Known risk factors largely explain links between loneliness and first time heart disease/stroke
But social isolation still associated with death among those with preexisting cardiovascular disease
March 26, 2018
Science Daily/BMJ
Conventional risk factors largely explain the links observed between loneliness/social isolation and first time heart disease/stroke, a new study finds. But having few social contacts still remains an independent risk factor for death among those with pre-existing cardiovascular disease.
Recent research has increasingly highlighted links between loneliness and social isolation and cardiovascular disease and death. But most of these studies have not considered a wide range of other potentially influential factors, say the authors.
In a bid to clarify what role these other factors might have, they drew on data from nearly 480,000 people aged between 40 and 69, who were all part of the UK Biobank study between 2007 and 2010.
Participants provided detailed information on their ethnic background, educational attainment, household income, lifestyle (smoking, drinking, exercise) and depressive symptoms.
They were also asked a series of questions to gauge their levels of social isolation and loneliness. Height, weight, and grip strength were measured, and blood samples taken.
Their health was then tracked for an average of 7 years.
Nearly one in 10 (9%) respondents were deemed to be socially isolated, 6 percent lonely, and 1 percent both.
Those who were socially isolated and/or lonely were more likely to have other underlying long term conditions and to be smokers, while those who were lonely reported more depressive symptoms.
During the 7 year monitoring period, 12,478 people died. And 5731 people had a first time heart attack while 3471 had a first time stroke.
Social isolation was associated with a 43 percent higher risk of first time heart attack, when age, sex, and ethnicity were factored in.
But when behavioural, psychological, health, and socioeconomic factors were added into the mix, these factors accounted for most (84%) of the increased risk, and the initial association was no longer significant.
Similarly, social isolation was initially associated with a 39 percent heightened risk of a first time stroke, but the other conventional risk factors accounted for 83 percent of this risk.
Similar results were observed for loneliness and risk of first time heart attack or stroke.
But this was not the case for those with pre-existing cardiovascular disease among whom social isolation was initially associated with a 50 percent heightened risk of death. Although this halved when all the other known factors were considered, it was still 25 percent higher.
Similarly, social isolation was associated with a 32 percent heightened risk of death even after all the other conventional factors had been accounted for.
This is an observational study so no firm conclusions can be drawn about cause and effect, but the findings echo those of other research in the field, say the study authors.
And the size and representative nature of the study prompt the authors to conclude that their findings "indicate that social isolation, similarly to other risk factors such as depression, can be regarded as a risk factor for poor prognosis of individuals with cardiovascular disease."
This is important, they emphasise, as around a quarter of all strokes are recurrent, and targeting treatment of conventional risk factors among the lonely and isolated might help stave off further heart attacks and strokes, they suggest.
https://www.sciencedaily.com/releases/2018/03/180326213304.htm
Coffee affects cannabis and steroid systems
March 15, 2018
Science Daily/Northwestern University
Coffee affects your metabolism in dozens of other ways besides waking you up, including your metabolism of neurotransmitters typically linked to cannabis, a study reports. The neurotransmitters related to the endocannabinoid system -- the same ones affected by cannabis -- decreased after drinking four to eight cups of coffee in a day. That's the opposite of what occurs after someone uses cannabis. The study also gives possible insight in the cause of munchies. Coffee may also increase the elimination of steroids.
It's well known that a morning cup of joe jolts you awake. But scientists have discovered coffee affects your metabolism in dozens of other ways, including your metabolism of steroids and the neurotransmitters typically linked to cannabis, reports a new study from Northwestern Medicine.
In a study of coffee consumption, Northwestern scientists were surprised to discover coffee changed many more metabolites in the blood than previously known. Metabolites are chemicals in the blood that change after we eat and drink or for a variety of other reasons.
The neurotransmitters related to the endocannabinoid system -- the same ones affected by cannabis -- decreased after drinking four to eight cups of coffee in a day. That's the opposite of what occurs after someone uses cannabis. Neurotransmitters are the chemicals that deliver messages between nerve cells.
Cannabinoids are the chemicals that give the cannabis plant its medical and recreational properties. The body also naturally produces endocannabinoids, which mimic cannabinoid activity.
In addition, certain metabolites related to the androsteroid system increased after drinking four to eight cups of coffee in a day, which suggests coffee might facilitate the excretion or elimination of steroids. Because the steroid pathway is a focus for certain diseases including cancers, coffee may have an effect on these diseases as well.
"These are entirely new pathways by which coffee might affect health," said lead author Marilyn Cornelis, assistant professor of preventive medicine at Northwestern University Feinberg School of Medicine. "Now we want to delve deeper and study how these changes affect the body."
Little is known about how coffee directly impacts health. In the new study, Northwestern scientists applied advanced technology that enabled them to measure hundreds of metabolites in human blood samples from a coffee trial for the first time. The study generates new hypotheses about coffee's link to health and new directions for coffee research.
The paper will be published March 15 in the Journal of Internal Medicine.
Drinking lots of coffee for science
In the three-month trial based in Finland, 47 people abstained from coffee for one month, consumed four cups a day for the second month and eight cups a day for the third month. Cornelis and colleagues used advanced profiling techniques to examine more than 800 metabolites in the blood collected after each stage of the study.
Blood metabolites of the endocannabinoid system decreased with coffee consumption, particularly with eight cups per day, the study found.
The endocannabinoid metabolic pathway is an important regulator of our stress response, Cornelis said, and some endocannabinoids decrease in the presence of chronic stress.
"The increased coffee consumption over the two-month span of the trial may have created enough stress to trigger a decrease in metabolites in this system," she said. "It could be our bodies' adaptation to try to get stress levels back to equilibrium."
The endocannabinoid system also regulates a wide range of functions: cognition, blood pressure, immunity, addiction, sleep, appetite, energy and glucose metabolism.
"The endocannabinoid pathways might impact eating behaviors," suggested Cornelis, "the classic case being the link between cannabis use and the munchies."
Coffee also has been linked to aiding weight management and reducing risk of type 2 diabetes.
"This is often thought to be due to caffeine's ability to boost fat metabolism or the glucose-regulating effects of polyphenols (plant-derived chemicals)," Cornelis said. "Our new findings linking coffee to endocannabinoids offer alternative explanations worthy of further study."
It's not known if caffeine or other substances in coffee trigger the change in metabolites.
https://www.sciencedaily.com/releases/2018/03/180315091253.htm
Can't sleep? Could be down to genetics
Large study confirms that insomnia is hereditary
March 9, 2018
Science Daily/Springer
Researchers have identified specific genes that may trigger the development of sleep problems, and have also demonstrated a genetic link between insomnia and psychiatric disorders such as depression, or physical conditions such as type 2 diabetes.
Up to 20 percent of Americans and up to 50 percent of US military veterans are said to have trouble sleeping. The effects insomnia has on a person's health can be debilitating and place a strain on the healthcare system. Chronic insomnia goes hand in hand with various long-term health issues such as heart disease and type 2 diabetes, as well as mental illness such as post-traumatic stress disorder (PTSD) and suicide.
Twin studies have in the past shown that various sleep-related traits, including insomnia, are heritable. Based on these findings, researchers have started to look into the specific gene variants involved. Stein says such studies are important, given the vast range of reasons why people suffer from insomnia, and the different symptoms and varieties of sleeplessness that can be experienced.
"A better understanding of the molecular bases for insomnia will be critical for the development of new treatments," he adds.
In this study, Stein's research team conducted genome-wide association studies (GWAS). DNA samples obtained from more than 33,000 soldiers participating in the Army Study To Assess Risk and Resilience in Servicemembers (STARRS) were analyzed. Data from soldiers of European, African and Latino descent were grouped separately as part of efforts to identify the influence of specific ancestral lineages. Stein and his colleagues also compared their results with those of two recent studies that used data from the UK Biobank.
Overall, the study confirms that insomnia has a partially heritable basis. The researchers also found a strong genetic link between insomnia and type 2 diabetes. Among participants of European descent, there was additionally a genetic tie between sleeplessness and major depression.
"The genetic correlation between insomnia disorder and other psychiatric disorders, such as major depression, and physical disorders such as type 2 diabetes suggests a shared genetic diathesis for these commonly co-occurring phenotypes," says Stein, who adds that the findings strengthen similar conclusions from prior twin and genome-wide association studies.
Insomnia was linked to the occurrence of specific variants on chromosome 7. In people of European descent, there were also differences on chromosome 9. The variant on chromosome 7, for instance, is close to AUTS2, a gene that has been linked to alcohol consumption, as well as others that relate to brain development and sleep-related electric signaling.
"Several of these variants rest comfortably among locations and pathways already known to be related to sleep and circadian rhythms," Stein elaborates. "Such insomnia associated loci may contribute to the genetic risk underlying a range of health conditions including psychiatric disorders and metabolic disease."
https://www.sciencedaily.com/releases/2018/03/180309095520.htm
Is your stress changing my brain?
Stress isn't just contagious; it alters the brain on a cellular level
March 8, 2018
Science Daily/University of Calgary
Scientists have discovered that stress transmitted from others can change the brain in the same way as a real stress does.
In a new study in Nature Neuroscience, Jaideep Bains, PhD, and his team at the Cumming School of Medicine's Hotchkiss Brain Institute (HBI), at the University of Calgary have discovered that stress transmitted from others can change the brain in the same way as a real stress does. The study, in mice, also shows that the effects of stress on the brain are reversed in female mice following a social interaction. This was not true for male mice.
"Brain changes associated with stress underpin many mental illnesses including PTSD, anxiety disorders and depression," says Bains, professor in the Department of Physiology and Pharmacology and member of the HBI. "Recent studies indicate that stress and emotions can be 'contagious'. Whether this has lasting consequences for the brain is not known."
The Bains research team studied the effects of stress in pairs of male or female mice. They removed one mouse from each pair and exposed it to a mild stress before returning it to its partner. They then examined the responses of a specific population of cells, specifically CRH neurons which control the brain's response to stress, in each mouse, which revealed that networks in the brains of both the stressed mouse and naïve partner were altered in the same way.
The study's lead author, Toni-Lee Sterley, a postdoctoral associate in Bains' lab said, "What was remarkable was that CRH neurons from the partners, who were not themselves exposed to an actual stress, showed changes that were identical to those we measured in the stressed mice."
Next, the team used optogenetic approaches to engineer these neurons so that they could either turn them on or off with light. When the team silenced these neurons during stress, they prevented changes in the brain that would normally take place after stress. When they silenced the neurons in the partner during its interaction with a stressed individual, the stress did not transfer to the partner. Remarkably, when they activated these neurons using light in one mouse, even in the absence of stress, the brain of the mouse receiving light and that of the partner were changed just as they would be after a real stress.
The team discovered that the activation of these CRH neurons causes the release of a chemical signal, an 'alarm pheromone', from the mouse that alerts the partner. The partner who detects the signal can in turn alert additional members of the group. This propagation of stress signals reveals a key mechanism for transmission of information that may be critical in the formation of social networks in various species.
Another advantage of social networks is their ability to buffer the effects of adverse events. The Bains team also found evidence for buffering of stress, but this was selective. They noticed that in females the residual effects of stress on CRH neurons were cut almost in half following time with unstressed partners. The same was not true for males.
Bains suggests that these findings may also be present in humans. "We readily communicate our stress to others, sometimes without even knowing it. There is even evidence that some symptoms of stress can persist in family and loved ones of individuals who suffer from PTSD. On the flip side, the ability to sense another's emotional state is a key part of creating and building social bonds."
This research from the Bains lab indicates that stress and social interactions are intricately linked. The consequences of these interactions can be long-lasting and may influence behaviours at a later time.
https://www.sciencedaily.com/releases/2018/03/180308143212.htm
Heart attack patients prescribed antidepressants have worse one-year survival
March 3, 2018
Science Daily/European Society of Cardiology (ESC)
Heart attack patients prescribed antidepressants have lower one-year survival rates, according to new research.
The observational study of nearly 9,000 patients found that those prescribed antidepressants at discharge from hospital after a heart attack had a 66% greater risk of mortality one year later than patients not prescribed the drugs, although they noted the cause is not necessarily related directly to the antidepressants.
Lead author Ms Nadia Fehr, a medical student at the University of Zurich, Switzerland, said: "Previous studies have suggested that cardiovascular disease may increase the likelihood of being depressed. On the other hand, depression appears to increase the probability of developing cardiovascular risk factors. However, little is known about the impact of depression on outcome after a heart attack."
This study assessed the association of antidepressant prescription at hospital discharge with the one-year outcomes of patients with acute myocardial infarction (heart attack).
Data from AMIS Plus, the Swiss nationwide registry for acute myocardial infarction, were used to analyse 8,911 heart attack patients admitted to hospitals in Switzerland between March 2005 and August 2016. Patients were followed up by telephone 12 months after discharge.
The researchers compared patients who received antidepressant medication at discharge with those who did not with regard to baseline characteristics and one-year outcomes including mortality, a subsequent heart attack, and stroke.
A total of 565 (6.3%) patients received antidepressants at discharge from hospital. Compared to those who did not receive the drugs, patients prescribed antidepressants were predominantly female, older, and more likely to have hypertension, diabetes, dyslipidaemia, obesity and comorbidities. They were less likely to undergo percutaneous coronary intervention or receive P2Y12 blockers or statins, and stayed in hospital longer.
After adjusting for baseline characteristics the researchers found that the rates of stroke and subsequent heart attacks were similar between the two groups, but patients prescribed antidepressants had significantly worse survival. The rate of all-cause mortality at one-year after discharge was 7.4% in patients prescribed antidepressants compared to 3.4% for those not prescribed antidepressants (p<0.001).
Antidepressant prescription was an independent predictor for mortality, and increased the odds by 66% (odds ratio: 1.66; 95% confidence interval: 1.16 to 2.39).
"This was an observational study so we cannot conclude that antidepressants caused the higher death rate," noted Ms Fehr.
She concluded: "Our study showed that many patients are treated with antidepressants after a heart attack. More research is needed to pinpoint the causes and underlying pathological mechanisms for the higher mortality we observed in this patient group."
https://www.sciencedaily.com/releases/2018/03/180303095445.htm
Holding hands can sync brainwaves, ease pain
March 1, 2018
Science Daily/University of Colorado at Boulder
A new study by a pain researcher shows that when a romantic partner holds hands with a partner in pain, their brain waves sync and her pain subsides.
Reach for the hand of a loved one in pain and not only will your breathing and heart rate synchronize with theirs, your brain wave patterns will couple up too, according to a study published this week in the Proceedings of the National Academy of Sciences (PNAS).
The study, by researchers with the University of Colorado Boulder and University of Haifa, also found that the more empathy a comforting partner feels for a partner in pain, the more their brainwaves fall into sync. And the more those brain waves sync, the more the pain goes away.
"We have developed a lot of ways to communicate in the modern world and we have fewer physical interactions," said lead author Pavel Goldstein, a postdoctoral pain researcher in the Cognitive and Affective Neuroscience Lab at CU Boulder. "This paper illustrates the power and importance of human touch."
The study is the latest in a growing body of research exploring a phenomenon known as "interpersonal synchronization," in which people physiologically mirror the people they are with. It is the first to look at brain wave synchronization in the context of pain, and offers new insight into the role brain-to-brain coupling may play in touch-induced analgesia, or healing touch.
Goldstein came up with the experiment after, during the delivery of his daughter, he discovered that when he held his wife's hand, it eased her pain.
"I wanted to test it out in the lab: Can one really decrease pain with touch, and if so, how?"
He and his colleagues at University of Haifa recruited 22 heterosexual couples, age 23 to 32 who had been together for at least one year and put them through several two-minute scenarios as electroencephalography (EEG) caps measured their brainwave activity. The scenarios included sitting together not touching; sitting together holding hands; and sitting in separate rooms. Then they repeated the scenarios as the woman was subjected to mild heat pain on her arm.
Merely being in each other's presence, with or without touch, was associated with some brain wave synchronicity in the alpha mu band, a wavelength associated with focused attention. If they held hands while she was in pain, the coupling increased the most.
Researchers also found that when she was in pain and he couldn't touch her, the coupling of their brain waves diminished. This matched the findings from a previously published paper from the same experiment which found that heart rate and respiratory synchronization disappeared when the male study participant couldn't hold her hand to ease her pain.
"It appears that pain totally interrupts this interpersonal synchronization between couples and touch brings it back," says Goldstein.
Subsequent tests of the male partner's level of empathy revealed that the more empathetic he was to her pain the more their brain activity synced. The more synchronized their brains, the more her pain subsided.
How exactly could coupling of brain activity with an empathetic partner kill pain?
More studies are needed to find out, stressed Goldstein. But he and his co-authors offer a few possible explanations. Empathetic touch can make a person feel understood, which in turn -- according to previous studies -- could activate pain-killing reward mechanisms in the brain.
"Interpersonal touch may blur the borders between self and other," the researchers wrote.
The study did not explore whether the same effect would occur with same-sex couples, or what happens in other kinds of relationships. The takeaway for now, Pavel said: Don't underestimate the power of a hand-hold.
"You may express empathy for a partner's pain, but without touch it may not be fully communicated," he said.
https://www.sciencedaily.com/releases/2018/03/180301094822.htm
How to Help a Senior Through Chemotherapy
Going through chemotherapy is traumatic at any age, but seniors may face particular difficulties. They may have pre-existing medical conditions that already impact their independence. This is a time when support is essential, both practical and emotional. Here are a few things to consider to help a senior through this difficult time.
Prepare
Preparing for chemotherapy is not easy, and it can be upsetting. For a senior, there may be added complexities, but certain preparations should be considered regardless of age. If there is concern about hair loss, you could help the senior choose wigs to wear during treatment. Consider making the act of shaving hair an event that could be followed by a day out. Look to shop for comfortable clothes that are easy for a senior to put on, no matter how fatigued. In addition to fatigue, dry skin may become an issue, so advise them to use body lotion and lip balm to mitigate this. Make sure that the care team is aware of any non-cancer related medication to establish their safety. Additionally, consult with the team to develop a plan to maintain the senior's health through nutrition, mental stimulation, and physical activity.
Create a Support Network
No matter one's age, support is essential. Chemotherapy can be exhausting, stressful, and frightening, and it should not be faced alone. Support can alleviate some of the impact and give a senior an opportunity to rest. Basic acts of self-care can become daunting during chemo. This can itself become a source of anxiety. Delegating tasks to friends and loved ones, as well as to other caregivers, can be a way to reduce the strain. Organize rooms, prepare meals, clean, care for pets, and run errands. These tasks can become overwhelming if they accumulate. Emotional support will also be important. Being listened to and having someone to confide in can feel like a weight has been lifted. One way to maintain support is assembling a “phone team” to keep everyone up to date and aware when it's alright to contact and visit.
Promote Nutrition
Chemotherapy can adversely affect taste and smell, leading to reduced appetite. However, a diet of up to 8,000 calories may be necessary for a senior during treatment. A big breakfast could be a good approach to deal with appetite loss. Consider foods high in fiber and calories, such as fruits, yogurts, smoothies, and whole-grain cereals, as they can alleviate some of chemotherapy's physical side effects. Also, make food more appealing by adding flavor through safe spices. It may be a good idea to avoid meals that need to be heated to minimize smells that might inhibit appetite. Make sure that there is snacking between meals throughout the day. Fruits and vegetables are good choices, as are yogurt and peanut butter. Lastly, look to minimize chemo-related nausea through cold ginger tea and water.
Opioid Vigilance
Chemotherapy can cause painful side effects. This is common for all ages, but older patients may be more prone to it. Pain relief is something that may become necessary. If pain is experienced, don't hesitate to alert the senior's care team so they can assess if medication should be provided. Unfortunately, with concerns about an opioid epidemic, there is fear of addiction. However, when used responsibly and where there is no history of addiction, opioids can be taken safely. One precaution to take is mindfulness of behavioral changes. Have a conversation with the senior about symptoms, as awareness can prevent escalation. Symptoms can include taking an excessive dosage or using medication to manage stressful or upsetting situations. Any use of pain relief that seems irregular should be communicated to the care team. Remember, however, that everyone deserves relief from pain. Sometimes, upsetting symptoms do occur, especially after withdrawal, but that is normal and does not equate to addiction.
No one can be prepared for chemotherapy, nor for providing support to someone going through it. Thankfully, there is much that can be done to ease the strain. Whatever care is provided, you will, above all, be ensuring that they do not face cancer alone.
Author
Scott Sanders is the creator of CancerWell.org, which provides resources and support for anyone who has been affected by any form of cancer. He is also the author of the book Put Yourself First: A Guide to Self-care and Spiritual Wellness During and After Cancer Treatment, coming Summer 2018!
The late effects of stress: New insights into how the brain responds to trauma
December 28, 2016
Science Daily/National Centre for Biological Sciences
A new study has shown how a single instance of severe stress can lead to delayed trauma. A stressful incident can lead to increased electrical activity in a brain region known as the amygdala. This activity is delayed and is dependent on a molecule known as the N-Methyl-D-Aspartate Receptor (NMDA-R), a protein on nerve cells known to be crucial for memory functions.
Mrs. M would never forget that day. She was walking along a busy road next to the vegetable market when two goons zipped past on a bike. One man's hand shot out and grabbed the chain around her neck. The next instant, she had stumbled to her knees, and was dragged along in the wake of the bike. Thankfully, the chain snapped, and she got away with a mildly bruised neck. Though dazed by the incident, Mrs. M was fine until a week after the incident.
Then, the nightmares began.
She would struggle and yell and fight in her sleep every night with phantom chain snatchers. Every bout left her charged with anger and often left her depressed. The episodes continued for several months until they finally stopped. How could a single stressful event have such extended consequences?
A new study by Indian scientists has gained insights into how a single instance of severe stress can lead to delayed and long-term psychological trauma. The work pinpoints key molecular and physiological processes that could be driving changes in brain architecture.
The team, led by Sumantra Chattarji from the National Centre for Biological Sciences (NCBS) and the Institute for Stem Cell Biology and Regenerative Medicine (inStem), Bangalore, have shown that a single stressful incident can lead to increased electrical activity in a brain region known as the amygdala. This activity sets in late, occurring ten days after a single stressful episode, and is dependent on a molecule known as the N-Methyl-D-Aspartate Receptor (NMDA-R), an ion channel protein on nerve cells known to be crucial for memory functions.
The amygdala is a small, almond-shaped groups of nerve cells that is located deep within the temporal lobe of the brain. This region of the brain is known to play key roles in emotional reactions, memory and making decisions. Changes in the amygdala are linked to the development of Post-Traumatic Stress Disorder (PTSD), a mental condition that develops in a delayed fashion after a harrowing experience.
Previously, Chattarji's group had shown that a single instance of acute stress had no immediate effects on the amygdala of rats. But ten days later, these animals began to show increased anxiety, and delayed changes in the architecture of their brains, especially the amygdala. "We showed that our study system is applicable to PTSD. This delayed effect after a single episode of stress was reminiscent of what happens in PTSD patients," says Chattarji. "We know that the amygdala is hyperactive in PTSD patients. But no one knows as of now, what is going on in there," he adds.
Investigations revealed major changes in the microscopic structure of the nerve cells in the amygdala. Stress seems to have caused the formation of new nerve connections called synapses in this region of the brain. However, until now, the physiological effects of these new connections were unknown.
In their recent study, Chattarji's team has established that the new nerve connections in the amygdala lead to heightened electrical activity in this region of the brain.
"Most studies on stress are done on a chronic stress paradigm with repeated stress, or with a single stress episode where changes are looked at immediately afterwards -- like a day after the stress," says Farhana Yasmin, one of the Chattarji's students. "So, our work is unique in that we show a reaction to a single instance of stress, but at a delayed time point," she adds.
Furthermore, a well-known protein involved in memory and learning, called NMDA-R has been recognised as one of the agents that bring about these changes. Blocking the NMDA-R during the stressful period not only stopped the formation of new synapses, it also blocked the increase in electrical activity at these synapses. "So we have for the first time, a molecular mechanism that shows what is required for the culmination of events ten days after a single stress," says Chattarji. "In this study, we have blocked the NMDA Receptor during stress. But we would like to know if blocking the molecule after stress can also block the delayed effects of the stress. And if so, how long after the stress can we block the receptor to define a window for therapy," he adds.
Chattarji's group first began their investigations into how stress affects the amygdala and other regions of the brain around ten years ago. The work has required the team to employ an array of highly specialised and diverse procedures that range from observing behaviour to recording electrical signals from single brain cells and using an assortment of microscopy techniques. "To do this, we have needed to use a variety of techniques, for which we required collaborations with people who have expertise in such techniques," says Chattarji. "And the glue for such collaborations especially in terms of training is vital. We are very grateful to the Wadhwani Foundation that supports our collaborative efforts and to the DBT and DAE for funding this work," he adds.
https://www.sciencedaily.com/releases/2016/12/161228102418.htm
Recovery from brain injury, better sleep go hand in hand
December 22, 2016
Science Daily/American Academy of Neurology (AAN)
After a traumatic brain injury (TBI), people also experience major sleep problems, including changes in their sleep-wake cycle. A new study shows that recovering from these two conditions occurs in parallel.
"These results suggest that monitoring a person's sleep-wake cycle may be a useful tool for assessing their recovery after TBI," said study author Nadia Gosselin, PhD, of the University of Montréal in Québec, Canada. "We found that when someone sustained a brain injury and had not recovered a certain level of consciousness to keep them awake and aware of their surroundings, they were not able to generate a good sleep-wake cycle. But as they recovered, their quality of sleep improved."
A good sleep-wake cycle was defined as being alert and active during the day and getting uninterrupted sleep at night.
The study involved 30 people, ages 17 to 58, who had been hospitalized for moderate to severe TBI. Most of the patients were in a coma when they were admitted to the hospital and all initially received care in an intensive care unit. The injuries were caused by motor vehicle accidents for 20 people, falls for seven people, recreational or sports injuries for two people and a blow to the head for one person. They were hospitalized for an average of 45 days with monitoring for the study beginning an average of 21 days into a person's stay.
Each person was monitored daily for an average of 11 days for level of consciousness and thinking abilities using the Rancho Los Amigos scale, which ranges from 1 to 8. Each person also wore an activity monitor on their wrist so researchers could measure their sleep.
Researchers found that consciousness and thinking abilities improved hand-in-hand with measures of quality of sleep, showing a linear relationship.
One measure, the daytime activity ratio, shows percentage of activity that occurs during the day. Immediately after the injury, activity occurs throughout the day and night. The study showed that participants reached an acceptable sleep-wake cycle, with a daytime activity ratio of at least 80 percent, at the same point when they emerged from a minimally conscious state.
The participants still had inadequate sleep-wake cycles at a score of 5 on the Rancho Los Amigos scale, where people are confused and give inappropriate responses to stimuli but are able to follow simple commands. Sleep-wake cycles reached adequate levels at the same time that people reached a score of 6 on the Rancho Los Amigos scale, which is when people can give appropriate responses while still depending on outside input for direction. At that level, they can remember relearned tasks, but cannot remember new tasks.
The results were the same when researchers adjusted for the amount of time that had passed since the injury and the amount of medications they had received while they were in the ICU.
"It's possible that there are common underlying brain mechanisms involved in both recovery from TBI and improvement in sleep," said Gosselin. "Still, more study needs to be done and future research may want to examine how hospital lighting and noise also affect quality of sleep for those with TBI."
https://www.sciencedaily.com/releases/2016/12/161222095319.htm
Doctors' burnout should be treated as organization-wide problem
December 5, 2016
Manchester University
Current approaches to dealing with burnouts in doctors on an individual case-by-case basis is not effective and the issue should instead be tackled with organization-wide initiatives, according to researchers.
A meta-analysis study, which brought together the results of previously conducted research, was carried out to explore the effectiveness of interventions in reducing burnout in doctors. It explored the comparison between doctor-directed interventions that target the individual and organisation-directed interventions that target the working environment. The strength of the doctor's experience and the particular healthcare setting they worked in was also assessed.
The research concluded that while doctor-focused tactics such as mindfulness and cognitive behavioural are important, the greatest success at preventing and reducing burnout in doctors can be achieved through the adoption of organisation-directed approaches such as improved working environment and organisational culture.
Burnout is a major problem in the healthcare industry and is often driven by excessive workload, imbalance between job demands and skills, a lack of job control and prolonged stress. It is a syndrome consisting of emotional exhaustion, depersonalisation, and a diminished sense of personal accomplishment. Importantly, burnout can result in an increase in medical errors, reduced quality of patient care, and lower patient satisfaction.
It was found that organisations that combined several elements such as structural changes, fostering communications between members of the health care team, and cultivating a sense of teamwork and job control tended to be the most effective in reducing burnout. However, such intense organisation-directed interventions were rare and had not been evaluated sufficiently.
What's more, the evidence indicated that young doctors starting out in their career, are at higher risk of burnout compared to those with more experience, and interventions focused on enhancing teamwork, mentoring, and leadership skills might be particularly suitable for this group.
Dr Maria Panagioti, Research fellow in Primary Care at the University of Manchester who led this study said: 'Our findings clearly show that we need more effective intervention models to prevent burnout in doctors. Such models could be organization-directed interventions which promote healthy individual-organization relationships and view burnout a problem of the whole healthcare systems.'
George Lewith, Professor of Health Research at the University of Southampton who supervised the research, said: "This work suggests that if we want to retain safe and professionally competent NHS clinicians working in very demanding front line jobs we need to support their mental and physical health and creating appropriate and enabling working environments for them. Efforts need to be focused on finding appropriate ways of reaching doctors who work in stressful environments to ensure their wellbeing is taken care of. If we don't patient safety could be at risk."
https://www.sciencedaily.com/releases/2016/12/161205120500.htm
Heading a soccer ball causes instant changes to the brain
October 23, 2016
Science Daily/University of Stirling
Researchers have explored the true impact of heading a soccer ball, identifying small but significant changes in brain function immediately after routine heading practice.
The study from Scotland's University for Sporting Excellence published in EBioMedicine is the first to detect direct changes in the brain after players are exposed to everyday head impacts, as opposed to clinical brain injuries like concussion.
A group of soccer ball players headed a ball 20 times, fired from a machine designed to simulate the pace and power of a corner kick. Before and after the heading sessions, scientists tested players' brain function and memory.
Increased inhibition in the brain was detected after just a single session of heading. Memory test performance was also reduced by between 41 and 67 per cent, with effects normalising within 24 hours.
Whether the changes to the brain remain temporary after repeated exposure to a soccer ball and the long-term consequences of heading on brain health, are yet to be investigated.
Played by more than 250 million people worldwide, the 'beautiful game' often involves intentional and repeated bursts of heading a ball. In recent years the possible link between brain injury in sport and increased risk of dementia has focussed attention on whether soccer ball heading might lead to long term consequences for brain health.
Cognitive neuroscientist Dr Magdalena Ietswaart from Psychology at the University of Stirling, said: "In light of growing concern about the effects of contact sport on brain health, we wanted to see if our brain reacts instantly to heading a soccer ball. Using a drill most amateur and professional teams would be familiar with, we found there was infact increased inhibition in the brain immediately after heading and that performance on memory tests was reduced significantly.
"Although the changes were temporary, we believe they are significant to brain health, particularly if they happen over and over again as they do in soccer ball heading. With large numbers of people around the world participating in this sport, it is important that they are aware of what is happening inside the brain and the lasting effect this may have."
Dr Angus Hunter, Reader in Exercise Physiology in the Faculty of Health Sciences and Sport, added: "For the first time, sporting bodies and members of the public can see clear evidence of the risks associated with repetitive impact caused by heading a soccer ball.
"We hope these findings will open up new approaches for detecting, monitoring and preventing cumulative brain injuries in sport. We need to safeguard the long term health of soccer ball players at all levels, as well as individuals involved in other contact sports."
Dr Ietswaart and Dr Hunter were supported in the research by Stirling neuropsychologist Professor Lindsay Wilson and PhD student Tom Di Virgilio, consulting with leading Glasgow University Medical School Neuropathologist Dr Willie Stewart and a wider multi-disciplinary team.
In the study, scientists measured levels of brain function using a basic neuroscience technique called Transcranial Magnetic Stimulation (TMS). The findings from this study, funded by the NIHR Brain Injury Healthcare Technology Cooperative (HTC) are the first to show the TMS technique can be used to detect changes to brain function after small, routine impacts.
https://www.sciencedaily.com/releases/2016/10/161023154804.htm
What's really going on in PTSD brains? Experts suggest new theory
October 7, 2016
Science Daily/University of Michigan Health System
PTSD experts agree that the condition has its roots in very real, physical processes within the brain – and not some sort of psychological “weakness”. But no clear consensus has emerged about what exactly has gone “wrong” in the brain. A new theory that integrates decades of research focuses on a key function called context processing.
For decades, neuroscientists and physicians have tried to get to the bottom of the age-old mystery of post-traumatic stress disorder, to explain why only some people are vulnerable and why they experience so many symptoms and so much disability.
All experts in the field now agree that PTSD indeed has its roots in very real, physical processes within the brain -- and not in some sort of psychological "weakness." But no clear consensus has emerged about what exactly has gone "wrong" in the brain.
In a Perspective article published this week in Neuron, a pair of University of Michigan Medical School professors -- who have studied PTSD from many angles for many years -- put forth a theory of PTSD that draws from and integrates decades of prior research. They hope to stimulate interest in the theory and invite others in the field to test it.
The bottom line, they say, is that people with PTSD appear to suffer from disrupted context processing. That's a core brain function that allows people and animals to recognize that a particular stimulus may require different responses depending on the context in which it is encountered. It's what allows us to call upon the "right" emotional or physical response to the current encounter.
A simple example, they write, is recognizing that a mountain lion seen in the zoo does not require a fear or "flight" response, while the same lion unexpectedly encountered in the backyard probably does.
For someone with PTSD, a stimulus associated with the trauma they previously experienced -- such as a loud noise or a particular smell -- triggers a fear response even when the context is very safe. That's why they react even if the noise came from the front door being slammed, or the smell comes from dinner being accidentally burned on the stove.
Context processing involves a brain region called the hippocampus, and its connections to two other regions called the prefrontal cortex and the amygdala. Research has shown that activity in these brain areas is disrupted in PTSD patients. The U-M team thinks their theory can unify wide-ranging evidence by showing how a disruption in this circuit can interfere with context processing and can explain most of the symptoms and much of the biology of PTSD.
"We hope to put some order to all the information that's been gathered about PTSD from studies of human patients, and of animal models of the condition," says Israel Liberzon, M.D., a professor of psychiatry at U-M and a researcher at the VA Ann Arbor Healthcare System who also treats veterans with PTSD. "We hope to create a testable hypothesis, which isn't as common in mental health research as it should be. If this hypothesis proves true, maybe we can unravel some of the underlying pathophysiological processes, and offer better treatments."
Liberzon and his colleague, James Abelson, M.D., Ph.D., describe in their piece models of PTSD that have emerged in recent years, and lay out the evidence for each. The problem, they say, is that none of these models sufficiently explains the various symptoms seen in patients, nor all of the complex neurobiological changes seen in PTSD and in animal models of this disorder.
The first model, abnormal fear learning, is rooted in the amygdala -- the brain's 'fight or flight' center that focuses on response to threats or safe environments. This model emerged from work on fear conditioning, fear extinction and fear generalization.
The second, exaggerated threat detection, is rooted in the brain regions that figure out what signals from the environment are "salient," or important to take note of and react to. This model focuses on vigilance and disproportionate responses to perceived threats.
The third, involving executive function and regulation of emotions, is mainly rooted in the prefrontal cortex -- the brain's center for keeping emotions in check and planning or switching between tasks.
By focusing only on the evidence bolstering one of these theories, researchers may be "searching under the streetlight," says Liberzon. "But if we look at all of it in the light of context processing disruption, we can explain why different teams have seen different things. They're not mutually exclusive."
The main thing, says Liberzon, is that "context is not only information about your surroundings -- it's pulling out the correct emotion and memories for the context you are in."
A deficit in context processing would lead PTSD patients to feel "unmoored" from the world around them, unable to shape their responses to fit their current contexts. Instead, their brains would impose an "internalized context" -- one that always expects danger -- on every situation.
This type of deficit, arising in the brain from a combination of genetics and life experiences, may create vulnerability to PTSD in the first place, they say. After trauma, this would generate symptoms of hypervigilance, sleeplessness, intrusive thoughts and dreams, and inappropriate emotional and physical outbursts.
Liberzon and Abelson think that testing the context processing theory will enhance understanding of PTSD, even if all of its details are not verified. They hope the PTSD community will help them pursue the needed research, in PTSD patients and in animal models. They put forth specific ideas in the Neuron paper to encourage that, and are embarking on such research themselves.
The U-M/VA team is currently recruiting people with PTSD -- whether veterans or not -- for studies involving brain imaging and other tests.
In the meantime, they note that there is a growing set of therapeutic tools that can help patients with PTSD, such as cognitive behavioral therapy mindfulness training and pharmacological approaches. These may work by helping to anchor PTSD patients in their current environment, and may prove more effective as researchers learn how to specifically strengthen context processing capacities in the brain.
https://www.sciencedaily.com/releases/2016/10/161007123407.htm
Fish oil may help improve mood in veterans
September 22, 2016
Science Daily/Texas A&M University
Low concentration of fish oil in the blood and lack of physical activity may contribute to the high levels of depressed mood among soldiers returning from combat, according to researchers.
In a study titled "Fatty Acid Blood Levels, Vitamin D Status, Physical Performance, Activity and Resiliency: A Novel Potential Screening Tool for Depressed Mood in Active Duty Soldiers," researchers worked with 100 soldiers at Fort Hood to identify which factors affected moods in returning soldiers.
The research was conducted by Major Nicholas Barringer when he was a Texas A&M doctoral student under the direction of Health & Kinesiology Professor and Department Head Richard Kreider, in collaboration with several current and former members of the U.S. Army, and colleagues at Texas A&M.
"We looked at how physical activity levels and performance measures were related to mood state and resiliency," Kreider says. "What we found was the decrease in physical activity and the concentration of fish oil and Omega-3s in the blood were all associated with resiliency and mood."
Kreider says fish oil contains Omega-3 fatty acids that help to boost brain function. He says studies also show that fish oil acts as an anti-inflammatory within the body -- helping athletes and soldiers manage intense training better. Fish oil content is especially important for soldiers due to the consistent training and physical regiments performed in and out of combat and risk to traumatic brain injury.
The study originated from research conducted by Colonel Mike Lewis, M.D. who examined Omega-3 fatty acid levels of soldiers who committed suicide compared to non-suicide control and found lower Omega-3 levels in the blood were associated with increased risk of being in the suicide group.
Barringer says he believes these findings to be significant toward addressing some of the issues many soldiers face.
"The mental health of our service members is a serious concern and it is exciting to consider that appropriate diet and exercise might have a direct impact on improving resiliency," Barringer notes.
In order to properly measure soldiers physically, Kreider and Barringer developed a formula they say has the potential to assist in effectively screening soldiers with potential PTSD ahead of time. The formula measures a number of factors including: fitness and psychometric assessments, physical activity, and additional analysis.
"By improving resiliency in service members, we can potentially decrease the risk of mental health issues," Barringer says. "Early identification can potentially decrease the risk of negative outcomes for our active service members as well as our separated and retired military veterans."
"The military is using some of our exercise, nutrition, and performance-related work and the findings may help identify soldiers at risk for depression when they return from combat tours," Kreider notes. He says that by working to identify such high-risk issues faced by soldiers, it can set a precedent that will benefit not only military leadership, but also the general public.
"The public must realize that our soldiers need support before, during, and after their service," Kreider explains. "There needs to be a time for soldiers to transition, become re-engaged within a community, and stay engaged in that community."
https://www.sciencedaily.com/releases/2016/09/160922104406.htm
Employees of medical centers report high stress, negative health behaviors
September 8, 2016
Science Daily/Mayo Clinic
Approximately 15 to 20 percent of adults in the U.S. will report high levels of stress, several American surveys have found. A new study has identified stress and burnout as a major problem employees face within the medical industry, leading to negative health behaviors. With rising stress levels in the workplace for employees, many companies are looking to integrate, engage and enroll employees into wellness programs.
"It's important to teach individuals to monitor their stress levels over time and practice effective, ongoing stress-reduction strategies, such as getting involved in wellness programs, this will in-turn help health care employees live a happy and health life," says Matthew Clark, Ph.D., lead author of the study and resiliency expert at the Mayo Clinic Healthy Living Program.
The study, which is published in the Journal of Occupational and Environmental Medicine, measured stress and health behaviors (exercise, nutrition, sleep, etc.) by a series of five annual surveys administered to 676 participants who are employees at Mayo Clinic and have access to a wellness center. A significant relationship was found between the stress levels of an employee and four domains of quality of life: poor physical health, low mental health, poor nutritional habits and lower perceived overall health. Unfortunately, according to the study, employees who reported high stress levels and perceived poor quality of life also reported the lowest usage of wellness programs.
According to Dr. Clark, "Increasing the awareness of wellness centers and programs in academic medical environments will increase the quality of life of employees and lead to less physician and staff burnout."
Many companies are taking note of burnout and job strain in their staff and have created wellness centers, offer stress reduction programs, provide wellness coaching and healthy sleep programs for their employees in an effort to reduce stress, job strain and burnout. Muscular strength, cardiovascular fitness and flexibility exercises are also beneficial to overall quality of life, Dr. Clark writes.
He adds, "We are beginning to encourage employees to monitor their stress levels and to engage in daily resiliency practices, such as exercise, time with family and friends, meditation or gratitude journaling, to help reduce their stress levels and improve their quality of life."
Given the significance of stress in the workplace, the researchers note that exploring ways to effectively engage employees who have high levels of stress into wellness programs warrants further investigation.
https://www.sciencedaily.com/releases/2016/09/160908165052.htm
Using light to image and potentially to treat PTSD
September 6, 2016
Science Daily/University of Texas at Arlington
After years of studying the effects of near-infrared light on veterans with post-traumatic stress disorder or traumatic brain injuries, a team of bioengineers has published research that could result in an effective, long-term treatment for brain disorders.
Professor Hanli Liu was the primary investigator on the project. Her team of graduate students and a research associate, Fenghua Tian, worked with co-investigators Alexa Smith-Osborne, a UTA social work associate professor; Francisco Gonzalez-Lima, a psychology professor at UT Austin; and Fu Lye Martin Woon, a former assistant professor of psychiatry at UT Southwestern; to show potential intervention using light in brain disorders including post-traumatic stress disorder.
Their research is funded in part by a UT System BRAIN or Brain Research through Advancing Innovative Neurotechnologies seed grant titled, "Transcranial light therapy and imaging of prefrontal cognition in PTSD."
With the UT System's support, Liu's interdisciplinary collaborative team has not only investigated the brain imaging capability of light but also revealed the therapeutic rationale for potentially improving cognitive functions of patients with PTSD. The first paper resulting from the seed funding is published online and titled, "Interplay between up-regulation of cytochrome-c-oxidase and hemoglobin oxygenation induced by near-infrared laser."
As in the first study, the team used a human forearm as a biological model instead of the human brain to avoid confounding factors due to such anatomical structures as the scalp and skull. The paper outlines their discovery that shining near-infrared light on the subject's forearm increases production of cytochrome-c-oxydase, a protein inside the neurons that stimulates blood flow. This discovery shows great potential that NIR or infrared light also will work within the brain.
"This is the first time that effects of light stimulation have been quantified on living human tissue," Liu said. "The next challenge is to apply what was learned in a simpler system to the brain, where the light must pass through the scalp and the skull, as well as the brain. In the past several years, we have used the knowledge gained in the NIR field to detect, monitor and understand certain brain disorders, such as PTSD. But we have never utilized NIR light for treatment."
Now the team is moving to report and publish its findings of transcranial NIR stimulation on the human brain by quantifying production of cytochrome-c-oxydase and increase of blood flow. It would support a novel, non-invasive treatment with imaging ability, especially for memory, which could really help veterans who suffer from PTSD.
The UT BRAIN initiative was approved by the UT System Board of Regents in 2014 and supports a virtual UT System Neuroscience and Neurotechnology Research Institute that promotes trans-disciplinary, multi-institutional research projects focused on neuroscience and neurotechnology. It has provided a total of $5 million with a $100,000 per grant in a 2-year period of Sept.1, 2015 to Aug. 31, 2017.
Eight days prior to that paper, Liu and her team published another paper in Scientific Reports, titled, "Prefrontal responses to Stroop tasks in subjects with post-traumatic stress disorder assessed by functional near infrared spectroscopy." That paper outlined Liu's work to understand how the brains of people suffering from PTSD are different from a healthy group of non-PTSD sufferers using a Stroop test.
Stroop tests are attention tests that are commonly used in psychology.
Liu measured blood flow in the left side of the dorsal lateral prefrontal cortex of subjects' brains and found that those suffering from PTSD don't have the ability to pay attention and also have insufficient blood flow in that area of the brain. Michael Cho, chair of UTA's Bioengineering Department, says that Liu's continuing focus on using NIR light to detect, monitor and potentially treat brain injuries underscores the UTA's focus on health and the human condition contained within the Strategic Plan 2020: Bold Solutions | Global Impact.
"Dr. Liu and her collaborators have made incredible strides in identifying how the brain is affected by trauma, as well as how to treat disorders such as PTSD noninvasively with light," Cho said. "This is truly innovative, groundbreaking research, and the results are a testament to Hanli and the input of her collaborators."
Liu, a Fellow of the American Institute for Medical and Biological Engineering and a member of the UTA Academy of Distinguished Scholars, joined UTA's College of Engineering in 1996 and has secured more than $11 million as principal investigator or co-PI in research funding during her career. Her work is focused on medical instrumentation and imaging, minimally invasive and noninvasive spectroscopy and imaging of tissue, optical diffuse imaging for cancer prognosis, and brain activities.
She has studied PTSD extensively with Smith-Osborne and Tian, and they have applied a portable brain-mapping device that allows them to "see" where memory fails student veterans with PTSD. That research led the team to connect with Gonzalez-Limam and further discovered that shining low-level light on the brain by placing the light source on the forehead can stimulate and energize neurons to function more effectively. When cells are stimulated with light, they remain stimulated for a lengthy period of time even after the light is removed. The approach differs from other therapies that use magnets or electric shocks and has the potential to yield effective, longer-lasting treatments.
https://www.sciencedaily.com/releases/2016/09/160906213622.htm
Concussions and brain injury: Can omega-3 intake aid in brain health recovery?
August 24, 2016
Science Daily/Taylor & Francis
The treatment of concussions and traumatic brain injury (TBI) is a clinical challenge. Clinical studies thus far have failed to identify an effective treatment strategy when a combination of targets controlling aspects of neuroprotection, neuroinflammation, and neuroregeneration is needed. According to emerging science and clinical experience, aggressive intake of omega-3 fatty acids (n-3FA) seems to be beneficial to TBI, concussion, and post-concussion syndrome patients.
Research suggests that early and optimal doses of omega-3 fatty acids (n-3FA) have the potential to improve outcomes from traumatic brain injury. The article reviews preclinical research and cites three brain injury case studies that resulted from a mining accident, a motor vehicle accident, and a drowning accident. Each instance showcased evidence of safety and tolerability, wherein the patients who sustained life-threatening brain injuries recovered brain health with the aid of omega-3 fatty acids (n-3FA).
Growing clinical experience by numerous providers is that the brain needs to be saturated with high doses of n-3FA in order for the brain to have the opportunity to heal. Without an optimal supply of omegas, healing is less likely to happen. It is well recognized that n-3FAs are not a drug and not a cure and every situation is different. Clinically, some patients respond better than others. However, there is no downside to providing optimal levels of nutrition in order to give a patient the best opportunity to regain as much function as possible following a TBI.
https://www.sciencedaily.com/releases/2016/08/160824140113.htm
Combat exposure may jeopardize the behavioral health of women in the military
August 2, 2016
Wiley
In a recent study, combat exposure among Army enlisted women was associated with an increased likelihood of developing behavioral health problems post-deployment, including post-traumatic stress disorder (PTSD), depression, and at-risk drinking.
In the study, which was funded by the National Institute on Drug Abuse, 42,397 Army enlisted women who returned from Afghanistan or Iraq were assigned combat exposure scores of 0, 1, 2, or 3+ based on their self-reported experiences. Importantly, any report of combat exposure among Army women was associated with an increased likelihood of each post-deployment behavioral health problem (PTSD, depression, and at-risk drinking), suggesting that the impact of even one exposure event should not be overlooked.
The magnitude of the association between combat exposure and PTSD was most striking. Active duty and National Guard/Reserve women with combat exposure scores of 3+ had at least a 20 times higher likelihood of screening positive for PTSD compared with women with no combat exposure.
"Our findings suggest that injuries, assaults, and combat exposures experienced by women during deployment may have an additive, negative effect on their post-deployment behavioral health," said Dr. Rachel Sayko Adams, lead author of the Journal of Traumatic Stress study. "Ongoing force-wide screening for behavioral health problems should be coupled with development and evaluation of programs to improve the psychological wellbeing of the Armed Forces."
https://www.sciencedaily.com/releases/2016/08/160802130109.htm
Diet shown to reduce stroke risk may also reduce risk of depression
February 25, 2018
Science Daily/American Academy of Neurology
People who eat vegetables, fruit and whole grains may have lower rates of depression over time, according to a preliminary study.
The study found that people whose diets adhered more closely to the Dietary Approaches to Stop Hypertension (DASH) diet were less likely to develop depression than people who did not closely follow the diet. In addition to fruit and vegetables, the DASH diet recommends fat-free or low-fat dairy products and limits foods that are high in saturated fats and sugar. Studies have shown health benefits such as lowering high blood pressure and bad cholesterol (LDL), along with lowering body weight.
"Depression is common in older adults and more frequent in people with memory problems, vascular risk factors such as high blood pressure or high cholesterol, or people who have had a stroke," said study author Laurel Cherian, MD, of Rush University Medical Center in Chicago and a member of the American Academy of Neurology. "Making a lifestyle change such as changing your diet is often preferred over taking medications, so we wanted to see if diet could be an effective way to reduce the risk of depression."
For the study, 964 participants with an average age of 81 were evaluated yearly for an average of six-and-a-half years. They were monitored for symptoms of depression such as being bothered by things that usually didn't affect them and feeling hopeless about the future. They also filled out questionnaires about how often they ate various foods, and the researchers looked at how closely the participants' diets followed diets such as the DASH diet, Mediterranean diet and the traditional Western diet.
Participants were divided into three groups based on how closely they adhered to the diets. People in the two groups that followed the DASH diet most closely were less likely to develop depression than people in the group that did not follow the diet closely. The odds of becoming depressed over time was 11 percent lower among the top group of DASH adherers versus the lowest group. On the other hand, the more closely people followed a Western diet -- a diet that is high in saturated fats and red meats and low in fruits and vegetables -- the more likely they were to develop depression.
Cherian noted that the study does not prove that the DASH diet leads to a reduced risk of depression; it only shows an association.
"Future studies are now needed to confirm these results and to determine the best nutritional components of the DASH diet to prevent depression later in life and to best help people keep their brains healthy," said Cherian.
https://www.sciencedaily.com/releases/2018/02/180225191804.htm
Getting sleepy? Fruit flies constantly tune into environmental temperature to time sleep
February 21, 2018
Science Daily/University of Michigan
Humans and fruit flies may have not shared a common ancestor for hundreds of millions of years, but the neurons that govern our circadian clocks are strikingly similar.
Now, University of Michigan researchers have made a discovery in fruit flies that may teach us a little more about our own sleep cycles. Using the fruit flies, they showed how circadian clock neurons use thermoreceptors to constantly monitor the temperature of their environment. They found even mild changes in temperature have physiological effects on clock neurons that control sleep timing.
This discovery will help researchers understand how neurons are using environmental temperature in addition to light to regulate sleep timing in mammals, including humans. Their study will be published Feb. 21 in Nature.
"Decades of work from recent Nobel Prize winners and many other labs have have actually worked out the details of how light is able to adjust the clock, but the details of how temperature was able to adjust the circadian clock were not well understood," said Swathi Yadlapalli, first author of the study and a postdoctoral researcher in the U-M Department of Molecular, Cellular and Developmental Biology.
"Going forward, we can ask questions of how these two stimuli are processed and integrated into the clock system, and how this has effects on our sleep behavior and other physiological processes."
Circadian clocks are biochemical mechanisms that allow living things to organize their sleep and waking across the 24-hour cycle of a day. Researchers know that circadian clocks in mammals control the internal body temperature to drive sleep patterns, says Orie Shafer, principal investigator of the study. For example, we think of the human body temperature as a steady 98.6 degrees, Shafer said, but actually, our body temperature changes throughout the day.
"In fact, it's fluctuating," Shafer said. "The circadian system produces a daily rhythm in temperature which is an important cue for when it's time to go to sleep."
As we're coasting toward bedtime, these circadian clocks cool our internal body temperature. As we're gliding toward wakefulness, these clocks turn up the heat. This is regardless of the temperature of the room we're sleeping in. But showing that circadian clock neurons in fruit flies use external temperature to trigger sleep suggests that some clock neurons in humans could be similarly sensitive.
To study how the fruit fly neurons responded to external temperature, Yadlapalli worked with Chang Jiang, a postdoctoral researcher in the labs of Pramod Reddy and Edgar Meyhofer of the U-M Department of Mechanical Engineering. Together, they developed an optical imaging and temperature control system that enabled them to take a snapshot of neural activity in the circadian clock network of fruit flies when the flies are exposed to heat or cold stimulus.
"It looks like clock neurons are able to get the temperature information from external thermoreceptors, and that information is being used to time sleep in the fly in a way that's fundamentally the same as it is in humans," Shafer said. "As temperature drops, these neurons that promote sleep become excited, and that really entrains the sleep activity cycle to external temperature cycles. It's precisely what happens to sleep in mammals when internal temperature drops."
https://www.sciencedaily.com/releases/2018/02/180221131853.htm
Depression linked to reduced arginine levels
February 21, 2018
Science Daily/University of Eastern Finland
People suffering from major depressive disorder, MDD, have reduced arginine levels, a new study from the University of Eastern Finland shows. Arginine is an amino acid which the body uses to produce, e.g., nitric oxide. Nitric oxide, in turn, is a nervous system and immune defence mediator, and it also plays a role in vascular regulation. The global arginine bioavailability ratio, GABR, is an indicator of the body's arginine levels, and the ratio has previously been used to measure the body's capacity to produce nitric oxide. Reduced arginine bioavailability is also known to be an independent risk factor of cardiovascular diseases.
Published in Journal of Affective Disorders, the study shows that people suffering from MDD have reduced arginine bioavailability.
"It is possible that depression-induced inflammatory responses lead to reduced arginine levels. This may result in insufficient production of nitric oxide for the needs of the nervous system and circulation. However, we don't know yet what exactly causes reduced arginine bioavailability in people with depression," says Doctoral Student Toni Ali-Sisto, the lead author of the study.
The study carried out by the University of Eastern Finland and Kuopio University Hospital involved 99 adults with diagnosed major depressive disorder and 253 non-depressed controls. The concentrations of three amino acids, namely arginine, citrulline and ornithine, were analysed from their fasting glucose samples, and this data was used to calculate their GABRs. Symmetric and asymmetric dimethylarginine concentrations were also measured, as they both play a role in the production of nitric oxide. The findings were then compared between the depressed and the non-depressed controls. The study also analysed whether these concentrations changed in people with depression during a follow-up of eight months, and whether remission of depression had an effect on the concentrations.
"Although our study shows that people with depression have reduced arginine bioavailability, this doesn't mean that taking an arginine supplement would protect against depression. That's an area for further research," Ali-Sisto says.
People with depression had weaker arginine bioavailability than their non-depressed controls. The study did not find significant differences in the symmetric and asymmetric dimethylarginine concentrations. The use of anti-depressants or anti-psychotics did not affect the concentrations, either.
Contrary to the researchers' expectations, there were no clear differences in the concentrations measured from people who had recovered from depression and people who remained depressed.
"Arginine bioavailability was slightly higher in people who had recovered from depression than in people who remained depressed. However, a more extensive set of data and a longer follow-up period are necessary for estimating arginine's role in depression recovery."
https://www.sciencedaily.com/releases/2018/02/180221122850.htm