MedicalResearch.com Interview with:
David C. Rettew, MD
Associate Professor of Psychiatry and Pediatrics
Director, Child & Adolescent Psychiatry Fellowship
Director, Pediatric Psychiatry Clinic
University of Vermont College of Medicine
Medical Research: What is the background for this study? What are the main findings?
Dr. Rettew: We did this study because while everyone knew that antipsychotic medication rates were going up, there was very little data that drilled deeper and was able to get at the question about the appropriateness of this increase.
There’s good news and bad news in this study. The bad news is that our data show that about half the time, kids are not being treated with antipsychotic medications according to best practice guidelines. The good news is that it doesn’t look like these medications are being used casually or in a knee jerk way. In the vast majority of cases, youth are getting to this class of medications only after many other things have failed.
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MedicalResearch.com Interview with:
Dr. Raza M. Naqvi, MD, FRCPC
Assistant Professor of Medicine
Division of Geriatric Medicine
Western University
Victoria Hospital London, ON
Medical Research: What is the background for this study? What are the main findings?
Dr. Naqvi: The rates of dementia are rising worldwide. Currently we have over 35 million individuals with dementia in the world and this number will triple to over 100 million by 2050 according to the WHO. Many of these cases are in countries where English is not the first language and thus it is important to ensure that the diagnostic and assessment tools we use are valid in the populations being assessed.
The Rowland Universal Dementia Assessment Scale (RUDAS) was developed in Australia in 2004 specifically to address the challenges of detecting cognitive impairment in culturally and linguistically diverse populations. This assessment tool is a brief questionnaire that clinicians can use as part of their initial assessment in those with memory loss or cognitive decline. It is freely available online (Search ‘RUDAS’) and takes less than 10 minutes for a clinician to complete with the individual being assessed.
Our study was a systematic review and meta-analysis of the RUDAS which aimed to clarify the diagnostic properties of the test and see how it compares to other similar tests that are available.
Through our detailed search of the literature we found 11 studies including over 1200 patients that assessed the RUDAS. The studies showed a combined sensitivity of 77.2% and specificity of 85.9%. This means that a positive test increases one’s likelihood of having dementia more than 5-fold and a negative test decreases their likelihood by 4-fold.
Across the various studies, the Rowland Universal Dementia Assessment Scale performed similarly to the Mini-Mental State Examination (MMSE), the most commonly used cognitive assessment tool worldwide. The RUDAS appeared to be less influenced by language and education than the MMSE. (more…)
MedicalResearch.com Interview with:
Dr Søren Dalsgaard
National Centre for Register-based Research
Aarhus University Denmark
Medical Research: What is the background for this study? What...
MedicalResearch.com Interview with:
Dr. Rebecca E. Amariglio Ph.D.
Massachusetts Alzheimers Disease Research CenterMassachusetts General Hospital
Medical Research: What is the background for this study? What are the main findings?Dr. Amariglio: As the field of Alzheimer’s disease moves towards early detection and treatment, new tests that can measure very subtle changes in cognitive functioning are needed. A new instrument developed by the Alzheimer’s Disease Cooperative Study that measures subjective report of memory changes of both the study participant and a study partner (usually a family member) was associated with cognitive decline over four years. Specifically, greater report of memory concerns was associated with worse memory performance over time.
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MedicalResearch.com Interview with:
Bruno Meloni PhD
Centre for Neuromuscular and Neurological Disorders
The University of Western Australia, Nedlands,
Western Australia, Australia
MedicalResearch: What is the background for this study?A/Prof Meloni: Due to the lack of clinically available neuroprotective drugs to minimize brain injury after stroke we had been working in the neuroprotection field for some years within the Stroke Research Group at the WA Neuroscience Research Institute.
With respect to the latest findings, we were using arginine-rich peptides for several years as delivery vehicles to introduce experimental “neuroprotective peptides” into brain cells and the brain. Peptides are small chains of amino acids and the building blocks of protein. Arginine is one of the twenty amino acids naturally produced in the body. Arginine-rich peptides have an unique property in that they can transverse cell membranes and gain entry into cells, and even cross the blood brain barrier, which is unusual as most drugs able unable to do so.
Using in vitro neuronal cell culture stroke models we soon discovered that poly-arginine and arginine-rich peptides on their own possessed potent neuroprotective properties. Furthermore, we showed that as the length of the poly-arginine peptide increased so did the peptides neuroprotective properties. Excitingly, the poly-arginine peptides were even more potent than the ”neuroprotective peptides” we had been working with and peptides developed by other overseas researchers.
We have now confirmed using a laboratory animal stroke model that poly-arginine peptides could reduce brain damage when administered up to 1-hour after the stroke. (more…)
MedicalResearch.com Interview with:
Line Kenborg, MSc, PhD
Survivorship Unit
Danish Cancer Society Research Center
Copenhagen
Medical Research: What is the background for this study? What are the main findings?
Response: The hypothesis that head injuries increase the risk for Parkinson disease has been examined in many studies during the past decades, but the findings have been highly inconsistent. We have previously examined the hypothesis in a study based on information on head injuries and Parkinson disease from the Danish National Hospital Registry. In this study, we found a positive association between a hospital contact for a head injury in middle or late adulthood and a diagnosis of Parkinson disease. The reported association, however, was almost entirely due to injuries that occurred during the months preceding the first hospital contact for Parkinson disease. Because we used information from registries, we lacked detailed diagnostic information to distinguish Parkinson disease from other types of parkinsonism, and we had no information on milder head injuries and head injuries in early life. So we wanted to study whether head injuries throughout life increased the risk for Parkinson disease in the largest interview-based case-control study to date including patients with a verified diagnosis of Parkinson disease. The main finding of our study is that we do not find any association between head injuries and Parkinson disease.
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MedicalResearch.com Interview with:
Alisa G. Woods, Ph.D., MS Assistant Professor
Biochemistry & Proteomics Group
Department of Chemistry & Biomolecular Science
Clarkson University, Potsdam, NY, 13699
Medical Research: What is the background for this study? What are the main findings?
Dr. Woods: Objective assessments for autism are greatly needed in order to understand autism cause and also to diagnose autism. Currently autism is diagnosed based on behavior, despite theories that autism may have a biological cause. We sought to develop a non-invasive biological test for autism, using saliva and mass spectrometry-based proteomics. We found nine statistically significant proteins that were elevated in the saliva of children with autism relative to typically developing controls and three proteins that were significantly decreased or absent.
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MedicalResearch.com Interview with:
Carol Mathews
Professor, PsychiatryUCSF School of Medicine
Medical Research: What is the background for this study? What are the main findings?Dr. Mathews: The background for this study is that, as a part of ongoing genetic studies of Tourette Syndrome, the Tourette Syndrome Association International Genetics Collaborative (TSAICG) has collected a wealth of information about commonly co-occurring psychiatric disorders in individuals with Tourette Syndrome and their families, providing us with an opportunity to explore questions about Tourette Syndrome that are relevant to individuals with Tourette Syndrome, their families, and their treating clinicians.
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MedicalResearch.com Interview with:
Elizabeth Walker, PhD, MPH, MAT
FIRST Postdoctoral Fellow
Center for Behavioral Health Policy Studies
Rollins School of Public Health, Emory University
Medical Research: What is the background for this study?
Response: Mental disorders are a major cause of disability globally and are associated with premature mortality. Quantifying and understanding excess mortality among people with mental disorders can inform approaches for reducing this burden. The purpose of this study was to systematically review the literature in order to estimate individual- and population-level mortality rates associated with mental disorders. We conducted a comprehensive systematic review and meta-analysis, which included 203 studies from 29 countries.
Medical Research: What are the main findings?
Response: We estimated that 8 million deaths worldwide per year are attributable to mental disorders. People with mental disorders have over 2 times the risk of mortality compared to the general population or people without mental disorders. This translates to a median of 10 years of life lost. In total, 67.3% of people with mental disorders died from natural causes, 17.5% from unnatural causes, and the remainder from unknown causes.
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MedicalResearch.com Interview with:
Prof.dr. Judith K. Sluiter Principal Investigator
Manager KMKA: Kenniscentrum Medische Keuringen in Arbeid
Nationaal secretaris voor ICOH (International Commission on Occupational Health)
Coronel Instituut voor Arbeid en Gezondheid, Academisch Medisch Centrum / UvA Meibergdreef Amsterdam
Medical Research: What is the background for this study?
Prof. Sluiter: Professional footballers contain a group of employees working in a job with specific job demands. The occupational guidance and prevention of decreased work functioning of workers in these kinds of jobs should receive more attention. The mental health of professional footballers receive less attention compared to their physical health. We studied the prevalence of self-reported mental health problems and psychosocial difficulties in a group of current and former professional footballers, and we explored the association between having had psychosocial stressors and the health conditions under study.
Medical Research: What are the main findings?
Response: The response rate was 29% with available data from 253 footballers. In current players, the prevalence of mental health complaints ranged from 5% (burnout) to 26% (anxiety/depression). In former players, the prevalence ranged from 16% (burnout) to 39% (anxiety/depression). A small percentage of players had low self-esteem (3-5%). One quarter to two-fifth of the players showed adverse nutrition behaviour. Small but significant association between experiencing lower social support (OR=1.1) and having had recent life events (OR=1.4-1.6) and mental health complaints were found in current players. Having had severe injuries was associated with better nutrition behavior. In former players, having had life events showed a preventive effect on smoking (OR=0.4) and having had previous surgery was significantly associated with current smoking behavior (OR=1.9).
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MedicalResearch.com Interview with:
Erin L. Kelly PhD Post Doctoral Scholar
Health Services Research Center
University of California, Los Angeles, California
MedicalResearch: What is the background for this study? What are the main findings?Dr. Kelly: Mental health facilities can be hazardous workplaces. Nationally, compared to their counterparts in other healthcare settings, mental health workers are at the highest risk for patient assaults. Many studies have focused on predictors for assault such as gender, years of experience, or the position that staff hold in the hospital, which can account for a small amount of violence. However, psychiatric care is largely about relationships. Our study examined how conflicts with patients and coworkers, and how people react to conflict, influences their risk of assault.
In our study, 70% of staff at a large public mental hospital were assaulted in a single year, which is closer to the lifetime assault rate for mental health workers. We also found that the likelihood of assault is predicted by conflicts when we also include stress reactions to conflict as a moderator. We found that workers who reported being less reactive to conflict but experienced a great deal of conflict, with staff or patients, were at the highest risk of assault. This could mean that people who aren't afraid of conflict with patients are more likely to jump in with agitated patients or that people who are insensitive to conflict are missing important social cues and being assaulted more often. However, despite the similarity in the relationships of staff conflict and patient conflict with assault risk, it’s possible that the direction of the relationship between staff conflict and assault may be different. For example, mental health staff who have a lot of conflict with their co-workers may be isolated and therefore a target for assault by patients.
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MedicalResearch.com Interview with:
Ezequiel Morsella, Ph.D.
Associate Professor of Neuroscience Department of Psychology
San Francisco State University Assistant Adjunct Professor
Department of Neurology University of California, San Francisco
Boardmember, Scientific Advisory Board
Institute of Cognitive Neurology (INECO), Buenos Aires
Medical Research: What is the background for this study? What are the main findings?
Dr. Morsella: Previous studies have demonstrated that, under certain experimental conditions, conscious processes in the brain can function in a way that resembles reflexes. In past research, a single ‘high-level’ thought (e.g., the name of a visually-presented object) was triggered involuntarily by external stimuli. The current research is the first to trigger, not one, but two high-level unintentional conscious thoughts. In this experiment, participants were presented with an object (e.g., the picture of a star) and instructed to not subvocalize (i.e., name in one’s head but not aloud) the name of the object nor count the number of letters comprising the name of the object. On many trials, participants experienced both cognitions (e.g., “STAR” and “4”), even though these thoughts were against the intentions of the participant. Thus, this is the first demonstration of external control of two thoughts in the stream of consciousness. This research is based in part on the pioneering investigations of Wegner, of Gollwitzer, and of Ach.
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MedicalResearch.com Interview with:
Ashok K. Shetty, Ph.D.
Professor and Director of NeurosciencesInstitute for Regenerative Medicine and Department of Molecular and Cellular Medicine Texas A&M Health Science Center College of Medicine, Temple, TX Research Career Scientist, Central Texas Veterans Health Care System (CTVHCS), Temple, TX
Medical Research: What is the background for this study?
Prof. Shetty: Hippocampus is a region in the brain important for maintaining functions such as learning, memory and mood. However, this region is highly vulnerable to aging and brain insults. Previous research has shown that diminished function in the dentate gyrus region of the hippocampus is one of the key reasons for memory impairments seen in old age. Dentate gyrus is also one of the few regions in the brain where neural stem cells generate new neurons on a daily basis, also referred to as "adult neurogenesis". Studies have suggested that a significant fraction of newly born neurons mature, get incorporated into the existing hippocampus circuitry and contribute to learning, formation of new memories, and normal mood. However, with aging, the dentate gyrus shows decreased function with some conspicuous structural changes, which include reduced production of new neurons, diminished microvasculature implying reduced blood flow, and occurrence of hypertrophy of astrocytes and activated microglia, signs of chronic low-level inflammation. Because alterations such as reduced neurogenesis, decreased blood flow and brain inflammation can contribute to memory and mood impairments, the idea that drugs that are efficacious for mitigating these changes may preserve memory and mood function in old age has emerged. Such drugs may be prescribed to the aging population if they are efficacious for maintaining normal cognitive and mood function in old age with no or minimal side effects.
Medical Research: What is the rationale for choosing resveratrol for preventing age-related memory dysfunction in this study?Prof. Shetty: Administration of resveratrol, a naturally occurring polyphenol found in the skin of red grapes, red wine, peanuts and some berries, appeared suitable for counteracting age-related detrimental changes in the hippocampus. This is because, previous studies have shown that resveratrol has ability to promote the formation of new capillaries (through pro-angiogenic effects) and to suppress oxidative stress and inflammation (via antioxidant and antiinflammatory effects) with no adverse side effects. Other studies have also reported that resveratrol can mediate extension of the life span and delayed onset of age related diseases. More importantly, a recent human study suggested that a reasonably lower dose of resveratrol intake for 26 weeks is good enough to improve memory performance as well as hippocampus functional connectivity in 23 healthy overweight older individuals (Witte et al., J. Neurosci., 34: 7862-7870, 2014).
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MedicalResearch.com Interview with:
Ashley Di Battista, Ph.D.
Research Fellow
Critical Care Medicine| Neurosciences & Mental Health Program
The Hospital for Sick Children Toronto, ON, Canada
Medical Research: What is the background for this study? What are the main findings?
Dr.Di Battista: Most of what is known about adolescent quality of life (QoL) after traumatic brain injury (TBI) doesn’t come from adolescents – it comes from their parents. This profoundly non- concordant data (known as the “Proxy Problem”) is drawn from parent reported health-related quality of life (HRQoL) questionnaires (e.g. the PedsQL ™). Parent report can be influenced by the parents’ own distress after their child’s traumatic brain injury – which results in parents providing poorer estimates of their child’s QoL. Lack of insight is often purported to explain this difference, in the absence of direct examination of insight, or subsequent data, to support this claim. HRQoL has been criticized in the broader wellbeing literature as incompatible with the QoL construct– due to the absence of core features of the overall QoL model, and an inherent suggestion that a lack of overt pathology is equivalent to a good outcome.
Proxy reported, HRQoL focused research has generated a polarized view of quality of life after pediatric traumatic brain injury. This misrepresentation is due in part to the way in which we acquire this data (e.g. the tools) and who we ask (e.g. parents). The current study explored the individual adolescent experience of quality of life after traumatic brain injury and whether the tools commonly used to assess quality of life after brain injury are of capturing what adolescents define as relevant to their definition of quality of life.
Our findings revealed that when adolescents did endorse changes in functioning on the PedsQL, they did not consider these changes to be relevant to, or impact on, their self-described QoL. While the PedsQL™ is capable of documenting changes post-injury, it does not seem to capture domains of relevance to the adolescent idea of QoL. The ability of these adolescents to reflect on their own circumstances, engage in pre-to-post injury analysis of their functioning challenges default positioning that lack of insight is the sole determinant for differences in reports between proxies and adolescents on quality of life .
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MedicalResearch.com Interview with:Paula Iso-Markku, MD,
Department of Clinical Physiology and Nuclear Medicine,
HUS Medical Imaging Center,
Helsinki University Central Hospital and University of Helsinki
Helsinki , Finland
MedicalResearch: What is the background for this study? What are the main findings?Dr. Iso-Markku : The social, financial and humane burden of the dementia is extensive as the worldwide prevalence of dementia is estimated around 35.6 million. Finding efficient prevention strategies for dementia is crucial. Within the past decade vascular risk factors have been recognized as very potential risk factors of dementia. As physical activity is known to affect vascular risk factors, it might also be a potential preventive tool against dementia. Few comprehensive epidemiological studies on physical activity in middle age and dementia occurrence later in life have been conducted.
The comprehensive Finnish Twin Study offers a unique approach to the subjects as the shared growing up environment and genes can be taken into account. The study population is extensive and a good representation of the Finnish population. In this study the association of physical activity in adulthood and dementia mortality was investigated in a 29-year follow-up.
The main finding in this study was that persistent vigorous (i.e. more strenuous than walking) physical activity was significantly associated with lower dementia mortality. The results in the paired analysis, comparing twins to co-twins, were similar but remained non-significant. The analyses of the volume of physical activity were, however, controversial.
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MedicalResearch.com Interview with: Jason R. Richardson MS,PhD DABT Associate Professor
Department of Environmental and Occupational Medicine
Robert Wood Johnson Medical School and
Resident Member
Environmental and Occupational Health Sciences Institute
Piscataway, NJ
MedicalResearch: What is the background for this study? What are the main findings?Dr. Richardson: Although ADHD is often though of as a genetic disorder, no single gene can explain more than a fraction of the cases. This suggests that environmental factors are likely to interact with genetic susceptibility to increase risk for ADHD. Our study reports that exposure of pregnant mice to relatively low levels of a commonly used pesticide reproduces the behavioral effects of ADHD in their offspring. Because the study was in animals, we wanted to see if there was any association in humans. Using data from the Centers for Disease Control and Prevention we found that children and adolescents with elevated levels of metabolites of these pesticides in their urine, which indicates exposure, were more than twice as likely to be diagnosed with ADHD.
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MedicalResearch.com Interview with:
V. Zlokovic, MD, PhD
Professor and Chair
Department of Physiology and Biophysics
Keck School of Medicine of USC.
Medical Research: What is the background for this study? What are the main findings?
Dr. Zlokovic: Our team used high-resolution imaging of the living human brain to show for the first time that the brain’s protective blood barrier becomes leaky with age, starting at the hippocampus, a critical learning and memory center that is damaged by Alzheimer’s disease.
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MedicalResearch.com Interview with:
Michael Wilson, MD, PhD, FAAEM
Attending Physician, UCSD Department of Emergency Medicine
Director, Department of Emergency Medicine Behavioral Emergencies Research (DEMBER) lab UC San Diego Health System
MedicalResearch: What is the background for this study? What are the main findings?Dr. Wilson: Emergency departments (EDs) nationwide are crowded. Although psychiatric patients do not make up the largest proportion of repeat visitors to the emergency department, psychiatric patients stay longer in the ED than almost any other type of patient. So, it’s really important to find out things about these patients that may predict longer stays.
In this study, we looked at patients on involuntary mental health holds. The reasoning is simple: patients on involuntary mental health holds aren’t free to leave the ED. So, the only thing that should really matter is how quickly an Emergency department can release them from the involuntary hold. Surprisingly, though, this wasn’t the only thing that correlated with longer stays.
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MedicalResearch.com Interview with: Uzma Samadani, M.D., Ph.D.
Assistant Professor
Departments of Neuroscience and Physiology
NYU Langone Medical Center
Medical Research: What is the background for this study? What are the main findings?
Dr. Samadani: Research dating back as early as 3,500 years ago suggests the eyes serve as a window into the brain, with disconjugate eye movements -- eyes rotating in different directions -- considered a principal marker for head trauma. Current estimates suggest up to 90 percent of patients with concussions or blast injuries exhibit dysfunction in their eye movements.
We wanted to find a way to objectively track and analyze eye movements following a head injury to measure injury severity and replace the current “state of the art” method of asking a patient to follow along with a finger. CT-scans and MRIs may not necessarily reveal concussion or traumatic brain injury (TBI) in the absence of structural damage, presenting a need for a diagnostic measure of head injury severity.
In a study published earlier this year in the Journal of Neurosurgery, my team at the NYU Cohen Veterans Center tested our novel eye-tracking technology on military veterans, and found our device and tracking algorithm could reveal edema in the brain as a potential biomarker for assessing brain function and monitoring recovery in people with head injuries.
Our latest paper, published January 29 in Journal of Neurotrauma, looked at a civilian population of patients admitted to the Bellevue Medical Center emergency department in New York City, with whom the NYU School of Medicine has an affiliation agreement. We compared 64 healthy control subjects to 75 patients who had experienced trauma that brought them to emergency department. We tracked and compared the movements of patients' pupils for over 200 seconds while watching a music video.
We found that 13 trauma patients who had hit their heads and had CT scans showing new brain damage, as well as 39 trauma patients who had hit their heads and had normal CT scans, had significantly less ability to coordinate their eye movements than normal, uninjured control subjects. Twenty-three trauma subjects who had bodily or extremity injuries but did not require head CT scans had similar abilities to coordinate eye movements as normal uninjured controls.
Among patients who had hit their heads and had normal CT scans, most were slightly worse at 1-2 weeks after the injury, and subsequently recovered about one month after the injury. Among all trauma patients, the severity of concussive symptoms correlated with severity of disconjugacy.
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MedicalResearch.com Interview with:
Mark Slifstein, PhD
Associate Professor of Neurobiology (In Psychiatry) Dept. of Psychiatry
Columbia University NYSP
Dr New York NY 10032MedicalResearch: What is the background for this study?Dr. Slifstein:There has been considerable basic and clinical neuroscience research showing that the neurotransmitter dopamine plays a role in tuning cognitive processes taking place in the cortex. It has long been thought that dopamine is involved in the cognitive difficulties experienced by patients with schizophrenia, but it has been challenging to study dopamine in the cortex and other parts of the brain except in a deep structure rich in this neurotransmitter and its receptors, the striatum. In our study, we used an experimental design with Positron Emission Tomography (PET) imaging that allowed us to infer the amount of dopamine in the cortex.
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MedicalResearch.com Interview with:
Dr Stefan M Gold
Institute of Neuroimmunology and Multiple Sclerosis (INIMS)
Centre for Molecular Neurobiology, University Medical Center Hamburg-Eppendorf
Hamburg, Germany
Medical Research: What is the background for this study? What are the main findings?
Dr. Gold: Multiple sclerosis (MS) is a chronic inflammatory disorder of the central nervous system (brain and the spinal cord). In addition to motor symptoms such as walking impairment, patients with Multiple sclerosis frequently suffer from psychological problems including difficulties with learning and memory as well as depressed mood. Depression is particularly common in this patient group with a 3-4 fold elevated risk for developing major depressive disorder compared to the general population. Depression in Multiple sclerosis is associated with decreased quality of life, absence from work, and numerous other psychosocial problems. Despite this major impact on patients’ lives, depression in Multiple sclerosis is often not adequately diagnosed and treated: Antidepressant medication in this patient group often has side effects and the neurological problems associated with MS such as difficulties with concentration and fatigue make it particularly difficult for MS patients to complete “classical” depression treatments such as psychotherapy. The goal of our study was to make psychological treatments available for the many patients with Multiple sclerosis suffering from depression, who often have difficulties to find adequate treatment.
For this study, published in The Lancet Psychiatry, we conducted a randomized controlled trial of a fully-automated, computer-based program that can be accessed directly from patients’ homes over the internet. The program called “deprexis” was developed by the Hamburg-based company GAIA and uses methods of “cognitive behavioral therapy” or “CBT”. Ninety Multiple sclerosis patients were enrolled in the trial and randomly assigned to a 3 months therapy using the deprexis program or a waitlist control group. At the end of the intervention, depression had significantly decreased in the treatment group but remained unchanged in patients who did not have access to the program. In addition, patients using the computer program also reported reduced fatigue and improved quality of life. (more…)
MedicalResearch.com Interview with
Gavin M. Bidelman, Ph.D.
Assistant Professor Institute for Intelligent Systems
School of Communication Sciences & Disorders
University of Memphis
Memphis, TN 38105
MedicalResearch: What is the background for this study? What are the main findings?
Dr. Bidelman: Musical training as been shown to enhance brain function and impact behavioral skills (e.g., speech and language functions) in younger adults. In the current study, we investigated whether or not these advantages extend to older brains, which are thought to be less "plastic" (i.e., less malleable to experience/training). Older adults also often experience reduced speech recognition abilities later in life so we wanted to see if musicianship can serve as an effective means to bolster speech listening skills that decline across the lifespan.
Main findings:1) On average, older musicians were 20% faster in identifying speech sounds behaviorally than their nonmusician peers. Interestingly, this is similar to the benefit we have observed in young people with musical training.
2) We were able to predict how well people classify/identify speech via (EEG) brain activity in both groups. However, this brain-behavior correspondence was ~2-3x better in older musicians. In other words, old musicians' brains provide a much more detailed, clean, and accurate depiction of the speech signal which is likely why they are much more sensitive to speech behaviorally.
3) We compared neural responses generated from multiple levels of the auditory system and found that musicians had more coordination (significantly higher correlations) between different regions. This implies that the "musical brain" operates more in concert than in non-musicians.
All of these findings challenge conventional views that older brain's are no longer plastic, are somehow noisier, and show poorer coordination across brain regions. In fact we show just the opposite. In older brains, musicianship does produce pervasive plasticity, provides cleaner (less noisy) representations of speech, and orchestrates more neural coordination.
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MedicalResearch.com Interview with:Peter Bayley PhD
War Related Illness and Injury Study Center
Veteran Affairs Palo Alto Health Care System
Palo Alto, California
MedicalResearch.com: What is the background for this study? What are the main findings?Dr. Bayley: There is currently widespread interest and debate surrounding the topic of screening for Alzheimer’s disease and other types of dementia The study describes results from National Memory Screening Day in 2010, an annual community event sponsored by the Alzheimer Foundation of America. Face-to-face screening takes place in a private setting; only the individual being tested and the screener are present. The memory screening consists of one of seven validated cognitive tests: the GPCOG (General Practitioner Assessment of Cognition), MINI-COG, MIS (Memory Impairment Screen), the BAS (Brief Alzheimer’s Screening), Kokmen Short Test of Mental Status, Mini-Mental State Examination, Montreal Cognitive Assessment, or the Saint Louis University Mental Status Examination. Participants with scores below cutoff for possible dementia are encouraged to bring the results to their healthcare professional for follow-up and/or inclusion in medical files.
We report the results from a subset of 3,064 participants. Overall, 11.7% failed one of the memory screening tests. As expected, failure rates were higher in older and less-educated participants (P’s < .05). Subjective memory concerns were associated with a 40% greater failure rate for persons of similar age and education but no memory concerns (odds ratio = 1.4, 95% confidence interval = 1.07–1.78). However, most individuals who expressed concern about their memories passed the screening tests (54-96%, depending on age and education).
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MedicalResearch.com Interview with:Dennis Kim, MD
Los Angeles Biomedical Research Institute MedicalResearch: What is the background for this study? What are the main findings?Dr. Kim: More than 1.7 million people in the U.S. alone suffer a traumatic brain injury (TBI) every year, often resulting in permanent disabilities or death. Up to half of these patients will experience progression of bleeding inside or around the brain, the occurrence of which is associated with an increased risk of death.
A common treatment to prevent progression of “traumatic intracranial hemorrhage” is the transfusion of platelets, which are irregular shaped cells that cause blood to clot, and the administration of desmopressin (DDAVP), a naturally occurring hormone used to treat bleeding and a number of other medical conditions. Researchers at LA BioMed conducted a three-year retrospective study of the records of patients admitted to a Level 1 trauma center with traumatic brain injury between Jan. 1, 2010 and Dec. 31, 2012. Of the 408 patients who fit the criteria, 126 received platelet transfusions and DDAVP and 282 did not.
Overall, 37% of the patients demonstrated progression of traumatic intracranial hemorrhage within four hours of admission. We compared outcomes for patients who received platelet transfusions and DDAVP and patients who did not receive this therapy. Our comparison found no significant differences in mortality or hemorrhage progression between the two groups. We reported our findings in a study that was recently published online ahead of print in the Journal of Neurotrauma.(more…)
MedicalResearch.com Interview with:
Gabriel S. Dichter, PhD
Associate Professor
UNC Departments of Psychiatry and Psychology
Carolina Institute for Developmental DisabilitiesMedical Research: What is the background for this study? What are the main findings?
Dr. Dichter: The background for this study is that although most brain imaging research in autism spectrum disorders has focused on understanding the brain basis of social communication impairments, we know that autism symptoms are pervasive and may include difficulties with irritability, anxiety, mood, and even in some instances aggression or self injurious behaviors. Additionally, these types of associated features are among the first that prompt parents to bring their child to a pediatrician for an evaluation for a neurodevelopmental disorder, and so we know these symptoms can be deeply troubling to parents. All of these associated symptoms of autism suggest difficulty with regulating emotional responses, and so our team set out to investigate the brain basis of these difficulties. We taught participants with and without autism simple strategies to change their emotion responses and then scanned them using functional MRI to measure brain activity when they actively tried to change their emotional responses to pictures of faces. Our central finding was that although they reported they were able to change their emotional responses, brain imaging findings told us something quite different. The dorsolateral prefrontal cortex, a part of the brain that controls emotional responses, was underactive in the participants with autism. Consequently, they were less able to modulate parts of the brain’s limbic system that produces strong emotional responses. In other words, they had difficulty “turning on the brakes” to control emotional responses. Finally, the differences we observed in their brain activity predicted the severity of their overall autism symptoms, suggestion a direct linkage between emotion regulation impairments and autism severity. (more…)
MedicalResearch.com Interview with:
Sophie Cohen MD, PhD Student
Department of Pediatric Haematology, Immunology and Infectious Diseases,
Emma Children's Hospital, Academic Medical Center, Amsterdam, the Netherlands
Cairns Base Hospital AustraliaMedical Research: What is the background for this study? What are the main findings?
Response: Since combination antiretroviral therapy (cART) has become widely available for HIV-infected children, the incidence of severe neurological complications has decreased drastically from 30-50% to less than 2%. Unfortunately, even in cART-treated HIV-infected children a range of cognitive problems have been found, such as a lower intelligence quotient (IQ) and poorer visual-motor integration. Importantly, while most HIV-infected children in industrialized countries are immigrants with a relatively low socioeconomic status (SES), cognitive studies comparing HIV-infected children to SES-matched controls are very scarce. Understanding the prevalence and etiology of cognitive deficits in HIV-infected children is essential because they may result in more pronounced problems, and influence future intellectual performance, job opportunities and community participation. Also, early detection of cognitive impairment might trigger the development of early intervention strategies.
In this study we aimed to compare the neuropsychological profile of HIV-infected children to that of healthy controls, matched for age, gender, ethnicity and SES. Also, we aimed to determine the prevalence of cognitive impairment in the HIV-infected group and detect associations between HIV/cART parameters and cognitive performance.
We found that the HIV-infected group had a poorer cognitive performance compared with the healthy children on all tested domains (including intelligence, information processing speed, attention, memory, executive- and visual-motor functioning). Using a novel statistical method called Multivariate normative comparison (MNC), we detected a prevalence of 17% with cognitive impairment in the HIV-infected group. Lastly, we found that the center for disease control (CDC) clinical category at HIV diagnosis was inversely associated with verbal IQ (CDC C: coefficient -22.98, P=0.010).
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MedicalResearch.com Interview with:Shelly L. Gray, PharmD, MS
Professor of Pharmacy
School of Pharmacy, University of Washington, Seattle
Medical Research: What is the background for this study? What are the main findings?Dr. Gray: Many medications have anticholinergic effects such as those used to treat overactive bladder, seasonal allergies, and depression. The general view is that anticholinergic-induced cognitive impairment is reversible, however, emerging evidence suggests that these medications may be associated with increased dementia risk. We conducted a prospective population-based cohort study in 3434 older adults to examine whether cumulative anticholinergic medication use is associated with increased risk of incident dementia. Using automated pharmacy data, we found that higher 10-year cumulative dose was associated with increased risk for dementia and Alzheimer disease over an average of 7.3 years of follow-up. In particular, people with the highest use (e.g. taking the equivalent of oxybutynin 5 mg/day or chlorpheniramine 4 mg/day for longer than 3 years) were at greatest risk.(more…)
MedicalResearch.com Interview with:Craig S. Atwood
Associate Professor, University of Wisconsin
Madison, WI
Richard L. Bowen, M.D.
Private Practice, Charleston, SC
Medical Research: What is the background for this study? Response: Currently, there is no treatment for Alzheimer’s disease that halts or slows its progression. Alzheimer’s disease is a neurodegenerative disorder resulting in memory loss and impairments of behavioral, language and visuo-spatial skills. A growing body of biological, preclinical and epidemiological data suggests that the age-related changes in hormones of the hypothalamic-pituitary-gonadal (HPG) axis are a major etiological factor in Alzheimer disease. The changes in these hormones include not only the decline in the sex steroids, (i.e. 17-estradiol and testosterone), but the elevations in gonadotropin-releasing hormone and luteinizing hormone. In particular there are encouraging epidemiological studies involving the use of Lupron Depot which suppresses these hormones. In one such study which included hundreds of thousands of patients it was found that men who had prostate disease and were treated with Lupron Depot had a 34 to 55 percent decreased risk of developing Alzheimer’s disease compared with prostate-cancer patients who didn’t receive the drug.
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MedicalResearch.com Interview with:
Michael K. Scullin, Ph.D.
Principal Investigator of the Sleep Neuroscience & Cognition (SNaC) Laboratory and an Assistant Professor of Psychology & Neuroscience Director Sleep Neuroscience and Cognition Laboratory Baylor University
Medical Research: What is the background for this study? What are the main findings?
Dr. Scullin: One of the purposes of sleep in healthy adults is to optimize cognitive functioning. When we lose out on a few hours of sleep we tend not to be able to focus or think as well as when we get enough sleep (typically 8 hours). Even more interesting is that particular aspects of sleep physiology—our deepest levels of sleep known as slow wave sleep and rapid eye movement sleep—are essential to our brain’s ability to take the information that we learn during the day and stabilize those memories so that we can use them in the future.
Sleep quantity and quality change markedly across the lifespan, though there are individual differences in how much one’s sleep changes. Our work was concerned with the possible long-term repercussions of cutting back on sleep and getting lower quality sleep (less slow wave sleep and rapid eye movement sleep). We reviewed approximately 200 scientific articles on this topic and we found that the amount of total sleep and the quality of that sleep is important to cognitive and memory functioning in young adults and middle-aged adults and can even predict how well someone’s cognitive functioning will be decades later. Thus, if you’re sleeping well when you are 40 then you are investing in preserving your mental functioning at age 50.
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MedicalResearch.com Interview with: Gavin RumbaugProfessor (Associate)
The Scripps Research Institute
Medical Research: What is the background for this study? What are the main findings?Response: We have developed a genetic approach that protects animal models against a type of genetic disruption that causes intellectual disability, including serious memory impairments and altered anxiety levels. The findings focus on treating the effects of mutations to a gene known as Syngap1. In our new study, we examined the effect of damaging Syngap1 mutations during development and found that the mutations disrupt a critical period of neuronal growth—a period between the first and third postnatal weeks in mouse models. We found that a certain type of cortical neuron grows too quickly in early development, which then leads to the premature formation of certain types of neural circuits. These findings help explain why genetic treatments in adult mice are not very effective. (more…)
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MedicalResearch.com Interview with:
David C. Rettew, MD
Associate Professor of Psychiatry and Pediatrics
Director, Child & Adolescent Psychiatry Fellowship
Director, Pediatric Psychiatry Clinic
University of Vermont College of Medicine
Medical Research: What is the background for this study? What are the main findings?
Dr. Rettew: We did this study because while everyone knew that antipsychotic medication rates were going up, there was very little data that drilled deeper and was able to get at the question about the appropriateness of this increase.
There’s good news and bad news in this study. The bad news is that our data show that about half the time, kids are not being treated with antipsychotic medications according to best practice guidelines. The good news is that it doesn’t look like these medications are being used casually or in a knee jerk way. In the vast majority of cases, youth are getting to this class of medications only after many other things have failed.
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