RxPG News : Psychiatry

Behavioural signs of autism become evident between the ages of 6 and 12 months

Tue, 16 Feb 2010 14:04:40 PST

( from http://www.rxpgnews.com ) A study of the development of autism in infants, comparing the behavior of the siblings of children diagnosed with autism to that of babies developing normally, has found that the nascent symptoms of the condition — a lack of shared eye contact, smiling and communicative babbling — are not present at 6 months, but emerge gradually and only become apparent during the latter part of the first year of life.

Researchers conducted the study over five years by painstakingly counting each instance of smiling, babbling and eye contact during examinations until the children were 3. They found that by 12 months the two groups’ development had diverged significantly. Intentional social and communicative behavior among children developing normally increased while among infants later diagnosed with autism it decreased dramatically. The study is published online early and will appear in the March issue of the Journal of the American Academy of Child & Adolescent Psychiatry.

“This study provides an answer to when the first behavioral signs of autism become evident,” said Sally Ozonoff, the study’s lead author, a professor of psychiatry and behavioral sciences and a researcher with the UC Davis MIND Institute. “Contrary to what we used to think, the behavioral signs of autism appear later in the first year of life for most children with autism. Most babies are born looking relatively normal in terms of their social abilities but then, through a process of gradual decline in social responsiveness, the symptoms of autism begin to emerge between 6 and 12 months of age.”

Autism is a pervasive developmental disorder of deficits in social skills and communication, as well as in repetitive and restricted behaviors, with onset occurring prior to age 3. Abnormal brain development, probably beginning prenatally, is known to be fundamental to the behaviors that characterize autism. Current estimates place the condition’s incidence at between 1 in 100 and 1 in 110 children in the United States.

Children with a sibling already diagnosed with autism are known to be among those at greatest risk of developing the disorder. The current study included 25 high-risk children who met criteria for autism at 3 years of age, matched with 25 low-risk peers who were developing normally. It was conducted at the MIND Institute and the University of California, Los Angeles. The sole inclusion criterion for the high-risk group was having a sibling with autism; low-risk participants had to have been born after 36 weeks gestation and have no autistic family members.

The children’s development was evaluated at 6, 12, 18, 24 and 36 months of age using a series of widely implemented diagnostic tools, including the Autism Diagnostic Observation Schedule (ADOS) and the Autism Diagnostic Interview-Revised (ADI-R). Examiners were not told which babies were at high- or low-risk when evaluating the participants’ development.

The researchers found that there were few discernable differences between the two groups at the outset but that after six months, 86 percent of the infants who developed autism showed declines in social communication that were outside the range for typical development. “After six months,” the study found, “the autism spectrum disorder group showed a rapid decline in eye contact, social smiling, and examiner-rated social responsiveness.” Group differences were significant by 12 months in eye contact and social smiling and all other measures by 18 months, the study found.

The study is notable because of the accuracy and precision of its prospective methodology, assiduously recording exact numbers of social and communicative behaviors during lab visits. Previously, researchers have constructed evidence of autism’s earliest manifestations by interviewing parents about when they believed their children’s symptoms first arose or by reviewing home movies for clues to when children begin exhibiting symptoms of autism.

"Until now, research has relied on asking parents when their child reached developmental milestones. But that can be really difficult to recall, and there is a phenomenon called the “telescoping effect” where people usually say that they remember something happening more recently than when it occurred,” Ozonoff said. In addition parents frequently will turn off the video camera when their children are behaving poorly — precisely when autistic symptoms may appear.

Ozonoff said that the study provides a deeper understanding for parents, caregivers and health-care providers and for future research of the developmental trajectory for very young children with autism.

“We need to be careful about how we screen, and we need to know what we’re looking for,” Ozonoff said. “This study tells us that screening for autism early in the first year of life probably is not going to be successful because there isn’t going to be anything to notice. It also tells us that we should be focusing on social behaviors in our screening, since that is what declines early in life.”

“This study also found that the loss of skills continues into the second and third year of life,” she said. “So it may not be adequate, as the American Academy of Pediatrics currently suggests, that providers screen for autism twice before the end of the second year. Autism has a slow, gradual onset of symptoms, rather than a very abrupt loss of skills.”

“Screening may need to continue into the third year of life, since symptom emergence takes place over a long time. If a child starts exhibiting a declining trajectory and a sustained reduction in social communication we want to refer them into therapy, especially if they are at risk,” Ozonoff said, “even before we might be able to make a definitive diagnosis.”

Ozonoff said that the study does not address the etiology of autism or causality. In this study, the infants who participated were at high risk due to having strong family histories of autism, suggesting that genetics plays a major role in the later autism diagnoses, despite the fact that their symptoms were not apparent at birth.

Are bees also addicted to caffeine and nicotine?

Wed, 10 Feb 2010 04:59:36 PST

( from http://www.rxpgnews.com ) *A study carried out at the University of Haifa has found that bees prefer nectar with a small concentration of caffeine and nicotine over nectar that does not comprise these substances at all. This could be an evolutionary trait intended to make the bee addicted, the researchers say.*

Bees prefer nectar with small amounts of nicotine and caffeine over nectar that does not comprise these substances at all, a study from the University of Haifa reveals. This could be an evolutionary development intended, as in humans, to make the bee addicted, states Prof. Ido Izhaki, one of the researchers who conducted the study.

Flower nectar is primarily comprised of sugars, which provide energy for the potential pollinators. But the floral nectar of some plant species also includes small quantities of substances known to be toxic, such as caffeine and nicotine. The present study, carried out by researchers at the Department of Environmental and Evolutionary Biology and the Department of Science Education at the University of Haifa-Oranim, headed by Prof. Ido Izhaki along with Prof. Gidi Ne'eman, Prof. Moshe Inbar and Dr. Natarajan Singaravelan, examined whether these substances are intended to entice the bees or whether they are byproducts that are not necessarily linked to any such objective.

Nicotine is found naturally in floral nectar at a concentration of up to 2.5 milligrams per liter, primarily in various types of tobacco tree (Nicotiana glauca). Caffeine is found at concentration levels of 11-17.5 milligrams per liter, mostly in citrus flowers. In the nectar of grapefruit flowers, however, caffeine is present in much higher concentrations, reaching 94.2 milligrams per liter. In order to examine whether bees prefer the nectar containing caffeine and nicotine, the researchers offered artificial nectar that comprised various natural sugar levels and various levels of caffeine and nicotine, alongside clean nectar that comprised sugar alone. The caffeine and nicotine concentrations ranged from the natural levels in floral nectar up to much higher concentrations than found in nature.

The results showed that bees clearly prefer nectar containing nicotine and caffeine over the clean nectar. The preferred nicotine concentration was 1 milligram per liter, similar to that found in nature. Given a choice of higher levels of nicotine versus clean nectar, the bees preferred the latter.

According to the researchers, it is difficult to determine for sure whether the addictive substances in the nectar became present in an evolutionary process in order to make pollination more efficient. It can be assumed, however, based on the results of the study, that the plants that survived natural selection are those that developed correct levels of these addictive substances, enabling them to attract and not repel bees, thereby giving them a significant advantage over other plants. The researchers emphasized that this study has proved a preference, not addiction, and they are currently examining whether the bees do indeed become addicted to nicotine and caffeine.

Autism clusters indentified in California

Mon, 04 Jan 2010 22:14:12 PST

( from http://www.rxpgnews.com ) Researchers at UC Davis have identified 10 locations in California where the incidence of autism is higher than surrounding areas in the same region. Most of the areas, or clusters, are in locations where parents have higher-than-average levels of educational attainment. Because children with more educated parents are more likely to be diagnosed with an autism spectrum disorder, one need look no further for a cause, the authors say. The other clusters are located close to major autism treatment centers.

The clusters are located primarily in the high-population areas of Southern California and, to a lesser extent, in the San Francisco Bay Area. The researchers said that, while children born within the clusters during the study period were more likely to be diagnosed with autism, the majority of the state's children with autism were born in adjacent areas outside the clusters.

For the rigorous study, published online today in the journal Autism Research, scientists examined nearly all of the approximately 2-1/2 million births recorded in the state of California from 1996 through 2000. About 10,000 children born during that five-year period were later diagnosed with an autism spectrum disorder, according to the California Department of Developmental Services (DDS).

After mapping the state’s birth cohort based on where the mothers lived at the time when their children were born, the researchers pinpointed birth locations of children who were later diagnosed with autism. The study looked for areas of higher incidence within each of the service zones of DDS’s regional centers, which coordinate services for individuals with developmental disorders like autism.

“This is the first time that anyone has looked at the geography of autism births in California in order to see whether there might be some local patches of elevated environmental risk. This method ignores unknown widespread factors (such as a regional pollutant) that could increase autism incidence,” said Karla Van Meter, the study’s lead author. Van Meter is an epidemiologist and was a doctoral student in the UC Davis Department of Public Health Sciences and at the Center for Animal Disease Modeling and Surveillance when the study was conducted.

“This spatial study was extremely rigorous because we developed a methodology that greatly improved accuracy in identifying areas of higher autism incidence. With so many possible environmental health risk factors, we see this method as generally useful for focusing studies on exposures that are elevated in such clusters,” Van Meter said.

However, the researchers said that in this investigation the clusters probably are not correlated with specific environmental pollutants or other “exposures.” Rather, they correlate to areas where residents are more educated.

“What we found with these clusters was that they correlated with neighborhoods of high education or neighborhoods that were near a major treatment center for autism,” said senior author Irva Hertz-Picciotto, a professor of public health sciences and a researcher with the UC Davis MIND Institute.

“In the U.S., the children of older, white and highly educated parents are more likely to receive a diagnosis of autism or autism spectrum disorder. For this reason, the clusters we found are probably not a result of a common environmental exposure. Instead, the differences in education, age and ethnicity of parents comparing births in the cluster versus those outside the cluster were striking enough to explain the clusters of autism cases,” Hertz-Picciotto said.

Autism is a neurodevelopmental disability characterized by impaired social development and communication and restricted, repetitive behaviors. It is considered a lifelong condition that develops by the time a child is 3 years old. The researchers limited their study to the five-year period between 1996 and 2000 in order to allow all of the children born during that time to grow to an age by which they probably would have received a diagnosis — 6 years old.

Van Meter said that the increased risk of autism in these areas is roughly a doubling of the incidence of autism over the incidence in the surrounding zone. For example, for the cluster area located in the service zone of the San Diego Regional Center, the autism incidence was 61.2 per 10,000 births and, in the rest of the Regional Center service zone, 27.1 per 10,000 births. For the Harbor Regional Center the incidence was 103.4 and 57.8, respectively. Van Meter added that it is important to remember that most of the children with autism were not born in the cluster areas.

In Southern California, the areas of increased incidence were located within these Regional Center service zones:

1. The Westside Regional Center, headquartered in Culver City, Calif., which serves the communities of western Los Angeles County, including the cities of Culver City, Inglewood and Santa Monica;
2. The Harbor Regional Center, headquartered in Torrance, Calif., which serves southern Los Angeles County, including the cities of Bellflower, Harbor, Long Beach and Torrance;
3. The North Los Angeles County Regional Center, headquartered in Van Nuys, Calif., which serves the San Fernando and Antelope valleys — two clusters were located in this regional center’s service zone.
4. The South Central Los Angeles Regional Center, headquartered in Los Angeles, which serves the communities of Compton and Gardena;
5. The Regional Center of Orange County, headquartered in Santa Ana, Calif., which serves the residents of Orange County; and
6. The Regional Center of San Diego County, headquartered in San Diego, which serves people living in Imperial and San Diego counties.

In Northern California, the areas of increased incidence were located within these regional centers’ service zones:

7. The Golden Gate Regional Center, headquartered in San Francisco, which serves Marin and San Mateo counties and the City and County of San Francisco. Two clusters were located within the Golden Gate Regional Center’s service zone; and
8. The San Andreas Regional Center, headquartered in Campbell, Calif., which serves Santa Clara, Santa Cruz, Monterey and San Benito counties.

Two areas of increased incidence were located in Central California regional centers’ service zones:

9. The Central Valley Regional Center, headquartered in Fresno, Calif., which serves Fresno, Kings, Madera, Mariposa, Merced and Tulare counties; and
10. The Valley Mountain Regional Center, headquartered in Stockton, Calif., which serves Amador, Calaveras, San Joaquin, Stanislaus and Tuolumne counties.

The South Central Los Angeles and Valley Mountain Regional Center autism clusters were listed as “potential clusters” because their clusters met a reduced set of statistical conditions.

All of these areas were identified using a sophisticated new biostatistical testing procedure developed by Van Meter in collaboration with study co-author Lasse Christiansen and constructed on Christiansen’s earlier statistical work. This method looked for combinations of events, in this case, autism, within a set of locations, in this case, births, whose occurrence would not be expected to occur at random. This is the first application of that method. UC Davis undertook the epidemiological study as a step toward identifying geographic risk factors for autism in California, Van Meter said.

The study also examined demographic factors recorded on the children’s birth records that are known to be associated with both autism and residential location. These included having an older parent — a known autism risk factor. The researchers found a statistically significant but small association of the cluster areas with older parental age at the time their child was born.

Hertz-Picciotto said that the findings do not counter the idea that the environment plays a role in autism, but rather, help to focus attention toward certain types of exposures.

“Because of the strong link between demographics, particularly parental education, and the locations of clusters, other explanations for these pockets of high autism incidence, such as localized sources of exposure, are not likely," Van Meter explained.

“The risk for a child with highly educated parents to be diagnosed with autism is probably not caused by the location of the mother’s residence or any local shared environmental exposures," she said. "Our result indicates that the most likely sources of environmental hazards for autism in California are in or around the home or else are widespread."

"The strong link between demographics, particularly parental education, and the locations of the clusters validated the effectiveness of the statistical method that we employed because it successfully identified areas where a known risk factor was concentrated," she added.

Undergrad researchers lay groundwork for drug addiction remedy

Tue, 08 Dec 2009 04:59:36 PST

( from http://www.rxpgnews.com ) DURHAM, N.C. -- Sarah Steele and Langtian Ren Yuan were both self-admittedly inexperienced Duke freshmen in the spring of 2006. But then they followed helpful directions of an assistant chemistry professor, added their own patience and ingenuity, and ended up identifying compounds that might allay the powerful cravings of methamphetamine and cocaine addiction.

The two women, now seniors, have since moved on to other things. But their earlier accomplishment was recently celebrated by a research paper in a British journal. It also helped bring the professor, Jiyong Hong, a $390,000 stimulus grant from the National Institutes of Health and the American Recovery and Investment Act to do follow-up research.

I think this is a kind of showcase for something that Duke is very strong in -- undergraduate research, Hong said. And, socioeconomically, it deals with drugs of abuse that are huge problems.

Hong, whose research group investigates the synthesis of natural products for drug design as well as small molecules' roles in biological processes, got interested in finding small molecules that could inhibit the good feelings induced by meth and coke after reading a 2006 paper in the journal Science.

That study implicated a derivative of an enzyme called protein kinase C zeta (abbreviated PKCzeta) in brain chemistry changes involved in memory and learning.

When people take methamphetamines and cocaine, that gets engraved in their memories, Hong said. So the hypothesis was that by inhibiting a specific enzyme, in this case PKCzeta, we might be able to delete those memories.

The problem was that researchers had never identified a PKCzeta inhibitor, he added. PKCzeta is one of the least studied members of the PKC family. In other words, his quest would be like searching for needles in a haystack.

Enter the two undergraduates. Steele, an intended biology major, showed up in Hong's lab to do an independent study tied to a freshman chemistry research seminar class. I hadn't taken organic chemistry, but he explained everything to me so I was sure of what I was doing, she said.

Following Hong's elaborate instructions, Steele began the task of canvassing about 1,200 different small molecules looking for candidate PKCzeta blockers. It was repetitive work, but once we learned the concept it was easy to continue, she recalled.

The work involved placing each candidate inhibitor into one of 96 tiny wells on a sample plate, along with PKCzeta and an energy-providing chemical called adenosine triphosphate (ATP), plus a light-emitting enzyme called luciferase.

If a candidate compound was ineffectual, then the ATP in the well would be used by PKCzeta's activity. But if a compound did interfere with the PKCzeta, then the energy of the ATP would instead cause the luciferase to light up. The better the blocking action, the brighter the glow.

Yuan, originally a premed student planning to triple major in biomedical engineering, economics and public policy, had also approached Hong seeking freshman work as a lab assistant, though not as part of a class.

Originally I was asked to try to find an inhibitor for something other than PKCzeta, she said. But when Steele entered a different summer research program after the spring semester, I kind of picked up where Sarah stopped.

I was doing similar things as she, but really trying to pinpoint which specific compounds worked as inhibitors, Yuan recalled. We were almost out of molecules to test by then. But, in the last batch, there were a series that were similar that all lit up really well.

The work required lots of transferring chemicals with the aid of a pipette, and then incubating them at different temperatures and at different concentrations. That was a lot of hours, she said. I was working almost full time during the summer. But I'm glad it paid off.

Other researchers from Duke's Chemistry Department and Medical Center, as well as a separate group from Korea, filled in gaps in the research. Their results were published online on May 8, 2009 in

Schema therapy offers hope for mental disorder patients

Sat, 21 Nov 2009 12:23:40 PST

( from http://www.rxpgnews.com ) Patients coping with mental disorders can now look forward to major changes in their lives through an innovative treatment called Schema Therapy -.

Schema therapists help patients change their entrenched, self-defeating life patterns - or schemas - using cognitive, behavioural, and emotion-focused techniques.

Three major outcome studies have shown that many patients with 'borderline personality disorder' - can fully recover across the complete spectrum of symptoms.

In one study, ST was shown to be more than twice as effective in bringing about full recovery as a widely-practiced traditional treatment. It was also found to be more cost-effective and to have a much lower dropout rate.

In a second study, group ST led to even stronger outcomes than those in the previous investigation over a briefer period with a zero percent drop out rate and a recovery rate of 94 percent over an eight month period.

A third study, now in press, shows that individual ST can be successfully implemented in regular mental health care settings with no loss of effectiveness.

While other specialised treatments for BPD have demonstrated empirical support, all but ST have serious limitations in their impact on patients' functioning and quality of life, says a release of the International Society of Schema Therapy.

Dutch investigators, including Josephine Giesen-Bloo and Arnoud Arntz, were associated with the study along with Joan Farrell, Ida Shaw and Michael Webber of the Indiana University School of Medicine.

The first of these studies was reported in the Archives of General Psychiatry, published by the American Medical Association, the second published in the Journal of Behavioural Therapy and Experimental Psychiatry and the third will soon be appearing in Behaviour Research and Therapy.

These findings will be published by the Cambridge University Press this year.

Depression as deadly as smoking

Tue, 17 Nov 2009 04:59:36 PST

( from http://www.rxpgnews.com ) A study by researchers at the University of Bergen, Norway, and the Institute of Psychiatry (IoP) at King's College London has found that depression is as much of a risk factor for mortality as smoking.

Utilising a unique link between a survey of over 60,000 people and a comprehensive mortality database, the researchers found that over the four years following the survey, the mortality risk was increased to a similar extent in people who were depressed as in people who were smokers.

Dr Robert Stewart, who led the research team at the IoP, explains the possible reasons that may underlie these surprising findings: 'Unlike smoking, we don't know how causal the association with depression is but it does suggest that more attention should be paid to this link because the association persisted after adjusting for many other factors.'

The study also shows that patients with depression face an overall increased risk of mortality, while a combination of depression and anxiety in patients lowers mortality compared with depression alone. Dr Stewart explains: 'One of the main messages from this research is that 'a little anxiety may be good for you'.

'It appears that we're talking about two risk groups here. People with very high levels of anxiety symptoms may be naturally more vulnerable due to stress, for example through the effects stress has on cardiovascular outcomes. On the other hand, people who score very low on anxiety measures, i.e. those who deny any symptoms at all, may be people who also tend not to seek help for physical conditions, or they may be people who tend to take risks. This would explain the higher mortality.'

In terms of the relationship between mortality and anxiety with depression as a risk factor, the research suggests that help-seeking behaviour may explain the pattern of outcomes. People with depression may not seek help or may fail to receive help when they do seek it, whereas the opposite may be true for people with anxiety.

Dr Stewart comments: 'It would certainly not surprise me at all to find that doctors are less likely to investigate physical symptoms in people with depression because they think that depression is the explanation, but may be more likely to investigate if someone is anxious because they think it will reassure them. These are conjectures but they would fit with the data.'

The researchers point out that the results should be considered in conjunction with other evidence suggesting a variety of adverse physical health outcomes and poor health associated with mental disorders such as depression and psychotic disorders.

In light of the findings, Dr Stewart makes suggestions on the focus of future developments in the treatment of depression and anxiety: 'The physical health of people with current or previous mental disorder needs a lot more attention than it gets at the moment.

'This applies to primary care, secondary mental health care and general hospital care in the sense that there should be more active screening for physical disorders and risk factors, such as blood pressure, cholesterol, adverse diet, smoking, lack of exercise, in people with mental disorders. This should be done in addition to more active treatment of disorders when present, and more effective general health promotion.'

Anxious women more likely to have smaller babies

Wed, 04 Nov 2009 12:13:19 PST

( from http://www.rxpgnews.com ) Women with severe and chronic anxiety during pregnancy are more likely to have smaller babies, says a new study.

The study authors demonstrated that the mother's anxiety during pregnancy impacts birth outcomes, including smaller babies, over and beyond factors such as drug use, education, and race.

Low to moderate levels of anxiety in women during either the first or second trimester did not significantly affect the birth outcomes, but women who are severely anxious during much of their pregnancy should be considered for anxiety-reducing interventions.

Shahla M. Hosseini of the University of Pittsburgh Medical Centre, co-authored the study with Minhnoi W. Biglan, Cynthia Larkby, Maria M. Brooks, Michael B. Gorin, and Nancy L. Day.

'One way to prevent health problems in children and adults is to focus care on the prenatal period,' the authors note.

'It is key to pursue further research which addresses interventions to ameliorate the effects that a woman's trait anxiety has on the development of foetuses,' they said.

The study was published in Paediatric and Perinatal Epidemiology.

Smoking bans reduce the risk of heart attacks associated with secondhand smoke

Thu, 15 Oct 2009 03:59:36 PST

( from http://www.rxpgnews.com ) WASHINGTON -- Smoking bans are effective at reducing the risk of heart attacks and heart disease associated with exposure to secondhand smoke, says a new report from the Institute of Medicine. The report also confirms there is sufficient evidence that breathing secondhand smoke boosts nonsmokers' risk for heart problems, adding that indirect evidence indicating that even relatively brief exposures could lead to a heart attack is compelling.

It's clear that smoking bans work, said Lynn Goldman, professor of environmental health sciences, Johns Hopkins Bloomberg School of Public Health, Baltimore, and chair of the committee of experts that wrote the report. Bans reduce the risks of heart attack in nonsmokers as well as smokers. Further research could explain in greater detail how great the effect is for each of these groups and how secondhand smoke produces its toxic effects. However, there is no question that smoking bans have a positive health effect.

About 43 percent of nonsmoking children and 37 percent of nonsmoking adults are exposed to secondhand smoke in the United States, according to public health data. Despite significant reductions in the percentages of Americans breathing environmental tobacco smoke over the past several years, roughly 126 million nonsmokers were still being exposed in 2000.

A 2006 report from the U.S. Surgeon General's office, THE HEALTH CONSEQUENCES OF INVOLUNTARY EXPOSURE TO TOBACCO SMOKE, concluded that exposure to secondhand smoke causes heart disease and indicated that smoke-free policies are the most economical and effective way to reduce exposure. However, the effectiveness of smoking bans in reducing heart problems has continued to be a source of debate.

The IOM committee conducted a comprehensive review of published and unpublished data and testimony on the relationship between secondhand smoke and short-term and long-term heart problems. Eleven key studies that evaluated the effects of smoking bans on heart attack rates informed the committee's conclusions about the positive effects of smoke-free policies. The studies calculated that reductions in the incidence of heart attacks range from 6 percent to 47 percent. Given the variations in how the studies were conducted and what they measured, the committee could not determine more precisely how great the effect is. Only two of the studies distinguished between reductions in heart attacks suffered by smokers versus nonsmokers. However, the repeated finding of decreased heart attack rates overall after bans were implemented conclusively demonstrates that smoke-free policies help protect people from the cardiovascular effects of tobacco smoke, the committee said.

The report also provides a detailed discussion of the evidence from animal research and epidemiological studies showing a cause-and-effect relationship between secondhand smoke exposure and heart problems. The committee was not able to determine the exact magnitude of the increased risk presented by breathing environmental tobacco smoke, but noted that studies consistently indicate it increases the risks by 25 percent to 30 percent. Although there is no direct evidence that a relatively brief exposure to secondhand smoke could precipitate a heart attack, the committee found the indirect evidence compelling. Data on particulate matter in smoke from other pollution sources suggest that a relatively brief exposure to such substances can initiate a heart attack, and particulate matter is a major component of secondhand smoke.

Young age at first drink may affect genes and risk for alcoholism

Fri, 18 Sep 2009 03:59:36 PST

( from http://www.rxpgnews.com ) The age at which a person takes a first drink may influence genes linked to alcoholism, making the youngest drinkers the most susceptible to severe problems.

A team of researchers, led by scientists at Washington University School of Medicine in St. Louis, studied 6,257 adult twins from Australia. They wanted to learn whether twins who start drinking at an early age are more likely to develop a more heritable form of alcohol dependence than those who begin drinking later in life. The researchers found that the younger an individual was at first drink, the greater the risk for alcohol dependence and the more prominent the role played by genetic factors.

There seemed to be a greater genetic influence in those who took their first full drink at a younger age, says first author Arpana Agrawal, Ph.D. That's very consistent with what has been predicted in the literature and in the classification of types of alcohol dependence, but we present a unique test of the hypothesis.

Agrawal and her colleagues examined previously collected data from identical and fraternal, male and female twins, using statistical methods to measure the extent to which age at first drink changed the role of heritable influences on symptoms of alcohol dependence. Using the twin model, they were able to tease out genetic influences, shared environmental influences and non-shared environmental factors.

Agrawal's team found that when twins started drinking early, genetic factors contributed greatly to risk for alcohol dependence, at rates as high as 90 percent in the youngest drinkers. For those who started drinking at older ages, genes explained much less, and environmental factors that make twins different from each other, such as unique life events, gained prominence.

The twins in the study were 24 to 36 years old when they were interviewed, but some reported taking their first drink as young as age 5 or 6. The researchers found that those who were 15 or younger when they started drinking tended to have a greater genetic risk for alcohol dependence. Some who were 16 or older before they took their first drink later became alcohol dependent, but their dependence was related more to environmental factors.

We don't have actual gene expression data in this study, but we could hypothesize that exposure to early-onset drinking somehow modifies the developing brain, Agrawal says. Particularly frequent or heavy early drinking may influence gene expression and contribute to more severe outcomes. Our research cannot prove that, but it's something that neuro-imaging and gene expression studies certainly should investigate.

Another possibility is that early drinking exposes adolescents to certain environment influences, such as their peer groups, that somehow enhance genetic influences that contribute to risk for alcohol dependence.

Something about starting to drink at an early age puts young people at risk for later problems associated with drinking, Agrawal says. We continue to investigate the mechanisms, but encouraging youth to delay their drinking debut may help.

Prevalence of Mental Illness May Be Twice Than Believed

Fri, 11 Sep 2009 15:41:09 PST

( from http://www.rxpgnews.com ) The prevalence of anxiety, depression and drug dependency may be twice as high as the mental health community has been led to believe.

Duke University psychologists Terrie Moffitt, Avshalom Caspi and colleagues used a long-term tracking study of more than 1,000 New Zealanders from birth to the age 32 to conclude that people vastly under-report the degree of mental illness they have suffered.

But such self-reporting from memory is the basis of much of what we know about the prevalence of anxiety, depression, alcohol dependence and marijuana dependence.

Longitudinal studies like the Dunedin Study in New Zealand that track people over time are rare and expensive, Moffitt said.

'If you start with a group of children and follow them their whole lives, sooner or later almost everybody will experience one of these disorders,' said Moffitt, professor of psychology at Duke.

The Great Smoky Mountains Study, a similar effort based at Duke, tracked 1,400 American children from age 9-13 into their late 20s and found similar patterns, said Jane Costello, professor of medical psychology at Duke.

'I think we've got to get used to the idea that mental illness is actually very common,' Costello said. 'People are growing up impaired, untreated and not functioning to their full capacity because we've ignored it.'

Similarly, the survey studies have reported a six to 17 percent lifetime rate of alcohol dependence between the ages 18-32, versus nearly 32 percent in the Dunedin Study.

Moffitt and Caspi's findings appeared online in Psychological Medicine.

Longitudinal study investigates cocaine's impact on adolescent development

Wed, 19 Aug 2009 03:59:36 PST

( from http://www.rxpgnews.com ) Teen years are filled with experimenting. Sometimes that means trying some risky behaviors.

Nearly 400 teens, half of which were prenatally exposed to cocaine, will be studied in their adolescent years. Researchers will look at the youths' choices when it comes to using drugs, having sex or engaging in delinquent behaviors, and see if there is an association with prenatal cocaine exposure. The study will also closely follow the cognitive development and mental health behavior of the young people.

Sonia Minnes, an assistant professor from the Mandel School of Applied Social Sciences at Case Western Reserve University and now the lead researcher in phase four of a long-term study of cocaine exposed children, has received a five-year, nearly $5 million grant from the National Institute on Drug Abuse (NIDA).

This latest funding will help us to continue to tell the story of what happens in the development of prenatally cocaine-exposed children, says Minnes.

With the inception of this new study, Prenatal Cocaine Exposure in Adolescence, Minnes and her co-investigators will follow the children through age 18.

The study began with 415 infant-mother (or caretaker) pairs recruited at the infant's birth. Over the years, the children's development has been followed, as well as the mental health and substance abuse by the mother or caregiver. In three previous phases of NIDA funding, the researchers found that prenatal cocaine exposure negatively affects attention, language development, behavior and the ability to process visual information.

Most people know that mothers should not use drugs during pregnancy, says Minnes. This study over time will tell us what risks are associated with a specific prenatal drug exposure and how environmental influences shape developmental outcomes.

She adds that they have found important environmental factors such as elevated blood lead, maternal mental health and vocabulary level and the type of caregiver placement, are important to consider in evaluating prenatal cocaine exposure's effect on developmental outcome. The study will help us understand what interventions are needed at different developmental stages in their lives.

The study has been underway since 1994, when Lynn Singer, deputy provost and professor of pediatrics in the school of medicine, questioned what happens to prenatally cocaine-exposed children as they grow older. Minnes, who worked as the project coordinator since its beginning, became the study's principal investigator in 2007.

Her recent appointment to the Mandel School of Applied Social Science, where she earned her doctorate in social work, comes at a pivotal point in the study's progress as the focus shifts towards social behavior issues traditionally studied in the realm of social work, says Minnes. She will draw from the expertise of colleagues at MSASS who can provide additional insight regarding the effects of neighborhood and family violence, parental substance use, and placement issues on the development of prenatally cocaine-exposed adolescents.

Findings from the study will provide important information to early intervention specialists and child policy experts who can then develop targeted therapeutic interventions.

New reagents for genomic engineering of mouse models to understand human disease

Wed, 19 Aug 2009 03:59:36 PST

( from http://www.rxpgnews.com ) The ability to specifically target and modify genes in the mouse allows researchers to use this small rodent to study how certain genes contribute to human disease. A common method used to make genetic changes in mice and cells is called site-specific recombination, where two DNA strands are exchanged. The two strands may contain very different sequences, but are designated at their ends by specific target sequences that are not commonly found elsewhere in the genome. A protein, called a recombinase, cuts the DNA at its target sites and rearranges it. Scientists use this technique to exchange a naturally occurring DNA sequence for an altered or deleted gene to gain insight into the gene's normal function or how it contributes to disease.

Currently there are a few systems available to create genetic mutations in mice, including the recombinases FLP and Cre. These proteins are very efficient genetic modifiers and specifically target their appropriate sequences. They can also be turned on or off at precise times, or within specific tissues, to make carefully reegulated genetic changes. However, the small number of available methods that can be used together to mutate genes limits the complexity of the modifications that can be produced. For example, it would be informative to independently regulate the temporal and tissue-specific expression of genes with overlapping functions to understand their individual and combined effects.

Scientists now report that a new recombinase, Dre, induces controlled genetic changes in mice. Dre works similarly to the currently popular recombinase Cre, with an important exception: Dre recognizes a distinct target sequence and only recombines DNA around its target sequence, even if the target sequence for Cre is present. The ability of the related proteins, Cre and Dre to distinguish their own target sequences indicates that Dre can be used in combination with Cre, and other recombinases, to produce more sophisticated mouse models. This should facilitate the analysis of complex gene interactions and how they function in disease.

This technological advance also highlights the progress that might be made through open reagent sharing within the scientific community. The discovery of Dre recombinase was originally reported by Sauer and McDermott at the Stowers Institute for Medical Research. The Institute holds an intellectual patent for the system that allows it to be shared openly for non-commercial purposes and evaluates requests on a case-by-case basis for its use by for-profit institutions. Thus, the authors of the new DMM report do not have any proprietary claims to the system that they used to create this valuable mouse model. This is the first of a series of Resource Articles that will appear in

New study uses wastewater to map large-scale patterns of illicit drug use

Fri, 17 Jul 2009 03:59:36 PST

( from http://www.rxpgnews.com ) A team of researchers has mapped patterns of illicit drug use across the US state of Oregon using a method of sampling municipal wastewater before it is treated.

Their findings provide a one-day snapshot of drug excretion that can be used to better understand patterns of drug use in multiple municipalities over time. Municipal water treatment facilities across Oregon volunteered for the study to help further the development of this methodology as a proactive tool for health officials.

Applying analytical methods advanced at Oregon State University (OSU), researchers from the University of Washington, McGill University and OSU collected single-day samples from 96 municipalities across Oregon and tested the samples for evidence of methamphetamine, cocaine, and ecstasy or MDMA.

This work is the first to demonstrate the use of wastewater samples for spatial analyses, a relatively simple and cost-effective approach to measuring community drug use, said Caleb Banta-Green, lead author of the paper and epidemiologist at the University of Washington Alcohol and Drug Abuse Institute. Current measures of the true prevalence of drug use are severely limited both by cost and methodological issues. We believe these data have great utility as a population measure of drug use and provide further evidence of the validity of this methodology.

Municipalities across the state generously volunteered to help us test our methods by collecting samples more or less simultaneously, providing us with 24-hour composite influent samples from one day - March 4, 2008, said OSU's Jennifer Field, who led the laboratory analyses of the samples.

Using these samples from 96 municipalities, the researchers calculated the presence, measured as index loads, of three stimulant drugs: methamphetamine, ecstasy, and benzoylecgonine (BZE, a cocaine metabolite).

They found that the index loads of BZE were significantly higher in urban areas and below the level of detection in some rural areas. Methamphetamine was present in all municipalities, rural and urban. MDMA or ecstasy was at quantifiable levels in less than half of the communities, with a significant trend toward higher index loads in more urban areas.

Researchers said the study validates wastewater drug testing methodology that could serve as a tool for public health officials. Officials could, for example, use the methodology to identify patterns of drug abuse across multiple municipalities over time.

The research team said data used for this study are inadequate as a complete measure of drug excretion for a community or entire state. The team looked at a single day, mid-week sample, for instance. Results might be altered depending on the day or time of year the sample was gathered.

We believe this methodology can dramatically improve measurement of the true level and distribution of a range of illicit drugs, said Banta-Green. By measuring a community's drug index load, public health officials will have information applicable to a much larger proportion of the total population than existing measures can provide.

Currently, Field and Banta-Green are working on a project funded by the National Institutes of Health to determine the best method for collecting data in order to get a reliable annual estimate of drug excretion for a community.

DOD, VA should take stronger steps to combat tobacco use in military, veteran populations

Fri, 26 Jun 2009 03:59:36 PST

( from http://www.rxpgnews.com ) WASHINGTON -- Because tobacco use impairs military readiness, harms the health of soldiers and veterans, and imposes a substantial financial burden on the departments of Defense and Veterans Affairs, these agencies should implement a comprehensive strategy to achieve the Defense Department's stated goal of a tobacco-free military, says a new report from the Institute of Medicine. DOD should gradually phase in a ban on tobacco use in the military, starting at military academies and officer training programs and among new recruits, the report says. DOD should also stop selling tobacco products in Army and Air Force commissaries -- Navy and Marine Corps commissaries already do not sell them -- and should stop selling them at a discount in military exchanges and other stores. In addition, Congress should allow VA to establish tobacco-free medical centers.

The report was requested by DOD and VA, who asked the Institute of Medicine to identify policies and practices that could lower rates of smoking and help soldiers and veterans quit.

Tobacco use reduces soldiers' physical fitness and endurance and is linked to higher rates of absenteeism and lost productivity, the report says. In 2005, 32 percent of active-duty personnel and 22 percent of veterans were smokers; rates among active-duty personnel have recently increased, possibly because of growing tobacco use by deployed troops.

We found that the adverse effects of tobacco use on military readiness, the health of both smokers and nonsmokers, and the financial cost of the medical care of smoking-related illness in military and veteran populations are a sound basis for moving systematically toward a tobacco-free military, said Stuart Bondurant, professor of medicine and dean emeritus of the School of Medicine at the University of North Carolina, Chapel Hill, and chair of the committee that wrote the report. The state of the art in tobacco control is such that with well-managed programs, DOD and VA could eventually be tobacco free with minimal disruption, and with substantial benefit to military personnel and veterans.

DOD and VA should ensure that all personnel have quick and easy access to comprehensive, evidence-based tobacco-cessation services, the report says. All DOD and VA health care providers should be able to provide brief counseling and nicotine-replacement therapy to patients. In addition, the committee recommended that VA and DOD develop toll-free quitlines to provide military personnel and veterans with counseling on quitting tobacco. Quitline counselors should be trained to deal with issues related to these populations, such as post-traumatic stress disorder.

The Defense Department should set a date by which the military will be tobacco-free and require each of the four services to develop and enforce a timeline for achieving this goal, the report says. Recognizing that immediately banning tobacco use in deployed personnel is not realistic, the committee urged an incremental strategy, starting with closing the pipeline of new tobacco users entering the military. Smoking should be banned at military academies, and the current ban on tobacco use during basic training should be extended to include subseqent technical training. That ban could eventually be extended to all new enlistees, who would be informed during recruitment that they would be expected to remain tobacco-free during their entire military careers.

Eventually, all military installations and active-duty personnel should be required to be tobacco-free -- a goal that could realistically be achieved in 20 years or even sooner, if the plan's initial phase for military academies and new recruits starts within a year, the report says.

Only with assistance from DOD and VA will tobacco use be stopped, the report says, and ideally DOD should not sell tobacco products as they inhibit military readiness. As a first step, DOD should prohibit tobacco sales in Army and Air Force commissaries and stop selling tobacco products at a discount in other military stores. Congress should direct DOD to sell any tobacco products in military exchanges at prices equal to those in the civilian sector, and preferably higher.

Congressional action is also necessary to allow VA to implement tobacco-free medical facilities. The VA's efforts to do so have been hampered by the language of the Veterans Health Care Act of 1992, which requires them to maintain smoking areas for veterans and employees. This act should be repealed, the report says.

Care Management Reduces Suicidal Ideation in Geriatric Depression

Wed, 24 Jun 2009 03:59:36 PST

( from http://www.rxpgnews.com ) Depression in older adults too often goes unrecognized and untreated, resulting in untold misery, worsening of medical illness, and early death. A new study has identified one important remedy: Adding a trained depression care manager to primary care practices can increase the number of patients receiving treatment, lead to a higher remission rate of depression, and reduce suicidal thoughts.

"Almost one in 10 older adults in the United States has some form of depression, and one-fifth among them contemplates suicide. Two-thirds of these patients are treated by primary care physicians. Sadly, their depression is often inadequately treated due to the primary care physician's time constraints and the patient's reluctance to discuss their symptoms and adhere to treatment," says Dr. Alexopoulos.

The critical finding of the PROSPECT study is that adding a trained care manager to primary care practices increases the number of depressed older patients who receive treatment and improves their outcomes, not only in the short term, but over two years.

"This is important because depression can either become chronic or relapse after an initial improvement," adds Dr. Alexopoulos. "Most diseases have worse outcomes when an old person becomes depressed. Depression almost doubles the risk for death. It follows that treating depression effectively can reduce sickness, disability and death."

The study, conduced by NewYork Presbyterian/Weill Cornell, the University of Pittsburgh, and the University of Pennsylvania, followed 599 patients aged 60 years and older with depression at 20 primary care practices of varying sizes in New York and Pennsylvania. Participants were randomized to receive either the PROSPECT intervention or usual care. Those in the PROSPECT group were assigned a care manager -- a trained social worker, nurse or psychologist -- who helped the physician offer treatment according to accepted practice guidelines, monitored treatment response and provided follow-up over two years. Practice guidelines included the antidepressant citalopram (Celexa), with the option of other drugs or psychotherapy.

The PROSPECT intervention worked especially well for a subgroup of patients with major depression, the more severe form of the disease, with a greater number achieving remission, or the near absence of symptoms. Patients with minor depression had favorable outcomes regardless of their study group.

Various forms of care management are being used successfully for cardiovascular patients needing anticoagulation medication and for diabetes patients needing insulin monitoring, says Dr. Alexopoulos. "The PROSPECT study has demonstrated that care management is highly successful for older adults with major depression."

"At this time, our nation is focused on disease prevention as a way to improve the health of Americans and to reduce health care cost. Reducing depression over long periods of time can be one of the ways to achieve this objective," continues Dr. Alexopoulos. "Care management, like that of the PROSPECT study, is relatively inexpensive. Finding ways to reimburse it can make it broadly available and have a major impact on the overall heath care."

Snoring due to sleep apnea can damage brain severely

Mon, 22 Jun 2009 11:23:33 PST

( from http://www.rxpgnews.com ) Snoring due sleep apnea may impair brain function in a much worse way than previously thought, according to a new study.

Sufferers of Obstructive Sleep Apnea - experience similar changes in brain biochemistry as people who have had a severe stroke or who are dying, the research shows.

OSA is caused by obstruction of the airway, a disorder characterised by pauses in breathing during sleep.

A study by University of New South Wales - Brain Sciences is the first to analyse, in a second-by-second timeframe, what is happening in the brains of sufferers as they sleep.

Previous studies have focussed on recreating oxygen impairment in patients who are awake.

'It used to be thought that apnoeic snoring had absolutely no acute effects on brain function but this is plainly not true,' said study co-author Caroline Rae, professor at Prince of Wales Medical Research Institute.

Sleep apnea affects as many as one in four middle-aged men, with around three percent going on to experience a severe form of the condition characterised by extended pauses in breathing, repetitive asphyxia and sleep fragmentation.

Children with enlarged tonsils and adenoids are also affected, raising concerns of long-term cognitive damage.

Rae and collaborators from Sydney University's Woolcock Institute used magnetic resonance spectroscopy to study the brains of 13 men with severe, untreated, obstructive sleep apnea, said a UNSW release.

They found that even a moderate degree of oxygen desaturation during the patients' sleep had significant effects on the brain's bioenergetic status.

'The findings show that lack of oxygen while asleep may be far more detrimental than when awake, possibly because the normal compensatory mechanisms don't work as well when you are asleep,' said Rae.

These findings were published in the May edition of Journal of Cerebral Blood Flow and Metabolism.

Meditation may be effective for treating insomnia

Thu, 18 Jun 2009 13:00:57 PST

( from http://www.rxpgnews.com ) Meditation may be an effective remedy in treating insomnia, latest research suggests.

According to Ramadevi Gourineni, principal study investigator and director of the insomnia programme at Northwestern Memorial Hospital in Illinois, insomnia is thought to be a 24-hour problem of hyper-arousal. Moreover, elevated measures of arousal are seen throughout the day.

The study collected data from 11 healthy subjects between the ages of 25 and 45 years who suffered from chronic primary insomnia. Participants were divided into two intervention groups for two months.

The first group was taught Kriya Yoga, a form of meditation that is used to focus internalized attention and has been shown to reduce measures of arousal. The second group received health education.

Participants of the health education group also received information about health-related topics and how to improve health through nutrition, exercise, weight loss and stress management.

Results suggested that patients saw improvements in subjective sleep quality and sleep diary parameters while practicing meditation. Patients who practiced meditation saw improvements in sleep latency, total sleep time, total wake time, wake after sleep onset, sleep efficiency and sleep quality.

Findings of this study were presented at SLEEP 2009, the 23rd Annual Meeting of the Associated Professional Sleep Societies.

Dr. Ramadevi Gourineni completed her medical school at Kurnool Medical College in Andhra Pradesh, India. She was raised in the United States prior to this. Dr. Gourineni's has a special interest in behavioural treatment of insomnia and currently is involved in research studying the effects of meditation on stress and sleep in individuals with chronic insomnia.

Society doing hyperactive kids a disservice

Thu, 18 Jun 2009 11:30:22 PST

( from http://www.rxpgnews.com ) Authors and educators are doing hyperactive children a disservice by insisting that hyperactivity has always existed.

Canadian researcher Matthew Smith said not only is that notion wrong, it misleads patients, their parents and their physicians. Smith, from Edmonton is completing his doctorate at the Centre for Medical History, University of Exeter.

Hyperactivity disorder - is currently the most commonly diagnosed childhood psychiatric disorder, said Smith, and millions of children are prescribed drugs including Ritalin to treat it. Yet prior to the 1950s, it was clinically and culturally insignificant.

He argued in a paper that hyperactivity disorder as we understand it today is a modern construct that was first described in 1957. Before that hyperactive behaviour existed - but it wasn't always thought of as a disorder or pathology worth treating, said Smith.

However, Smith said many today assert that hyperactivity is a universal phenomenon, which can be seen in historical figures like Mozart or Einstein. Smith argues that hyperactivity is rooted in social, cultural, political and economic changes of the last half century.

'When history is extended back beyond 1957, it overlooks all the social factors that contributed to the idea that children were hyperactive - and that that was a problem,' he says.

Smith says that whether you consider hyperactivity a disease worth treating often depends on context - and the context changed in the late 1950s when the US refocussed its education system in response to the space race, said an Exeter release.

'If a child's playing soccer, there's a chance hyperactivity isn't going to be a problem. But if they are stuck in a classroom, it is a problem,' he said.

Brain protein BDNF might get you hooked on drugs, alcohol

Wed, 17 Jun 2009 14:23:35 PST

( from http://www.rxpgnews.com ) A brain protein can practically hook you on to drugs and alcohol by hijacking the normal functioning of its reward circuitry.

Researchers investigating this addiction 'switch' have now implicated a naturally occurring protein, a dose of which allowed them to get rats hooked with no drugs at all.

Chronic drug users, as noted by previous research, can experience an increase in this protein called BDNF - in the brain's reward circuitry.

Researchers noted that a single injection of BDNF made rats behave as though they were dependent on opiates -.

Though rats instinctively prefer certain smells, lighting and texture, these rats left their comfort zone in search of a fix.

'If we can understand how the brain's circuitry changes in association with drug abuse, it could potentially suggest ways to medically counteract the effects of dependency,' said Scott Steffensen, neuroscientist at Brigham Young University -.

He co-authored the study with two of his undergraduate students, one of his graduate students, and a team of researchers at the University of Toronto, said a BYU release.

'This work may reveal a mechanism that underlies drug addiction,' said study co-author Hector Vargas-Perez, a Toronto neurobiologist.

The study was published in Science.

Caffeine may prevent risk taking after sleep deprivation

Fri, 12 Jun 2009 14:35:47 PST

( from http://www.rxpgnews.com ) Washington, June 12 - A dose of caffeine may prevent increased risk taking that occurs after several nights of total sleep deprivation, according to the latest research.

Results suggest that despite extreme sleep deprivation, subjects who consumed caffeine did not exhibit increased risky behaviour on the Balloon Analog Risk Task -, a computerized measure of impulsive risk-taking.

According to William Killgore, principal study investigator and research psychologist at Harvard Medical School, sleep deprivation may not have a simple linear effect on risk taking, but there may be a 'breaking point' during which a person may show a drastic reduction in their ability to control or inhibit behaviour. In this study, caffeine appeared to protect against that breaking point.

'People who were awake for three days straight became more impulsive and acted with less regard for consequences. However, if they had consumed caffeine each night -, they showed no increase in risky behaviour' said Killgore.

Though this study looked at the most extreme range of sleep deprivation and most people may not experience such effects under normal circumstances, results from a previous study have shown that those who were constantly restricted to three hours of sleep per night for a week showed an increase in risk-taking behaviour.

Findings of this study were presented at SLEEP 2009, the 23rd Annual Meeting of the Associated Professional Sleep Societies.

Report on US tobacco control policies and use finds stark contrasts in progress among states

Wed, 10 Jun 2009 03:59:36 PST

( from http://www.rxpgnews.com ) BUFFALO, N.Y. -- The United States is becoming a nation of haves and have-nots when it comes to tobacco control, according to a comprehensive publication on cigarette smoking prevalence and policies in the U.S. that was released today.

The new report, Cigarette Smoking Prevalence and Policies in the 50 States: An Era of Change -- the Robert Wood Johnson Foundation ImpacTeen Tobacco Chart Book, was presented today at the National Conference on Tobacco or Health meeting in Phoenix.

It was prepared for the Robert Wood Johnson Foundation by researchers in the University at Buffalo Department of Health Behavior in UB's School of Public Health and Health Professions and at the Roswell Park Cancer Institute. Researchers from eight other institutions also contributed, including the University of Illinois at Chicago, the National Cancer Institute and the Robert Wood Johnson Foundation.

The report includes individualized data on smoking behaviors for all 50 states as well as a discussion of national trends revealed by the data.

States can reduce death and disease by reducing smoking prevalence, said Gary G. Giovino, Ph.D., professor and chair of the Department of Health Behavior in the UB School of Public Health and Health Professions and principal investigator on the report. It's that simple.

States should feel morally obligated to use a higher proportion of the revenues they receive from cigarette excise taxes and settlement payments to prevent smoking initiation, protect nonsmokers and help people who smoke to quit. Strong tobacco control programs save lives, he added.

The report points out that even after four decades of tobacco control efforts, one-fifth of American adults still smoke and prevalence is especially high among populations with lower levels of education and income, Native Americans and those with psychiatric and substance abuse problems.

While much progress has been made in reducing cigarette smoking in the United States, there still is much work to do, said Giovino, who has long studied the epidemiology of tobacco use among youth and adults and how it is affected by public health policies; he was previously chief of the Epidemiology Branch in the Office on Smoking and Health of the U.S. Centers for Disease Control and Prevention.

According to the report, serious disparities remain in the use of tobacco and access to effective policies and treatments that curtail it.

There is wide variation in cigarette smoking prevalence across states and a clear relationship between smoking prevalence and the rate of mortality that can be attributed to smoking, Giovino said.

For example, among 18-29 year olds, smoking prevalence was 2.5 times higher in Kentucky (36.2 percent) than in California (14.4 percent). And in 2006-07, 66 percent of adults aged 30 or older in New Hampshire who had ever smoked said they had quit, while in West Virginia for the same age group, only 45 percent of smokers said they had quit.

The report also presents state-level analyses showing that in states with the lowest prevalence of smoking, the remaining smokers are less likely to show indicators of dependence and more likely to want to quit, compared to smokers in high prevalence states.

The same programs and policies that lower prevalence also reduce the number of cigarettes smoked each day and motivate quitting, Giovino stated.

He said that while a combination of outreach programs, legislation, cigarette price increases and coverage for and access to stop-smoking treatments has been proven to work, the report nevertheless reveals that most states are not fully implementing these approaches to reduce smoking rates and protect nonsmokers.

According to the report, in 2006, approximately 27 percent of adult Medicaid recipients were smokers, significantly higher than the 17 percent rate among adults with private insurance. But in 2006, Medicaid programs in a dozen states still did not provide coverage for proven tobacco treatment to their clients who smoked.

The report also reveals that increases in excise taxes on cigarettes have consistently been proven to be effective in both preventing smoking and causing people to quit, but these taxes range from a high of $3.46 in Rhode Island to a low of just 7 cents in South Carolina.

Even considering the recent 61-cent federal excise tax increase, state and federal excise taxes still accounted for a smaller percentage of the retail price of a pack of cigarettes in 2009 (40 percent) than they did in 1970 (49 percent).

The percentage of resources available to states from cigarette excise taxes and settlement payments that is dedicated to tobacco prevention and cessation is dwindling, said Giovino. This is a tragic development.

According to the report, the increase in state programs and policies designed to reduce both smoking prevalence and exposure to tobacco smoke pollution has resulted in numerous positive outcomes from 1992-93 to 2006-07, including:

High Risk of Disordered Eating in OCD

Mon, 08 Jun 2009 10:55:51 PST

( from http://www.rxpgnews.com ) Doctors and other health workers should be more aware of the high risk of eating disorders among people with obsessive compulsive disorder (OCD) and other anxiety disorders.

According to new research presented at the recently concluded Royal College of Psychiatrists’ 2009 Annual Meeting, as many as one in five people with OCD could also have some form of disordered eating. In addition, disordered eating may occur in as many as one in three patients with other anxiety disorders.

OCD is a serious anxiety-related condition that affects 2-3% of the adult population. People with severe OCD may find it difficult to work regularly, or even take part in their family or social life.

Dr Lynne Drummond, a consultant psychiatrist at South West London and St George's NHS Mental Health Trust, collected data from a sample of patients with severe OCD who were referred to a specialist unit for treatment. A control group of patients with other anxiety disorders referred for treatment to the same unit was also studied.

The study found that a fifth of the patients with OCD also had signs of disordered eating. The prevalence for those with other anxiety disorders was a one in three.

Dr Drummond said: “Although these have been several studies examining the prevalence of OCD and obsessive symptoms in patients with eating disorders, there is a dearth of studies where patients with OCD and other anxiety disorders are examined for eating disorders.

“This study suggests that clinicians should be made aware of the high prevalence of disordered eating in patients with all anxiety disorders as well as OCD.”

'Happy hour' gene discovery suggests cancer drugs might treat alcoholism

Thu, 21 May 2009 03:59:36 PST

( from http://www.rxpgnews.com ) A class of drugs already approved as cancer treatments might also help to beat alcohol addiction. That's the conclusion of a discovery in flies of a gene, dubbed happyhour, that has an important and previously unknown role in controlling the insects' response to alcohol.

Animals with a mutant version of the gene grow increasingly resistant to alcohol's sedative effects, the research shows. The researchers report further evidence that the gene normally does its work by blocking the so-called Epidermal Growth Factor (EGF) pathway. That EGF pathway is best known for its role in cancer, and drugs designed to inhibit the EGF receptor, including erlotinib (trade name Tarceva) and gefitinib (trade name Iressa), are FDA-approved for the treatment of non-small cell lung cancer.

Now, the researchers show that flies and mice treated with erlotinib also grow more sensitive to alcohol. What's more, rats given the cancer-fighting drug spontaneously consumed less alcohol when it was freely available to them. Their taste for another rewarding beverage -- sugar water -- was unaffected.

This is a very powerful example of how simple model organisms -- and the little fruit fly in particular -- can be used to move quickly from an unknown gene to a potential therapy for drug addiction, said Ulrike Heberlein of the University of California, San Francisco, noting that erlotinib and gefitinib, along with other EGFR inhibitors, not only cross the blood-brain barrier in humans, but they are also well-tolerated in general.

Alcohol is one of the most popular and abused drugs in the world, the researchers said. Therefore, a better understanding of the genetic and environmental factors that lead to its addiction would have considerable benefit for those who suffer its consequences and for society at large. Despite the well-known effects of alcohol consumption on behavior and cognition, the underlying basis for those effects on the nervous system are still rather incomplete.

Human studies have pointed to a strong genetic component to alcoholism, but identifying the specific genes responsible has proved difficult. Studies have also indicated that an individual's sensitivity to alcohol intoxication acts as a predictor of future alcoholism, with a link between lower initial response and increased risk of addiction. Therefore, Heberlein's team explained, genes and pathways involved in the acute response to alcohol can yield insight into the genetic factors contributing to the more complex process of addiction.

Earlier studies have shown that fruit flies are a useful tool for unraveling the basis for the effects of alcohol. Several genes previously identified as playing a role in fruit flies' alcohol response hold similar roles in mammals.

In search of more in the new study, the researchers screened mutant flies for those less sensitive to ethanol. That screen led them to happyhour, a gene closely related to mammalian enzymes known as the Ste20-family kinases of the GCK-1 subfamily.

Heberlein said they still don't know exactly how alcohol exerts its influence on the EGFR pathway or how that leads to the telltale changes in behavior that come with alcohol intoxication. Those questions will be the subject of future investigation. Her team is also exploring other new gene candidates that turned up in the fly screens. She says that several of those appear to be tied to the EGFR pathway in different ways.

It's not yet clear how it all fits together, she said. But the fact that we've come, in an unbiased way, to molecules in the same pathway is telling us this is really, really important.

Experience vital for complex decision-making

Wed, 20 May 2009 11:31:22 PST

( from http://www.rxpgnews.com ) Experience is vital when we have to make complex decisions based on uncertain or confusing information, a new study has found.

'Learning from experience actually rewires our brains so that we can categorise the things we are looking at, and respond appropriately to them,' said Zoe Kourtzi from the University of Birmingham, who led the research.

In selecting a course of action that is most likely to be successful, the brain has to interpret and ascribe meaning to inherently uncertain information - being able to do this is vital for our survival.

This ability is critical when we are responding to visual stimuli that are very similar - for example, trying to recognise friends in a crowd or discern a tumour from healthy tissue on a medical scan.

'We have shown that this learning process is not just a matter of learning the structure of the physical world - when I look at something I'm not just playing a game of 'snap' in my head where I try to match images to each other,' Kourtzi said.

'In fact, areas in our brains are actually trained to learn the rules that determine the way we interpret sensory information,' he said, according to a university statement.

Kourtzi and colleagues wanted to find out about the human brain mechanisms that mediate flexible decision-making through learning, which have so far not been well understood, despite it being fairly clear that successful decisions benefit from previous experience.

They combined measurements of behaviour and brain signals to study how volunteers learned to discriminate between highly similar visual patterns and to assign them in different categories.

The research was published in Wednesday's edition of Neuron.

Disrupted UBE3A Gene Causes Angelman Syndrome

Mon, 11 May 2009 10:23:59 PST

( from http://www.rxpgnews.com ) Washington, May 11 - A disrupted gene triggers severe mental retardation known as the Angelman Syndrome, according to a new study.

The syndrome is one of a small family of single gene, autism-related, neuro-developmental disorders.

The study by Duke University Medical Centre - and University of North Carolina - researchers identified the gene as UBE3A in mice, which helps neurons form and connect with other neurons for storing sensory information.

Angelman Syndrome develops typically when children are between one and two years old. This is the period when the cortex, the sheet of convoluted folds at the brain surface, undergoes profound rearrangements driven by sensory experiences.

The experience of seeing reorganises the visual cortex, for example, during the same period when symptoms are becoming obvious in Angelman Syndrome.

'We wanted to look at an animal model to learn if this experience-dependent reorganisation of the cortex was abnormal in animals that were missing the gene,' said Michael Ehlers, Duke professor of neurobiology and co-senior author of the study.

The authors found that brains cells in Angelman Syndrome mice lacked the ability to appropriately strengthen or weaken in the cortex, an area of the brain important for cognitive abilities, said a DUMC release.

'By strengthening and weakening appropriate connections between brain cells, a process termed synaptic plasticity, we are able to constantly learn and adapt to an ever-changing environment.' Ben Philpot, UNC professor in Cell and Molecular Physiology and co-senior author of the study.

Afflicted children appear to respond normally to stimuli during their first year but around 12-18 months, they start missing milestones of cognitive development and language, typically learning only a two to three words over their lifetime.

These findings were published in Nature Neuroscience.

Mind over muscle

Fri, 24 Apr 2009 03:59:36 PST

( from http://www.rxpgnews.com ) One in five women between the ages of 18 and 24 are smokers, and most say they keep lighting up for fear of gaining weight. But researchers at Temple University have found that when it comes to quitting, a little bit of dialogue and support can be more effective than an exercise plan in helping women not only keep off the weight, but also stay smoke-free.

A lot of college--age women report smoking to keep their weight down and for body image reasons, and we think that by providing them with the tools to make them feel better about themselves, it alleviates some of those stressors, said Melissa Napolitano, a clinical psychologist at Temple's Center for Obesity Research and Education.

In a two-phased study, Napolitano and a team of researchers looked at the smoking habits and weight gain of women aged 18-24. The first phase collected data from focus groups who stated that stress, peer pressure and weight management were the main reasons why they smoked. Participants also felt that group-based programs that provide ongoing social support would be instrumental in helping them quit.

Those results laid the groundwork for the project's next phase, dubbed Fit to Quit, a small pilot study of 24 women who were randomly assigned to either a supervised group exercise program or body image group counseling sessions. All women were provided with a nicotine patch as well.

After eight weeks, the body image counseling group showed a rate of smoking cessation that was more than double that of the exercise group (18 percent vs. 8 percent). In addition, the body image group lost more than three times the weight of their exercise counterparts (3.3 pounds vs. less than a pound). These findings were presented this week at the Society for Behavioral Medicine's annual meeting.

Smoking has psychological and psychosocial implications, especially for young women, said Napolitano, an associate professor of kinesiology and public health in the College of Health Professions. We wanted to design a program that would not only address the physical addiction by providing a nicotine patch, but would also address those social and behavioral aspects as well.

Another aspect of the program relied on technology to reach their population of smokers. Text message and email were used to stay in contact with participants, more so than phone calls, because those were the preferred methods of communication among the young women in the study.

A lot of times, we would try to call participants to remind them of different sessions, and they would respond back via text or e-mail, so we took that message and used avenues like text messaging and the Internet not just as a means of getting information out, but for support as well.

Napolitano says that the results derived from this study have laid the groundwork for larger future studies at Temple and nationwide that focus on smoking cessation in college age women. The hope is to see if the results continue to hold true in studies with larger numbers of participants.

Temple's Student Health Services supported the Fit to Quit program, and Napolitano says it has the potential to be permanently offered as part of the menu of health promotion services on campus.

Our hope is to make programs like Fit to Quit sustainable on other college campuses, because we know that if we can give young people the tools they need to make better health decisions, it helps them not only improve their health but it also helps them do better academically.

Adolescent risk-taking has major consequences when it comes to marriage

Wed, 22 Apr 2009 03:59:36 PST

( from http://www.rxpgnews.com ) BUFFALO, N. Y. -- A national study of data collected over 12 years finds that delinquent teens marry earlier than their peers, while substance-abusing teens -- especially girls who abuse marijuana -- marry later than peers, if at all.

The Influence of Risk-Taking Behaviors on the Transition into Marriage: An Examination of the Long-Term Consequences of Adolescent Behavior by University at Buffalo sociologist Sampson Lee Blair, Ph.D., is a rare look at the long-term effects of teen delinquency and drug abuse on adult role attainment.

Delinquency was defined as anti-social behavior, including frequency of running away, arrests, physical fights and behavioral problems in school.

The study analyzed data from a U.S. Department of Education survey collected from a nationally representative sample of 9,813 young adults from 1988 to 2000. The results were presented at the March conference of the Eastern Sociological Society in Baltimore, Md.

The results are significant, says Blair, associate professor of sociology at UB, because in the U.S. marriage is commonly regarded as offering substantial economic, social and health advantages for individuals. The vast majority of high school girls -- much more so than boys -- tend to view marriage as extremely important to them.

But adolescent substance abuse and delinquent behaviors, he says, clearly have far-reaching consequences for the marital status of young adults, particularly girls.

Most previous studies have focused on the relatively short-term effects of adolescent substance use and delinquency, he says, but here we find good evidence that, for both sexes, delinquent behavior is linked to an increase in the likelihood of marriage and a lower age at first marriage. On the other hand, adolescents with relatively high levels of abuse of alcohol and marijuana have a lower likelihood of marriage even by their late 20s.

The likelihood of marriage by that age is substantially lower among female adolescent substance abusers, particularly if the substance abused is marijuana.

He says the results suggest that delinquency and substance abuse may influence adolescents' orientation toward other adult roles as well.

The analyses employed data from 5,331 females and 4,482 males participants in the National Educational Longitudinal Study (NELS), a nationally representative sample of high school students that collected information from respondents over a 12-year period.

NELS, conducted by the U.S. Department of Education, collected data from surveys of students, parents, teachers and school administrators in 1988, 1990, 1992, 1994 and 2000, at which time most of the students in the sample were in their mid- to late-20s, had completed their educational goals and had already entered into marriage.

Adolescent respondents were asked about the frequency of their alcohol use and marijuana use; delinquent and anti-social behavior, including frequency of running away, arrests, physical fights and school problems (cutting classes, skipping school, getting into trouble for violating rules, suspension or probation, transfer for disciplinary reasons).

The study also assessed data relative to family income, parental expectations about college attendance and the importance peers placed on various activities like going to parties, drinking alcohol, having sex and using drugs. Control measures for the race/ethnicity of respondents were used as well.

It is certainly the case that many of these variables had an effect on the timing of the participants' marital experience, Blair says.

Nevertheless, this analysis clearly suggests that even when all of them are considered, adolescent substance abuse and delinquent behaviors have far-reaching consequences for the marital status of young adults, he says.

Additional research is needed to learn how developmental processes of adolescence are affected by delinquent behavior and substance abuse and the relative influences of these sex-based differences on other forms of adult status attainment.

Naltrexone also curbs compulsive thieving instincts

Wed, 01 Apr 2009 14:56:36 PST

( from http://www.rxpgnews.com ) Washington, April 1 - A medication for treating alcohol and drug addiction also curbs compulsive thieving instincts, according to a new research.

University of Minnesota - Medical School's psychiatry department conducted an eight-week, double-blind study of 25 men and women aged 17-75, who spent an average of at least one hour a week stealing.

Those who took the drug Naltrexone - reported significantly greater decline in stealing behaviour compared to those taking placebo.

'It gets rid of that rush and desire,' said Jon Grant, U-M associate professor of psychiatry and principal investigator of the study. 'The difference in their behaviour was significant, and these people were really troubled by their behaviour,' he added.

A recent epidemiological study of about 43,000 adults found that more than 11 percent admitted to having shoplifted in their lifetime. Epidemiology is the study of factors affecting the health and illness of populations.

It is unclear, however, how many people who steal suffer from kleptomania -.

While the drug is not a cure for kleptomania, Grant said it offers hope to those who are suffering from the addiction. He also said the drug would most likely work best in combination with individual therapy, said a U-M release.

'These are people who steal even though they can easily afford not to,' Grant said.

The research was published in the Wednesday issue of the Journal of Biological Psychiatry.

People With Schizophrenia Face Increased Risk Of Diabetes - Research

Tue, 31 Mar 2009 14:33:38 PST

( from http://www.rxpgnews.com ) Are people with schizophrenia at an increased risk of developing type-2 diabetes? It would seem so, according to the results of a new study.

Of the 50 people diagnosed with schizophrenia or a related psychotic disorder that participated in the study, eight had either diabetes or an abnormal rate of glucose metabolism, said Brian Kirkpatrick, vice-chairman of the Medical College of Georgia's - Department of Psychiatry and Health Behaviour.

'These findings point toward there being some shared environmental factors or genetic factors between the development of schizophrenia and diabetes,' he said.

Schizophrenia symptoms include memory and attention problems, hallucinations, disorganised thinking and behaviour and delusions. Psychotic symptoms typically start in late adolescence and early adulthood.

People with diabetes cannot produce or properly use insulin, a hormone that converts glucose, starch and other food into energy.

Kirkpatrick and colleagues at the Universities of Barcelona - and Maryland - administered a two-hour oral glucose test to patients who had not yet been placed on anti-psychotic medication.

Catching them before prescriptive treatment was important because researchers already knew that some of the most effective schizophrenia drugs also cause rapid weight gain - a risk factor for type-2 diabetes, according to MGC release.

'We know the medicine causes problems but we wanted to know whether the disease also causes them,' said Kirkpatrick.

Researchers believe that developmental abnormalities they don't yet know about also increase diabetes risk.

Kirkpatrick presented his findings at the International Congress on Schizophrenia Research in San Diego March 28-April 1.

Inconsistancy in response underlies impaired working memory in ADHD

Wed, 25 Mar 2009 00:41:20 PST

( from http://www.rxpgnews.com ) Children with attention-deficit hyperactivity disorder (ADHD) show more variable or inconsistent responses during on ‘working’ or short-term, memory tasks when compared with typically developing peers, a study by UC Davis M.I.N.D. Institute Julie Schweitzer has found.

“We think poor working memory is a characteristic present in many children and adults with ADHD,” said Schweitzer, an associate professor in the Department of Psychiatry and Behavioral Sciences.

“Our study helps explain why working memory may be fine at one moment and poor at another, just as one day a child with ADHD seems to be able to learn and focus in class and on another day seems distracted and not paying attention,” Schweitzer said.

According to the national Centers for Disease Control and Prevention (CDC), an estimated 4.4 million youth, ages 4 to17, have been diagnosed with ADHD by a healthcare professional. In 2003 nearly 8 percent of school-aged children were reported to have an ADHD diagnosis by their parent. The current study, published online in February in the journal Child Neuropsychology, supports the idea that what underlies impaired working memory is a problem in how consistently a child with ADHD can respond during a working memory task.
“We have known for some time that children with ADHD vary in how fast they are able to complete working memory tasks when compared to normally developing control subjects,” Schweitzer explained .

Previous studies have suggested that children with ADHD might be slower at responding to tasks. The current study took a closer look at their performance using a relatively newer statistical analytical approach, to determine whether the children with ADHD were indeed faster, slower, or if perhaps another, more complicated process was occurring. The hypothesis was that children with ADHD were actually mostly responding at the same rate as healthy children, but with more frequent very slow responses than the control subjects.

To test this hypothesis, the study authors presented 25 children with ADHD and 24 typically developing peers with the Visual Serial Addition Task, a computerized program that presents children with a number on one screen and then asks them to mentally add it to another number shown on a second screen. The children are then asked to decide whether or not a given sum is correct. From session to session, the task is presented at different speeds and at different levels of difficulty.

“We found that the children with ADHD were much less consistent in their response times,” said Wendy Buzy, study lead author and a graduate student when the experiments were conducted.

Schweitzer and Buzy were both at the University of Maryland at the time. Buzy said that the children with ADHD had more frequent longer response times when compared with their typically developing peers, but the responses they did give were just as accurate.
“Once we controlled for omission errors, the accuracy of the two groups was the same,” she said.

Buzy and Schweitzer pointed out that one of the unique things about their study was the way in which their data were analyzed. Previous studies compared only the range of reaction times and average reaction times for children with ADHD and controls. The method used in the current study allowed researchers to compare variation in response times within and between individuals, as well as within and between the two groups. The researchers also showed that working memory variability correlated with ADHD symptoms as scored by parent surveys (using the Conners’ ADHD rating scale) prior to testing.

“We found that higher levels of hyperactivity and restlessness or impulsivity correlated with slower reaction times,” Schweitzer said.

The current results led another Schweitzer laboratory member, postdoctoral fellow Catherine Fassbender, to design a study looking at variability in response time during a working memory task in the brains of children with ADHD using functional magnetic resonance imaging (fMRI).

“This study increases our understanding of what might be happening at a physiological level that underlies the inconsistency in responding in ADHD,” she said.

Schweitzer also hopes to look at whether behavioral interventions and/or medications can help reduce the kind of variability observed in the current study. Variability in working memory, she said, means children cannot generalize what they learn in one situation to another.

“Improving consistency in how children with ADHD respond to the environment should help them generalize what they learn in clinical interventions improving their skills across situations.”

Drawing enhances emotional verbalization among children under the shadow of drug-addicted fathers

Thu, 12 Mar 2009 03:59:36 PST

( from http://www.rxpgnews.com ) Research at the new School of Creative Arts Therapies at the University of Haifa: Drawing enhances emotional verbalization among children who live under the shadow of drug-addicted fathers

*The use of art seems to help with verbalizing trauma. It is usually difficult to express the trauma through speech, yet the body remembers it, said Prof. Rachel Lev-Wiesel, Head of the Graduate School of Creative Arts Therapies who carried out the study.*

Drawing helps children whose fathers are drug addicts to express their feelings, concludes a new study carried out at the School of Creative Arts Therapies at the University of Haifa. It is difficult to verbally describe a trauma, yet the body remembers it, said Head of the school Prof. Rachel Lev-Wiesel, who carried out the study alongside Revital Liraz of the Hosen Center in Beer Sheba.

People who have experienced trauma often find it difficult to describe their feelings and experiences in words. Art therapy enables the client to expose these feelings first through non-verbal symbols, and then narrate them. The Graduate School of Creative Arts Therapies at the University of Haifa is the first Israeli academic track that grants an MA degree in creative arts therapies to its graduates. There are three courses of study in the school: Plastic Art Therapy, Movement Therapy, and Drama Therapy. The importance of therapy through the arts has increased over the past years, and as with every other discipline of therapy, much weight ought to be placed on basing therapist training on research, said Prof. Lev-Wiesel.

Participating in this study were 60 children, aged nine to fourteen, who were arbitrarily divided into two groups. The children in the first group were asked to draw their life in the shadow of a drug-addicted father and then to describe their experiences to a social worker who interviewed them. The second group was asked to describe life with a drug-addicted father without use of drawings. It was observed that already while drawing the first group of children spoke freely about their lives.

An analysis of the narratives provided by the two groups revealed that the descriptions given by those children who had been asked to draw first included more feelings and sensations, were longer, and expressed optimism for the future. The children in the second group, however, were more reluctant to talk. Their narratives were shorter, without feeling, and less coherent. Emotional-verbal ability is crucial for growth and for social skills, so enabling a child to increase ability of expression and sharing by means of drawing pictures is beneficial in contributing to the efficiency and effectiveness of therapy, Prof. Lev-Wiesel concluded.

Therapy through art is a relatively new field, she said, there is still a lack of empirical studies. One of the goals of the new school is to expand the pool of researchers in the field.

UCSF Gallo team reports hormone disorder drug could help drinkers stay sober

Mon, 23 Feb 2009 04:59:36 PST

( from http://www.rxpgnews.com ) A drug prescribed for male and female infertility and menstrual disorders could hold the key to a more effective treatment for alcoholism, according to a study by researchers at the UCSF-affiliated Ernest Gallo Clinic and Research Center.

The study showed that alcoholic rodents, when injected with the drug cabergoline, decreased their alcohol consumption and alcohol-seeking behavior and were less likely to relapse.

Cabergoline, which is marketed under the trade name Dostinex, is approved by the Food and Drug Administration in pill form to treat conditions caused by excess of the hormone prolactin.

The study, led by Dorit Ron, PhD, a principal investigator at the Gallo Center and associate professor of neurology at UCSF, is now on line (February 20, 2009), in the journal Biological Psychiatry. (See end of news release for link to paper.)

Notably, cabergoline did not impact the rats' consumption of sucrose and, in a subgroup of binge-drinking mice, the drug did not appear to significantly affect intake of water or saccharin.

This is encouraging, says Ron, because it demonstrates that cabergoline is specific for alcohol, but does not affect general reward or pleasure. One of the problems with some existing drugs to treat alcoholism is a side effect that decreases pleasure, making compliance an obstacle to sobriety.

The research builds on an earlier, provocative finding by Ron and her colleagues regarding the protein GDNF (glial cell line-derived neurotrophic factor), which they had injected into rats' VTA (ventral tegmental area) brain region, associated with drug-seeking behavior.

In this earlier study, the scientists had trained rats to consume alcohol. Some, like humans, drank in moderation, while others binged. But when GDNF was administered, both heavy and light drinkers lost at least some of their craving for alcohol. This effect became apparent within 10 minutes and lasted at least 24 hours, the scientists discovered. Importantly, administration of GDNF into the brain prevented the rats from relapsing after a period of abstinence.

While the discovery broke new ground, the scientists knew that GDNF could not be used to treat alcoholic humans because its molecule is too large to cross the blood-brain barrier. So, in the present study, Ron and her colleagues looked at cabergoline, a compound that has been shown in cells to increase the expression of GDNF.

After establishing that cabergoline treatment resulted in an increase of the level of GDNF and activation of the GDNF pathway in the rats' VTA, the researchers sought to test its impact on rodents' drinking habits.

Rats underwent a two-month training program in which they learned to press a lever to obtain alcohol. Researchers found that when rats were injected with cabergoline, they were less likely to press the lever. The higher the dose of cabergoline, the lower the number of lever presses reported. The researchers also found that binge-drinking mice consumed less alcohol after cabergoline administration.

In further study, the researchers found that cabergoline was effective in reducing both craving for alcohol and relapse to drinking. Relapse is a critical issue for alcoholic patients trying to stay abstinent.

As further evidence of the interplay between cabergoline and GDNF, alcohol intake was tested on mice that had been genetically engineered to have a single copy of the GDNF gene, and therefore less GDNF in the brain. As expected, the scientists found that the drinking habits of these genetically modified mice were not affected by cabergoline.

Although the results of the study offer fresh hope to problem drinkers, Ron cautions that human clinical trials are needed before cabergoline can be safely prescribed. Higher doses of cabergoline have been used to treat Parkinson's disease and have been linked to heart valve problems.

However, notes Ron, we show that in mice and rats, a low dose of the drug is enough to reduce excessive alcohol consumption, alcohol seeking and relapse. The dose is similar to what is given to humans for the treatment of hyperprolactinemia.

Cabergoline may eventually be prescribed for other addictions. A pilot study conducted on cocaine addicts, cited in Ron's paper, reported a substantial reduction in cocaine use.

In the United States, 17.6 million people -- approximately one in every 12 adults -- abuses alcohol or is alcohol-dependent, according to the National Institutes of Health. But there are just three medications approved to treat alcohol dependence -- disulfiram (Antabuse), naltrexone (Depade, ReVia), and acamprosate (Campral).

Virtual studies answer real questions

Sat, 14 Feb 2009 04:59:36 PST

( from http://www.rxpgnews.com ) Are online games just for male teenagers?

About 80 percent of Ever Quest II players are male, but the hardcore players are women. And, almost all players are adults.

The women play more intensely than the guys do, Williams says. They're less likely to quit, and they're happier playing.

They also buy into the males-only stereotypes of technology use: women under-reported their playing time much more than men. Williams believes that female players may lie about their playing habits out of a sense of shame.

But female players spent an average of 29 hours a week in-world, versus 25 for males.

Can game researchers trust players to self-report their playing time?

No. As the first researcher with the ability to compare survey responses to server data, Williams found a large discrepancy, with most players systematically underestimating by 3-4 hours per week. This potentially calls into question 30 years of game research based on self-reported data.

Why don't we do anything together anymore?

Server data doesn't lie: in the online game EverQuest II, men in committed heterosexual relationships prefer to play alone, while women prefer to play with their partner. Follow-up surveys confirm that what's good for the goose is not good for the gander, Williams says.

Men are happier when playing without their partner. Women are happier when they play with them, says Williams, a sociologist and assistant professor in the USC Annenberg School for Communication. He will report findings at AAAS from his upcoming study of gender differences.

If I'm a head case, will role-playing make it worse?

Not necessarily, says Williams: We found it to be, surprisingly, a pretty healthy thing.

Only a small number of players adopt a character other than their real self, Williams explains. Those that do tend to have more mental health problems than average.

Every psychological indicator is worse for them: drug use, ADD, depression, substance abuse, Williams says.

However, Williams found that online play provided a valuable outlet.

They're very aware of the pitfalls of doing it for the wrong reasons or in the wrong way, and most of them see it as a release. It's people who feel they can't express themselves offline.

Williams was the first game researcher to be granted access to a major online world's database. As a result, he was able to match hard data about in-world behavior with survey responses. Nearly 7,000 players of EverQuest II agreed to participate in exchange for an in-world prize, The Great Staff of the Sun Serpent.

The symposium Analyzing Virtual Worlds: Next Step in the Evolution of Social Science Research, will start at 8:30 a.m. on Feb. 14 in the Columbus GH room of the Hyatt Regency Hotel.

The symposium organizers are Jaideep Srivastava of the University of Minnesota, Noshir Contractor of Northwestern University, and Scott Poole of the University of Illinois at Urbana-Champaign. Each will present on a different aspect of virtual world research.

Smokers putting their loved ones at risk of heart attacks

Wed, 11 Feb 2009 04:59:36 PST

( from http://www.rxpgnews.com ) Researchers at University College London and St George's, University of London measured recent exposure to tobacco smoke in non-smoking middle-aged men taking part in the British Regional Heart Study by measuring the levels of cotinine - a compound carried in the blood - at two time points 20 years apart. A blood cotinine level above 0.7ng/mL is associated with a 40% increase in the risk of a heart attack (2), and other studies have suggested that even a level of 0.2ng/mL may increase the risk (3). The researchers found that while in 1978-80, 73% of men had a cotinine level above 0.7ng/mL, by 1998-2000 that proportion had fallen to 17%.

However, despite the number of non-smoking men at risk having fallen, half of those who still had a high cotinine level (above 0.7 ng/ml) in 1998-2000 lived with a partner who smoked. Non-smoking men who had a partner who smoked had average cotinine levels of 1.39ng/mL, almost twice the level associated with an increased risk of a heart attack. Their cotinine levels were nearly eight times higher than the cotinine levels of men whose partner did not smoke.

During the period the study looked at, national data shows that the prevalence of smoking amongst adults across the UK declined from 40% to 27% and the number of cigarettes consumed by smokers fell from 114 to 97 per week. Restrictions on smoking in public spaces and workplaces were also introduced, although the study period was before the national legislative bans on smoking in public places introduced between 2006 and 2007.

Dr Barbara Jefferis, from University College London who led the research, said: The decline in smoking together with restrictions on smoking in public places has created an environment where people are exposed to far less tobacco smoke. This has resulted in the dramatic fall in the number of non-smokers at an increased risk of a heart attack.

However, we can clearly see that living with someone who smokes puts you at a heightened risk. If we are going to reduce people's exposure to tobacco smoke further then we will need to focus efforts on reducing smoking in the home.

Professor Peter Weissberg, Medical Director at the BHF, said: This research shows that a great deal of progress has been made in reducing exposure to potentially damaging environmental tobacco smoke over the past 20 years. Importantly, it also shows that people are now more at risk of exposure in their own homes than in public places.

We cannot stop people smoking in their own home, but we would urge smokers to think of the risk they're exposing their non smoking friends and relatives to when they have a cigarette in the house.

The BHF are calling for a proper plan to reduce the harm from smoking including measures in the NHS Bill that will put an end to point of sale displays and prohibit cigarette vending machines, which are disproportionately used by underage smokers.

Methamphetamine use cost the US about $23 billion in 2005, RAND study estimates

Wed, 04 Feb 2009 04:59:36 PST

( from http://www.rxpgnews.com ) The economic cost of methamphetamine use in the United States reached $23.4 billion in 2005, including the burden of addiction, premature death, drug treatment and many other aspects of the drug, according to a new RAND Corporation study.

The RAND study is the first effort to construct a comprehensive national assessment of the costs of the methamphetamine problem in the United States.

Our findings show that the economic burden of methamphetamine abuse is substantial, said Nancy Nicosia, the study's lead author and an economist at RAND, a nonprofit research organization.

Although methamphetamine causes some unique harms, the study finds that many of the primary issues that account for the burden of methamphetamine use are similar to those identified in economic assessments of other illicit drugs.

Given the uncertainty in estimating the costs of methamphetamine use, researchers created a range of estimates. The lowest estimate for the cost of methamphetamine use in 2005 was $16.2 billion, while $48.3 billion was the highest estimate. Researchers' best estimate of the overall economic burden of methamphetamine use is $23.4 billion

The study was sponsored by the Meth Project Foundation, a nonprofit group dedicated to reducing first-time methamphetamine use. Additional support was provided by the National Institute on Drug Abuse.

We commissioned this study to provide decision makers with the best possible estimate of the financial burden that methamphetamine use places on the American public, said Tom Siebel, founder and chairman of the Meth Project. This is the first comprehensive economic impact study ever to be conducted with the rigor of a traditional cost of illness study, applied specifically to methamphetamine. It provides a conservative estimate of the total cost of meth, and it reinforces the need to invest in serious prevention programs that work.

The RAND analysis found that nearly two-thirds of the economic costs caused by methamphetamine use resulted from the burden of addiction and an estimated 900 premature deaths among users in 2005. The burden of addiction was measured by quantifying the impact of the lower quality of life experienced by those addicted to the drug.

Crime and criminal justice expenses account for the second-largest category of economic costs, according to researchers. These costs include the burden of arresting and incarcerating drug offenders, as well as the costs of additional non-drug crimes caused by methamphetamine use, such as thefts committed to support a drug habit.

Other costs that significantly contribute to the RAND estimate include lost productivity, the expense of removing children from their parents' homes because of methamphetamine use and spending for drug treatment.

One new category of cost captured in the analysis is the expense associated with the production of methamphetamine. Producing methamphetamine requires toxic chemicals that can result in fire, explosions and other events. The resulting costs include the injuries suffered by emergency personnel and other victims, and efforts to clean up the hazardous waste generated by the production process.

Researchers caution that their estimates are in some cases based on an emerging understanding of methamphetamine's role in these harms and should be further refined as understanding of these issues matures. The RAND report also identifies costs that cannot yet be adequately quantified.

Estimates of the economic costs of illicit drug use can highlight the consequences of illegal drug use on our society and focus attention on the primary drivers of those costs, Nicosia said. But more work is needed to identify areas where interventions to reduce these harms could prove most effective.

Methamphetamine is a highly addictive substance that can be taken orally, injected, snorted or smoked. While national surveys suggest that methamphetamine use is far from common, there is evidence that the harms of methamphetamine may be concentrated in certain regions. One indicator of the problem locally is treatment admissions. Methamphetamine was the primary drug of abuse in 59 percent of the treatment admissions in Hawaii in 2004 and accounted for 38 percent of such admissions in Arizona in 2004.

Genetics may increase propensity for alcoholism

Tue, 03 Feb 2009 23:20:37 PST

( from http://www.rxpgnews.com ) In Poland, alcohol dependence (AD) affects about four percent of the population, causing about 10,000 deaths per year. While a number of biological markers have been linked to a predisposition for developing AD, a new study has found a link between the Val66Met (rs6265) polymorphism in the brain-derived neurotrophic factor (BDNF) gene and risk for post-treatment relapse among AD patients.

Results will be published in the April issue of Alcoholism: Clinical & Experimental Research and are currently available at Early View.

"Some people are simply more likely than others to become dependent on alcohol," explained Marcin Wojnar, associate professor of psychiatry at the Medical University of Warsaw and adjunct researcher at the University of Michigan. "Clearly, cultural, social, and psychological factors are involved. AD also runs in families, so there is an inherited component to it. Once AD has developed, certain people are more likely to relapse after treatment than others. Some studies show that a family history of alcoholism can lead to a more severe illness that is harder to treat, which is why our group and others are looking at genetic factors."

"Although some biological predictors of the re-emergence of AD have been described," said Lance Bauer, professor of psychiatry at the University of Connecticut School of Medicine, "biological measures can be affected by many variables, such as the time of day; the patient's gender, age, or medical background; or medications that have been prescribed. Most genetic differences are not complicated by these same variables. Accordingly, this study by Wojnar and colleagues points us toward a new and promising approach."

"We selected genetic polymorphisms that were, one, related to serotonin or dopamine function; and two, associated with suicidality and/or impulsivity," said Wojnar, who is the study's first author. "Serotonin's decreased functioning has consistently been reported to be associated with both impulsivity and suicidal behaviors. Regarding dopamine, most researchers agree that it plays an essential role in addiction, either by causing pleasure from taking drugs or by telling the brain to associate that pleasure with certain cues in the environment."

The researchers examined 154 patients (117 males, 37 females) from addiction-treatment programs in Poland who met Diagnostic and Statistical Manual of Mental Disorders - Fourth Edition criteria for AD. All were assessed for demographics, severity of alcohol use, suicidality, impulsivity, depression, hopelessness, and severity of alcohol use at baseline; 123 patients were followed for approximately one year to evaluate treatment outcomes. In addition, patients were tested for genetic polymorphisms in several genes as predictors of relapse – defined as "any drinking during follow-up" – which were: rs1386483 in the tryptophan hydroxylase type 2 gene, C102T (rs6313) in the serotonin receptor 2A gene, 5-HTT gene-linked polymorphic region in locus SLC6A4, C(-1019)G (rs6295) in the serotonin receptor 1A gene, Val158Met (rs4680) in the catechol-O-methyl transferase gene, and the Val66Met (rs6265) in the BDNF gene.

"Our study indicated that some patients may have inherited a tendency to return to drinking even after intensive treatment," said Wojnar, "and [may be] more treatment-resistant than other patients. Specifically, we found that a particular type or variant of the gene that codes for BDNF was associated with an increased risk for relapse in alcoholic patients, particularly those with a family history of AD." BDNF is a protein found in the brain that helps nerve cells survive and connect to one another.

"These findings provide further support for the assertion that alcoholic patients are not all alike," said Bauer. "Some possess genetic propensities which … may motivate or promote risk for alcoholism as well as risk for treatment failure."

"These patients may have special difficulty in responding well to currently available treatments because of their biological makeup," added Wojnar, "and therefore may need newly constructed intensive programs of therapy that are preferably individualized. This might be a step forward towards 'personalized medicine.'"

Bauer agreed. "During the past 10 years, several new treatments have become available," he said. "However, 'how does one decide among the options?' Genetic differences may eventually help us make the decision. For example, individuals possessing the high-risk-for-relapse variant of the BDNF gene might warrant assignment to the most intensive – and usually most expensive – treatment. Individuals with the low-risk variant might not require this level of treatment to have a good outcome."

Increase in the number of children born in California with autism

Thu, 08 Jan 2009 12:44:53 PST

( from http://www.rxpgnews.com ) A study by researchers at the UC Davis M.I.N.D. Institute has found that the seven- to eight-fold increase in the number children born in California with autism since 1990 cannot be explained by either changes in how the condition is diagnosed or counted — and the trend shows no sign of abating.

Published in the January 2009 issue of the journal Epidemiology, results from the study also suggest that research should shift from genetics to the host of chemicals and infectious microbes in the environment that are likely at the root of changes in the neurodevelopment of California’s children.

“It’s time to start looking for the environmental culprits responsible for the remarkable increase in the rate of autism in California,” said UC Davis M.I.N.D. Institute researcher Irva Hertz-Picciotto, a professor of environmental and occupational health and epidemiology and an internationally respected autism researcher.

Hertz-Picciotto said that many researchers, state officials and advocacy organizations have viewed the rise in autism's incidence in California with skepticism.

The incidence of autism by age six in California has increased from fewer than nine in 10,000 for children born in 1990 to more than 44 in 10,000 for children born in 2000. Some have argued that this change could have been due to migration into California of families with autistic children, inclusion of children with milder forms of autism in the counting and earlier ages of diagnosis as consequences of improved surveillance or greater awareness.

Hertz-Picciotto and her co-author, Lora Delwiche of the UC Davis Department of Public Health Sciences, initiated the study to address these beliefs, analyzing data collected by the state of California Department of Developmental Services (DDS) from 1990 to 2006, as well as the United States Census Bureau and state of California Department of Public Health Office of Vital Records, which compiles and maintains birth statistics.

Hertz-Picciotto and Delwiche correlated the number of cases of autism reported between 1990 and 2006 with birth records and excluded children not born in California. They used Census Bureau data to calculate the rate of incidence in the population over time and examined the age at diagnosis of all children ages two to 10 years old.

The methodology eliminated migration as a potential cause of the increase in the number of autism cases. It also revealed that no more than 56 percent of the estimated 600-to-700 percent increase, that is, less than one-tenth of the increased number of reported autism cases, could be attributed to the inclusion of milder cases of autism. Only 24 percent of the increase could be attributed to earlier age at diagnosis.

“These are fairly small percentages compared to the size of the increase that we’ve seen in the state,” Hertz-Picciotto said.

Hertz-Picciotto said that the study is a clarion call to researchers and policy makers who have focused attention and money on understanding the genetic components of autism. She said that the rise in cases of autism in California cannot be attributed to the state’s increasingly diverse population because the disorder affects ethnic groups at fairly similar rates.

“Right now, about 10 to 20 times more research dollars are spent on studies of the genetic causes of autism than on environmental ones. We need to even out the funding,” Hertz-Picciotto said.

The study results are also a harbinger of things to come for public-health officials, who should prepare to offer services to the increasing number of children diagnosed with autism in the last decade who are now entering their late teen years, Hertz-Picciotto said.

“These children are now moving toward adulthood, and a sizeable percentage of them have not developed the life skills that would allow them to live independently,” she said.

The question for the state of California, Hertz-Picciotto said, will become: 'What happens to them when their parents cannot take care of them?'

“These questions are not going to go away and they are only going to loom larger in the future. Until we know the causes and can eliminate them, we as a society need to provide those treatments and interventions that do seem to help these children adapt. We as scientists need to improve available therapies and create new ones,” Hertz-Picciotto said.

Hertz-Picciotto and her colleagues at the M.I.N.D Institute are currently conducting two large studies aimed at discovering the causes of autism. Hertz-Picciotto is the principal investigator on the CHARGE (Childhood Autism Risk from Genetics and the Environment) and MARBLES (Markers of Autism Risk in Babies-Learning Early Signs) studies.

CHARGE is the largest epidemiologic study of reliably confirmed cases of autism to date, and the first major investigation of environmental factors and gene-environment interactions in the disorder. MARBLES is a prospective investigation that follows women who already have had one child with autism, beginning early in or even before a subsequent pregnancy, to search for early markers that predict autism in the younger sibling.

“We’re looking at the possible effects of metals, pesticides and infectious agents on neurodevelopment,” Hertz-Picciotto said. “If we’re going to stop the rise in autism in California, we need to keep these studies going and expand them to the extent possible.”

Decreased Dopamine processing ability - cause for high risk behaviour?

Wed, 31 Dec 2008 08:31:24 PST

( from http://www.rxpgnews.com ) For risk-takers and impulsive people, New Year's resolutions often include being more careful, spending more frugally and cutting back on dangerous behavior, such as drug use. But new research from Vanderbilt finds that these individuals--labeled as novelty seekers by psychologists--face an uphill battle in keeping their New Year's resolutions due to the way their brains process dopamine. The research reveals that novelty seekers have less of a particular type of dopamine receptor, which may lead them to seek out novel and exciting experiences--such as spending lavishly, taking risks and partying like there's no tomorrow.

The research was published Dec. 31, 2008, in the Journal of Neuroscience.

The neurotransmitter dopamine is produced by a select group of cells in the brain. These dopamine-producing cells have receptors called autoreceptors that help limit dopamine release when these cells are stimulated.

"We've found that the density of these dopamine autoreceptors is inversely related to an individual's interest in and desire for novel experiences," David Zald, associate professor of psychology and lead author of the study, said. "The fewer available dopamine autoreceptors an individual has, the less they are able to regulate how much dopamine is released when these cells are engaged. Because of this, novelty and other potentially rewarding experiences that normally induce dopamine release will produce greater dopamine release in these individuals."

Dopamine has long been known to play an important role in how we experience rewards from a variety of natural sources, including food and sex, as well as from drugs such as cocaine and amphetamine. Previous research has shown that individuals differ in both their number of dopamine receptors and the amount of dopamine they produce, and that these differences may play a critical role in addiction. Zald and his colleagues set out to explore the connection between dopamine receptors and the novelty-seeking personality trait.

"Novelty-seeking personality traits are a major risk factor for the development of drug abuse and other unsafe behaviors," Zald and his colleagues wrote.

"Our research suggests that in high novelty-seeking individuals, the brain is less able to regulate dopamine, and this may lead these individuals to be particularly responsive to novel and rewarding situations that normally induce dopamine release," Zald said.

Previous research in rodents showed that some respond differently to novel environments. Those who explore novel environments more are also more likely to self-administer cocaine when given the chance. Dopamine neurons fire at a higher rate in these novelty-responsive rodents, and the animals also have weak autoreceptor control of their dopamine neurons. Zald and colleagues speculated that the same relationships would be seen in humans.

The researchers used positron emission topography to view the levels of dopamine receptors in 34 healthy humans who had taken a questionnaire that measured the novelty-seeking personality trait. The questionnaire measured things such as an individual's preference for and response to novelty, decision-making speed, a person's readiness to freely spend money, and the extent to which a person is spontaneous and unconstrained by rules and regulations. The higher the score, the more likely the person was to be a novelty seeker.

The researchers found that those that scored higher on the novelty-seeking scale had decreased dopamine autoreceptor availability compared to the subjects that scored lower.

Monthly shot for holiday drinkers on wagon

Wed, 17 Dec 2008 04:59:37 PST

( from http://www.rxpgnews.com ) ALCOHOLICS struggling to keep off shots of the hard stuff over the festive season may want to consider an alternative shot: a monthly injection that keeps them off the booze.

For people battling alcoholism, holidays pose a strong danger of relapse. When you interview patients about triggers for drinking, they often say holidays and family events, says David Rosenbloom, a specialist in substance abuse at Boston University School of Public Health. For some it's the stress of being lonely, for others it's the stress of being with people. Over Christmas and New Year, social pressure and opportunities to drink add to the intoxicating mix.

Some people take pills containing naltrexone, a substance that reduces the desire to drink by blocking the receptors in the brain responsible for the high that drinking brings. But during the holiday season, pressures often drive alcoholics to stop taking the tablets. With a pill, they have to make a decision every day, says Sandra Lapham at the Behavioral Health Research Center of the Southwest in Albuquerque, New Mexico.

In 2006, the US Food and Drug Administration approved a slow-release formulation of naltrexone, in which the drug is stored in microscopic spheres made of a biodegradable polymer and injected into muscle once a month. Lapham wondered if this might help people who stop taking naltrexone pills during holidays. Working with the company that manufactures the formulation - Alkermes, based in Cambridge, Massachusetts - she reanalysed data from a previous clinical trial, focusing on the drug's performance during 10 US holidays and celebrations.

The study was small - just 28 patients received full-dose naltrexone shots, compared with another 28 given placebos. The shots reduced the frequency of drinking days, the number of drinks and the percentage of days classed as heavy drinking sessions - five or more drinks a day for men, and four for women. Crucially, the drug was just as effective during the holidays as it was for the rest of the year (Journal of Substance Abuse Treatment, vol 36, p 1).

The results have impressed Rosenbloom, who describes their significance for public health as huge. Lapham warns that naltrexone injections must be given with care, because they can cause abscesses if the drug is deposited into fatty tissue.

The treatment might also reduce deaths from drink-driving: in the US, 40 per cent of road deaths over Christmas and the New Year involve at least one driver impaired by alcohol, compared with about 28 per cent for the rest of December. Rosenbloom would like to see courts offer naltrexone shots to repeat drink-driving offenders.

Up to 2 drinks per day not linked with higher risk of irregular heart beat for women

Tue, 02 Dec 2008 04:59:37 PST

( from http://www.rxpgnews.com ) Women who have up to two alcoholic drinks per day do not appear to be at increased risk of atrial fibrillation (irregular heart beat), but drinking more than that amount is associated with a higher risk, according to a study in the December 3 issue of JAMA.

Studies assessing the effects of regular alcohol consumption on the risk of atrial fibrillation have provided inconsistent results, with several studies finding significant associations between moderate to high amounts of alcohol intake and increased risks of atrial fibrillation among men, but not among women. However, these studies were not of adequate size to detect significant associations among women, according to background information in the article.

David Conen, M.D., M.P.H., of Brigham and Women's Hospital, Harvard Medical School, Boston, and University Hospital, Basel, Switzerland, and colleagues analyzed data from a completed randomized controlled trial involving 34,715 women participating in the Women's Health Study, to assess the effects of regular alcohol consumption on the risk of atrial fibrillation. The participants were older than 45 years and had no atrial fibrillation at the start of the study and underwent follow-up from 1993 to October 2006. Alcohol consumption was assessed via questionnaires at the beginning of the trial and at 48 months of follow-up and was grouped into 4 categories: 0 drinks per day, greater than 0 and less than 1, 1 or more and less than 2, and 2 or more drinks per day. Atrial fibrillation was self-reported on the yearly questionnaires and subsequently confirmed by electrocardiogram and medical record review.

During a median (midpoint) follow-up of 12.4 years, there were 653 confirmed cases of new atrial fibrillation. Among women consuming no alcohol (n = 15,370), there were 294 events (1.9 percent); for women consuming more than 0 and less than 1 drink per day (n = 15,758), there were 284 events (1.8 percent); for 1 to 2 drinks per day (n = 2,228), there were 35 events (1.6 percent); and for women consuming 2 or more drinks per day (n = 1,359), there were 40 atrial fibrillation events (2.9 percent).

In the present study, alcohol consumption of up to 2 drinks per day was not associated with an increased risk of incident atrial fibrillation among initially healthy, middle-aged women. In contrast, the small group of women who consumed 2 or more alcoholic beverages per day had a 1.6-fold greater risk for atrial fibrillation relative to nondrinking women. While this finding needs to be interpreted with some caution because of the small number of women in some subgroups, it supports a possible threshold effect in the relationship between alcohol consumption and risk of atrial fibrillation among women, the authors write.

Genes behind bipolar disorder mapped by scientists

Sun, 23 Nov 2008 11:44:34 PST

( from http://www.rxpgnews.com ) New York, Nov 22 - In a first, scientists have comprehensively mapped the genes believed to cause bipolar disorder.

Indiana University neuroscientists combined data from the latest gene hunting studies for bipolar disorder with information from their own studies to zero in on the best candidate genes for the illness.

Their findings, reported in the latest issue of the American Journal of Medical Genetics, describe how researchers analysed how these genes work together to create a comprehensive biological model of bipolar disorder.

'Based on our work, we now project that there will be hundreds of genes -- possibly as much as 10 percent of the human genome -- involved in this illness,' said Alexander B. Niculescu, who led the team, in a press release.

'Not all genetic mutations will occur in every individual with bipolar disorder. Different individuals will have different combinations of genetic mutations. This genetic complexity is most likely what made past attempts to identify genes for the disorder through genetic-only studies so difficult and inconsistent.'

Until now there have been few statistically significant findings in searches of the human genome as it applies to bipolar disorder, he said.

'By integrating the findings of multiple studies, we were able to sort through, identify genes that were most likely to be involved in bipolar disorder, and achieve this major breakthrough in our understanding of the illness,' Niculescu said.

Bipolar disorder, sometimes called manic depression, affects millions worldwide and people who suffer from it can experience mild or dramatic mood swings, shifts in energy and a diminished capacity to function.

The findings of the study hold out the hope that, having assessed individual gene combinations, individuals likely to suffer from bipolar disorder can be identified even before the illness manifests itself.

This could result in preventive measures like lifestyle changes, counselling and low-dose medications.

ADHD afflicted may find it difficult to kick the habit

Sat, 22 Nov 2008 13:56:38 PST

( from http://www.rxpgnews.com ) New York, Nov 22 - Smoking is more prevalent among people with Attention Deficit Hyperactivity Disorder - - and they are less likely to quit, according to a new study.

The study found that ADHD smokers with higher levels of hyperactivity and impulsivity, with or without inattention, showed lower quit rates after eight weeks than those without ADHD.

The findings of the study, available online in the journal Nicotine and Tobacco Research, could help smokers and physicians to better tailor cessation treatment for individuals with ADHD.

'Greater understanding of the associations between different kinds of ADHD have important public health consequences for smoking cessation and decreased tobacco-related mortality in this population,' said the study's lead author Lirio Covey of the Columbia University Medical Center.

'The effect of ADHD by itself on smoking cessation has rarely been examined; the effects of the individual ADHD symptoms on smoking cessation, even less so.

'To our knowledge, the effects of inattention or hyperactivity at baseline as separate domains of ADHD on cessation treatment outcome have never been examined,' Covey said.

ADHD is a neuropsychiatric condition that begins in early childhood and, in most cases, persists to adolescence and adulthood. Its core symptoms are inattention and hyperactivity/impulsivity.

The study examined 583 adult smokers, 43 of whom were identified with clinically significant ADHD symptoms. They were treated with the medication buproprion, the nicotine patch and regular cessation counselling.

Compared to smokers without ADHD, smokers of both ADHD subtypes showed lower abstinence rates throughout the study.

'The knowledge gained from further study of how these early onset disorders of nicotine dependency and ADHD are related could lead to early prevention of either one or both of these conditions,' Covey said.

Deep brain mapping to isolate evidence of Gulf War syndrome

Fri, 21 Nov 2008 10:31:43 PST

( from http://www.rxpgnews.com ) Washington, Nov 20 - Researchers are pioneering use of spatial statistical modelling to analyse brain scan data from military veterans, aiming to pinpoint brain areas affected by Gulf War Syndrome.

Richard Gunst, Wayne Woodward and William Schucany, professors in Southern Methodist University -, are collaborating with imaging specialists at University of Texas Southwestern Medical Centre - to compare brain scans of people suffering from the syndrome with those of a healthy control group.

Gulf War Veterans - are being tested at UTSW using a type of brain imaging called functional Magnetic Resonance Imaging - while they perform tasks intended to activate specific regions of the brain.

The SMU team is analysing brain activation signals reflected from the multiple images taken of each subject's brain to determine which variations are naturally occurring and which are due to the syndrome. Previous analyses have been unable to separate real distinctions from 'noise'.

The SMU team's primary challenge is in identifying differences in brain activation from locations deep within the brain using measured brain signals that are weak and vary from location to location, according to an SMU release.

Spatial modelling uses information from neighbouring locations to strengthen the weak signals in active brain locations so the signal can be detected as real.

'Spatial modelling in brain imaging is new,' Gunst said. 'This has not been done the way we are doing it.'

Rapid technological advances in medical imaging of the human brain are imposing demands for new statistical methods that can be used to detect small differences between normal and dysfunctional brain activity, Gunst said.

3 esophageal, stomach cancer subtypes linked to smoking; 1 associated with alcohol use

Mon, 17 Nov 2008 04:59:37 PST

( from http://www.rxpgnews.com ) WASHINGTON, D.C. - Researchers who have been following the health of more than 120,000 residents of the Netherlands for more than two decades have found that smoking is associated with two forms of esophageal cancer as well as a form of stomach cancer, and that drinking alcohol is strongly linked to one form of esophageal cancer.

Researchers say that while their findings, presented at the American Association for Cancer Research's Seventh Annual International Conference on Frontiers in Cancer Prevention Research, confirm risk factors previously associated with these cancers, they don't explain the rising incidence of these tumors, especially esophageal adenocarcinoma (EAC) and gastric cardia adenocarcinoma (GCA), a cancer of the upper stomach area, where it joins the esophagus.

The results of this study again confirm recommendations for a healthy lifestyle, namely not to smoke and to drink alcohol in moderation, said study author, Jessie Steevens, M.Sc., of the Department of Epidemiology at Maastricht University, in Maastricht. But it also suggests that there must be other risk factors for EAC and GCA, she said. Smoking is a risk factor for both cancers, but since a decreasing part of the population smokes, this cannot explain why the incidence is rising so rapidly for both cancers in Western countries in recent decades.

Other factors that might be associated with the risk of these cancers include obesity, diet and nutrition, exercise, occupational exposures, medical factors and so forth, which we are beginning to study, Steevens said.

Their findings are from one of the first large cohort studies to investigate risk factors in esophageal adenocarcinoma and gastric cardia adenocarcinoma, as well as in esophageal squamous cell carcinoma (ESCC), which resembles head and neck cancer.

ESCC, which can occur anywhere along the esophagus, was at one time responsible for more than 90 percent of all esophageal cancers, but now EAC, which is typically found in the lower esophagus, makes up more than half of this cancer type. Esophageal cancer, in general, had been linked to alcohol and tobacco use, but this study sought to refine that risk between different cancer subtypes.

Researchers in the Netherlands Cohort Study, which began in 1986, administered lifestyle questionnaires to participants, who were healthy when they enrolled, and then followed the group to see who developed cancer. After 16 years, investigators identified 120 ESCC cases, 168 EAC cases, and 187 GCA cases among the group of 120,852 enrollees.

For esophageal squamous cell carcinoma, they found a dose-response relationship between alcohol use and cancer development. For example, a person drinking four glasses of alcohol had five times the risk of developing the cancer compared to a person who does not drink alcohol, Steevens said.

Another way to explain this is that a person's lifetime risk of developing ESCC is one in 250 if that person doesn't drink alcohol and the lifetime risk would be about one in 50 if the person drinks four glasses of alcohol per day, she said.

Former and current smoking was associated with an increased risk of all three cancers, although the risks of ESCC were higher than those of EAC and GCA.

It appeared that current smokers have the highest risks, and former smokers have an intermediate risk compared with never smokers. This was true for ESCC, EAC and GCA. These are the results when no other aspects of smoking were considered, such as the amount of cigarettes smoked per day and the number of years a person smoked, Steevens said. When we took into account the smoking duration and frequency, it appeared that the difference in risk between former smokers and current smokers could partly be explained by these other aspects of smoking. This is also logical, because a former smoker, for example, has usually smoked fewer years than a current smoker.

Incubator care at birth reduces depression risk in adult life

Sat, 15 Nov 2008 11:11:53 PST

( from http://www.rxpgnews.com ) Toronto, Nov 12 - A Canadian study says babies who receive incubator care after birth are two to three times less likely to suffer depression in their adult life.

The study was conducted by scientists from Montreal University, in collaboration with researchers from Montreal-based Sainte Justine Hospital Research Center, McGill University and Douglas Hospital Research Centre and the Britain-based Institute of Psychiatry at King's College over a period of many years.

The research was undertaken following observations about mammal behaviour where separation between mother and child after birth can lead to behavioural problems in adulthood.

'Our hypothesis was that mother-baby separation resulting from incubator care could heighten depression in adolescence or adulthood,' said study co-author and psychiatrist Richard E. Tremblay of Montreal University Monday.

'Instead, we found that incubator care could decrease the risk of depression two-to-three fold by the age of 21,' he added. It was close to three times for girls.

As part of the study, 1,212 children were recruited from kindergartens. These children had been picked up for another study in 1986.

The researchers obtained reports on their birth condition, obstetrical complications and incubator care from medical records.

After subjecting these participants to psychiatric assessments at the ages of 15 and 21, the researchers found that out of the 16.5 percent babies placed in incubators, only five percent suffered major depression by age 21.

Among those who were not placed in incubators, nine percent developed depression, which is the average rate in society.

The researchers found correlation between decreased depression and incubator care after factoring participant age, weight at birth, family adversity or maternal depression.

They also found that girls were three times less likely to experience depression by the age of 15 if they had received incubator care at birth.

'This difference was due to the fact that more girls experience depression than boys during adolescence and how boys suffer depression in later adolescent years,' said study co-author Frank Vitaro of Montreal University.

According to the researchers, children who received incubator care as babies, received more emotional support from their mothers throughout childhood because they were perceived as more vulnerable.

'Incubator care was not the sole factor that shielded participants from future depression,' said psychiatrist David Gourion of Montreal University.

'We believe that incubator care is a trigger for a complex chain of biological and emotional factors that helped decrease depression,' he said.

The study has been published in the journal Pyschiatry Research.

Brisk walk could help chocoholics stop snacking

Tue, 11 Nov 2008 04:59:37 PST

( from http://www.rxpgnews.com ) Researchers at the University of Exeter have found that a walk of just fifteen minutes can reduce chocolate cravings. The benefits of exercise in helping people manage dependencies on nicotine and other drugs have previously been recognised. Now, for the first time, newly-published research shows that the same may be true for food cravings.

Following three days of abstinence, 25 regular chocolate eaters were asked to either complete a 15-minute brisk walk or rest, in a random order. They then engaged in tasks that would normally induce chocolate cravings, including a mental challenge and opening a chocolate bar.

After exercise participants reported lower cravings than after rest. Cravings were not only reduced during the walk, but for at least ten minutes afterwards. The exercise also limited increases in cravings in response to the two tasks.

Professor Adrian Taylor comments: Our ongoing work consistently shows that brief bouts of physical activity reduce cigarette cravings, but this is the first study to link exercise to reduced chocolate cravings. Neuroscientists have suggested common processes in the reward centres of the brain between drug and food addictions, and it may be that exercise effects brain chemicals that help to regulate mood and cravings. This could be good news for people who struggle to manage their cravings for sugary snacks and want to lose weight.

Previous research has suggested that 97% of women and 68% of men experience food cravings. Craved foods tend to be calorie-dense, fatty or sugary foods, with chocolate being the most commonly reported. Chocolate has a number of biologically active constituents that temporarily enhance our mood with a result that eating it can become a habit, particularly when we are under stress and when it is readily available, and perhaps when we are least active.

Professor Taylor concludes: While enjoying the occasional chocolate bar is fine, in time, regular eating may lead to stronger cravings during stress and when it is readily available. Recognising what causes us to eat high energy snacks, even if we have plans to not do so, can be helpful.

Short bouts of physical activity can help to regulate how energised and pleasant we feel, and with a sedentary lifestyle we may naturally turn to mood regulating behaviours such as eating chocolate. Accumulating 30 minutes of daily physical activity, with two 15 minute brisk walks, for example, not only provides general physical and mental health benefits but also may help to regulate our energy intake. This research furthers our understanding of the complex physical, psychological and emotional relationship we have with food.

The research is now published online in the journal

Stimulating scalp with weak current improves dexterity

Mon, 03 Nov 2008 14:57:21 PST

( from http://www.rxpgnews.com ) Washington, Nov 3 - Stimulating the scalp with weak current and underlying motor regions of the brain could make you more skilled at delicate tasks.

New research shows that a non-invasive brain-stimulation technique, transcranial direct current stimulation -, is able to improve the use of a person's non-dominant hand.

Gottfried Schlaug and Bradley Vines from Beth Israel Deaconess Medical Centre - and Harvard Medical School, tested the effects of using tDCS over one or both sides of the brain on 16 healthy, right-handed volunteers, as well as testing the effect of simply pretending to carry out the procedure.

'The results of our study are relevant to clinical research on motor recovery after stroke,' said Schlaug.

Volunteers were not aware of which of the three procedures they were receiving. The test involved using the fingers of the left hand to key in a series of numbers displayed on a computer screen, according to a BMC press release.

The results were striking; stimulating the brain over both the right and left motor regions - resulted in a 24 percent improvement in the subjects' scores.

This was significantly better than stimulating the brain only over one motor region or using the sham treatment -.

tDCS involves attaching electrodes to the scalp and passing a weak direct current through the scalp and skull to alter the excitability of the underlying brain tissue.

The treatment has two principal modes depending on the direction in which the current runs between the two electrodes. Brain tissue that underlies the positive electrode - becomes more excitable and the reverse is true for brain tissue that underlies the negative electrode -.

No relevant negative side effects have been reported with this type of non-invasive brain stimulation. It is not to be confused with electroconvulsive therapy, which uses currents around a 1,000 times higher.

These findings are scheduled for publication in BMC Neuroscience.

Gene mutation in worms key to alcohol tolerance

Sun, 02 Nov 2008 14:46:10 PST

( from http://www.rxpgnews.com ) London, Oct 23 - Liverpool University reseachers, picking up from a study by the Oregon Health and Science University on the linkage between gene mutation and tolerance to alchohol in mice, investigated it in worms.

This gene specifies the ways in which amino acids arrange themselves into a protein called UNC-18 - or Munc18-1 - in humans, an essential component of the nervous system.

Researchers found that a naturally occurring change in this gene can result in a change in the nature of one of the amino acids, which then alters communication between cells in the nervous system.

Consequently, with these changes the nervous system becomes less sensitive to the effects of alcohol, allowing the body to consume more, according to a Liverpool University release.

Bob Burgoyne, the head of the university's School of Biomedical Sciences, explained, 'Alcohol consumption can affect the nervous system in a number of ways. Low concentrations of alcohol can make the body more alert, but high concentrations can also reduce its activity, resulting in motor dysfunction and a lack of coordination.'

'Some people, however, are more susceptible to these effects than others, but it has never been fully understood why this is.

'We used the nematode worm as a model to look at the role genes play in alcohol tolerance because all of the worm's genome has been characterised and we can therefore identify its genes easily,' he said.

'The gene we looked at corresponds to a gene in humans that performs the same function in the nervous system. Mutations in genes can occur naturally without any known cause and will persist if they are not particularly harmful,' Burgoyne concluded.

Jeff Barclay, co-author of the research, added, 'We investigated alterations in amino acids in two genetically identical worms. One carried a mutation that was exactly the same as the genetic change our American colleagues found in mice and the other carried a different change within the same gene.'

'Both these mutations altered the way communicate occurs between cells in the nervous system. The mutations reduce the negative behavioural effects of alcohol and so more can be consumed before the body starts to react badly to it.

'Now that we have shown the link between the gene and alcohol tolerance in worms, it is possible to search the human gene to see if there are any spontaneous changes that could help identify individuals with a predisposition to alcoholism,' he said.

The research is published in the journal Molecular Biology of the Cell.

Physicians lack smoking cessation training

Mon, 27 Oct 2008 03:59:37 PST

( from http://www.rxpgnews.com ) Physicians and other health-care providers may advise their patients to quit smoking, but few providers have the adequate training to follow their patients through the cessation process. New research presented at CHEST 2008, the 74th annual international scientific assembly of the American College of Chest Physicians (ACCP), shows that 87 percent of physicians and other medical professionals receive less than 5 hours of training on tobacco dependence and less than 6 percent knew Agency for Healthcare Research and Quality (AHRQ) treatment guidelines for tobacco dependence, including the signs of nicotine withdrawal. Researchers speculate that this lack of knowledge related to tobacco dependence treatment may, in turn, affect quit rates among smokers.

If health-care providers are unaware of the AHRQ guidelines for tobacco dependence, and consequently unsure of how to treat their patients who are tobacco-dependent, they are less likely to do more than ask and advise their patients to quit, said the study's lead researcher, Virginia Reichert, NP, who conducted her research while at the North Shore-LIJ Health System Center for Tobacco Control, Great Neck, NY.

Researchers from the North Shore-LIJ Center for Tobacco Control surveyed 600 health-care providers, of which 322 were considered prescribers (physicians, nurse practitioners, or physician assistants), and the remaining 278 participants were considered nonprescribers (pharmacists, registered nurses, social workers, counselors, respiratory therapists, and students). Survey questions regarding tobacco control issues were related to prevalence of smoking, tobacco treatment guidelines, cessation pharmacotherapy, interaction of nicotine with other drugs, and symptoms and implications of nicotine withdrawal.

Results showed that a significant number of health-care providers lack general knowledge related to tobacco dependence treatment. Of those surveyed, 87 percent of prescribers and 93 percent of nonprescribers received less than 5 hours of tobacco-dependence training. In addition, only 6 percent of prescribers and 5 percent of nonprescribers knew the AHRQ treatment guidelines for tobacco dependence.

Without appropriate training in tobacco dependence treatment, health-care providers may lack the knowledge and confidence to help their patients quit smoking, said Ms. Reichert. Furthermore, providers may not recognize that tobacco dependence is a chronic relapsing condition and become frustrated when patients do not quit when advised to do so. Research indicates that approximately 70 percent of smokers report a desire to quit but believe it will be too difficult without assistance. Research also indicates that smokers are 30 percent more likely to quit with assistance from their health-care provider.

In relation to cessation pharmacotherapy, 16 percent of prescribers and 8 percent of nonprescribers knew which FDA-approved medications were over-the-counter and which required a prescription. The majority of prescribers and nonprescribers also failed to recognize select contraindications and changes to medication dosages in patients undergoing smoking cessation. In addition, only 1 percent of prescribers and 3 percent of nonprescribers correctly identified the signs of nicotine withdrawal.

If clinicians are unaware of the contraindications related to cessation medications, this could lead to adverse reactions for the patient and, consequently, a failure to quit, said study author Patricia Folan, RN, acting director of the North Shore-LIJ's Center for Tobacco Control. In addition, if clinicians are unaware of withdrawal symptoms, they may not encourage their patients to use the cessation medications. Without the cessation medications, patients experience the discomfort of withdrawal symptoms and are less likely to sustain their quit attempt.

Patients who are advised to quit smoking, but who are not given the tools and resources to help them, will be less likely to quit, said James A. L. Mathers, Jr., MD, FCCP, President of the American College of Chest Physicians. Health-care providers must be educated about the smoking cessation process and available resources in order to provide comprehensive guidance to patients who wish to stop smoking.

Depression during pregnancy doubles risk of premature delivery

Fri, 24 Oct 2008 13:33:16 PST

( from http://www.rxpgnews.com ) Washington, Oct 23 - Depressed pregnant women face twice the risk of premature delivery than their counterparts with no such symptoms, according to a new study.

Besides the increased risk of premature delivery, the study found that the risk grows with the severity of the depressive symptoms, among pregnant women.

These findings also provide preliminary evidence that social and reproductive risk factors, obesity, and stressful events may aggravate depression-premature delivery link, according to researchers.

'Premature delivery is the leading cause of infant mortality, and yet we don't know what causes it,' said co-author De-Kun Li, a reproductive and perinatal epidemiologist at Kaiser Permanente's Division of Research in Oakland.

'This study adds to emerging evidence that depression during early pregnancy may interfere with the neuroendocrine pathways and subsequently placental function,' Li said.

'The placenta and neuroendocrine functions play an important role in maintaining the health of a pregnancy and determining the onset of labour,' Li explained.

Because the majority of the women in the study did not use anti-depressants, the study provides a clear look at the link between depression and preterm delivery.

The study, among the first to examine depression and premature delivery in a representative and diverse population in the US, looked at 791 pregnant Kaiser Permanente members in San Francisco city and county from October 1996 through October 1998.

Researchers interviewed the women around their 10th week of pregnancy and found that 41 percent of the women reported significant or severe depressive symptoms, according to a Kaiser Permanente press release.

The women with less severe depressive symptoms had a 60 percent higher risk of premature delivery -- defined as delivery at less than 37 completed weeks of gestation -- compared with women without significant depressive symptoms, and the women with severe depressive symptoms had more than twice the risk.

In addition to being the leading cause of infant mortality and morbidity, preterm delivery is also the leading medical expenditure for infants, with estimated annual cost of about $26 billion in the US alone.

The study is published online in the Oxford University Press' journal Human Reproduction.

UCLA issues new report on Prop. 36

Tue, 14 Oct 2008 03:59:37 PST

( from http://www.rxpgnews.com ) The effectiveness of Proposition 36, a ballot measure approved by California voters in 2000 that offers treatment instead of incarceration for nonviolent drug offenders is being undermined by inadequate funding, participants dropping out of treatment, and increased arrests for drug and property crimes.

The good news, however, is that the initiative has saved taxpayers millions of dollars, several promising new programs have the potential to improve Proposition 36's results, and violent crime arrests have decreased more in California than nationally since the proposition's implementation.

These are some of the key findings from UCLA's latest report on Proposition 36, also known as the Substance Abuse and Crime Prevention Act (SACPA) of 2000. The measure, which went into effect in July 2001, allows nonviolent adult drug offenders to receive substance-abuse treatment with supervision as an alternative to incarceration or supervision without treatment. The law also calls for an independent evaluation of the program, which is being conducted by UCLA's Integrated Substance Abuse Programs at the Semel Institute for Neuroscience and Human Behavior.

According to the report, under Proposition 36, more than 30,000 drug offenders enter treatment each year and about half of them are being treated for the first time. Most receive outpatient care, which is less expensive than residential treatment but is also less effective for heavy drug users. Although the number of available residential treatment beds has increased since the measure's enactment, the increases have not been able to meet the rising need. Stakeholders interviewed in focus groups indicated that this was due to limited funding and infrastructure.

The report also found that drug and property crime arrests were higher among Proposition 36 participants than among a comparison group of pre-Proposition 36 drug offenders, the latter having spent more days in custody and fewer days on the street during which they could get arrested. However, despite early concerns by critics of SACPA that the law would result in an increase in violent crime, the rate of violent crime dropped more in California (12 percent between 2001 and 2005) than nationally (9 percent over the same period).

While the Proposition 36 group was more likely to be rearrested, the measure has been a much less expensive alternative to jail or prison time. By reducing incarceration, Proposition 36 has helped save taxpayers about $2 for every $1 invested in the program. To improve Proposition 36's implementation, the report calls for greater use of narcotics-treatment programs, employment assistance and residential treatment, as well as graduated sanctions, ranging from more drug-test requirements to short jail stays, for those participants who fail to comply with the program's provisions.

More than half college students have suicidal thoughts

Mon, 18 Aug 2008 13:15:24 PST

( from http://www.rxpgnews.com ) Washington, Aug 18 - More than half of 26,000 students surveyed across 70 colleges and universities across the US admitted having at least one episode of suicidal thinking at some point in their lives.

Furthermore, 15 percent of them reported having seriously considered attempting suicide and more than five percent reported making a suicide attempt at least once in their lifetime.

The survey was administered in early 2006 and gathered information about a range of suicidal thoughts and behaviours among college students. The survey was reviewed by the campus counselling directors as well as two experts in suicidology.

Six percent of undergraduates and four percent of graduates reported seriously considering suicide within the 12 months prior to answering the survey. Therefore, the researchers posit, at an average college with 18,000 undergraduate students, some 1,080 undergraduates will seriously contemplate taking their lives at least once within a single year.

Approximately two-thirds of those who contemplate suicide will do so more than once in a 12-month period.

The majority of students described their typical episode of suicidal thinking as intense and brief, with more than half the episodes lasting one day or less. The researchers found that, for a variety of reasons, more than half of students who experienced a recent suicidal crisis did not seek professional help or tell anyone about their suicidal thoughts.

The researchers used separate samples of undergraduate and graduate students. College sizes ranged from 820 to 58,156 students, with 17,752 being the average. For the 15,010 undergraduates, 62 percent were female and 38 percent were percent male. Seventy-nine percent were white and 21 percent were minorities.

Ninety-five percent identified themselves as heterosexual and five percent identified as bisexual, gay or undecided. The average age was 22. For the 11,441 graduates, 60 percent were female and 40 percent were male.

Seventy-two percent were white and 28 percent were minorities. Ninety-four percent identified themselves as heterosexual and 6 percent identified as bisexual, gay or undecided. The average age was 30.

Both undergraduate and graduate students gave these reasons for their suicidal thinking, in the following order: - wanting relief from emotional or physical pain; - problems with romantic relationships; - the desire to end their life; and - problems with school or academics.

Fourteen percent of undergraduates and eight percent of graduate students who seriously considered attempting suicide in the previous 12 months made a suicide attempt. Nineteen percent of undergraduate attempters and 28 percent of graduate student attempters required medical attention. Half of attempters reported overdosing on drugs as their method, said the authors.

From the survey, the authors found that suicidal thoughts are a frequently recurring experience akin to substance abuse, depression and eating disorders. They also found that relying solely upon the current treatment model, which identifies and helps students who are in crisis, is insufficient for addressing reducing all forms of suicide behavior on college campuses.

These findings were presenting on Sunday at the 116th Annual Convention of the American Psychological Association, by psychologist David J. Drum, and co-authors at the University of Texas, based on a survey conducted by the National Research Consortium of Counselling Centres in Higher Education.

Surgical weight loss does not eliminate sleep apnea

Fri, 15 Aug 2008 12:42:25 PST

( from http://www.rxpgnews.com ) Washington, Aug 15 - Weight loss by surgery might not really help those with obstructive sleep apnea that merrily continues in moderate or severe forms even a year later, according to a study.

Results suggest that it is the severity of the condition, rather than a patient's pre-surgical weight, that determines if the condition will be resolved.

Bariatric - surgery reduced body mass index - from an average of 51 to 32 in 24 adults with obstructive sleep apnea -. At the one-year follow-up, however, only one participant experienced its resolution and the majority of the study group - still had moderate to severe OSA.

Patients who have residual OSA after surgery are encouraged to maintain ongoing treatment with continuous positive airway pressure - therapy.

The prevalence of OSA among obese individuals is high and correlates with increasing BMI; among the severely obese, the prevalence of OSA ranges from 55 percent to 90 percent.

OSA itself may promote weight gain through ineffective sleep, impaired glucose metabolism and imbalances of leptin, ghrelin and orexin levels.

'We were surprised by the severity of the residual sleep apnea in postoperative patients,' said principal investigator Christopher J. Lettieri at Walter Reed Army Medical Centre. 'The majority of individuals still had moderate to severe OSA.'

'The second surprising finding of this study was that despite the persistence and severity of the disease, most people thought their sleep apnea was resolved after their weight loss and only a few still used CPAP,' he said.

According to Lettieri, weight loss has many overall benefits; however, most people should not assume their OSA will be resolved after they have lost weight.

The study was published on Friday in the Journal of Clinical Sleep Medicine.

Depression is wrongly seen as natural part of getting older

Tue, 12 Aug 2008 10:02:18 PST

( from http://www.rxpgnews.com )

Photo by paveitapics

The vast majority of older people over the age of 65 in England have symptoms of depression are denied any help, according to a new report published today by Age Concern.

The charity found that shocking ageist attitudes held by many people, including GPs, and ageist rules in the NHS mean that an astounding eight out of ten older people with clinical depression don’t get any treatment. Most mental health services for depression exclude people aged 65 and older, despite the risk of depression increasing with age in later life.

Age Concern’s new campaign, ‘Down, but not out’, aims to improve the quality of life for older people with depression. Depression is the most common mental health problem in later life, affecting one in four older people yet it is often ignored. If depression is not identified and treated, it can lead to a life of misery. It can also cause other illnesses and, in extreme cases, can lead to suicide.

The charity will be helping older people to recognise the symptoms of depression and encouraging them to seek help. It will also be working with GPs to improve the diagnosis of older people with depression and ensure that effective treatments are available to all, regardless of age.

Poor health and problems, such as money worries, losing a loved one and stressful events like moving into a care home can trigger depression. Recently bereaved older people are three times more likely than married older people to show signs of depression.

Gordon Lishman, Director General of Age Concern, said:
“Negative attitudes about mental health problems make it very difficult for older people to talk about their feelings or to ask for help. It is scandalous that hundreds of thousands of older people may be denied treatment because depression is wrongly seen as a natural part of getting older.

“Older people deserve better treatment - there should be no excuse for inaction. Without a major change in policy and practice, there will be 3.5 million older people in UK with symptoms of depression by 2021.

“The Government and the NHS need to take action to stamp out ageist attitudes and practice, once and for all. The neglect of older people’s mental health ruins lives and must no longer be ignored.”

Awareness of depression is low among older people themselves and their relatives and is worse in some communities because of negative cultural perceptions of mental health problems. Beliefs about the origin of the illness and the high value placed on family reputation results in many black and minority ethnic (BME) elders, and their families, keeping the depression a secret.

Study highlights risky behavior, lack of care among HIV-infected crack users

Mon, 04 Aug 2008 03:59:37 PST

( from http://www.rxpgnews.com ) Doctors who treat HIV-infected crack users refer to them as the forgotten population. A study being presented at this week's International AIDS Conference in Mexico City reveals that these patients frequently lack outpatient health care, do not receive life-saving antiretroviral therapy and continue to engage in risky sexual behavior that likely contributes to HIV transmission.

Researchers interviewed 190 HIV-infected crack-using patients at Grady Memorial Hospital in Atlanta and Jackson Memorial Hospital in Miami over 14 months as part of an NIH/National Institute on Drug Abuse funded study.

One fourth of the group reported having unprotected sex in the last six months, half had not seen an HIV specialist in the last six months, and more than three fourths were not getting antiretroviral therapy, according to the interviews.

The five-year HOPE study (Hospital visit is an Opportunity for Prevention and Engagement) is a collaboration between the NIH funded Center for AIDS Research at Emory University School of Medicine and the NIH funded Developmental Center for AIDS Research at the University of Miami School of Medicine.

At a time when life-saving medications are available to treat persons living with HIV, there continues to be a population of HIV-positive people who have fallen through the cracks, says Lisa Metsch, PhD, associate professor of epidemiology and public health at University of Miami School of Medicine. Frequently, their only contact with the healthcare system is during a hospitalization.

Metsch is director of the University of Miami CFAR's behavior, social sciences and community outreach core and principal investigator for the HOPE study.

Previous studies of crack users in urban hospitals found that their drug use bars them from getting HIV-related care. Drug treatment experts say the short, intense nature of the crack high and lack of a methadone equivalent make crack users a unique group, on top of the chaotic lives they share with other drug users.

In addition, the study's interviews found that, compared with males, female HIV-infected crack users were more likely to report lack of HIV-related care (almost twice as likely) and recent unprotected sex (three times as likely), as well as annual income less than $5,000 and homelessness.

We know that not being engaged in care and prevention services is not only bad for the individuals but is also bad for society, in that a substantial fraction of HIV-infected crack users engage in behavior that transmits the virus to others, says Carlos Del Rio, MD, professor of medicine and chief of medical services at Grady Memorial Hospital, co-director of the Emory Center for AIDS Research and co-principal investigator for the HOPE study.

The Emory and University of Miami researchers are testing the effectiveness of an eight-session intervention program that helps participants get into HIV care, teaches them about reducing risky sex practices and helps them into drug treatment if they are ready.

Del Rio says that the findings from this intervention study may be used to establish future interventions targeted to HIV-infected crack users to get them into care, keep them in care and allow them to benefit from care and prevention services available in HIV outpatient clinics.

Hospitals like Grady and Jackson are doing the best they can in the face of a persistent problem, with limited resources, Del Rio says. More needs to be done to address substance abuse and mental health in this population.

Research says fat friends and poor education helps people think thin

Thu, 24 Jul 2008 03:59:37 PST

( from http://www.rxpgnews.com ) Research by economists at the University of Warwick, Dartmouth College, and the University of Leuven, finds that people are powerfully but subconsciously influenced by the weight of those around them. Without being aware of it, the researchers believe, human beings keep up with the weight of the Joneses. For a whole society, this can lead to a spiral of imitative obesity. The researchers will present their results on Friday July 25th at a National Bureau of Economic Research conference in Cambridge Massachusetts in a paper entitled Imitative Obesity and Relative Utility at the NBER Summer Institute on Health Economics.

Using data on 27,000 Europeans from 29 countries, the researchers find that nearly half of European women feel overweight. Less than a third of males feel overweight.

The authors suggest that whether for reasons of job promotions or finding a mate it is someone's weight relative to others that matters. They show that overweight perceptions and dieting decisions are influenced by people's comparisons with others of the same age and gender.

Highly educated Europeans hold themselves to a particularly tough standard, the research shows. For any given level of Body Mass Index (BMI), somebody with a university degree feels much fatter than someone with low educational qualifications.

Overall, the researchers believe that a person's utility (an economic term roughly meaning satisfaction levels) depends on their own weight relative to the weight of those around them. They suggest that it is easier to be fat in a society that is fat.

However, the authors also found a significant gender split. Females were much more prone, for any given BMI value, to feel overweight. For European women, weight dissatisfaction and overweight perceptions depended crucially upon not just their own absolute BMI, but also upon their BMI relative to other women of exactly the same age in their country. Conversely, being overweight tended not to be a significant issue for men if many of those around them were as overweight as they were.

Professor Andrew Oswald at the University of Warwick, one of the researchers, said Consumption of calories has gone up but that does not tell us why people are eating more. Some have argued that obesity has been produced by cheaper food, but if fatness is a response to greater purchasing power, why do we routinely observe that rich people are thinner than poor people?

He said: A lot of research into obesity, which has emphasized sedentary lifestyles or human biology or fast-food, has missed the key point. Rising obesity needs to be thought of as a sociological phenomenon not a physiological one. People are influenced by relative comparisons, and norms have changed and are still changing.

However, the authors found a significant gender split. Females were much more prone, for any given BMI value, to feel overweight. For European women, weight dissatisfaction and overweight perceptions depended crucially upon not just their own absolute BMI, but also upon their BMI relative to other women of exactly the same age in their country.

Energy drinks linked to risk-taking behaviors among college students

Thu, 24 Jul 2008 03:59:37 PST

( from http://www.rxpgnews.com ) BUFFALO, N.Y. -- Over the last decade, energy drinks -- such as Red Bull, Monster and Rockstar -- have become nearly ubiquitous on college campuses. The global market for these types of drinks currently exceeds $3 billion a year and new products are introduced annually.

Although few researchers have examined energy drink consumption, a researcher at the University at Buffalo's Research Institute on Addictions (RIA) has been investigating links between energy drinks and public health concerns like substance abuse and risky behaviors.

Two new research reports by RIA Research Scientist Kathleen E. Miller, Ph.D., examine the relationships between energy drink consumption and risk-taking in college students as well as toxic jock identity -- characterized by hyper-masculinity and risk-taking behaviors among college-age athletes.

Miller's research validates and expands upon existing concerns about energy drink consumption: The principal target demographic for energy drinks is young adults ages 18-25, but they're nearly as common among younger teens, she explains. This is a concern because energy drinks typically contain three times the caffeine of a soft drink, and in some cases, up to 10 times as much. They also include ingredients with potential interactions such as taurine and other amino acids, massive doses of vitamins, and plant and herbal extracts.

Miller is a sociologist and an adjunct research assistant professor in the Department of Sociology in UB's College of Arts and Sciences. The research was funded by a $471,000 grant by the National Institute on Drug Abuse.

In the first set of results published online in June in the Journal of Adolescent Health, Miller identified links between energy drink consumption, risky substance use and sexual risk-taking.

Frequent energy drink consumers (six or more days a month), according to Miller's findings, were approximately three times as likely than less-frequent energy drink consumers or non-consumers to have smoked cigarettes, abused prescription drugs and been in a serious physical fight in the year prior to the survey. They reported drinking alcohol, having alcohol-related problems and using marijuana about twice as often as non-consumers. They were also more likely to engage in other forms of risk-taking, including unsafe sex, not using a seatbelt, participating in an extreme sport and doing something dangerous on a dare. The associations with smoking, drinking, alcohol problems and illicit prescription use were found for white but not African-American students.

A total of 795 Western New York male and female undergraduate students participated in the study and 39 percent reported consuming at least one energy drink in the previous month. There was significantly higher consumption by men (46 percent) than by women (31 percent) and higher consumption by whites (40 percent) than by blacks (25 percent). Eighty-seven percent of the students in the study were white; 52 percent were male.

Two-thirds of the energy drink consumers in Miller's study had used energy drinks as mixers with alcoholic beverages. The growing popularity of this practice further heightens concern, Miller says.

It is widely, but incorrectly, believed that the caffeine in energy drinks counteracts the effects of alcohol, so students will have the energy to party all night without getting as drunk, she explains. While the combination may reduce perceptions of intoxication, it does not reduce alcohol-induced impairments of reaction time or judgment.

According to Miller, these findings suggest that frequent energy drink consumption may serve as a useful screening indicator to identify students at risk for what scientists call problem behavior syndrome.

Energy drink consumption is correlated with substance use, unsafe sexual activity and several other forms of risk-taking, Miller notes. For parents and college officials, frequent energy drink consumption may be a red flag or warning sign for identifying a young person at higher risk for health-compromising behavior.

Although energy drink consumption can be used to predict other problem behaviors, it does not necessarily follow that drinking these substances is a gateway to more serious health-compromising activities, Miller cautions. It is entirely possible that a common factor, such as a sensation-seeking personality or involvement in risk-oriented peer sub-cultures, contributes to both. More investigation is needed to study these relationships further, over longer periods of time.

In the second set of results, published in the March/April issue of the Journal of American College Health, Miller looked at energy drink consumption and toxic jock identity.

For many people, being an athlete is an important part of who they are, Miller explains. Some go a step farther, though, and come to see themselves as 'jocks.' For them, sport is wrapped up in a larger identity that also emphasizes hyper-masculinity and a willingness to take excessive risks. Unlike an athlete identity, a jock identity can be considered toxic, according to Miller, because it's associated with a wide range of risky or problem behaviors, including problem drinking, sexual risk-taking, interpersonal violence, academic misconduct, delinquency and even suicide attempts.

Miller's research found that undergraduates who consumed energy drinks more often were also more likely to develop a jock identity and to engage in risk-taking behaviors. Ultimately, she says, undergraduates' frequent use of Red Bull and other energy drinks should be seen by peers, parents and college officials as a potential predictor of 'toxic jock identity.'

In the wake of several recent deaths linked to energy drinks, a number of countries have instituted restrictions on their use. Some, like France, Turkey, Denmark, Norway, Uruguay and Iceland ban high-caffeine/taurine energy drinks altogether, Miller notes. Sweden only permits them to be sold in pharmacies as medicinal products. Canada, which banned these drinks until 2004, now requires warning labels cautioning against use by children or pregnant women, use in large quantities or use with alcohol. However, energy drink consumption remains unregulated in the United States.

Miller says she hopes to develop future research into the influence of personality traits, peer norms and other factors that may influence the relationships among energy drink consumption, race, gender and risk-taking. Better understanding of these relationships, she argues, may be useful in developing programs for preventing substance use and other health-compromising behaviors.

Psychiatrist warns about impact of social networking sites

Sat, 12 Jul 2008 04:44:16 PST

( from http://www.rxpgnews.com ) A generation of Internet users who have never known a world where you can't surf on-line may be growing up with a different and potentially dangerous view of the world and their own identity, according to a warning delivered to the Annual Meeting of the Royal College of Psychiatrists.

Dr Himanshu Tyagi, a psychiatrist at West London Mental Health Trust, said that people born after 1990, who were just five-years-old or younger when the use of Internet became mainstream in 1995, have grown up in a world dominated by online social networks such as Facebook and MySpace.

”This is the age group involved with the Bridgend suicides and what many of these young people had in common was their use of Internet to communicate. It's a world where everything moves fast and changes all the time, where relationships are quickly disposed at the click of a mouse, where you can delete your profile if you don't like it and swap an unacceptable identity in the blink of an eye for one that is more acceptable,” said Dr Tyagi. “People used to the quick pace of online social networking may soon find the real world boring and unstimulating, potentially leading to more extreme behaviour to get that sense.

”It may be possible that young people who have no experience of a world without online societies put less value on their real world identities and can therefore be at risk in their real lives, perhaps more vulnerable to impulsive behaviour or even suicide. This is definitely a line of reasoning that warrants more investigation and
research.”

Dr Tyagi became interested in factors shaping an online identity when he founded an online professional network by the name of RxPG (Prescription for Professional Growth) which is now subscribed by more than 60,000 medical graduates and undergraduates worldwide. He warned the meeting that there was a massive generation gap amongst current psychiatrists and young patients around the Internet related issues. A survey of International psychiatrists conducted by him at a recent psychiatric conference in US showed that the vast majority of psychiatrists worldwide were unaware of the full magnitude of impact of online world on the younger generation.

Chat room communication was also more likely to encourage disinhibition because of anonymity, and involve reduced sensory experience: “If you can't see the person's expression or body language or hear the subtle changes in their voice, it shapes your perceptions of the interaction differently,' Dr Tyagi said.

A session in front of the computer was also likely to create “an altered perception, a
dream-like state, an unnatural blending of their mind with the other person – something that rarely happens in real life. The new generation raised alongside internet is attaching an entirely different meaning to friendship and relations, something we are largely failing to notice”.

Dr Tyagi said there were significant benefits for the online social networking. It provides an equalised status where wealth race and gender were less meaningful; a loss of geographical boundaries which meant that opportunities to access unrestricted peer support are abundant, which can be important in maintaining good psychological health for many. He said: “No one is a pariah on net, it works great in
flattening the hierarchies of the real world.”

But Dr Tyagi warned that while many people today cannot remember a world without the Internet, it may be “quite different for teens and children who cannot imagine a world where you can't go online to talk and apply the same principles to real-world interpersonal communications, mostly to a dysfunctional outcome. It's vital that we
face up to what is happening. The Internet will not go away so these issues, which would inevitably grow in magnitude with time, need to be addressed soon.”

Claims linking health problems and the strength of cannabis may be exaggerated

Tue, 17 Jun 2008 03:59:37 PST

( from http://www.rxpgnews.com ) Claims that a large increase in the strength of cannabis over the last decade is driving the occurrence of mental health and other problems for users are not borne out by a study of the worldwide literature, say researchers at the National Drug and Alcohol Research Centre (NDARC) and the National Drug Research Institute (NDRI), both from Australia.

Their conclusions, published in this month's issue of ADDICTION, are that increased potency has been observed in some countries, but there is enormous variation between samples, meaning that cannabis users may be exposed to greater variation in the strength of the cannabis they use in a single year than over years or decades.

Cannabis samples tested in the United States, the Netherlands, the United Kingdom and Italy have shown increases in potency over the last decade, but no significant growth in other European countries or in New Zealand has been found during the same period.

THC is the active ingredient in cannabis, which produces the strongest psychoactive effect. In the United States, the level of THC in confiscated cannabis was 8.5% in 2006, up from 4.5% in 1997. Recent Dutch data show that the THC of cannabis sold in coffee shops more than doubled between 2000 and 2004, but has since levelled off.

THC content varies according to the part of the plant that is used, the method of storage, and cultivation techniques. Popular belief is that hydroponic or other methods of indoor cultivation produce higher concentrations of THC than occur naturally, but the jury is still out on this issue.

The ability to control the indoor environment means that plants can reach their full potential, which includes reaching the maximum level of THC. The increase in market share of indoor-grown cannabis seen in Australia as well as North America and Europe may have led to a more consistent product which could explain the potency increases reported in some countries.

While some public debate has linked large increases in cannabis potency to increased mental health problems, there are currently insufficient data to justify this claim, and care ought to be taken when considering policy decisions on this basis. Importantly, further research is required to understand whether cannabis users can, or do, alter their intake in response to a change in potency.

In their discussion of potential health risks, the authors point to studies that observe that some cannabis smokers, when faced with a 'strong' product, act rather like tobacco smokers and adjust their dose by increasing the interval between puffs, or holding smoke in their lungs for a shorter period of time. This behaviour may reduce possible harms caused by increased potency.

Drink and drugs fuel Scottish suicide and homicide rates

Mon, 16 Jun 2008 03:59:37 PST

( from http://www.rxpgnews.com ) Alcohol and drug misuse mean Scots are almost twice as likely to kill or take their own life compared to people living in England and Wales, research published today (Monday, June 16) reveals.

The findings by The University of Manchester's National Confidential Inquiry into Suicide and Homicide by People with Mental Illness (NCI) also show that the number of mental health patients committing homicide or suicide was proportionately much higher in Scotland.

The 'Lessons for Mental Health Care in Scotland' report, commissioned by the Scottish Government, blames these higher death rates north of the border on alcohol and drug consumption, both in the general population and among mental health patients.

The NCI examined all suicides and homicides in the general population in Scotland, as well as those committed by people who had sought help from mental health services, and compared them to its findings for England and Wales.

Suicide rates in Scotland equated to 18.7 per 100,000 of the population, compared to 10.2 per 100,000 in England and Wales, while homicide rates north of the border were 2.12 per 100,000 people compared to 1.23 per 100,000 in England and Wales. The north-south divide was highest among teenagers, the report found.

Memory loss linked to common sleep disorder

Wed, 11 Jun 2008 03:59:37 PST

( from http://www.rxpgnews.com ) For the first time, UCLA researchers have discovered that people with sleep apnea show tissue loss in brain regions that help store memory. Reported in the June 27 edition of the journal Neuroscience Letters, the findings emphasize the importance of early detection of the disorder, which afflicts an estimated 20 million Americans.

Sleep apnea occurs when a blocked airway repeatedly halts the sleeper's breathing, resulting in loud bursts of snoring and chronic daytime fatigue. Memory loss and difficulty focusing are also common complaints. Prior studies have linked the disorder to a higher risk of stroke, heart disease and diabetes.

Our findings demonstrate that impaired breathing during sleep can lead to a serious brain injury that disrupts memory and thinking, said principal investigator Ronald Harper, a distinguished professor of neurobiology at the David Geffen School of Medicine at UCLA.

The study focused on structures called mammillary bodies, so named because they resemble small breasts, on the underside of the brain.

The UCLA team scanned the brains of 43 sleep apnea patients, using magnetic resonance imaging (MRI) to collect high-resolution images of the entire brain, including slices of the mammillary bodies.

The structures' small size and proximity to bone and fluid make them difficult to measure by conventional MRI. So the researchers manually traced the mammillary bodies from the high-resolution scans and calculated their volumes from the hand-drawn outlines.

When they compared the results to images of 66 control subjects matched for age and gender, the scientists discovered that the sleep apnea patients' mammillary bodies were nearly 20 percent smaller, particularly on the left side.

The findings are important because patients suffering memory loss from other syndromes, such as alcoholism or Alzheimer disease, also show shrunken mammillary bodies, said lead author Rajesh Kumar, a UCLA assistant researcher in neurobiology.

Physicians treat memory loss in alcoholic patients with massive amounts of thiamine, or vitamin B1, he added. We suspect that the dose helps dying cells to recover, enabling the brain to use them again.

The scientists' next step is to determine how sleep apnea causes tissue loss in the mammillary bodies.

Harper hypothesizes that repeated drops in oxygen lead to the brain injury. During an apnea episode, the brain's blood vessels constrict, starving its tissue of oxygen and causing cellular death. The process also incites inflammation, which further damages the tissue.

The reduced size of the mammillary bodies suggests that they've suffered a harmful event resulting in sizable cell loss, Harper said. The fact that patients' memory problems continue despite treatment for their sleep disorder implies a long-lasting brain injury.

In a future study, Harper and Kumar will explore whether taking supplemental vitamin B1 helps restore sleep apnea patients' memory. The vitamin helps move glucose into the cells, preventing their death from oxygen starvation.

UCLA researchers used sophisticated imaging technology to identify brain lesions associated with impaired memory in individuals with obstructive sleep apnea, said Elizabeth G. Nabel, director of the National Heart, Lung and Blood Institute, which funded the study. These results underscore the importance of early diagnosis and treatment of sleep-disordered breathing, which can have long-term effects on patients' health and well-being.

Obstructive sleep apnea occurs when the muscles in the throat, soft palate and tongue relax during sleep and sag, narrowing the airway. The tongue slides to the back of the mouth, blocking the windpipe and cutting off oxygen to the lungs.

The sleeper wakes up, gasping for air, and falls back into a fitful sleep. The cycle can repeat itself hundreds of times per night.

Excessive drinking and relapse rapidly cut in new approach

Mon, 09 Jun 2008 03:59:37 PST

( from http://www.rxpgnews.com ) Boosting the level of a specific brain protein quickly cut excessive drinkingof alcohol in a new animal study, and also prevented relapse -- the common tendency found in sober alcoholics to easily return to heavy drinking after just one glass.

In addition, the treatment did not block other pleasure-seeking behaviors -- in this case, craving sweets. Interference with these normal behaviors has been a problem with drugs developed for alcoholism treatment. Nor did the brain chemical boost appear to carry any side effects, the study researchers report.

The findings are being published June 9 in The Proceedings of the National Academy of Sciences.

The research by scientists at theUCSF-affiliatedErnest Gallo Clinic and Research Center builds on their earlier work. In 2005, they reported the first hints that increased levels of this brain protein, known as GDNF, cut down alcohol consumption. The new study established how quickly the effect kicks in, and shows for the first time that the chemical blocks relapse and does not interfere with normal cravings. The research also pinpointed the brain site where GDNF acts to control drinking.

Alcoholism is a devastating and costly psychiatric disease with enormous socioeconomic impact, said Dorit Ron, PhD, senior author on the paper and principal investigator at the Gallo Center. There is a tremendous need for therapies to treat alcohol abuse.

Unfortunately, only three drugs are currently approved to treat excessive drinking, and all have serious limitations. Our findings open the door to a promising new strategy to combat alcohol abuse, addiction and especially relapse. Ron is also associate professor of neurology at UCSF.

GDNF, or glial cell-derived neurotrophic factor, is already a focus of strong interest for treating Parkinson's disease. A new orally-delivered, experimentaldrug has been shown to raise brain GDNF levels in rats, suggesting its promise against Parkinson's. Research by Ron and her colleagues suggests such a drug might also treat alcoholism.

The Gallo Center scientists set out to test the actions of GDNF in a brain site known as the Ventral Tegmental Area, or VTA, a region of the brain thought to be strongly involved in drug-seeking behavior. The first part of the study was designed to model both human social and excessive drinking. Researchers first trained rats to seek alcohol for two months. GDNF was then injected into the VTA brain region, and their motivation to drink in both models dropped significantly within as little as 10 minutes. The effect lasted at least three hours, the scientists reported.

In a second part of the study, rats had access to sugar water, and the scientists showed that after GDNF treatment, the animals still sought sugar -- convincing evidence that increased GDNF did not decrease other, related pleasure-seeking behaviors.

Repeated methamphetamine use causes long-term adaptations in brains of mice, researchers find

Wed, 09 Apr 2008 03:59:37 PST

( from http://www.rxpgnews.com ) Repeatedly stimulating the mouse brain with methamphetamine depresses important areas of the brain, and those changes can only be undone by re-introducing the drug, according to research at the University of Washington and other institutions. The study, which appears in the April 10 issue of the journal Neuron, provides one of the most in-depth views of the mechanisms of methamphetamine addiction, and suggests that withdrawal from the drug may not undo the changes the stimulant can cause in the brain.

The researchers set out to determine what sort of changes happen in the brain because of repeated use of the stimulant methamphetamine, and to better understand addiction-related behaviors like drug craving and relapse. Methamphetamine, also known as simply meth, is one of the most popular illegal drugs in the United States, and abuse of the drug can cause severe addiction.

Scientists have believed that abuse of drugs like meth can cause changes to the neurons in the brain and the synapses and terminals that control transmission of information in the brain. In this project, researchers focused on the mouse brain, and how it was affected by methamphetamine over 10 days, which is the mouse equivalent of chronic use in humans.

They found that the long administration and withdrawal of the drug depressed the neural terminals controlling the flow of signals between two areas of the brain, the cortex and striatum. Even a long period of withdrawal -- the equivalent of years in humans -- did not return the terminals to normal activity level. Re-introducing the drug, however, reversed the changes in the brain.

The areas affected by the drug are called pre-synaptic terminals, and are related to the flow of information from the cortex to the striatum. When a person sees something new in their environment, the scientists explained, she focuses attention on that item. At the neuron level, that process stimulates the release of dopamine, a chemical involved in transmitting signals in the brain. As the person sees the new item over and over again, the dopamine response drops, and synapses in the brain adapt to the no-longer-new item.

What happens with methamphetamine use is that the drug makes the nervous system release dopamine, which helps a user focus a lot of attention on a particular goal. Scientists believe that meth allows dopamine in the striatum to filter information coming from the cortex through the pre-synaptic terminals. The filtering of some of the terminals would help someone ignore other things and focus on that one goal or task.

After chronic use of methamphetamine, the filtering process eventually becomes a permanent depression in the activity of those terminals in the brain, the scientists found. And the only thing that can help the pre-synaptic terminals recover in mice, they found, was re-administering the drug.

What we found is that the repeated use of methamphetamine causes adaptations in the brain, and that only re-introducing the drug can reverse that, said Dr. Nigel Bamford, UW assistant professor of neurology and pediatrics and a physician at Seattle Children's Hospital. We think these changes in the brain may account for at least some of the physiological components of meth addiction.

If the mechanism turns out to be similar in people, Bamford said, this could have big effects on the treatment and management of methamphetamine addiction. One treatment for drug addiction is to give people smaller and smaller amounts of the drug to wean them from it and reduce the effects of withdrawal. Unfortunately, that method would not affect the adaptation of the neural terminals in the brain.

Now that we have some understanding of the mechanism through which meth addiction occurs, we may be able to develop other approaches to treating addiction, explained Bamford. We might be able to target some of the chemical receptors in the brain to reset the system and get rid of this depressed state in the pre-synaptic terminals.

Though scientists believe that other stimulants, like methylphenidate, may have similar effects on the brain, they caution against applying these findings to other situations. These synaptic changes may not occur in patients with underlying conditions that require treatment with stimulants, the scientists said.

Depression increases risk of Alzheimer's disease

Tue, 08 Apr 2008 09:37:44 PST

( from http://www.rxpgnews.com ) Washington, April 8 - Depressed people are more likely to develop Alzheimer's disease than those with a more positive outlook to life, says a new study.

The finding is based on a six-year survey of 486 healthy people aged 60 to 90. Of those, 134 people had experienced depression once, prompting them to seek medical advice - 33 of them developed Alzheimer's.

People who experienced depression were 2.5 times more likely to develop Alzheimer's disease than normal people, the study found.

The risk was four times greater for those who were depressed before 60, according to the study, which has been published in the latest issue of the journal Neurology.

'We don't know yet whether depression contributes to the development of Alzheimer's disease or whether another unknown factor causes both depression and dementia,' said the study's author Monique MBreteler of Erasmus University Medical Centre in Rotterdam.

'We'll need to do more studies to understand the relationship between depression and dementia.'

One theory is that depression leads to loss of brain cells, which contributes to Alzheimer's disease.

Brain DNA 'remodeled' in alcoholism

Tue, 01 Apr 2008 03:59:37 PST

( from http://www.rxpgnews.com ) Reshaping of the DNA scaffolding that supports and controls the expression of genes in the brain may play a major role in the alcohol withdrawal symptoms, particularly anxiety, that make it so difficult for alcoholics to stop using alcohol.

The finding is reported by researchers at the University of Illinois at Chicago and the Jesse Brown VA Medical Center in the April 2 issue of the Journal of Neuroscience.

DNA can undergo changes in function without any changes in inheritance or coded sequence. These epigenetic changes are minor chemical modifications of chromatin -- dense bundles of DNA and proteins called histones.

This is the first time anyone has looked for epigenetic changes related to chromatin remodeling in the brain during alcohol addiction, said Dr. Subhash C. Pandey, professor and director of neuroscience alcoholism research at the UIC College of Medicine and the Jesse Brown VA Medical Center in Chicago, the lead author of the study.

Chemical modification of histones can change the way DNA and histones are wound up together. Histone acetyltransferases (HATs) are enzymes that add acetyl groups to histones and loosen the packing, promoting gene expression. On the other hand, histone deacetylases (HDACs) remove acetyl groups from histones, causing them to wrap with DNA more tightly, decreasing gene expression.

The UIC researchers had previously shown in an animal model that levels of neuropeptide Y in the amygdala modulate anxiety and alcohol-drinking behavior. In the new study, they looked at the HDAC activity, acetylation of histones, and expression of the genes for NPY in the amygdala and the anxiety-like behaviors associated with withdrawal from chronic alcohol use.

Pandey and his colleagues found that acute exposure to alcohol decreases HDAC activity; increases the acetylation histones; increases levels of NPY -- and reduced anxiety in the animals.

Conversely, anxiety-like behaviors during withdrawal in animals with chronic alcohol exposure was associated with an increase in HDAC activity and decrease in histones acetylation and NPY levels.

Importantly, blocking the observed increase in HDAC activity using an HDAC inhibitor during alcohol withdrawal brought up histone acetylation and NPY expression levels in the amygdala and prevented the development of anxiety-like behaviors.

Our findings suggest that HDAC inhibitors may have potential as therapeutic agents in treating alcoholism, Pandey said.

The researchers also found that levels of a protein known as CREB binding protein, which has HAT enzymatic activity, were increased by acute alcohol but were decreased during ethanol withdrawal.

They concluded that the enzymes that are involved in remodeling of chromatin play an important role in the anxiety that accompanies alcohol withdrawal as well as in the anti-anxiety effects of acute alcohol use.

We need new strategies to treat alcoholism that are directed toward the prevention of withdrawal symptoms, Pandey said. Anxiety associated with withdrawal from alcohol abuse is a key factor in the maintenance of alcohol addiction.

Adolescent girls with ADHD are at increased risk for eating disorders, study shows

Fri, 14 Mar 2008 03:59:37 PST

( from http://www.rxpgnews.com ) Girls with attention deficit hyperactivity disorder stand a substantially greater risk of developing eating disorders in adolescence than girls without ADHD, a new study has found.

Adolescent girls with ADHD frequently develop body-image dissatisfaction and may go through repeating cycles of binge eating and purging behaviors that are common in bulimia nervosa, said University of Virginia psychologist Amori Yee Mikami, who led the study.

The findings appear in the current issue of the Journal of Abnormal Psychology.

ADHD is a disorder that affects about 5 percent of school-age children, and three times more boys than girls. Symptoms include a short attention span, poor organization, excessive talking, disruptive and aggressive behavior, restlessness and irritability. Many children with ADHD suffer through a range of problems, from poor grades to poor relations with parents and teachers, and more than half have serious problems making friends.

Because the disorder is far more common in boys, researchers are still learning its long-term effects on girls.

Our finding suggests that girls may develop a broader range of problems in adolescence than their male counterparts, Mikami said. They may be at risk for eating problems, which are a female-relevant domain of impairment. We know that eating disorders occur 10 times more often in girls than boys.

Additionally, Mikami noted that because ADHD is more common in boys, many girls with the disorder may go undiagnosed and untreated.

Girls with ADHD may be more at risk of developing eating problems as adolescents because they already have impulsive behaviors that can set them apart from their peers, Mikami said. As they get older, their impulsivity may make it difficult for them to maintain healthy eating and a healthy weight, resulting in self-consciousness about their body image and the binging and purging symptoms.

The study was conducted with an ethnically diverse sample of 228 girls in the San Francisco Bay area; 140 who had been diagnosed with ADHD and 88 matched comparison girls without ADHD. They were first assessed between the ages of 6 and 12 and again five years later.

Girls with the combined type of ADHD (those with both inattention and hyperactivity/impulsivity) were most likely to have adolescent bulimia nervosa symptoms, relative to girls with the inattentive type of ADHD (those with inattention only) and girls without ADHD. Girls with both types of ADHD were more likely to be overweight, to have experienced harsh/critical parenting in childhood, and to have been peer-rejected than girls without ADHD. Mikami said she believes these factors could contribute to the bulimia nervosa symptoms.

An additional concern is that stimulant medications used to treat ADHD have a side effect of appetite suppression, creating a risk that overweight girls could abuse these medicines to encourage weight loss, though we have not yet investigated that possibility, Mikami said.

She warned parents and teachers to be aware that adolescent girls with ADHD may develop an array of female-relevant symptoms beyond the standard ADHD symptoms, to include eating disorders, depression and anxiety.

Brain recruiting pattern incorrect in Schizophrenic patients

Wed, 12 Mar 2008 05:38:02 PST

( from http://www.rxpgnews.com ) The enduring memory problems that people with schizophrenia experience may be related to differences in how their brains process information, new research has found.

The Public Library of Science published the report by Vanderbilt University researchers Junghee Lee, Bradley S. Folley, John Gore and Sohee Park in the online journal PLOS One March 12.

“We found that schizophrenic patients use different areas of their brain than healthy individuals do for working memory, which is an active form of short-term memory,” Park said.

“Both groups used their frontal cortex while remembering and forgetting. However, while healthy subjects groups used the right side of this brain area when asked to remember spatial locations, the schizophrenic patients used a wider network in both hemispheres.

“This suggests that while healthy people recruit a specialized and focused network of brain areas for specific memory functions, schizophrenic patients seem to rely on a more diffuse and wider network to achieve the same goal.”

The researchers also found a fundamental difference in the way healthy people and schizophrenic patients made errors. When healthy people forgot, they had no confidence in their response for that trial and the brain areas that were recruited during correct memory trials remained inactive. A more complex picture emerged for schizophrenic patients.

“When healthy people are correct, there is an increased activation of the right frontal cortex. When they forget, there is no such increase. Their brain activation pattern is tightly coupled with their memory performance. Not so with schizophrenic patients,” Park said.

“Schizophrenic patients may encode and remember incorrect information. The brain activation pattern during such error trials indicate that indeed they were remembering something, albeit incorrect,” she continued. “Such coupling of storing incorrect information and feeling confident of one’s response may be one way to think about how delusions get initiated,” Park said.

Researchers have known since the early 1990s that working memory problems are a consistent symptom of schizophrenia. The researchers sought to better understand what is occurring in the brain that may be causing these problems.

“The right hemisphere is usually recruited during spatial information processing but if it is malfunctioning, as it may be in schizophrenia, the left hemisphere may also be recruited,” Park said. “Another possible explanation is that schizophrenic patients may have more difficulty with these tasks, and as a result recruit more brain areas to assist them.”

In the experiment, the subjects were shown a point on a computer screen and told to concentrate upon it. Three identical black circles were then flashed on a gray background, each in a different location. After a short delay, the subjects were shown a probe and told to press one key if the probe matched one of the circles shown earlier and another if it did not. They then were told to press another key ranking on a scale from one to five their confidence in their answer about the probe.

The researchers captured images of brain activity during these tasks using functional magnetic resonance imaging, or fMRI. They repeated the experiment to capture data using another tool, near infrared spectroscopy, or NIRS. NIRS is a new and promising way to study schizophrenia, the researchers believe.

“Many patients exceed the fMRI safety weight limit due to the side effects of their medication. The paranoia and anxiety that are often part of this disorder also make fMRI, which involves entering a tube while laying down, impossible for many patients. Also, individuals with metal implants cannot be scanned,” Park said. “NIRS does not have these problems. As a participant, you sit in an office chair while the experimenter places a plastic ‘probe set’ on your head with a couple of straps. Even babies tolerate it pretty well. Our study demonstrates that NIRS can be used as a viable alternative to fMRI, which means many more people can participate in experiments.”

The researchers chose to publish their work in PLOS One, a relatively new, open access journal, because it is freely available to the public.

“We felt that the fact that anybody can access scientific papers in this journal was a big plus,” Park said. “One normally has to pay for access to journals. Most schizophrenic patients, including the individuals who participated in our study, simply do not have the money to do so. This article is available for free to anyone.”

Brain chemistry ties anxiety and alcoholism

Tue, 04 Mar 2008 04:59:37 PST

( from http://www.rxpgnews.com ) Doctors may one day be able to control alcohol addiction by manipulating the molecular events in the brain that underlie anxiety associated with alcohol withdrawal, researchers at the University of Illinois at Chicago College of Medicine and the Jesse Brown VA Medical Center report in the March 5 issue of the Journal of Neuroscience.

The association of anxiety with increased alcohol use is a key factor in the initiation and maintenance of alcohol addition, says Dr. Subhash Pandey, UIC professor of psychiatry and director of neuroscience alcoholism research, the lead author of the study.

Previous research has shown that people with inherently high levels of anxiety are at an increased risk of becoming alcoholics. In addition, withdrawal of alcohol in chronic users is often accompanied by extreme anxiety.

Alcoholics may feel a need to continue to drink alcohol in an attempt to self-medicate to reduce their anxiety and other unpleasant withdrawal symptoms, said Pandey.

Pandey and his colleagues have discovered the molecular basis for the link between anxiety and alcohol addiction, which may help in identifying new therapeutic strategies for the treatment of alcohol addiction.

The researchers found that a protein within neurons in the amygdala -- the area of the brain associated with emotion and anxiety -- controls the development of alcohol withdrawal symptoms and drinking behaviors in laboratory animals by changing the shape of the neurons. This change in shape affects the communication between neurons, leading to changes in behavior.

Neurons communicate by sending signals through branches called dendritic spines. The researchers found that short-term alcohol exposure increased the number of dendritic spines in certain regions of the amygdala, producing anti-anxiety effects. Alcohol-dependent animals eventually developed a tolerance to the anxiety-lowering effects of alcohol.

The researchers traced the anti-anxiety effect to the production of a particular protein, Arc, in response to a nerve growth factor called BDNF that is stimulated by alcohol exposure. BDNF is vital in the functioning and maintenance of neurons.

When alcohol was withheld from animals that had been chronically exposed, they developed high anxiety. Levels of BDNF and Arc -- and the number of dendritic spines -- were decreased in the amygdala. But the researchers were able to eliminate the anxiety in the alcohol-dependent animals by restoring BDNF and Arc to normal levels.

Pandey suggested that an initial easing of anxiety may encourage people to begin to use alcohol, while for chronic users, a lack of alcohol provokes high anxiety, creating a need to continue drinking to feel normal.

The researchers blocked Arc production in normal rats by injecting a complementary sequence to Arc gene DNA into the central amygdala. They found that when levels of Arc in the central amygdala were lowered, the spines decreased and anxiety and alcohol consumption increased. When levels of Arc were returned to normal three days post-injection, anxiety and alcohol consumption also returned to normal. In a previous study, researchers found that lowering BDNF in amygdala promoted anxiety and alcohol drinking.

This is the first direct evidence of the molecular processes occurring in the neurons that is responsible for the co-morbidity of anxiety and alcoholism, which we believe plays a major role in the addictive nature of alcohol, said Pandey.

This offers the possibility of new therapeutic target -- BDNF-Arc signaling and associated dendritic spines in the amygdala -- or new drug development.

These observations by Dr. Pandey's research group provide an insight into the link between alcohol and anxiety and could be used to identify new targets for developing medications that alleviate withdrawal-induced anxiety and potentially modify a motivation for drinking, said Antonio Noronha, director of neuroscience and behavior research at the National Institute on Alcohol Abuse and Alcoholism.

Study shows how context dictates what we believe we see

Fri, 22 Feb 2008 07:21:07 PST

( from http://www.rxpgnews.com ) Scientists at UCL (University College London) have found the link between what we expect to see, and what our brain tells us we actually saw. The study reveals that the context surrounding what we see is all important – sometimes overriding the evidence gathered by our eyes and even causing us to imagine things which aren’t really there.

The paper reveals that a vague background context is more influential and helps us to fill in more blanks than a bright, well-defined context. This may explain why we are prone to ‘see’ imaginary shapes in the shadows when the light is poor.

Eighteen observers were asked to concentrate on the centre of a black computer screen. Every time a buzzer sounded they pressed one of two buttons to record whether or not they had just seen a small, dim, grey ‘target’ rectangle in the middle of the screen. It did not appear every time, but when it did appear it was displayed for just 80 milliseconds (80 one thousandths of a second).

“People saw the target much more often if it appeared in the middle of a vertical line of similar looking, grey rectangles, compared to when it appeared in the middle of a pattern of bright, white rectangles. They even registered ‘seeing’ the target when it wasn’t actually there,” said Professor Zhaoping, lead author of the paper. “This is because people are mentally better prepared to see something vague when the surrounding context is also vague. It made sense for them to see it – so that’s what happened. When the target didn’t match the expectations set by the surrounding context, they saw it much less often.

Demonstration of Inferences of Objects from Images (A) and (B) show two images containing the same white patch, and (C) and (D) show the two possible inferred objects in the scene causing this white patch. The inferred causes for any particular input image patch is not unique, although some inferences are more likely than others. The difference in the most likely inferred object for the same image patch in (A) and (B) demonstrates that inference could be greatly influenced by the image context.

“Illusionists have been alive to this phenomenon for years,” continued Professor Zhaoping. “When you see them throw a ball into the air, followed by a second ball, and then a third ball which ‘magically’ disappears, you wonder how they did it. In truth, there’s often no third ball - it’s just our brain being deceived by the context, telling us that we really did see three balls launched into the air, one after the other.

“Contrary to what one might expect, it is a vague rather than a bright and clearly visible context that most strongly permits our beliefs to override the evidence and fill in the blanks. In fact, a bright and clearly visible context actually overrides the evidence in the opposite direction - suppressing our ‘seeing’ of the vague target even when it is present.

“Mathematical modelling suggests that visual inference through context is processed in the brain beyond the primary visual cortex. By starting with a relatively simple experiment such as this, where visual input can be more easily and systematically manipulated, we are gaining a better understanding of how context influences what we see. Further studies along these lines can hopefully enable us to dissect the workings behind more complex and wondrous illusions.”

Cocaine's effects on brain metabolism may contribute to abuse

Mon, 18 Feb 2008 04:59:37 PST

( from http://www.rxpgnews.com ) UPTON, NY - Many studies on cocaine addiction - and attempts to block its addictiveness - have focused on dopamine transporters, proteins that reabsorb the brain's reward chemical once its signal is sent. Since cocaine blocks dopamine transporters from doing their recycling job, it leaves the feel-good chemical around to keep sending the pleasure signal. Now a new study conducted at the U.S. Department of Energy's Brookhaven National Laboratory suggests that cocaine's effects go beyond the dopamine system. In the study, cocaine had significant effects on brain metabolism, even in mice that lack the gene for dopamine transporters.

In dopamine-transporter-deficient mice, these effects on metabolism are clearly independent of cocaine's effects on dopamine, said Brookhaven neuroscientist Panayotis (Peter) Thanos, who led the research. These metabolic factors may be a strong regulator of cocaine use and abuse, and may also suggest new avenues for addiction treatments. The study will appear in the May 2008 issue of the journal Synapse, and will be available online on Monday, February 18, 2008.

The scientists used positron emission tomography, or PET scanning, to measure brain metabolism in dopamine-transporter deficient mice (known as DAT knockouts) and in littermates that had normal dopamine transporter levels. In this technique, the scientists administer a radioactively labeled form of sugar (glucose) - the brain's main fuel - and use the PET scanner to track its site-specific concentrations in various brain regions. They tested the mice before and after cocaine administration, and compared the results to mice treated with saline instead of the drug.

Before any treatment, mice lacking dopamine transporters had significantly higher metabolism in the thalamus and cerebellum compared with normal mice. This elevated metabolism may be linked to chronically high levels of dopamine in the DAT knockout mice. It also suggests that dopamine levels may play an important role in modulating glucose levels in these brain areas, which play important roles integrating sensory information, learning, and motor function.

Interestingly, DAT knockout mice have been suggested as an animal model for attention-deficit hyperactivity disorder (ADHD). Elevated metabolism due to persistent elevated dopamine levels may be a factor contributing to the symptoms of ADHD, Thanos said.

After the scientists administered cocaine, whole brain metabolism decreased in both groups of mice, but more significantly in normal mice than in DAT knockouts. The scientists were able to detect this reduction in metabolism in a wide range of brain regions in the normal mice, suggesting that these decreases in metabolism are somehow associated with the blockade of dopamine transporters by cocaine.

The scientists also observed a reduction in metabolism in the thalamus region in the DAT knockout mice. This effect may likely be due to the effect of cocaine on other neurotransmitter systems, for example, norepinepherine or serotonin.

In summary, cocaine exposure has an effect on regional brain activity, which is mostly driven by dopamine action and to a secondary degree norepinephrine or serotonin. These results also support the idea that the thalamus and the cerebellum play key roles in cocaine's mechanism of effect on sensory input, learning, and motor function. This is particularly of interest in better understanding the mechanism of cocaine addiction as well as the neurobiology of ADHD.

UTMB wins $3.4 million federal grant to study addiction-recovery drugs

Thu, 07 Feb 2008 04:59:37 PST

( from http://www.rxpgnews.com ) GALVESTON, Texas -- The National Institute on Drug Abuse has awarded University of Texas Medical Branch at Galveston researchers a four-year, $3.4 million grant to develop what may become the first effective drugs to help people conquer cocaine addiction.

The researchers believe this ambitious program may ultimately benefit compulsive overeaters as well.

Led by the director of UTMB's Center for Addiction Research, Kathryn A. Cunningham, the effort centers on components of the brain's electrochemical signaling system that laboratory research suggests are crucially linked to success or failure in recovering from cocaine addiction. The scientists will focus on two types of molecules on the surfaces of nerve cells in the brain that respond to serotonin, a chemical that carries messages across the tiny gaps between the cells. Stimulation of these receptor molecules prompts a nerve cell to generate an electrical pulse that travels from one end of the nerve to the other, where the signal launches still more chemical messengers to be picked up by receptors on other nerve cells.

UTMB scientists have discovered that chemicals that increase the activity of one of the two kinds of serotonin receptors under study -- designated the 5-HT2C receptor -- dramatically reduce cocaine-induced behavior in rats, including the animals' tendency to press a lever to dose themselves intravenously with the drug.

Chemicals that block the activity of the other serotonin receptor, called the 5-HT2A receptor, suppress a characteristic seen in humans with a history of addiction: the sudden craving for a drug long associated with certain stimuli, like the desire for a cigarette some smokers get when having a drink in a bar.

In the laboratory, scientists have found that when rats were trained to associate lights and sound with pressing a lever to self-administer cocaine and then denied the drug for a time, they relapsed by pressing the lever for the drug when again exposed to the same sounds and lights. When the scientists activated the 5-HT2C receptor or blocked the 5-HT2A receptor, the rats were significantly less likely to initiate such relapses.

Changes in serotonin signaling have also been implicated in such disorders as depression, anxiety and anorexia, Cunningham said. Recent experiments have led the UTMB investigators to believe that drugs affecting the 5-HT2A and 5-HT2C receptors may also curb compulsive overeating and obesity.

Our ongoing research strongly suggests that drug therapies aimed at the 5-HT2A and 5-HT2C receptors could be potent weapons against both cocaine addiction and obesity, two of the most significant public health problems facing the U.S., Cunningham said. We hope this research will bring us closer to developing treatments for substance abuse and addiction that are as effective as those used for such other conditions as high blood pressure, asthma and diabetes.

The new program is divided into three parts.

A clinical research component, directed by Professor F. Gerard Moeller of the University of Texas Health Science Center at Houston, will investigate the responses of cocaine addicts to two antidepressants that increase the concentration of serotonin in nerve cell synapses.

A neurobiology project, headed by Cunningham, will use laboratory rat experiments to study the effects of new compounds specifically targeted at the 5-HT2A and 5-HT2C receptors (two of 14 known serotonin receptor subtypes).

Finally, a drug-design project led by UTMB chemical biologist Scott Gilbertson will seek to produce new molecules that could become powerful anti-addiction drugs themselves.

The entire effort will be supported by a cellular and molecular biology core lab directed by UTMB biochemistry and molecular biology professor Cheryl Watson, enabling the researchers to perform genetic analyses of serotonin function in individuals, along with cell-culture studies of new compounds aimed at the 5-HT2A and 5-HT2C receptors.

We believe that recovery in the brain's serotonin signaling systems can lead to recovery from cocaine addiction, Cunningham said. Our new research may jump-start a new generation of discovery for anti-addiction, and, potentially, anti-obesity therapies.

Antidepressants that are more efficient and faster

Tue, 05 Feb 2008 04:59:37 PST

( from http://www.rxpgnews.com ) In the PhD defended by the pharmacologist and biochemist Jorge Emilio Ortega Calvo at the University of the Basque Country, a new anti-depressant treatment strategy is proposed that is capable of improving on the current one with its drawbacks.

Depression is a chronic and recurrent illness that can affect at least 20% of the population at some period in their lifetime, according to a number of studies carried out. Moreover, according to the WHO, by 2020 emotional state disorders could be the foremost or second cause for sick leave from work in the developed countries. Current ant-depressive therapies, nevertheless, are far from optimum.

This was the theme of the PhD presented by the pharmacologist and biochemist from the Basque province of Gipuzkoa, Jorge Emilio Ortega Calvo, undertaken at the Faculty of Medicine and Odontology of the University of the Basque Country (UPV/EHU). Basically it was a study in which an analysis was undertaken of the action mechanisms of current antidepressant pharmacological drugs and new antidepressant treatment strategies put forward and that could be useful in the near future in order to address the failings in the current ones.

Video games activate reward regions of brain in men more than women, Stanford study finds

Mon, 04 Feb 2008 04:59:37 PST

( from http://www.rxpgnews.com ) STANFORD, Calif. - Allan Reiss, MD, and his colleagues have a pretty good idea why your husband or boyfriend can't put down the Halo 3. In a first-of-its-kind imaging study, the Stanford University School of Medicine researchers have shown that the part of the brain that generates rewarding feelings is more activated in men than women during video-game play.

These gender differences may help explain why males are more attracted to, and more likely to become 'hooked' on video games than females, the researchers wrote in their paper, which was recently published online in the Journal of Psychiatric Research.

More than 230 million video and computer games were sold in 2005, and polls show that 40 percent of Americans play games on a computer or a console. According to a 2007 Harris Interactive survey, young males are two to three times more likely than females to feel addicted to video games, such as the Halo series so popular in recent years.

Despite the popularity of video and computer games, little is known about the neural processes that occur as people play these games. And no research had been done on gender-specific differences in the brain's response to video games.

Reiss, senior author of the study and the Howard C. Robbins Professor of Psychiatry and Behavioral Sciences, has long been interested in studying gender differences; in 2005, he published a study showing that men and women process humor differently. He and his colleagues became interested in exploring the concept of territoriality, and they determined the best way to do so was with a simple computer game.

The researchers designed a game involving a vertical line (the wall) in the middle of a computer screen. When the game begins, 10 balls appear to the right of the wall and travel left toward the wall. Each time a ball is clicked, it disappears from the screen. If the balls are kept a certain distance from the wall, the wall moves to the right and the player gains territory, or space, on the screen. If a ball hits the wall before it's clicked, the line moves to the left and the player loses territory on the screen.

During this study, 22 young adults (11 men and 11 women) played numerous 24-second intervals of the game while being hooked up to a functional magnetic resonance imaging, or fMRI, machine. fMRI is designed to produce a dynamic image showing which parts of the brain are working during a given activity.

Study participants were instructed to click as many balls as possible; they weren't told that they could gain or lose territory depending on what they did with the balls. Reiss said all participants quickly learned the point of the game, and the male and female participants wound up clicking on the same number of balls. The men, however, wound up gaining a significantly greater amount of space than the women. That's because the men identified which balls - the ones closest to the wall - would help them acquire the most space if clicked.

The females 'got' the game, and they moved the wall in the direction you would expect, said Reiss, who is director of the Center for Interdisciplinary Brain Sciences Research. They appeared motivated to succeed at the game. The males were just a lot more motivated to succeed.

After analyzing the imaging data for the entire group, the researchers found that the participants showed activation in the brain's mesocorticolimbic center, the region typically associated with reward and addiction. Male brains, however, showed much greater activation, and the amount of activation was correlated with how much territory they gained. (This wasn't the case with women.) Three structures within the reward circuit - the nucleus accumbens, amygdala and orbitofrontal cortex - were also shown to influence each other much more in men than in women. And the better connected this circuit was, the better males performed in the game.

The findings indicate, the researchers said, that successfully acquiring territory in a computer game format is more rewarding for men than for women. And Reiss, for one, isn't surprised. I think it's fair to say that males tend to be more intrinsically territorial, he said. It doesn't take a genius to figure out who historically are the conquerors and tyrants of our species-they're the males.

Reiss said this research also suggests that males have neural circuitry that makes them more liable than women to feel rewarded by a computer game with a territorial component and then more motivated to continue game-playing behavior. Based on this, he said, it makes sense that males are more prone to getting hooked on video games than females.

Most of the computer games that are really popular with males are territory- and aggression-type games, he pointed out.

Reiss said the team's findings may apply to other types of video and computer games. This is a fairly representative, generic computer game, he said, adding that he and his colleagues are planning further work in this area.

Congenital heart defects increasing among IVF twins

Sun, 03 Feb 2008 13:29:37 PST

( from http://www.rxpgnews.com ) The prevalence of congenital heart disease (CHD) among in vitro fertilization (IVF) pregnancies was similar to that of the general population, but there is an increasing risk of CHD among twins resulting from IVF, according to research by Yale School of Medicine researchers.

Working with the Fetal Cardiovascular Center at Yale University and Yale-New Haven Hospital, a central referral center for the State of Connecticut, Bahtiyar and his colleagues examined almost 2,000 patients using fetal echocardiography. The study lasted from January 1, 2006 through July 31, 2007. Among those patients, 250 women were specifically seen due to pregnancy resulting from in vitro fertilization. They did not have other medical problems that would require echocardiograms. The team conducted 357 fetal echocardiograms for 347 fetuses on these 250 women. Approximately 30 percent had twin pregnancies.

“We found that twin pregnancies conceived through IVF have a higher prevalence of CHD than singletons,” said Bahtiyar, who saw a three-fold increase. “IVF twins are usually fraternal, but past studies of identical twins also showed up to a 13-fold increase in congenital heart defects.”

Bahtiyar said that previous reports of increased CHD risk in pregnancies conceived via IVF may be due, in part, to a higher frequency of multiple pregnancies resulting from this form of conception. “The increased twinning seems to be the cause of the abnormality and not IVF per se.”

Bahtiyar and his team plan to increase the number of study subjects to replicate these preliminary results.

“The next step is to explore why this is happening,” he said. “Knowing about the risk of these defects will help increase the likelihood of survival after birth.”

Chronic anxiety may cause heart attack

Thu, 10 Jan 2008 16:50:07 PST

( from http://www.rxpgnews.com ) New York, Jan 10 - Chronic anxiety may trigger heart attack, says a new study, suggesting highly anxious individuals to stay careful.

While earlier studies have linked stress to an increased risk of heart problems, this is the first time that chronic anxiety has been identified as a risk factor also.

A team of researchers led by Biing-Jiun Shen, an assistant professor of psychology at the University of Southern California in Los Angeles, collected data on 735 men who participated in the Normative Aging Study, which assesses medical and psychological changes associated with aging.

The findings of the new study, which appeared in the Jan 15 issue of the Journal of the American College of Cardiology, said that the risk of getting heart attack was more among people who are suffering from chronic anxiety.

All the men whose data were used for the study had completed psychological testing in 1986 and had no heart problems at the time. The men were followed for an average of 12 years.

During follow up, the researchers found men who had chronic anxiety had a 30-40 percent increased risk of heart attack. Those with the highest levels of anxiety had an even higher risk of heart attack, health portal HealthDay reported.

The risk posed by anxiety remained even after the researchers adjusted their data to account for standard cardiovascular risk factors, health habits and negative psychological and personality traits, Shen said.

Whether treating anxiety reduces the risk of heart attack is not yet known, Shen said. 'But the implication is there,' he added. 'It is something that doctors can look out for.'

Highly anxious individuals should be aware they might face an increased risk of a heart attack, the researchers said.

'They should take proactive steps under physician supervision to control heart attack risk factors which are modifiable including blood pressure, lipid levels, activity level and weight,'

However, the researchers said they were not sure whether women with same anxiety conditions also face the similar risk.

Daily alcohol use causes changes in sexual behavior, new study reveals

Wed, 02 Jan 2008 04:59:37 PST

( from http://www.rxpgnews.com ) A team of researchers at Penn Sate has used an animal model to reveal, for the first time, a physiological basis for the effect of alcohol on male sexual behavior, including increased sexual arousal and decreased sexual inhibition. The research, which will be published on 2 January 2008 in the scientific journal PLoS ONE, resulted in four novel findings with broad importance for further addiction research. It is the first study to characterize the effects of chronic alcohol exposure in fruit flies. Physiological evidence supporting various theories about the effect of alcoholic drinks has been lacking, so our now having a suitable animal model makes it possible to conduct much-needed laboratory research on this issue, explains research-team-leader Kyung-An Han, associate professor of biology and a neuroscientist at Penn State. Information from this research can serve as a baseline for similar studies in other animals, including humans.

In contrast to previous studies in other labs, which subjected fruit flies to short-term doses of ethanol -- the intoxicating ingredient in alcoholic drinks -- Han's team administered to fruit flies a daily dose of ethanol to more closely mimic the drinking habits of alcoholics and chronic alcohol abusers. The team investigated several factors that influence the physiological effects of ethanol, including genetic and cellular components, age, and prior experience.

Among the team's discoveries is that male fruit flies, which typically court females, also actively court males when they are given a daily dose of ethanol. We identified three molecules that are crucial for ethanol-induced courtship disinhibition, Han said. In one of the team's experiments, Han and her students generated transgenic flies whose brain activities regulated by the neurotransmitter dopamine could be turned off temporarily by changing the temperature to 32-degrees C. Without a temperature change, the transgenic males showed conspicuous inter-male courtship under the influence of ethanol; however, they exhibited negligible inter-male courtship when we changed the temperature to block the transmission of dopamine neurons in the brain, Han said. This result suggests that dopamine is a key mediator of ethanol-induced inter-male courtship.

A second discovery is that repeated exposure to ethanol causes male flies to engage in more inter-male courtship, a phenomenon known as behavioral sensitization. If a behavior like alcohol consumption becomes more pleasurable the more often you do it, you are more likely to keep doing it, Han explained. Because the researchers suspect that behavioral sensitization results from adaptive changes in the brain's cells and molecules induced by chronic alcohol consumption, they plan to use behavioral sensitization as a model for further physiological studies of alcohol-associated behavior and addiction. This part of our study demonstrates that sexual behavior is not determined only during an organism's development, but it also can be influenced by a post-developmental environmental factor; in this case, recurring exposure to ethanol, Han said. These findings represent the first demonstration of enduring behavioral changes induced by recurring ethanol exposure in a fly model.

A third achievement of the team's research is its demonstration that daily ethanol exposure induces chronic tolerance to the sedative effect of ethanol in flies, as it does in other animals. Han and her students also made a fourth discovery -- that ethanol-induced intermale courtship is affected by aging. As flies get older, their cognitive capacities decline, making them more susceptible to the negative effect of ethanol on cognition, Han reports. The research revealed that, under the influence of ethanol, middle-aged and old male flies (2- to 4-weeks old) have a higher propensity for uninhibited inter-male courtship compared to fully mature male flies (4-days old).

As a result of our research with the fruit fly, we are now just beginning to discover the molecular and cellular mechanisms underlying neural changes in the brain that result from the chronic use of alcohol and that result in alcohol addiction and other behavior changes in our fly model, Han said. Taken together, the studies described by Han's team provide novel insights into the physiological effects of chronic ethanol exposure on sexual behavior and adaptive physiological changes within the brain, plus a foundation for future research on the effect of alcohol consumption on sexual behavior in mammals and other species.

Cognitive, genetic clues identified in imaging study of alcohol addiction

Tue, 25 Dec 2007 04:59:37 PST

( from http://www.rxpgnews.com ) People with clinical addictions know first-hand the ravages the disease can take on almost every aspect of their lives. So why do they continue addictive behaviors, even after a period of peaceable abstinence

Some answers appear rooted in regions of the brain active during decision making.

It's perhaps not just that people are slaves to pleasure, but that they have trouble thinking through a decision, said Charlotte Boettiger, an assistant professor of psychology at the University of North Carolina at Chapel Hill, and lead author of a study in the December issue of the Journal of Neuroscience that took a novel tack in addiction imaging research.

Our data suggest there may be a cognitive difference in people with addictions, Boettiger said. Their brains may not fully process the long-term consequences of their choices. They may compute information less efficiently.

The study also found that a variant of the COMT gene, which controls the level of the neurotransmitter dopamine in the cortex, was associated with a tendency to make impulsive decisions and with high activity in certain brain areas during decision making.

Current medications for addictions are not universally effective; many either mimic the addictive substance to help people get through withdrawal periods or block the substance to prevent its effects. For stimulants, such as methamphetamines, there are no therapies yet, Boettiger said.

What's exciting about this study is that it suggests a new approach to therapy. We might prescribe medications, such as those used to treat Parkinson's or early Alzheimer's disease, or tailor cognitive therapy to improve executive function, said Boettiger, who led the study as scientist at the University of California, San Francisco's Gallo Clinic and Research Center.

I am very excited about these results because of their clinical implications, said Dr. Howard Fields, a professor of neurology at UCSF and an investigator in the Gallo Center.

The genetic findings raise the hopeful possibility that treatments aimed at raising dopamine levels could be effective treatments for some individuals with addictive disorders, said Fields, who is senior author of the study.

Most addiction imaging studies have focused on the brain response to drug-related stimuli.

Boettiger used functional magnetic resonance imaging (fMRI), which shows brain activity while a subject performs a function, to see what happened inside their heads when sober alcoholics and people in a non-alcoholic control group made decisions between immediate and delayed rewards.

Boettiger recruited 24 subjects; 19 provided fMRI data, nine were recovering alcoholics in abstinence and 10 had no history of substance abuse. Another five were included in the genotyping analysis.

At the fMRI research facility at the University of California, Berkeley, the subjects were asked to decide between receiving a small monetary award immediately or wait for a larger payoff. The scenarios were hypothetical, but the tasks measured rational thinking and impulsivity; sober alcoholics chose the now reward almost three times more often than the control group, reflecting more impulsive behavior.

While decisions were being made the imaging detected activity the predicted individual choice in regions associated with decision making -- the posterior parietal cortex, the dorsal prefrontal cortex, the anterior temporal lobe and the orbital frontal cortex.

People who sustain damage to the orbital frontal cortex generally suffer impaired judgment; they manage money poorly and act impulsively. Boettiger's study revealed reduced activity in the orbital frontal cortex in the brains of subjects who preferred nowover later, most of whom had a history of alcoholism.

The orbital frontal cortex activity may be a neural equivalent of long-term consequences. Think of the orbital frontal cortex as the brakes, Boettiger said. With the brakes on, people choose for the future; without the brakes they choose for the short-term gain.

The dorsal prefrontal cortex and the parietal cortex often form cooperative circuits, and this study found that high activity in both is associated with a bias toward choosing immediate rewards.

The frontal and parietal cortex are also involved in working memory -- being able to hold data in mind over a short delay. When asked to choose between $18 now or $20 in a month, the subjects had to calculate how much that $18 (or what it could buy now) would be worth in a month and then compare it to $20 and decide whether it would be worth the wait.

The parietal cortex and the dorsal prefrontal cortex were much more active in people unwilling to wait. This could mean, Boettiger said, that the area is working less efficiently in those people.

The COMT gene has two common variants with a single amino acid difference at position 158; valine (Val) or methionine. The Val form of the gene is associated with lower dopamine levels, and Boettiger's study showed that people with two copies of the Val allele (resulting in the lowest dopamine levels) had significantly higher frontal and parietal activity and chose now over later significantly more often.

We have a lot to learn, Boettiger said. But the data take a significant step toward being able to identify subtypes of alcoholics, which could help tailor treatments, and may people who are at risk for developing addictions and provide earlier intervention.

The bigger picture, Boettiger said, is that her study provides more evidence that addiction is a disease, something even some of her peers do not yet believe.

It's not unlike chronic diseases, such as diabetes, she said. There are underlying genetic and other biological factors, but the disease is triggered by the choices people make.

It wasn't that long ago that we believed schizophrenia was caused by bad mothers and depression wasn't a disease. Hopefully, in 10 years, we'll look back and it will seem silly that we didn't think addiction was a disease, too.

Innovative Brain Imaging Identify Brain Abnormalities In Borderline Personality Disorder

Sun, 23 Dec 2007 03:44:41 PST

( from http://www.rxpgnews.com ) Using new approaches, an interdisciplinary team of scientists at NewYork-Presbyterian Hospital/Weill Cornell Medical Center in New York City has gained a view of activity in key brain areas associated with a core difficulty in patients with borderline personality disorder—shedding new light on this serious psychiatric condition.

"It's early days yet, but the work is pinpointing functional differences in the neurobiology of healthy people versus individuals with the disorder as they attempt to control their behavior in a negative emotional context. Such initial insights can help provide a foundation for better, more targeted therapies down the line," explains lead researcher Dr. David A. Silbersweig, the Stephen P. Tobin and Dr. Arnold M. Cooper Professor of Psychiatry and Professor of Neurology at Weill Cornell Medical College, and attending psychiatrist and neurologist at NewYork-Presbyterian Hospital/Weill Cornell Medical Center.

Borderline personality disorder is a devastating mental illness that affects between 1 to 2 percent of Americans, causing untold disruption of patients' lives and relationships. Nevertheless, its underlying biology is not very well understood. Hallmarks of the illness include impulsivity, emotional instability, interpersonal difficulties, and a preponderance of negative emotions such as anger—all of which may encourage or be associated with substance abuse, self-destructive behaviors and even suicide.

"In this study, our collaborative team looked specifically at the nexus between negative emotions and impulsivity—the tendency of people with borderline personality disorder to 'act out' destructively in the presence of anger," Dr. Silbersweig explains. "Other studies have looked at either negative emotional states or this type of behavioral disinhibition. The two are closely connected, and we wanted to find out why. We therefore focused our experiments on the interaction between negative emotional states and behavioral inhibition."

Advanced brain-scanning technologies developed by the research team made it possible to detect the brain areas of interest with greater sensitivity.

"Previous work by our group and others had suggested that an area at the base of the brain within the ventromedial prefrontal cortex was key to people's ability to restrain behaviors in the presence of emotion," Dr. Silbersweig explains.

Unfortunately, tracking activity in this brain region has been extremely difficult using functional MRI (fMRI). "Due to its particular location, you get a lot of signal loss," the researcher explains.

However, the Weill Cornell team used a special fMRI activation probe that they developed to eliminate much of that interference. This paved the way for the study, which included 16 patients with borderline personality disorder and 14 healthy controls.

The team also used a tailored fMRI neuropsychological approach to observe activity in the subjects' ventromedial prefrontal cortex as they performed what behavioral neuroscience researchers call "go/no go" tests.

These rapid-fire tests require participants to press or withhold from pressing a button whenever they receive particular visual cues. In a twist from the usual approach, the performance of the task with negative words (related to borderline psychology) was contrasted with the performance of the task when using neutral words, to reveal how negative emotions affect the participants' ability to perform the task.

As expected, negative emotional words caused participants with borderline personality disorder to have more difficulty with the task at hand and act more impulsively—ignoring visual cues to stop as they repeatedly pressed the button.

But what was really interesting was what showed up on fMRI.

"We confirmed that discrete parts of the ventromedial prefrontal cortex—the subgenual anterior cingulate cortex and the medial orbitofrontal cortex areas—were relatively less active in patients versus controls," Dr. Silbersweig says. "These areas are thought to be key to facilitating behavioral inhibition under emotional circumstances, so if they are underperforming that could contribute to the disinhibition one so often sees with borderline personality disorder."

At the same time, the research team observed heightened levels of activation during the tests in other areas of the patients' brains, including the amygdala, a locus for emotions such as anger and fear, and some of the brain's other limbic regions, which are linked to emotional processing.

"In the frontal region and the amygdala, the degree to which the brain aberrations occurred was closely correlated to the degree with which patients with borderline personality disorder had clinical difficulty controlling their behavior, or had difficulty with negative emotion, respectively," Dr. Silbersweig notes.

The study sheds light not only on borderline personality disorder, but on the mechanisms healthy individuals rely on to curb their tempers in the face of strong emotion.

Still, patients struggling with borderline personality disorder stand to benefit most from this groundbreaking research. An accompanying journal commentary labels the study "rigorous" and "systematic," and one of the first to validate with neuroimaging what scientists had only been able to guess at before.

"The more that this type of work gets done, the more people will understand that mental illness is not the patient's fault—that there are circuits in the brain that control these functions in humans and that these disorders are tied to fundamental disruptions in these circuits," Dr. Silbersweig says. "Our hope is that such insights will help erode the stigma surrounding psychiatric illness."

As pointed out in the commentary, the research may help explain how specific biological or psychological therapies could ease symptoms of borderline personality disorder for some patients, by addressing the underlying biology of impulsivity in the context of overwhelming negative emotion. The more scientists understand the neurological aberrations that give rise to the disorder, the greater the hope for new, highly targeted drugs or other therapeutic interventions.

"Going forward, we plan to test hypotheses about changes in these brain regions associated with various types of treatment," Dr. Silberswieg says. "Such work by ourselves and others could help confirm these initial findings and point the way to better therapies."

Research reveals secrets of alcohol's effect on brain cells

Fri, 07 Dec 2007 04:59:37 PST

( from http://www.rxpgnews.com ) NEW YORK (Dec. 7, 2007) -- Alcohol triggers the activation of a variety of genes that can influence the health and activity of brain cells, and new research from Weill Cornell Medical College in New York City sheds light on how that process occurs.

The findings, published in the Nov. 21 issue of The Journal of Neuroscience, may also edge scientists closer to understanding alcohol-linked disorders such as the brain damage associated with chronic alcoholism, and the abnormal brain development seen in the fetal alcohol syndrome (FAS).

If you are going to understand the biological effects of alcohol on genes within cells, you have to understand the molecular machinery driving the transcription, or activation, of the genes in question. That's what we believe we have done here, says the study's senior author Dr. Neil L. Harrison, professor of pharmacology and pharmacology in anesthesiology at Weill Cornell.

In research conducted in cell cultures and in mouse neurons in vivo, his team found that alcohol stimulates a ubiquitous, stress-linked biochemical cascade -- called the heat shock pathway -- to send a molecule called heat shock factor 1 (HSF1) into the neuron's nucleus. HSF1 then stimulates the transcription of many of the genes known to be activated by alcohol.

The fact that alcohol triggers the activation of genes in the brain is not new and has long been the subject of intense research.

One gene in particular, called Gabra4, is closely linked to the function (or dysfunction) of receptors for GABA, an important neurotransmitter.

We knew that levels of expression of Gabra4 fluctuated rapidly in the presence of alcohol, and so we wondered if we could find out how this happens, says lead author Dr. Leonardo Pignataro, instructor in pharmacology in anesthesiology at Weill Cornell.

At the same time, research in Korea with the C. elegans worm (a common tool for genomics research) had discovered that alcohol worked on a particular bit of DNA to trigger activity in the heat shock pathway, finding the same piece of DNA in the Gabra4 gene of mice and humans. This was all very intriguing, because the heat shock pathway is a biochemical mechanism found in almost all cells and all organisms, says Dr. Harrison. Scientists believe it helps cells deal with stressors -- including excessive heat or environmental toxins -- substances such as alcohol.

Working with mouse cells in the lab, the researchers used microarray technologies to search for genes other than Gabra4 that might be activated when the heat shock pathway was exposed to alcohol. They found many others.

The big question that remains is how does this activation occur The current theory holds that, under conditions of stress, heat shock proteins break away from a key molecule, HSF1. HSF1 then makes its way to the cell nucleus, where it helps stimulate the transcription and activation of a variety of genes that enable the cell to survive stress. We think this may happen with alcohol exposure, Dr. Harrison explains.

This finding, observed in vitro in the cell cultures, was replicated in in vivo experiments in mice, conducted in the lab of Dr. Daniel Herrera, assistant professor of psychiatry at Weill Cornell and an attending psychiatrist at NewYork-Presbyterian/Weill Cornell.

It was really exciting to see this mechanism work itself out in an animal model, suggesting that this same pathway may mediate at least some of the effects of alcohol on human brain cells, Dr. Herrera says.

Exactly what those effects might mean clinically remains in the realm of speculation for now, the researchers stress.

Alcohol can have bad effects -- the well-known effects of alcoholism, such as liver or brain damage, for example -- but moderate alcohol use also has more benign effects, such as the improvement in cardiovascular health observed in drinkers of red wine compared with tee-totallers, Dr. Pignataro points out.

One theory holds that alcohol-mediated stimulation of the heat shock pathway might trigger genes that help mop up mis-folded proteins that can damage cells. This would be a beneficial effect.

But it might also be possible that inappropriate activity of this pathway -- either during fetal brain development or in the adult brain -- is harmful. We just don't know, Dr. Harrison says. We'd certainly like to explore these issues going forward, and this research will give us some tools to answer these questions.

New research review shows that your family doctor may be the key to quitting smoking

Mon, 26 Nov 2007 04:59:37 PST

( from http://www.rxpgnews.com ) Scientists at the Centre for Addiction and Mental Health (CAMH) are defining the most effective ways to treat tobacco dependence, and in an article released in the November issue of the Canadian Medical Association Journal (CMAJ) they highlight the surprisingly significant role that the health practitioner can play in helping people quit smoking. Many people's attempts to quit are unsuccessful, so effective interventions are critical for the 4.5 million smokers in Canada alone.

Advising patients to quit, even just once, helps to double quit rates, write CAMH researchers Dr. Bernard Le Foll and Dr. Tony George. Their article Treatment of tobacco dependence: integrating recent progress into practice is a comprehensive summary of tobacco use, causes of nicotine dependence, and advances in treatment and intervention.To initiate as many cessation attempts as possible, practitioners should advise all of their patients who smoke to quit.

Research shows that since an estimated 70% of smokers visit a physician each year, family doctors have a substantial opportunity to influence smoking behaviour. Even a short intervention (three minutes or less) can increase a person's motivation to quit and can significantly increase abstinence rates, the authors write. They provide an algorithm topped by the simple question Are you smoking to help physicians integrate a patient's smoking status and his or her readiness to quit, taking a comprehensive approach that combines assessment, behavioural interventions and pharmacologic treatment of tobacco dependence.

The article also showed that smokers with moderate to severe tobacco dependence have been found to respond best to three types of pharmacotherapy -- nicotine replacement therapy, bupropion and varenicline -- but there is no clear threshold that can help clinicians decide whether a particular patient will benefit from a particular pharmacotherapy, and there is no consensus on which one should be used first. The authors' provide physicians with a clear comparative table of these three first-line pharmacologic treatments, as well as advice on whether to combine these pharmotherapies, or to consider nortriptyline and clonidine as second-line medications.

Epidemiologic studies have indicated that the majority of successful attempts to quit smoking occur without direct medical assistance or without pharmacotherapy. The use of nonpharmacologic methods (such as counseling) should be encouraged, especially for people for whom medication use is problematic, say the authors. The goal is to motivate the patient to try to quit smoking. Moreover, pharmacological interventions are clearly effective and allow doctors to double or triple the odds of success.

NSF grant funds research on risky decision-making in pre-teens

Mon, 26 Nov 2007 04:59:37 PST

( from http://www.rxpgnews.com ) Researchers at the University of Iowa have secured a $396,000 grant from the National Science Foundation (NSF) to study risky decision-making among pre-teens.

We hope to identify characteristics of kids who become risk-takers, such as lack of attention to risk levels or unwillingness to factor in long-term consequences, said Irwin Levin, principal investigator for the project and a UI professor with joint appointments in psychology in the College of Liberal Arts and Sciences and marketing in the Henry B. Tippie College of Business. If we can do that, future research could identify ways to proactively intervene and help those kids before they engage in risky behaviors like smoking or drinking, having unprotected sex, or disregarding traffic laws.

In the first phase of the study, funded by a $262,000 National Science Foundation grant, Levin tested children between the ages of 6 and 11 to gauge their ability to weigh risks. In a computer game, the subjects chose between two arrays of cups. Their options were to play it safe, selecting the cups guaranteed to contain one coin, or to take a chance, choosing the cups that sometimes had several coins and sometimes had none. The youngest children made the riskiest choices, while the older children varied their choices depending on the level of risk and whether the risk involved potential gains or potential losses.

Levin is conducting the second phase of the study with co-principal investigator Joshua Weller, who earned a doctorate in psychology from the UI in May and is now working for Decision Research in Eugene, Ore. The researchers plan to track changes in children's decision-making competence.

At age 10, children will complete surveys about the perceived risk of real-life scenarios, such as riding a bike without a helmet, being in the sun without sunscreen, riding in a vehicle without a seat belt, eating too much junk food, or playing violent video games. They will report the extent to which they engage in such risks, the extent to which they consider the behaviors risky, and how they think their peers would respond. The two-part survey will also include questions to assess each child's personality and grasp of probability. Parents will be surveyed on what they think their children are doing or would do in each scenario.

The same group will be surveyed again when the children reach age 13 or 14, this time including questions on some of the temptations they may be beginning to face, such as smoking, experimenting with drugs or alcohol, or sex.

Levin hopes to enroll 100 children and 100 parents in the study.

We expect steady increases in decision-making competence over a three-year period, and we should be able to identify profiles of at-risk children and track how their decision-making deficits affect choices in their everyday lives, Levin said. If we can define deficits in terms of some children not understanding the concept of risk very well, we can reach out to these potential risk-takers and help them better understand the possible consequences of some of these risks.

Cocaine abuse blunts sensitivity to monetary reward

Wed, 07 Nov 2007 04:59:37 PST

( from http://www.rxpgnews.com ) SAN DIEGO, CA - New measurements of brain activity in individuals addicted to cocaine confirm that addicted individuals have compromised sensitivity to monetary rewards.

This altered sensitivity to reward may help explain why some drug-addicted individuals are unable to modify their drug-taking behavior, even in the face of well-understood negative consequences and/or positive incentives for behavioral change, said Rita Goldstein, who runs the neuropsychoimaging lab at the U.S. Department of Energy's Brookhaven National Laboratory where the work was done. Muhammad A. Parvaz, a Stony Brook University graduate student working with Goldstein, will present the findings at the Society for Neuroscience annual meeting in San Diego on Wednesday, November 7, 2007.

The researchers studied 18 current cocaine users and 18 age-matched control subjects. They outfitted each subject with a cap of electrodes to measure brain activity after instructing the subjects to press or not press a button in response to certain visual prompts. During the task, subjects were told they could earn various amounts of money for fast and accurate performance.

The scientists were specifically interested in the P300 component of the brain waves time locked to the task (known as Event-Related Potentials). The P300, a positive voltage potential occurring at a latency of 300 milliseconds after presentation of a novel or meaningful stimulus, has been shown to be blunted in individuals addicted to alcohol and their offspring. The current study demonstrates, for the first time, a blunted P300 response to a commonly occurring and generalized abstract reward - money - in cocaine-addicted individuals with recent cocaine use.

The findings: In healthy control subjects, the P300 response was significantly higher and both accuracy and speed of performance were significantly better and faster, respectively, when a monetary reward was offered compared with when the reward was absent (45 vs. 0 cents). These responses to money in both brain and behavioral measures - and their interdependence - were reduced in cocaine-addicted individuals. In addition, those who had used cocaine most frequently during the year preceding the study were the least able to improve their behavioral performance in response to monetary rewards.

Interestingly, these results could not be attributed to decreased task engagement in the cocaine users, who instead reported being more interested in the task than the control subjects. It is possible that this heightened interest could be attributed to recent cocaine use, which was documented in all cocaine-using subjects in this study by positive urine screening tests.

So despite greater self-reported interest, cocaine users did not respond faster or more accurately and their brain activity did not change in response to monetary reward to the same degree as in the healthy control subjects, Parvaz said.

These results confirm findings from earlier studies conducted in Goldstein's lab that used functional magnetic resonance imaging (fMRI) to demonstrate a similar compromise in neural sensitivity to monetary reward in cocaine addiction.

Individuals with such blunted neural and behavioral sensitivity to rewards may have a particularly difficult time responding to abstract incentives designed to motivate behavioral changes - especially when outside of a structured treatment environment or when rewards are not readily available or clearly contingent on behavior, Goldstein said.

It would be interesting to see if there are any differences between the cocaine users studied here, who were not seeking treatment, and those in treatment or abstinent for longer periods of time, Parvaz suggested. Such a comparison would allow the researchers to determine whether recovery of sensitivity to reward can be expected, and assess the time frame for such recovery. The researchers may also extend the study to see if their findings can be generalized to negative reinforcement, such as the loss of money.

D-cycloserine reduces cocaine-seeking behavior in 'addicted' mice

Tue, 06 Nov 2007 04:59:37 PST

( from http://www.rxpgnews.com ) SAN DIEGO, CA - Scientists at the U.S. Department of Energy's Brookhaven National Laboratory provide further evidence that a drug known as D-cycloserine could play a role in helping to extinguish the craving behaviors associated with drug addiction. Their study found that mice treated with D-cycloserine were less likely to spend time in an environment where they had previously been trained to expect cocaine than mice treated with a placebo.

Since the association between drugs and the places where they are used can trigger craving and/or relapse in humans, a medication that could aid in the reduction or even extinction of such responses could be a powerful tool in the treatment of addiction, said Carlos Bermeo, a Stony Brook University graduate student working under the direction of Brookhaven Lab neuroscientist Panayotis (Peter) Thanos. Bermeo will present these results in a talk at the Society for Neuroscience annual meeting in San Diego on Tuesday, November 6, 2007, at 11 a.m.

D-cycloserine was originally developed as an antibiotic. But it has also been shown to extinguish conditioned fear in pre-clinical (animal) studies, and has been successfully tested in human clinical trials for the treatment of acrophobia (fear of heights). This finding led several researchers to wonder whether D-cycloserine could extinguish drug-seeking behaviors as well.

In 2006, a group of scientists not affiliated with Brookhaven Lab tested this hypothesis in rats. They found that D-cycloserine facilitated the extinction of cocaine conditioned place preference - the tendency for the animals to spend more time in a chamber where they had been trained to expect cocaine than in a chamber where they had no access to the drug.

The Brookhaven study builds on the previous work and adds information on the drug dose effect, the lasting properties of the treatment, and the locomotor effects of this compound.

Bermeo and Thanos' group worked with C57bL/c mice. Animals were first trained to receive cocaine in a particular environment. Once conditioned place preference was established (that is, animals willingly spent more time in a cocaine-paired environment than in a neutral environment), the mice were treated with either D-cycloserine or saline and allowed to spend forty minutes in either the previously cocaine-paired environment (with the drug no longer available) or the neutral environment.

This paradigm would be analogous to a clinical approach where the addict is returned to the environment that previously was the place of drug use (e.g., the neighborhood or home), but this time with no drug available, said Thanos. Reduced seeking of the drug in the same environment - that is extinction behavior - is a great indicator of future success in treatment and reduced chance of relapse, he added.

Mice treated with D-cycloserine showed less preference for the cocaine-paired environment and did this more rapidly than mice treated with saline. The low dose (15 milligrams D-cycloserine per kilogram of body weight, given intraperitonially) showed a 10 percent decrease in time spent in the previously cocaine-paired environment, and the high dose (30 mg/kg i.p.) showed a 17 percent decrease in the time spent in the previously cocaine-paired environment. The high dose produced a more pronounced and consistent extinction than the lower dose.

Interestingly, animals treated with the high dose of D-cycloserine exhibited lower locomotor activity compared to both the low-dose D-cycloserine group and the saline-treated animals. These two groups exhibited similar levels of locomotor activity. This indicates that dosing may have to be fine tuned to achieve optimal efficacy with minimum side effects.

It's important to remember that these are very preliminary results from a small animal study, Thanos cautions. Much further research will be required before testing this drug in humans. But it is inspiring to know that this drug may show promise in treating cocaine addiction, which continues to take a toll on society and for which no pharmacological treatment currently exists.

Hold your horses

Thu, 25 Oct 2007 03:59:37 PST

( from http://www.rxpgnews.com ) For those who suffer with the debilitating symptoms of Parkinson's disease, Deep Brain Stimulation offers relief from the tremors and rigidity that can't be controlled by medicine. A particularly troublesome downside, though, is that these patients often exhibit compulsive behaviors that healthy people, and even those taking medication for Parkinson's, can easily manage.

Michael Frank, an assistant professor of psychology and director of the Laboratory for Neural Computation and Cognition at The University of Arizona, and his research colleagues have shed some light on how DBS interferes with the brain's innate ability to deliberate on complicated decisions. Their results are published in the current (Oct. 26) issue of the journal Science.

DBS implants affect the region of the brain called the subthalamic nucleus (STN), which also modulates decision-making.

This particular area of the brain is needed for what's called a 'hold-your-horses' signal, Frank said. When you're making a difficult choice, with a conflict between two or more options, an adaptive response for your system to do is to say 'Hold on for a second. I need to take a little more time to figure out which is the best option.'

The STN, he said, detects conflict between two or more choices and reacts by sending a neural signal to temporarily prevent the selection of any response. It's this response that DBS seems to interrupt. DBS acts much like a lesion on the subthalamic nucleus. Frank's hypothesis predicted that DBS would negate the hold-your-horses response to high-conflict choices. Surprisingly, it actually sped up the decision-making process, a signature, he said, indicated of impulsive decision making.

The tendency toward impulsive behavior in Parkinson's patients is well-documented but only dimly understood. How is the STN involved in decision-making and why should things go awry when you stimulate it

For those taking them, medications did not slow down decision-making conflict. Regardless of whether these patients are on or off medication, for the purposes of the experiment they looked like healthy people or people who are off DBS.

But what Frank found was that medications prevent people from learning from negative outcomes of their choices. That could be one explanation for why patients develop gambling habits. If you learn from the positive outcomes instead of the negative, it could cause you to become a gambler.

Whereas the DBS had no effect on positive v. negative learning, but it had an effect on your ability to 'hold your horses,' so it was a dissociation between two treatments which we think reveal different mechanisms of the circuit of the brain that we're interested in.

Frank said the results of his experiments are a test of a basic science mechanism for how the brain makes adaptive decisions. The same basal ganglia is involved in other disorders. People who are addicts, for example, are more likely to make impulsive choices, and DBS and medication used to treat Parkinson's have been shown to cause pathological gambling to some degree.

We may be able to use this to understand that from this more basic sciences perspective. Maybe the same circuits are involved in gamblers who don't have Parkinson's, Frank said.

He also hinted that the study might also offer clues to consumer behavior.

I think that you can have the opposite effect, where the hold-your-horses signal is too strong in responding to decision conflict. One thing that has been shown in healthy people who have been presented with too many options exhibit is a kind of 'decision paralysis,' he said.

For example, if shoppers are exposed to two dozen varieties of essentially the same product, research shows very few will actually make a purchase. Employees faced with too many options for 401k plans are less likely to invest in any of them, even though their employer is going to match their contributions.

Frank is interested in whether impulsive decision making can be prevented in DBS patients. One long-range goal, he said, is to be able to test the STN during the implant surgery, avoiding the decision-making areas and target only the brain's motor function.

We hope that in the operating room we can actually when they record this brain area, we can determine selective parts of it that respond to this conflict-based decision-making and use that as a potential way of avoiding stimulating that area and have it be selective to just the pure motor function.

Decision-makers seek internal balance, not balanced alternatives

Thu, 25 Oct 2007 03:59:37 PST

( from http://www.rxpgnews.com ) A researcher at the University of California, San Diego (UCSD) School of Medicine suggests that psychiatrists may need to approach the treatment of psychiatric patients from a new direction � by understanding that such individuals� behavior and decision-making are based on an attempt to reach an inner equilibrium.

In a special section in the October 26 issue of the journal Science, Martin Paulus, M.D., professor in UCSD�s Department of Psychiatry, has compiled a body of growing evidence that human decision-making is inextricably linked to an individuals� need to maintain a homeostatic balance.

�This is a state of dynamic equilibrium, much like controlling body temperature,� said Paulus. �How humans select a particular course of action may be in response to raising or lowering that �set point� back to their individual comfort zone. In people with psychiatric disorders or addictions, the thermostat may be broken.�

Up to now, according to Paulus, psychiatrists and others have looked at the decision-making process as a considered series of options and values.

�What has never been considered closely, but should be, is the state of the decision-maker,� Paulus said. According to the researcher, this homeostatic state � the tendency to maintain internal stability, due to the mind and body�s coordinated responses to any stimulus that disturbs the normal condition � is altered in individuals with addictions and psychiatric disorders such as schizophrenia or anxiety. �This disturbance of homeostatic balance leads to dysfunctions in decision-making � which helps explain why such patients make seemingly bad choices,� he said.

Recent neuroimaging research shows strong support for the homeostatic nature of decision making, according to Paulus. �For example, interoceptive information � which is related to the body�s internal state or sense of balance � is integrated in a particular part of the brain called the anterior insular cortex,� he said. The same brain structures implicated in the urge to take drugs are involved in other biological urges, Paulus added, suggesting that a homeostatic approach could have a broad impact on treatments that seek to control addictions or psychiatric disorders, and will lay the groundwork for new areas of research.

The question addressed in part by this paper are whether changes in decision-making behavior and associated brain functions are a result of pre-existing characteristics � which may predispose individuals to use drugs � or as a consequence of long-term use.

�Decision-making dysfunctions and resultant altered neural processing could provide a biomarker to identify those at high-risk for addictive behaviors,� said Paulus, who added that much additional research is needed before scientists could begin to use such an approach.

In an upcoming paper in the journal �Dialogues in Clinical Neuroscience,� Paulus cites the complex affective, cognitive and behavioral phenomena that come into play during decision-making. �The interoceptive system is able to connect with various physiological systems in the brain to orchestrate a complex set of responses,� he said, adding that craving and urges are among the most notable responses that play important functions in maintaining homeostasis. Insights into how pleasure and urge are integrated in the brain and how this process is modulated can play an important role in the understanding of � and possible future treatment of � drug addiction, according to Paulus.

Gauging parent knowledge about teens' substance use

Wed, 24 Oct 2007 03:59:37 PST

( from http://www.rxpgnews.com ) BUFFALO, N.Y. -- New research results from the University at Buffalo�s Research Institute on Addictions (RIA) suggest that most parents are aware of and accurately evaluate the extent of their teenager�s cigarette smoking, marijuana use, drinking and overall substance use.

Researchers also found that in cases where parents provided lower estimates of substance use, parents were nearly twice as likely to underestimate frequency of marijuana use and quantity of alcohol use. Parents also were less likely to be aware of extent of use by younger teens and of their children�s use if they themselves had personal problems or were using alcohol more frequently.

What is novel about these findings is that for the first time, detailed statistics are available about parental knowledge of teen substance use for families in which the teen�s substance use is causing the parent stress, but the teen is not necessarily in treatment. Previous studies have been restricted to families with a teen in substance-buse treatment or families with no current substance use issues.

For a six-month reporting period, 82 percent of parents accurately evaluated the presence of teen cigarette smoking; the parents� reports corresponded with the teens� reports of their own smoking. Eighty-six percent of parents accurately evaluated the presence of teen alcohol use, and 86 percent accurately reported the presence of teen marijuana use. However, only 72 percent of the parents in the RIA study accurately reported the presence of illicit drug use (other than marijuana) by teens.

According to lead researcher Neil B. McGillicuddy, Ph.D., �This study begins to dispel the notion that parents don�t know the extent to which their teens are using cigarettes, alcohol and illicit drugs. It seems that, despite a few exceptions, many parents do know the extent of their teenager�s substance use. Parents can use this knowledge to help themselves cope with teenage substance use and the resulting stress on the family, as well as to begin conversations with their teen about making changes.�

McGillicuddy is a research scientist at RIA with extensive background in treatment interventions for parents of substance-abusing adolescents, interventions for partners of addicted persons and treatment for alcohol and drug-abusing adolescents.

This research was funded by the National Institute on Drug Abuse and published in the most recent issue of the Journal of Child and Adolescent Substance Abuse.

For this study, 75 parents and their teenagers were interviewed separately about the teens� recent use of cigarettes, alcohol, marijuana and other illicit drugs. Parent-participants were, on average, female (85 percent), 39 years of age with 13 years of education. Teen-participants were, on average, male (61 percent), 16 years of age and not receiving substance abuse treatment (76 percent).

When parents� and teens� reports were discrepant, parents provided lower estimates of substance use than teens. That is, teens tended to report greater frequency and amount of substance use. Although some of these discrepancies were small (for instance regarding how often teens drank alcohol), others were substantial (parents were nearly twice as likely to underestimate the frequency of marijuana use and the quantity of alcohol use).

In addition, McGillicuddy and colleagues set out to find factors that might explain the discrepancies in parent-teen reports of teen substance use. Parents were less aware of the extent of the teen�s substance use if the teen was younger (about 14 or 15), and if the parents did less monitoring of what their teens were doing after school, during the evening and on weekends. Together, these findings suggest that parents need to consider increasing their monitoring of how teens spend their time and begin thinking about substance use at a significantly younger age.

Lastly, parents who are caught up in their own issues or problems, whether stressed, feeling depressed or using alcohol more frequently, also made less accurate reports.

�What we would hope that people come away with from this study, is that parents can be more aware of their teen�s substance use,� McGillicuddy explained, �by reducing their own alcohol use, giving more attention to what their teen is doing 24/7, particularly if the teen is younger, and taking steps to reduce their own psychological distress. Participation in parenting programs, especially those geared toward coping with an adolescent�s substance use, can give the parent important skills to deal with teen behavior and have been found to reduce the parent�s distress.�

Sleep deprivation linked to psychiatric disorders

Wed, 24 Oct 2007 00:37:46 PST

( from http://www.rxpgnews.com ) It has long been assumed that sleep deprivation can play havoc with our emotions.

This is notably apparent in soldiers in combat zones, medical residents and even new parents. Now there's a neurological basis for this theory, according to new research from the University of California, Berkeley, and Harvard Medical School.

In the first neural investigation into what happens to the emotional brain without sleep, results from a brain imaging study suggest that while a good night's rest can regulate your mood and help you cope with the next day's emotional challenges, sleep deprivation does the opposite by excessively boosting the part of the brain most closely connected to depression, anxiety and other psychiatric disorders.

"It's almost as though, without sleep, the brain had reverted back to more primitive patterns of activity, in that it was unable to put emotional experiences into context and produce controlled, appropriate responses," said Matthew Walker, director of UC Berkeley's Sleep and Neuroimaging Laboratory and senior author of the study, which will be published today (Monday, Oct. 22) in the journal Current Biology.

brain (amygdala) is much more active when deprived of sleep. Top brain images show the response of the amygdala, circled in green, for study participants who viewed negative images after a normal night of sleep. Brain images below show the amygdala, circled in red, for participants who viewed negative images after 35 hours of no sleep. (Courtesy Matthew Walker/UC Berkeley)

"Emotionally, you're not on a level playing field, "Walker added.

That's because the amygdala, the region of the brain that alerts the body to protect itself in times of danger, goes into overdrive on no sleep, according to the study. This consequently shuts down the prefrontal cortex, which commands logical reasoning, and thus prevents the release of chemicals needed to calm down the fight-or-flight reflex.

If, for example, the amygdala reacts strongly to a violent movie, the prefrontal cortex lets the brain know that the scene is make-believe and to settle down. But instead of connecting to the prefrontal cortex, the brain on no sleep connects to the locus coeruleus, the oldest part of the brain which releases noradrenalin to ward off imminent threats to survival, posing a volatile mix, according to the study.

The study's findings lay the groundwork for further investigation into the relationship between sleep and psychiatric illnesses. Clinical evidence has shown that some form of sleep disruption is present in almost all psychiatric disorders.

Matthew Walker

"This is the first set of experiments that demonstrate that even healthy people's brains mimic certain pathological psychiatric patterns when deprived of sleep, "Walker said."Before, it was difficult to separate out the effect of sleep versus the disease itself. Now we're closer to being able to look into whether the person has a psychiatric disease or a sleep disorder."

Using functioning Magnetic Resonance Imaging (fMRI), Walker and his team found that the amygdala, which is also a key to processing emotions, became hyperactive in response to negative visual stimuli - mutilated bodies, children with tumors and other gory images - in study participants who stayed awake for 35 hours straight. Conversely, brain scans of those who got a full night's sleep in their own beds showed normal activity in the amygdala.

"The emotional centers of the brain were over 60 percent more reactive under conditions of sleep deprivation than in subjects who had obtained a normal night of sleep," Walker said.

The team studied 26 healthy participants aged 18 to 30, breaking them into two groups of equal numbers of males and females. The sleep-deprived group stayed awake during day 1, night 1 and day 2, while the sleep-control group stayed awake both days and slept normally during the night. During the fMRI brain scanning, which was performed at the end of day 2, each was shown 100 images that ranged from neutral to very negative. Using this emotional gradient, the researchers were able to compare the increase in brain response to the increasingly negative pictures.

Since 1998, Walker, an assistant professor of psychology at UC Berkeley and a former sleep researcher at Harvard Medical School, has been studying sleep's impact on memory, learning and brain plasticity.

During his research, he was struck with the consistency of how graduate students in his studies would turn from affable, rational beings into what he called "emotional JELL-O" after a night without sleep. He and his assistants searched for research that would explain the effect of sleep deprivation on the emotional brain and found none, although there is countless anecdotal evidence that lack of sleep causes emotional swings.

"You can see it in the reaction of a military combatant soldier dealing with a civilian, a tired mother to a meddlesome toddler, the medical resident to a pushy patient. It's these everyday scenarios that tell us people don't get enough sleep." Walker said.

The body alternates between two different phases of sleep during the night: Rapid Eye Movement (REM), when body and brain activity promote dreams, and Non-Rapid Eye Movement (NREM), when the muscles and brain rest.

"All signs point to sleep doing something for emotional regulation and emotional processing," Walker said. "My job now is to figure out what kind of sleep."

Age affects motivation for quitting smoking

Mon, 22 Oct 2007 03:59:37 PST

( from http://www.rxpgnews.com ) (Chicago, IL, October 22, 2007) � A new study shows that obstacles to smoking cessation and motives for quitting smoking vary with age. The study presented at CHEST 2007, the 73rd annual international scientific assembly of the American College of Chest Physicians (ACCP), found that smokers over age 65 reported quitting smoking due to physician pressure and stress due to a major health problem, while smokers under age 65 reported cigarette cost and tobacco odor as reasons for quitting.

�The current common perception among the medical community is that if smokers age 65 and older haven�t quit by now, they can�t or won�t quit � a perception which may lead physicians to focus less on their older patients� smoking habit,� said lead study author Virginia Reichert, NP, Center for Tobacco Control, North Shore-LIJ Health System, Great Neck, New York. �Our results show that older smokers are motivated to quit smoking by very different factors compared with younger smokers. If these factors are addressed, we may see cessation rates improve for both age groups.�

Ms. Reichert and colleagues from the Center for Tobacco Control at North Shore-LIJ compared health status and motives and obstacles for quitting smoking between 1,909 smokers under age 65 (younger smokers) and 143 smokers over age 65 (older smokers) who were attending a 6-week comprehensive cessation program. Older smokers were more likely than younger smokers to have a recent hospitalization (23% vs 13%), comorbid cardiac disease (78% vs 38%), cancer (20% vs 7%), and/or chronic obstructive lung disease/asthma (37% vs 23%). Regarding motivation, older smokers cited pressure by their physician and stress of a major health problem as main reasons for quitting. Younger smokers attributed their reasons for quitting to the cost of cigarettes, tobacco odor, and general health concerns.

�If the cost of cigarettes hasn�t made the older smoker quit by now, they are not as likely to be affected by the rising costs as much as younger smokers may be,� said Ms. Reichert. �On the other hand, younger smokers may not have experienced health effects from their smoking, but they may have felt the impact of the cost of cigarettes/cigars.�

Obstacles to smoking cessation also varied by age group. Younger smokers were more likely than older smokers to report concerns of weight gain (30% vs 15%), stress management (59% vs 45%), fear of failure (15% vs 8%), handling social situations (24% vs 7%), and cravings (44% vs 36%) as obstacles to quitting smoking. Furthermore, 54% of older smokers and 69% of younger smokers reported not wanting to give up their first cigarette in the morning as an obstacle to quitting smoking. Young smokers also believe that trying to quit �cold turkey� is best, when in reality, only 7% of smokers achieve long-term abstinence without professional help.

�To be most effective, treatment plans and education should be relevant to each group�s concerns,� said Ms. Reichert. She suggests that health-care providers offer weight management programs and stress management strategies as part of the treatment and relapse prevention programs for younger smokers, while older smokers may be more successful with physician encouragement and knowledge of how smoking is influencing their current health conditions.

�Tobacco-related diseases are major causes of death in the United States,� said Alvin V. Thomas, Jr., MD, FCCP, President of the American College of Chest Physicians. �The more we know about what motivates smokers to quit their habit and what personal obstacles they face in doing so, the more we can tailor smoking cessation programs to fit the individual needs of our patients.�

Carbon monoxide test helps doctors determine patients' smoking status

Mon, 22 Oct 2007 03:59:37 PST

( from http://www.rxpgnews.com ) (Chicago, IL, October 22, 2007) � Pulse cooximeters have long been used to identify and measure the levels of carbon monoxide (CO) in the blood of patients or firefighters. But new research, presented at CHEST 2007, the 73rd annual international scientific assembly of the American College of Chest Physicians (ACCP), indicates that the device has another use� it can quickly, inexpensively, and noninvasively identify a person who smokes. The study argues that if smokers know their blood CO levels, they may be more prone to quit or more likely to never start in the first place.

�By using this device in the office, the poisoning of the hemoglobin or blood with carbon monoxide can be detected and shown to the patient before they actually develop a clinical disease such as emphysema or cancer,� said study author Sridhar P. Reddy, MD, MPH, FCCP, St. Clair Pulmonary and Critical Care, St. Clair, MI. �In our practice, when the carboxyhemoglobin is 10%, it�s easy to tell a patient that 10% of his or her blood is poisoned and unable to carry oxygen. By doing this, we catch the patient�s attention right away and can begin smoking cessation counseling.�

The study originated as a high school science project. Carried out by Dr. Reddy�s son. At each outpatient visit, Dr. Reddy measured patients� carboxyhemoglobin, blood poisoned by CO, and methhemoglobin, blood transformed by other substances, such as nitrogen dioxide, with a pulse cooximeter. And, as part of his project, his son, who was a sophomore at Detroit Country Day School, developed and distributed questionnaires regarding the patients� smoking status.

�When I was searching for a science project, I realized that the question of how much carboxyhemoglobin is needed to suggest smoking seemed unanswered,� said coauthor and son Ashray Reddy. �I thought that by trying to answer this question, I could help people quit smoking.�

Researchers used the pulse cooximeter, a device that is clipped to the patient�s finger and reads the percentages of poisoned blood through a light that is shined through the nail bed. A total of 476 patients who visited the clinic participated. Patients were identified as a smoker, based on a combination of their questionnaire responses and if they�re CO levels exceeded 6% of their blood. Researchers were also able to identify secondhand smokers based on slight changes found in their levels, as well. Results showed that 98 patients were smokers, 72 were secondhand smokers, and 306 were nonsmokers.

�For the first time, the entire smoking cessation story can be quickly and noninvasively played out from beginning to end�detection, revealing the effect, and intervention, all while being respectful of available resources,� said Dr. Reddy. �Using this device, we can deliver the whole package, and based on our data, we believe it should be routinely used in any program geared toward smoking cessation.�

Researchers conclude that pulse cooximetery is a quick, inexpensive, and noninvasive way to detect patients� smoking status, and that the outpatient clinic is an ideal setting for its use. They also suggest its use for screening smoking status in multiple settings and populations, such as smoking cessation programs, high schools, hospitals, and the workplace.

�Physicians need to be able to identify a patient�s smoking status in order to effectively counsel them about smoking cessation,� said Alvin V. Thomas, Jr., MD, FCCP, President of the American College of Chest Physicians. �A method or device that could help physicians do this, and potentially reduce the number of people who smoke, is a method that is worth further exploration.�

Insulin's brain impact links drugs and diabetes

Tue, 16 Oct 2007 03:59:37 PST

( from http://www.rxpgnews.com ) Insulin, long known as an important regulator of blood glucose levels, now has a newly appreciated role in the brain.

Vanderbilt University Medical Center researchers, working with colleagues in Texas, have found that insulin levels affect the brain�s dopamine systems, which are involved in drug addiction and many neuropsychiatric conditions.

In addition to suggesting potential new targets for treating drug abuse, the findings raise questions as to whether improper control of insulin levels � as in diabetes � may impact risk for attention deficit hyperactivity disorder (ADHD) or influence the effectiveness of current ADHD medications.

The study, led by Aurelio Galli, Ph.D., in the Center for Molecular Neuroscience and Calum Avison, Ph.D., in the Institute of Imaging Science (VUIIS), appears online this week in the Public Library of Science Biology (PLoS Biology).

The psychostimulant drugs amphetamine and cocaine, as well as related medications for ADHD, block the reuptake of the neurotransmitter dopamine by dopamine transporters (DATs) and increase the level of dopamine signaling. Some of these compounds, including amphetamine, also cause a massive outpouring of dopamine through DATs.

The resulting surge of synaptic dopamine alters attention, increases motor activity and plays an important role in the addictive properties of psychostimulants.

But the link between insulin status and dopaminergic function is not readily apparent.

�In the 1970s, there were articles showing that, in animals with type 1 diabetes, psychostimulants like amphetamine would not increase locomotor behavior,� said Galli, associate professor of Molecular Physiology and Biophysics. �We didn�t have a clear understanding of why that was happening.�

This sparked Galli and colleagues to investigate the link between insulin signaling and amphetamine action.

Using a rat model of type 1 � or juvenile � diabetes in which insulin levels are depleted, Galli�s group assessed the function of the dopaminergic pathway in the striatum, an area of the brain rich in dopamine.

In the absence of insulin, amphetamine-induced dopamine signaling was disrupted, they found. Dopamine release in the striatum was severely impaired and expression of DAT on the surface of the nerve terminal � where it normally acts to inactivate dopamine � was significantly reduced.

The lack of the protein on the plasma membrane prevents the amphetamine-induced increase in extracellular dopamine, and in turn, amphetamine fails to activate the dopamine pathways that stimulate reward, attention and movement, Galli noted.

The researchers then restored insulin by pulsing the hormone back into the brain of the diabetic animals and found that the system returns to normal, indicating that the lack of insulin in the striatum directly affected amphetamine action.

To connect the physiological findings to activity in the intact brain, collaborators in the VUIIS, led by Avison, developed a probe for brain DAT activity using functional magnetic resonance imaging (fMRI).

�You can do molecular dissection in very well defined model systems and break the system down into its constituents,� said Avison, professor of Radiology and Radiological Sciences, and professor of Pharmacology. �But the question is: how does that relate to the intact brain? What�s the relevance to overall functioning in the intact system?�

Working with Galli and Avison, Jason Williams, Ph.D., used fMRI to demonstrate that in normal, healthy rats with plenty of insulin, amphetamine increased neural activity in the striatum. But in diabetic animals, activity in the striatum was suppressed.

�This finding is in vivo evidence that, in the intact diabetic rat, loss of insulin has compromised DAT trafficking to the plasma membrane,� Avison said. �These experiments show that there is likely a strong interplay between these important dopamine neurotransmitter systems and insulin signaling mechanisms, which we know are altered in diabetes�

The results are some of the first to link insulin status and dopaminergic brain function and hold several implications for human health and disease.

�This is really the first mechanistic connection in vivo between diabetes and amphetamine action,� Galli said. �This offers a completely new perspective on the influence of this disease (diabetes) on brain function, as well as diseases with altered dopamine signaling, such as schizophrenia and ADHD.�

The findings suggest that ADHD risk may have an insulin-dependent component and that control of insulin levels and response to the hormone may be an important determinant of amphetamine efficacy in patients with ADHD, Galli noted.

�We have described a novel mechanism by which diabetes may affect brain function.�

Why it is impossible for some to 'just say no'

Wed, 10 Oct 2007 03:59:37 PST

( from http://www.rxpgnews.com ) Drug abuse, crime and obesity are but a few of the problems our nation faces, but they all have one thing in common�people�s failure to control their behavior in the face of temptation. While the ability to control and restrain our impulses is one of the defining features of the human animal, its failure is one of the central problems of human society. So, why do we so often lack this crucial ability

As human beings, we have limited resources to control ourselves, and all acts of control draw from this same source. Therefore, when using this resource in one domain, for example, keeping to a diet, we are more likely to run out of this resource in a different domain, like studying hard. Once these resources are exhausted, our ability to control ourselves is diminished. In this depleted state, the dieter is more likely to eat chocolate, the student to watch TV, and the politician to accept a bribe.

In a recent study, Michael Inzlicht of the University of Toronto Scarborough and colleague Jennifer N. Gutsell offer an account of what is happening in the brain when our vices get the better of us.

Inzlicht and Gutsell asked participants to suppress their emotions while watching an upsetting movie. The idea was to deplete their resources for self-control. The participants reported their ability to suppress their feelings on a scale from one to nine. Then, they completed a Stroop task, which involves naming the color of printed words (i.e. saying red when reading the word �green� in red font), yet another task that requires a significant amount of self-control.

The researchers found that those who suppressed their emotions performed worse on the Stroop task, indicating that they had used up their resources for self-control while holding back their tears during the film.

An EEG, performed during the Stroop task, confirmed these results. Normally, when a person deviates from their goals (in this case, wanting to read the word, not the color of the font), increased brain activity occurs in a part of the frontal lobe called the anterior cingulate cortex, which alerts the person that they are off-track. The researchers found weaker activity occurring in this brain region during the Stroop task in those who had suppressed their feelings. In other words, after engaging in one act of self-control this brain system seems to fail during the next act.

These results, which appear in the November issue of Psychological Science, a journal of the Association for Psychological Science, have significant implications for future interventions aiming to help people change their behavior. Most notably, it suggests that if people, even temporarily, do not realize that they have lost control, they will be unable to stop or change their behavior on their own.

The 'arms' race: Adult steroid users seek muscles, not medals

Wed, 10 Oct 2007 03:59:37 PST

( from http://www.rxpgnews.com ) The majority of non-medical anabolic-androgenic steroid (AAS) users are not cheating athletes or risk-taking teenagers. According to a recent survey, containing the largest sample to date and published in the online open access publication, Journal of the International Society of Sports Nutrition, the typical male user is about 30 years old, well-educated, and earning an above-average income in a white-collar occupation. The majority did not use steroids during adolescence and were not motivated by athletic competition or sports performance.

The study, conducted by a collaboration of researchers from around the country coordinated by Jason Cohen, Psy.D. candidate, used a web-based survey of nearly 2,000 US males. Whereas athletes are tempted to take anabolic steroids to improve sports performance, the study suggests that physical self-improvement motivates the unrecognized majority of non-medical AAS users who particularly want to increase muscle mass, strength, and physical attractiveness. Other significant but less highly ranked factors included increased confidence, decreased fat, improved mood and attraction of sexual partners.

Although often considered similar to abusers of narcotics and other illicit drugs (e.g., heroin or cocaine), non-medical AAS users are remarkably different. These users follow carefully planned drug regimens in conjunction with a healthy diet, ancillary drugs and exercise. As opposed to the spontaneous and haphazard approach seen in abusers of psychotropic drugs, everything is strategically planned to maximize benefits and minimize harm. This is simply not a style or pattern of use we typically see when we examine substance abuse said Jack Darkes, Ph.D., one of the authors. The notions of spontaneous drug seeking and loss of control do not apply to the vast majority of AAS users, added co-author Daniel Gwartney, M.D.

These findings question commonly held views of typical AAS users and their underlying motivations, said Rick Collins, one of the study's authors. The focus on 'cheating' athletes and at risk youth has led to irrelevant policy as it relates to the predominant group of non-medical AAS users. The vast majority of AAS users are not athletes and hence, are not likely to view themselves as cheaters. The targeting of athletes through drug testing and other adolescent or sports-based interventions has no bearing on non-competitive adult users.The study concludes that these AAS users are a driven and ambitious group dedicated to gym attendance, diet, occupational goals and educational attainment. The users we surveyed consider that they are using directed drug technology as one part of a strategy for physical self-improvement within a health-centered lifestyle, said Collins. Effective public policy should begin by accurately identifying who's using steroids and why. We hope our research - the largest adult survey of non-medical AAS use we know of - is a significant step forward in that direction.

Depressed older people risk losing their minds

Tue, 09 Oct 2007 14:30:12 PST

( from http://www.rxpgnews.com ) New York, Oct 9 - Older people who suffer from depression face higher risk of losing intellectual ability, the results of a study conducted in the US show.

Depression is a disorder that affects the functioning of a person in day-to-day life. It is a strong mood involving sadness, discouragement, despair or hopelessness that lasts for weeks, months or even longer.

The study by University of Rochester Medical Centre researchers looked into 700 patients aged 65 years and over for more than two years. The findings of the study suggest that older people who are depressed may be intellectually impaired and lose executive functions, reports science portal EurekAlert.

Researchers looked at loss of executive functions of the participants that involve high-level mental processes such a making decisions, organising, planning and doing a series of things in sequence.

Trained interviewers reviewed each patient's primary care medical chart, recording information about mood and cognitive symptoms, disorders or treatments as well as active and past medical problems and current medications. Psychiatrists and researchers also assessed their levels of cognition, functional status and depression.

The study published in the American Journal of Psychiatry found that depression increased the risk of subsequent mental impairment. The scientists said the depression symptoms could act as predictors of future intellectual decline.

Vanderbilt nets brain gene research center

Tue, 02 Oct 2007 03:59:37 PST

( from http://www.rxpgnews.com ) Neuroscientists at Vanderbilt University are stepping into the national limelight with the establishment of a Silvio O. Conte Center for Neuroscience Research.

The new center, funded by a $10 million grant from the National Institute of Mental Health (NIMH), will support interdisciplinary studies aimed at understanding the gene networks that control serotonin systems in the brain.

The neurotransmitter serotonin is central to brain biology: it participates in systems that control sleep, aggression, sexual drive, satiety, reward and mood. Serotonin has been implicated in a range of disorders including depression, obsessive-compulsive disorder, schizophrenia and autism, and medications that affect serotonin signaling, such as the SSRI (selective serotonin reuptake inhibitor) antidepressants, are widely prescribed.

The Vanderbilt Conte Center investigators are focusing their efforts on the raphe nuclei, a cluster of serotonin neurons that reside in the brain stem and receive input from and send messages to neurons throughout the rest of the brain.

�This is one of the most medically important cell groups in the nervous system, and the genes that control these neurons and their output are particularly key to our understanding of mental illness risk,� said Randy Blakely, Ph.D., director of the new Conte Center.

�Dr. Blakely has assembled the right team for the job of understanding how genetic variability affects neurotransmitter systems in the developing brain,� said Thomas Insel, M.D., director of the NIMH. �The new Center holds promise for hastening the day when discoveries in the lab will be translated into improved treatments for people with mental illnesses, from mood disorders to autism.�

Conte Centers for Neuroscience Research are a centerpiece of NIMH funding, said Beth-Anne Sieber, Ph.D., chief of the Developmental Biology Program at NIMH. �With these centers, NIMH is looking to the investigators to push their hypotheses forward, create new hypotheses, and find answers relevant to mental health.�

�The Vanderbilt center is the epitome of a Conte Center,� she said. �It really captures the spirit of integration and synergy between investigators.�

The centers are named for the late U.S. Rep. Silvio O. Conte, a longtime advocate for scientific research and organizer of the 1990s �Decade of the Brain� efforts. There are approximately 10 Conte Centers for Neuroscience Research and 10 Conte Centers for the Neuroscience of Mental Disorders � centers with a translational-clinical research emphasis.Blakely said the new center reflects Vanderbilt�s commitment to and investments in neuroscience programming, evident in the growth in research and education here over the last decade.

�This is a defining moment for the neurosciences at Vanderbilt,� said Jeffrey Balser, M.D., Ph.D., associate vice chancellor for Research. �Over the last few years, we have received several forms of external validation that affirm neuroscience at Vanderbilt has become absolutely top tier. An NIH Conte award makes that excellence even more visible to the national and international research community, and at the same time will provide crucial resources for making fundamental progress in mental health research.�

The Vanderbilt Conte Center includes scientists from the School of Medicine and the College of Arts and Science as well as researchers at other institutions. The center investigators will probe the workings of serotonin neurons in the raphe complex from their earliest stages of development to their function in mature animals. The operating hypothesis of the group, Blakely said, is that a rich network of genes establishes and maintains serotonin signaling in the brain and that deficits in the formation or stability of this network in humans underlies risk for mental illness.

The projects make extensive use of specialized mouse models, including mice in which serotonin neurons have been specifically tagged with fluorescent marker proteins or have had selective changes to their serotonin signaling molecules.

�We know that serotonin networks � broadly, all the genes that cooperate to control serotonin assembly and signaling � can be identified and manipulated in the mouse,� Blakely said, �and we feel strongly that the conservation of these networks in humans will allow us to formulate new hypotheses regarding disease-associated genetic variation.�

The Conte Center will also support multiple core facilities that �rest upon the significant technological framework that has been established at Vanderbilt through its shared resources program,� Blakely added.

In addition to its core facilities that will benefit the wider Vanderbilt research community, the Conte Center will administer a pilot grant program targeted to young investigators or established investigators who wish to enter the field of serotonin biology. The center will also host an annual symposium centered on the themes of the Conte program, and Conte Center members will participate in outreach activities that convey to a broader audience the �why� behind the research.

Vanderbilt Conte Center projects and leaders:

On-screen smoking in movies linked to young adult smoking behavior

Tue, 02 Oct 2007 03:59:37 PST

( from http://www.rxpgnews.com ) New study findings show that exposure to on-screen smoking in movies has a strong correlation with beginning to smoke or becoming established smokers among young adults 18-25, a critical age group for lifelong smoking behavior.

The research was conducted by a team from the University of California, San Francisco. Previous studies from around the world found that viewing on-screen smoking was linked to recruitment of adolescent smokers, but this is the first time that smoking among young adults has been associated with their exposure to smoking scenes on screen, said senior author Stanton Glantz, PhD, professor of medicine and director of the UCSF Center for Tobacco Control Research and Education.

�Ages 18 to 25 are critical years, when one-third of smokers start and others who began smoking as adolescents either stop smoking or become regular smokers,� he said.

The research team found a �dose-response relationship� between exposure to smoking on screen and the likelihood of having smoked in the past 30 days in a sample of 1,528 young adults. The study findings are published in the November issue of the �American Journal of Preventive Medicine.�

Young adults who saw the most smoking on screen have a 77 percent greater chance of having smoked at least once in the last 30 days (a measure of smoking initiation) and an 86 percent increased chance of being regular established smokers compared to young adults who saw little smoking in movies, the study showed. �Established smokers� are defined as those who have smoked 100 cigarettes or more and currently smoke.

Participants in the study reflected a cross-section of the U.S. population for the age group, and they took part through a web-based survey. Of the study group, 24.7 were smokers, comparable to estimates of the Centers for Disease Control and Prevention of 25.3 percent for this population. The survey format was similar to the studies of adolescents, with participants receiving a list of 60 motion pictures, selected at random from the top grossing 500 movies released during 2000-2004, and asked to identify the movies they had seen. Each participant was then placed in a quartile of exposure based on the sum of tobacco occurrences that had been viewed.

The results showed a direct effect between exposure and current smoking. The researchers found that two factors mediated the association between exposure to film smoking and established smoking: positive expectations about smoking and exposure to friends and relatives who smoke.

�The main effect is to recruit new smokers from among young adults,� Glantz noted. �Movies encourage them to experiment, and once they start experimenting with cigarettes other factors take hold. Movies create the expectation that smoking will turn out okay.�

The effect demonstrated in young adults is smaller than effects shown in adolescents, but comparable to other environmental risk factors for smoking initiation in young adults, he emphasized.

For example, in the 18-25 age group, researchers estimate that exposure to tobacco promotions in clubs and bars and at campus social events boosts the odds of 30-day smoking by a factor of 1.75, close to the risk of 1.77 posed by exposure to smoking on screen.

It has been estimated that awarding R-ratings on future tobacco imagery to eliminate smoking from youth-rated films would reduce teen exposure to the imagery by half and prevent about 200,000 youth a year from starting to smoke, Glantz said. The results of the new study indicate that young adults are also being recruited to smoke through their exposure to movie smoking, and a substantial reduction in smoking content has the potential to avert even more tobacco deaths, he added.

Scripps research study reveals mechanism behind nicotine dependency

Mon, 01 Oct 2007 03:59:37 PST

( from http://www.rxpgnews.com ) The research is being published the week of October 1, 2007, in an advance, online issue of the journal Proceedings of the National Academy of Sciences (PNAS).

The new study reveals that, in rats, chronic nicotine use recruits a major brain stress system, the extrahypothalamic corticotropin releasing factor (CRF) system, which contributes to continued tobacco use by exacerbating anxiety and craving upon withdrawal. The researchers found that administering a compound that blocked the receptors involved in this stress system alleviated withdrawal symptoms.

�We reduced the need to take nicotine by blocking CRF-1 receptors in the brain,� says Olivier George, a research associate in the Scripps Research Koob lab who conducted the study with Sandy Ghozland and other colleagues. �We were surprised by the compound�s dramatic effectiveness. We don�t know yet if the same mechanism is involved in humans with tobacco dependence, but it is very promising.�

Tobacco addiction is the leading avoidable cause of disease and premature death in the United States, responsible for more than 438,000 deaths annually, according to the Centers for Disease Control and Prevention. Nicotine, the main psychoactive ingredient in tobacco, is a tough drug, with smokers continuing to crave it long after they�ve started withdrawal. Most smoking-cessation medication is based on nicotine replacement therapy, using nicotine gum or patches, that substitutes one source of nicotine for another. Roughly 80 percent of smokers who try to quit relapse within a year.

While nicotine can produce mildly pleasurable effects, the Scripps Research scientists believe a more important factor in the difficulty in quitting is the brain�s adaptation to that reward, which produces an intense discomfort upon withdrawal.

�The key in nicotine addiction is that the positive pleasurable effects of nicotine are instantaneous and short lasting, while the negative effects are delayed and long lasting,� George says. �Even if nicotine may transiently induce a relief from a negative emotional state, its long-term consequences are disastrous.�

For years, scientists have wanted to know what changes in the brain occur in the transition from nicotine use to nicotine dependence. In the current study, the researchers set out to see if nicotine dependence is linked to changes in the CRF system in the amygdala, an area of the brain that plays a primary role in the processing and memory of emotional reactions. The CRF system is activated by CRF-1, an essential protein for coping with stressful events.

When the researchers induced nicotine withdrawal in rats, the nicotine-deprived group exhibited severe anxiety-like behavioral symptoms of withdrawal-such as burying and �freezing� (becoming motionless)-compared with controls. In addition, withdrawal whetted the rats� appetite for even greater quantities of the drug, a result the researchers call the �nicotine deprivation effect.�

�Rats exhibited drug-loading behavior following a cycle of abstinence, attaining an amount of nicotine in roughly six hours that previously took 12 hours,� George says. �This is like the light smoker becoming a chain smoker after trying to quit.�

Measurements showed this behavior was indeed matched by hyperactivity in the CRF system, and that these withdrawal effects lasted a surprisingly long time. In addicted rats, these effects developed in under a week and maintained a hold for at least two months.

�That�s a long time for a rat, considering its life expectancy is two years,� says George. �These results suggest long-lasting neuroadaptations of the CRF system, possibly through gene regulation, that may help explain why many cigarette smokers relapse even after a long abstinence from smoking.�

Importantly, the researchers were able to moderate the effects of nicotine deprivation. When addicted rats were injected with a CRF receptor antagonist, the injected rats showed less anxiety-like behavior during withdrawal and self-administered less nicotine compared with an addicted controls.

The Scripps Research scientists hope their work will lead to new nicotine-free pharmacological treatments, as well as shedding light on questions such as what makes some people more likely than others to become addicted in the first place.

Mixing large doses of both acetaminophen painkiller and caffeine may increase risk of liver damage

Wed, 26 Sep 2007 03:59:37 PST

( from http://www.rxpgnews.com ) WASHINGTON, Sept. 26 2007 -- Consuming large amounts of caffeine while taking acetaminophen, one of the most widely used painkillers in the United States, could potentially cause liver damage, according to a preliminary laboratory study reported in the Oct. 15 print issue of ACS� Chemical Research in Toxicology, a monthly journal. The toxic interaction could occur not only from drinking caffeinated beverages while taking the painkiller but also from using large amounts of medications that intentionally combine caffeine and acetaminophen for the treatment of migraine headaches, menstrual discomfort and other conditions, the researchers say.

Health experts have warned for years that consuming excess alcohol while taking acetaminophen can trigger toxic interactions and cause liver damage and even death. However, this is the first time scientists have reported a potentially harmful interaction while taking the painkiller with caffeine, the researchers say.

While the studies are preliminary findings conducted in bacteria and laboratory animals, they suggest that consumers may want to limit caffeine intake -- including energy drinks and strong coffee -- while taking acetaminophen.

Chemist Sid Nelson, Ph.D., and colleagues, of the University of Washington in Seattle, tested the effects of acetaminophen and caffeine on E. coli bacteria genetically engineered to express a key human enzyme in the liver that detoxifies many prescription and nonprescription drugs. The researchers found that caffeine triples the amount of a toxic byproduct, N-acetyl-p-benzoquinone imine (NAPQI), that the enzyme produces while breaking down acetaminophen. This same toxin is responsible for liver damage and failure in toxic alcohol-acetaminophen interactions, they say.

In previous studies, the same researchers showed that high doses of caffeine can increase the severity of liver damage in rats with acetaminophen-induced liver damage, thus supporting the current finding.

�People should be informed about this potentially harmful interaction,� Nelson says. �The bottom line is that you don�t have to stop taking acetaminophen or stop taking caffeine products, but you do need to monitor your intake more carefully when taking them together, especially if you drink alcohol.�

Nelson points out that the bacteria used in the study were exposed to �megadoses� of both acetaminophen and caffeine, much higher than most individuals would normally consume on a daily basis. Most people would similarly need to consume unusually high levels of these compounds together to have a dangerous effect, but the toxic threshold has not yet been determined, he says.

Certain groups may be more vulnerable to the potentially toxic interaction than others, Nelson says. This includes people who take certain anti-epileptic medications, including carbamazepine and phenobarbital, and those who take St. John�s Wort, a popular herbal supplement. These products have been shown to boost levels of the enzyme that produces the toxic liver metabolite NAPQI, an effect that will likely be heightened when taking both acetaminophen and caffeine together, he says.

Likewise, people who drink a lot of alcohol may be at increased risk for the toxic interaction, Nelson says. That�s because alcohol can trigger the production of yet another liver enzyme that produces the liver toxin NAPQI. The risks are also higher for those who take large amounts of medications that combine both acetaminophen and caffeine, which are often used together as a remedy for migraine headaches, arthritis and other conditions.

The researchers are currently studying the mechanism by which this toxic interaction occurs and are considering human studies in the future, they say. The National Institutes of Health funded the initial animal and bacterial studies.

Study reveals possible genetic risk for fetal alcohol disorders

Fri, 21 Sep 2007 03:59:37 PST

( from http://www.rxpgnews.com ) MADISON - New research in primates suggests that infants and children who carry a certain gene variant may be more vulnerable to the ill effects of fetal alcohol exposure.

Reported online today (Sept. 21) in Biological Psychiatry, the findings represent the first evidence of a genetic risk for fetal alcohol spectrum disorder - a condition that is characterized by profound mental retardation in its most severe form, but which is also associated with deficits in learning, attention, memory and impulse control.

By identifying a genetic marker that might signal susceptibility to these more subtle fetal alcohol-induced problems, the research fills a pressing need, says Mary Schneider, the University of Wisconsin-Madison professor of kinesiology and psychology who led the study.

The big concern used to be the link between fetal alcohol exposure and mental retardation, but today there is increased concern over behavioral problems in these children, says Schneider. If this genetic marker could provide a way of recognizing the most vulnerable fetal alcohol-exposed children early in life, perhaps we could help them to live more successful and satisfying lives.

The study's results may also help to explain why some children of mothers who drink during pregnancy suffer birth defects, while others seem to escape unharmed.

Children who are exposed to alcohol because their mothers drank during pregnancy have varying degrees of problems, and the same is true for monkeys who are exposed to moderate levels of alcohol in utero, says Schneider. So we know there are other factors involved.

With colleagues at UW-Madison, the University of Toronto and the National Institutes of Health, Schneider investigated two forms of a gene called the serotonin transporter gene promoter, which helps regulate the brain chemical serotonin. Past studies of both people and primates suggest that carriers of a short form of this gene are at increased risk for depression, but only if they also experience adverse life events.

To test whether the gene's short form might also raise the risk of fetal alcohol-induced problems, Schneider's team analyzed data from an ongoing, long-term study into the impacts of moderate fetal alcohol exposure on behavior and brain function in rhesus monkeys. Although fetal alcohol syndrome was first recognized in children of alcoholic mothers, attention has shifted in recent years to moderate drinking because of its potential to affect many more children, says Schneider.

We know that 60 percent of women of child-bearing age consume alcohol and more than 50 percent of pregnancies are unplanned, she says. So it doesn't take much to figure out that prenatal exposure to alcohol - at least in the weeks before pregnancy is detected - is substantial.

In line with this, the mother monkeys in the study's experimental group consumed the equivalent of just two alcoholic beverages five times a week during breeding and pregnancy. After the infants were born, the scientists recorded their irritability during a standard battery of developmental tests, measured their reactivity to stress when separated from their mothers at six months for weaning, and determined whether they carried the short or long form of the serotonin transporter gene promoter.

What the researchers found is that fetal alcohol-exposed infants who carried a copy of the short form were more irritable and reactive to stress than either control group infants who weren't exposed to alcohol or those who were exposed but had two copies of the gene's long form. Overall, says Schneider, the results indicate a substantial interaction between fetal alcohol exposure and genotype.

She and her colleagues are now conducting additional studies to see if these findings fit a larger pattern of fetal alcohol-induced problems as the monkeys grow up. At the same time, extreme irritability and stress responsiveness in infants can themselves lead to problems, she says.

If a baby is very irritable and stress reactive, one of the things this can interfere with is the caregiver-infant interaction, she says. In real life, negative events tend to cluster. So if there's alcohol in the environment, there may also be stress. And then if you have an irritable baby, this all could have cascading effects on the child's psychological development.

Recognizing that complex behaviors are seldom, if ever, governed by a single gene, Schneider and her colleagues are also investigating other gene alleles for their potential to interact with fetal-alcohol exposure and put children at risk.

Genetics by themselves rarely tell us much, because life experiences may trigger the actual effects of our genetic vulnerabilities, says Schneider. So the more knowledge we have about the ways that genes interact with environmental factors, the more we can envision interventions early in life to help a vulnerable child.

Family history of alcoholism affects response to drug used to treat heavy drinking

Wed, 19 Sep 2007 03:59:37 PST

( from http://www.rxpgnews.com ) Philadelphia, PA, September 19, 2007 � Naltrexone is one of four oral medications approved by the U.S. Food and Drug Administration (FDA) for the treatment of alcoholism. A recent large multicenter research study of alcohol dependence supported by the National Institute of Alcoholism and Alcohol Abuse (NIAAA), the COMBINE Study, suggested that naltrexone produced a modest but significant benefit but another FDA-approved medication, acamprosate, was ineffective. Perhaps consistent with its modest effects in COMBINE, naltrexone is not widely prescribed in the treatment of alcoholism. Yet, clinicians report that naltrexone may have significant benefits for individual patients. To make naltrexone a more useful medication, it would be important to begin to identify groups of patients who might be more or less likely to show a significant clinical benefit from naltrexone prescription and to understand the causes of differential naltrexone efficacy. A new study that will appear in the September 15th issue of Biological Psychiatry suggests that alcohol dependent individuals with a family history of alcohol dependence may be more likely than alcohol dependent individuals without a family history of alcohol dependence to reduce their drinking in the laboratory when prescribed naltrexone.

Krishnan-Sarin and colleagues at the NIAAA Center for the Translational Neuroscience of Alcoholism studied alcohol consumption in the laboratory by alcohol-dependent individuals who were not seeking treatment. The participants were studied in the laboratory after 6 days of treatment with 0 mg (placebo), 50 mg, or 100 mg of naltrexone. The authors discovered that naltrexone decreased drinking in those with a family history of alcoholism and this effect was greatest with the highest naltrexone dose. However, it increased drinking in those without a family history of alcoholism and this effect was greatest at the highest naltrexone dose.

John H. Krystal, M.D., one of the authors, notes that �When studied in large groups, naltrexone appears to have a rather small effect upon the ability to reduce drinking or remain abstinent from alcohol. However, there is growing evidence that there are subgroups of patients who show substantial benefit from naltrexone, even when naltrexone fails to work in the overall trial (see Gueorguieva R et al. Biol Psychiatry. 2007 Jun 1;61(11):1290-5).� According to Suchitra Krishnan-Sarin, Ph.D., the lead author, �The results suggest that family history of alcoholism may be an important predictor of clinical response to naltrexone and could potentially be used to guide clinical practice.� Dr. Krystal agrees, �These data suggest that family history might influence the optimal dosing of naltrexone and the nature of the clinical response.� Their hope is that these findings ultimately can contribute to a better treatment experience for some who are seeking to end their battle with alcohol.

Schizophrenia Risk Gene DISC1 Plays a Broader Role in the Development of Nervous System

Mon, 10 Sep 2007 04:18:45 PST

( from http://www.rxpgnews.com ) How the gene that has been pegged as a major risk factor for schizophrenia and other mood disorders that affect millions of Americans contributes to these diseases remains unclear. However, the results of a new study by Hopkins researchers and their colleagues, appearing in Cell this week, provide a big clue by showing what this gene does in normal adult brains.

It turns out that this gene, called disc1, makes a protein that serves as a sort of musical conductor for newly made nerve cells in the adult brain, guiding them to their proper locations at the appropriate tempo so they can seamlessly integrate into our complex and intertwined nervous system. If the DISC1 protein doesn’t operate properly, the new nerves go hyper.

"DISC1 plays a broader role in the development of adult nerves than we anticipated," says Hongjun Song, Ph.D., an associate professor at Hopkins’ Institute for Cell Engineering. "Some previous studies hinted that DISC1 is important for nerve migration and extension, but our study in mice suggests it is critical for more than that and may highlight why DISC1 is associated with multiple psychiatric disorders."

"Almost every part of the nerve integration process speeds up," adds fellow author Guo-li Ming, M.D., Ph.D., also an associate professor at ICE. "The new nerves migrate and branch out faster than normal, form connections with neighbors more rapidly, and are even more sensitive to electrical stimulation."

While it may not be obvious why high-speed integration would be detrimental, Song notes that because of the complexity of the brain, timing is critical to ensure that new nerves are prepared to plug into the neural network.

Ming, Song and their collaborators at the National Institutes of Health and UC Davis tracked the abnormal movements of the hyperactive nerve cells by injecting a specially designed virus into a part of a mouse brain known as the hippocampus -a region important for learning and memory and therefore quite relevant to psychiatric disorders. The virus would only infect newly born cells and would both knock down the expression of the disc1 gene and make the nerves glow under a microscope.

Combined with other recent Hopkins research that successfully engineered mouse models that have abnormal DISC1 and can effectively reproduce schizophrenia symptoms such as anxiety, hyperactivity, apathy and altered senses, these current findings teasing out the normal role of this protein may help unravel the causes for this complex disease

Song and Ming add that their studies in the hippocampus - one of the few places where new nerves are made in the adult brain - might answer why symptoms typically first appear in adults despite the genetic basis of many psychiatric illnesses. They plan on continuing their mouse work to try and find those answers.