Role of sleep-related brain activity in clearing toxic proteins and preventing Alzheimer's disease

June 1, 2021

Science Daily/PLOS

Evidence of sleep-dependent low-frequency (<0.1 Hz) global brain activity in the clearance of Alzheimer's disease-related toxin buildup is presented in research published on 1st June 2021 in the open access journal PLOS Biology by Xiao Liu and colleagues at The Pennsylvania State University. This neuronal activity was more strongly linked with cerebrospinal fluid flow in healthy controls than higher risk groups and patients, and the findings could serve as a potential imaging marker for clinicians in evaluating patients.

The development of Alzheimer's disease is believed to be driven by the buildup of the toxic proteins amyloid-β and tau in the brain. The brain's glymphatic system plays a crucial role in clearing these toxins and previous work has shown a possible relationship between sleep-dependent global brain activity and the glymphatic system by showing this activity is coupled by cerebrospinal fluid flow essential for the glymphatic system.

Using 118 subjects in the Alzheimer's Disease Neuroimaging Initiative project, the researchers measured this global brain activity and cerebrospinal fluid flow as well as looking at behavioral data. Individuals underwent resting-state fMRI sessions two years apart, and the team compared their findings with neurobiological and neuropsychological markers related to Alzheimer's disease, such as levels of the toxic protein amyloid-β.

The strength of the connection between brain activity and cerebrospinal fluid flow was weaker in individuals at a higher risk or who had already developed Alzheimer's disease. Additionally, this weaker connection was associated with higher levels of amyloid-β and disease-related behavioral measures two years later. This suggests an important role for sleep-dependent global brain activity in the clearance of brain waste, and its connection to cerebrospinal fluid flow could be helpful as a future marker for clinical evaluation.

Dr. Liu adds, "The study linked the coupling between the resting-state global brain activity and cerebrospinal fluid flow to Alzheimer's disease pathology. The finding highlights the potential role of low-frequency (<0.1 Hz) resting-state neural and physiological dynamics in the neurodegenerative diseases, presumably due to their sleep-dependent driving of cerebrospinal fluid flow to wash out brain toxins. Future studies are warranted to fully understand the global brain activity and associated physiological modulations and their role in glymphatic clearance and neurodegenerative diseases."

https://www.sciencedaily.com/releases/2021/06/210601152018.htm

Memory details fade over time, with only the main gist preserved

May 26, 2021

Science Daily/University of Birmingham

What information is retained in a memory over time, and which parts get lost? These questions have led to many scientific theories over the years, and now a team of researchers at the Universities of Glasgow and Birmingham have been able to provide some answers.

Their new study, which is published today in Nature Communications, demonstrates that our memories become less vibrant and detailed over time, with only the central gist eventually preserved. Moreover, this 'gistification' of our memories is boosted when we frequently recall our recent experiences.

The work could have implications in a number of areas, including the nature of memories in post-traumatic stress disorder, the repeated questioning of eye-witness testimonies and even in best practice for exam studying.

While memories are not exact carbon copies of the past -- remembering is understood to be a highly reconstructive process -- experts have suggested that the contents of a memory could change each time we bring it back to mind.

However, exactly how our memories differ from the original experiences, and how they are transformed over time, has until now proven difficult to measure in laboratory settings.

For this study the researchers developed a simple computerised task that measures how fast people can recover certain characteristics of visual memories when prompted to do so. Participants learned word-image pairs and were later required to recollect different elements of the image when cued with the word. For example, participants were asked to indicate, as fast as possible, if the image was coloured or greyscale (a perceptual detail), or whether it showed an animate or inanimate object (a semantic element).

These tests, probing the quality of the visual memories, happened immediately after learning and also after a two-day delay. Reaction time patterns showed that participants were faster to recollect meaningful, semantic elements than surface, perceptual ones.

Julia Lifanov, lead author of the study from the University of Birmingham, said: "Many memory theories assume that over time, and as people re-tell their stories, they tend to forget the surface details but retain the meaningful, semantic content of an event.

"Imagine reminiscing about a pre-COVID dinner with a friend -- you realize that you cannot recall the table décor but know exactly what you ordered; or you remember the conversation with the bartender, but not the colour of his shirt. Memory experts call this phenomenon 'semanticization'."

Prof Maria Wimber, senior author on the study from the University of Glasgow, said: "The pattern towards recollection of meaningful semantic elements we demonstrate in this study indicates that memories are biased towards meaningful content in the first place -- and we have shown in previous studies that this bias is clearly reflected in brain signals too.

"Our memories change with time and use and that is a good and adaptive thing. We want our memories to retain the information that is most likely to be useful in the future, when we encounter similar situations."

The researchers found that the bias towards semantic memory content becomes significantly stronger with the passage of time, and with repeated remembering. When participants came back to the lab two days later, they were much slower at answering the perceptual-detailed questions, but they show relatively preserved memory for the semantic content of the images. However, the shift from detail-rich to more concept-based memories was far less pronounced in a group of subjects who repeatedly viewed the images, rather than being asked to actively bringing them back to mind.

The study has implications for probing the nature of memories in health and disease. It provides a tool to study maladaptive changes, for example in post-traumatic stress disorder where patients often suffer from intrusive, traumatic memories, and tend to over-generalize these experiences to novel situations. The findings are also highly relevant for understanding how eyewitness memories may be biased by frequent interviews and repeatedly recalling the same event.

The findings also demonstrate that testing yourself prior to an exam (for example, by using flashcards) will make the meaningful information stick for longer, especially when followed by periods of rest and sleep.

https://www.sciencedaily.com/releases/2021/05/210526085058.htm

'Rejuvenating' the Alzheimer's brain

May 25, 2021

Science Daily/Netherlands Institute for Neuroscience - KNAW

Alzheimer's disease is the main cause of dementia and current therapeutic strategies cannot prevent, slow down or cure the pathology. The disease is characterized by memory loss, caused by the degeneration and death of neuronal cells in several regions of the brain, including the hippocampus, which is where memories are initially formed. Researchers from the Netherlands Institute for Neuroscience (NIN) have identified a small molecule that can be used to rejuvenate the brain and counteract the memory loss.

New cells in old brains 

The presence of adult-born cells in the hippocampus of old people was recently demonstrated in scientific studies. It suggests that, generally speaking, the so-called process of adult neurogenesis is sustained throughout adulthood. Adult neurogenesis is linked to several aspects of cognition and memory in both animal models and humans, and it was reported to sharply decrease in the brains of patients with Alzheimer's disease. Researchers also found that higher levels of adult neurogenesis in these patients seem to correlate with better cognitive performance before death. "This could suggest that the adult-born neurons in our brain may contribute to a sort of cognitive reserve that could later on provide higher resilience to memory loss," says Evgenia Salta, group leader at the NIN. Therefore, researchers from the NIN investigated if giving a boost to adult neurogenesis could help prevent or improve dementia in Alzheimer's disease.

A small molecule with big potential 

Salta: "Seven years ago, while studying a small RNA molecule that is expressed in our brain, called microRNA-132, we came across a rather unexpected observation. This molecule, which we had previously found to be decreased in the brain of Alzheimer's patients, seemed to regulate homeostasis of neural stem cells in the central nervous system." Back then, Alzheimer's was thought to be a disease affecting only mature neuronal cells, so at first glance this finding did not seem to explain a possible role of microRNA-132 in the progression of Alzheimer's.

In this study, the researchers set out to address whether microRNA-132 can regulate adult hippocampal neurogenesis in healthy and Alzheimer's brains. Using distinct Alzheimer's mouse models, cultured human neural stem cells and post-mortem human brain tissue, they discovered that this RNA molecule is required for the neurogenic process in the adult hippocampus. "Decreasing the levels of microRNA-132 in the adult mouse brain or in human neural stem cells in a dish impairs the generation of new neurons. However, restoring the levels of microRNA-132 in Alzheimer's mice rescues neurogenic deficits and counteracts memory impairment related to adult neurogenesis," Sarah Snoeck, technician in the group of Salta, explains.

These results provide a proof-of-concept regarding the putative therapeutic potential of bringing about adult neurogenesis in Alzheimer's. Salta: "Our next goal is to systematically assess the efficacy and safety of targeting microRNA-132 as a therapeutic strategy in Alzheimer's disease."

https://www.sciencedaily.com/releases/2021/05/210525113701.htm

Press (re)play to remember - How the brain strengthens memories during sleep

May 25, 2021

Science Daily/University of Birmingham

While we sleep, the brain produces particular activation patterns. When two of these patterns -- slow oscillations and sleep spindles -- gear into each other, previous experiences are reactivated. The stronger the reactivation, the clearer will be our recall of past events, a new study reveals.

Scientists have long known that slow oscillations (SOs) and sleep spindles -- sudden half-second to two-second bursts of oscillatory brain activity -- play an important role in the formation and retention of new memories.

But experts in the UK and Germany have discovered that the precise combination of SOs and sleep spindles is vital for opening windows during which memories are reactivated; helping to form and cement memories in the human brain.

Researchers at the University of Birmingham and Ludwig-Maximilians-University Munich today published their findings in Nature Communications.

Co-author Dr Bernhard Staresina, from the University of Birmingham's School of Psychology, commented: "Our main means of strengthening memories while we sleep is the reactivation of previously learnt information, which allows us to solidify memories in neocortical long-term stores.

"We have discovered an intricate interplay of brain activity -- slow oscillations and sleep spindles -- which create windows of opportunity enabling this reactivation."

Co-author Dr Thomas Schreiner, from Ludwig-Maximilians-University, Munich, commented: "Memory reactivation is specifically bound to the presence of SO-spindle complexes. These results shed new light on the memory function of sleep in humans and emphasise the importance of orchestrated sleep rhythms in strengthening our powers of recall and orchestrating the creation of memories."

Before this study, evidence of the brain's capacity to reactivate memories during sleep was scarce, but the team devised novel tests where participants were shown information before taking a nap and closely monitored brain activity during non-rapid eye movement (NREM) sleep using EEG recording. Those taking part were then tested on their memory recall after waking up, allowing the researchers to link the extent of memory reactivation during sleep to memory performance.

The results revealed reactivation of learning material during SO-spindle complexes, with the precision of SO-spindle coupling predicting how strongly the memory would be reactivated by the brain. This in turn predicted the level of memory consolidation across participants and the subsequent clarity of recall.

https://www.sciencedaily.com/releases/2021/05/210525084300.htm

A complex link between body mass index and Alzheimer's

Study finds combined genetic risk, lower BMI predict disease progression

May 19, 2021

Science Daily/Ohio State University

Though obesity in midlife is linked to an increased risk for Alzheimer's disease, new research suggests that a high body mass index later in life doesn't necessarily translate to greater chances of developing the brain disease.

In the study, researchers compared data from two groups of people who had been diagnosed with mild cognitive impairment -- half whose disease progressed to Alzheimer's in 24 months and half whose condition did not worsen.

The researchers zeroed in on two risk factors: body mass index (BMI) and a cluster of genetic variants associated with higher risk for Alzheimer's disease.

Their analysis showed that a higher genetic risk combined with a lower BMI was associated with a higher likelihood for progression to Alzheimer's, and that the association was strongest in men.

The finding does not suggest people should consider gaining weight in their later years as a preventive effort -- instead, researchers speculate that lower BMI in these patients was likely a consequence of neurodegeneration, the progressive damage to the brain that is a hallmark of Alzheimer's. Brain regions affected by Alzheimer's are also involved in controlling eating behaviors and weight regulation.

"We don't want people to think they can eat everything they want because of this lower BMI association," said senior study author Jasmeet Hayes, assistant professor of psychology at The Ohio State University.

"We know that maintaining a healthy weight and having a healthy diet are extremely important to keeping inflammation and oxidative stress down -- that's a risk factor that is modifiable, and it's something you can do to help improve your life and prevent neurodegenerative processes as much as possible," she said. "If you start to notice rapid weight loss in an older individual, that could actually be a reflection of a potential neurodegenerative disease process."

The study was published online recently in the Journals of Gerontology: Series A.

Previous research has found a link between obesity and negative cognitive outcomes, but in older adults closer to the age at which Alzheimer's disease is diagnosed, the results have been mixed, Hayes said. And though a variant to the gene known as APOE4 is the strongest single genetic risk factor for Alzheimer's, it explains only about 10 to 15% of overall risk, she said.

Hayes has focused her research program on looking at multiple risk factors at the same time to see how they might interact to influence risk -- and to identify health behaviors that may help reduce the risk.

"We're trying to add more and more factors. That is my goal, to one day build a more precise and better model of the different combinations of risk factors," said Hayes, also an investigator in Ohio State's Chronic Brain Injury Initiative. "Genetic risk is important, but it really explains only a small part of Alzheimer's disease, so we're really interested in looking at other factors that we can control."

For this study, the research team obtained data from the Alzheimer's Disease Neuroimaging Initiative, compiling a sample of 104 people for whom BMI and polygenic risk scores were available. Fifty-two individuals whose mild cognitive impairment (MCI) had progressed to Alzheimer's in 24 months were matched against demographically similar people whose MCI diagnosis did not change over two years. Their average age was 73.

Statistical analysis showed that individuals with mild cognitive impairment who had both a lower BMI and higher genetic risk for Alzheimer's were more likely to progress to Alzheimer's disease within 24 months compared to people with a higher BMI.

"We think there's interaction between the genetics and lower BMI, and having both of these risk factors causes more degeneration in certain brain regions to increase the likelihood of developing Alzheimer's disease," said Jena Moody, a graduate student in psychology at Ohio State and first author of the paper.

The effect of the BMI-genetic risk interaction was significant even after taking into account the presence of beta-amyloid and tau proteins in the patients' cerebrospinal fluid -- the core biomarkers of Alzheimer's disease.

The relationship between low BMI and high genetic risk and progression to Alzheimer's was stronger in males than in females, but a larger sample size and additional biological data would be needed to expand on that finding, the researchers said.

Because brain changes can begin long before cognitive symptoms surface, a better understanding of the multiple risk factors for Alzheimer's could open the door to better prevention options, Moody said.

"If you can identify people at higher risk before symptoms manifest, you could implement interventions and prevention techniques to either slow or prevent that progression from happening altogether," she said.

To date, scientists have suggested preventive steps include maintaining a healthy weight and diet and participating in activities that reduce inflammation and promote neurofunctioning, such as exercise and mentally stimulating activities.

"We're finding again and again how important inflammation is in the process," Hayes said. "Especially in midlife, trying to keep that inflammation down is such an important aspect of maintaining a healthy lifestyle and preventing accelerated aging."

https://www.sciencedaily.com/releases/2021/05/210519120835.htm

What Is Telemedicine In Healthcare?

Guest post by John Mullen Training COR

*We do not endorse guest posts. For informational purposes only.

Telemedicine is a novel new way of getting you healthy without having to see the doctor in person. Offering you innovative solutions and twenty-four-hour access to your medical records and results, you have the best opportunity to meet with your doctor and talk about your concerns without stepping outside your house. That offers great benefit to those who suffer from anxiety and fear of getting sick during the pandemic.

Using Technology

 Technology is your friend when using telemedicine. By using the app or the patient portal, you can talk to your doctor quickly. You also have access to your complete set of files and full knowledge of what is going on with your health. In addition to that, you have an easier time understanding your lab results, medication, and notes from the doctor. 

You also have the chance to speak with your doctor freely through text or call them from your phone. That saves time and frustration because you can call them anytime, no matter what location you find yourself in.  It will work when your parked and waiting for the kids at school, at home, or if you are walking somewhere. The service is around the clock, so you never go without professional help should you need it. When you need instant urgent care telemedicine options, service anytime is what you need. 

A Virtual Appointment

The way telemedicine works for an appointment is that you call your doctor's office like usual, and then on the day of your appointment, they will call you on your phone when it's time. If you are using video calling, you will be able to see them, and the same is true with Skype. 

That option works better for people because they don't have to go to the doctor's office in person. It helps them retain their schedule, and it's more convenient, which is something they appreciate. It also works for people stuck in areas that make it hard to get to the doctor or people who are not well enough to make the trip to the doctor. Those at risk with the pandemic can't leave the house either but still need medical help. This system was put in place with them in mind. 

Try Telemedicine

It’s easy to have appointments virtually instead of in person. It’s easier on you, your car, and your time. It also helps the doctor help you medically. Insurance isn't a problem; there are no hidden fees; it is the perfect way to see a doctor when you need assistance during this pandemic. 

Eating more fruit and vegetables linked to less stress

May 14, 2021

Science Daily/Edith Cowan University

Eating a diet rich in fruit and vegetables is associated with less stress, according to new research from Edith Cowan University (ECU).

The study examined the link between fruit and vegetable intake and stress levels of more than 8,600 Australians aged between 25 and 91 participating in the Australian Diabetes, Obesity and Lifestyle (AusDiab) Study from Baker Heart and Diabetes Institute.

The findings revealed people who ate at least 470 grams of fruit and vegetables daily had 10 per cent lower stress levels than those who consumed less than 230 grams. The World Health Organization (WHO) recommends eating at least 400 grams of fruit and vegetables per day.

Lead researcher, PhD candidate Simone Radavelli-Bagatini from ECU's Institute for Nutrition Research, said the study strengthens the link between diets rich in fruit and vegetables and mental wellbeing.

"We found that people who have higher fruit and veggie intakes are less stressed than those with lower intakes, which suggests diet plays a key role in mental wellbeing," said Ms Radavelli-Bagatini.

A growing issue

Mental health conditions are an increasing problem in Australia and around the world. Around one in two Australians will experience a mental health issue in their lifetime. Globally, approximately 1 in 10 people live with a mental health disorder.

According to Ms Radavelli-Bagatini, some stress is considered normal, but long-term exposure can significantly impact mental health.

"Long-term and unmanaged stress can lead to a range of health problems including heart disease, diabetes, depression and anxiety so we need to find ways to prevent and possibly alleviate mental health problems in the future," said Ms Radavelli-Bagatini.

The benefits of a healthy diet are well known, but only 1 in 2 Australians eat the recommended two serves of fruit per day and fewer than 1 in 10 eat the recommended five serves of vegetables each day.

"Previous studies have shown the link between fruit and vegetable consumption and stress in younger adults, but this is the first time we're seeing similar results across adults of all ages," said Ms Radavelli-Bagatini.

"The study's findings emphasise that it's important for people to have a diet rich in fruit and vegetables to potentially minimise stress."

Food and mood

While the mechanisms behind how fruit and vegetable consumption influences stress are still unclear, Ms Radavelli-Bagatini said key nutrients could be a factor.

"Vegetables and fruits contain important nutrients such as vitamins, minerals, flavonoids and carotenoids that can reduce inflammation and oxidative stress, and therefore improve mental wellbeing," she said.

"Inflammation and oxidative stress in the body are recognised factors that can lead to increased stress, anxiety and lower mood."

"These findings encourage more research into diet and specifically what fruits and vegetables provide the most benefits for mental health."

The research is part of ECU's recently launched Institute for Nutrition Research, which aims to investigate how nutrition can help prevent and treat chronic health conditions.

'Fruit and vegetable intake is inversely associated with perceived stress across the adult lifespan' was published in Clinical Nutrition.

https://www.sciencedaily.com/releases/2021/05/210513100030.htm

Drivers with shift work sleep disorder 3x more likely to be in crash

May 13, 2021

Science Daily/University of Missouri-Columbia

People who work nontraditional work hours, such as 11 p.m.-7 a.m., or the "graveyard" shift, are more likely than people with traditional daytime work schedules to develop a chronic medical condition -- shift work sleep disorder -- that disrupts their sleep. According to researchers at the University of Missouri, people who develop this condition are also three times more likely to be involved in a vehicle accident.

"This discovery has many major implications, including the need to identify engineering counter-measures to help prevent these crashes from happening," said Praveen Edara, department chair and professor of civil and environmental engineering. "Such measures can include the availability of highway rest areas, roadside and in-vehicle messaging to improve a driver's attention, and how to encourage drivers who may have a late-night work shift to take other modes of transportation, including public transit or ride-share services."

Edara, one of the authors on the study, said the analysis was based on data collected from a real-world driving study for the second Strategic Highway Research Program established by the U.S. Congress.

As the demand for 24/7 business operations has increased in recent years to meet customer needs during all hours of the day and across multiple time zones, the traditional work day -- once defined as 9 a.m.-5 p.m. -- has shifted for many people to include evening and night shifts, causing sleeping difficulties and leading to shift work sleep disorder. Edara said he was surprised to see shift work sleep disorder increase the risk of a traffic crash by nearly 300%, as compared to both sleep apnea and insomnia, which both increased the risk of a crash by approximately 30%.

Edara said previous studies have shown sleep disorders increase the risk for a traffic crash, but the majority of these studies were conducted in a controlled environment, such as a laboratory driving simulator. He believes this real-world data now validates those efforts.

"In the past, researchers have studied sleep disorders primarily in a controlled environment, using test-tracks and driving simulators," Edara said. "Our study goes a step further by using actual observed crash and near-crash data from approximately 2,000 events occurring in six U.S. states. We've known for a while now that sleep disorders increase crash risk, but here we are able to quantify that risk using real world crash data while accounting for confounding variables such as roadway and traffic characteristics."

Edara said some of the limitations of their study include not having data for fatal crashes, and no formal measurement to define drowsiness.

Putting a spotlight onto a national problem

In the United States, the National Transportation Safety Board, or NTSB, is the federal agency that investigates major traffic accidents. Each year, they issue an annual "most wanted list" of safety improvements, and their 2019-2020 list includes "screening and treating obstructive sleep apnea" among the top 10 topic areas.

Edara said he hopes that by showing how big of a risk there is for traffic crashes caused by excessive daytime sleepiness, the researchers can help draw additional attention toward finding ways to keep people safe behind the wheel, including taking the driver out of the equation with ride-sharing options and automated vehicles. He said the ideal next step in this research would be to partner with medical professionals who have expertise in this area to better understand why this is happening.

"We want to partner with public health and medical professionals whose expertise is in sleep-related research to better understand why this is happening," Edara said. "That will also allow us to explore what kind of countermeasures we can develop and test to improve the overall safety of these drivers and the other motorists around them."

https://www.sciencedaily.com/releases/2021/05/210513142334.htm

Long term use of prescription meds for insomnia not linked to better quality sleep

No difference between those who did and didn't take these drugs for 1-2 years

May 11, 2021

Science Daily/BMJ

Long term use of prescription meds for insomnia doesn't seem to improve disturbed sleep in middle-aged women, suggests research published in the online journal BMJ Open.

There was no difference in sleep quality or duration between those who did and didn't take these meds for 1 to 2 years, the findings show.

Disturbed sleep -- difficulty falling and/or staying asleep and waking early -- is common. An estimated 9 million adults in the US alone say they take prescription meds to try and get a good night's sleep.

Poor quality sleep is associated with ill health, including diabetes, high blood pressure, pain and depression, and various drugs are prescribed to induce shut-eye.

These include benzodiazepines, Z-drugs which include zolpidem, zaleplon and eszopiclone, as well as other agents mostly intended for other conditions (off label use), such as quelling anxiety and depression.

The clinical trial data indicate that many of these drugs work in the short term (up to 6 months), but insomnia can be chronic, and many people take these drugs for longer, say the researchers.

They therefore wanted to assess the effectiveness of drugs used to tackle insomnia over the long term among an ethnically diverse group of middle aged women who developed sleep disorders.

The women were all part of the Study of Women's Health Across the Nation (SWAN), a long term multicentre study looking at biological and psychosocial changes arising during the menopause. The women's average age was 49.5 and around half were white.

Sleep disturbances were defined as difficulty falling asleep, frequent awakening, and waking up early and rated on a 5-point scale, ranging from no difficulty on any night (1) to difficulty on 5 or more nights of the week (5), reported during an average of 21 years of monitoring.

Sleep disturbances, as measured on the ratings scale, were compared among those who did and didn't take prescription meds to improve their sleep after 1 and 2 years.

Some 238 women who started using medication to tackle insomnia during the monitoring period were matched with 447 women who didn't take these drugs.

Both groups of women reported difficulty falling asleep on 1 out of every 3 nights, waking frequently on 2 out of 3 nights, and waking up early on 1 in every 3 nights of the week. More than 70% of women in both groups reported disturbed sleep at least 3 times a week.

To begin with, sleep disturbance ratings were similar between the two groups of women. Those taking prescription meds for their sleep problems had average scores for difficulty falling asleep, waking up frequently, and for waking up early of 2.7, 3.8, and 2.8 respectively.

This compares with equivalent ratings of 2.6, 3.7, and 2.7, respectively, for those not taking prescription meds to get a good night's sleep.

After 1 year, average ratings among those taking the meds were 2.6, 3.6, and 2.8, respectively. The equivalent average scores among those not using prescription meds for their sleep problems were 2.3, 3.5, and 2.5, respectively.

None of the 1 year changes was statistically significant nor did they differ between the two groups. And after 2 years there were no statistically significant reductions in sleep disturbances among those taking prescription meds compared with those who didn't.

This is an observational study, and as such can't establish cause, only correlation. What's more, around half of the women were current or former smokers and 1 in 5 were moderate to heavy drinkers, both of which may affect sleep quality.

Information collected on prescription meds was also collected only at annual or biennial study visits, and there may have been intermittent or periods of no use between visits, say the researchers. Nor were there any objective measures of sleep quality.

Nevertheless, conclude the researchers: "Sleep disturbances are common and increasing in prevalence. The use of sleep medications has grown, and they are often used over a long period, despite the relative lack of evidence from [randomised controlled trials]."

These drugs may work well in some people with sleep disturbances over several years, but the findings of this study should give pause for thought to prescribing clinicians and patients thinking about taking prescription meds for sleep disturbances in middle age, they add.

https://www.sciencedaily.com/releases/2021/05/210511201131.htm

Bacteria do not colonize the gut before birth

It happens during and after birth

May 10, 2021

Science Daily/McMaster University

It is well known that each person's gut bacteria is vital for digestion and overall health, but when does that gut microbiome start?

New research led by scientists from McMaster University and Charité -- Universitätsmedizin Berlin in Germany has found it happens during and after birth, and not before.

McMaster researchers Deborah Sloboda and Katherine Kennedy examined prenatal stool (meconium) samples collected from 20 babies during breech Cesarean delivery.

"The key takeaway from our study is we are not colonized before birth. Rather, our relationship with our gut bacteria emerges after birth and during infancy," said Kennedy, first author of the study and a PhD student, whose findings are published in Nature Microbiology.

Recent studies have sparked controversy by claiming that we are colonized by gut bacteria before birth. But, Kennedy said, studies such as these have been criticized for the ways they control for contamination.

"By including only breech caesarean deliveries in healthy pregnant women we were able to avoid the transmission of bacteria that occurs naturally during a vaginal birth," said Thorsten Braun, co-senior author and lead obstetric consultant and deputy director of the Department of 'Experimental Obstetrics' at Charité -- Universitätsmedizin Berlin.

Kennedy said recent data suggest that a person's relationship with their own gut bacteria is most important in early life, during critical stages of immunological and physiological development.

Sloboda, co-senior author, agrees.

"The fact that colonization of infants' guts occurs during and after their births, means that not only is it vulnerable to early environmental influences, but could also offers a window of potential intervention," said Sloboda, professor of biochemistry and biomedical sciences at McMaster and the Canada Research Chair in perinatal programming.

"While many of the exact mechanisms surrounding gut bacteria and their role in our early development is unclear, discovering when and how we are colonized is a key first step."

https://www.sciencedaily.com/releases/2021/05/210510133138.htm

Vegetarians have healthier levels of disease markers than meat-eaters

May 9, 2021

Science Daily/European Association for the Study of Obesity

Vegetarians appear to have a healthier biomarker profile than meat-eaters, and this applies to adults of any age and weight, and is also unaffected by smoking and alcohol consumption, according to a new study in over 166,000 UK adults, being presented at this week's European Congress on Obesity (ECO), held online this year.

Biomarkers can have bad and good health effects, promoting or preventing cancer, cardiovascular and age-related diseases, and other chronic conditions, and have been widely used to assess the effect of diets on health. However, evidence of the metabolic benefits associated with being vegetarian is unclear.

To understand whether dietary choice can make a difference to the levels of disease markers in blood and urine, researchers from the University of Glasgow did a cross-sectional study analysing data from 177,723 healthy participants (aged 37-73 years) in the UK Biobank study, who reported no major changes in diet over the last five years.

Participants were categorised as either vegetarian (do not eat red meat, poultry or fish; 4,111 participants) or meat-eaters (166,516 participants) according to their self-reported diet. The researchers examined the association with 19 blood and urine biomarkers related to diabetes, cardiovascular diseases, cancer, liver, bone and joint health, and kidney function.

Even after accounting for potentially influential factors including age, sex, education, ethnicity, obesity, smoking, and alcohol intake, the analysis found that compared to meat-eaters, vegetarians had significantly lower levels of 13 biomarkers, including: total cholesterol; low-density lipoprotein (LDL) cholesterol -- the so-called 'bad cholesterol; apolipoprotein A (linked to cardiovascular disease), apolipoprotein B (linked to cardiovascular disease); gamma-glutamyl transferase (GGT) and alanine aminotransferase (AST) -- liver function markers indicating inflammation or damage to cells; insulin-like growth factor (IGF-1; a hormone that encourages the growth and proliferation of cancer cells); urate; total protein; and creatinine (marker of worsening kidney function).

However, vegetarians also had lower levels of beneficial biomarkers including high-density lipoprotein 'good' (HDL) cholesterol, and vitamin D and calcium (linked to bone and joint health). In addition, they had significantly higher level of fats (triglycerides) in the blood and cystatin-C (suggesting a poorer kidney condition).

No link was found for blood sugar levels (HbA1c), systolic blood pressure, aspartate aminotransferase (AST; a marker of damage to liver cells) or C-reactive protein (CRP; inflammatory marker).

"Our findings offer real food for thought," says Dr Carlos Celis-Morales from the University of Glasgow, UK, who led the research. "As well as not eating red and processed meat which have been linked to heart diseases and some cancers, people who follow a vegetarian diet tend to consume more vegetables, fruits, and nuts which contain more nutrients, fibre, and other potentially beneficial compounds. These nutritional differences may help explain why vegetarians appear to have lower levels of disease biomarkers that can lead to cell damage and chronic disease."

The authors point out that although their study was large, it was observational, so no conclusions can be drawn about direct cause and effect. They also note several limitations including that they only tested biomarker samples once for each participant, and it is possible that biomarkers might fluctuate depending on factors unrelated to diet, such as existing diseases and unmeasured lifestyle factors. They also note that were reliant on participants to report their dietary intake using food frequency questionnaires, which is not always reliable.

https://www.sciencedaily.com/releases/2021/05/210509153814.htm

Sleep disorders tally $94.9 billion in health care costs each year

May 7, 2021

Science Daily/Massachusetts Eye and Ear Infirmary

Sleep disorders are associated with significantly higher rates of health care utilization, conservatively placing an additional $94.9 billion in costs each year to the United States health care system, according to a new study from researchers at Mass Eye and Ear, a member hospital of Mass General Brigham.

In their new analysis, published in the Journal of Clinical Sleep Medicine, the researchers found the number of medical visits and prescriptions filled were nearly doubled in people with sleep disorders such as sleep apnea and insomnia, compared to similar people without. Affected patients were also more likely to visit the emergency department and have more comorbid medical conditions.

Costly medical care for sleep disorder patients 

The researchers sought out to determine the true diagnostic prevalence of sleep disorders and how expensive these conditions were to the health care system. They examined differences in health expenditures in similar patients with and without a sleep disorder diagnosis, as determined by their ICD-10 diagnosis code. The study included data from a nationally-representative survey of more than 22,000 Americans called the 2018 Medical Expenditure Panel Survey, which is administered by the Department of Health and Human Services' Agency for Healthcare Research and Quality.

They found 5.6 percent of respondents had at least one sleep disorder, which translated to an estimated 13.6 million U.S. adults. This likely represents a significant underestimate, according to the authors, as insomnia alone is felt to conservatively affect 10 to 20 percent of the population. These individuals accumulated approximately $7,000 more in overall health care expenses per year compared to those without a sleep disorder -- about 60 percent more in annual costs. This equates to a conservative estimate of $94.9 billion in health care costs per year attributable to sleep disorders.

The analysis revealed that patients with sleep disorders attended more than 16 office visits and nearly 40 medication prescriptions per year, compared to nearly 9 visits and 22 prescriptions for those without a sleep disorder. The study did not quantify non-health care related costs, but the authors noted it can be assumed that more doctors' appointments means more time off from work, school or other social obligations, not to mention decreased productivity associated with symptoms, only exacerbating costs to society.

Sleep disorders raise risk for other conditions 

Sleep disorders can take a toll on health and quality of life in numerous ways. Individuals with certain sleep disorders experience decrease daytime functionality related to sleepiness, mental fog and an increased risk of motor vehicle accidents, for instance. Obstructive sleep apnea is one of the most common sleep disorders and if untreated, can increase risk for neurocognitive issues, such as difficulty concentrating and mood disorders, as well as cardiovascular conditions including heart attacks, strokes, high blood pressure and irregular heart rhythms.

Getting a proper diagnosis at the sign of asleep problem can lead to an effective treatment for a sleep disorder.

"Fortunately, studies have demonstrated that treating certain sleep disorders effectively reduces health care utilization and costs. Therefore, sleep issues should not be ignored. Greater recognition of sleep disorders and an early referral to a sleep specialist are essential," said Dr. Huyett. "Your sleep is important, and if there's an issue with your sleep, seek help for it."

https://www.sciencedaily.com/releases/2021/05/210507160008.htm

New evidence links gut bacteria and neurodegenerative conditions

May 6, 2021

Science Daily/University of Florida

Neurodegenerative diseases such as Alzheimer's, Parkinson's and ALS affect millions of adults, but scientists still do not know what causes these diseases, which poses a significant roadblock to developing treatments or preventative measures.

Recent research suggests that people with these conditions exhibit changes in the bacterial composition of their digestive tract. However, given the vast diversity of microbes found in the human body, identifying which bacteria may be associated with neurodegeneration is like finding a needle in a haystack.

Seeking that proverbial needle, scientists at the University of Florida are looking in an unexpected place: the digestive tract of a tiny, translucent worm called Caenorhabditis elegans.

New research published in PLOS Pathogens establishes, for the first time, a link between specific bacteria species and physical manifestations of neurodegenerative diseases. The study's lead author is Alyssa Walker, a microbiology and cell science doctoral candidate in the UF/IFAS College of Agricultural and Life Sciences.

"Looking at the microbiome is a relatively new approach to investigating what causes neurodegenerative diseases. In this study, we were able to show that specific species of bacteria play a role in the development of these conditions," said Daniel Czyz, Walker's dissertation advisor.

Czyz is the senior author of the study and an assistant professor in the UF/IFAS department of microbiology and cell science.

"We also showed that some other bacteria produce compounds that counteract these 'bad' bacteria. Recent studies have shown that patients with Parkinson's and Alzheimer's disease are deficient in these 'good' bacteria, so our findings may help explain that connection and open up an area of future study," he added.

All neurodegenerative diseases can be traced to problems with the way proteins are handled in the body. If proteins are misfolded, they build up and accumulate in tissues. These protein aggregates, as scientists call them, interfere with cell functioning and lead to neurodegenerative disorders.

Czyz and his co-authors wanted to know if introducing certain bacteria into the C. elegans worms would be followed by protein aggregation in the worms' tissues.

"That is, in fact, what we observed. We have a way of marking the aggregates so they glow green under the microscope. We saw that worms colonized by certain bacteria species were lit up with aggregates that were toxic to tissues, while those colonized by the control bacteria were not," Czyz said. "This occurred not just in the intestinal tissues, where the bacteria are, but all over the worms' bodies, in their muscles, nerves and even reproductive organs."

Surprisingly, the offspring of affected worms also showed increased protein aggregation -- even though these offspring never encountered the bacteria originally associated with the condition.

"This is very interesting because it suggests that these bacteria generate some sort of a signal that can be passed along to the next generation," Czyz said.

Worms colonized by the "bad" bacteria also lost mobility, a common symptom of neurodegenerative diseases.

"A healthy worm moves around by rolling and thrashing. When you pick up a healthy worm, it will roll off the pick, a simple device that we use to handle these tiny animals. But worms with the bad bacteria couldn't do that because of the appearance of toxic protein aggregates," explained Walker, who developed this assessment method.

"You could compare the pick to an obstacle course: just as a person with a neurodegenerative disease will have trouble getting across, the same is true with these worms, just at a much smaller scale," Czyz added.

Fun fact: Human eyebrow hairs or eyelashes make for very good picks.

"The worms are very delicate, so you need a tool that won't damage them. They are also transparent and have a simple body plan. Studies like ours are possible because these worms normally feed on bacteria," Czyz said.

"The worms are only one millimeter long, and they each have exactly 959 cells," Czyz said. "But in many ways, they are a lot like us humans -- they have intestines and muscles and nerves, but instead of being composed of billions of cells, each organ is just a handful of cells. They are like living test tubes. Their small size allows us to do experiments in a much more controlled way and answer important questions we can apply in future experiments with higher organisms and, eventually, people."

Currently the Czyz lab is testing hundreds of strains of bacteria found in the human gut to see how they affect protein aggregation in C. elegans. The group is also investigating how bacteria associated with neurodegeneration cause protein misfolding at the molecular level.

Czyz is also interested in possible connections between antibiotic-resistant bacteria and protein misfolding.

"Almost all of the bacteria we found associated with protein misfolding are also associated with antibiotic-resistant infections in people. However, it will take many more years of research before we can understand what, if any, connection there is between antibiotic resistance and neurodegenerative diseases," Czyz said.

https://www.sciencedaily.com/releases/2021/05/210506142109.htm

Secret behind maintaining a healthy weight loss

May 6, 2021

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

Half of the Danish population have overweight, while 17 percent live with obesity. Worldwide, almost 40 procent have overweight and 13 procent live with obesity.

The condition is associated with increased risk for early death, as well as sequelae such as Type 2 diabetes, cardiovascular diseases, cancer, and infertility.

Weight regain after an initial successful weight loss in people with obesity, constitutes an important and unsolved problem. Until now, no well-documented study on which treatment method is best for maintaining a healthy weight loss has been available.

Researchers at University of Copenhagen and Hvidovre Hospital have completed a new, sensational study, which is being published in the world's most quoted medical journal, The New England Journal of Medicine. By testing four different types of treatment following a diet-induced weight loss, the researchers demonstrate for the first time how it is possible for people with obesity to maintain long-term weight loss, says Professor Signe Torekov at the Department of Biomedical Sciences.

In a randomized clinical trial, the group of researchers has demonstrated a highly effective treatment after a diet-induced weight loss, by combining moderate to vigorous-intensive exercise with appetite-inhibiting obesity medication, an analogue to the appetite-inhibiting hormone GLP-1.

"This is new knowledge for doctors, dietitians and physical therapists to use in practice. This is evidence that we have been missing," explains Signe Torekov, who has been heading the study.

"The problem is that people are fighting against strong biological forces when losing weight. The appetite increases simultaneously with decreased energy consumption, and this counteracts weight loss maintenance. We have an appetite-stimulating hormone, which increases dramatically when we lose weight, and simultaneously the level of appetite-suppressing hormones drops dramatically. In addition, a weight loss can provoke loss of muscle mass, while the body reduces the energy consumption. Thus, when the focus in obesity treatment has been on how to obtain a weight loss -- rather than how to maintain a weight loss -- it is really difficult to do something about your situation," says Signe Torekov.

Highly efficient when combining treatments

215 Danes with obesity and low fitness ratings participated in the study. The participants initially followed a low calorie diet over eight weeks, where they each lost approximately 13 kg, which brought significant improvements to their health with a drop in blood sugar level and blood pressure.

The participants were then randomly divided into four groups. Two of the groups received placebo medication, while the two other groups received obesity medication. Among the two placebo groups, one group followed an exercise program of minimum 150 minutes of physical activity at moderate intensity or 75 minutes at vigorous-intensity during the week or a combination of the two, while the other group maintained their current level of physical activity. The two groups receiving obesity medication were similarly divided into one group with and one group without an exercise program.

All participants in the study were weighed monthly and received nutritional and diet counseling with the focus on healthy weight loss according to the guidelines from the Danish health and food administrations.

After one year, the group with exercise alone and the group with obesity medication alone maintained the weight loss of 13 kg and health improvements. The placebo group gained half of the weight back with deterioration of all risk factors, for example for development of Type 2 diabetes and cardiovascular disease.

The most dramatic improvements occurred in the combination group, which followed the exercise program and received obesity medication. The researchers observed additional weight loss in this group, and the total weight loss was approximately 16 kg over one year. The health benefits were also double that of each of the single treatments, i.e., twice the loss of fat mass while preserving muscle mass, higher fitness ratings, reduced blood sugar and improved quality of life.

The two groups that exercised increased their fitness rating, lost fat mass, and gained muscle mass. This could indicate a healthier weight loss than for people, who had only lost fat mass without increasing the fitness rating.

"It is an important aspect to highlight, as you do not necessarily get a healthier body from losing weight if, at the same time, you lose a lot of muscle mass," says Signe Torekov.

"It is great news for public health that a significant weight loss can be maintained with exercise for approximately 115 minute per week performed mostly at vigorous-intensity, such as cycling. And that by combining exercise with obesity medication, the effect is twice as good as each of the individual treatments." "

With the study, the researchers now hope people with obesity, together with their care provider, can create a useful framework for maintaining the weight loss.

Fundamental lifestyle change

Signe Torekov points out that many people with obesity have tried to lose weight before, only to regain the weight. This happens, because the general advice is to eat healthier and exercise more.

"Without a follow-up on whether people actually have support to perform exercise, the treatment will not be enough. Therefore, we also followed up with the participants on an ongoing basis to ensure that they received the support they needed in order to exercise. That is necessary, because maintaining weight loss is extremely hard. People need to understand this. Once you have lost weight, you are not "cured." "The ongoing exercise and effort will likely need to continue for many years," says Signe Torekov.

"Our study also demonstrates that without a structured treatment plan, there is a high risk of gaining the weight back. There were 12 individual consultations over the course of a year, including weighing and diet advice from Danish authorities according to guidelines for healthy weight maintenance. This was just not enough for the placebo group without exercise program, in this group all health benefits gained by weight loss during the eight week program were gone after one year, despite frequent weighing and diet and nutritional counseling based on official guidelines." Torekov says.

According to Signe Torekov, this underscores the importance of participating in a mutual weight maintenance program based on feedback when starting a weight loss programme.

"Therefore, it is important that there is a system for supporting people with obesity in maintaining the lifestyle change. Our study can help with this, because we can say this actually works to doctors, dietitians and municipalities, if they create a structured, joint treatment plan with the individual using ongoing follow-ups," says Torekov.

https://www.sciencedaily.com/releases/2021/05/210506105344.htm

Salad or cheeseburger? Your co-workers shape your food choices

April 22, 2021

Science Daily/Massachusetts General Hospital

Employees' cafeteria purchases -- both healthy and unhealthy foods -- were influenced by their co-workers' food choices, found a large, two-year study of hospital employees. The study made innovative use of cash register data to gain insights into how individuals' social networks shape their health behavior. The research suggests we might structure future efforts aimed at improving population health by capitalizing on how one person's behavior influences another.

The foods people buy at a workplace cafeteria may not always be chosen to satisfy an individual craving or taste for a particular food. When co-workers are eating together, individuals are more likely to select foods that are as healthy -- or unhealthy -- as the food selections on their fellow employees' trays. "We found that individuals tend to mirror the food choices of others in their social circles, which may explain one way obesity spreads through social networks," says Douglas Levy, PhD, an investigator at the Mongan Institute Health Policy Research Center at Massachusetts General Hospital (MGH) and first author of new research published in Nature Human Behaviour. Levy and his co-investigators discovered that individuals' eating patterns can be shaped even by casual acquaintances, evidence that corroborates several multi-decade observational studies showing the influence of people's social ties on weight gain, alcohol consumption and eating behavior.

Previous research on social influence upon food choice had been primarily limited to highly controlled settings like studies of college students eating a single meal together, making it difficult to generalize findings to other age groups and to real-world environments. The study by Levy and his co-authors examined the cumulative social influence of food choices among approximately 6,000 MGH employees of diverse ages and socioeconomic status as they ate at the hospital system's seven cafeterias over two years. The healthfulness of employees' food purchases was determined using the hospital cafeterias' "traffic light" labeling system designating all food and beverages as green (healthy), yellow (less healthy) or red (unhealthy).

MGH employees may use their ID cards to pay at the hospitals' cafeterias, which allowed the researchers to collect data on individuals' specific food purchases, and when and where they purchased the food. The researchers inferred the participants' social networks by examining how many minutes apart two people made food purchases, how often those two people ate at the same time over many weeks, and whether two people visited a different cafeteria at the same time. "Two people who make purchases within two minutes of each other, for example, are more likely to know each other than those who make purchases 30 minutes apart," says Levy. And to validate the social network model, the researchers surveyed more than 1,000 employees, asking them to confirm the names of the people the investigators had identified as their dining partners.

"A novel aspect of our study was to combine complementary types of data and to borrow tools from social network analysis to examine how the eating behaviors of a large group of employees were socially connected over a long period of time," says co-author Mark Pachucki, PhD, associate professor of Sociology at the University of Massachusetts, Amherst.

Based on cross-sectional and longitudinal assessments of three million encounters between pairs of employees making cafeteria purchases together, the researchers found that food purchases by people who were connected to each other were consistently more alike than they were different. "The effect size was a bit stronger for healthy foods than for unhealthy foods," says Levy.

A key component of the research was to determine whether social networks truly influence eating behavior, or whether people with similar lifestyles and food preferences are more likely to become friends and eat together, a phenomenon known as homophily. "We controlled for characteristics that people had in common and analyzed the data from numerous perspectives, consistently finding results that supported social influence rather than homophily explanations," says Levy.

Why do people who are socially connected choose similar foods? Peer pressure is one explanation. "People may change their behavior to cement the relationship with someone in their social circle," says Levy. Co-workers may also implicitly or explicitly give each other license to choose unhealthy foods or exert pressure to make a healthier choice.

The study's findings have several broader implications for public health interventions to prevent obesity. One option may be to target pairs of people making food choices and offer two-for-one sales on salads and other healthful foods but no discounts on cheeseburgers. Another approach might be to have an influential person in a particular social circle model more healthful food choices, which will affect others in the network. The research also demonstrates to policymakers that an intervention that improves healthy eating in a particular group will also be of value to individuals socially connected to that group.

"As we emerge from the pandemic and transition back to in-person work, we have an opportunity to eat together in a more healthful way than we did before," says Pachucki. "If your eating habits shape how your co-workers eat -- even just a little -- then changing your food choices for the better might benefit your co-workers as well."

https://www.sciencedaily.com/releases/2021/04/210422150341.htm

Meditative practice and spiritual wellbeing may preserve cognitive function in aging

May 11, 2021

Science Daily/IOS Press

It is projected that up to 152 million people worldwide will be living with Alzheimer's disease (AD) by 2050. To date there are no drugs that have a substantial positive impact on either the prevention or reversal of cognitive decline. A growing body of evidence finds that targeting lifestyle and vascular risk factors have a beneficial effect on overall cognitive performance. A new review in the Journal of Alzheimer's Disease, published by IOS Press, examines research that finds spiritual fitness, a new concept in medicine that centers on psychological and spiritual wellbeing, and Kirtan Kriya, a simple 12-minute meditative practice, may reduce multiple risk factors for AD.

"The key point of this review is that making a commitment to a brain longevity lifestyle, including spiritual fitness, is a critically important way for aging Alzheimer's disease free," explain authors Dharma Singh Khalsa, MD, Alzheimer's Research and Prevention Foundation, Tucson, AZ, USA, and Andrew B. Newberg, MD, Department of Integrative Medicine and Nutritional Sciences, Department of Radiology, Marcus Institute of Integrative Health, Thomas Jefferson University, Philadelphia, PA, USA. "We hope this article will inspire scientists, clinicians, and patients to embrace this new concept of spiritual fitness and make it a part of every multidomain program for the prevention of cognitive disability."

Research reveals that religious and spiritual involvement can preserve cognitive function as we age. The authors observe that today, spirituality is often experienced outside the context of an organized religion and may be part of every religion or separate to it. Spiritual fitness is a new dimension in AD prevention, interweaving basic, psychological and spiritual wellbeing. The authors discuss the research on how these factors affect brain function and cognition. For example, psychological wellbeing may reduce inflammation, cardiovascular disease, and disability. Significantly, individuals who have a high score on a "purpose in life" (PIL) measure, a component of psychological wellbeing, were 2.4 times more likely to remain free of AD than individuals with low PIL. In another study, participants who reported higher levels of PIL exhibited better cognitive function, and further, PIL protected those with already existing pathological conditions, thus slowing their decline.

Stress and stress management are under-discussed topics in AD prevention, yet the authors point out that there is ample evidence that physical, psychological, and emotional effects of stress may elevate AD risk. Kirtan Kriya (KK) is a 12-minute singing meditation that involves four sounds, breathing, and repetitive finger movements. It has multiple documented effects on stress, such as improving sleep, decreasing depression, and increasing wellbeing. It has also been found to increase blood flow to areas of the brain involved in cognition and emotional regulation and increases grey matter volume and decreases ventricular size in long-term practitioners, which may slow brain aging. Research in healthy individuals, caregivers, and those with cognitive decline found that the practice improves cognition, slows memory loss, and improves mood.

The overall relationship between spiritual fitness and a person's complete physical and mental health is a topic of investigation in the emerging field of study called neurotheology. Early work has focused on the development of models regarding which brain areas are affected through spiritual practices such as meditation or prayer. Over the last 20 years, there has been an extensive growth in neuroimaging and other physiological studies evaluating the effect of meditation, spiritual practices, and mystical experiences. A neuroimaging study of KK found long term brain effects, during meditation and afterwards. Neurotheological studies can help understanding of how a practice such as KK can lead to more permanent effects in brain function that support spiritual fitness, according to Dr. Khalsa and Dr. Newberg.

"Mitigating the extensive negative biochemical effects of stress with meditation practices, in tandem with the creation of heightened levels of spiritual fitness, may help lower the risk of AD. Small shifts in one's daily routine can make all the difference in AD prevention," Dr. Khalsa and Dr. Newberg conclude. "We are optimistic this article will inspire future research on the topic of spiritual fitness and AD."

https://www.sciencedaily.com/releases/2021/05/210511123727.htm

Alzheimer's study: A Mediterranean diet might protect against memory loss and dementia

May 6, 2021

Science Daily/DZNE - German Center for Neurodegenerative Diseases

In Alzheimer's disease, neurons in the brain die. Largely responsible for the death of neurons are certain protein deposits in the brains of affected individuals: So-called beta-amyloid proteins, which form clumps (plaques) between neurons, and tau proteins, which stick together the inside of neurons. The causes of these deposits are as yet unclear. In addition, a rapidly progressive atrophy, i.e. a shrinking of the brain volume, can be observed in affected persons. Alzheimer's symptoms such as memory loss, disorientation, agitation and challenging behavior are the consequences.

Scientists at the DZNE led by Prof. Michael Wagner, head of a research group at the DZNE and senior psychologist at the memory clinic of the University Hospital Bonn, have now found in a study that a regular Mediterranean-like dietary pattern with relatively more intake of vegetables, legumes, fruit, cereals, fish and monounsaturated fatty acids, such as from olive oil, may protect against protein deposits in the brain and brain atrophy. This diet has a low intake of dairy products, red meat and saturated fatty acids.

A total of 512 subjects with an average age of around seventy years took part in the study. 169 of them were cognitively healthy, while 343 were identified as having a higher risk of developing Alzheimer's disease -- due to subjective memory impairment, mild cognitive impairment that is the precursor to dementia, or first-degree relationship with patients diagnosed with Alzheimer's disease. The nutrition study was funded by the Diet-Body-Brain competence cluster of the German Federal Ministry of Education and Research (BMBF) and took place as part of the so-called DELCODE study of the DZNE, which does nationwide research on the early phase of Alzheimer's disease -- that period before pronounced symptoms appear.

"People in the second half of life have constant eating habits. We analyzed whether the study participants regularly eat a Mediterranean diet -- and whether this might have an impact on brain health ," said Prof. Michael Wagner. The participants first filled out a questionnaire in which they indicated which portions of 148 different foods they had eaten in the past months. Those who frequently ate healthy foods typical of the Mediterranean diet, such as fish, vegetables and fruit, and only occasionally consumed foods such as red meat, scored highly on a scale.

An extensive test series

The scientists then investigated brain atrophy: they performed brain scans with magnetic resonance imaging (MRI) scanners to determine brain volume. In addition, all subjects underwent various neuropsychological tests in which cognitive abilities such as memory functions were examined. The research team also looked at biomarker levels (measured values) for amyloid beta proteins and tau proteins in the so-called cerebrospinal fluid (CSF) of 226 subjects.

The researchers, led by Michael Wagner, found that those who ate an unhealthy diet had more pathological levels of these biomarkers in the cerebrospinal fluid than those who regularly ate a Mediterranean-like diet. In the memory tests, the participants who did not adhere to the Mediterranean diet also performed worse than those who regularly ate fish and vegetables. "There was also a significant positive correlation between a closer adherence to a Mediterranean-like diet and a higher volume of the hippocampus. The hippocampus is an area of the brain that is considered the control center of memory. It shrinks early and severely in Alzheimer's disease," explained Tommaso Ballarini, PhD, postdoctoral fellow in Michael Wagner's research group and lead author of the study.

Continuation of nutrition study is planned

"It is possible that the Mediterranean diet protects the brain from protein deposits and brain atrophy that can cause memory loss and dementia. Our study hints at this," Ballarini said. "But the biological mechanism underlying this will have to be clarified in future studies." As a next step, Ballarini and Wagner now plan to re-examine the same study participants in four to five years to explore how their nutrition -- Mediterranean-like or unhealthy -- affects brain aging over time.

https://www.sciencedaily.com/releases/2021/05/210506105355.htm

Chronic exposure to low levels of blast may be associated with neurotrauma

Exposure during occupational training is linked to biomarkers of brain damage

May 4, 2021

Science Daily/Walter Reed Army Institute of Research

Scientists at the Walter Reed Army Institute for Research demonstrated that biomarkers associated with traumatic brain injury were elevated among law enforcement and military personnel, particularly in active duty participants with longer duration of service. Most notably, these elevated biomarker levels were observed in individuals without a diagnosed brain injury or concussion.

Some law enforcement and military personnel are regularly exposed to low levels of blast, particularly during training, due to the use of explosive charges and high caliber weapons. Understanding effects from these occupational exposures is a military health care priority to improve diagnosis and mitigation of ill effects.

While repeated exposure to low level blast is not known to result in clinically diagnosed traumatic brain injury, exposures have been linked to a series of reported symptoms such as headaches, fatigue, dizziness, memory difficulties, and tinnitus (ringing in the ears) -- collectively referred to as "breacher's brain" among members of affected communities.

This study, published in the Journal of the American Medical Association, measured neurotrauma biomarker concentrations in blood samples from 106 military and law enforcement personnel who were not actively engaged in training or physical activity at the time of blood collection and compared those concentrations with commercially available samples from individuals who were similar in sex and age but unlikely to have been exposed to blast.

"We found that five biomarkers previously associated with TBI and brain diseases were elevated among personnel when compared to controls," said Dr. Angela Boutte, lead author on the paper and a researcher at the WRAIR Brain Trauma Neuroprotection branch. "Given the difficulty of identifying and evaluating injury associated with repeated low level blast exposure, we hope these data are the first step in our collective goal to identify objective biomarkers as clinically relevant diagnostic tools."

Dr. Bharani Thangavelu and Dr. Walter Carr, WRAIR brain health researchers and co-authors, emphasized the potential impact of blast exposure experienced by military personnel stating, "Low level blast exposure in routine military training should not be expected to result in acute, gross behavioral deficits for the majority of personnel. However, repeated exposure across years does correlate with symptomology, especially when a history of chronic exposure is exacerbated by new, large magnitude exposures."

Efforts to identify and quantify the impact of blast and traumatic brain injury on Service Members have increased dramatically in recent years, including initiatives in response to Congressional mandates. Biomarkers of blast effects on brain health will be a useful tool in this effort, especially as tools that augment decision-making based on symptoms reported by personnel.

https://www.sciencedaily.com/releases/2021/05/210504112644.htm

A third of kids develop a mental health problem after concussion

April 29, 2021

Science Daily/Murdoch Children’s Research Institute

A third of children and adolescents develop a mental health problem after a concussion, which could persist for several years post-injury, according to a new literature review.

The research, led by the Murdoch Children's Research Institute (MCRI) and published in the British Journal of Sports Medicine, found mental health should be evaluated as part of standard pediatric concussion assessment and management.

MCRI researcher and Monash University PhD candidate Alice Gornall said despite many post-concussion and mental health symptoms overlapping, the relationship between delayed recovery and mental health had remained poorly understood until this literature review.

The review of 69 articles published between 1980 to June 2020, involved almost 90,000 children, aged 0-18 years, from nine countries including Australia, US, Canada and New Zealand, who had a concussion. Falls (42.3 per cent) and sporting injuries (29.5 per cent) were the most common cause of injury, followed by car accidents (15.5 per cent).

It found up to 36.7 per cent experienced significantly high levels of internalising problems such as withdrawing, anxiety, depression and post-traumatic stress and 20 per cent externalising problems such as aggression, attention problems and hyperactivity after concussion compared with healthy children or children who sustained other injuries such as an arm fracture.

Pre-existing mental health problems were a strong predictor of post-concussion mental health issues. The review stated 29 per cent of children with a pre-injury mental health diagnoses received a new mental health diagnosis post-concussion. Up to 26 per cent without prior mental health problems went onto develop symptoms.

Ms Gornall said while significant improvements in mental health emerged between three and six months post-injury, a minority of children experienced persisting symptoms for several years afterwards.

The findings come after a recent study, led by MCRI and published in The Journal of Head Trauma Rehabilitation, found having a traumatic brain injury in early childhood was associated with lower IQ scores that persist up to seven years post-injury.

Ms Gornall said concussion was a growing public health concern with a third of children experiencing a head injury before 13 years of age.

"Despite the high incidence of concussion among children and adolescents, identifying those at risk of ongoing difficulties after concussion remains a prominent challenge for clinicians," she said.

"On top of this, children take twice as long to recover from concussion than adults, with one in four children experiencing symptoms beyond one-month post-injury."

Melbourne resident Emma, 17, has been seeking mental health support after suffering two concussions, a year apart.

In 2019 while playing netball she knocked her head on a goal post and last March she was hit with a ball in the back of the head.

Emma said after the second concussion she developed anxiety, headaches, a sense of hopelessness and had trouble concentrating.

"After my last concussion I found it very hard to be motivated for school and everyday life. Doing the simplest of tasks such as a walk was difficult for me, not being able to complete these tasks got me quite disheartened which impacted on my mental health," she said.

Emma's dad Bruce Henry said he welcomed the push for mental health to be part of paediatric concussion assessment and management as many cases would be going untreated.

"When a child has a concussion they might look fine but you can't see the underlying impact," he said. It's so important for mental health to form part of concussion management, which has been essential to Emma's recovery process."

MCRI researchers are also trialling an intervention, Concussion Essentials, to prevent children suffering long term post-concussion symptoms.

The eight session intervention combines physiotherapy and psychology treatments that target presenting symptoms with education around common concerns such as headache, fatigue and return to exercise, school and sports. Early data shows that the intervention is effective in accelerating recovery.

MCRI Professor Vicki Anderson said assessment, prevention and intervention of mental health difficulties after concussion should be integrated into standard concussion management.

"Mental health is central to concussion recovery. Concussion may both precipitate and exacerbate mental health difficulties, impacting delayed recovery and psychosocial outcomes," she said.

"Incorporating mental health risk into post-injury management represents an opportunity to engage children and adolescents with mental health services to either prevent unnecessary problems emerging or to treat already existing issues."

Developed by world-leading concussion experts at MCRI and The Royal Children's Hospital and in collaboration with the AFL, the HeadCheck app also helps parents, coaches and first aiders to recognise the signs of concussion and manage the child's safe return to school, play and organised sport.

https://www.sciencedaily.com/releases/2021/04/210429142621.htm

Brain changes following traumatic brain injury share similarities with Alzheimer's disease

Using MRIs and machine learning, researchers mapped comparable degenerative changes in gray and white matter of the brain

April 26, 2021

Science Daily/University of Southern California

Brain changes in people with Alzheimer's disease and in those with mild traumatic brain injuries (TBIs) have significant similarities, a new USC study shows, suggesting new ways to identify patients at high risk for Alzheimer's. The findings appear this week in GeroScience.

TBIs, which affect over 1.7 million Americans every year, are often followed by changes in brain structure and function and by cognitive problems such as memory deficits, impaired social function and difficulty with decision-making. Although mild TBI -- also known as concussion -- is a known risk factor for Alzheimer's disease, prior studies haven't quantified the extent to which these conditions share patterns of neural degeneration in the brain.

USC researchers hypothesized that comparing these patterns could reveal not only how the degenerative trajectories of the two conditions are similar but also which features of brain atrophy could predict Alzheimer's risk after TBI.

The study included 33 study participants with TBIs due to a fall, another 66 participants who had been diagnosed with Alzheimer's disease and 81 healthy control participants without either TBI or Alzheimer's. The researchers analyzed MRIs of the patients' brains and created additional computer-generated models to compare dozens of different brain structures, ultimately mapping similarities and differences between the three different groups.

In multiple brain areas of both TBI and Alzheimer's participants, the researchers found reduced cortical thickness when compared to the healthy controls. Cortical thickness is roughly correlated with brain age and its thinning is often associated with reductions in attention, memory and verbal fluency, as well as with decreased ability to make decisions, integrate new information and adapt one's behavior to new situations, among other deficits.

"These findings are the first to suggest that cognitive impairment following a traumatic brain injury is useful for predicting the magnitude of Alzheimer's-like brain degradation," said study author Andrei Irimia, an assistant professor of gerontology, neuroscience and biomedical engineering at the USC Leonard Davis School of Gerontology and the USC Viterbi School of Engineering. "The results may help health professionals to identify TBI victims who are at greater risk for Alzheimer's disease."

Using MRIs, the study identified significant similarities between TBI and Alzheimer's disease in how the brain's gray and white matter degrade after injury. In gray matter -- the part of the brain that contains neuron cell bodies and their short-range connections -- the most extensive similarities were in areas involved in memory (temporal lobes) and decision-making (orbitofrontal cortices).

In white matter -- which connects different brain regions and allows their neurons to communicate across longer distances -- the researchers found comparable degeneration patterns in structures such as the fornix, corpus callosum and corona radiata. Whereas the fornix is involved in memory function, the corpus callosum facilitates information exchange between brain hemispheres. The corona radiata is involved in limb movement, and its injury can lead to poorer coordination and balance.

The scientists also used machine learning techniques to accurately predict the severity of Alzheimer's-like brain changes observed during the chronic stage of mild TBI based on cognitive assessments conducted shortly after such injuries.

At least 15% of Americans have a history of TBI. Chronic TBI effects on cognitive function may be particularly severe in older people, who are approximately three times more likely to sustain a TBI than other age groups.

Studies of TBI effects on brain structure have identified both amyloid plaques and neurofibrillary tangles -- twisted fibers found inside the brain's cells -- which resemble those observed in Alzheimer's disease. Despite this evidence, the study authors said, few studies have investigated whether TBI can alter brain trajectories toward Alzheimer's, particularly at older ages.

The new findings do not establish a cause-and-effect relationship between TBI and Alzheimer's disease but do add to the evidence that the two conditions share common trajectories, researchers said. The study, which was co-authored by USC alumnus Kenneth Rostowsky, is a follow-up to the team's earlier study outlining TBI-related changes in brain function.

https://www.sciencedaily.com/releases/2021/04/210426140732.htm