Reflections on September 2008

I will look back at some of the areas covered in the blog in September 2008.

In dementia research there were a number of general findings. Doubling times in Alzheimers were found to be about 5 years across the world. There was evidence relating depression in the elderly to dementia to a greater extent than to ‘stress’. 42% of people over the age of 65 had mild cognitive impairment in one study and it was noted at the Leon Thal Symposium that in dementia, cognitive function in placebo groups tended to decline less in recent times perhaps reflecting trends in the general population. There was also the finding that apathy was related to not living with a spouse and this correlated with level of functioning. In terms of anatomical findings there was the use of Magnetic Transfer Ratios to examine the anatomy of the Subthalamic Nucleus and Ventral Tegmental area and the relationship of these findings to verbal memory. Researchers also found that Hippocmpal volume predicted memory performance in ageing pilots and that Hippocampal and Entorhinal Cortex volume as well as performance on a smell test predicted conversion from MCI to Alzheimers disease. In terms of treatment, treating Obstructive Sleep Apnoea in Alzheimer’s disease was found to have a beneficial effect on cognition. Also there was found to be a 80% stabilisation of cognitive decline on rivastigmine in patients who remained on this at 2 years. Insulin produced less neuritic plaques in one post-mortem study. This may tie in with findings of the brain’s secretion of insulin and a theory of relationship of Alzheimer’s Disease to a type III diabetes.

In schizophrenia or psychosis research there was found to be a strong modifying effect of social relationships on psychosis in people who are unemployed. A model of social cognition in schizophrenia by Oschner was discussed and there was a higher occurence of DES scores in people with schizophrenia exposed to civil strife in Northern Ireland. A very important study – the CLAMORS study showed increased risk of coronary artery disease if there was metabolic syndrome and also worse scores on PANSS and CGI. A study linked schizophrenia and Bardet-Biedl Syndrome through three genes acting in concert. There is also re-emerging evidence for a relationship between middle ear infections and schizophrenia.

In terms of mood disorders, a meta-analysis of structural imaging in Bipolar Illness showed lateral ventricle enlargement and white matter hyperintensities while another study correlated length of bipolar illness with grey matter volume. In terms of the relationship between depression and physical illness, depressive symptoms predicted  ischaemic stroke in men. Post-MI depression predicted survival as did night time heart rate. Increasing paternal age increased the likelihood of bipolar disorder whilst low birth weight childrn were more likely to experience anxiety or depression. In terms of treatment, there was a paper highlighting the importance of treating residual symptoms of depression and the many possible treatment strategies as well as another paper providing evidence for the efficacy of beating the blues in depression.

In PTSD research, higher IQ was found to be protective against PTSD in WWII prisoners of war whilst the authors of another study recommended the use of resilience scales in PTSD research. In alcohol research, there was evidence showing that alcohol reduced the respiratory burst in neutrophils and that reduced amgydala volume predicted relapse in alcohol dependence. There were found to be differences in the way girls and boys with autism behave and the possible resulting underdiagnosis in girls as well as decreased focus on people’s eyes in autism.

There were a number of miscellaneous pieces which tended to cross disciplines. Various benefits for computer assisted prescribing in the elderly were identified.There was a speculated relationship of attentional blink to dopamine and working memory. There was evidence in people with hearing impairment of the importance of motor feedback for speech rather than just auditory feedback.

A protective role for gut flora in autoimmune processes raises many important questions. An analogy was made between the placenta and the blood brain barrier in one book and the possibility that individual differences may account for differential responses to medications and/or teratogenicity. Henry Markram’s astounding blue brain simulation was presented at the 2008 Neuroinformatics Conference. A balanced biopsychosocial approach was recommended in stigma campaigns based on the results of one study. There was evidence for possible benefits of fluoxetine in multiple sclerosis and in another study an increased incidence of cerebral microbleeds in men when compared to women. The bomb pulse technique was presented for dating cells including neurons and is based on radiation fallout from nuclear testing many decades ago. An innate ability for children to estimate numbers that correlates with formal mathematical abilities was identified. In one book there was discussion of a recent growth spurt in the human brain 1.5-2 million years ago and 200-500,000 years ago. Albert Ellis’s areas that he thought would be important for health were covered in one book. An inflammatory marker NFKB is found to be raised in sleep deprivation.

Emerging themes are prevention in those who have not yet experienced a mental illness which is already starting to provoke debate, issues of how science manages large quantities of data and Discomgooglation in the emerging intersection between the internet and mental health.

Disclaimer

The comments made here represent the opinions of the author and do not represent the profession or any body/organisation. The comments made here are not meant as a source of medical advice and those seeking medical advice are advised to consult with their own doctor. The author is not responsible for the contents of any external sites that are linked to in this blog.

One comment

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