Abnormal gut bugs tied to worse cognitive performance in vets with PTSD and cirrhosis

Study involved more than 90 combat veterans

September 12, 2019

Science Daily/Veterans Affairs Research Communications

A study involving military veterans with PTSD and cirrhosis of the liver points to an abnormal mix of bacteria in the intestines as a possible driver of poor cognitive performance -- and as a potential target for therapy.

The study appeared Aug. 28, 2019, in the American Journal of Physiology.

Lead author Dr. Jasmohan Bajaj says the findings add to the substantial evidence linking gut health and brain function. He says they offer particular hope for people with PTSD and cirrhosis -- a common combination in the VA patient population.

"There is room for improvement in terms of the response to current therapies for PTSD," he says. "Targeting the gut microbiota might be an effective way to address the altered gut-brain axis in these patients and improve cognitive function, as well as other parameters of mental and physical health."

Bajaj is a physician-researcher with the McGuire Veterans Affairs Medical Center and Virginia Commonwealth University in Richmond.

Cirrhosis, or scarring of the liver, is prevalent in veterans with PTSD. Common causes include alcohol use disorder, obesity, and hepatitis C. Some patients with cirrhosis develop a complication called hepatic encephalopathy, which affects brain function. They become mentally sluggish and confused, and in severe cases can even lose consciousness.

PTSD, for its part, can also impair cognition. This can occur whether or not patients are taking drugs, such as antidepressants or sedatives, that act on the brain.

The researchers wanted to tease out the impact of abnormal gut microbiota in these conditions, and see whether those with cirrhosis and PTSD had different gut profiles than those with cirrhosis but no PTSD.

Bajaj's team took stool samples from 93 male veterans with cirrhosis, about a third of whom had combat-related PTSD. The other men had been exposed to combat during their military service but had not developed PTSD.

All the veterans completed a battery of cognitive exams. The tests covered areas such as reaction time, spatial ability, memory, and problem-solving.

Compared with the non-PTSD group, the men with PTSD had poorer cognitive performance.

Those with PTSD had microbiota that were less diverse, meaning they had fewer types of bacteria overall. This was true even after the researchers controlled for severity of cirrhosis, prior episodes of hepatic encephalopathy, alcohol use, and psychotropic medication use.

These veterans, along with the relative lack of diversity in their gut, tended to have more potentially harmful types of bacteria, such as Enterococcus and Escherichia/Shigella, and fewer beneficial ones, such as Lachnospiraceae and Ruminococcaceae.

In the study, higher levels of Enterococcus were associated with worse cognitive performance. The Ruminococcaceae family of bacteria, among others, was associated with better performance.

Ruminococcaceae bacteria are prevalent in healthy guts. These beneficial bugs help break down complex carbohydrates, such as those in unprocessed whole grains and legumes. People with healthier diets of this type tend to have higher counts of these organisms.

The same bacteria have been found to be scarcer in people with depression. There has been little study of their role in PTSD.

Could it be that the psychiatric drugs often used to treat PTSD affected these patients' microbiota? The study found that veterans with PTSD had similar gut profiles regardless of what medications they were on for the condition. This suggests the altered gut microbiome is a result of PTSD itself, and not any drug treatment.

One question the study couldn't answer was whether the combat trauma that triggered PTSD also triggered the bacterial changes, or whether those changes resulted over time from the chronic stress of PTSD.

Bajaj says it's hard to tease out that answer without prospectively following service members and veterans over many years, starting from before their deployments, and periodically sampling their gut bacteria. Such a study would be difficult to conduct.

In any case, he believes it's possible that restoring the gut microbiota to a healthy, normal balance could help ease PTSD symptoms -- especially when cirrhosis is also in play. But that idea has to be validated in studies.

"We need more research, including basic lab studies and clinical trials, to understand whether therapies that can change the gut microbiota can help these patients, and which particular types of bacteria are most beneficial," says Bajaj. He cited probiotic supplements or fecal transplants as two possible therapy approaches.

Recently, VA's Office of Research and Development launched an initiative to increase the number of such studies. Bajaj was among a group of more than 20 clinicians and biomedical scientists who helped develop a "roadmap" outlining VA's plans to fund work in this area over the next few years.

https://www.sciencedaily.com/releases/2019/09/190912165122.htm

Repetitive impacts key to understanding sports-associated concussions

September 9, 2019

Science Daily/Trinity College Dublin

Scientists at Trinity College Dublin have announced a significant advance in our understanding of mild head trauma (concussive brain injury) and how it may be managed and treated in the future. It seems that repetitive impacts -- as opposed to single events -- cause the all-important damage to blood vessels in the brain.

Mild head trauma has come to the fore in recent years as being associated with collision and combat sports. However, it is also a very common injury in children and young adults and represents a significant challenge to physicians due to the lack of any robust biomarkers or objective imaging approaches to manage the injury.

"This was a hypothesis-driven project whereby we challenged the hypothesis that repetitive head trauma would induce damage to small blood vessels in the brain that we would then be able to image with a novel form of MRI-based brain scans," said Dr Matthew Campbell, Assistant Professor at Trinity.

The study, which was undertaken by the Trinity-led Concussion Research Interest Group (CRIG) used both sensor-enabled mouthguard technology developed by the group of Professor David Camarillo at Stanford University and dynamic contrast-enhanced MRI to confirm the number and severity of head impacts that would lead to the appearance of "leaky" blood vessels within the brain.

Participants of combat and collision sports such as mixed martial arts (MMA) and rugby took part in the clinical research study, which took four years to complete and is part of a wider longitudinal study, which is still ongoing.

Concussive brain injuries

While it is clear that concussive brain injuries cause clinical symptoms such as dizziness, nausea and confusion, these symptoms all occur independent of any adverse findings on CT or MRI scans, and/or without the presence of any clear blood-based biomarkers. Therefore, the clinical management of concussive brain injuries is challenging and needs new technologies to assist in diagnosis and rehabilitation.

Dr Colin Doherty, Consultant Neurologist at St James's Hospital and clinical lead on the study, added: "Our findings, for the first time, suggest that repetitive head trauma can lead to an MRI signal that we can definitively link to the number and severity of impacts to the head. It appears that the repetitive nature of these impacts as opposed to single events are causing damage to the capillaries of the brain."

The study reports that repetitive impacts to the head, not necessarily just concussions, are likely able to induce changes to the micro-vessels of the brain. It is these changes that are then readily visible when using a novel form of MRI-based imaging.

While the study was based on a selected group of MMA fighters and rugby players, the findings could eventually pave the way for more robust and objective return-to-play guidelines and improved player safety in the longer term.

"This study has highlighted the critical importance of continued efforts to study the underlying effects of concussive brain injuries in all sports. It is imperative that the governing bodies take note of these findings and work together to protect athletes now and in the future," added co-author Professor Mick Molloy, former Chief Medical Officer of World Rugby.

https://www.sciencedaily.com/releases/2019/09/190909130227.htm

Player athleticism increases head impact exposure in youth football

September 6, 2019

Science Daily/Wake Forest Baptist Medical Center

Speed, agility and strength are definitely assets on the football field. But when it comes to hits to the head, those talents may actually increase exposure for the young athletes who account for about 70% of this country's football players.

A study of youth league football players by researchers at Wake Forest School of Medicine, part of Wake Forest Baptist Health, found that higher vertical jumping ability and faster times in speed and agility drills were generally associated with higher head impact exposure, especially in games as compared to practices.

"Previous studies have shown the severity and number of head impacts increases with the level of play in football, but we have found that there is significant variability in head impact exposure among individuals playing at the same level," said Jillian E. Urban, Ph.D., assistant professor of biomedical engineering at Wake Forest School of Medicine and the study's senior author. "Differences in position account for some of that variation at the high school and college levels, but less so in youth football. Our objective was to see if there is a relationship in youth football between head impact exposure and physical ability as measured by commonly used drills, and our results suggest there is."

The study, published in the current issue of the journal Medicine & Science in Sports & Exercise, quantified head impact exposure in terms of the number of hits experienced by players, the severity of each hit in terms of peak linear and rotational head acceleration and a measure that combines the number and severity of hits recorded in a season, known as risk-weighted cumulative exposure.

The researchers analyzed performance on four physical ability tests (vertical jump, 40-yard dash and two agility drills) and on-field head impact data from all practices and games in one season for 51 players age 9 to 13. These players were members of four teams in leagues in the same region operating under the same national youth football organization. A total of 13,770 head impacts were measured with the Head Impact Telemetry (HIT) System, which includes sensors embedded in football helmets and a sideline data-collection unit plus a video-confirmation component.

The study found that all four physical performance measures were significantly correlated with the total number of head impacts measured during practices and games over the course of a season and with the risk-weighted cumulative exposure measured during games. The strongest relationships were between 40-yard dash speed and the risk-weighted cumulative exposure measured during games.

The relationships between physical performance measures and head impact exposure during practices were not as strong as those with head impact exposure during games.

"Players with higher measures of physical performance may experience greater head impact exposure because they are on the field for more plays, engage in more contact while playing, arrive at points of contact at higher speeds and may prioritize using their athletic ability over technical skill when engaging in contact," Urban said. "Physical performance measures may aid in identifying young athletes at greater risk of head impact exposure but additional research is needed to better understand if this could be part of intervention strategies for reducing the risk of head injuries in youth football."

Urban said further research in this area should include a larger number of players from a variety of different organizations, regions, and demographic backgrounds; additional assessments of physical abilities, such as upper-body strength; and consideration of other factors, including playing time in games, player aggression and attitudes and behaviors related to tackling.

https://www.sciencedaily.com/releases/2019/09/190906172422.htm

PTSD linked to increased risk of ovarian cancer

September 5, 2019

Science Daily/Harvard T.H. Chan School of Public Health

Women who experienced six or more symptoms of post-traumatic stress disorder (PTSD) at some point in life had a twofold greater risk of developing ovarian cancer compared with women who never had any PTSD symptoms, according to a new study from researchers at Harvard T.H. Chan School of Public Health and Moffitt Cancer Center.

The findings indicate that having higher levels of PTSD symptoms, such as being easily startled by ordinary noises or avoiding reminders of the traumatic experience, can be associated with increased risks of ovarian cancer even decades after women experience a traumatic event. The study also found that the link between PTSD and ovarian cancer remained for the most aggressive forms of ovarian cancer.

The findings were published in Cancer Research, on September 5, 2019.

"In light of these findings, we need to understand whether successful treatment of PTSD would reduce this risk, and whether other types of stress are also risk factors for ovarian cancer," said co-author Andrea Roberts, research scientist at Harvard T.H. Chan School of Public Health.

Ovarian cancer is the deadliest gynecologic cancer and the fifth most common cause of cancer-related death among U.S. women. Studies in animal models have shown that stress and stress hormones can accelerate ovarian tumor growth, and that chronic stress can result in larger and more invasive tumors. A prior study found an association between PTSD and ovarian cancer in humans, but the study included only seven women with ovarian cancer and PTSD.

"Ovarian cancer has been called a 'silent killer' because it is difficult to detect in its early stages; therefore identifying more specifically who may be at increased risk for developing the disease is important for prevention or earlier treatment," said co-author Laura Kubzansky, Lee Kum Kee Professor of Social and Behavioral Sciences at Harvard Chan School.

To better understand how PTSD may influence ovarian cancer risk, researchers analyzed data from the Nurses' Health Study II, which tracked the health of tens of thousands of women between 1989 and 2015 through biennial questionnaires and medical records. Participants were asked about ovarian cancer diagnosis on each questionnaire, and information was validated through a review of medical records.

In 2008, 54,763 Nurses' Health Study II participants responded to a supplemental questionnaire focused on lifetime traumatic events and symptoms associated with those events. Women were asked to identify the event they considered the most stressful, and the year of this event. They were also asked about seven PTSD symptoms they may have experienced related to the most stressful event.

Based on the responses, women were divided into six groups: no trauma exposure; trauma and no PTSD symptoms; trauma and 1-3 symptoms; trauma and 4-5 symptoms; trauma and 6-7 symptoms; and trauma, but PTSD symptoms unknown.

After adjusting for various factors associated with ovarian cancer, including oral contraceptive use and smoking, the researchers found that women who experienced 6-7 symptoms associated with PTSD were at a significantly higher risk for ovarian cancer than women who had never been exposed to trauma. Women with trauma and 4-5 symptoms were also at an elevated risk, but the risk did not reach statistical significance.

The study also showed that women who experienced 6-7 symptoms associated with PTSD were at a significantly higher risk of developing the high-grade serous histotype of ovarian cancer -- the most common and aggressive form of the disease.

"Ovarian cancer has relatively few known risk factors -- PTSD and other forms of distress, like depression, may represent a novel direction in ovarian cancer prevention research," said Shelley Tworoger, associate center director of population science at Moffitt. "If confirmed in other populations, this could be one factor that doctors could consider when determining if a woman is at high risk of ovarian cancer in the future."

Other Harvard Chan School researchers who contributed to the study included Karestan Koenen and Yongjoo Kim. Tianyi Huang of Brigham and Women's Hospital and Harvard Medical School was also a co-author.

https://www.sciencedaily.com/releases/2019/09/190905094044.htm

Soldiers, athletes could improve outcomes from traumatic brain injuries

September 4, 2019

Science Daily/Purdue University

A traumatic brain injury is often easily suspected and can be confirmed and treated if necessary following an injury using a blood analysis, but scientists are reporting that even one mild blast to the brain can cause very subtle but permanent damage as well. Urine analysis taken within one week of a mild to traumatic brain injury also can provide faster diagnosis and treatment for such injuries. 

"We're finding that even a mild blast can cause long-term, life-changing health issues," said Riyi Shi, a professor of neuroscience and biomedical engineering in Purdue University's Department of Basic Medical Sciences. "The individual appears to be fine, and it's difficult to tell if you just look at a person. But the fact is that these types of hits are multiplied over years and often ignored until someone reaches an age when other factors come into play. Identifying and treating these incidents sooner can help mitigate issues later in life."

 A study led by Shi reports that checking the urine within seven days following such an injury, even a mild injury with no immediately obvious symptoms, could be less invasive, faster and help reduce the risk of long-term health issues including Parkinson's disease.

 "Even at one day post injury, a simple urine analysis can reveal elevations in the neurotoxin acrolein. The presence of this "biomarker" alerts us to the injury, creating an opportunity for intervention," said Shi, who has appointments in Purdue's College of Veterinary Medicine and Weldon School of Biomedical Engineering. "This early detection and subsequent treatment window could offer tremendous benefits for long-term patient neurological health."

 The research paper, titled "Acrolein-mediated Alpha-synuclein Pathology Involvement in the Early Post-injury Pathogenesis of Mild Blast-induced Parkinsonian Neurodegeneration," was published in July in the Journal of Molecular and Cellular Neuroscience.

 "Most people have heard that traumatic brain injuries are linked to Parkinson's, Alzheimer's and other neurodegenerative diseases, dating back as far as to Muhammad Ali and even earlier," Shi said. "The seriousness of this relationship is readily apparent; however, we want to, for the first time, implement a mechanism or protocol capable of connecting brain injuries to these diseases. We can accomplish this by testing for acrolein, which is well-researched and already recognized as a very important pathological factor in Parkinson's disease. This study establishes a solid link between the two and opens the door for faster treatments utilizing acrolein urine tests during the days following a traumatic episode."

 In the research study, a urine analysis tested for an increased elevation of acrolein or oxidative stress within one week following a neurological injury.

 "What's important is that urine tests can be performed much easier than blood tests or other more invasive medical procedures currently available," Shi said. "And it has been shown that individuals who experience brain injuries are three times more likely than their age-matched peers to develop neurological disease. If we can establish a protocol to routinely test urine following a traumatic brain injury, we can improve treatment options earlier and potentially offer better long-term outcomes."

 More than 500,000 people in the U.S. are currently living with Parkinson's disease, and another 50,000 people are diagnosed with this neurodegenerative disorder every year, according to the National Institutes of Health.

https://www.sciencedaily.com/releases/2019/09/190904154005.htm

Number of years in NFL, certain positions portend greater risk for cognitive, mental health problems

August 30, 2019

Science Daily/Harvard Medical School

Study shows link between longer NFL career and higher risk of cognitive, mental health problems. Risk persisted over time, even 20 years following injury. Certain positions also carried elevated risk for cognitive problems, depression and anxiety. Running backs, linebackers, defensive linemen had the greatest risk for cognitive problems.

Longer NFL careers and certain playing positions appear to each spell greater long-term risk for serious cognitive problems such as confusion, memory deficits, depression and anxiety in former football players, according to a new report published Aug. 30 in The American Journal of Sports Medicine.

The study is believed to be the first to explore the interplay between career length, position and cognitive and mental health outcomes among professional football players.

The analysis -- based on a survey of nearly 3,500 former NFL players -- was conducted by investigators at the Harvard T.H. Chan School of Public Health and Harvard Medical School as part of the ongoing Football Players Health Study at Harvard University.

The study results show that players who experienced concussions had elevated risk for serious cognitive problems, depression and anxiety, which persisted over time, as long as 20 years following injury. The investigators caution that their analysis relied on players' memories of experiencing concussion rather than on diagnosis at the time of injury. And the findings do not mean that everyone with concussion will necessarily experience cognitive or mental health problems, they add. Contrary to previous reports, the new research did not find a link between starting football at a young age and cognitive problems in adulthood.

On one level, the researchers say, many of their findings make intuitive sense and confirm what some might have already suspected: The longer players remain in the game, the more likely they are to suffer a head injury, which increases the risk for neurocognitive problems. It also affirms that certain positions are more prone to concussions and, therefore, players in them face greater risk for experiencing the downstream of effects of head injury.

Nonetheless, the researchers said, the analysis is the first to document and quantify the risk that stems from lengthier careers and certain high-impact positions.

Specifically, the analysis showed that players who reported the most concussion symptoms had 22-fold risk of reporting serious long-term cognitive problems and six times the risk of having symptoms of depression and anxiety, compared with those who reported the fewest symptoms.

"Our findings confirm what some have suspected -- a consistently and persistently elevated risk for men who play longer and who play in certain positions," said study lead investigator Andrea Roberts, a research scientist at the Harvard T.H. Chan School of Public Health. "Our results underscore the importance of preventing concussions, vigilant monitoring of those who suffer them and finding new ways to mitigate the damage from head injury."

For the study, former players, average age 53, were asked about the number of seasons played in the NFL, their positions and any history of blows to the head or neck followed by symptoms of concussion such as dizziness, confusion, vision problems, loss of consciousness, nausea, headaches and seizures, among other symptoms. Based on the number and severity of symptoms, players were given a concussion score.

Overall, one in eight players (12 percent) reported signs of serious cognitive problems. By comparison, about 2 percent of people in the general population in the United States report such problems. Age made no difference in the interplay between concussion and cognitive problems, the study showed. Those under age 52 reported serious cognitive problems at a similar rate as the rest (13 percent), a finding that suggests neurocognitive decline was likely not a function of mere aging. Alarmingly, that risk remained magnified even in those 45 and younger. Indeed, 30 percent of players 45 and younger who had the most concussions reported serious cognitive problems.

To gauge whether the number of seasons played and position type were linked to depression, anxiety and cognitive problems, the researchers used standard questionnaires commonly used to screen for the presence of such disorders. The researchers compared the proportion of players with serious cognitive problems among individuals with various career lengths -- one season, two to four seasons, five to six seasons, seven to nine seasons and 10 seasons or more. Overall, those with the longest careers -- 10 seasons or more -- were twice as likely to report severe cognitive problems compared with players who'd played a single season -- 12.6 percent in the 10-plus season group reported signs of severe cognitive problems, compared with 5.8 percent in the single-season category. The risk crept up proportionally with the number of seasons played, growing progressively higher as the number of years increased. Every five seasons of play carried a nearly 20 percent increase in risk for serious cognitive problems.

Which position one played also mattered. To evaluate the risk-position link, the researchers divided players into three groups based on the average concussion symptoms per year that players reported in each position. Kickers, punters and quarterbacks had the fewest symptoms per year, followed by wide receivers, defensive backs, linemen and tight ends. The groups with the highest number of symptoms included running backs, linebackers and special teams.

Those in the group with the most concussion symptoms had twice the risk for serious cognitive problems -- 15 percent of those in this group had cognitive difficulties -- compared with those reporting the fewest concussion symptoms (6 percent). Those with the most concussions also had a nearly 50 percent greater risk for depression and anxiety, compared with those playing in the group with the fewest concussion symptoms. One in four in the first group had symptoms indicative of depression, compared with 15 percent of players reporting problems in the latter one, while 27 percent had signs of anxiety, compared with 16 percent in the group with the fewest concussions. Those who played in the mid-range group had a 75 percent higher risk of cognitive problems and a 40 percent elevation in risk for depression and anxiety, compared with players in the group with the fewest symptoms.

Nearly one in four players reported symptoms of anxiety (26 percent) and depression (24 percent), and nearly one in five (18 percent) reported symptoms of both conditions. Career length influenced risk for depression, with every five seasons boosting the risk by 9 percent. The number of seasons, however, was not linked to greater anxiety risk.

The age at which an individual started playing organized football did not affect risk. Indeed, outcomes were similar between those who began playing the game before age 12 and those who began later. The findings, however, pertain solely to former NFL players and not necessarily to the general population, the researchers caution. The question of when a child should start playing organized football remains very much open, and should be made by each individual family, the researchers said.

"The overarching goal of the Football Players Health Study is to unravel risk factors and disease mechanisms and to inform interventions that preserve and optimize player health and wellness," said study senior author Marc Weisskopf, the Cecil K. and Philip Drinker Professor of Environmental Epidemiology and Physiology at the Harvard T.H. Chan School of Public Health. "These latest findings confirm much of what we know but they add much needed granularity and specificity to risk magnitude by career length and position."

"Clearly, not everyone who sustains a concussion is destined for cognitive trouble, but the results of the research highlight just how critical it is to continue to find ways to prevent head injuries from occurring in the first place because of the many downstream and long-lasting effects on physical, cognitive and mental health," said Ross Zafonte, the Earle P. and Ida S. Charlton Professor of Physical Medicine and Rehabilitation and head of the Department of Physical Medicine and Rehabilitation at Harvard Medical School. Zafonte is also principal investigator of the Football Players Health Study.

The research was supported by National Football League Players Association (NFLPA).

https://www.sciencedaily.com/releases/2019/08/190830082619.htm

New medication may be able to improve effects of psychological treatment for PTSD

August 29, 2019

Science Daily/Linköping University

A medication that boosts the body's own cannabis-like substances, endocannabinoids, shows promise to help the brain un-learn fear memories when these are no longer meaningful. These results, obtained in an early-stage, experimental study on healthy volunteers at Linköping University in Sweden, give hope that a new treatment can be developed for post-traumatic stress disorder, PTSD. The study has been published in the scientific journal Biological Psychiatry.

"We have used a medication that blocks the way the body breaks down its own cannabis-like substances, or 'endocannabinoids'. Our study shows that this class of medications, called FAAH inhibitors, may offer a new way to treat PTSD and perhaps also other stress-related psychiatric conditions. The next important step will be to see if this type of medication works in patients, particularly those with PTSD," says Leah Mayo, senior post-doctoral fellow and lead investigator on the study, which was carried out in the laboratory of Professor Markus Heilig at the Center for Social and Affective Neuroscience, CSAN, Linköping University.

Post-traumatic stress disorder, PTSD, arises in some -- but not all -- people who have experienced life-threatening events. A person affected by PTSD avoids reminders of the trauma, even when the danger is long gone. Over time, these patients become tense, withdrawn, and experience sleep difficulties. This condition is particularly common among women, where it is often the result of physical or sexual abuse. It is highly debilitating, and current treatment options are limited.

PTSD is currently best treated using prolonged exposure therapy, PE. In this treatment, patients are repeatedly exposed to their traumatic memory with the help of a therapist. This ultimately allows patients to acquire new learning: that these memories no longer signal imminent danger. Although clinically useful, effects of PE are limited. Many patients do not benefit, and among those who do, fears frequently return over time. The scientists who carried out the current study examined whether fear extinction learning, the principle behind PE therapy, can be boosted by a medication.

The researchers tested a pharmaceutical that affects the endocannabinoid system, which uses the body's own cannabis-like substances to regulate fear and stress-related behaviors. The experimental medication results in increased levels of anandamide, a key endocannabinoid, in regions of the brain that control fear and anxiety. The medication accomplishes this by blocking an enzyme, FAAH (fatty acid amide hydrolase), that normally breaks down anandamide. The FAAH inhibitor tested by the researchers was originally developed for use as a pain killer, but was not effective enough when tested clinically.

This early-stage experimental study was randomised, placebo-controlled and double-blind, which means that neither the participants nor the scientists knew who was receiving the active drug (16 people) and who was receiving placebo (29 people). Participants were healthy volunteers. After taking the drug for 10 days, they underwent several psychological and physiological tests. In one of these, participants learned to associate a highly unpleasant sound, that of fingernails scraping across a blackboard, with a specific visual cue -- an image of a red or blue lamp. Once they had learned to respond with fear to the previously innocuous image of the lamp, they were repeatedly re-exposed to it, but now in the absence of the unpleasant sound. This allowed them to unlearn the fear memory. The following day, the scientists measured how well participants remembered this new learning: that the lamp was no longer a threat signal. This process of un-learning fear is the same principle on which PE therapy for PTSD is based.

"We saw that participants who had received the FAAH inhibitor remembered the fear extinction memory much better. This is very exciting," say Leah Mayo.

"Numerous promising treatments coming out of basic research on psychiatric disorders have failed when tested in humans. This has created quite a disappointment in the field. This is the first mechanism in a long time where promising results from animal experiments seem to hold up when put to test in people. The next step, of course, is to see whether the treatment works in people with PTSD," adds professor Markus Heilig.

https://www.sciencedaily.com/releases/2019/08/190829115420.htm

Blood test detects concussion and subconcussive injuries in children and adults

Traumatic brain injury with no symptoms can cause wear and tear over time

August 26, 2019

Science Daily/Orlando Health

In one of the largest studies of its kind, researchers at Orlando Health are making new progress in finding ways to detect a traumatic yet sinister brain injury -- and getting closer to preventing further damage.

Subconcussive injuries often show no symptoms or immediate effects, but can cause wear and tear on the brain over time with repeated injuries. The latest study, published in the journal BMJ Paediatrics Open, includes more than 700 emergency room patients -- children and adults. The study gets us closer to developing a standard blood test to spot these injuries as early as possible.

"A unique feature of this study is that it includes patients who hit their heads but have no symptoms," said Linda Papa, MD, lead author of the study and emergency medicine doctor at Orlando Health. "This group is rarely -- if ever -- included in biomarker studies."

The blood test looks for two proteins (GFAP and UCH-L1) found in our brains and released into blood after an injury -- higher levels of which could indicate a concussion or subconcussive injury. Dr. Papa has been studying these biomarkers for more than a decade. Some of her previous studies have focused on athletes, but now she's expanding her research on subconcussive injuries to the general population and all age groups.

Historically, people who suffer head trauma without concussion symptoms may have been classified as having "no injury." Plus, there are very few studies addressing the impact of subconcussive injuries following head trauma in the civilian population, as opposed to military members or athletes.

"It is estimated that up to 3.8 million concussions occur in the U.S. annually from organized and recreational sports -- and there are more than 2 million ER visits for traumatic brain injuries and concussions," said Papa. "It is a significant health problem in both athletes and non-athletes."

The study looked at patients with concussions, those with head trauma without overt signs of concussion and those with body trauma without head trauma or concussion. Elevated levels of both biomarkers were found in patients with nonconcussive head trauma, potentially signaling a subconcussive brain injury.

Furthermore, this blood test goes even deeper than a routine CT scan. Previous studies using the two biomarkers have focused on detecting brain lesions, but subconcussive injuries don't necessarily result in lesions -- and even the vast majority of patients with concussions tend to have a normal CT scan.

"The study includes an array of patients with different injury mechanisms, including car crashes, falls and bicycle accidents in addition to recreational and sports injuries," said Papa. "It is not limited to just one group of injury types."

A number of companies are now working on developing a bench-top device for the hospital lab -- along with a point-of-care handheld device that can be used to detect subconcussive injuries in a variety of settings -- including sporting events, in the ambulance, at the scene of car crashes, in military settings or even after a simple bump to the head.

"The technology is only a year or two away," said Papa.

https://www.sciencedaily.com/releases/2019/08/190826092315.htm

Meaningful PTSD symptom decrease may lower type 2 diabetes risk

August 21, 2019

Science Daily/Saint Louis University

Research from Saint Louis University finds treatment for Post-Traumatic Stress Disorder (PTSD) that leads to an improvement in symptoms was associated with a 49 percent lower risk of incident type 2 diabetes.

The study, "Clinically Meaningful PTSD Improvement and Risk for Type 2 Diabetes," by Jeffrey Scherrer, Ph.D., professor in Family and Community Medicine at SLU, was published online Aug. 21 in JAMA Psychiatry.

"Some long-term chronic health conditions associated with PTSD may be less likely to occur among patients who experience clinically meaningful symptom reduction either through treatment or spontaneous improvement," Scherrer said.

PTSD affects up to 12 percent of civilians and nearly 30 percent of the veteran population. Those with PTSD are at risk for other health issues and improvement in PTSD symptoms is associated with parallel improvements in depression, emotional well-being, sleep, blood pressure and general physical health.

PTSD is associated with an increased risk of type 2 diabetes, which may be explained by the high prevalence of obesity, glucose dysregulation, inflammation, metabolic syndrome and depression among those diagnosed with PTSD versus those without PTSD.

This retrospective cohort study reviewed Veterans Health Affairs medical record data from 2008 to 2015. The researchers randomly selected 5,916 cases from among a veteran patient population aged 18 to 70 who had more than two visits to PTSD specialty care between 2008 and 2012. The patients were followed through until 2015.

After applying eligibility criteria, 1,598 patients with PTSD and free of diabetes risk were available for analysis.

Clinically meaningful symptom reduction is a decrease of 20 points on the PTSD Checklist score. The research found the results were independent of numerous demographic, psychiatric and physical comorbidities. The sample was 84.3 percent male, 66 percent Caucasian and 22 percent African-American. The mean age of the patients was 42.

The association was also independent of the number of PTSD psychotherapy sessions used.

"In patients with only PTSD, clinically meaningful PCL decrease is associated with lower risk for diabetes and in patients with PTSD and depression, we found improvement in PTSD was coupled with a decrease in depression," Scherrer said. "Thus decreased risk for type 2 diabetes appears to follow large PTSD symptom decrease and in patients with both PTSD and depression, improvement in both conditions may be necessary to reduce risk for type 2 diabetes."

"Surprisingly, clinically meaningful PTSD improvement was not associated with a change in BMI and A1C values." A prospective study is needed to advance research, Scherrer says, due in part to the limitations of medical record data. Such a study could determine if large decreases in PTSD checklist scores are associated with improved insulin resistance and reduced inflammation.

Take-aways

·      The observational study examined whether veterans who experienced a greater reduction in symptoms of posttraumatic stress disorder (PTSD) had an associated lower risk of developing type 2 diabetes.

·      The analysis included medical records from almost 1,600 veterans who received PTSD specialty care and had repeated completion of the PTSD Checklist as part of their treatment at the VA.

·      Patients with versus patients without clinically meaningful improvement in PTSD symptoms had a 49 percent lower risk for type 2 diabetes over a 3-6-year follow-up period.

·      In patients with PTSD and depression, improvement in both conditions was associated with lower risk for diabetes.

https://www.sciencedaily.com/releases/2019/08/190821142734.htm

More children suffer head injuries playing recreational sport than team sport

August 20, 2019

Science Daily/Murdoch Childrens Research Institute

An Australian/ New Zealand study examining childhood head injuries has found that children who do recreational sports like horse riding, skate boarding and bike riding are more likely to suffer serious head injuries  than children who play contact sport like AFL or rugby.

Research, conducted by the PREDICT research network, Murdoch Children's Research Institute (MCRI), published on Wiley and soon to be published in the Australian Medical Journal, examined the data of 8,857 children presenting with head injuries to ten emergency departments in Australian and New Zealand hospitals.

A third of the children, who were aged between five and 18 years, injured themselves playing sport. Of these children four out of five were boys.

Lead research author, MCRI's Professor Franz Babl, says the team looked at 'íntracranial' injuries in children because while there is a lot of interest about sport and concussion, less is understood about the severity of head injuries children suffer while playing sport.

"The study found that in children who presented to the emergency departments after head injury and participated in recreational sports like horse riding, skate boarding and bike riding were more likely to sustain serious head injuries than children who played contact sport like AFL, rugby, soccer or basketball," he says.

"We found that 45 of the 3,177 sports-related head injuries were serious and classified as clinically important Traumatic Brain Injury (ciTBI), meaning the patient required either neuro-surgery, at least two nights in hospital and/or being placed on a breathing machine. One child died as a result of head injuries."

Prof Babl says that the sports which resulted in the most frequent reason for presentation to emergency departments included bike riding (16 per cent), rugby (13 per cent), AFL (10 per cent), other football (9 per cent), and soccer (8 per cent).

The most frequent causes of serious injury included bike riding (44 per cent), skateboarding (18 per cent), horse riding (16 per cent), with AFL and rugby resulting in one serious head injury each and soccer resulting none.

A total of 524 patients with sports-related head injuries (16 per cent) needed CT imaging, and 14 children required surgery.

https://www.sciencedaily.com/releases/2019/08/190820101527.htm

Play sports for a healthier brain

Even football, soccer, hockey athletes have healthier brains

Science Daily/December 9, 2019

Northwestern University

There have been many headlines in recent years about the potentially negative impacts contact sports can have on athletes' brains. But a new Northwestern University study shows that, in the absence of injury, athletes across a variety of sports -- including football, soccer and hockey -- have healthier brains than non-athletes.

"No one would argue against the fact that sports lead to better physically fitness, but we don't always think of brain fitness and sports," said senior author Nina Kraus, the Hugh Knowles Professor of Communication Sciences and Neurobiology and director of Northwestern's Auditory Neuroscience Laboratory (Brainvolts). "We're saying that playing sports can tune the brain to better understand one's sensory environment."

Athletes have an enhanced ability to tamp down background electrical noise in their brain to better process external sounds, such as a teammate yelling a play or a coach calling to them from the sidelines, according to the study of nearly 1,000 participants, including approximately 500 Northwestern Division I athletes.

Kraus likens the phenomenon to listening to a DJ on the radio.

"Think of background electrical noise in the brain like static on the radio," Kraus said. "There are two ways to hear the DJ better: minimize the static or boost the DJ's voice. We found that athlete brains minimize the background 'static' to hear the 'DJ' better."

The study will be published Dec. 9 in the journal Sports Health.

"A serious commitment to physical activity seems to track with a quieter nervous system," Kraus said. "And perhaps, if you have a healthier nervous system, you may be able to better handle injury or other health problems."

The findings could motivate athletic interventions for populations that struggle with auditory processing. In particular, playing sports may offset the excessively noisy brains often found in children from low-income areas, Kraus said.

This is the latest study from the neural processing of sound in sports concussions and contact sports partnership, a five-year, National Institutes of Health-funded research collaboration between Brainvolts and Northwestern University Athletics, which launched last year. The study examined the brain health of 495 female and male Northwestern student athletes and 493 age- and sex-matched control subjects.

Kraus and her collaborators delivered speech syllables to study participants through earbuds and recorded the brain's activity with scalp electrodes. The team analyzed the ratio of background noise to the response to the speech sounds by looking at how big the response to sound was relative to the background noise. Athletes had larger responses to sound than non-athletes, the study showed.

Like athletes, musicians and those who can speak more than one language also have an enhanced ability to hear incoming sound signals, Kraus said. However, musicians' and multilinguals' brains do so by turning up the sound in their brain versus turning down the background noise in their brain.

"They all hear the 'DJ' better but the musicians hear the 'DJ' better because they turn up the 'DJ,' whereas athletes can hear the 'DJ' better because they can tamp down the 'static,'" Kraus said.

https://www.sciencedaily.com/releases/2019/12/191209080502.htm

Mental practice may improve golfers' putting performance

Science backs-up Arnold Palmer's golf theory

November 27, 2019

Science Daily/University of Limerick

Researchers from Lero, the Science Foundation Ireland Research Centre for Software, hosted at University of Limerick (UL), are lending support to Arnold Palmer's famous assertion that golf is predominantly played in "the six inches between the ears."

According to research by Lero and UL, kinaesthetic ability, which is an individual's ability to feel an action without actually performing it, may improve their golf game. Niall Ramsbottom, a researcher at Lero and UL, explained that recent research carried out by the team indicates that with mental practice, golfers can improve their putting.

"Our results indicate that a form of mental practice, i.e. the combination of action observation and motor imagery, may enhance the golf putting ability of experienced golfers," he said, "and that could well mean a reduction in a golfer's handicap."

The research was carried out at the Physical Education and Sports Sciences Department at University of Limerick, in conjunction with Lero. The findings for the work carried out by Mr Ramsbottom and his fellow researchers, Eoghan McNeill, Dr Adam Toth and Dr Mark Campbell, show that golfers who already had a good 'feel" for putting, may benefit the most from this mental practice.

"We found, kinaesthetic imagery ability -- an individual's ability to imagine the feel of an action without actually performing it -- may have an important role in determining the effectiveness of the exercise on putting performance. Putting is a feel-based motor skill and our research suggests that those with good kinaesthetic imagery ability may perform better following this mental practice technique," explained Mr Ramsbottom.

"The findings suggest that simply viewing a video of another performing an action may bolster one's ability to imagine and subsequently perform that action," he said.

Putting ability is crucial in golf as approximately 40% of golf strokes are taken with the putter.

"Furthermore, golf putting ability was found to be one of the most important skills in determining earnings on the Professional Golf Association (PGA) Tour," the report, published in Psychology of Sport and Exercise, states, citing previously conducted research.

In undertaking the research, 44 right-handed, skilled male golfers from the Limerick area were recruited. Each of the participants was required to hold a current Golfing Union of Ireland handicap, and could not have participated on any such research previously. In a laboratory environment, the golfers completed 40 putts with instructions to 'make the ball stop as close to the target as possible'. A three-dimensional ultrasound camera was used to record the putting and statistical analysis was conducted, using specialised software.

"A subset of golfers looked at an action observation video which consisted of an expert golfer performing the putting task in the same lab environment. They did so while listening to a motor imagery script consisting of short sentences describing key visual and kinaesthetic feelings associated with performing the putting the task. Having completed these simple exercises, the golfers who were found to have better kinaesthetic imagery (KI) ability benefited more from the mental practice intervention than those with poorer KI ability," explained Mr Ramsbottom.

https://www.sciencedaily.com/releases/2019/11/191127090208.htm

Any amount of running linked to significantly lower risk of early death

Any amount of running linked to significantly lower risk of early death

November 4, 2019

Science Daily/BMJ

Any amount of running is linked to a significantly lower risk of death from any cause, finds a pooled analysis of the available evidence, published online in the British Journal of Sports Medicine.

If more people took up running -- and they wouldn't have to run far or fast -- there would likely be substantial improvements in population health and longevity, conclude the researchers.

It's not clear how good running is for staving off the risk of death from any cause and particularly from cardiovascular disease and cancer, say the researchers.

Nor is it clear how much running a person needs to do to reap these potential benefits, nor whether upping the frequency, duration, and pace -- in other words, increasing the 'dose' -- might be even more advantageous.

To try and find out, the researchers systematically reviewed relevant published research, conference presentations, and doctoral theses and dissertations in a broad range of academic databases.

They looked for studies on the association between running/jogging and the risk of death from all causes, cardiovascular disease, and cancer.

They found 14 suitable studies, involving 232,149 people, whose health had been tracked for between 5.5 and 35 years. During this time, 25,951 of the study participants died.

When the study data were pooled, any amount of running was associated with a 27% lower risk of death from all causes for both sexes, compared with no running.

And it was associated with a 30% lower risk of death from cardiovascular disease, and a 23% lower risk of death from cancer.

Even small 'doses' -- for example, once weekly or less, lasting less than 50 minutes each time, and at a speed below 6 miles (8 km) an hour, still seemed to be associated with significant health/longevity benefits.

So running for 25 minutes less than the recommended weekly duration of vigorous physical activity could reduce the risk of death. This makes running a potentially good option for those whose main obstacle to doing enough exercise is lack of time, suggest the researchers.

But upping 'the dose' wasn't associated with a further lowering of the risk of death from any cause, the analysis showed.

This is an observational study, and as such, can't establish cause. And the researchers caution that the number of included studies was small and their methods varied considerably, which may have influenced the results.

Nevertheless, they suggest that any amount of running is better than none, concluding: "Increased rates of participation in running, regardless of its dose, would probably lead to substantial improvements in population health and longevity."

https://www.sciencedaily.com/releases/2019/11/191104190653.htm

Increase health benefits of exercise by working out before breakfast

October 18, 2019

Science Daily/University of Bath

Exercising before eating breakfast burns more fat, improves how the body responds to insulin and lowers people's risk of type 2 diabetes and cardiovascular disease.

According to a new study, published in the Journal of Clinical Endocrinology and Metabolism, health scientists at the Universities of Bath and Birmingham found that by changing the timing of when you eat and exercise, people can better control their blood sugar levels.

The six-week study, which involved thirty men classified as obese or overweight and compared results from two intervention groups (who ate breakfast before / after exercise) and a control group (who made no lifestyle changes), found that people who performed exercise before breakfast burned double the amount of fat than the group who exercised after breakfast.

They found that increased fat use is mainly due to lower insulin levels during exercise when people have fasted overnight, which means that they can use more of the fat from their fat tissue and the fat within their muscles as a fuel. To test proof-of-principle the initial study involved only men, but future studies will look to translate these findings for different groups including women.

Whilst this did not lead to any differences for weight loss over six weeks, it did have 'profound and positive' effects on their health because their bodies were better able to respond to insulin, keeping blood sugar levels under control and potentially lowering the risk of diabetes and heart disease.

Building on emerging evidence that the timing of meals in relation to exercise can shift how effective exercise is, the team behind this study wanted to focus on the impact on the fat stores in muscles for individuals who either worked out before or after eating and the effect this had on insulin response to feeding.

Dr Javier Gonzalez of the Department for Health at the University of Bath explained: "Our results suggest that changing the timing of when you eat in relation to when you exercise can bring about profound and positive changes to your overall health.

"We found that the men in the study who exercised before breakfast burned double the amount of fat than the group who exercised after. Importantly, whilst this didn't have any effect on weight loss, it did dramatically improve their overall health.

"The group who exercised before breakfast increased their ability to respond to insulin, which is all the more remarkable given that both exercise groups lost a similar amount of weight and both gained a similar amount of fitness. The only difference was the timing of the food intake."

Over the six-week trial, the scientists found that the muscles from the group who exercised before breakfast were more responsive to insulin compared to the group who exercised after breakfast, in spite of identical training sessions and matched food intake. The muscles from those who exercised before breakfast also showed greater increases in key proteins, specifically those involved in transporting glucose from the bloodstream to the muscles.

For the insulin response to feeding after the 6-week study, remarkably, the group who exercised after breakfast were in fact no better than the control group.

Co-author Dr Gareth Wallis of the University of Birmingham added: "This work suggests that performing exercise in the overnight-fasted state can increase the health benefits of exercise for individuals, without changing the intensity, duration or perception of their effort. We now need to explore the longer-term effects of this type of exercise and whether women benefit in the same way as men."

https://www.sciencedaily.com/releases/2019/10/191018080619.htm

Personality feature could predict how often you exercise

September 20, 2019

Science Daily/Association for Psychological Science

Individuals who make concrete plans to meet their goals may engage in more physical activity, including visits to the gym, compared to those who don't plan quite so far ahead, research shows. These research findings, published in Psychological Science, a journal of the Association for Psychological Science, suggest that self-reported levels of a trait called 'planfulness' may translate into real world differences in behavior.

Some people seem to be able to more consistently meet their goals than others, but it remains unclear if personality traits that have been found to promote goal achievement in the lab similarly encourage individuals to achieve long-term goals in their day-to-day lives, says lead researcher Rita M. Ludwig of the University of Oregon.

Conscientiousness, a measure of individuals' orderliness and dependability on the Big Five Inventory of personality, has long been tied with healthy behaviors, notes Ludwig and colleagues Sanjay Srivastava and Elliot T. Berkman, also of the University of Oregon. Narrowing their focus to a single facet of this trait, planfulness, allows researchers to zero in on the psychological processes -- such as mental flexibility, and a person's ability to make short-term sacrifices in pursuit of future success -- that contribute directly to achieving long-term goals.

"There indeed appears to be a certain way of thinking about goals that correlates with long-term progress," Ludwig says. "What's new in this study is that we used an objective measure of goal progress that could be recorded as participants naturally went about their lives: their check-ins at a local gym."

Ludwig and colleagues examined this relationship by analyzing the gym attendance of 282 participants over a 20-week period. The researchers tracked the number of times each participant swiped into the campus recreation center after enrolling in the study at the start of the winter 2018 academic semester. They also retroactively collected data on gym attendance throughout the fall 2017 term.

The participants, many of whom were students, provided a written description of their exercise plans and completed measures of self-control and grit, in addition to the Big Five Inventory of personality and Ludwig and colleagues' 30-item Planfulness Scale.

While all participants experienced a similar decline in gym attendance over the course of each semester, individuals who rated themselves high on planfulness items such as "developing a clear plan when I have a goal is important to me" went to the gym more throughout both semesters compared to those who ranked themselves lower on planfulness. The researchers found that a one point increase on the five-point Planfulness Scale corresponded with an additional 5.9 recreation center visits during the fall semester, and an additional 8.5 visits after enrolling in the study for the winter semester.

Planfulness was only significantly associated with the frequency of participants' gym attendance during the winter semester, possibly due to participants completing their physical activity plan later in the year, the researchers noted.

"This work is broadly informative for those who are curious about how people pursue health goals, including their own patterns of thought around goals," Ludwig says. "Clinicians might find it helpful in understanding how their patients tend to think about goals and whether person-to-person differences in such thinking are related to outcomes."

While there was a small, but significant relationship between participant planfulness and the level of detail in their physical activity plans, descriptiveness was unexpectedly found to have no relationship with gym attendance, Ludwig and colleagues noted.

"It seems logical that people who are successful with their goals would be able to write in detail about their planning process," Ludwig says. "We were surprised, then, to find no relationship between people's goal pursuit behavior and how they wrote about their goals."

Future psycholinguistic research might investigate alternative explanations for these findings, the researchers conclude.

https://www.sciencedaily.com/releases/2019/09/190920081906.htm

Exercise is good for the aging brain

Researchers find a single bout of exercise boosts cognition, memory performance in some older people

August 26, 2019

Science Daily/University of Iowa

Researchers have found that a single bout of exercise benefits some older people's brains. In experiments in which participants aged 60 to 80 exercised once and multiple times, the researchers found some individuals showed improved cognitive functions and working memory.

Exercise seems to endow a wealth of benefits, from the release of happiness-inducing hormones to higher physical fitness. New research shows it may provide a boost to the mind too.

University of Iowa researchers have found that a single bout of exercise improves cognitive functions and working memory in some older people. In experiments that included physical activity, brain scans, and working memory tests, the researchers also found that participants experienced the same cognitive benefits and improved memory from a single exercise session as they did from longer, regular exercise.

"One implication of this study is you could think of the benefits day by day," says Michelle Voss, assistant professor in the Department of Psychological and Brain Sciences and the study's corresponding author. "In terms of behavioral change and cognitive benefits from physical activity, you can say, 'I'm just going to be active today. I'll get a benefit.' So, you don't need to think of it like you're going to train for a marathon to get some sort of optimal peak of performance. You just could work at it day by day to gain those benefits."

Previous research has shown exercise can confer a mental boost. But the benefits vary: One person may improve cognitively and have improved memory, while another person may show little to no gain.

Limited research has been done on how a single bout of physical activity may affect cognition and working memory specifically in older populations, despite evidence that some brain functions slip as people age.

Voss wanted to tease out how a single session of exercise may affect older individuals. Her team enrolled 34 adults between 60 and 80 years of age who were healthy but not regularly active. Each participant rode a stationary bike on two separate occasions -- with light and then more strenuous resistance when pedaling -- for 20 minutes. Before and after each exercise session, each participant underwent a brain scan and completed a memory test.

In the brain scan, the researchers examined bursts of activity in regions known to be involved in the collection and sharing of memories. In the working memory tests, each participant used a computer screen to look at a set of eight young adult faces that rotated every three seconds -- flashcard style -- and had to decide when a face seen two "cards" previously matched the one they were currently viewing.

After a single exercise session, the researchers found in some individuals increased connectivity between the medial temporal (which surrounds the brain's memory center, the hippocampus) and the parietal cortex and prefrontal cortex, two regions involved in cognition and memory. Those same individuals also performed better on the memory tests. Other individuals showed little to no gain.

The boost in cognition and memory from a single exercise session lasted only a short while for those who showed gains, the researchers found.

"The benefits can be there a lot more quickly than people think," Voss says. "The hope is that a lot of people will then keep it up because those benefits to the brain are temporary. Understanding exactly how long the benefits last after a single session, and why some benefit more than others, are exciting directions for future research."

The participants also engaged in regular exercise, pedaling on a stationary bike for 50 minutes three times a week for three months. One group engaged in moderate-intensity pedaling, while another group had a mostly lighter workout in which the bike pedals moved for them.

Most individuals in the moderate and lighter-intensity groups showed mental benefits, judging by the brain scans and working memory tests given at the beginning and at the end of the three-month exercise period. But the brain gains were no greater than the improvements from when they had exercised a single time.

"The result that a single session of aerobic exercise mimics the effects of 12 weeks of training on performance has important implications both practically and theoretically," the authors write.

The researchers note their study had a small participant pool, with a homogenous population that excluded anyone with chronic health conditions or who were taking beta-blockers.

To address those limitations, Voss has expanded her participant pool in a current, five-year study to confirm the initial findings and learn more about how exercise alters older people's brains. The participants are healthy older individuals who are not physically active, similar to the participants' profile in the study's results reported here.

The National Institute on Aging, part of the National Institutes of Health, funded the research.

https://www.sciencedaily.com/releases/2019/08/190826110409.htm

One or the other: Why strength training might come at the expense of endurance muscles

July 25, 2019

Science Daily/University of Basel

The neurotransmitter brain-derived neurotrophic factor (BDNF) acts in the muscle, so that during strength training endurance muscle fiber number is decreased. Researchers at the University of Basel's Biozentrum have more closely investigated this factor, from the group of myokines, and demonstrated that it is produced by the muscle and acts on both muscles and synapses. The results published in PNAS also provide new insights into age-related muscle atrophy.

Fitness clubs are booming: New gyms are springing up like mushrooms. More and more people are striving to build up and strengthen their muscles. But what exactly happens in the muscle during training? In their recent work, Prof. Christoph Handschin's research group at the Biozentrum, University of Basel, has more closely studied strength muscles and the myokine brain-derived neurotrophic factor (BDNF), which plays an important role in the formation of strength muscle fibers.

Handschin's team has demonstrated that this factor is produced by the muscle itself and remodels the neuromuscular synapses, the neuronal junctions between the motor neurons and muscle. BDNF not only causes the strength muscles to develop, but at the same time leads to endurance muscle fiber number decline.

BDNF acts on muscles and synapses

Generally, it is differentiated between two types of muscle, depending on the type of fibers they are made of: There are the slow-twitch fibers for endurance muscles, which are formed mainly during endurance sports. Marathon runners primarily exercise this type of muscle. A great deal less well studied is the second form of muscle consisting of fast-twitch fibers. These strength muscles gain in volume during strength training and provide particularly great muscular power.

Christoph Handschin's team has now studied the hormone-like neurotransmitter from the myokine family in the mouse model. Myokines are released by the muscle during contraction. "It is interesting that BDNF is produced by the muscle itself and not only exerts an influence on the muscle. At the same time, it affects the neuromuscular synapses, which are the junctions between the motor neurons and muscle," explains Handschin.

BDNF converts endurance muscles into strength muscles

This remodeling of the neuromuscular synapses during strength training results in the body developing more strength muscle fibers. "However, strength muscle growth occurs at the expense of the endurance fibers. More precisely, through the release of BDNF, the endurance muscles are transformed into strength muscles," clarifies Handschin. This makes BDNF a factor proven to be produced by the muscle itself and to influence the type of muscle fibers formed.

Relevance to muscle training and age-related muscle atrophy

The new knowledge gained about the myokine BDNF also provides a possible explanation for the decrease in endurance musculature seen as a result of strength training. This correlation is already being taken into account in the training plan for high performance sports. Particularly in sporting disciplines such as rowing, which are geared towards strength and endurance, the muscle remodeling must be considered.

Moreover, in a follow-up study, the research group showed that in muscle lacking BDNF the age-related decline in muscle mass and function is reduced. "We didn't expect this result," says Handschin. "It also makes the findings interesting for treatment approaches for muscle atrophy in the elderly."

https://www.sciencedaily.com/releases/2019/07/190725112607.htm

Upbeat music can sweeten tough exercise

Insufficiently-active people might benefit from choosing the right tunes

June 20, 2019

Science Daily/University of British Columbia Okanagan campus

New research coming out of UBC's Okanagan campus demonstrates that upbeat music can make a rigorous workout seem less tough. Even for people who are insufficiently active.

Matthew Stork is a postdoctoral fellow in the School of Health and Exercise Sciences. He recently published a study examining how the right music can help less-active people get more out of their workout -- and enjoy it more.

High-intensity interval training (HIIT) -- brief, repeated bouts of intense exercise separated by periods of rest -- has been shown to improve physical health over several weeks of training. But, cautions Stork, it can be perceived as gruelling for many people, especially those who are less active.

"While HIIT is time-efficient and can elicit meaningful health benefits among adults who are insufficiently active, one major drawback is that people may find it to be unpleasant. As a result, this has the potential to discourage continued participation," he says.

Previous research led by Stork and UBC Okanagan's Kathleen Martin Ginis has examined the effects of music during HIIT with recreationally-active people. Their latest study tested the effects of music with participants who were insufficiently-active, used a more rigorous music selection process and implemented a HIIT regimen that is more practical for less-active adults.

The study took place at Brunel University London and Stork worked with Professor Costas Karageorghis, a researcher who studies the effects music has on sport and exercise. First, Stork gathered a panel of British adults to rate the motivational qualities of 16 fast-tempo songs. The three songs with the highest motivational ratings were used for the study.

"Music is typically used as a dissociative strategy. This means that it can draw your attention away from the body's physiological responses to exercise such as increased heart rate or sore muscles," says Stork. "But with high-intensity exercise, it seems that music is most effective when it has a fast tempo and is highly motivational."

Next, a separate group of 24 participants completed what has been referred to as the 'one-minute workout' -- three 20-second all-out sprints, totaling 60 seconds of hard work. A short rest separated the sprints, for a total exercise period of 10 minutes including a warm-up and cool-down. Participants completed these HIIT sessions under three different conditions -- with motivational music, no audio or a podcast that was devoid of music.

Participants reported greater enjoyment of HIIT. They also exhibited elevated heart rates and peak power in the session with music compared to the no-audio and podcast sessions.

"The more I look into this, the more I am surprised," he says. "We believed that motivational music would help people enjoy the exercise more, but we were surprised about the elevated heart rate. That was a novel finding."

Stork believes the elevated heart rates may be explained by a phenomenon called 'entrainment.'

"Humans have an innate tendency to alter the frequency of their biological rhythms toward that of musical rhythms. In this case, the fast-tempo music may have increased people's heart rate during the exercise. It's incredible how powerful music can be."

Stork's research indicates that for people who are deemed insufficiently active, music can not only help them work harder physically during HIIT but it can also help them enjoy HIIT more. And because motivational music has the power to enhance people's HIIT workouts, it may ultimately give people an extra boost to try HIIT again in the future.

"Music can be a practical strategy to help insufficiently active people get more out of their HIIT workouts and may even encourage continued participation."

The study was published this week in the Psychology of Sport and Exercise. Stork received financial support from the Social Sciences and Humanities Research Council of Canada and the Michael Smith Foundation for Health Research over the course of this project.

https://www.sciencedaily.com/releases/2019/06/190620100027.htm

Exercise may have different effects in the morning and evening

June 13, 2019

Science Daily/University of Copenhagen The Faculty of Health and Medical Sciences

Researchers from the University of Copenhagen have learned that the effect of exercise may differ depending on the time of day it is performed. In mice they demonstrate that exercise in the morning results in an increased metabolic response in skeletal muscle, while exercise later in the day increases energy expenditure for an extended period of time.

We probably all know how important a healthy circadian rhythm is. Too little sleep can have severe health consequences. But researchers are still making new discoveries confirming that the body's circadian clock affects our health.

Now, researchers from University of Copenhagen -- in collaboration with researchers from University of California, Irvine -- have learned that the effect of exercise may differ depending on the time of day it is performed. Studies in mice reveal that the effect of exercise performed in the beginning of the mouse' dark/active phase, corresponding to our morning, differs from the effect of exercise performed in the beginning of the light/resting phase, corresponding to our evening.

'There appears to be rather significant differences between the effect of exercise performed in the morning and evening, and these differences are probably controlled by the body's circadian clock. Morning exercise initiates gene programs in the muscle cells, making them more effective and better capable of metabolising sugar and fat. Evening exercise, on the other hand, increases whole body energy expenditure for an extended period of time', says one of the researchers behind the study, Associate Professor Jonas Thue Treebak from the Novo Nordisk Foundation Center for Basic Metabolic Research.

Morning Exercise Is Not Necessarily Better than Evening Exercise

The researchers have measured a number of effects in the muscle cells, including the transcriptional response and effects on the metabolites. The results show that responses are far stronger in both areas following exercise in the morning and that this is likely to be controlled by a central mechanism involving the protein HIF1-alfa, which directly regulates the body's circadian clock.

Morning exercise appears to increase the ability of muscle cells to metabolise sugar and fat, and this type of effect interests the researchers in relation to people with severe overweight and type 2 diabetes.

On the other hand, the results also show that exercise in the evening increases energy expenditure in the hours after exercise. Therefore, the researchers cannot necessarily conclude that exercise in the morning is better than exercise in the evening, Jonas Thue Treebak stresses.

'On this basis we cannot say for certain which is best, exercise in the morning or exercise in the evening. At this point, we can only conclude that the effects of the two appear to differ, and we certainly have to do more work to determine the potential mechanisms for the beneficial effects of exercise training performed at these two time-points. We are eager to extend these studies to humans to identify if timed exercise can be used as a treatment strategy for people with metabolic diseases', he explains.

https://www.sciencedaily.com/releases/2019/06/190613095209.htm

Exercise: Psych patients' new natural prescription

May 21, 2019

Science Daily/University of Vermont

When it comes to inpatient treatment of a range of mental health and mood disorders -- from anxiety and depression to schizophrenia, suicidality and acute psychotic episodes -- a new study suggest that physical exercise is so effective at alleviating patient symptoms that it could reduce patients' time admitted to acute facilities and reliance on psychotropic medications.

"The general attitude of medicine is that you treat the primary problem first, and exercise was never considered to be a life or death treatment option. Now that we know it's so effective, it can become as fundamental as pharmacological intervention," explains David Tomasi, a lecturer at the University of Vermont, psychotherapist and inpatient psychiatry group therapist at the University of Vermont Medical Center and lead researcher of the study.

Practitioners at inpatient psychiatric facilities -- often crowded, acute settings in which patients experience severe distress and discomfort -- typically prescribe psychotropic medications first, rather than natural remedies like physical exercise, to alleviate patients' symptoms such as anger, anxiety and depression. In fact, Tomasi estimates that only a handful of inpatient psychiatric hospitals in the U.S. provide psychotherapist-supported gym facilities exclusively for these patients. Instead, practitioners rely on classical psychotherapeutic and pharmacological frameworks to treat psychiatric symptoms, which they monitor to determine when a patient is ready to be discharged from the facility.

Tomasi, in collaboration with UVMMC's Sheri Gates and Emily Reyns, built a gym exclusively for roughly 100 patients in the medical center's inpatient psychiatry unit, and led and introduced 60-minute structured exercise and nutrition education programs into their treatment plans. The psychotherapists surveyed patients on their mood, self-esteem and self-image both before and after the exercise sessions to gauge the effects of exercise on psychiatric symptoms.

Patients reported lower levels of anger, anxiety and depression, higher self-esteem, and overall improved moods. Tomasi, Gates and Reyns found an average of 95 percent of patients reported that their moods improved after doing the structured exercises, while 63 percent of the patients reported being happy or very happy, as opposed to neutral, sad or very sad, after the exercises. An average of 91.8 of patients also reported that they were pleased with the way their bodies felt after doing the structured exercises.

"The fantastic thing about these results is that, if you're in a psychotic state, you're sort of limited with what you can do in terms of talk therapy or psychotherapy. It's hard to receive a message through talk therapy in that state, whereas with exercise, you can use your body and not rely on emotional intelligence alone" explains Tomasi.

"The priority is to provide more natural strategies for the treatment of mood disorders, depression and anxiety," he adds. "In practice, we hope that every psychiatric facility will include integrative therapies -- in our case, exercise in particular -- as the primary resource for their patients' psycho-physical wellbeing."

https://www.sciencedaily.com/releases/2019/05/190521124650.htm