December 21, 2005

Pain and The Brain

Chronic pain sufferers may be able to reduce pain levels by studying their own live brain images, scientists at the Stanford University School of Medicine report in a new study.

With training and the use of high-tech imaging equipment, subjects were able to influence their pain by controlling activity in one of the pain centers of the brain through the use of mental exercises and by visualizing their own brain activity in real time.

Compare it to exercising your muscles in a top-of-the-line weight room. After repeated practice, you get better at it.

The researchers are hopeful the new technique may have potential for future use as long-term therapy for chronic pain patients-possibly even without all the high-tech equipment. They caution that significantly more work is needed before it can be thought of as a clinical therapy.

"We believe these subjects and patients really learned to control their brain and, through that, their pain," said Sean Mackey, MD, PhD, assistant professor of anesthesia and co-author of the study would be published in the Dec. 12 online issue of the Proceedings of the National Academy of Sciences.

The study posed two questions: "Can healthy subjects and patients with chronic pain learn to control activity in specific regions of their brain? And, in doing so, does this lead to an improved control of their pain?" The answer to both was a resounding "Yes." A second, larger study is under way to test the potential for long-term use in future treatment.

"Pain has a huge impact on individual patients, their families and society," said Mackey, who is also associate director of Stanford's pain management division. A recent national survey showed that more than half of all Americans suffer from chronic pain. "I got incredibly jazzed by the results [of the imaging study]," Mackey added. "We could change people's lives. However, significantly more science and testing must be done before this can be considered a therapy for chronic pain".........

Daniel      Permalink


December 19, 2005

Stress impairs Human Body's Ability To Heal

The stress a typical married couple feels during an ordinary half-hour argument is enough to slow their bodies' ability to heal from wounds by at least one day, a new study has shown.

Moreover, if the couple's relationship is routinely hostile toward each other, the delay in that healing process can be even doubled. The results of this study have major financial implications for medical centers and health care insurers.

The new study, reported in the current issue of the Archives of General Psychiatry, is the latest discovery in a three-decade-long series of experiments underway at the Ohio State University 's Institute for Behavioral Medicine Research. The work is aimed at identifying and then explaining the ways psychological stress can affect human immunity.

Jan Kiecolt-Glaser, a professor of psychiatry and psychology, and partner Ronald Glaser, a professor of molecular virology, immunology and medical genetics, both at Ohio State, say the findings provide important recommendations for patients facing surgery.

"This shows specifically why it is so important that people be psychologically prepared for their surgeries," Kiecolt-Glaser explained.

Colleague Glaser added, "We have enough data now from all of our past studies to basically suggest that hospitals need to modify existing practices in ways that will reduce stress previous to surgery." Both scientists said such stress reduction could lead to shorter hospital stays -- with corresponding lower medical bills -- and a reduced risk of infections among patients.

The scientists focused on a group of 42 married couples who had been together an average of at least 12 years. Each couple was admitted into the university's General Clinical Research Center for two, 24-hour-long visits. The visits were separated by a two-month interval.........

JoAnn      Permalink


December 19, 2005

Twins Comparison Shows Genetic Factors for Dementia

On average, twins of people who have been diagnosed with dementia score lower on cognitive tests than do the twins of people without dementia, new research has found. The study, which included more than 100 Swedish twins age 65 and older, also found that, on average, identical twins of people with dementia have poorer cognitive skills than do fraternal (non-identical) twins of people with dementia.

The scientists suggest that these differences in thinking skills reflect a genetic risk for dementia. However, they emphasize that cognitive changes and elevated genetic risk do not always predict that twins or siblings of people with dementia will eventually develop dementia themselves.

The research, reported in the December 2005 issue of the Journal of Geriatric Psychiatry and Neurology, was led by Margaret Gatz, Ph.D., of the University of Southern California and the Karolinska Institute in Sweden. The study was funded by the National Institute on Aging (NIA), a component of the National Institutes of Health, U.S. Department of Health and Human Services, and a Zenith Award from the Alzheimer's Association. The University of Southern California Alzheimer's Disease Center is one of more than 30 Alzheimer's Disease Centers nationwide supported by the NIA.

"This research is intriguing because it associates genetic risk for dementia with twins' cognitive deficits, even in the absence of dementia," says Neil Buckholtz, Ph.D., chief of the Dementias of Aging Branch of NIA's Neuroscience and Neuropsychology of Aging Program. "The differences in cognitive deficits between identical and fraternal twins are also important, suggesting that the twins who were more similar genetically had the greater risk."

The study included 112 members of the Swedish Twin Registry who were at least 65 years old in 1998. The registry, established in 1961, includes all twins born in Sweden. Of the study participants, 23 were identical twins and 62 were fraternal twins whose co-twins had dementia but who did not have dementia themselves. A comparison group included 27 non-demented twins whose co-twins did not have dementia. The comparison group was similar to the other participants in terms of age, gender, and level of education.........

Daniel      Permalink


December 19, 2005

Survey Shows Continued Decline in Drug Use by Students

Overall, the 2005 Monitoring the Future (MTF) survey showed good news. While there was no substantive change in any illicit drug use between 2004 and 2005, analysis of the survey revealed an almost 19 percent decline in past month use of any illicit drug by 8th, 10th, and 12th graders between 2001 and 2005. This trend is driven largely by decreasing rates of marijuana use among these students. For example, since 2001, past month use of marijuana has fallen by 28 percent among 8th graders and by 23 percent among 10th graders.

Since 1975 the MTF survey has measured drug, alcohol, and cigarette use and related attitudes among adolescent students nationwide. Survey participants report their drug use behaviors across three time periods: lifetime, past year, and past month. Overall, 49,347 students in the 8th, 10th, and 12th grades from 402 public and private schools participated in this year's survey. The survey is funded by the National Institute on Drug Abuse (NIDA), a component of the National Institutes of Health (NIH), and conducted by the University of Michigan.

While the 2005 survey showed a continuing general decline in drug use, there are continued high rates of non-medical use of prescription medications, particularly opioid painkillers. For example, in 2005, 9.5 percent of 12th graders reported using Vicodin in the past year, and 5.5 percent of these students reported using OxyContin in the past year. Long term trends show a significant increase in the abuse of OxyContin from 2002 to 2005 among 12th graders. Also of concern is the significant increase in the use of sedatives/barbiturates among 12th graders since 2001.

"I'm pleased to see the decreased drug use noted in this survey; however, the upward trend in prescription drug abuse is disturbing," says NIH Director Dr. Elias Zerhouni. "We need to ensure that young people understand the very real risks of abusing any drug."........

JoAnn      Permalink


December 18, 2005

Testosterone Therapy For Alzheimer Disease

Testosterone replacement treatment may help improve the quality of life for elderly men with mild cases of Alzheimer's disease, as per a studyposted online today that will appear in the February 2006 print issue of the Archives of Neurology, one of the JAMA/Archives journals.

"There is a compelling need for therapies that prevent, defer the onset, slow the progression, or improve the symptoms of Alzheimer disease (AD)," the authors provide as background information in the article. They note that hormonal therapies have been the focus of research attention in recent years since male aging is associated with a gradual progressive decline in testosterone levels. "The gradual decline in testosterone level is associated with decreased muscle mass and strength, osteoporosis, decreased libido, mood alterations, and changes in cognition, conditions that may be reversed with testosterone replacement." The authors add that the age-related decline in testosterone is potentially relevant to AD as prior studies have found significantly lower concentrations of the hormone in middle-aged and elderly men who developed AD.

Po H. Lu, Psy.D., from the David Geffen School of Medicine, University of California, Los Angeles, and his colleagues conducted a 24-week, randomized study to evaluate the effects of testosterone treatment on cognition, neuropsychiatric symptoms, and quality of life in 16 male patients with mild AD and 22 healthy elderly men who served as controls. The study participants were randomized to receive packets of gel to apply on their skin that either contained testosterone or a placebo. Standardized tests were administered at least twice (baseline and end) during the study for the assessment of cognitive functions and quality of life.

"For the patients with AD, the testosterone-treated group had significantly greater improvements in the scores on the caregiver version of the quality-of-life scale," the scientists report. "No significant therapy group differences were detected in the cognitive scores at end of study, eventhough numerically greater improvement or less decline on measures of visuospatial functions was demonstrated with testosterone therapy compared with placebo. In the healthy control group, a nonsignificant trend toward greater improvement in self-rated quality of life was observed in the testosterone-treated group compared with placebo therapy. No difference between the therapy groups was detected in the remaining outcome measures."........

Daniel      Permalink


December 17, 2005

Brain Imaging to Learn if Alzheimer's Can Be Detected Earlier

Scientists at Emory University have received a $330,000 grant from the National Institutes of Health (NIH) and other organizations to study the use of brain imaging to identify and treat Alzheimer's disease (AD) at an earlier stage. The multi-center research trial, called the Alzheimer's Disease Neuroimaging Initiative (ADNI), will focus on brain imaging studies (MRI and PET scans) and biomarker tests (tests to detect diseases), together with measurements of memory, thinking, and daily functioning among three different groups of volunteers.

"The goal of the study is to learn how brain imaging can be used most effectively to monitor changes in the brain in Alzheimer's disease," says Allan Levey, MD, PhD, professor and chair of neurology, Emory University School of Medicine and lead investigator of the ADNI study at Emory. "Most importantly, the study will determine if brain imaging can be used to predict which healthy elderly individuals will develop mild cognitive impairment (MCI), and which individuals with MCI will go on to develop AD."

In recent years, the field of aging and dementia has moved toward trying to identify the earliest clinical signs of the process that is likely to evolve into AD. MCI has come to represent this transitional zone between the cognitive changes of normal aging and very early AD. MCI is most usually described as a subtle but measurable memory disorder. A person with MCI has memory problems greater than normally expected with aging, but does not show other symptoms of dementia, such as impaired judgment or reasoning. Researchers are still working to understand MCI and its relationship to Alzheimer's disease.

To date, this ADNI study is the most comprehensive effort to identify neuroimaging measures and biomarkers associated with cognitive and functional changes in the healthy elderly and those with both MCI and AD.........

Daniel      Permalink


December 17, 2005

Gene Mutation In Bardet-beidl Syndrome (BBS)

Johns Hopkins researchers studying a rare inherited syndrome marked by eye and kidney problems, learning disabilities and obesity have discovered a genetic mutation that makes the syndrome more severe but that alone doesn't cause it. Their report appears in the advance online edition of Nature (Dec. 4).

The new discovery about Bardet-Beidl syndrome (BBS) came from a panoply of studies -- starting with comparative genomics and experiments with yeast, and moving to experiments with zebrafish and genetic analysis of families with the syndrome -- and mirrors what experts expect for the genetically complex common diseases that kill most Americans, like diabetes, heart disease and cancer.

"Researchers are going to have to think very hard before they discount genetic variation that appears not to directly cause a disease," says the study's leader, Nicholas Katsanis, Ph.D., associate professor in the McKusick-Nathans Institute of Genetic Medicine at Johns Hopkins. "The onus is on us to figure out how to dissect the effects of what appear to be silent genetic variants. I have a greatly renewed respect for the complexity of the genome, for the subtle ways that genes and gene products interact with each other".

Conventional wisdom says that a collection of subtle genetic variations contribute to a person's risk of common diseases, but hunting for such subtle effects is daunting. As a result, most gene hunts have targeted relatively rare diseases that appear from their pattern in families to be fairly simple genetically.

Katsanis and colleagues have recognized for years that BBS, eventhough rare, is more similar to the genetic complexity of common diseases, in part because patients with this condition have extremely variable severity, even within families. The newly identified mutation, in a gene called MGC1203, is the first to affect only the severity of the syndrome. Mutations in eight other genes, all dubbed BBS genes, are known to cause the disease, often in combination with each other.........

Sue      Permalink


December 17, 2005, 10:24 PM CT

Mental Health A Major Priority At White House Conference On Aging

The American Psychological Association (APA) applauds the inclusion of mental health issues as a priority resolution of the 2005 White House Conference on Aging (WHCoA) .

Seventy-five percent (929 out of 1,200) of Conference national delegates voted to improve "recognition, assessment, and therapy of mental illness and depression among older Americans," a resolution supported by the APA. The resolution on the mental health of older Americans was ranked eighth by the delegates among the 10 most major priorities in dealing with America's aging population.

The WHCoA, is a nonpartisan, cross-disciplinary event made up of 1,200 delegates who formulate nonbinding policy recommendations to the president and Congress. The conference aims to help guide national aging policies and assist the public and private sectors for the next 10 years by promoting dignity, health, independence and economic security of current and future generations of older persons.

With over 36 million Americans older than 65, and the first of the 77 million baby boomers turning 60 this year, a surge of health care problems may soon face older adults. According to APA's Resolution on the 2005 White House Conference on Aging, 20-25 percent of older adults suffer from some form of mental disorder, which can impede physical health and independence. Fortunately, a wide variety of therapys are effective in improving mental and behavioral health problems in later life.

But, there are few geropsychology experts and other mental healthcare providers to provide this care to older adults at this time, particularly for those living in poor rural areas of the U.S. The mental health profession's growing role to address these concerns may reflect the start of a societal shift, said APA President Ronald F. Levant, EdD, a delegate at the conference. "We may be seeing the start of people viewing mental health as part of health overall," he says.........

JoAnn      Permalink


December 16, 2005

Type 2 Diabetes And Depression

Type 2 diabetes and depression can be a fatal mix. Patients whose type 2 diabetes was accompanied by minor or major depression had higher mortality rates, compared to patients with type 2 diabetes alone over the three-year period of a recent study in Washington state. The results appear in the November 2005 edition of Diabetes Care, published by the American Diabetes Association.

Scientists at the University of Washington and at Group Health Cooperative, a large, Seattle-based health plan, conducted the study. The scientists surveyed and followed up 4,154 patients with type 2 diabetes. The patients filled out written questionnaires. With patients' consent, automated diagnostic, laboratory, and pharmacy data were collected from Group Health Cooperative. The scientists also reviewed Washington state mortality data to analyze diabetes complications and deaths.

Depression is common among people who have type 2 diabetes. This high prevalence can have unfortunate repercussions. Both minor depression and major depression among people with diabetes are stongly linked with increased mortality.

"Depression may be associated with increased mortality in patients with diabetes because of both behavioral and biological factors," the scientists noted in their article. More work, they added, is needed to untangle the cause-and effect relationships among depression, behavior, diabetes complications, and mortality.

Dr. Wayne Katon, professor and vice chair of the UW Department of Psychiatry and Behavioral Sciences, and an adjunct professor in the UW Department of Family Medicine, led the recent study. He is a noted researcher on the associations between depression, aging, and chronic diseases, and on the medical costs and personal toll from untreated on inadequately treated depression. The research team included Drs. Carolyn Rutter, Greg Simon, Elizabeth Lin, Evette Ludman, and Michael Von Korff from the Group Health Cooperative Center for Health Studies; Dr. Paul Ciechnowski, UW assistant professor of psychiatry and behavioral sciences; Dr. Leslie Kinder from the Veterans Affairs Puget Sound Health Care System; and Dr. Bessie Young from the UW Department of Medicine.........

JoAnn      Permalink


December 16, 2005, 9:15 PM CT

Cause Of Breathing Problems In Rett Syndrome Children

A multi-institutional team, led by University of Chicago researchers, has taken a crucial step toward understanding and treating Rett syndrome (RS), a rare and often misdiagnosed neurodevelopmental disorder that affects 1 in 10,000 children, mostly females.

As per a research findings published in the December 14, 2005, issue of the Journal of Neuroscience, the scientists describe in a mouse model for RS the source of erratic breathing, which has important implications for children with RS.

Along with breathing problems, RS causes slowed brain and head growth, mental retardation, seizures, gait abnormalities, and handwringing.

"It is absolutely tragic for the family," said Jan-Marino Ramirez, professor of organismal biology and anatomy at Chicago and lead author of the paper. "It's a progressive disease that shows no mercy".

In order to study the breathing pattern more closely, Ramirez and his team showed that mice with the RS gene exhibit the same behavior as children: They breathe irregularly and stop breathing often.

According to Ramirez, one hypothesis that has dominated the thinking of a number of clinicians is that the erratic breathing is due to cortical problems. "It's as if they want to stop breathing," he said. "Some clinicians went that far to suggest that it could be pleasurable for the child to stop breathing all of the time because they get a euphoric high. Or they do this because they're agitated".

However, the scientists traced the problem not to the cortex but to the breathing center itself--in the medulla. The scientists isolated the breathing center from mutant mice and were able to demonstrate that the same erratic breathing pattern, which is so characteristic for RS, also was expressed in the isolated brain tissue, revealing the breathing center as the source of the problem.........

JoAnn      Permalink