Reflections on October 2009

October 2009 featured World Mental Health Day (October 10th) reminding people of the importance of mental wellbeing. There were a number of papers reviewed covering in particular mental health informatics and cognitive impairment. Blogs reviewed focused on mental health informatics topics including an open-source healthcare database MRS. There were some interesting podcasts reviewed which included an interview with Professor Sir David Goldberg as well as a lecture in which the benefits of bringing positive psychology into psychiatry were considered. Books reviewed covered evolution, psychoanalytic and related theories and sociological topics. In the news there was a look at studies on olive oil and amyloid plaques, an association between cholesterol in middle-age and subsequent Alzheimer’s Disease, the efficacy of telephone-based delivery of CBT, an increase in antidepressant prescriptions in the UK, new electrophysiological findings about the functioning of Broca’s area, a Japanese supercomputing project to simulate life, new findings about Dimebolin’s receptor sensitivity and the development of the Neuroscience Information Framework Version 2.0.

Book Review


Book Review: The Greatest Show on Earth

Book Review: Alfred Adler on The Education of Children

Book Review: The Divided Mind

Book Review: Linked

Book Review: Outliers

Podcast/Media Reviews


Podcast Review: Nature Neuropod Oct 28th 2009

Podcast Review: October 2009 Edition of American Journal of Psychiatry

Podcast Review: Nature Podcasts from October 2009

Podcast Review: Acta Scandinavica Psychiatrica Interview with Professor Sir David Goldberg

Podcast Review: Bringing Psychology’s ‘Positive Psychology’ to Psychiatry

Blog Review

Blog Review: Doctor Dymphna’s Diliberations

Blog Review: Open MRS

Blog Review: Medical Ethics Blog

Blog Review: Mobile Healthcare

Blog Review: New Media Medicine Blog

Social Psychiatry Article Reviews


Review: Accuracy of Prevalence Rates in Multiple Sclerosis

Review: The Genetic Epidemiology of Neurodegenerative Disease

Review: Mobile and Fixed Computer Use by Doctors and Nurses on Hospital Ward

Review: YouTube and ‘Neurological Knowledge’

Psychology/Psychotherapy Article Reviews


Review: Implicit and Explicit Aspects of Sequence Learning in Presymptomatic Huntington’s Disease

Review: Cognitive Impairment in MS: Evidence-based analysis

Review: Differential Cognitive Impairment for Diverse Forms of Multiple Sclerosis

Review: Vascular Cognitive Impairment No Dementia (VCIND)

Biological Psychiatry Article Reviews


Review: Beyond the Brain in Huntington’s Disease

Review: Relationship Between 24-hour Blood Pressures, Subcortical Ischemic Lesions and Cognitive Impairment

Review: Autophagy in Neurodegeneration and Development

Review: Striosomes and Mood Dysfunction In Huntington’s Disease

Miscellaneous

World Mental Health Day

News Round-Up October 2009

In this article there is coverage of a prospective cohort study in Honolulu which includes post-mortems to clarify the processes leading to the dementia. The study has been going on for many decades and the researchers have now accumulated data from close to 800 autopsies and are able to compare this with neuropsychological and other data. NHS Choices discuss a study involving Olive Oil and finding that it binds to A Beta-derived diffusible ligands (ADDLs) and influences in turn their binding to synapses which may have implications for the disease process in Alzheimer’s Disease. In America, a group of neurologists have developed consensus guidelines for the use of cognitive enhancers in adults without dementia. Another study involved contacting retired American Football (NFL) players and conducting a survey over the phone. The researchers found a much higher prevalence of dementia in the NFL players than the national average. In one study there was found to be an association between plasma levels of ABeta42 and risk of conversion from Mild Cognitive Impairment to Alzheimer’s Disease and it will be useful to see further replication of these findings. Levels of a class of transcription factors NFAT’s (Nuclear Factors of Associated T-Cells) was significantly elevated in the hippocampi of subjects with Mild Cognitive Impairment or Alzheimer’s Disease compared to controls and at least one pathway has been suggested between activation by Amyloid plaques and expression of regulated genes.

A prospective California study with 9000 subjects provided evidence of an association between higher levels of cholesterols in people aged in their 40’s and the subsequent prevalence of Alzheimer’s Disease in their 60’s to 80’s. The article is freely available here. Analysis of the data from the Nun study continues with over 500 brains obtained post-mortem. The Nun study followed up several hundred nuns, examining a large number of factors and identifying associations with Alzheimer’s Disease. In this article you can watch an interesting video containing interviews with some of the nuns as well as a post-mortem dissection of a brain with enlarged ventricles. The Nuns have been very generous in ensuring that their brains can be used for research after their death and this type of research is very important in coming to a better understanding of the disease process. A study has provided evidence of a possible association between a virus XRV and Chronic Fatigue Syndrome. In a study of people with Parkinson’s disease using a driving simulator and comparing this group to age-matched controls, the Parkinson’s subjects were significantly more likely to experience a crash under low visibility settings than the control group. There were a number of factors including visual processing speed which were significantly associated with driving performance in the simulator. A phase 1 clinical trial is currently underway to examine the potential neuroprotective role of the antibiotic Minocycline in acute ischaemic stroke. Experimental evidence has shown that expression of IL-6 in murine brain can lead to removal of amyloid plaque by microglial cells. There has been significant evidence to suggest a role for inflammation in the disease process and these new findings show that the relationship between inflammation and build up of Amyloid Plaques in the brain is complex.

An American study provided evidence of the cost-effectiveness of telephone-based Cognitive Behavioural Therapy for depression in primary care (covered here and here) although the application of these results will depend on local protocols and service structure. The study is in the Archives of General Psychiatry. Aaron Beck who developed CBT was awarded the Lasker prize for clinical research. A prospective study involving 10,094 subjects over 4 years looked at adherence to a Mediterranean diet and new-onset depression and found evidence of an inverse relationship between increasing adherence to the diet and incidence of new-onset depression. A study in the BMJ showed an increase in the number of prescriptions of antidepressants from 1993 to 2004 and this was attributed to the use of long term prescriptions. There is further coverage here. In a cross-sectional study of symptoms in people with bipolar disorder (n=88) published in the journal of the World Psychiatric Association, the researchers found a significant association between the mixed affective state and negative cognition and hyperactivity (article freely available here). In a study of people in the Andean highlands in Ecuador (n=167), the researchers used the Spanish version of the Beck Depression Inventory II and identified that the scores on the somatic component of the scale were significantly higher than the cognitive component (article freely available here). The researchers interpreted this as  resulting from the influence of culture on the expression of the depressive illness.

Scientific American have coverage of some studies supporting the hypothesis that long term relationships foster creativity. In the studies they contrasted analytical with creative thinking. The types of relationships considered were tested indirectly by the use of imagination or by presentation of words with subtle meanings related to the paradigm. However it could be argued that the relationship status of the subject would provide more convincing evidence. A conference on empathy took place at the end of September 2009 and the conference website can be found here. There has been a relative large study comparing people with Tourette’s and OCD with healthy controls and finding no significant evidence of the former conditions with Streptococcal throat infection. There is contrary evidence which suggests that Strep throat infections can be associated with autoimmune processes which involve the central nervous system and these are termed PANDAS. In an intracranial electrophysiological study published in Science, the researchers provided evidence that language processing occurs in Broca’s area and is divided into processes for grammar, meaning and articulation with each process being separated by milliseconds. There is a preliminary report on a new technology which measures electrical signals between the central nervous system and the vestibular apparatus in the ear. The Australian research team state that they are able to characterise responses in a number of central nervous system disorders and they include depression. There is a website which details the technology and which also contains a link to a promotional video. Using Medline, I was able to find 5 studies including 1 on schizophrenia and 1 on depression, although both had small sample sizes they provided data on the application of the technology. It will be interesting to see  further published data with larger sample sizes as this becomes available.

A 1 Billion dollar Japanese project to create a supercomputer which will amongst it’s many functions will aim to simulate life is currently underway and is covered here. In the Proceedings of the National Academy of Sciences there is a paper on the use of a new genome sequencing technology – whole exome sequencing (which focuses on genes coding for proteins rather than the entire genome sequence) in a case which resulted in a rapid diagnosis and it will be interesting to see further developments in this area. The Natural Health Service is an ambitious project being undertaken in the NHS to plant 1.3 million trees which should reduce the carbon footprint of the NHS.

Research In Dementia

The researchers found that gamma-secretase, an enzyme implicated in Alzheimer’s Disease pathology binds to a class of  transmembrane proteins known as tetraspanins  (Wakabayashi et al, 2009) as well as to a number of other proteins. The tetraspanins have a number of different functions within the cell and it will be interesting to see how gamma secretase relates to these functions. There is further coverage here. An in-vivo study has provided evidence that Dimebolin has a high affinity for the Serotonin 5HT6 receptor in vivo (Schaffhauser et al, 2009). Dimebolin under the name Dimebon was trialled in Alzheimer’s Disease and showed promising results. There may be a focus on this receptor for therapeutics if these results are replicated. A small study of people with Alzheimer’s Disease (AD) compared with people with mild cognitive impairment and healthy controls (n=55) provided evidence that there was a correlation between the PET and CSF markers of ABeta but that they did not correlate significantly with cognitive impairment (Jagust et al, 2009). There is an interesting article on the National Dementia Research Brain Bank here. A meta-analysis of prospective and case-control studies examining the relationship between smoking and Alzheimer’s Disease which adjusted for a number of factors including tobacco company affiliation of the studies showed that smoking was a significant risk factor for Alzheimer’s Disease (Cataldo et al, 2009). A post-mortem study comparing the brains of people who had Alzheimer’s Disease and hyperphagia with those who did not found a significant reduction in 5HT4 receptors in the former group  (Tsang et al, 2009).

Evolutionary Psychiatry


There is also evidence that neighbouring groups of Chimpanzees approach the same problem in different ways which the researchers have interpreted as cultural differences. Such interpretations may have implications for developing models of human culture. Steve Peters, psychiatrist and coach for the Olympic Cyclists is appearing on a television program to work with members of the public to improve their fitness. In this article that covers the story, Steve Peters discusses some of the underlying theory he uses (which appears to relate to evolutionary psychology). An anthropological study looked at old world monkeys and found that increasing neocortical size was associated with the ability to form large social networks. Researchers have provided indirect evidence that Macaque monkeys experience the ‘Uncanny Valley‘ effect. This effect describes the tendency for people, or monkeys in this case, to become uncomfortable if computer simulations of members of their species are too realistic. The finding in monkeys suggests an evolutionary basis for this effect. It will be interesting to see if this has implications for social bonding. An fMRI study in monkeys and humans provided evidence of activation of the inferior Parietal lobe in humans alone when watching tool-using activities. There were a number of other areas that were activated in both humans and monkeys when undertaking this task. There is an estimate from one study that each person has roughly 100 new mutations in their genome based on an analysis of the difference in genes in two chinese men who shared an ancestor at the beginning of the nineteenth century.

Psychiatry 2.0


Over at Science Life there is coverage of the Neuroscience conference in Chicago which amongst other items reports on a talk by Erik Kandel, the genetics of anxiety and neuroscience in social media. October 19-23rd was Open Access week and over at Beta Science, Morgan Langille writes about the use of an open-access website BioTorrents for sharing data and other resources. Over at Medical News Today there is a look at an association between gamma synuclein and depression. Software Advice has an article on iPhone applications for doctors and medical students. The Neuroscience Information Framework Version 2.0 is now online. The NIF is described as

A dynamic inventory of web-based neuroscience resources: data, materials, and tools accessible via any computer connected to the internet

The NIF is also described as a National Institute of Health Blueprint for Neuroscience Research initiative (see also this review of a paper on the Neuroscience Information Framework). The NIF Tools include a registry of electronic catalogues of neuroscience resources, a ‘deep web’ resource – the NIF Data Federation, the NIF Web Index – essentially a search tool for neuroscience information on the internet and the NIF vocabulary which includes Neurolex. Neurolex is a neuroscience lexicon which at the time of writing contains 7972 terms. Such a lexicon has implications not just for the ability to find relevant information on the internet but also has potential for facilitating neuroscience dialogue.

References


Cataldo JK, Prochaska JJ, Glantz SA. Cigarette Smoking is a Risk Factor for Alzheimer’s Disease: An Analysis Controlling for Tobacco Industry Affiliation. J Alzheimers Dis. 2009 Oct 8. [Epub ahead of print]

Jagust WJ, Landau SM, Shaw LM, Trojanowski JQ, Koeppe RA, Reiman EM, Foster NL, Petersen RC, Weiner MW, Price JC, Mathis CA; Alzheimer’s Disease Neuroimaging Initiative. Relationships between biomarkers in aging and dementia. Neurology. 2009 Oct 13;73(15):1193-9.

Schaffhauser H et al. Dimebolin is a 5-HT6 antagonist with acute cognition enhanching activities. Biochemical Pharmacology. Vol 78. Issue 8. pp 1035-42. 2009.

Tsang SW, Keene J, Hope T, Spence I, Francis PT, Wong PT, Chen CP, Lai MK. A serotoninergic basis for hyperphagic eating changes in Alzheimer’s disease. J Neurol Sci. 2010 Jan 15;288(1-2):151-5. Epub 2009 Oct 8.

Wakabayashi T, Craessaerts K, Bammens L, Bentahir M, Borgions F, Herdewijn P,Staes A, Timmerman E, Vandekerckhove J, Rubinstein E, Boucheix C, Gevaert K, De Strooper B.Nat Cell Biol. 2009 Oct 18. [Epub ahead of print]. Analysis of the gamma-secretase interactome and validation of its association with tetraspanin-enriched microdomains.

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Responses

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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.

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