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…)
Author Interviews, Depression, Dermatology, NYU / 26.08.2015

Roger S. Ho, MD, MS, MPH, FAAD Assistant Professor The Ronald O. Perelman Department of Dermatology NYU Langone Medical CenterMedicalResearch.com Interview with: Roger S. Ho, MD, MS, MPH, FAAD Assistant Professor The Ronald O. Perelman Department of Dermatology NYU Langone Medical Center Medical Research: What is the background for this study? What are the main findings? Dr. Ho: In recent years, the impact of psoriasis on quality of life has come to light. We have seen several studies show that patients with psoriasis experience worse quality of life because of their disease. Few studies however have examined the association between psoriasis and mental illness, specifically depression. Many chronic diseases are known to be associated with depression. As more and more evidence supports the relationship between psoriasis and cardiovascular disease, it is important to examine the relationship between psoriasis and depression, while controlling for cardiovascular comorbidity. In our study of a nationally-representative population of US patients, we found that patients with psoriasis had twice the odds of having depression than patients without psoriasis, even after adjusting for major confounders including a history of myocardial infarction, stroke, and diabetes that may independently be associated with depression. The risk of depression did not depend on extent or severity of psoriatic disease. (more…)
Author Interviews, Blood Pressure - Hypertension, Cognitive Issues, Geriatrics, JAMA / 25.08.2015

MedicalResearch.com Interview with: Justine Moonen and Jessica Foster-Dingley On behalf of the principal investigators: Roos van der Mast, Ton de Craen, Wouter de Ruijter and Jeroen van der Grond Department of Psychiatry, Leiden University Medical Center Leiden, the Netherlands Medical Research: What is the background for this study? What are the main findings? Response: Mid-life high blood pressure is a well-known risk factor for cerebrovascular pathology and, consequently, cognitive decline in old age. However, the effect of late-life blood pressure on cognition is less clear. It has been suggested that at old age not a higher, but a lower blood pressure increases the risk of cognitive decline as well as neuropsychiatric symptoms. Older persons are at risk for impaired regulation of their cerebral blood flow, and stringently lowering their blood pressure may compromise cerebral blood flow, and thereby cognitive function. Therefore, we hypothesized that increasing blood pressure by discontinuation of antihypertensive treatment would improve cognitive and psychological functioning. We performed a community-based randomized controlled trial in a total of 385 participants aged ≥75 years with mild cognitive deficits and without serious cardiovascular disease, and who were all receiving antihypertensive treatment. Persons were randomized to continuation or discontinuation of antihypertensive treatment. Contradictory to our expectation, we found that discontinuation of antihypertensive treatment in older persons did not improve cognitive functioning at 16-week follow-up. (more…)
Author Interviews, Cognitive Issues, UCSF / 22.08.2015

Jin-Tai Yu MD, PhD Memory and Aging Center, Department of Neurology University of California San Francisco San Francisco, CA 94158 MedicalResearch.com Interview with: Jin-Tai Yu MD, PhD Memory and Aging Center, Department of Neurology University of California San Francisco San Francisco, CA 94158 Medical Research: What is the background for this study? What are the main findings? Response: The number of dementia cases in the whole world was estimated to be 35.6 million in 2010 and this number was expected to almost double every 20 years, to 65.7 million in 2030 and 115.4 million in 2050. The global prevalence of dementia was 5-7% and Alzheimer’s disease accounts for roughly 60%. This data means that we are facing an increasing number of global populations of this specific neurodegenerative disease and also the heavy burden brought by it. Data from the website of global clinical trials (http://clinicalTrials.gov) showed that a total of 1,732 clinical trials for Alzheimer’s disease were under way. However, the previous results are not so optimistic, possibly due to the complex etiological mechanisms. In one word, we had currently no effective drugs for this disease. Figuring out how to effectively prevent its occurrence is increasingly attracting people’s attentions.Therefore, we have done the most extensive and comprehensive systematic review and meta-analysis to date, which employs a full-scale search of observational studies to calculate effect sizes and grade the evidence strength of various modifiable risk factors for this disease. We hope these results will be informative and instructive. (more…)
Aging, Author Interviews, Cognitive Issues, Exercise - Fitness / 22.08.2015

Rikke Hodal Meincke PhD student Center for Healthy Aging and the Department of Public Health University of CopenhagenMedicalResearch.com Interview with: Rikke Hodal Meincke PhD student Center for Healthy Aging and the Department of Public Health University of Copenhagen Medical Research: What is the background for this study? Response: A sufficient level of physical capability is a precondition for maintaining independence and quality of life. Physical capability can be assessed objectively by tests of physical performance, for instance handgrip strength, chair-rising and postural balance. Physical performance is associated with mortality and disability in late life, so gaining insights into the variance in physical performance is important to promote sustained physical capability and prevent disability. Research has previously found physical activity, health status and socioeconomic position to be associated with physical performance. In addition, early life factors, such as childhood SEP, have been found to be associated with measures of physical performance later in life. The objective of our study was to examine the association between intelligence in early adulthood and midlife physical performance in Danish men. If an association between intelligence in early life and midlife physical performance exists it may indicate that cognitive abilities and physical performance share some of the same neurodevelopmental processes, but may also indicate that intelligence has an independent effect on later physical performance through various pathways. Medical Research: What are the main findings? Response: In our study of more than 2800 Danish men, we found positive associations between intelligence in early adulthood and five objective measures of physical performance in midlife independent of other early life factors. A one standard deviation increase in intelligence score resulted in 1.1 more chair-rises in 30 seconds, a 1 cm higher jump, a 3.7% smaller balance area, a 0.7 kg increase in handgrip-strength, and a 0.5 kg increase in lower back force. (more…)
Author Interviews, Depression, PNAS / 20.08.2015

Edward Hill PhD student Centre for Complexity Science Member of the Warwick Infectious Disease Epidemiology Research Centre (WIDER) at the University of WarwickMedicalResearch.com Interview with: Edward Hill PhD student Centre for Complexity Science Member of the Warwick Infectious Disease Epidemiology Research Centre (WIDER) at the University of Warwick Medical Research: What is the background for this study? Response: Depression is a major public health concern worldwide. We know social factors, such as living alone, can influence whether someone becomes depressed. We also know that social support (having people to talk to) is important for recovery from depression. Our study is slightly different as we looked at the effect of being friends with people on whether you are likely to develop depression or recover from being depressed. To do this, we looked at over 2,000 adolescents in a network of US high school students to see how their mood influenced each other. (more…)
Author Interviews, Memory / 20.08.2015

Laura Steenbergen, MSc., PhD Candidate Cognitive Psychology at Institute of Psychology Leiden UniversityMedicalResearch.com Interview with: Laura Steenbergen, MSc., PhD Candidate Cognitive Psychology at Institute of Psychology Leiden University  Medical Research: What is the background for this study? What are the main findings? Response: A recent initiative supported by several eminent research institutes and scientists calls for a more critical and active role of the scientific community in evaluating the sometimes far-reaching, sweeping claims from the brain training industry with regard to the impact of their products on cognitive performance. tDCS is a noninvasive brain stimulation technique that has developed into a promising tool to boost human cognition. Previous studies using medical tDCS devices have shown that tDCS promotes working memory (WM) updating in healthy individuals and patients. The aim of the current study was to investigate whether the commercial tDCS headset foc.us (v.1), which is easily and freely available to anyone in the world, does in fact improve cognitive performance, as advertised in the media. Results showed that active stimulation with the commercial device, compared to sham stimulation, significantly decreased working memory performance. The device we tested is just one example of a commercial device that can easily be purchased and, without any control or expert knowledge, used by anyone. The results of our study are straightforward in showing that the claims made by companies manufacturing such devices need to be validated. Even if the consequences of long-term or frequent use of the device are yet to be demonstrated, our findings provide strong support the important role of the scientific community in validating and testing far reaching claims made by the brain training industry. (more…)
Addiction, Author Interviews, Mental Health Research, Psychological Science / 18.08.2015

Professor Jackie Andrade PhD School of Psychology Cognition Institute Plymouth University Plymouth Australia MedicalResearch.com Interview with: Professor Jackie Andrade PhD School of Psychology Cognition Institute Plymouth University Plymouth Australia   Medical Research: What is the background for this study? What are the main findings? Dr. Andrade: We want to understand the mental processes that are going on during episodes of craving for drugs or food. We know that cravings are largely mental events because people rarely experience them when in the middle of a mentally-engaging task - giving a presentation or finishing an exciting novel, for example. By understanding the mental processes underpinning cravings, we can improve treatments for addiction and eating problems, and also find ways of strengthening desires for healthy activities. Visual mental imagery is a key component of craving, with people picturing themselves indulging their desires. Laboratory research has shown that blocking this craving imagery can reduce the strength of cravings for food and cigarettes. Tetris is a good task for doing this because it involves a lot of visual processing to keep track of the different coloured shapes and mentally rotate them to fit the spaces. For our latest study, we wanted to find out if Tetris helped block cravings in ‘real life’ rather than in the laboratory, and whether it worked for a range of common cravings. We asked 31 participants to carry iPods with them for a week. They received text messages 7 times a day prompting them to use the iPod to report whether they were craving something and, if so, what it was and how strong the craving was. A random 15 participants assigned to the Tetris condition were also asked to play Tetris for 3 minutes and answer the craving questions again. For this group, we compared the before-Tetris and after-Tetris craving scores on each occasion and found that cravings were 20% weaker after playing Tetris. People played Tetris 40 times on average, but the craving-reducing effect did not wear off as they got used to the game. The control group who reported cravings without playing Tetris allowed us to see how cravings varied naturally across the week. Tetris reduced craving strength across the range of cravings reported, which included cravings for drugs (alcohol, nicotine, caffeine), food, and ‘other activities’ including sleep, videogaming, sex and social interaction. (more…)
Author Interviews, Depression, JAMA, Pediatrics / 18.08.2015

Edward D. Barker, PhD Developmental Psychopathology Group Department of Psychology, King’s College London Institute of Psychiatry LondonMedicalResearch.com Interview with: Edward D. Barker, PhD Developmental Psychopathology Group Department of Psychology, King’s College London Institute of Psychiatry London Medical Research: What is the background for this study? Dr. Barker: The study looks at how the brain may be affected by experiences that happen early in life and adolescence. It has been known for a long time now that people who experience intense adversity are at increased risk of developing depression and other psychiatric problems. Previous research has also shown that both adversity and depression can affect the development of the brain and lead to altered brain structure. In this study, we wanted to examine how early adversity and depression relate to altered brain structure when you examined each within a specific temporal order (i.e., adversity, then depression/anxiety, then brain structure). This study design allowed us to examine not only the effects of adversity and depression, but also if some of the variation in brain structure associated with depression may also be explained by early adversity. Other researchers have previously suggested that some of the variation in brain structure observed in depressed patients may relate to early adversity, but no previous study has examined this prospectively like we did, using the Avon Longitudinal Study of Parents and Children. (more…)
Alzheimer's - Dementia, Author Interviews, Diabetes, Diabetologia / 14.08.2015

Laura Ekblad, MD, researcher Turku PET CentreMedicalResearch.com Interview with: Laura Ekblad, MD, researcher Turku PET Centre Medical Research: What is the background for this study? What are the main findings? Dr. Ekblad: The background for our study is that the metabolic syndrome and diabetes have been shown to increase the risk for cognitive decline and dementia. Also, insulin resistance is thought to play a pivotal role in the pathophysiology of Alzheimer´s disease. In addition, intranasal insulin administration is being studied as a promising treatment for Alzheimer´s disease. Previous studies indicate that both gender and APOE epsilon 4 genotype modulate the effects of insulin on cognition. Our main findings are that insulin resistance is associated with poorer verbal fluency, but only in women. Our population-based study consisted of adults from 30-97 years of age and we had nearly 6000 participants. Age did not modulate the association of insulin resistance and cognition, which means that our results apply even to young adults. We also found that insulin resistance associated with poorer verbal fluency only in non-carriers of the APOE epsilon 4 genotype. (more…)
Author Interviews, Cognitive Issues, Geriatrics, UCSF, Weight Research / 13.08.2015

Meera Sheffrin MD Geriatrics Fellow Division of Geriatrics | Department of Medicine San Francisco VA Medical Center University of California, San Francisco MedicalResearch.com Interview with: Meera Sheffrin MD Geriatrics Fellow Division of Geriatrics | Department of Medicine San Francisco VA Medical Center University of California, San Francisco Medical Research: What is the background for this study? What are the main findings? Dr. Sheffrin: The main drug treatments for dementia are a class of medications called cholinesterase inhibitors. They have only modest effects on cognition and function in most patients, but since they are one of the few available treatments for dementia and thus very commonly prescribed. However,they are known to cause GI side effects (nausea, vomiting, diarrhea, and anorexia) in many patients when first started. It is plausible they could also caust weight loss, espeically considering they cause nausea and anorexia. However, the data on weight loss from randomized controlled trials is very limited and inconclusive, so we did a very large observational study in a real-world of the VA national healthcare system who were newly started on these medications, to see if they were associated with weight loss. We found that patient with dementia started on cholinesterase inhibitors had a substantially higher risk of clinically significant weight loss over a 12-month period compared to matched controls. 1,188 patients started on cholinesterase inhibitors were matched to 2,189 similar patients who were started on other new chronic medications. The primary outcome was time to a 10-pound weight loss over a 12-month period, as this represents a degree of loss that would be clinically meaningful – not only noticed by a clinician but would perhaps prompt further action in considering the causes of the weight loss and medical work-up. We found that starting cholinesterase inhibitors was associated with a 24% greater risk of developing weight loss. Overall, 29% of patients started on cholinesterase inhibitors experienced a weight loss of 10 pounds or more, compared with 23% of the control group. This corresponds to a number needed to harm of 21 over 1 year; meaning only 21 patients need to be treated with a cholinesterase inhibitor over the course of a year for one patient to experience a 10 pound weight loss. (more…)
ADHD, Author Interviews, OBGYNE / 12.08.2015

Scott A. Adler, Ph.D. Associate Professor Coordinator Developmental Science Graduate Program Dept. of Psychology & Centre for Vision Research Visual and Cognitive Development Project York University Toronto, Ontario CanadaMedicalResearch.com Interview with: Scott A. Adler, Ph.D. Associate Professor Coordinator Developmental Science Graduate Program Dept. of Psychology & Centre for Vision Research Visual and Cognitive Development Project York University Toronto, Ontario Canada   Medical Research: What is the background for this study? Dr. Adler: Experiences that we have early in life clearly have an impact on our brain development and behavior as we get older.  Numerous studies have detailed these experiences, ranging from how we were fed as a baby to how many languages we hear to traumatic events.  These experiences have been shown to influence formation, maintenance, and pruning of the networks of synaptic connections in our brain's that impact all manner of thought and behavior.  Yet, the impact of one of the earliest experiences, that of being born, on brain and psychological behavior has not before been explored.  A recent study with rat pups has strongly suggested that the birth process has a definite impact on initial brain development.  If that is the case, what happens if the infant's birth is one in which she does not experience the natural birth process, such as occurs with caesarean section births? Medical Research: What are the main findings? Dr. Adler: There were two main findings from this study.  We measured the speed and timing of infants' saccadic eye movements, which are overt indicators of attention, relative to the onset of visual events on a computer monitor.  Moving attention and eye movements can occur through two general classes of processes.  The first is bottom-up mechanisms in which attention is moved reactively and automatically to the appearance or existence of unique and salient events in the world.  In this case, where attention goes is essentially controlled by the events in the world. The second is top-down mechanisms in which we move attention voluntarily to what we determine to be relevant event in the world based on our own cognitive biases and goals. This study found that 3-month-old infants born by caesarean section were significantly slower to move attention and make eye movements in reaction to the occurrence of visual events on the basis of bottom-up mechanisms than were infants born vaginally.  In contrast, there was difference between infants in moving attention and making eye movements in anticipation of the appearance of visual events on the basis of top-down mechanisms.  Additionally, maternal age, which has been shown to be related to the occurrence of caesarean sections, was found not to be related to the current effects. (more…)
Author Interviews, Biomarkers, Brain Injury, Johns Hopkins / 09.08.2015

Frederick Korley MD Ph.D Johns Hopkins University School of Medicine Emergency Medicine Baltimore, MarylandMedicalResearch.com Interview with: Frederick Korley MD Ph.D Johns Hopkins University School of Medicine Emergency Medicine Baltimore, Maryland Medical Research: What is the background for this study? Dr. Korley: Each year, millions of Americans are evaluated in emergency departments for traumatic brain injuries. Currently the only test available for diagnosing traumatic brain injury is a brain CT scan. Brain CT scans accurately identify bleeding in the brain from trauma. However, they are unable to identify damage to brain cells. Approximately 90% of patients with traumatic brain injury have no bleeding in the brain and therefore have unremarkable brain CT scans. However, these patients typically have damaged brain cells and they continue to suffer headaches, dizziness, attention and memory deficits, sleep problems among others for months after their injury and can’t figure out why. Therefore new tests are needed to identify traumatic brain injury patients with damaged brain cells and especially those who are likely to have persistent traumatic brain injury-related symptoms for months after injury. If you or any one in your family has sustained a brain injury in an accident, you might want to get in touch someone similar to this Personal Injury Lawyer St. Louis or a law firm more local to your area, who might be able to look into your case. Medical Research: What are the main findings? Dr. Korley: Our study determined that the blood levels of a protein called brain derived neurotrophic factor (BDNF) can help predict whether a patient will continue to have symptoms related to traumatic brain injury at six 6 months after injury, even if they had an unremarkable brain CT scan. (more…)
Alzheimer's - Dementia, Author Interviews, Sleep Disorders / 08.08.2015

Helene Benveniste, MD, PhD Professor of Anesthesiology and Radiology Vice Chair for Research, Department of Anesthesiology Stony Brook Medicine, Stony Brook NYMedicalResearch.com Interview with: Helene Benveniste, MD, PhD Professor of Anesthesiology and Radiology Vice Chair for Research, Department of Anesthesiology Stony Brook Medicine, Stony Brook NY Medical Research: What is the background for this study? Dr. Benveniste: The ‘glymphatic’ pathway is a part of the brain and is responsible for removal of waste products and excess fluid that built up especially during wakefulness. The concept was introduced by Nedergaard’s team in 2012 from University of Rochester. Importantly it has been shown to remove waste products such as soluble amyloid beta and tau protein which build up excessively in the brain of subjects afflicted with Alzheimer’s disease. The glymphatic system has been studied in detail in animal models (not yet humans) and actually is a brain-wide pathway which runs along (i.e. on the outside) of all vessels in the brain and connects to the space around the brain cells (referred to as the interstitial fluid (ISF) space). The outer part of the glymphatic network ‘tube’ is bordered by a certain type of brain cells so-called ‘astroglial’ cells which are arranged in a special way so that their endfeet cover >97% of the surface of all brain vessels. One can think of this as if the astroglial cell’s ‘endfeet’ are arranged as a donut shaped tube around all the vessels. On the astroglial endfeet there are special water channels (aquaporin-4 water channels) which are critical for how efficiently the glymphatic system can get rid of waste because it allows water to move fast through the brain tissue so as to ‘flush’ waste products out efficiently. The small gap between the astroglial endfeet also act like a ‘sieve’ so that only waste products of a certain size can access the entire pathway. Cerebrospinal fluid (CSF) circulates into the glymphatic pathway from the surface of the brain along the arteries which dives directly from the surface into the deeper part of the brain; and ultimately enters the space around the brain cells; and sweeps through it and thereby mixes with the interstitial fluid of the brain which contains waste products. The CSF-ISF mix with the waste products is then flushed out on the other ‘side’ along the veins and ultimately ends up in lymph vessels in the body and then in the blood. It has been shown that the glymphatic pathway removes brain waste more efficiently in a state of ‘unconsciousness’ e.g. sleep or anesthesia when compared to wakefulness. Given this intriguing finding i.e. that sleeps seems to affect the waste clearance from the brain we thought that the next to look at was sleeping positions. We did these studies in anesthetized rodents. (more…)
Author Interviews, JAMA, PTSD / 05.08.2015

Melissa A. Polusny, PhD, LP Staff Psychologist/Clinician Investigator Core Investigator, Center for Chronic Disease Outcomes Research Associate Professor, University of Minnesota Medical School Minneapolis VA Health Care System (B68-2) One Veterans Drive Minneapolis, MN 5541MedicalResearch.com Interview with: Melissa A. Polusny, PhD, LP Staff Psychologist/Clinician Investigator Core Investigator, Center for Chronic Disease Outcomes Research Associate Professor, University of Minnesota Medical School Minneapolis VA Health Care System One Veterans Drive Minneapolis, MN 5541 Medical Research: What is the background for this study? What are the main findings? Dr. Polusny: VA has invested heavily in the dissemination of prolonged exposure therapy and cognitive processing therapy as first-line treatments for PTSD; however, 30% to 50% of Veterans do not show clinically significant improvements and dropout rates are high. Evidence suggests that mindfulness-based stress reduction – an intervention that teaches individuals to attend to the present moment in a non-judgmental, accepting manner – can reduce symptoms of anxiety and depression. This randomized clinical trial compared mindfulness-based stress reduction with present-centered group therapy – sessions focused on current life problems. We randomly assigned 116 Veterans with PTSD to receive nine sessions of mindfulness-based stress reduction therapy (n=58) or nine sessions of present-centered group therapy (n=58). Outcomes were assessed before, during and after treatment, and at two-month follow-up. Exclusion criteria included: substance dependence (except nicotine), psychotic disorder, suicidal or homicidal ideation, and/or cognitive impairment or medical illness that could interfere with treatment. The primary outcome was a change in self-reported PTSD symptom severity over time. Secondary outcomes included interview-rated PTSD severity scores, self-reported depression symptoms, quality of life, and mindfulness skills. Mindfulness-based stress reduction therapy – compared with present-centered group therapy – resulted in a greater decrease in self-reported PTSD symptom severity. Veterans in the mindfulness-based stress reduction group were more likely to show clinically significant improvement in self-reported PTSD symptom severity (49% vs. 28%) at two-month follow-up, but they were no more likely to have loss of PTSD diagnosis (53% vs. 47%). Veterans participating in mindfulness-based stress reduction therapy reported greater improvement in quality of life and depressive symptoms than those in present-centered group therapy; however improvement in depressive symptoms scores did not reach the level of significance. Improvements in quality of life made during treatment were maintained at 2-month follow-up for Veterans in the mindfulness-based stress reduction group, but reports of quality of life returned to baseline levels for those in present-centered group therapy. The dropout rate observed for mindfulness-based stress reduction therapy (22%) in this study was lower than dropout rates reported in previous studies for PE (28.1% to 44%) and CPT (26.8% to 35%). (more…)
Author Interviews, Biomarkers, Brain Injury / 31.07.2015

Dr. Heinrich Thaler Trauma Hospital Meidling Vienna AustriaMedicalResearch.com Interview with: Dr. Heinrich Thaler Trauma Hospital Meidling Vienna Austria Medical Research: What is the background for this study? Dr. Thaler:  An increased prevalence of minor head injuries in elderly patients combined with the frequent use of platelet aggregation inhibitors resulted in increased hospital admissions and cranial computed tomography. We undertook the study with the aim to reduce the workload of medical staff and costs as well as the radiation burden in the management of patients with mild head injuries. Medical Research: What are the main findings? Dr. Thaler:  S 100B is a reliable negative predictor in elderly patients and/or in patients on platelet aggregation inhibitors to rule out an intracranial hemorrhage after minor head injury (S100B is an astroglial derived protein detectable in serum in the case of cerebral tissue damage). The negative predictive value of S100B is 99,6%. We conclude that S100B levels below 0.105 µg/L can accurately predict a normal cranial computed tomography after minor head injury in older patients and those on antiplatelet medication. Additionally we found no increased risk for intracranial hemorrhage in older patients or in patients receiving antiplatelet therapy. (more…)
Alzheimer's - Dementia, Author Interviews, Diabetes, JAMA, Nutrition / 31.07.2015

Auriel A. Willette, M.S., Ph.D. Food Science and Human Nutrition Neuroscience Interdepartmental Graduate Program Gerontology Interdepartmental Graduate Program Iowa State University, AmesMedicalResearch.com Interview with: Auriel A. Willette, M.S., Ph.D. Food Science and Human Nutrition Neuroscience Interdepartmental Graduate Program Gerontology Interdepartmental Graduate Program Iowa State University, Ames Medical Research: What is the background for this study? What are the main findings? Response: Obesity is a major health concern around the world. Obesity causes insulin resistance, defined in this case as the inability of insulin to bind to its receptor and mediate glucose metabolism. Other researchers and I have recently found that higher insulin resistance is associated with less glucose metabolism in the brains of patients with Alzheimer's disease. This relationship is found primarily in medial temporal lobe, an area necessary for generating new memories of facts and events. This is important because Alzheimer's disease is characterized by progressive decreases in glucose metabolism over time, and partly drives worse memory performance. Insulin resistance in midlife also increases the risk of developing Alzheimer's disease. We wanted to determine if insulin resistance is linked to similar effects in cognitively normal, late middle-aged participants decades before Alzheimer's disease typically occurs. If so, insulin resistance might be an important biological marker to track from middle-age onwards. Thus, we examined the association between insulin resistance, regional glucose metabolism using FDG-PET, and memory function in 150 middle-aged participants, many of whom had a mother or father with Alzheimer's disease. We found that higher insulin resistance was strongly associated with less glucose metabolism throughout many brain regions, predominantly in areas that are affected by Alzheimer's disease. The strongest statistical effects were found in left medial temporal lobe, which again is important for generating new memories. This relationship, in turn, predicted worse memory performance, both immediately after learning a list of words and a 20-minute delay thereafter. The take-home message is that insulin resistance has an Alzheimer's-like association with glucose metabolism in middle-aged, cognitively normal people at risk for Alzheimer's, an association which is related to worse memory. (more…)
Author Interviews, Brigham & Women's - Harvard, JAMA, Mental Health Research / 30.07.2015

Alexander C. Tsai, MD, PhD Center for Global Health, Massachusetts General Hospital, Boston Harvard Center for Population and Development Studies, Cambridge, MassachusettsMedicalResearch.com Interview with: Alexander C. Tsai, MD, PhD Center for Global Health Massachusetts General Hospital, Boston Harvard Center for Population and Development Studies Cambridge, Massachusetts Medical Research: What is the background for this study? What are the main findings? Dr. Tsai: Suicide is one of the leading causes of death among middle aged women, and the rates have been climbing over the past decade. At the same time, we know that Americans are becoming more and more isolated. As one example, over the past two decades, there has been a tripling in the number of people who say they don't have anyone to confide in about important matters. In our study, we tracked more than 70,000 American women over two decades and found that the most socially isolated women had a threefold increased risk of suicide. (more…)