MedicalResearch.com Interview with:
Miranda M. Lim, MD, PhD
Assistant Professor, Sleep Medicine
Division of Pulmonary and Critical Care
Portland VA Medical Center and Oregon Health & Science University
MedicalResearch.com: What are the main findings of the study?
Dr. Lim: People with traumatic brain injury (TBI) often have persistent sleep-wake disturbances including excessive daytime sleepiness and nighttime insomnia, yet the link between a hard blow to the head and drowsiness remains a mystery. We report that a dietary supplement containing branched chain amino acids helps keep mice with TBI awake and alert. The findings suggest that branched chain amino acids, something all humans produce from foods in their normal diets, could potentially alleviate sleep problems associated with TBI. In experiments with brain-injured mice that had trouble staying awake, we found that feeding the animals a dietary supplement enriched with branched chain amino acids improved wakefulness. Treated mice not only stayed continuously awake for longer periods of time, they also showed more orexin neuron activation, neurons known to be involved in maintaining wakefulness. (Previous studies have shown that people with narcolepsy lose significant amounts of orexins.) Branched chain amino acids are the building blocks of neurotransmitters, the chemicals released by neurons in the brain, including glutamate and GABA. We believe that branched chain amino acids act to restore the excitability of orexin neurons after brain injury, which could potentially promote wakefulness. Further studies are needed to pinpoint the exact mechanism of branched chain amino acids effect on sleep pathways in the brain, and to determine any side effects.
MedicalResearch.com Interview with:
Dr. Vitria Adisetiyo, Ph.D.
Postdoctoral Research Fellow
Medical University of South Carolina
Center for Biomedical Imaging Charleston, SC 29425
MedicalResearch.com: What are the main findings of the study?
Dr. Adisetiyo: Using a non-invasive MRI method called magnetic field correlation imaging, we detected significantly reduced striatal and thalamic brain iron in medication-naive children and adolescents with ADHD compared to age-, gender- and IQ-matched typically developing controls. ADHD patients who had a history of psychostimulant medication treatment (e.g. Ritalin, Aderrall) had brain iron levels comparable to controls, suggesting brain iron may normalize with psychostimulants. Blood iron measures did not differ between patients and controls.
MedicalResearch.com Interview with:
Professor Desiree Silva MB BS, FRACP, MPH
Consultant Paediatrician
Suite 210 Specialist Centre, Joondalup Health Campus
60 Shenton Avenue, Joondalup WA 6027
MedicalResearch.com: What are the main findings of the study?
Prof. Silva: Our study is one of the largest population based studies of 12,991 children with ADHD. We found that smoking in pregnancy, maternal urinary infections, preeclampsia, being induced and threatened pre-term labour increases the risk of ADHD with little gender differences. Prematurity also increased the risk of ADHD including babies born late preterm and early term marginally increased the risk of ADHD.
MedicalResearch.com Interview with:
J. Randall Curtis, MD, MPH
Professor of Medicine
Director, UW Palliative Care Center of Excellence
Section Head, Pulmonary and Critical Care Medicine, Harborview Medical CenterA. Bruce Montgomery, M.D. – American Lung Association Endowed Chair in Pulmonary and Critical Care Medicine, University of Washington, Seattle, WA 98104
MedicalResearch.com: What are the main findings of the study?
Dr. Curtis: We examined the effect of a communication-skills intervention for internal medicine and nurse practitioner trainees on patient- and family-reported outcomes. The study was funded by the National Institutes of Nursing Research of the National Institutes of Heatlh. We conducted a randomized trial with 391 internal medicine and 81 nurse practitioner trainees at two universities. Participants were randomized to either an 8-session simulation-based, communication-skills intervention or to usual education. We collected outcome data from a large number of patients with life-limiting illness and their families, including 1866 patient ratings and 936 family ratings. The primary outcome was patient-reported quality of communication and, overall, this outcome did not change with the intervention. However, when we restricted our analyses to only patients who reported their own health status as poor, the intervention was associated with increased communication ratings. Much to our surprise, the intervention was associated with a small but significant increase in depression scores among post-intervention patients. Overall, this study demonstrates that among internal medicine and nurse practitioner trainees, simulation-based communication training compared with usual education improved communication skills acquisition, but did not improve quality of communication about end-of-life care for all patients. However, the intervention was associated with improved patient ratings of communication for the sickest patients. Furthermore, the intervention was associated with a small increase in patients’ depressive symptoms, and this appeared most marked among patients of the first-year residents.
MedicalResearch.com Interview with:
Alessandra d’Azzo PhD
Department of Genetics, St Jude Children’s Research Hospital
262 Danny Thomas Place, Memphis, Tennessee 38105
MedicalResearch.com: What are the main findings of the study?
Dr. d’Azzo: We have discovered a connection between a rare childhood disorder and Alzheimer’s disease that usually affects older people.
The culprit is a metabolic enzyme called NEU1 that normally controls the recycling or disposal of proteins in a specific cell compartment, the lysosome.
When NEU1 is defective, children develop the severe metabolic disease, sialidosis.
Our study suggests that NEU1 also plays an important role in the development of Alzheimer’s disease. Based on this discovery, we decided to increase NEU1 enzyme activity in the brain of an Alzheimer’s disease mouse model that shows features characteristic of the human disease, namely the accumulation of toxic protein aggregates or plaques. Remarkably, we could significantly diminish the number of plaques in the brain of these mice by increasing NEU1 enzyme activity.
MedicalResearch.com Interview with:
Ian Kronish, MD, MPH
Assistant Professor of Medicine
Center for Behavioral Cardiovascular Health
Division of General Medicine
Columbia University Medical Center
MedicalResearch.com: What are the main findings of the study?
Dr. Kronish: Among primary care patients with persistently uncontrolled blood pressure despite medication treatment, we found that medication non-adherence was more than twice as common in patients with PTSD (68%) as compared to patients without PTSD (26%). The association between PTSD and medication non-adherence remained present after adjustment for key covariates including regimen complexity and depression. Recent research shows that PTSD not only contributes to psychological distress, but is also associated with increased risk for incident and recurrent cardiovascular disease. The data from our study suggest that medication non-adherence may be an important mechanism by which PTSD increases risk for cardiovascular disease.
MedicalResearch.com Interview
Dr. Michael Shevell
Chair of the Pediatrics Department at the McGill Faculty of Medicine and Pediatrician-in-Chief at the Montreal Children’s Hospital and the McGill University Health Centre
MedicalResearch.com: What are the main findings of the study?
Dr. Shevell: At risk term infants who have spent some time in a Level III NICU after birth are at substantially increased later risk for an autistic spectrum disorder. Frequently this disorder occurs in conjunction with substantial co-morbidity.
MedicalResearch.com Interview with:
Prof Ype Elgersma PhD
Professor, Neuroscience
Neuroscience Institute, Erasmus University Rotterdam
Rotterdam, Netherlands
MedicalResearch.com: What are the main findings of the study?
Answer: Research in genetic mouse models suggested that inhibition of HMG-CoA-reductase by statins might ameliorate the cognitive and behavioral phenotype of children with Neurofibromatosis type 1 (NF1), an autosomal dominant disorder. In a 12-month randomized placebo-controlled study including 84 children with NF1, we found that simvastatin, an inhibitor of the HMG-CoA-reductase pathway had no effect on full-scale intelligence, attention problems or internalizing behavioral problems, or on any of the secondary outcome measures.
MedicalResearch.com Interview with:
Alize J. Ferrari
University of Queensland
School of Population Health
Herston, Queensland, Australia
MedicalResearch.com: What are the main findings of the study?
Answer: In our paper recently published in PloS Medicine, we report findings from the Global Burden of Disease Study 2010 for depression. We found that depression (defined as major depressive disorder and dysthymia) accounted fr 8% of the non fatal burden in 2010, making it the second leading cause of disability worldwide. Burden due to depression increased by 35% between 1990 and 2010, although this increase was entirely driven by population growth and ageing. Burden occurred across the entire lifespan, was higher in females compared to males, and there were differences between world regions.When depression was considered a risk factor for other health outcomes it explained 46% of the burden allocated to suicide and 3% of the burden allocated ischemic heart disease.
MedicalResearch.com Interview with:
Dr. Soo Borson, M.D.
Professor Department of Psychiatry and Behavioral Sciences,
University of Washington School of Medicine
MedicalResearch.com: What are the main findings of the study?
Dr. Borson: We developed a new short screen to help clinicians and health care systems identify dementia patients and their caregivers who have unmet needs for dementia care services - extra help from primary care providers or clinical specialists skilled in understanding and managing problems related to dementia, working with caregivers to alleviate stress and burden, and locating community-based support services.
MedicalResearch.com Interview with:
Dr. Andrew R. Mayer, PhD
The Mind Research Network Lovelace Biomedical and Environmental Research Institute
MedicalResearch.com: What are the main findings of the study?
Dr. Mayer:
a) Just because mTBI patients self-report reduced and/or no post-concussive symptoms does not mean that they have completed the healing process.
b) Current gold-standards in the clinical world (CT scans and self-report) may not be accurately capturing brain health after injury.
c) Diffusion imaging shows promise for being a more sensitive biomarker for measuring recovery than currently used techniques.
MedicalResearch.com:
Samantha Gardener PhD Student
Senior Research Assistant for DIAN and AIBL Studies
McCusker Alzheimer's Research Foundation
2/142 Stirling Hwy
NEDLANDS
6009
Western Australia
MedicalResearch.com: What are the main findings of your study?
Answer: Our research indicates that consuming larger quantities of foods included in a western dietary pattern is associated with greater cognitive decline in visuospatial functioning after 36 months. Foods included in the western dietary pattern are red and processed meats, high fat dairy products, chips, refined grains, potatoes, sweets and condiments. Visuospatial functioning is an area which includes distance and depth perception, reproducing drawings and using components to construct objects or shapes.
In contrast, adherence to the Mediterranean diet, a healthy eating pattern is associated with less decline in executive function. Foods included in the Mediterranean diet are vegetables, fruits and fish. Examples of executive function include planning and organising, problem solving and time management.
MedicalResearch.com Interview with:
Hugh C. Hendrie, MB ChB, DSc
Professor, Department of Psychiatry, Indiana University School of Medicine
Center Scientist, Indiana University Center for Aging Research
Research Scientist, Regenstrief Institute, Inc.
MedicalResearch.com: What are the main findings of the study?
Answer: Our findings of higher rates of emergency care, longer hospitalizations and increased frequency of falls, substance abuse and alcoholism suggest that seriously mentally ill older adults remain a vulnerable population.
MedicalResearch.com Interview with:
Prof David K Menon MD PhD FRCP FRCA FFICM FMedSci
Head, Division of Anaesthesia, University of Cambridge
Consultant,
Neurosciences Critical Care Unit
BOC Professor,
Royal College of Anaesthetists
Professorial Fellow, Queens' College, Cambridge
Senior Investigator, National Institute for Health Research
Box 93, Addenbrooke's Hospital,
Cambridge CB2 2QQ, UK
MedicalResearch.com: What is the background for your study?
Dr. Menon: We have known for some time that a history of traumatic brain injury (TBI) results in a significant (between 2 and 10 fold) increase in the likelihood of getting dementia in later life. On possible mechanistic explanation for this comes from the finding that about a third of individuals who died of TBI, regardless of age, are found at autopsy to have deposits of β-amyloid in the brain, often Aβ42, which is the same variant of amyloid seen in the brain of patients who have Alzheimer’s Disease.
However, such detection after death has made it impossible to examine the linkage of such early amyloid deposition to late dementia. More recently, imaging with positron emission tomography (PET) and Pittsburgh compound B (PIB) has been used to image amyloid deposits in Alzheimer’s Disease. However, the technique had not been validated in traumatic brain injury.
MedicalResearch.com Interview with:
Richard L. Kravitz, MD, MSPH
Professor and Co-vice Chair (Research)
Interim Director, UC Center Sacramento
Co-Editor in Chief, Journal of General Internal Medicine
MedicalResearch.com: What is the background for your study?
Dr. Kravitz: Depression in the United States is both undertreated and overtreated. As the de facto mental health care system for many, primary care is at the nexus of this problem. Up to 30% of patients with major depression in primary care go undiagnosed. At the same time, partly as a result of marketing, lots of patients who don’t need meds are started on antidepressants. So we were interested in finding ways to get more truly depressed patients into treatment without overtreating patients who don’t need it.
MedicalResearch.com Interview with:
Linda Brzustowicz, M.D.
Professor and Chair
Department of Genetics
Rutgers University,Piscataway, NJ 08854
MedicalResearch.com: What are the main findings of the study?
Dr. Brzustowicz: The objective of this study was to search for locations in the human genome that impact language ability in individuals with autism as well as in their family members without autism. To do this, we recruited families with an individual with autism and at least one other family member without autism but with a language learning impairment. We identified two locations in the human genome that are linked to language ability in these families. Importantly, these locations do not appear to be specific to language impairment in the individuals with autism, but are related to language ability in other family members as well. This suggests that while individuals with autism may have new, or de novo, genetic variations that are important for risk of illness, they may also carry inherited genetic variation that influence the expression of their illness. The effects of these inherited variants can also be seen in the language performance of family members without autism.
MedicalResearch.com Interview with
Professor Stefan Priebe, Dipl.-Psych., Dr. med. habil., FRCPsych
Unit for Social and Community Psychiatry
WHO Collaborating Centre for Mental Health Services Development
Queen Mary, University of London
MedicalResearch.com: What are the main findings of the study?
Answer: Offering modest financial incentives can help patients to achieve better adherence to anti-psychotic maintenance medication.
MedicalResearch.com Interview with
Dr. Kees-Jan Kan PhD
Department of Biological Psychology, VU University
Department of Psychological Methods, University of Amsterdam
MedicalResearch.com: What are the main findings of the study?
Answer: We asked ourselves how well theories of intelligence actually predict empirical results. To this end, we reviewed and scrutinized the predictions from intelligence theories and collected relevant results that have been published in the scientific literature over the last decades. The results pertained to intelligence test scores from thousands of subjects across the world. We found that on essential aspects the empirical results were opposite of the predictions from the mainstream theories of intelligence, in which intelligence is interpreted as a biological trait.
MedicalResearch.com Interview with:
Prof. Timothy Salthouse
Brown-Forman Professor of Psychology
Department of Psychology
University of Virginia
Charlottesville, VA 22904-4400
MedicalResearch.com: What prompted this work?
Prof. Salthouse: I think it is noteworthy that the research originated as an undergraduate project by Arielle Mandell. Ms. Mandell was supported by a University of Virginia Harrison Undergraduate Research Award while she was doing the research, and a report of the research served as her Distinguished Major Thesis.
The research was prompted by the observation that according to self-reports, tip-of-the-tongue experiences occur more and more frequently with increased age, and often seem to be associated with concerns about memory decline and possibly impending dementia. We wondered
MedicalResearch.com Interview with:
Dr. Rebecca Todd
Assistant Professor
University of British Columbia
Department of Psychology
Centre for Interactive Research on Sustainability
4342A-2260 West Mall
Vancouver, BC V6T 1Z4
MedicalResearch.com: What are the main findings of the study?
Answer: What we found, in essence, is that some individuals are genetically predisposed to see the world more darkly than others. We find that a common gene variant is linked to perceiving emotional events --especially negative ones --¬ more vividly than others. This gene variant has been previously linked (by other researchers) to emotional memory and the likelihood of experiencing intrusive, or “flashback” memories following traumatic experience. Our findings suggest that in healthy young adults this enhanced emotional memory may be because individuals are more likely to perceive what’s emotionally relevant in the first place. We've all heard of rose colored glasses, but this is more like gene-colored glasses, tinted a bit darkly.
MedicalResearch.com Interview with:
Dr. Elisabeth Jeppesen MPH, PhD-fellow
National Resource Center for Late Effects after Cancer Treatment, Department of Oncology, Oslo University, Hospital, The Norwegian Radiumhospitalet, Oslo, Norway
mobil +47 951 05271
Wisit: Ullernchaussen 70 (Radiumhospitalet)
www.oslo-universitetssykehus.no
MedicalResearch.com: What is the background of this study?
Answer: Each year a considerable number of parents with children younger than 18 years of age are affected by cancer in a parent. Cancer in one of the parents might represent a potentially traumatic event and thereby may be a risk factor for psychosocial problems in the offspring. So far, teenagers’ psychosocial responses to parental cancer have only been studied to a limited extent in controlled trials. Using a trauma theory perspective many studies have shown significant direct associations between parental cancer and psychosocial problems in teenagers. However, the literature also indicates that most children and teenagers have normal stress reactions to such events. In order to identify the need for eventual prevention and intervention among teenagers exposed to such a stressor, we need more empirical knowledge of their psychosocial situation.
MedicalResearch.com Interview with:
Shu-Sen Chang, MD, MSc, PhD
Research Assistant Professor
HKJC Centre for Suicide Research and Prevention
The University of Hong Kong
2/F, The Hong Kong Jockey Club Building for Interdisciplinary Research, 5 Sassoon Road Pokfulam, Hong Kong
MedicalResearch.com: What are the main findings of the study?
Dr. Chang: The study shows a marked increase in suicide in 2009 following the 2008 global economic crisis, particularly in men in the 27 European and 18 American countries included in the study. There were estimated approximately 5000 excess suicides across all 54 study countries in 2009. The largest increase in Europe was seen in 15-24 year old men and in 45-64 year old men in America.