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  • December 18, 2014
  • 02:35 PM

Gene fragments linked to brain development and autism

by Dr. Jekyll in Lunatic Laboratories

While the anti-vaccine movement enjoys the simple (and very wrong) answer to the cause of autism, there are people who want the actual truth. This drive had lead to a slew of causes (and risk factors) for autism in recent times. Now scientists have found that very small segments of genes called “microexons” influence how proteins interact with each other in the nervous system. In turn, this opens up a new line of research into the cause of autism.... Read more »

Irimia, M., Weatheritt, R., Ellis, J., Parikshak, N., Gonatopoulos-Pournatzis, T., Babor, M., Quesnel-Vallières, M., Tapial, J., Raj, B., O’Hanlon, D.... (2014) A Highly Conserved Program of Neuronal Microexons Is Misregulated in Autistic Brains. Cell, 159(7), 1511-1523. DOI: 10.1016/j.cell.2014.11.035  

  • December 18, 2014
  • 05:08 AM

Autistic traits in adults with epilepsy

by Paul Whiteley in Questioning Answers

"Increased autistic characteristics found in adults with epilepsy without an ASD [autism spectrum disorder] diagnosis suggest that epilepsy syndromes may incorporate behavioral aspects of autism in the absence of some of its core cognitive features."Contrariwise, if you think we're alive you ought to speak to us.That was the intriguing finding reported by Sally Ann Wakeford and colleagues [1] who examined test performance on the Autism Spectrum Quotient (AQ) and "systemizing and empathizing abilities" in a small-ish sample of adults with epilepsy compared with those without epilepsy. They found that: "Significantly more autistic behavioral traits, as measured by the AQ, were related to having epilepsy" but those systemising (UK spelling) and empathising abilities did not differ between the groups. The AQ, as I've indicated in previous posts, is a self-report measure and not necessarily autism-specific in terms of the features being described, so one has to be slightly cautious from this angle. But please don't let that detract from the interesting suggestion being reported...Autism and epilepsy is an association which goes back quite a few years. Not only is epilepsy one of the more frequently reported comorbidities suggested to follow at least some diagnoses of autism (see here), epilepsy and autism co-occurring in certain situations, also provides some of the strongest evidence yet that the plural autisms might be a better definition than the catch-all categorisation that we currently use (see here). Dare I even direct you also to the preliminary research talking about joint intervention for autism and epilepsy too?Insofar as the connection between autism and epilepsy, the Wakeford results might also imply that the genetics and biology of autism (some autism) and epilepsy (some epilepsy) might also show some kind of interplay with one and another. From me, this could imply that the research by Ong and colleagues [2] talking about a heightened risk of epilepsy in those with autoimmune disorders (see here for my take), might also extend into autism as per quite the increasing body of peer-reviewed literature talking about autoimmunity and [some] autism.I'm also minded to suggest that despite the lack of a relationship between epilepsy and the core cognitive features of autism, I wouldn't yet rule out more subtle presentation as uniting the two diagnostic concepts [3].Music then... Pharrell Williams - Gust of Wind.----------[1] Wakeford S. et al. Autistic characteristics in adults with epilepsy. Epilepsy Behav. 2014 Oct 30;41C:203-207.[2] Ong MS. et al. Population-level evidence for an autoimmune etiology of epilepsy. JAMA Neurol. 2014 May;71(5):569-74.[3] Kavanaugh BC. et al. Parent-rated emotional–behavioral and executive functioning in childhood epilepsy. Epilepsy & Behavior. 2015; 42: 22-28.----------Wakeford S, Hinvest N, Ring H, & Brosnan M (2014). Autistic characteristics in adults with epilepsy. Epilepsy & behavior : E&B, 41C, 203-207 PMID: 25461216... Read more »

Wakeford S, Hinvest N, Ring H, & Brosnan M. (2014) Autistic characteristics in adults with epilepsy. Epilepsy , 203-207. PMID: 25461216  

  • December 18, 2014
  • 02:44 AM

Correcting Metabolic Abnormalities May Help Lessen Urinary Problems

by Wiley Asia Blog in Wiley Asia Blog - Health Sciences

Metabolic syndrome is linked with an increased frequency and severity of lower urinary tract symptoms, but weight loss surgery may lessen these symptoms. The findings, which come from two studies published in BJU International, indicate that urinary problems may be added to the list of issues that can improve with efforts that address altered metabolism.

Lower urinary tract symptoms related to urinary frequency and urgency, bladder leakage, the need to urinate at night, and incomplete bladder emptying are associated with obesity in both men and women. To see if these symptoms might also be linked with metabolic syndrome (a cluster of abnormalities including hypertension, high cholesterol, high blood glucose levels, and abdominal obesity), François Desgrandchamps, MD, PhD, of Saint-Louis Hospital in France, and his colleagues analyzed information on 4666 male patients aged 55 to 100 years who consulted a general practitioner during a 12-day period in 2009. Metabolic syndrome was reported in 51.5 percent of the patients and 47 percent were treated for lower urinary tract symptoms. There was a significant link between metabolic syndrome and treated lower urinary tract symptoms. The risk to be treated for lower urinary tract symptoms also increased with increasing number of metabolic syndrome components. Also, among individuals with lower urinary tract symptoms, symptoms were more severe in those with metabolic syndrome. “The prevention of such modifiable factors by the promotion of dietary changes and regular physical activity practice may be of great interest for public health,” the authors concluded.... Read more »

  • December 17, 2014
  • 02:54 PM

Epigenetic changes and autism

by Dr. Jekyll in Lunatic Laboratories

Despite what you may think, the supposed “explosion” of children diagnosed with autism can directly attributed to better diagnosing techniques and — more importantly — the change of definition to make Autism spectrum disorders more broad. Thankfully more causes of autism have been found, none of them remotely related to vaccines and now scientists have found that chemical modifications to DNA’s packaging—known as epigenetic changes—can activate or repress genes involved in autism spectrum disorders (ASDs) and early brain development.... Read more »

Gao, Z., Lee, P., Stafford, J., von Schimmelmann, M., Schaefer, A., & Reinberg, D. (2014) An AUTS2–Polycomb complex activates gene expression in the CNS. Nature, 516(7531), 349-354. DOI: 10.1038/nature13921  

Ntziachristos, P., Tsirigos, A., Welstead, G., Trimarchi, T., Bakogianni, S., Xu, L., Loizou, E., Holmfeldt, L., Strikoudis, A., King, B.... (2014) Contrasting roles of histone 3 lysine 27 demethylases in acute lymphoblastic leukaemia. Nature, 514(7523), 513-517. DOI: 10.1038/nature13605  

  • December 17, 2014
  • 02:04 PM

Google Translate not yet ready for medical communications

by Shelly Fan in Neurorexia

Image credits: Communications is key in any relationship, particularly that between patients and doctors.  So what happens when the two parties don’t speak the same...... Read more »

  • December 17, 2014
  • 08:00 AM

Christmas Greenery - Friend Or Foe?

by Mark Lasbury in As Many Exceptions As Rules

Your Christmas tree can kill you, but it can also save your life. The same holds true for mistletoe, ivy, and holly. Each is toxic, but each has uses in medicine. The least toxic Christmas plant is the most often thought of as poisonous – poinsettias really aren’t that bad, kids would have to eat 500 leaves to bring on the nastiest effects.... Read more »

  • December 17, 2014
  • 04:29 AM

Folate receptor autoantibodies and (some) schizophrenia

by Paul Whiteley in Questioning Answers

I am the league's director, Silas Ramsbottom.Upon reading the paper published by Ramaekers and colleagues [1] talking about the use of folinic acid in cases of schizophrenia as a function of the presence of "Auto-antibodies against folate receptor alpha (FRα)", I raised a little smile. Not only because the authors suggested that there may be quite a lot more to see in this area on top of some already interesting discussions about the folate cycle and schizophrenia, but also because of the 'overlap' with some autism findings which have been previously discussed on this blog (see here). Indeed, if readers would like quite a nice summary of this area of investigation - folate receptor autoantibodies - I'm minded to direct them to the paper by Richard Frye and colleagues [2] (open-access) which initially presented the idea of cerebral folate receptor autoantibodies occurring in autism to the world and was the source material for that previous blog post.Quoting from the Ramaekers study text: "Fifteen of 18 patients (83.3%) had positive serum FR auto-antibodies compared to only 1 in 30 controls". This was a study of those described as having "schizophrenia unresponsive to conventional treatment" and alongside the presence of those autoantibodies, researchers also assessed what some of the metabolic knock-on effects might have been in terms of analysis of spinal fluid levels of "MTHF [5,10-Methylenetetrahydrofolate] and the metabolites of pterins, dopamine and serotonin". It appears that FR autoantibodies may indeed affect levels of said compounds alongside "intermediates linked to metabolic processes affecting homocysteine levels... [and] synthesis of tetrahydrobiopterin". Homocysteine and tetrahydrobiopterin (BH4) in schizophrenia y'say?"Administration of folinic acid (0.3-1mg/kg/day) to 7 participating patients during at least six months resulted in clinical improvement." Without wishing to provide any medical or clinical advice on the utility of folinic acid for schizophrenia or anything else, these are interesting findings. This is not the first time that folinic acid has been discussed in the research literature with schizophrenia in mind as per the case report by Wang and colleagues [3]. In that single case, authors described the presence of the MTHFR mutation - "665C>T homozygous mutations in the MTHFR gene" - as the reason for secondary cerebral folate deficiency. Other authors have discussed more pertinent cases [4]. Obviously one would like to see more formal clinical trials on the use of folinic acid as potentially being appropriate for at least some of the [plural] schizophrenias. The important thing to take from the Ramaekers and other studies is that a panel of tests might be able to spot who might be best responders to this kind of intervention...Music to close, and Peter Griffin sings the opening tune to Indiana Jones and The Last Crusade? Why not.----------[1] Ramaekers VT. et al. Folinic acid treatment for schizophrenia associated with folate receptor autoantibodies. Mol Genet Metab. 2014 Oct 12. pii: S1096-7192(14)00311-4.[2] Frye RE. et al. Cerebral folate receptor autoantibodies in autism spectrum disorder. Molecular Psychiatry 2013;18(3):369-381. doi:10.1038/mp.2011.175.[3] Wang Q. et al. Methylenetetrahydrofolate reductase deficiency-induced schizophrenia in a school-age boy. Zhongguo Dang Dai Er Ke Za Zhi. 2014 Jan;16(1):62-6.[4] Ho A. et al. Cerebral folate deficiency presenting as adolescent catatonic schizophrenia: a case report. J Child Neurol. 2010 Jul;25(7):898-900.----------Ramaekers VT, Thöny B, Sequeira JM, Ansseau M, Philippe P, Boemer F, Bours V, & Quadros EV (2014). Folinic acid treatment for schizophrenia associated with folate receptor autoantibodies. Molecular genetics and metabolism PMID: 25456743... Read more »

Ramaekers VT, Thöny B, Sequeira JM, Ansseau M, Philippe P, Boemer F, Bours V, & Quadros EV. (2014) Folinic acid treatment for schizophrenia associated with folate receptor autoantibodies. Molecular genetics and metabolism. PMID: 25456743  

  • December 17, 2014
  • 12:05 AM

Some More Education on Exertional Heat Stroke Could go a Long Way

by Kyle Harris in Sports Medicine Research (SMR): In the Lab & In the Field

While multiple certifications exist for strength and conditioning coaches, both the CSCS and SCCC do not adequately prepare coaches to recognize or prevent exertional heat stroke during high-intensity training sessions.... Read more »

  • December 16, 2014
  • 02:37 PM

Methamphetamine use and the onset of parkinson’s

by Dr. Jekyll in Lunatic Laboratories

We’ve all seen the PSA’s trying to show the effects of meth use and in particular, what it does to your teeth. Typically, when it comes to drug use, people will not look at the long term side effects from their addiction instead thinking in the short term. This is unfortunate because as it turns out, methamphetamine users are three times more at risk for getting Parkinson’s disease than non-illicit drug users with even worse news for women, new research shows.... Read more »

  • December 16, 2014
  • 08:00 AM

Giving, Getting, and Grey Matter

by Mark E. Lasbury in The 'Scope

It’s time to search out Christmas gifts! Let brain research guide you in your giving. We now know why women are often better at picking out gifts, and we know that you expect people to like your homemade gifts more than you should. We have learned that we give gifts to make ourselves feel good, and that too many gifts can screw your kids up for life. But most importantly, it actually is the thought that counts! Merry Christmas.... Read more »

Moll, J., Krueger, F., Zahn, R., Pardini, M., de Oliveira-Souza, R., & Grafman, J. (2006) Human fronto-mesolimbic networks guide decisions about charitable donation. Proceedings of the National Academy of Sciences, 103(42), 15623-15628. DOI: 10.1073/pnas.0604475103  

  • December 16, 2014
  • 04:41 AM

Thioredoxin... a new 'diagnosis indicator' for autism?

by Paul Whiteley in Questioning Answers

My name's Buttercup. You've met Baron von Shush."Our study demonstrated that serum TRX [thioredoxin] levels were associated with ASD [autism spectrum disorder], and elevated levels could be considered as a novel, independent diagnosis indicator of ASD." So was the conclusion reported by Qing-biao Zhang and colleagues [1] looking at serum levels of TRX in 80 children diagnosed with an ASD compared against "100 sex and age matched typically developing children".I'll freely admit that I was not even aware of thioredoxin (TRX) before reading this study; although a quick trawl through some of the research literature on this protein that "act as antioxidants by facilitating the reduction of other proteins by cysteine thiol-disulfide exchange" (thank you Wikipedia) hints that I should have been. Quite a good [peer-reviewed] overview of TRX can be found in the paper by Arnér & Holmgren [2] and in particular, describing their role in the process of reducing oxidative stress similar to another compound of interest to this blog: glutathione.Zhang and colleagues reported significantly higher median serum levels of TRX in their participants with autism compared to asymptomatic controls. Further, that the severity of autism  - as measured using the CARS - might also be linked to TRX levels, and "the optimal cut-off value of serum TRX levels as an indicator for auxiliary diagnosis of autism was projected to be 10.6ng/ml". I might add that such results should not be translated as serum levels of TRX higher than 10.6 ng/ml = autism exclusively, as per other research looking at elevated levels of TRX in other conditions [3].This is not the first time however that TRX has been studied with autism in mind. The paper by Yusra A Al-Yafee and colleagues [4] (open-access) looking at "sulfur-dependent detoxification mechanisms" in relation to the autism spectrum noted that alongside aberrant values for glutathione (yes, quite consistently so) in their autistic cohort, elevated levels of TRX and related thioredoxin reductase (TrxR) were also detected compared with controls. They stated: "the recorded raised levels of Trx, TrxR and Prxs [peroxidoxins] of the present study could be related to... previous work... which they proved that Saudi autistic children are under H2O2 stress due to over expression of SOD and a slightly lower activity of catalase." Interestingly, this group also suggested that TRX and glutathione parameters might also have some legs when it comes to their usefulness "as diagnostic biomarkers of autism."Oxidative stress and autism is a research area in the ascendancy. With links being made to the gastrointestinal (GI) issues quite commonly reported alongside a diagnosis of autism (see here) and some really quite interesting work talking about oxidative stress potentially inducing mitochondrial issues in autism (see here), some important correlations are being made. My recent discussions including the paper by Main and colleagues [5] (open-access) suggesting that: "children with autism are more sensitive to necrosis caused by oxidative and nitrosative stress than their non-autistic siblings" adds to the intrigue, as does a little study about broccoli extracts recently...Of course, quite a lot more replicative work is required, also including more focus on the hows and whys of issues with redox regulation related to autism. But more and more, oxidative stress is taking a place among quite a few other issues detected in at least some cases of autism [6].Music to close: Queenie Eye by Paul McCartney.----------[1] Zhang QB. et al. Thioredoxin: A novel, independent diagnosis marker in children with autism. Int J Dev Neurosci. 2014 Nov 26. pii: S0736-5748(14)00191-9.[2] Arnér ES. & Holmgren A. Physiological functions of thioredoxin and thioredoxin reductase. Eur J Biochem. 2000 Oct;267(20):6102-9.[3] Yamada Y. et al. Elevated serum levels of thioredoxin in patients with acute exacerbation of asthma. Immunol Lett. 2003 Apr 3;86(2):199-205.[4] Al-Yafee YA. et al. Novel metabolic biomarkers related to sulfur-dependent detoxification pathways in autistic patients of Saudi Arabia. BMC Neurol. 2011 Nov 4;11:139.[5] Main PA. et al. Necrosis is increased in lymphoblastoid cell lines from children with autism compared with their non-autistic siblings under conditions of oxidative and nitrosative stress. Mutagenesis. 2013 Jul;28(4):475-84.[6] Rossignol DA, Frye RE. Evidence linking oxidative stress, mitochondrial dysfunction, and inflammation in the brain of individuals with autism. Frontiers in Physiology 2014;5:150. doi:10.3389/fphys.2014.00150.----------Zhang QB, Gao SJ, & Zhao HX (2014). Thioredoxin: A novel, independent diagnosis marker in children with autism. International journal of developmental neuroscience : the official journal of the International Society for Developmental Neuroscience PMID: 25433158... Read more »

Zhang QB, Gao SJ, & Zhao HX. (2014) Thioredoxin: A novel, independent diagnosis marker in children with autism. International journal of developmental neuroscience : the official journal of the International Society for Developmental Neuroscience. PMID: 25433158  

  • December 15, 2014
  • 03:07 PM

Finding the neurons that deal with distraction

by Dr. Jekyll in Lunatic Laboratories

What’s that over there!? The next time you are around people, count how many people are on their phone? Distractions invade every aspect of our lives. Status updates, text messages, email notifications all threaten to steal our attention away from the moment. While we fight the urge to check the phone, our brains are making constant judgment calls about where to focus attention. The brain must continually filter important information from irrelevant interference.... Read more »

Ahrens, S., Jaramillo, S., Yu, K., Ghosh, S., Hwang, G., Paik, R., Lai, C., He, M., Huang, Z., & Li, B. (2014) ErbB4 regulation of a thalamic reticular nucleus circuit for sensory selection. Nature Neuroscience. DOI: 10.1038/nn.3897  

  • December 15, 2014
  • 08:42 AM

Who is Getting High in Europe (and Where)?

by William Yates, M.D. in Brain Posts

My research training is in psychiatric epidemiology. Alcohol and drug dependence have been two of my topic areas of research.So I found a recent novel study of the epidemiology of illicit drug use in Europe intriguing.Typical methods of looking for the prevalence of drug use in populations are direct diagnostic interviews and studies of emergency room attendees or autopsy cases with medical complications of drug use.However, Christopher Ort from Switzerland along with a host of European colleagues took an interesting approach to studying illicit drug use in European populations.They conducted population wastewater illicit drug concentration analyses using liquid chromatography. They examined changes in illicit drug concentrations over time and across a number of cities and regions in Europe.This approach is slightly messy (pun intended) but logically follows a reasonable argument: high illicit drug concentrations in waste water reflects high drug use in the population producing the waste.Their full text manuscript can be accessed by clicking on the PMID link below. But for the few lazy readers of my blog here are the five highest ranked European cities by the five illicit drug classes. This list is produced by me through the precise method known as "eyeballing" from charts in the manuscript. Countries are listed after municipalities where waste water was sampled when city first makes a list.CannabisAmsterdam, NetherlandsParis, FranceNovisad, SerbiaAntwerp, BelgiumUtrecht, NetherlandsAmphetaminesEindhoven, NetherlandsAntwerpGothenburg, SwedenNinove, BelgiumHelsinki, FinlandMethamphetaminePrague, Czech RepublicBudweis, Czech RepublicOslo, NorwayBratislava, SlovakiaDresden, GermanyCocaineAntwerpLondon, EnglandZurich, SwitzerlandAmsterdamBarcelona, SpainMDMA (Ecstasy)EindhovenUtrechtAmsterdamAntwerpZurich/Barcelona (Eyeball tie)The authors note their findings for the prevalence of illicit drugs in wastewater generally match regional prevalence estimates for drug use using other methods.They note wastewater samples can be done by day of the week to follow chronological patterns of drug use (no surprise levels of drugs in wastewater samples are higher on the weekend). Additionally, this approach may be a valuable secondary source of trends in regional drug use over longer periods such as years.  I found the differences in metabolite rankings for amphetamine versus methamphetamine interesting. The methamphetamine rank list is made up of more cities with lower per capita incomes. This suggests possible local production of methamphetamine while amphetamine is more likely diverted from pharmaceutical grade manufacture.This study did not include samples from the U.S., South America, Japan, China or Russia so it only reflects the cities listed in the methods section of the paper. Again, click on the citation PMID link below if you are interested in getting into more detail of this study. I would be interested in any comments from readers in Europe on whether these results seem valid.Image is from a Wikipedia Commons file showing tablets of ecstasy (MDMA) from a public domain file produced by the U.S. DEA.Follow the author on Twitter WRY999Ort C, van Nuijs AL, Berset JD, Bijlsma L, Castiglioni S,... Read more »

Ort C, van Nuijs AL, Berset JD, Bijlsma L, Castiglioni S, Covaci A, de Voogt P, Emke E, Fatta-Kassinos D, Griffiths P.... (2014) Spatial differences and temporal changes in illicit drug use in Europe quantified by wastewater analysis. Addiction (Abingdon, England), 109(8), 1338-52. PMID: 24861844  

  • December 15, 2014
  • 04:45 AM

Rates of medical illnesses in bipolar disorder

by Paul Whiteley in Questioning Answers

I've mentioned a few times on this blog that a diagnosis of autism or autism spectrum disorder (ASD) is by no means protective against any other diagnosis being received, be it based on a somatic illness or condition, or something more behaviourally defined.Reading through the paper by Liz Forty and colleagues [1] (open-access) it appears that a similar scenario might also pertain to other behaviourally-defined conditions as per the example of bipolar disorder (BD) and their conclusion: "Bipolar disorder is associated with high rates of medical illness."If I had a world of my own, everything would be nonsenseI was drawn to discuss this paper for a few reasons. First and foremost is the idea that a psychiatric diagnosis may actually place a person 'at risk' of a few important comorbidities above and beyond the presentation of their behavioural symptoms. We seem to be in an unfortunate situation these days that receipt of a psychiatric diagnosis seems to lead to a severe lack of appreciation that other symptoms or ailments of a more physical nature can also be present. Take for example the health inequalities which seem to be springing up as and when a diagnosis of schizophrenia is received (see here) and coincidentally in the same journal as the Forty paper, the study results from Mike Crawford and colleagues [2] concluding: "Assessment and treatment of common physical health problems in people with schizophrenia falls well below acceptable standards." Another reason I want to talk about the Forty paper is the fact that bipolar disorder (previously referred to as manic depression) has been described as occurring 'quite frequently' with regards to at least one part of the autism spectrum (see here). What this might suggest is that a co-occurrence of BD and something like Asperger syndrome might mean that said medical illness/conditions reported to be raised in BD would also be raised in BP + Asperger syndrome.The Forty paper is open-access but a few pointers might be useful...Based on quite an impressive participant number (N=1720) diagnosed with bipolar disorder, lifetime rates of self-reported medical illnesses were compared with data derived from participants diagnosed with unipolar depression (N=1737) and asymptomatic controls (N=1340) (both previously described in other work from some of the authors [3]).Participants were quizzed - yes, no or uncertain - over whether any of 20 health conditions had been diagnosed by a health professional including: "asthma, cancer, diabetes type 1, diabetes type 2, elevated lipids/high cholesterol, epilepsy, gastric ulcers, heart disease, hypertension, kidney disease, liver disease, memory loss/dementia, migraine headaches, multiple sclerosis, osteoarthritis, osteoporosis, Parkinson’s disease, rheumatoid arthritis, stroke, thyroid disease." All the 'uncertain' codings were "excluded from analyses for that medical illness".Results: "The most prevalent medical conditions in the bipolar sample were migraine headache (23.7%), asthma (19.2%), elevated lipids (19.2%), hypertension (15%), thyroid disease (12.9%) and osteoarthritis (10.8%)." Quite a few of these conditions were significantly more frequently reported in cases of BD over control groups (see Figure 1 here). I'll in particular highlight the findings for asthma and thyroid disease as being more commonly reported in the BD group.Authors also divided the BD group up into subgroups (BD1 and BD2) based on the severity of manic episodes, and reported that: "The rates of gastric ulcers, heart disease, Parkinson’s disease and rheumatoid arthritis were significantly higher in the bipolar II group." They also found that several variables seemed to be linked to an increased medical illness burden including: "a longer illness duration, a typically acute onset of mood episodes, a greater number of psychiatric in-patient admissions, deterioration in functioning, increased rates of anxiety disorder, suicide attempt, rapid cycling, and treatment with anxiolytics, mood stabilisers and electroconvulsive therapy (ECT)." Some of these variables also predicted the high medical illness burden group too.Reiterating the authors' sentiments about the need for such medical comorbidity to be taken into account by healthcare professionals "in order to improve outcomes for patients with bipolar disorder" these are important results. Assuming that there may be shared/overlapping genetic or biological mechanisms at work which influence risk of BD and also such medical comorbidity, one might think that future work would take this into account when looking at the possible underlying aetiology of BD. Such work might also accept the heterogeneity noted in BD as per similar sentiments when it comes to conditions like 'the autisms' (see here) and 'the schizophrenias' (see here).Asthma has been highlighted from the Forty results on the basis of the condition already showing something of an interesting 'link' with conditions like autism and attention-deficit hyperactivity disorder, ADHD (see here). Indeed, data from Taiwan (yes, further interrogation of the Taiwan National Health Insurance Research Database) concluded that a diagnosis of asthma might increase the risk of subsequent mood disorders (including BD) later in life [4]. Forty et al suggested that of the possible reasons why asthma might be more frequently present in BD "carbon dioxide hypersensitivity and corticosteroid therapy may partly explain this association." I'd be perhaps inclined to add that other [speculative] work looking at the link between autism and asthma for example, might also offer another potential explanation [5].Thyroid disease was also plucked out from the Forty data. The reason: some interesting data previously covered on this blog talking about autoimmune thyroiditis and various types of depression (see here). I'm not by the way saying that every case of thyroid disease in BD is due to such an autoimmune pathology, but as per other discussions, there might be quite a bit more to see when it comes to immune system function and behavioural and/or psychiatric diagnoses. At the very least, testing for said autoimmune issues might be considered for some.There is little more for me to say on this subject matter. This is by no means the first time that medical comorbidity has been linked to BD [6] and even more widely depression [7] and I very much doubt it will be the last. If there are lessons to be learned from this area of investigation, the primary one must be to look at mind and body when it comes to diagnosing and managing psychiatric issues such as bipolar disorder as per other examples.Oh, and I wonder if this would be a good time to introduce ... Read more »

Forty L, Ulanova A, Jones L, Jones I, Gordon-Smith K, Fraser C, Farmer A, McGuffin P, Lewis CM, Hosang GM.... (2014) Comorbid medical illness in bipolar disorder. The British journal of psychiatry : the journal of mental science. PMID: 25359927  

  • December 15, 2014
  • 02:31 AM

Treatment for Elderly with Breast Cancer May Not Be as Effective

by Wiley Asia Blog in Wiley Asia Blog - Health Sciences

A new analysis has found that while clinical trial data support omitting radiation treatments in elderly women with early stage breast cancer, nearly two-thirds of these women continue to receive it. The findings are published early online in CANCER, a peer-reviewed journal of the American Cancer Society.

Results published in 2004 from a large, randomized clinical trial showed that adding radiation therapy to surgery plus tamoxifen does not reduce 5-year recurrence rates or prolong survival in elderly women with early stage tumors. Despite the findings, many doctors still administer radiation to these patients.... Read more »

  • December 15, 2014
  • 12:05 AM

Returning to play in the same season following a traumatic shoulder dislocation or subluxation. Is it worth the risk?

by Catherine E. Lewis and Adam B. Rosen, PhD, ATC in Sports Medicine Research (SMR): In the Lab & In the Field

Returning the same season from a traumatic anterior shoulder dislocation or subluxation likely results in additional episodes of instability even after undergoing a strengthening and stability protocol. Self-report questionnaires immediately after initial injury may be useful in determining a return to play timeline.... Read more »

Dickens, J., Owens, B., Cameron, K., Kilcoyne, K., Allred, C., Svoboda, S., Sullivan, R., Tokish, J., Peck, K., & Rue, J. (2014) Return to Play and Recurrent Instability After In-Season Anterior Shoulder Instability: A Prospective Multicenter Study. The American Journal of Sports Medicine, 42(12), 2842-2850. DOI: 10.1177/0363546514553181  

  • December 14, 2014
  • 01:28 PM

Scientists find a drug (currently used) to turn white fat to brown

by Dr. Jekyll in Lunatic Laboratories

It seems like we’ve been on a weight loss campaign here at the labs, but there just has been so much new and interesting research on the subject to report on, this is no exception. Researchers have uncovered the mechanism by which white fat cells from humans (an important distinction) gets reprogrammed to become browner.... Read more »

Anne Loft, Isabel Forss, Majken Storm Siersbæk, Søren Fisker Schmidt, Ann-Sofie Bøgh Larsen, Jesper Grud Skat Madsen, Didier F. Pisani, Ronni Nielsen, Mads Malik Aagaard, Angela Mathison.... (2014) Browning of human adipocytes requires KLF11 and reprogramming of PPARγ superenhancers. Genes . info:/10.1101/gad.250829.114

  • December 14, 2014
  • 07:57 AM

Increasing Rigor in Huntington’s Disease Research

by Neuroskeptic in Neuroskeptic_Discover

The CHDI Foundation, a charitable organization who fund a lot of research into Huntington's disease, are interested in reforming the scientific process.

The story comes from a paper written by British neuroscientist Marcus Munafo and colleagues (the authors including CHDI staff) published in Nature Biotechnology a couple of months ago: Scientific rigor and the art of motorcycle maintenance.

Munafo et al. begin by pointing to the history of car manufacturing as an analogy for the scie... Read more »

Munafo M, Noble S, Browne WJ, Brunner D, Button K, Ferreira J, Holmans P, Langbehn D, Lewis G, Lindquist M.... (2014) Scientific rigor and the art of motorcycle maintenance. Nature Biotechnology, 32(9), 871-3. PMID: 25203032  

  • December 14, 2014
  • 04:48 AM

Beware the inflated science related press release!

by Paul Whiteley in Questioning Answers

I'm not normally minded to post on a Sunday (day of rest and all that) but I did want to bring your attention to the results presented by Petroc Sumner and colleagues [1] (open-access) concluding that: "Exaggeration in news is strongly associated with exaggeration in press releases" when it comes to the media reporting of [some] health-related science news.The idea behind this particular study - which has been summarised pretty well in some of the accompanying media and in an editorial in the publishing journal [2] - was to look at the contribution of the press release (the 'look at me' part of some science publishing) to those sometimes 'inflated' health science headlines which we all encounter on a day-to-day basis. The results suggested that whilst [some] journalists and editors might need a refresher course on some of the basics of science (including the concept of probability and risk), academic press offices and even the very academics behind said research might also have to shoulder some responsibility (bearing in mind correlation is not the same as causation!) So when for example, a mouse study correlating the presence of compound X with improvement in the [mouse] condition Y is interpreted as meaning that compound X is the elixir of life for Homo sapiens and that we should instantly rush out and buy as much of it as we can afford, look to the press release before blaming the newspaper. I exaggerate of course with that example.So as not to keep you from your Sunday breakfast or that magnificent Sunday lunch you no doubt have planned/are eating, I'm not going to say much more about this topic aside from making two additional points:(a) Post-publication peer-review is mentioned somewhere in one of the texts. Although this is traditionally meant to imply that researchers who have a beef about some study or interpretation of results send a letter to the publishing (or other) journal outlining their issues, there are quite a few other mediums these days which seem to get the job done just as well. You are reading one of those mediums - yes, bloggers of the world unite - and how on occasion, blog entries have talked about press releases and peer-reviewed results not quite tallying together. I dare say someone somewhere might eventually start a blog titled something like: 'pressing ahead: press release vs. actual results' if it hasn't already been done. Other social media might also play an important role in highlighting discrepancies.(b) Although interesting, the Sumner results perhaps leave out one very important variable in this scientific producer - consumer relationship: the consumer. You might well scoff that anyone without a PhD or related qualification 'doesn't understand science' but I would say that you are wrong. Although there are people out there who actually believe the term 'scientifically proven', as if God himself endorsed the product, I'd suggest that there are enough people who don't believe every headline they read and are vocal enough to say so. Search engines such as Google do a pretty good job of ensuring that anyone researching a scientific claim important to them (which most people do these days) quickly get both sides of the story. In that respect, an inflated press release (which are also generally detectable on the web) will probably not stay inflated for too long. Probably less so, after this and other research [3] starts to percolate through the web...Without further ado, I'll leave you to finish of your 'super-food' packed Sunday lunch. And just in case anyone is interested, a few things to bear in mind when reading and interpreting science...----------[1] Sumner P. et al. The association between exaggeration in health related science news and academic press releases: retrospective observational study. BMJ 2014; 349: g7015.[2] Goldacre B. Preventing bad reporting on health research. BMJ 2014; 349: g7465.[3] Woloshin S. et al. Press releases by academic medical centers: not so academic? Ann Intern Med. 2009 May 5;150(9):613-8.----------Sumner, P., Vivian-Griffiths, S., Boivin, J., Williams, A., Venetis, C., Davies, A., Ogden, J., Whelan, L., Hughes, B., Dalton, B., Boy, F., & Chambers, C. (2014). The association between exaggeration in health related science news and academic press releases: retrospective observational study BMJ, 349 (dec09 7) DOI: 10.1136/bmj.g7015... Read more »

  • December 13, 2014
  • 01:51 PM

High fat diet leads to brain inflammation and obesity

by Dr. Jekyll in Lunatic Laboratories

The stomach strikes again, or so it seems. We’ve already covered how your stomach seemingly controls your brain and your blood-brain barrier, but now it seems that what you eat –not too indirectly related to your stomach– might make you fatter, but not in the way you might be thinking thinking. What you are eating may be causing inflammation in the brain.... Read more »

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