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I am a physician interested in clinical neuroscience research. I will use this blog to post more detailed analysis of recent studies in addition to my @WRY999 Twitter scientific reading log. I will also post some of my wildlife/sports photography. Aim to educate and amuse. Not selling anything.

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  • October 14, 2016
  • 11:50 AM

Pathways to Substance Use and Abuse

by William Yates, M.D. in Brain Posts

Neuroscience medicine clinicians encounter patients every day who have both a mental and substance use disorder.This co-occurrence, or comorbidity, complicates diagnosis, treatment and outcome.The exact mechanism for this comorbidity issue is unclear.A recent study out of Washington University in St. Louis and King's College London provides some insight into this comorbidity issue.They examined participants in the Study of Addiction: Genetics and Environment (SAGE). These subjects provided genet........ Read more »

Carey CE, Agrawal A, Bucholz KK, Hartz SM, Lynskey MT, Nelson EC, Bierut LJ, & Bogdan R. (2016) Associations between Polygenic Risk for Psychiatric Disorders and Substance Involvement. Frontiers in genetics, 149. PMID: 27574527  

  • October 10, 2016
  • 11:54 AM

Alzheimer's Disease: Atrophy Pattern and Symptoms

by William Yates, M.D. in Brain Posts

Memory impairment is a key symptom of Alzheimer's dementia common to patients with the condition.However, additional cognitive and behavioral symptoms vary between patients with a clinical and pathological diagnosis of Alzheimer's disease.A key area of research is focused on understanding factors that contribute to symptom variability in Alzheimer's disease.A team of researchers from Singapore and Harvard Medical School recently published an important study on this topic.They analyzed structural........ Read more »

Zhang X, Mormino EC, Sun N, Sperling RA, Sabuncu MR, Yeo BT, & Alzheimer’s Disease Neuroimaging Initiative. (2016) Bayesian model reveals latent atrophy factors with dissociable cognitive trajectories in Alzheimer's disease. Proceedings of the National Academy of Sciences of the United States of America. PMID: 27702899  

  • October 3, 2016
  • 10:56 AM

Robin Williams and Lewy Body Disease

by William Yates, M.D. in Brain Posts

In a post last week, I highlighted a recent study examining clinical issues in the diagnosis of Lewy body dementia (LBD).This study examined differentiating clinical and neuropsychological factors between LBD, Alzheimer's dementia and Parkinson's disease.You can access this post by clicking HERE.This topic received significant attention following the description of comedian Robin Williams' last years by his wife in the journal Neurology.Robin Williams suffered from LBD and like many, his diagnos........ Read more »

Williams SS. (2016) The terrorist inside my husband's brain. Neurology, 87(13), 1308-1311. info:/

  • September 28, 2016
  • 11:10 AM

Lewy Body Versus Alzheimer's Dementias and Parkinson's

by William Yates, M.D. in Brain Posts

One clinical challenge is making an accurate diagnosis in patients with dementia.Alzheimer's disease is typically the predominant diagnosis in dementia. However a significant number of patients will present with dementia due to Lewy Body disease, Parkinson's dementia,  frontotemporal dementia or vascular dementia.A recent study helps clinicians to distinguish Lewy Body  from Alzheimer's dementia and Parkinson's disease.Douglas Scharre and collegues from Ohio State University conducted ........ Read more »

Scharre, D., Chang, S., Nagaraja, H., Park, A., Adeli, A., Agrawal, P., Kloos, A., Kegelmeyer, D., Linder, S., Fritz, N.... (2016) Paired Studies Comparing Clinical Profiles of Lewy Body Dementia with Alzheimer’s and Parkinson’s Diseases. Journal of Alzheimer's Disease, 1-10. DOI: 10.3233/JAD-160384  

  • September 21, 2016
  • 11:46 AM

Brain Imaging: UK Biobank Epidemiology Study

by William Yates, M.D. in Brain Posts

I wanted to alert Brain Posts readers to a very important ongoing study out of the United Kingdom.The UK Biobank prospective epidemiological study is a study designed to identify imaging markers for a wide variety of diseases. Additionally, a goal of the study is to better understand disease mechanisms.Here is what is being collected on 100,000 healthy participants who will be tracked over decades:Brain structural and functional imaging (fMRI)Brain diffusion tensor imaging (DTI)Neuropsychologica........ Read more »

Miller KL, Alfaro-Almagro F, Bangerter NK, Thomas DL, Yacoub E, Xu J, Bartsch AJ, Jbabdi S, Sotiropoulos SN, Andersson JL.... (2016) Multimodal population brain imaging in the UK Biobank prospective epidemiological study. Nature neuroscience. PMID: 27643430  

  • September 19, 2016
  • 11:11 AM

Preventing Depression Following Brain Injury

by William Yates, M.D. in Brain Posts

Depression is a common feature following traumatic brain injury (TBI). Post-TBI depression may be difficult to treat and evolve into a chronic depression syndrome.A recent published study demonstrates that prophylactic SSRI antidepressant treatment may reduce the incidence of depression following TBI.This study was conducted by investigators affiliated with Baylor College of Medicine and the Department of Psychiatry at the University of Iowa.Ninety four subjects were recruited to this randomized........ Read more »

  • September 16, 2016
  • 10:16 AM

The Brain in Super Agers

by William Yates, M.D. in Brain Posts

My Twitter post on a recently published study of brain structure in a group of high performing older adults received quite a bit of attention (see below).Felicia Sun and colleagues at Massachusetts General Hospital and Harvard Medical School selected an interesting research design.A group of elderly subjects between the ages of 60 and 80 years were identified as showing "superaging". This was defined as scoring like young adults on two neuropsychological tests: The Long Delay Free Recall measure........ Read more »

Sun FW, Stepanovic MR, Andreano J, Barrett LF, Touroutoglou A, & Dickerson BC. (2016) Youthful Brains in Older Adults: Preserved Neuroanatomy in the Default Mode and Salience Networks Contributes to Youthful Memory in Superaging. The Journal of neuroscience : the official journal of the Society for Neuroscience, 36(37), 9659-9668. PMID: 27629716  

  • September 12, 2016
  • 12:36 PM

Opioid Abuse: Treatment Guidelines

by William Yates, M.D. in Brain Posts

Molecular model of the drug buprenorphineThe U.S. Surgeon General recently sent a letter to all physicians about the danger of prescription opioids, particularly when used in combination with benzodiazepines (i.e. Valium, Xanax).  This combination greatly increases the risk of overdose death.Clinicians can successfully assist those with opioid use disorders. Marc Schuckit, M.D. recently published a nice summary review of entitled "Treatment of Opioid-Use Disorder" in the New England Journal........ Read more »

Schuckit, M. (2016) Treatment of Opioid-Use Disorders. New England Journal of Medicine, 375(4), 357-368. DOI: 10.1056/NEJMra1604339  

  • September 9, 2016
  • 12:10 PM

Statin Therapy: Rethinking Benefits and Risks

by William Yates, M.D. in Brain Posts

A recent 30-page manuscript provides an exhaustive review of the evidence for the efficacy and safety of statin therapy.The authors of this excellent review provide some context for the relative value of statins.The note that putting 10000 individuals with a history of a vascular event on a statin drug for 5 years would prevent 1,000 subsequent events. This is an example of secondary prevention--preventing another adverse outcome in those already experiencing an adverse event.But the statin drug........ Read more »

Collins, Rory, Reith, Christina, & Emberson, Jonathan. (2016) Interpretation of the evidence for the efficacy and safety of statin therapy. Lancet. info:/

  • September 7, 2016
  • 12:05 PM

Nuturing the Gifted: II

by William Yates, M.D. in Brain Posts

Earlier this summer I posted a review and commentary on a Duke University study of the outcome of children identified as gifted.You can access this post by clicking HERE.Today in Nature News, Tom Clynes publishes a nice review of the history of this topic.He notes there have several large scale studies to examine prospectively children with high academic potential. The cohorts include:Study of Mathematically Precocious Youth-SMPY (Johns Hopkins)Duke University Talent Identification ProgramMunich........ Read more »

  • September 6, 2016
  • 11:17 AM

Keeping the Weight Off

by William Yates, M.D. in Brain Posts

Weight loss and maintenance of weight loss is difficult if not nearly impossible for most people.A registry of individuals who have lost 30 pounds or more and maintained their weight loss over a year exists in the U.S. This research effort is known as the National Weight Control Registry. It currently has over 10,000.I was looking at some of the published research results from this study. A paper published in 2012 used cluster analysis to identify sub-types of individuals with successful long-te........ Read more »

  • September 2, 2016
  • 11:53 AM

Obesity Surgery: VA Outcome Study

by William Yates, M.D. in Brain Posts

Weight loss (bariatric) surgery is likely to become increasingly important to address the obesity epidemic in the U.S. and other nations.There are several types of surgical techniques used for bariatric surgery.One of the most invasive is the Rous-en-Y gastric bypass (RYG) operation. This operation involves bisection of the small intestine and reattachment of the upper section to a position lower down the small intestine. This provides for a shorter distance for food to be absorbed.Less invasive........ Read more »

Maciejewski ML, Arterburn DE, Van Scoyoc L, Smith VA, Yancy WS Jr, Weidenbacher HJ, Livingston EH, & Olsen MK. (2016) Bariatric Surgery and Long-term Durability of Weight Loss. JAMA surgery. PMID: 27579793  

  • August 30, 2016
  • 11:59 AM

Dyslexia Improvement in Medication Trial

by William Yates, M.D. in Brain Posts

Dyslexia or developmental reading disorder is a common learning disorder affecting about 5% of the school age population.Treatment of dyslexia is difficult and typically is focused on special education classes and reading exercises.Medication treatment for dyslexia is nearly unheard of as no FDA-approved drug is available for the condition.However, a recent randomized clinical drug trial found evidence to support the potential use of atomoxetine for dyslexia.Atomoxetine is a drug approved for at........ Read more »

  • August 29, 2016
  • 12:08 PM

Mediterranean Diet and Cognition

by William Yates, M.D. in Brain Posts

The evidence for a beneficial effect of a Mediterranean style diet (MedDiet) on brain health grows on a regular basis.For those interested in a good summary of the effects of the MedDiet on cognition, I recommend reading the free full text review recently published in Frontiers in Neuroscience.In this review, Roy Hardman and colleagues searched for research studies on cognition and the Mediterranean diet published between 2000 and 2015.A figure in the review proposed several mechanisms where com........ Read more »

  • August 23, 2016
  • 10:36 AM

The Brain: Red Meat and Mediterranean Diet

by William Yates, M.D. in Brain Posts

Entorhinal Cortex Highlighted in BluePrevious posts in this blog have highlighted some the research related to links between brain health and elements of the Mediterranean diet.I want to inform readers of a new important research study from the Mayo Clinic.In this study, researchers completed brain cortical thickness analyses on 672 cognitively normal adults. It is generally accepted that greater cortical thickness relates to improved cognitive performance.The participants completed an extensive........ Read more »

Staubo SC, Aakre JA, Vemuri P, Syrjanen JA, Mielke MM, Geda YE, Kremers WK, Machulda MM, Knopman DS, Petersen RC.... (2016) Mediterranean diet, micronutrients and macronutrients, and MRI measures of cortical thickness. Alzheimer's . PMID: 27461490  

  • August 9, 2016
  • 11:16 AM

Genetics of Depression: Secondary Markers

by William Yates, M.D. in Brain Posts

In my previous post, I highlighted a recent study of genetics and major depression from the 23andMe database.I have had a chance to review this manuscript in more detail. One of the findings of interest involved secondary marker or secondary phenotypes.Fifteen genetic loci were identified in this 23andMe sample using a discovery and replication data set.Secondary phenotypes with the highest correlation with the 17 SNPs identified in the study included (effect) :Taking a selective serotonin reupt........ Read more »

  • July 29, 2016
  • 11:22 AM

Elite Cyclists and Brain Fatigue Resistance

by William Yates, M.D. in Brain Posts

In a Brain Post from 2012 I reviewed a study of fatigue in elite athletic performance. This study supported a key role in the brain insula in regulating the perception of exercise-induced fatigue. You can access this post by clicking HERE.An update on this topic was recently published in PloS One by a research team in Australia.This study compared performance on a cognitive task after extreme 20 minute cycling time trial. Professional cyclists were compared to recreational cyclists on the Stroop........ Read more »

Martin K, Staiano W, Menaspà P, Hennessey T, Marcora S, Keegan R, Thompson KG, Martin D, Halson S, & Rattray B. (2016) Superior Inhibitory Control and Resistance to Mental Fatigue in Professional Road Cyclists. PloS one, 11(7). PMID: 27441380  

  • July 12, 2016
  • 11:36 AM

Dextromethorphan for Alzheimer's Disease Agitation

by William Yates, M.D. in Brain Posts

In my last post I summarized a review of the pharmacology of the drug dextromethorphan.This drug is receiving significant attention for disorders in neuroscience medicine. A phase 2 clinical trial of dextromethorphan-quinidine (DM-Q) was published last fall in JAMA.Here are the key design and results from this study:Subjects: 220 subjects with a diagnosis of probable Alzheimer's disease with clinically significant agitation.Randomization Design: This was a five week trial of 3:4 random........ Read more »

Cummings JL, Lyketsos CG, Peskind ER, Porsteinsson AP, Mintzer JE, Scharre DW, De La Gandara JE, Agronin M, Davis CS, Nguyen U.... (2015) Effect of Dextromethorphan-Quinidine on Agitation in Patients With Alzheimer Disease Dementia: A Randomized Clinical Trial. JAMA, 314(12), 1242-54. PMID: 26393847  

  • July 11, 2016
  • 11:41 AM

When Laughing Isn't Funny

by William Yates, M.D. in Brain Posts

Inappropriate uncontrollable laughing or crying is common in many neuroscience medicine disorders including after traumatic brain injury or stroke. It can be socially embarrassing and restrict opportunities for social interaction.This loss of control over emotional responses is known by the term pseudobulbar affect or PBA. Until recently, few therapeutic options were available to treat this condition. Now a relatively new drug Nuedexta uses a combination of dextromethorphan and quinide to treat ........ Read more »

  • June 14, 2016
  • 12:18 PM

Nurturing the Gifted

by William Yates, M.D. in Brain Posts

My photo of Mozart No one denies the importance of public education. Raising graduation rates and academic ability in the general population are highly accepted education system goals. Additionally, identification of learning disorders and the barriers to academic progress are the focus of many.However, the study of the gifted is perhaps no less important but this topic receives less attention and research.Matthew Makel and colleagues at Duke University and Vanderbi........ Read more »

Kell HJ, Lubinski D, Benbow CP, & Steiger JH. (2013) Creativity and technical innovation: spatial ability's unique role. Psychological science, 24(9), 1831-6. PMID: 23846718  

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