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Physician, Writer and Bird Photographer. Translating Neuroscience Research Into Better Care for Brain Disorders.
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by William Yates, M.D. in Brain Posts
Parents of children with autism and autism spectrum disorder commonly report sleep problems in their child.However, there have been few prospective systematic studies of sleep in this disorder.Joanna Humphreys from Canada and colleagues from England recently published an important manuscript addressing this topic.They used data from the Avon Longitudinal Study of Parents and Children. This data set includes prospective data collected from a cohort of over 14,000 children born between April 1991 ........ Read more »
Humphreys JS, Gringras P, Blair PS, Scott N, Henderson J, Fleming PJ, & Emond AM. (2014) Sleep patterns in children with autistic spectrum disorders: a prospective cohort study. Archives of disease in childhood, 99(2), 114-8. PMID: 24061777
by William Yates, M.D. in Brain Posts
Chronic primary insomnia is a sleep disorder characterized by delayed sleep onset, reduced total sleep duration and fatigue on morning awakening.In addition, by definition chronic primary insomnia cannot be due to a primary medical or psychiatric disorder. Some patients with chronic primary insomnia also demonstrate subjective and objective impairment in concentration and memory.Eun Yeon Joo and colleagues from South Korea recently published an analysis of brain structural features in 27 su........ Read more »
Joo EY, Noh HJ, Kim JS, Koo DL, Kim D, Hwang KJ, Kim JY, Kim ST, Kim MR, & Hong SB. (2013) Brain Gray Matter Deficits in Patients with Chronic Primary Insomnia. Sleep, 36(7), 999-1007. PMID: 23814336
by William Yates, M.D. in Brain Posts
This is the second in series of posts examining recent research in sleep and the brain.Rapid eye movement (REM) sleep behavior disorder is a complex sleep problem seen primarily in older adults.REM, or dream sleep, typically occurs with atonia. Atonia is the temporary state of muscle paralysis. This prohibits muscular activity or acting out during dream states.With REM sleep behavior disorder, atonia is not present with REM sleep resulting in motor restlessness, agitation and occasio........ Read more »
Iranzo A, Fernández-Arcos A, Tolosa E, Serradell M, Molinuevo JL, Valldeoriola F, Gelpi E, Vilaseca I, Sánchez-Valle R, Lladó A.... (2014) Neurodegenerative Disorder Risk in Idiopathic REM Sleep Behavior Disorder: Study in 174 Patients. PloS one, 9(2). PMID: 24587002
by William Yates, M.D. in Brain Posts
This month I will be focusing on sleep and the brain. The importance of sleep to normal and abnormal brain functioning is receiving increased research attention.A variety of sleep abnormalities have been described in major depression and bipolar affective disorder. Depression has been linked to delayed sleep onset, reduced time to first rapid eye movement (REM) period, reduced sleep efficiency and disruption of the circadian rhythm of sleep.Sleep physiology also varies throughout the lifesp........ Read more »
Robillard, R., Naismith, S., Smith, K., Rogers, N., White, D., Terpening, Z., Ip, T., Hermens, D., Whitwell, B., Scott, E.... (2014) Sleep-Wake Cycle in Young and Older Persons with a Lifetime History of Mood Disorders. PLoS ONE, 9(2). DOI: 10.1371/journal.pone.0087763
by William Yates, M.D. in Brain Posts
Individuals with schizophrenia or bipolar disorder are at higher risk for obesity.This risk may be related to physical inactivity, diet or the weight gain commonly associated with psychotropic drug use.Few clinical trials for weight loss have targeted individuals with serious mental illness (SMI). This population may pose specific challenges in recruitment, adherence and outcome.Gail Daumit and colleagues recently published a randomized clinical trial of behavioral weight loss in a cohort with S........ Read more »
Daumit GL, Dickerson FB, Wang NY, Dalcin A, Jerome GJ, Anderson CA, Young DR, Frick KD, Yu A, Gennusa JV 3rd.... (2013) A behavioral weight-loss intervention in persons with serious mental illness. The New England journal of medicine, 368(17), 1594-602. PMID: 23517118
by William Yates, M.D. in Brain Posts
I have previously examined outcomes for MRI changes known as brain white matter hyperintensities (WMHI).WMHIs are noted in a minority of adults and are not completely understood. The changes are considered subclinical in nature, meaning they do not reach a threshold for medical significance.However, these subclinical WMHI are linked to higher rates of premature cognitive decline. Absence of WMHI is seen by some as one marker of brain health.Jyrki Virtanen and colleagues from Finl........ Read more »
Virtanen JK, Siscovick DS, Lemaitre RN, Longstreth WT, Spiegelman D, Rimm EB, King IB, & Mozaffarian D. (2013) Circulating omega-3 polyunsaturated fatty acids and subclinical brain abnormalities on MRI in older adults: the Cardiovascular Health Study. Journal of the American Heart Association, 2(5). PMID: 24113325
by William Yates, M.D. in Brain Posts
Exercise appears to be therapeutic in treatment of a variety of medical conditions.However, the relative magnitude of the effect of exercise is less well documented. Comparing the magnitude of the therapeutic effect of exercise with that of common drug interventions can be quite informative.Such comparisons provide insight into the relative value of exercise and the role of exercise in comprehensive treatment planning.Huseyin Naci and John Ioannidis recently published a study of the compara........ Read more »
Naci H, & Ioannidis JP. (2013) Comparative effectiveness of exercise and drug interventions on mortality outcomes: metaepidemiological study. BMJ (Clinical research ed.). PMID: 24473061
by William Yates, M.D. in Brain Posts
This month I have been reviewing recent research on the effects of exercise on the brain.Exercise appears to have both acute and chronic effects on brain physiology and function. Newer imaging techniques provide sensitive tools to study exercise and the brain.Bradley Macintosh and colleagues recently paired an aerobic exercise task with measurements of cerebral blood flow and blood oxygen utilization.The key elements of the design of their experiment included the following elements:Subjects........ Read more »
Macintosh BJ, Crane DE, Sage MD, Rajab AS, Donahue MJ, McIlroy WE, & Middleton LE. (2014) Impact of a single bout of aerobic exercise on regional brain perfusion and activation responses in healthy young adults. PloS one, 9(1). PMID: 24416356
by William Yates, M.D. in Brain Posts
This is the fifth in a series of articles examining research findings on exercise and the brain.Type 2 diabetes and obesity can contribute to risk for early cognitive decline and dementia.Strategies that reduce risk of Type 2 diabetes may indirectly contribute to brain health.Aerobic exercise and weight loss are known to reduce Type 2 diabetes risk.However, the role of weight training on diabetes risk is less clear.A recent study has shed some light on the potential role for weight training........ Read more »
Grøntved A, Pan A, Mekary RA, Stampfer M, Willett WC, Manson JE, & Hu FB. (2014) Muscle-Strengthening and Conditioning Activities and Risk of Type 2 Diabetes: A Prospective Study in Two Cohorts of US Women. PLoS medicine, 11(1). PMID: 24453948
by William Yates, M.D. in Brain Posts
The beneficial effects of exercise on the brain has received significant research attention in children and older adults.Fewer research studies target young and middle aged adults.William Killgore and colleagues recently addressed this population in a study published in Scientific Reports.They preformed a cross-sectional correlation study of brain structure and self-reported exercise habits.Sixty one men and women between the ages of 18 and 45 years of age were recruited for the study.Subjects w........ Read more »
Killgore WD, Olson EA, & Weber M. (2013) Physical exercise habits correlate with gray matter volume of the hippocampus in healthy adult humans. Scientific reports, 3457. PMID: 24336512
by William Yates, M.D. in Brain Posts
Current drug treatments for cognitive impairment and dementia show limited effectiveness.Alternative adjunctive treatments in those with early cognitive impairment are needed.In a previous post, I outlined a review of what we know about exercise and cognition in elderly populations.An additional study is relevant to this topic and important.Takao Suzuki and colleagues in Japan conducted a randomized controlled trial of multicomponent exercise in older adults with evidence of mild cognitive impai........ Read more »
Suzuki T, Shimada H, Makizako H, Doi T, Yoshida D, Ito K, Shimokata H, Washimi Y, Endo H, & Kato T. (2013) A randomized controlled trial of multicomponent exercise in older adults with mild cognitive impairment. PloS one, 8(4). PMID: 23585901
by William Yates, M.D. in Brain Posts
Over the next month, I will be focusing on the effects of exercise on the brain.This topic is important for several reasons. Exercise appears to play a preventive role in the effects of brain aging in normal adults.Exercise may aid in the slowing of progression of brain disorders such as Alzheimer's disease and Parkinson's disease.Exercise is a promising adjunct to treatment of a variety of other brain disorders including depression and anxiety disorder.For this post, I want to highlight wh........ Read more »
Erickson KI, Gildengers AG, & Butters MA. (2013) Physical activity and brain plasticity in late adulthood. Dialogues in clinical neuroscience, 15(1), 99-108. PMID: 23576893
by William Yates, M.D. in Brain Posts
One of the potential advances in diabetes management is modulation of the vagus nerve.The vagus nerve appears to influence a variety of physiological factors related to calorie intake, metabolism and blood glucose control.Severing the vagus nerve (vagotomy) results in weight loss and increased satiety but can cause gastric retention.An implantable device that can intermittently block vagal nerves may provide favorable metabolic modulation without the adverse effects of vagotomy.An initial study ........ Read more »
Shikora S, Toouli J, Herrera MF, Kulseng B, Zulewski H, Brancatisano R, Kow L, Pantoja JP, Johnsen G, Brancatisano A.... (2013) Vagal blocking improves glycemic control and elevated blood pressure in obese subjects with type 2 diabetes mellitus. Journal of obesity, 245683. PMID: 23984050
Sarr MG, Billington CJ, Brancatisano R, Brancatisano A, Toouli J, Kow L, Nguyen NT, Blackstone R, Maher JW, Shikora S.... (2012) The EMPOWER study: randomized, prospective, double-blind, multicenter trial of vagal blockade to induce weight loss in morbid obesity. Obesity surgery, 22(11), 1771-82. PMID: 22956251
by William Yates, M.D. in Brain Posts
I have previously commented on the alternate day fasting diet for weight loss. Studies have generally supported this strategy. Alternate day fasting restricts caloric intake to an evening meal of 25% of caloric needs every other day.On non-fasting days, dieters are encouraged to eat a typical diet without restriction.A recent randomized controlled trial of alternate day fasting has been published in Nutrition Journal.Krista Varady and colleagues from the University of Illinois designe........ Read more »
Varady KA, Bhutani S, Klempel MC, Kroeger CM, Trepanowski JF, Haus JM, Hoddy KK, & Calvo Y. (2013) Alternate day fasting for weight loss in normal weight and overweight subjects: a randomized controlled trial. Nutrition journal, 12(1), 146. PMID: 24215592
by William Yates, M.D. in Brain Posts
Obesity is a risk factor for obstructive sleep apnea. Use of a positive airway pressure (PAP) device is the standard treatment for sleep apnea.However, PAP commonly is only moderately effective in reducing sleep disruption and day time fatigue. A significant number of individuals fail to use their PAP devices due to inconvenience or mask problems.Weight loss alone can improve sleep in those developing sleep apnea. Winslow and colleagues at the Kentucky Research conducted a randomi........ Read more »
Winslow DH, Bowden CH, DiDonato KP, & McCullough PA. (2012) A randomized, double-blind, placebo-controlled study of an oral, extended-release formulation of phentermine/topiramate for the treatment of obstructive sleep apnea in obese adults. Sleep, 35(11), 1529-39. PMID: 23115402
by William Yates, M.D. in Brain Posts
In keeping with this month's theme of obesity, the brain and weight loss I want to look at some clinical trial research.Brain Posts does not endorse any type of diet or weight loss pills or substances. Personal dietary and obesity medication use choices need to be made with a qualified health professional.However, I do post some dietary research that I find interesting. I have previously posted summaries of research related to the Mediterranean diet and beneficial cognitive and cardiovascular ef........ Read more »
Paoli A, Bianco A, Grimaldi KA, Lodi A, & Bosco G. (2013) Long term successful weight loss with a combination biphasic ketogenic mediterranean diet and mediterranean diet maintenance protocol. Nutrients, 5(12), 5205-17. PMID: 24352095
by William Yates, M.D. in Brain Posts
Weight loss with aerobic physical activity does not correspond to a one-to-one relationship.For example if you started to burn 500 calories per day on a seven day per week basis, you might expect to lose one pound per week (3500 calories = one pound).But this is not the case. In a previous post, weight loss does occur with starting a physical exercise program but may be only 10-20% efficient over time.One way the body blocks exercise-induced weight loss is via adjustment in what is known as the ........ Read more »
Bonomi AG, Soenen S, Goris AH, & Westerterp KR. (2013) Weight-loss induced changes in physical activity and activity energy expenditure in overweight and obese subjects before and after energy restriction. PloS one, 8(3). PMID: 23555733
by William Yates, M.D. in Brain Posts
Exercise alone without dieting appears to have a limited effect on weight loss.However, even small amounts of weight loss can lead to improved health and reduction of risk for diabetes and other obesity-related disorders.A recent study examined the effect of a supervised aerobic exercise activity on weight loss.Joseph Donnelly along with colleagues from the University of Kansas recently published their results on weight with exercise.This trial comes from the study known as the Midwest Exercise ........ Read more »
Donnelly JE, Honas JJ, Smith BK, Mayo MS, Gibson CA, Sullivan DK, Lee J, Herrmann SD, Lambourne K, & Washburn RA. (2013) Aerobic exercise alone results in clinically significant weight loss for men and women: midwest exercise trial 2. Obesity (Silver Spring, Md.), 21(3). PMID: 23592678
by William Yates, M.D. in Brain Posts
I have reviewed some research evidence documenting the adverse effect of obesity on cognition.Dementia rates do appear increased in obese populations but the mechanism and issue of causality is unclear.If there is a direct effect of obesity on brain function, one might expect weight loss to improve cognition.There have been a series of papers examining changes in cognition following bariatric weight loss surgery using the Longitudinal Assessment of Bariatric Surgery study.At baseline, about one ........ Read more »
Gunstad J, Strain G, Devlin MJ, Wing R, Cohen RA, Paul RH, Crosby RD, & Mitchell JE. (2011) Improved memory function 12 weeks after bariatric surgery. Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery, 7(4), 465-72. PMID: 21145295
Alosco ML, Galioto R, Spitznagel MB, Strain G, Devlin M, Cohen R, Crosby RD, Mitchell JE, & Gunstad J. (2013) Cognitive function after bariatric surgery: evidence for improvement 3 years after surgery. American journal of surgery. PMID: 24119892
by William Yates, M.D. in Brain Posts
I want to start 2014 out with a focus on diet, obesity and cognitive health. I will be reviewing some recent randomized controlled trials for weight loss.However, before looking a weight loss, I wanted to frame the discussion with an overview of what is known about the general population trend for increased obesity in the context of longer mean length of life.Roger Fielding and colleagues recently published an excellent review of this issue in a manuscript entitled "The Paradox of Overnutrition ........ Read more »
Fielding RA, Gunstad J, Gustafson DR, Heymsfield SB, Kral JG, Launer LJ, Penninger J, Phillips DI, & Scarmeas N. (2013) The paradox of overnutrition in aging and cognition. Annals of the New York Academy of Sciences, 31-43. PMID: 23682739
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