015

Adam Hanley, Doctoral candidate College of Education's Counseling/School Psychology program Florida State UniversityMedicalResearch.com Interview with: Adam Hanley Doctoral candidate College of Education's Counseling/School Psychology program Florida State University Medical Research: What is the background for this study? What are the main findings? Response: This study emerged from the intersection of my personal dislike of dishwashing, my grandmother’s unquestioned enjoyment of the task, and the inevitability of finding myself neck deep in her sink after holiday meals.  Contrasting my suffering with her cheer while pursuing my interest in informal meditation practices challenged me to revisit my dishwashing technique.  Approaching the dishes mindfully, attending to the full sensory experience and connecting with the task as an act of kindness, shifted my dishwashing experience.  The current study was developed to explore whether my new relationship with dishwashing was an isolated phenomenon or might be more generalizable.  To test this generalizability, 51 undergraduate college students were recruited and randomly assigned to wash a standardized set of dishes after reading instructions on either mindful or “correct” dishwashing procedures. (more…)
Author Interviews, Depression, Genetic Research, JAMA / 03.10.2015

Dr. David Brent MD Department of Psychiatry Western Psychiatric Institute and Clinic University of Pittsburgh Medical Center Pittsburgh, PennsylvaniaMedicalResearch.com Interview with: Dr. David Brent MD Department of Psychiatry Western Psychiatric Institute and Clinic University of Pittsburgh Medical Center Pittsburgh, Pennsylvania Medical Research: What is the background for this study? Dr. Brent: Youth with a parent with a history of depression are at increased risk for having a depressive episode themselves. Medical Research: What are the main findings? Dr. Brent: Those who received a cognitive behavioral educational group program were less likely to have had a depressive episode, and were functioning better than those who did to receive the program 6 years later, especially if their parent was NOT depressed at the time that they received the program. If the parent was depressed then the program was no better than usual care. (more…)
Author Interviews, Depression, OBGYNE, Pediatrics / 02.10.2015

Marte Handal PhD Division of Epidemiology Norwegian Institute of Public Health Oslo, Norway MedicalResearch.com Interview with: Marte Handal PhD Division of Epidemiology Norwegian Institute of Public Health Oslo, Norway  Medical Research: What is the background for this study? Dr. Handal: The prevalence of depression during pregnancy is estimated to be as high as between 7 and 15%. It is well understood that untreated maternal depression may be harmful to both the mother and the child. When medical treatment of pregnant women is necessary, selective serotonin reuptake inhibitors (SSRIs) is the most common treatment. However, limited information is available on the potential effect of prenatal exposure to SSRIs on the child’s motor development. Medical Research: What are the main findings? Dr. Handal: We did find a week association between prolonged maternal use of SSRIs during pregnancy and delayed motor development in the child even after we had taken the mothers history of depression and her symptoms of anxiety and depression during and after pregnancy into account. However, only a few children were in the least developed category, corresponding to clinical motor delay, indicating that clinical importance is limited. (more…)
Author Interviews, Mental Health Research / 30.09.2015

Brick Johnstone, Ph.D., ABPP Professor MU Department of Health Psychology DC116.88 Columbia, MO 65212 MedicalResearch.com Interview with: Brick Johnstone, Ph.D., ABPP Professor MU Department of Health Psychology DC116.88 Columbia, MO 65212  Medical Research: What is the background for this study? What are the main findings? Dr. Johnstone:  We are interested in identifying the specific religious/spiritual factors associated with health.  In general it is known that positive spirituality is associated with better health, and for a small population, negative spiritual beliefs are associated with worse health.  We wanted to see about such relationships for individuals who had any degree of negative spirituality (i.e., belief they were being punished, abandoned). The main finding is that even a minor degree of negative spiritual beliefs is associated with worse health. (more…)
Author Interviews, Depression, Heart Disease, JAMA / 28.09.2015

MedicalResearch.com Interview with:Dr-Ken-Freedland Kenneth E. Freedland, PhD Professor of Psychiatry and Psychology Washington University School of Medicine St. Louis, Missouri Medical Research: What is the background for this study? What are the main findings? Dr. Freedland: Major depression is a common problem in patients with heart failure, and it makes heart failure self-care tasks such as daily weight checks and compliance with dietary restrictions more difficult for these them.  Unfortunately, recent clinical trials have shown that both depression and inadequate self-care can be hard to treat in patients with heart failure. Cognitive behavior therapy (CBT) is often used to treat depression in otherwise healthy individuals, but it hasn’t been tested in patients with heart failure. We added a self-care component to the standard CBT treatment protocol and conducted a clinical trial to determine whether it is effective both for depression and for self-care.  We randomized 158 heart failure patients to  cognitive behavior therapy or to usual care, and both groups received heart failure education.  About 1/3 of the patients in both groups were also taking antidepressant medications. The intervention was effective for depression, with remission rates of 51% in the cognitive behavior therapy group compared to only 20% in the usual care group.  However, it was not effective for heart failure self-care. (more…)
Author Interviews, Cognitive Issues, Pediatrics, PLoS / 27.09.2015

Sophie von Stumm BSc MSc PhD Department of Psychology Goldsmiths University of London London, United KingdomMedicalResearch.com Interview with: Sophie von Stumm BSc MSc PhD Department of Psychology Goldsmiths University of London London, United Kingdom Medical Research: What is the background for this study? Dr. von Stumm: At the Hungry Mind Lab (www.hungrymindlab.com), which I direct, we study individual differences in lifespan cognitive development. In particular, I am interested in factors that influence change in cognitive ability and knowledge. One such factor is breastfeeding, which some previous studies suggested to be associated children's intelligence and IQ gains while others failed to find a relationship. Medical Research: What are the main findings? Dr. von Stumm: For this study, which was published last week in PloS One (link:http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0138676), data were analyzed from more than 11,000 children born in the UK between 1994 and 1996. The children had been repeatedly assessed on IQ: the first time they were tested on intelligence at age 2, and then again repeatedly throughout childhood, overall 9 times, until the age of 16 years. We found that having been breastfed versus not having been breastfed was not meaningfully associated with children's IQ differences at age 2 and also not with differences in children's IQ gains until age 16. That is not to say that breastfeeding may not have other benefits for children's development but our study strongly suggests that breastfeeding is not important for children's IQ.   (more…)
Author Interviews, Mental Health Research / 24.09.2015

MedicalResearch.com Interview with: Dr. Sanda Dolcos PhD Post-doc Fellow University of Illinois Medical Research: What is the background for this study? Dr. Dolcos : With its high prevalence rate, anxiety is a pressing concern in our society. Identifying psychological and neural markers indexing resilience against anxiety will help the development of prevention and intervention programs. It has been recognized that trait optimism fosters resilience against anxiety, and the orbitofrontal cortex (OFC) is sensitive to anxiety symptoms, but the relationship among the factors at these different levels --personality, brain, and symptoms-- has not been clear. Medical Research:  What are the main findings? 1) trait optimism was associated with lower level of anxiety 2) trait optimism is positively associated with the left OFC volume 3) the left OFC volume was negatively linked to anxiety, a relation partially accounted for by their mutual association with trait optimism. (more…)
Author Interviews, Lancet, Mental Health Research / 24.09.2015

Professor Jane Pirkis PhD Centre for Mental Health Melbourne School of Population and Global Health University of Melbourne, AustraliaMedicalResearch.com Interview with: Professor Jane Pirkis PhD Centre for Mental Health Melbourne School of Population and Global Health University of Melbourne, Australia Medical Research: What is the background for this study? What are the main findings? Professor Pirkis:  Public sites that gain a reputation as places where people might go to seek to end their lives are a particular problem in suicide prevention.  Any suicide is tragic, but suicides at these sites have an extra level of complexity because they can lead to copycat acts and can have a major impact on people who work at or live near these sites, or visit them for other reasons.  Our meta-analysis, which pooled data from 18 individual studies from around the world,  found that three interventions work really well in reducing suicides at these sites.
  • Restricting access to means (e.g., installing barriers) can reduce suicides at these sites by 90% or more, and
  • encouraging help-seeking (e.g., installing phones that link directly to crisis services) and
  • increasing the likelihood of someone intervening (e.g., installing CCTV cameras, training staff who work at these sites) can each reduce them by around 50%, or more in some cases.  The interventions seem to work well together and complement each other too.  
(more…)
Alzheimer's - Dementia, Author Interviews, Cleveland Clinic, JAMA / 22.09.2015

Jeffrey L. Cummings, M.D., Sc.D. Director, Lou Ruvo Center for Brain Health Camille and Larry Ruvo Chair for Brain Health Cleveland Clinic Las Vegas, NV 89106MedicalResearch.com Interview with: Jeffrey L. Cummings, M.D., Sc.D. Director, Lou Ruvo Center for Brain Health Camille and Larry Ruvo Chair for Brain Health Cleveland Clinic  Las Vegas, NV 89106  Medical Research: What is the background for this study? What are the main findings? Dr. Cummings: Agitation is a common problem in Alzheimer’s disease (AD); approximately 70% of patients with AD will experience periods of agitation.  This difficult behavior challenges patients and caregivers, adversely affects quality of life, and may precipitate institutionalization.  There are not drugs approved for treatment of agitation in Alzheimer’s disease. The study reported in JAMA showed that a drug based on a combination of dextromethorphan and quinidine (DM/Q) produced statistically significant and clinically meaningful reduction in agitation in Alzheimer’s disease patients.  The study met its primary outcome (decline in the Neuropsychiatric Inventory agitation scale in drug compared to placebo) and many of its secondary outcomes (e.g, decreases in caregiver stress).  The agent was safe and well tolerated. (more…)
Author Interviews, Cognitive Issues, Exercise - Fitness, Nutrition / 21.09.2015

Beetroot juice WikipediaMedicalResearch.com Interview with: Chris Thompson BSc MSc ANutr AFHEA University of Exeter St. Luke's Campus Exeter Devon Medical Research: What is the background for this study? Response: Dietary nitrate has been shown to favourably alter the contractility of type II muscle fibres and enhance blood flow to working muscles that are predominantly type II. Dietary nitrate may also improve perfusion to areas of the brain responsible for cognitive function. It is therefore possible that through these mechanisms, nitrate-rich beetroot juice supplementation may improve both physical and cognitive performance during exercise which reflects the high intensity intermittent nature of team sport play. Medical Research: What are the main findings? Response: Participants were able to complete greater total work during an intermittent sprint test following nitrate-rich beetroot juice supplementation. We also found that dietary nitrate enabled a reduction in response time to decision making during the cognitive tasks performed throughout the exercise test. (more…)
AHA Journals, Author Interviews, Blood Pressure - Hypertension, Cognitive Issues, Mental Health Research / 16.09.2015

Daniela Carnevale, PhD, Researcher Laboratory of Giuseppe Lembo, MD, PhD Dept. of Molecular Medicine "Sapienza" University of Rome & Dept. of Angiocardioneurology and Translational Medicine IRCCS Neuromed - Technology Park Località CamerelleMedicalResearch.com Interview with: Daniela Carnevale, PhD, Researcher Laboratory of Giuseppe Lembo, MD, PhD Dept. of Molecular Medicine "Sapienza" University of Rome & Dept. of Angiocardioneurology and Translational Medicine IRCCS Neuromed - Technology Park Località Camerelle Medical Research: What is the background for this study? Dr. Carnevale: Nowadays, one of the most demanding challenge in medicine is preserving cognitive functions during aging. It is well known that cardiovascular risk factors have a profound impact on the possibility of developing dementia with aging. However, we have no means to investigate this aspect in patients with cardiovascular diseases. Indeed, although we have clear clinical paradigms to explore target organ damage of vascular diseases like hypertension, we are less prepared to afford the brain damage that may result from chronic vascular diseases and impact on cognitive functions. Thus, we aimed at finding a diagnostic paradigm to assess brain damage that could predict for future development of dementia. Since it is becoming increasingly clear that hypertension may determine cognitive decline, even before manifest neurodegeneration, we elaborated a paradigm of analysis that are essentially focused on brain imaging and cognitive assessment. In particular, we used diffusion tensor imaging (DTI) on magnetic resonance that allows to reconstruct white matter connections that correlate with selective cognitive functions, and specifics tests for the evaluation of subtle alterations of cognitive functions. (more…)
Aging, Author Interviews, Mental Health Research, Neurology / 15.09.2015

R. Scott Turner, MD, PhD Director of the Memory Disorders Program Georgetown University Medical CenterMedicalResearch.com Interview with: R. Scott Turner, MD, PhD Director of the Memory Disorders Program Georgetown University Medical Center Medical Research: What is the background for this study? What are the main findings? Dr. Turner: The resveratrol trial originated from the extensive scientific literature demonstrating that caloric restriction (consuming only 2/3 usual calories) prevents or delays diseases of aging - including Alzheimer's disease (AD) in laboratory animals. The molecular mechanism is thought to involve sirtuins - a group of genes/proteins that sense energy balance to regulate gene expression. Sirtuins are activated by caloric restriction (a mild stressor) to express genes that promote resilience of the organism. Resveratrol is a potent activator of sirtuins - thus bypassing the requirement for caloric restriction. On the opposite side of the coin - caloric excess, midlife obesity, and diabetes are strong risk factors for Alzheimer's disease. And we have long-known that resveratrol is found in red grapes, red wine, and other foods that promote general health. (more…)
Author Interviews, Cognitive Issues, JAMA, Vitamin D / 15.09.2015

Joshua W. Miller, PhD Professor and Chair Dept. of Nutritional Sciences Rutgers The State University of New Jersey New Brunswick, NJ 08901 MedicalResearch.com Interview with: Joshua W. Miller, PhD Professor and Chair Dept. of Nutritional Sciences Rutgers The State University of New Jersey New Brunswick, NJ 08901  Medical Research: What is the background for this study? What are the main findings? Response: In recent years, there has been a growing scientific literature on the associations between low vitamin D status in older adults and risk of Alzheimer's disease/dementia, cognitive impairment and decline, and brain atrophy.  The vast majority of these studies have been conducted in predominantly white populations.  The relatively unique aspect of our study was that over half of the cohort consisted of African Americans and Hispanics.  What we found in our cohort (mean age ~75y, n=382 at baseline) was that participants with vitamin D deficiency (serum 25-hydroxyvitamin D <12 ng/ml) or vitamin D insufficiency (serum 25-hydroxyvitamin D between 12 ng/ml and <20 ng/ml) on average experienced faster rates of cognitive decline in episodic memory and executive function than participants with adequate vitamin D status.  Importantly, the association between vitamin D status and the rate of decline in cognitive function was independent of race/ethnicity.  However, the prevalence of low vitamin D status in the study participants was significantly higher in the African American and Hispanic participants compared with the White participants.  This is most likely due to the fact that darker skin pigmentation reduces the ability of sunlight to induce vitamin D synthesis in the skin.  It may also reflect differences in dietary intake of vitamin D and supplement use between the different race/ethnicity groups, though we did not assess this in our study.  Thus, though the rate of cognitive decline in African Americans and Hispanics does not seem to be more or less affected by low vitamin D status than in Whites, because African Americans and Hispanics have a higher prevalence of low vitamin D status, as subpopulations they may be more prone to rapid cognitive decline in old age.  Further studies addressing this possibility are needed. (more…)
Author Interviews, BMJ, Depression, Fish / 12.09.2015

MedicalResearch.com Interview with: Dr. Fang Li Department of Epidemiology and Health Statistics, The Medical College of Qingdao University, Qingdao, Shandong Province, People's Republic of China Medical Research: What is the background for this study? What are the main findings? Response: Fish, rich in multiple beneficial nutrients, including  n-3 polyunsaturated fattyacids, high-quality protein, vitamins and minerals, have been hypothesized to protect against chronic diseases generally , such as cardiovascular disease and cancer. Depression is a common mental health disorder,with an estimated 350 million people affected. We hypothesis that fish consumption may be benefical in depression prevention. Several epidemiological studies have investigated associations between fish intake and depression risk, but the findings are inconsistent. Therefore we conducted a meta-analysis to expect to find this association. A total of 26 studies involving 150 278 participants were included in the present meta-analysis.The pooled relative risk of depression for the highest versus lowest consumption of fish was 0.83 (95% CI 0.74 to 0.93). The findings remained significant in the cohort studies.This meta-analysis indicates that high-fish consumption can reduce the risk of depression. (more…)
Author Interviews, Mental Health Research, Sexual Health / 10.09.2015

Emmanuele A. Jannini, MD Chair of Endocrinology and Medical Sexology Department of Systems Medicine Tor Vergata University of Rome Roma, Italy.MedicalResearch.com Interview with: Emmanuele A. Jannini, MD Chair of Endocrinology and Medical Sexology Department of Systems Medicine Tor Vergata University of Rome Roma, Italy Medical Research: What is the background for this study? What are the main findings? Prof. Jannini: The background is due to the large experience of the researcher of my team, Dr. Giacomo Ciocca, on homophobia, a largely diffuse phenomenon in various forms. Although many social and cultural factors predispose to homophobic attitude, we have hypothesized that some psychological aspects of personality were in association with homophobia. Therefore, we found that psychoticism, a dysfunctional trait of thought, immature defense mechanisms, i.e., primitive responses to anxiety states, and a fearful model of relationship with other due to an insecure attachment style, could be considered risk factors for homophobic attitude. (more…)
Addiction, Author Interviews, CMAJ, Mental Health Research / 09.09.2015

Dr. Evan Wood MD, PhD, ABIM, FRCPC, ABAM Diplomat Professor of Medicine, UBC Canada Research Chair in Inner City Medicine Co-Director, Urban Health Research Initiative Medical Director for Addiction Services, Vancouver Coastal Health Physician Program Director for Addiction, Providence Health CareMedicalResearch.com Interview with: Dr. Evan Wood MD, PhD, ABIM, FRCPC, ABAM Diplomat Professor of Medicine, UBC Canada Research Chair in Inner City Medicine Co-Director, Urban Health Research Initiative Medical Director for Addiction Services, Vancouver Coastal Health Physician Program Director for Addiction Providence Health Care  Medical Research: What is the background for this study? What are the main findings? Dr. Wood: Drugs with the potential to produce altered states of consciousness were once the focus of intensive study in the 1950s and 1960s. While promising, this field of research has been dormant for decades but is now re-emerging as an area of intensive investigation and showing real potential as a new therapeutic paradigm in addiction medicine and mental health. While in its infancy, this is expected to be an area of much study in the coming years. Medical Research: What should clinicians and patients take away from your report? Dr. Wood: Psychedelic medicine is in its infancy and not ready for implementation in clinical practice. Clinicians and the community of individuals suffering from addiction and other concerns will hopefully support this area of research so that critical information on impacts and safety can be gathered. (more…)
Author Interviews, Exercise - Fitness, Mental Health Research / 07.09.2015

MedicalResearch.com Interview with: Eric A.F. Herbst MSc Ph.D. student Human Health and Nutritional Sciences University of Guelph Guelph, ONEric A.F. Herbst MSc Ph.D. student Human Health and Nutritional Sciences University of Guelph Guelph, ON Medical Research: What is the background for this study? What are the main findings? Response: Many neurological diseases result in declines in mitochondrial content and function in the brain. Therefore, the purpose for this study was to determine if mitochondrial content could be enhanced in the brain through exercise, as previously demonstrated in skeletal muscle, and also to determine if similar exercise-signaling pathways are activated between the two tissues in the process. This study found that despite reproducing similar findings in skeletal muscle, acute and chronic exercise did not activate traditional signaling mechanisms (AMPK, ERK1/2, CAMKII, P38) in either the cortex or striatum of the brain, nor did it result in sustained increases in mitochondrial respiration, DNA copy number, or protein content. (more…)
Author Interviews, Blood Pressure - Hypertension, Cognitive Issues, Geriatrics / 05.09.2015

Christine McGarrigle PhD Research Director The Irish Longitudinal Study on Ageing (TILDA) Lincoln Gate Trinity College Dublin Dublin MedicalResearch.com Interview with: Christine McGarrigle PhD Research Director The Irish Longitudinal Study on Ageing (TILDA) Lincoln Gate Trinity College Dublin Dublin   Medical Research: What is the background for this study? What are the main findings? Dr. McGarrigle: Mild cognitive impairment (MCI) is the intermediate state between healthy ageing and dementia and is a stage at which intervention could be effective in reducing conversion to dementia. Neurocardiovascular instability is an age-related dysregulation of the blood pressure systems manifesting as exaggerated blood pressure variability and orthostatic hypotension (OH). Previous evidence has shown that autonomic dysfunction, blood pressure variation and hypotension are associated with mild cognitive impairment. Our study found that systolic blood pressure variation was associated with cognitive decline. Mild cognitive impairment participants were more likely to have had OH and more prolonged OH compared to cognitively normal controls. Mild cognitive impairment participants with impaired orthostatic blood pressure responses were twice more likely to convert to dementia than mild cognitive impairment participants without the impaired response over a three year follow-up period. (more…)
Author Interviews, BMJ, Depression, Nutrition / 03.09.2015

Dr. Mila Kingsbury PhD Senior Research Associate at Department of Epidemiology and Community Medicine University of Ottawa MedicalResearch.com Interview with: Dr. Mila Kingsbury PhD Senior Research Associate at Department of Epidemiology and Community Medicine University of Ottawa   Medical Research: What is the background for this study? Dr. Kingsbury: Eating a healthy diet, including enough fruits and vegetables, is good for physical health, and some evidence suggests that it may be good for mental health, too. Specifically, intake of fruits and vegetables has been associated with lower risk of depression. However, there are very few longitudinal studies on this topic. Most studies haven’t accounted for the effects of other related lifestyle factors such as smoking and exercise, nor for the fact that the links between lifestyle and mental health are bidirectional (i.e., depression can also hinder our ability to engage in healthy behaviours). Medical Research: What are the main findings? Dr. Kingsbury: While we found an association between fruit and vegetable consumption and psychological distress and depression two years later, depression and distress also predicted future fruit and vegetable consumption. Importantly, these associations became non-significant when we controlled for lifestyle factors like smoking and exercise. (more…)
Author Interviews, McGill, Mental Health Research / 01.09.2015

Fabrice Jollant, MD, PhD McGill University, Department of Psychiatry & Douglas Mental Health University Institute McGill Group for Suicide Studies Montréal (Québec), CanadaMedicalResearch.com Interview with: Fabrice Jollant, MD, PhD McGill University, Department of Psychiatry & Douglas Mental Health University Institute McGill Group for Suicide Studies Montréal (Québec), Canada Medical Research: What is the background for this study? What are the main findings? Dr. Jollant: Suicide takes almost 1 million lives each year worldwide. Improving suicide prevention necessitates improving our understanding of the mechanisms leading to these complex acts. We know that while many people who died from suicide had experienced negative life events (divorce, job loss, grief), most people who experience these events will not commit suicide, not even think about suicide. Similarly, while more than 90% of suicide completers had suffered a major mental disorders (mainly depression and substance abuse) and treating these mental disorders can reduce suicide rates, 90% of patients will never die from suicide. Thus, research focuses now on the specific factors that make some individuals more vulnerable. We previously found that individuals who attempted suicide are more likely to make risky choices at a gambling task than patients who went through depression but never attempted suicide. They tend to choose the options that yield more gains immediately but are long-term disadvantageous. People who choose this way are also more likely to have problems in their interpersonal relationships, a classic trigger of suicidal crisis. Medical Research: What are the main findings? Dr. Jollant: This study continues our previous series of investigations. Here, we assessed decision-making in close biological relatives of suicide completers. We know that suicide is heritable and can run within some families. So, we were interested in knowing if risky decision-making could be one factor transmitted within families of suicide completers. We recruited healthy individuals who had lost a close biological relative from suicide, but never attempted suicide themselves. We found that these persons also tend to choose the riskiest options. However, we could not find some other cognitive deficits previously found in suicide attempters, e.g. deficient cognitive control. These normal cognitions may therefore counterbalance their deficits in decision-making and maybe protect them against suicide. (more…)
Author Interviews, Mental Health Research, Psychological Science / 30.08.2015

Brian W. Haas, Ph.D. Assistant Professor Department of Psychology University of Georgia MedicalResearch.com Interview with: Brian W. Haas, Ph.D. Assistant Professor Department of Psychology University of Georgia Medical Research: What is the background for this study? What are the main findings? Dr. Haas: We used a new way to study Borderline Personality Disorder.  We studied the traits associated with this condition in healthy people not diagnosed with Borderline Personality Disorder.  We found that people that possess more Borderline Personality traits exhibit reduced brain activity in parts of the brain important for empathy. (more…)
ADHD, Author Interviews, Memory / 28.08.2015

Dr. Graham Murray PhD University Lecturer Department of Psychiatry Addenbrooke's Hospital Cambridge UKMedicalResearch.com Interview with: Dr. Graham Murray PhD University Lecturer Department of Psychiatry Addenbrooke's Hospital Cambridge UK Medical Research: What is the background for this study? What are the main findings? Dr. Murray: There is debate about the extent to which ADHD persists into adulthood, with estimates suggesting that between 10-50% of children still have ADHD in adulthood. Diagnosis (whether in childhood or adulthood) is currently reliant on meeting symptom checklists (such as the American Psychiatric Association’s Diagnostic and Statistical Manual), and a current diagnosis is often the prerequisite to access health care from psychiatric services. We decided to follow up a sample of 49 teens who all had a confirmed diagnosis of ADHD at age 16. We also followed a control group made up of comparison healthy volunteers from the same social, ethnic and geographical background. When we used the symptom checklist criteria of persistence, only 10% of patients still met ADHD diagnostic criteria in adulthood. However, there is more to ADHD than this. When it comes to adult brain structure and function, it didn’t make any difference whether symptom checklists were still met or not. On reaching adulthood, the adolescent ADHD group show reduced brain volume in the caudate nucleus - a key brain region that supports a host of cognitive functions, including working memory function. When we assessed working memory ability, we noted persistent problems in the adolescent ADHD group, with a third of the adolescent ADHD sample failing the memory test. The poor memory scores seemed to relate to a lack of responsiveness in the activity of the caudate nucleus that we could detect using functional MRI scans. In the control group, when the memory questions became more difficult, the caudate nucleus became more active, and this appeared to help the control group perform well; in the adolescent ADHD group, the caudate nucleus kept the same level of activity throughout the test. It was as if, for the controls, when the test got harder, the caudate nucleus went up a gear in its activity, and this is likely to have helped solve the memory problems. But for the adolescence ADHD group, the caudate couldn’t go up a gear when the test became harder, and this likely resulted in poorer performance.  (more…)
Author Interviews, Depression, Fertility / 28.08.2015

MedicalResearch.com Interview with: Camilla Sandal Sejbaek PhD Department of Public Health University of Copenhagen Medical Research: What is the background for this study? What are the main findings? Response: Previous literature have shown ambiguous results when investigating the association between becoming a mother and depression among women in fertility treatment. Small questionnaire-based studies with self-reported depression have shown that women in unsuccessful fertility treatment had a higher risk of depressive symptoms compared to women in successful fertility treatment. Two larger register-based studies using clinical depression (depression diagnosed at the psychiatric hospitals) have shown that women becoming a mother are at increased risk of clinical depression. Our findings, from a large register-based study with about 41,000 women in assisted reproductive technology (ART) treatment, showed that women WHO became mothers had a higher risk of clinical depression compared to women in ART treatment WHO did not become mothers. The risk of clinical depression were more than five-fold higher within the first 6 weeks after becoming a mother to a live-born child. (more…)
Author Interviews, Mental Health Research, Microbiome / 26.08.2015

Keith A. Crandall, PhD Director - Computational Biology Institute George Washington University Innovation Hall Suite 305 Ashburn, VA 20147-2766MedicalResearch.com Interview with: Keith A. Crandall, PhD Director - Computational Biology Institute George Washington University Innovation Hall Suite 305 Ashburn, VA 20147-2766 Medical Research: What is the background for this study? What are the main findings? Dr. Crandall: We wanted to investigate whether or not there were significant differences in the microbiome (microbial composition) of patients with schizophrenia versus controls.  The other researchers have demonstrated a connection between microbiome diversity and brain development and behavior modulation associated with a variety of disorders.  Our initial study focuses on the oropharyngeal as a target for the microbiome characterization, but we have additional work relating to other microbiomes (e.g., gut) for which we are still in the process of analyzing the data.     Collected microbiome data from 16 individuals with schizophrenia and 16 controls (matched as best we could and corrected statistically for differences between the populations), we showed differences in the microbiome taxonomic diversity and functional diversity.  Specifically, we identified a significant increase in the number of metabolic pathways related to metabolite transport systems; whereas, carbohydrate and lipid pathways and energy metabolism were abundant in controls. (more…)
Alzheimer's - Dementia, Author Interviews, JAMA / 26.08.2015

Dr. Eric Reiman MD Executive Director, Banner Alzheimer’s Institute (BAI) Chief Executive Officer, Banner Research, Clinical Director of the Neurogenomics Division at the Translational Genomics Research Institute (TGen) Professor of Psychiatry, University of Arizona Director, Arizona Alzheimer’s ConsortiumMedicalResearch.com Interview with: Dr. Eric Reiman MD Executive Director, Banner Alzheimer’s Institute (BAI) Chief Executive Officer, Banner Research Clinical Director of the Neurogenomics Division at the Translational Genomics Research Institute (TGen) Professor of Psychiatry, University of Arizona Director, Arizona Alzheimer’s Consortium Phoenix Arizona   Medical Research: What is the background for this study? What are the main findings? Dr. Reiman: Beta-amyloid plaque deposition is a cardinal feature of Alzheimer’s disease. Recent positron emission tomography (PET) have suggested that about one-fourth of patients with the clinical diagnosis of mild-to-moderate Alzheimer’s dementia—and more than a third of those who had no copies of the APOE4 gene, the major genetic risk factor for Alzheimer’s—do not have appreciable amyloid plaque deposition. We wondered whether this finding reflected an absence of appreciable brain amyloid, particularly in APOE4 non-carriers, or instead an underestimation of amyloid plaques using PET. In those patients with minimal plaque deposition, we also wondered what percentages had neuropathological evidence of another dementia-causing disease, neurofibrillary tangle pathology (the other cardinal feature of Alzheimer’s, or no known pathological contribution. We surveyed data from the 100 APOE4 non-carriers and 100 APOE4 carriers who had the clinical diagnosis of mild-to-moderate Alzheimer’s dementia during their last visit at any of the nation’s Alzheimer’s Disease Centers and had an autopsy performed within the next 2 years. As we reported in JAMA Neurology, 37 percent of APOE4 non-carriers and 13 percent of APOE4 carriers with a clinical diagnosis of mild-to-moderate Alzheimer’s had minimal evidence of neuritic or diffuse amyloid plaques—and those for whom we had brain samples had no evidence of increased soluble amyloid. A proportion of individuals had a different neuropathological diagnosis. While nearly half of those patients with minimal amyloid or any other pathology had extensive tangle formation, a similar percentage was found in cognitively unimpaired persons in the same age range. Our findings suggest the PET findings are correct – that a quarter of all patients (and more than a third of APOE4 non-carriers) with the clinical diagnosis of Alzheimer’s dementia do not have appreciable amyloid pathology, and that about 10 to 15 percent of patients do not have a clear explanation for their dementia. (more…)