Author Interviews, Brigham & Women's - Harvard, Mental Health Research, Stroke, Toxin Research / 22.04.2015

Elissa Hope Wilker, Sc.D. Beth Israel Deaconess Medical Center Cardiovascular Epidemiology Research Harvard Medical SchoolMedicalResearch.com Interview with: Elissa Hope Wilker, Sc.D. Beth Israel Deaconess Medical Center Cardiovascular Epidemiology Research Harvard Medical School Medical Research: What is the background for this study? What are the main findings? Dr. Wilke: Long-term exposure to ambient air pollution is associated with cerebrovascular disease and cognitive impairment, but the impact on structural changes in the brain is not well understood. We studied older adults living in the greater Boston area and throughout New England and New York and we looked at the air pollution levels and how far they lived from major roads. We then linked this information to findings from MRI studies of structural brain images. Although air pollution levels in this area are fairly low compared to levels observed in other parts of the world, we found that people who lived in areas with higher levels of air pollution had smaller brain volumes, and higher risk of silent strokes. The magnitude of association that we observed for a 2 µg/m3 increase in fine particulate matter (PM2.5) (a range commonly observed across urban areas) was approximately equivalent to one year of brain aging. The association with silent strokes is of concern, because these are associated with increased risk of overt strokes, walking problems, and depression.
Author Interviews, Autism, Education, Emory, JAMA, Pediatrics / 22.04.2015

MedicalResearch.com Interview with: Lawrence Scahill, MSN, PhD and Karen Bearss, PhD Department of Pediatrics, Marcus Autism Center Children’s Healthcare of Atlanta and Emory University Atlanta, Georgia Medical Research: What is the background for this study? What are the main findings? Response: Autism spectrum disorder (ASD) affects an estimated 0.6 to 1% of children worldwide. In young children with ASD (e.g. 3 to 7 years of age) up to 50% also have disruptive behaviors such as tantrums, aggression, self-injury and noncompliance. When present, these disruptive behaviors interfere with the child’s readiness to make use of educational and other supportive services. The presence of disruptive behaviors also hinders the acquisition of routine daily living skills. Parent Training has been shown to be effective for young children with disruptive behaviors who do not have Autism spectrum disorder – but it has not be well-studied in children with ASD. The current multisite study shows that parent training is effective in reducing serious behavioral problems in young children with ASD. This is the largest randomized trial of a behavioral intervention in children with ASD.  180 children were randomly assigned to parent training or parent education. Both treatments were delivered individually to parents over 24 weeks. Serious behavioral problems were reduced by almost 50% in the parent-training group compared to about 30% for parent education. A clinician who was blind to treatment assignment rated positive response in 69% of children in the parent training group compared to 40% for parent education. In addition, 79% of children who showed a positive response to parent training at the end of the 24-week trial maintained benefit at 6 months post treatment. Parent training provided parents with specific strategies on how to manage tantrums, aggression, self-injury and noncompliance in children with autism spectrum disorder. Parent education provided up-to-date and useful information about ASD, but no instruction on how to address behavioral problems. Parents were engaged in the study treatments as evidenced by the low drop-out rate of 10% .
Author Interviews, Breast Cancer, Cancer Research, Cognitive Issues, JNCI / 19.04.2015

Dr. Kerstin Hermelink Senior psychologist Dept. of Gynecology and Obstetrics Ludwig Maximilian University of MunichMedicalResearch.com Interview with: Dr. Kerstin Hermelink Senior psychologist Dept. of Gynecology and Obstetrics Ludwig Maximilian University of Munich MedicalResearch: What is the background for this study? What are the main findings? Dr. Hermelink: Many breast cancer patients report problems of cognitive functioning that interfere considerably with their professional and private lives. In the last two decades, a number of studies have confirmed that subgroups of breast cancer patients show at least subtle cognitive impairment. Initially, the condition has entirely been attributed to chemotherapy effects and has therefore colloquially been named “chemobrain”. Meanwhile, however, cognitive impairment has also been found in patients who were managed without chemotherapy and, surprisingly, even in patients who had not yet received any systemic treatment at all. Several hypotheses on the causation of cognitive impairment that occurs already pretreatment have been put forward; for instance, biological effects of the cancer itself might affect cognitive functioning, or there might be shared genetic vulnerability for cancer and cognitive impairment. None of these hypotheses have been empirically confirmed; thus, pretreatment cognitive impairment is as yet unexplained. Our study was designed to investigate the effects of cancer-related post-traumatic stress on cognitive function in breast cancer patients before the start of treatment. Stress has a substantial influence on cognitive functioning, and post-traumatic stress disorder (PTSD) is associated with impairment of cognitive function. While the incidence of full diagnosis of stress disorder is low among breast cancer patients, many of these patients show symptoms of PTSD, with a peak shortly after diagnosis. We did not find an elevated risk of overall cognitive impairment in pretreatment breast cancer patients compared with matched non-cancer controls; however, the cancer patients scored worse than the controls on a small fraction of the cognitive indices that were used. Performance on these indices was indeed robustly associated with PTSD symptoms. Our results therefore indicate that pretreatment cognitive impairment in breast cancer patients may be largely caused by the stress of being diagnosed with cancer.
ADHD, AHRQ, Author Interviews, CDC / 17.04.2015

Susanna N. Visser, DrPH Epidemiologist at the National Center on Birth Defects and Developmental Disabilities CDCMedicalResearch.com Interview with: Susanna N. Visser, DrPH Epidemiologist at the National Center on Birth Defects and Developmental Disabilities CDC   Medical Research: What is the background for this study? What are the main findings? Dr. Visser: Attention-Deficit/Hyperactivity Disorder, or ADHD is one of the most common chronic conditions of childhood. It often persists into adulthood. When children diagnosed with ADHD receive proper treatment, they have the best chance of thriving at home, doing well at school, and making and keeping friends. In 2011, the American Academy of Pediatrics (AAP) updated their guidelines for ADHD treatment. The new guidelines give this advice to healthcare providers, psychologists, educators, and parents of children with ADHD:
  • For preschoolers ages 4-5 with ADHD, use behavioral therapy before medication.
  • For older children and teens with ADHD, use behavioral therapy along with medication.
In order to learn more about ADHD treatment patterns, CDC researchers looked at data from a national sample of children with special health care needs, ages 4-17 years, collected in 2009-10 just before the release of the 2011 guidelines. We found that most children with ADHD received either medication treatment or behavioral therapy as well as some other form of ADHD therapy to help. However, we also found that many children were not receiving treatment in the way it was outlined in the 2011 best practice guidelines.
  • Less than 1 in 3 children with ADHD received both medication treatment and behavioral therapy, the preferred treatment approach for children ages 6 and older.
  • Only half of preschoolers (4-5 years of age) with ADHD received behavioral therapy, which is now the recommended first-line treatment for this group.
  • About half of preschoolers with ADHD were taking medication for ADHD, and about 1 in 4 were treated only with medication.
Author Interviews, Cognitive Issues, Nutrition / 16.04.2015

Dr. Fredrik Jernerén PhD Postdoctoral Research Fellow Department of Pharmacology University of Oxford Oxford, United KingdomMedicalResearch.com Interview with: Dr. Fredrik Jernerén PhD Postdoctoral Research Fellow Department of Pharmacology University of Oxford Oxford, United Kingdom Medical Research: What is the background for this study? What are the main findings? Dr. Jernerén: Development of dementia and Alzheimer’s disease is associated with an accelerated rate of brain shrinkage. Identifying ways to reduce the brain atrophy rate at an early stage may offer new strategies to prevent or delay the onset of dementia. In this study on elderly subjects diagnosed with Mild cognitive impairment (MCI), who are at increased risk of developing dementia, we investigated whether the effect of B vitamin supplementation on reducing the brain atrophy rate was influenced by circulating levels of omega-3 fatty acids. We have found that this indeed was the case. The higher the baseline concentration of the combined omega-3 fatty acids (DHA+EPA), the greater the protective effect of the B vitamin treatment. In subjects with high omega-3 concentrations who at the same time had elevated homocysteine levels (indicating a lack of B vitamins), B vitamin treatment reduced the brain atrophy rate by about 70% compared with the placebo group. 
Author Interviews, Mental Health Research, Probiotics / 14.04.2015

MedicalResearch.com Interview with: Laura Steenbergen Leiden University, Institute for Psychological Research, Cognitive Psychology Leiden, The Netherlands Medical Research: What is the background for this study? What are the main findings? Response: Food supplements, among which probiotics, are becoming more and more popular. A lot is known about the effect of probiotics on the physical functioning, but even though there are some rat studies on the effects of probiotics on mental well-being, not much is known about the effect in humans. The few studies on humans that are available show beneficial effects on mood when people experience a bad mood, or psychological distress. Worldwide, millions of people are suffering from mood disorders like for instance depression, but not everyone receives treatment for this. Research on probiotics has shown that they are safe and easily available, and we therefore wanted to investigate if probiotics could perhaps be promising in serving as a preventive or adjuvant therapy for mood disorders of anxiety or depression. We therefore focused on cognitive reactivity to sad mood, which measures the degree to which people activate dysfunctional thought patterns when experiencing a sad mood. This measure is known to be predictive of the onset and development of depression. Compared to subjects who received a 4-week placebo intervention, participants who received a 4-week multispecies probiotics intervention showed significantly reduced aggressive and ruminative thoughts. Even if preliminary, these results provide the first evidence that the intake of probiotics may help reduce negative thoughts associated with sad mood. As such, our findings shed an interesting new light on the potential of probiotics to serve as adjuvant or preventive therapy for depression. So if you are interested in taking probiotics then you could check out something like these probiotics in india.
Author Interviews, Depression, JAMA, Race/Ethnic Diversity, University of Michigan / 11.04.2015

Addie Weaver PhD Research Investigator and LEO Adjunct Lecturer School of Social Work University of MichiganMedicalResearch.com Interview with: Addie Weaver PhD Research Investigator and LEO Adjunct Lecturer School of Social Work University of Michigan Medical Research: What is the background for this study? What are the main findings? Dr. Weaver: The mental health of both African Americans and rural Americans has been understudied. Though depression is one of the most common, debilitating mental illnesses among women, very little is known about depression among African American women living in rural areas of the United States. In fact, much of what we know about rural women's depression in general is based on research conducted with community samples, as limited epidemiolgical research includes large enough samples of both African American respondents and rural respondents to assess potentially important subgroup differences by urbanicity (e.g., urban, suburban, rural) and race. Our study used the National Survey of American Life, the first and only nationally representative survey of African Americans, to examine the interaction of urbanicity and race/ethnicity on Major Depressive Disorder and mood disorder prevalence among African American and non-Hispanic white women residing in the South. We found that rural residence has a differential effect on depression and mood disorder for African American women and non-Hispanic white women. Overall, African American women living in rural areas experienced significantly lower odds of meeting criteria for lifetime and 12-month Major Depressive Disorder and lifetime and 12-month mood disorder than urban African American women. Conversely, non-Hispanic white women residing in rural areas had significantly higher odds of meeting criteria for lifetime and 12-month Major Depressive and lifetime and 12-month mood disorder when compared to rural African American women, and had significantly higher prevalence rates of 12-month Major Depressive Disorder and 12-month mood disorder than urban non-Hispanic white women. All analyses controlled for age, education level, household income, and marital status, suggesting that the urbanicity differences were not due to resource disparities often experienced by individuals residing in rural communities.
Author Interviews, Depression, Endocrinology, Testosterone / 09.04.2015

Mohamed Kabbaj, PHD Professor of Biomedical Sciences & Neurosciences College of Medicine Florida State UniversityMedicalResearch.com Interview with: Mohamed Kabbaj, PHD Professor of Biomedical Sciences & Neurosciences College of Medicine Florida State University Medical Research: What is the background for this study? What are the main findings? Dr. Kabbaj: While anxiety and depressive disorders a major public health concern worldwide, so too are the pervasive sex differences that exist within these pathologies. Fluctuations in the predominant female reproductive hormones, estradiol and progesterone, are thought to be a major contributor to the higher prevalence of anxiety and depression in women compared to men. However, many studies in humans and rodents alike have demonstrated that testosterone, the primary male sex hormone, also influences affective status and may yield protective benefits against the development of mood-related disturbances. Indeed, hypogonadal males with low testosterone levels experience increased rates of anxiety and depressive symptoms. In many of these cases, testosterone replacement alone or in addition to antidepressant medication have been shown to effectively improve mood. How this hormone acts in the brain to exert its beneficial effects, however, is much less clear. Interestingly, it is well-known that many of testosterone’s effects in the brain occur via its conversion to estrogen by the enzyme aromatase. What remained unclear was whether or not this conversion to estrogen was critical for testosterone’s protective anxiolytic and antidepressant effects—so Nicole Carrier and Samantha Saland from Dr. Kabbaj’s lab aimed to figure out just that. To do this, Carrier and Saland targeted an area of the hippocampus in the brain involved in mood regulation where testosterone is known to act to carry out some of its anxiolytic and antidepressant effects in male rats. Here, they inhibited the enzyme responsible for the conversion of testosterone into estrogen and investigated performance in mood-related behaviors. In doing so, they discovered that testosterone’s anxiolytic- and antidepressant-like effects were lost unless this hormone was first converted into estrogen. Importantly, they also found that continuous testosterone and estrogen treatments had very similar effects on the expression of genes within this brain region that are highly implicated in the regulation of mood as well as antidepressant treatments.
Author Interviews, Cognitive Issues, Memory / 07.04.2015

[caption id="attachment_13389" align="alignleft" width="300"]Associate Professor Lim Lee Wei (Sunway University, Malaysia) and Assistant Professor Ajai Vyas (Nanyang Technological University, Singapore) discover a new treatment using deep brain stimulation of the Prefrontal Cortex for dementia. Associate Professor Lim Lee Wei (Sunway University, Malaysia) and Assistant Professor Ajai Vyas (Nanyang Technological University, Singapore) discover a new treatment using deep brain stimulation of the Prefrontal Cortex for dementia.[/caption] MedicalResearch.com Interview with: Dr. Lim Lee Wei School of Biological Sciences, Nanyang Technological University, Singapore; Department of Biological Sciences, Sunway University, Malaysia Medical Research: What is the background for this study? What are the main findings? Response: To date, pharmacological treatments for dementia have limited effects (most of the drugs failed in the second or third clinical trials) and there are no known treatments that cure or delay the progression of this memory impairment. Therefore, a novel non-pharmacological approach such as deep brain stimulation (DBS) is currently considered as an alternative treatment to reduce the symptomatic and progression of this memory deterioration. Deep brain stimulation for dementia-related disease is currently evaluated as a potential therapy. In line with this development, evidence from recent studies suggests that deep brain stimulation might enhance memory functions when particular brain areas are stimulated. Of particular interest in our study, electrical stimulation of the Prefrontal Cortex induced striking antidepressant activity in both patients and animals studies (see our recent study, Lim et al., 2015 Translational Psychiatry; http://www.nature.com/tp/journal/v5/n3/full/tp201524a.html). However, no studies have shown the putative role of Prefrontal Cortex deep brain stimulation in learning and memory performance. In our finding, we have shown that deep brain stimulation of this region (Prefrontal Cortex) improved the short-term and long-term memory by a very important mechanism, which led to the formation of new brain cells in another region of the brain called the hippocampus, which is also involved in memory. Therefore, our findings suggest that deep brain stimulation of the Prefrontal Cortex has the potential to be developed into a therapy to treat dementia and other conditions that lead to memory loss in humans.
Author Interviews, JAMA, Mental Health Research, Pediatrics / 01.04.2015

Dr. Julie Magno Zito, PhD University of Maryland, Baltimore, MD 21201MedicalResearch.com Interview with: Dr. Julie Magno Zito, PhD University of Maryland, Baltimore, MD 21201 MedicalResearch: What is the background for this study? Dr. Zito: Atypical antipsychotic (AAP) use in children and adolescents has grown substantially in the past decade, largely for behavioral (non-psychotic) conditions. Poor and foster care children with Medicaid-insurance are particularly affected. This ‘off-label’ usage has insufficient evidence of benefits regarding improved functioning (i.e. appropriate behavior and performance, socially and academically) while the little evidence that accrues tends to emphasize ‘symptoms’, i.e. less acting out. Recent evidence shows that youth treated with atypical antipsychotics are at risk of serious cardiometabolic adverse events including diabetes emerging after atypical antipsychotics are ‘on board’.
Author Interviews, BMJ, Johns Hopkins, Mental Health Research / 26.03.2015

Melinda C Power, ScD Post-Doctoral Research Fellow Epidemiology Department, Johns Hopkins Bloomberg School of Public Health Neurology Department, Johns Hopkins School of MedicineMedicalResearch.com Interview with: Melinda C Power, ScD Post-Doctoral Research Fellow Epidemiology Department, Johns Hopkins Bloomberg School of Public Health Neurology Department, Johns Hopkins School of Medicine Medical Research: What is the background for this study? What are the main findings? Dr. Power: Air pollution may be related to mental health, particularly anxiety, through effects on oxidative stress and systemic inflammation or through promotion or aggravation of chronic diseases.  However, there has been very little research on the relation between air pollution exposures and anxiety in people.   Our study found that those with higher exposures to fine particulate matter, a type of air pollution, were more likely to experience elevated anxiety symptom levels.  Our study also suggests that recent exposures to find particulate matter air pollution are potentially more relevant to anxiety symptom levels than long-term past exposures.
Author Interviews, Hospital Readmissions, Mental Health Research / 26.03.2015

Brian K. Ahmedani, PhD, LMSW Research Scientist Henry Ford Health System Center for Health Policy & Health Services Research Detroit, MI 48202MedicalResearch.com Interview with: Brian K. Ahmedani, PhD, LMSW Research Scientist Henry Ford Health System Center for Health Policy & Health Services Research Detroit, MI 48202 Medical Research: What is the background for this study? What are the main findings? Dr. Ahmedani: The Centers for Medicare and Medicaid Services (CMS) have begun penalizing hospitals for excessive all-cause hospital readmissions within 30 days after discharge for pneumonia, heart failure, and myocardial infarction.  We wanted to determine the influence of comorbid mental health and substance use conditions on the rate of 30-day hospital readmissions for individuals with these conditions.  Overall, individuals with a comorbid mental health condition were readmitted to the hospital within 30-days approximately 5% more often than those without one (21.7% versus 16.5%).  Comorbid depression and anxiety were associated with a 30-day readmission rate of more than 23% each, overall.
Alzheimer's - Dementia, Author Interviews, Mayo Clinic / 25.03.2015

Melissa Murray, Ph.D Assistant Professor of Neuroscience Mayo ClinicMedicalResearch.com Interview with: Melissa Murray, Ph.D Assistant Professor of Neuroscience Mayo Clinic   Medical Research: What is the background for this study? What are the main findings? Dr. Murray: Our study investigates two of the hallmark brain pathologies that underlie Alzheimer’s disease, abnormally accumulated tau and amyloid proteins.  While both are integral to diagnosing Alzheimer’s disease postmortem, their exclusive relationship with cognitive decline has been debated.  Using a large series from our brain bank we found that while an increase in abnormal accumulation of both proteins shares a close relationship with a decline in cognition, tau is the key driver of decline.  This was important for us to understand as the second part of our study investigated amyloid brain scanning. We found that amyloid brain scanning closely represents amyloid deposits and not tau in postmortem brain tissue.  One particular aspect we focused on is the cutoff for what would be a amyloid-positive brain scan that indicates Alzheimer’s disease.  Our study supports that currently available cutoffs correspond to a level of amyloid accumulation that occurs before Alzheimer’s disease has too far advanced.
Author Interviews, Breast Cancer, Depression, Mental Health Research / 23.03.2015

Michael H. Antoni, Ph.D. Professor of Psychology and Psychiatry and Behavioral Sciences Director, Center for Psycho-oncology Research Program co-Leader, Cancer Prevention Control and Survivorship Sylvester Cancer Center Sylvester Professor Director Miami CTSI Pilot and Translational Studies Component University of MiamiMedicalResearch.com Interview with: Michael H. Antoni, Ph.D. Professor of Psychology and Psychiatry and Behavioral Sciences Director, Center for Psycho-oncology Research Program co-Leader, Cancer Prevention Control and Survivorship Sylvester Cancer Center Sylvester Professor, Director Miami CTSI Pilot and Translational Studies Component University of Miami Medical Research: What is the background for this study? What are the main findings? Dr. Antoni: We have been conducting stress management intervention trials with breast cancer patients for the past two decades. We have shown that the form of stress management we developed, a 10-week cognitive behavioral stress management (CBSM) intervention, combining relaxation techniques, cognitive behavioral therapy techniques and coping and interpersonal skills training (assertiveness and anger management) delivered in a supportive group, can improve how women adapt during breast cancer treatment and up to one year later. These improvements in psychological status (less depressive symptoms, less negative mood and more positive mood) are associated with reductions in circulating serum cortisol levels, improved immune function and decreased inflammatory signaling over the first year of treatment. Since depressive symptoms are prevalent during cancer treatment our prior work showing that cognitive behavioral stress management reduces depressive symptoms over the 1st yr of treatment is significant . Since persisting depressive symptoms into survivorship are also common these new findings that women receiving cognitive behavioral stress management during primary treatment show beneficial effects out to 15 yrs suggests a real impact on their quality of life well into survivorship. Further, since data just released this week at the American Psychosomatic Society meeting in Savannah, GA shows that depressive symptoms during breast cancer treatment predict greater odds of mortality over the next 8-15 yrs it is plausible that these cognitive behavioral stress management effects on reduced long-term depressive symptoms may have implications for survival. Finally since depressive symptoms relate to greater signs of inflammation in breast cancer patients and because inflammation promotes cancer disease progression via effects on angiogenesis, invasion and metastasis, then managing depressive symptoms during and after active treatment for breast cancer could have effects on health outcomes via lower inflammation.
Alzheimer's - Dementia, Author Interviews, Johns Hopkins, Medical Imaging / 20.03.2015

Arnold Bakker, Ph.D. Assistant Professor Division of Psychiatric Neuroimaging Department of Psychiatry and Behavioral Sciences The Johns Hopkins University School of Medicine Baltimore, MD 21287MedicalResearch.com Interview with: Arnold Bakker, Ph.D. Assistant Professor Division of Psychiatric Neuroimaging Department of Psychiatry and Behavioral Sciences The Johns Hopkins University School of Medicine Baltimore, MD 21287 Medical Research: What is the background for this study? What are the main findings? Dr. Bakker: Patients who are at increased risk for developing dementia due to Alzheimer’s disease show hyperactivity in an area of the brain called the hippocampus, which is critically important for memory function. This study investigated the functional significance of this hyperactivity and determined if, similar to animal studies, treatment with low dose levetiracetam would reduce this increased activation and improve memory function in these patients. Results showed that this overactivity is a dysfunctional condition that contributes to the memory impairment such that treatment with very low doses of levetiracetam both reduces this overactivity and improves memory function in these patients.
Author Interviews, Lancet, Mental Health Research / 19.03.2015

Dr. Angela WoodsMedicalResearch.com Interview with: Dr Angela Woods Associate Editor, BMJ Medical Humanities Journal Senior Lecturer in Medical Humanities Deputy Director, Centre for Medical Humanities Durham University   Medical Research: What is the background for this study? What are the main findings? Dr. Woods: We’ve known for a long time that hearing voices, or auditory hallucinations, is reported by people with a wide range of psychiatric diagnoses as well as by those who have no diagnosis. 5–15 per cent of adults will hear voices at some point during their lives – in circumstances that may be related to spiritual experiences, bereavement, trauma, sensory deprivation or impairment, as well as mental and emotional distress. However, what we know about voices clinically and empirically comes from a small handful of studies, typically conducted in mental health settings with patients with a diagnosis of schizophrenia using quantitative scales and measures. Our study asked people to describe, in their own words, what it is like to hear voices. We designed an open-ended online questionnaire which was completed by 153 people with a range of diagnoses, including 26 who had never had a psychiatric diagnosis. Our study found that a large majority of participants described hearing multiple voices (81%) with characterful qualities (70%). While fear, anxiety, depression and stress were often associated with voices, 31% of participants reported positive and 32% neutral emotions. To our surprise less than half the participants reported hearing literally auditory voices; 45% reported either thought-like or mixed experiences. Perhaps the most startling finding concerned the physicality of voices. Bodily sensations while hearing voices were reported by 66% of participants – these included feelings of tingling, numbness, burning, pressure, and a sense of being distanced or disconnected from the body.
Author Interviews, Depression, Vitamin D / 18.03.2015

David C.R. Kerr Ph.D. Sch of Psychological Science Associate Professor College of Liberal Arts Oregon State UniversityMedicalResearch.com Interview with: David C.R. Kerr Ph.D. Sch of Psychological Science Associate Professor College of Liberal Arts Oregon State University Medical Research: What is the background for this study? What are the main findings? Dr. Kerr: Many people assume we already know that low levels of vitamin D contribute to depression, especially in winter. However, studies have not found consistent evidence for this, and most studies have focused on people in late life or with serious medical conditions. We focused on apparently healthy young women living in the Pacific Northwest. We found that women with low blood levels of vitamin D were more likely to report clinically significant depressive symptoms. This link existed even when we considered other factors that might explain both problems, such as diet, obesity, and time of year.
Author Interviews, Cognitive Issues, JAMA, University of Michigan / 18.03.2015

Donovan Maust, MD, MS Assistant Professor of Psychiatry University of Michigan Research Scientist, Center for Clinical Management Research VA Ann Arbor Healthcare SystemMedicalResearch.com Interview with: Donovan Maust, MD, MS Assistant Professor of Psychiatry University of Michigan Research Scientist, Center for Clinical Management Research VA Ann Arbor Healthcare System Medical Research: What is the background for this study? What are the main findings? Dr. Maust: From a recent government report, we known that about 1/3 of older adults with dementia in nursing homes and about 14% of those in the community have been prescribed an antipsychotic. While providers focus on what benefit the treatment they offer, it is important to also be aware of the potential harms, particularly when it is death. Prior estimates came from relatively short studies and showed a 1% increase. This paper finds that, over 180 days, the increased mortality comparing antipsychotic users to matched non-users is about 2 to 5 times higher.
Alzheimer's - Dementia, Author Interviews, Karolinski Institute, Lancet / 13.03.2015

MedicalResearch.com Interview with: Miia Kivipelto MD, PhD, Professor Deputy Head, Senior Geriatrician Aging Research Center and Alzheimer Disease Research Center Karolinska Institutet Clinical Trials Unit, Memory Clinic Karolinska University Hospital Stockholm, Sweden Medical Research: What is the background for this study? What are the main findings? Dr. Kivipelto: Epidemiological studies have linked several modifiable risk factors to cognitive impairment and dementia but evidence from randomized controlled trials (RCT) has been lacking showing the efficacy of the interventions. Because cognitive impairment, dementia and Alzheimer’s disease are complex, multi-factorial disorders, multidomain interventions targeting several risk factors and disease mechanisms simultaneously could be needed for optimum preventive effect. The FINGER study is the first large, long-term RCT indicating that multi-domain intervention can improve and maintain cognitive functioning in at risk elderly people from the general population. We observed a significant intervention effects on the primary outcome (overall cognition), main secondary outcomes (executive functioning and processing speed) as well as on complex memory tasks and risk of cognitive decline. The multidomain lifestyle intervention was feasible and safe.
Author Interviews, Brain Injury, Yale / 09.03.2015

Dr. Pina Violano, RN, PhD Trauma Department, Yale-New Haven Hospital, Injury Free Coalition for Kids of New Haven Yale-New Haven Children’s Hospital New Haven 06510, CTMedicalResearch.com Interview with: Dr. Pina Violano, RN, PhD Trauma Department, Yale-New Haven Hospital, Injury Free Coalition for Kids of New Haven Yale-New Haven Children’s Hospital New Haven 06510, CT MedicalResearch: What is the background for this study? Dr. Violano: In July of 2012, Connecticut became one of the first states to enact legislation to ensure the safety and appropriate evaluation and management of sports-related concussions (SRC) among High School students. SRCs are a common occurrence in high school sports with their diagnosis increasing over the last decade. While the exact reasons are not known, public health campaign efforts and education may have facilitated improvement in the evaluation and detection of sports-related concussions and may have contributed to increase awareness and treatment. MedicalResearch: What are the main findings? Dr. Violano: Evaluation of two emergency department records revealed a marked increase in the frequency of high school student athletes being treated for sports-related concussions after the implementation of Connecticut’s SRC law. This suggests that Connecticut’s legislation is effective in improving the evaluation and detection of sports-related concussions in high school students.
Author Interviews, Depression, Heart Disease, Statins / 07.03.2015

Heidi May, Ph.D., M.S.P.H. Cardiovascular Epidemiologist Intermountain Medical Center Heart Institute Salt Lake CityMedicalResearch.com Interview with: Heidi May, Ph.D., M.S.P.H. Cardiovascular Epidemiologist Intermountain Medical Center Heart Institute Salt Lake City   Medical Research: What is the background for this study? What are the main findings? Dr. Heidi May: Cardiovascular disease remains the leading cause of morbidity and mortality worldwide. Statin therapy is known to reduce the risk of cardiovascular disease incidence through the reduction of blood cholesterol levels and through its pleiotropic cardioprotective properties. Depression is a risk factor for cardiovascular disease. It has been recommended that antidepressant medications should be considered first-line treatment for depression of any severity. We hypothesized that taking both statins and antidepressants would reduce cardiovascular risk more than either medication alone. However, we did not find this. Instead we found that the effectiveness of antidepressants and statin therapy to reduce death and incident cardiovascular disease at 3 years varied by the severity of depressive symptoms. Among those with none to mild depressive symptoms, statin use, with or without antidepressant therapy, was associated with a decrease in risk, but among those with moderate to severe depression, antidepressant use was associated with a decrease in risk. The combination of antidepressant and statin use did not result in a greater risk reduction in either depressive symptom category.
Author Interviews, Mental Health Research, Pediatrics, University of Pennsylvania / 04.03.2015

Courtney Benjamin Wolk, Ph.D. Postdoctoral Researcher Center for Mental Health Policy and Services Research Perelman School of Medicine Department of Psychiatry University of Pennsylvania Philadelphia, PA 19104MedicalResearch.com Interview with: Courtney Benjamin Wolk, Ph.D. Postdoctoral Researcher Center for Mental Health Policy and Services Research Perelman School of Medicine Department of Psychiatry University of Pennsylvania Philadelphia, PA 19104 Medical Research: What is the background for this study? What are the main findings? Response: Previous research investigating the relationship between anxiety and suicidality has been mixed. An ongoing question in the field has been whether anxiety disorders independently increase risk for suicidal ideation and behavior or if the high co-occurrence of anxiety and mood symptoms or other shared demographic factors are driving relationships that have been observed between anxiety and suicidality. We examined the relationship between response to treatment for an anxiety disorder in childhood and suicidal ideation, plans, and attempts 7 to 19 years after treatment with cognitive-behavioral therapy, more commonly referred to as CBT. Our results indicated that participants who responded favorably to cognitive-behavioral therapy during childhood had lower rates of lifetime, past month, and past two-week suicidal ideation endorsement than treatment non-responders. This was the case across both self-report and interview-report of suicidal ideation. Treatment response was not significantly associated with suicide plans or attempts, though plans and attempts were infrequently endorsed in our sample, limiting the ability to detect findings.
Author Interviews, Mental Health Research / 03.03.2015

Julie M. Zito, PhD Professor of Pharmacy and Psychiatry Department of Pharmaceutical Health Services Research University of Maryland School of Pharmacy Baltimore, MD 21201MedicalResearch.com Interview with: Julie M. Zito, PhD Professor of Pharmacy and Psychiatry Department of Pharmaceutical Health Services Research University of Maryland School of Pharmacy Baltimore, MD 21201 MedicalResearch: What is the background for this study? Dr. Zito: Atypical antipsychotic (AAP) use in children and adolescents has grown substantially in the past decade, largely for behavioral (non-psychotic) conditions. Poor and foster care children with Medicaid-insurance are particularly affected. This ‘off-label’ usage has insufficient evidence of benefits regarding improved functioning (i.e. appropriate behavior and performance, socially and academically) while the little evidence that accrues tends to emphasize ‘symptoms’, i.e. less acting out. Recent evidence shows that youth treated with Atypical antipsychotics are at risk of serious cardiometabolic adverse events including diabetes emerging after atypical antipsychotics are ‘on board’. MedicalResearch: What are the main findings? Dr. Zito: The continued expansion in Atypical antipsychotics use for behavioral conditions, particularly in poor and foster care youth prompted several government reports asking states to implement oversight programs. In our survey of state Medicaid agencies, we identified programs implementing a new and promising approach to increase the likelihood that these medications are used appropriately. These ‘peer review’ programs have been launched in 15 of the 31 prior authorization state Medicaid programs. There is a distinct advantage in having a qualified peer review, on a case-by-case basis, of the rationale for use of an atypical antipsychotic in a condition or age group that is ‘off-label’ according to the FDA product information label.
Author Interviews, Blood Pressure - Hypertension, Cognitive Issues, Geriatrics, JAMA / 03.03.2015

MedicalResearch.com Interview with: Dr. Enrico Mossello Research Unit of Medicine of Ageing Department of Experimental and Clinical Medicine University of Florence MedicalResearch: What is the background for this study? What are the main findings? Dr. Mossello: In spite of the high prevalence of high blood pressure (HBP) and cognitive impairment in old age, their relationship is still controversial. While several (but not all) studies have identified high blood pressure as a risk factor for incident cognitive impairment, evidence regarding the prognostic role of blood pressure in cognitively impaired older subjects is scarce and inconsistent. To our knowledge, no longitudinal study has been published up to now regarding Ambulatory Blood Pressure Monitoring (ABPM) in subjects with cognitive impairment. Moreover recent European and American guidelines on HBP leave decisions on antihypertensive therapy of frail elderly patients to the treating physician and do not provide treatment targets for cognitively impaired patients. In the present cohort study of subjects with dementia and Mild Cognitive Impairment (MCI) low values of day-time systolic blood pressure measured with ABPM were associated with greater progression of cognitive decline after a median 9-month follow-up. This association was limited to subjects treated with anti-hypertensive drugs and was independent of age, vascular comorbidity and baseline cognitive level, holding significant both in dementia and in Mild Cognitive Impairment subgroups. A similar trend of association was observed for office systolic blood pressure, although this was weaker and did not reach statistical significance in all analyses.
Author Interviews, Mental Health Research, Pediatrics / 02.03.2015

David C. Rettew, MD Associate Professor of Psychiatry and Pediatrics Director, Child & Adolescent Psychiatry Fellowship Director, Pediatric Psychiatry Clinic University of Vermont College of MediciMedicalResearch.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.
Author Interviews, CMAJ, Cognitive Issues / 28.02.2015

Optimized-dr-raza-naqviMedicalResearch.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.
Alzheimer's - Dementia, Author Interviews, Brigham & Women's - Harvard, JAMA, Memory / 24.02.2015

Dr. Rebecca E. Amariglio Ph.D. Massachusetts Alzheimers Disease Research Center Massachusetts General HospitalMedicalResearch.com Interview with: Dr. Rebecca E. Amariglio Ph.D. Massachusetts Alzheimers Disease Research Center Massachusetts 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.
Author Interviews, Brain Injury, Stroke / 22.02.2015

Bruno Meloni PhD Centre for Neuromuscular and Neurological Disorders The University of Western Australia, Nedlands, Western Australia, AustraliaMedicalResearch.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.