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RichardbBrunner

Category Archives: brain

Types of Depression

24 Wednesday May 2023

Posted by RichardB in brain, Depression

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depression, know yourself, types

Whether you’re a college student in the middle of a major slump, a new mom who can’t pinpoint why she’s feeling so glum, or a retiree grieving over the loss of a loved one, that question isn’t an easy one to answer.

But there’s one thing for sure: “It is much more than just a sad mood,” said Angelos Halaris, MD, a professor of psychiatry and medical director of adult psychiatry at the Loyola University Medical Center in Chicago. Symptoms may include everything from hopelessness and fatigue to physical pain. And just as symptoms vary from person to person, so do the actual diagnoses. The word depression is actually just an umbrella term for a number of different forms, from major depression to atypical depression to dysthymia.

The most common form of depression? Major depression. In fact, about 7 percent of the adult U.S. population has this debilitating mental health condition at any given time, according to the National Institute of Mental Health (NIMH).

If you’re experiencing major depression, you may feel and see symptoms of extreme sadness, hopelessness, lack of energy, irritability, trouble concentrating, changes in sleep or eating habits, feelings of guilt, physical pain, and thoughts of death or suicide — and for an official diagnosis, your symptoms must last for more than two weeks. In some instances, a person might only experience one episode of major depression, but the condition tends to recur throughout a person’s life.

The best treatment is usually with antidepressant medications, explained Dr. Halaris, but talk therapy may also be used to treat depression. And there’s good news: An estimated 80 to 90 percent of people with major depression respond well to treatment.

About 2 percent of the American population has a form of depression that’s less severe than major depression but is still very real — dysthymia.

Dysthymia is a type of depression that causes a low mood over a long period of time — perhaps for a year or more, explained Halaris. “People can function adequately, but not optimally.” Symptoms include sadness, trouble concentrating, fatigue, and changes in sleep habits and appetite.

This depression usually responds better to talk therapy than to medications, though some studies suggest that combining medication with talk therapy may lead to the greatest improvement. People with dysthymia may also be at risk for episodes of major depression.

A whopping 85 percent of new moms feel some sadness after their baby is born — but for up to 16 percent of women, that sadness is serious enough to be diagnosable.

Postpartum depression is characterized by feelings of extreme sadness, fatigue, loneliness, hopelessness, suicidal thoughts, fears about hurting the baby, and feelings of disconnect from the child. It can occur anywhere from weeks to months after childbirth, and Halaris explained it most always develops within a year after a woman has given birth.

“It needs prompt and experienced medical care,” he said — and that may include a combination of talk and drug therapy.

Would you prefer to hibernate during the winter than face those cold, dreary days? Do you tend to gain weight, feel blue, and withdraw socially during the season?

You could be one of 4 to 6 percent of people in the United States estimated to have seasonal affective disorder, or SAD. Though many people find themselves in winter funks, SAD is characterized by symptoms of anxiety, increased irritability, daytime fatigue, and weight gain. This form of depression typically occurs in winter climates, likely due to the lessening of natural sunlight. “We don’t really know why some people are more sensitive to this reduction in light,” said Halaris. “But symptoms are usually mild, though they can be severe.”

This depression usually starts in early winter and lifts in the spring, and it can be treated with light therapy or artificial light treatment.

Despite its name, atypical depression is not unusual. In fact, it may be one of the most common types of depression — and some doctors even believe it is underdiagnosed.

“This type of depression is less well understood than major depression,” explained Halaris. Unlike major depression, a common sign of atypical depression is a sense of heaviness in the arms and legs — like a form of paralysis. However, a study published in the Archives of General Psychiatry (now known as JAMA Psychiatry) found that oversleeping and overeating are the two most important symptoms for diagnosing atypical depression. People with the condition may also gain weight, be irritable, and have relationship problems.

Some studies show that talk therapy works well to treat this kind of depression.

Psychosis — a mental state characterized by false beliefs, known as delusions, or false sights or sounds, known as hallucinations — doesn’t typically get associated with depression. But according to the National Alliance on Mental Illness, about 20 percent of people with depression have episodes so severe that they see or hear things that are not there.

“People with this psychotic depression may become catatonic, not speak, or not leave their bed,” explained Halaris. Treatment may require a combination of antidepressant and antipsychotic medications. A review of 10 studies concluded that it may be best to start with an antidepressant drug alone and then add an antipsychotic drug if needed. Another review, however, found the combination of medications was more effective than either drug alone in treating psychotic depression.

If your periods of extreme lows are followed by periods of extreme highs, you could have bipolar disorder (sometimes called manic depressive disorder because symptoms can alternate between mania and depression).

Symptoms of mania include high energy, excitement, racing thoughts, and poor judgment. “Symptoms may cycle between depression and mania a few times per year or much more rapidly,” Halaris said. “This disorder affects about 2 to 3 percent of the population and has one of the highest risks for suicide.” Bipolar disorder has four basic subtypes: bipolar I (characterized by at least one manic episode); bipolar II (characterized by hypomanic episodes — which are milder — along with depression); cyclothymic disorder; and other specified bipolar and related disorder.

People with bipolar disorder are typically treated with drugs called mood stabilizers.

Premenstrual dysphoric disorder, or PMDD, is a type of depression that affects women during the second half of their menstrual cycles. Symptoms include depression, anxiety, and mood swings. Unlike premenstrual syndrome (PMS), which affects up to 85 percent of women and has milder symptoms, PMDD affects about 5 percent of women and is much more severe.

“PMDD can be severe enough to affect a woman’s relationships and her ability to function normally when symptoms are active,” said Halaris. Treatment may include a combination of depression drugs as well as talk and nutrition therapies.

Also called adjustment disorder, situational depression is triggered by a stressful or life-changing event, such as job loss, the death of a loved one, trauma — even a bad breakup.

Situational depression is about three times more common than major depression, and medications are rarely needed — that’s because it tends to clear up over time once the event has ended. However, that doesn’t mean it should be ignored: Symptoms of situational depression may include excessive sadness, worry, or nervousness, and if they don’t go away, they may become warning signs of major depression.

Drugs and the Brain

17 Wednesday May 2023

Posted by RichardB in Addiction, brain

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brain, drugs, long post

The human brain is the most complex organ in the body. This three-pound mass of gray and white matter sits at the center of all human activity—you need it to drive a car, to enjoy a meal, to breathe, to create an artistic masterpiece, and to enjoy everyday activities. In brief, the brain regulates your body’s basic functions; enables you to interpret and respond to everything you experience; and shapes your thoughts, emotions, and behavior.

The brain is made up of many parts that all work together as a team. Different parts of the brain are responsible for coordinating and performing specific functions. Drugs can alter important brain areas that are necessary for life-sustaining functions and can drive the compulsive drug abuse that marks addiction. Brain areas affected by drug abuse include:

  • The brain stem, which controls basic functions critical to life, such as heart rate, breathing, and sleeping.
  • The cerebral cortex, which is divided into areas that control specific functions. Different areas process information from our senses, enabling us to see, feel, hear, and taste. The front part of the cortex, the frontal cortex or forebrain, is the thinking center of the brain; it powers our ability to think, plan, solve problems, and make decisions.
  • The limbic system, which contains the brain’s reward circuit. It links together a number of brain structures that control and regulate our ability to feel pleasure. Feeling pleasure motivates us to repeat behaviors that are critical to our existence. The limbic system is activated by healthy, life-sustaining activities such as eating and socializing—but it is also activated by drugs of abuse. In addition, the limbic system is responsible for our perception of other emotions, both positive and negative, which explains the mood-altering properties of many drugs.

How do the parts of the brain communicate?

The brain is a communications center consisting of billions of neurons, or nerve cells. Networks of neurons pass messages back and forth among different structures within the brain, the spinal cord, and nerves in the rest of the body (the peripheral nervous system). These nerve networks coordinate and regulate everything we feel, think, and do.

  • Neuron to Neuron
    Each nerve cell in the brain sends and receives messages in the form of electrical and chemical signals. Once a cell receives and processes a message, it sends it on to other neurons.
  • Neurotransmitters – The Brain’s Chemical Messengers
    The messages are typically carried between neurons by chemicals called neurotransmitters.
  • Receptors – The Brain’s Chemical Receivers
    The neurotransmitter attaches to a specialized site on the receiving neuron called a receptor. A neurotransmitter and its receptor operate like a “key and lock,” an exquisitely specific mechanism that ensures that each receptor will forward the appropriate message only after interacting with the right kind of neurotransmitter.
  • Transporters – The Brain’s Chemical Recyclers
    Located on the neuron that releases the neurotransmitter, transporters recycle these neurotransmitters (that is, bring them back into the neuron that released them), thereby shutting off the signal between neurons.

To send a message, a brain cell (neuron) releases a chemical (neurotransmitter) into the space (synapse) between it and the next cell. The neurotransmitter crosses the synapse and attaches to proteins (receptors) on the receiving brain cell. This causes changes in the receiving cell—the message is delivered.

How do drugs work in the brain?

Drugs are chemicals that affect the brain by tapping into its communication system and interfering with the way neurons normally send, receive, and process information. Some drugs, such as marijuana and heroin, can activate neurons because their chemical structure mimics that of a natural neurotransmitter. This similarity in structure “fools” receptors and allows the drugs to attach onto and activate the neurons. Although these drugs mimic the brain’s own chemicals, they don’t activate neurons in the same way as a natural neurotransmitter, and they lead to abnormal messages being transmitted through the network.

Other drugs, such as amphetamine or cocaine, can cause the neurons to release abnormally large amounts of natural neurotransmitters or prevent the normal recycling of these brain chemicals. This disruption produces a greatly amplified message, ultimately disrupting communication channels.

How do drugs work in the brain to produce pleasure?

Most drugs of abuse directly or indirectly target the brain’s reward system by flooding the circuit with dopamine. Dopamine is a neurotransmitter present in regions of the brain that regulate movement, emotion, motivation, and feelings of pleasure. When activated at normal levels, this system rewards our natural behaviors. Overstimulating the system with drugs, however, produces euphoric effects, which strongly reinforce the behavior of drug use—teaching the user to repeat it.

Most drugs of abuse target the brain’s reward system by flooding it with dopamine.

How does stimulation of the brain’s pleasure circuit teach us to keep taking drugs?

Our brains are wired to ensure that we will repeat life-sustaining activities by associating those activities with pleasure or reward. Whenever this reward circuit is activated, the brain notes that something important is happening that needs to be remembered, and teaches us to do it again and again without thinking about it. Because drugs of abuse stimulate the same circuit, we learn to abuse drugs in the same way.

Why are drugs more addictive than natural rewards?

When some drugs of abuse are taken, they can release 2 to 10 times the amount of dopamine that natural rewards such as eating and sex do. In some cases, this occurs almost immediately (as when drugs are smoked or injected), and the effects can last much longer than those produced by natural rewards. The resulting effects on the brain’s pleasure circuit dwarf those produced by naturally rewarding behaviors. The effect of such a powerful reward strongly motivates people to take drugs again and again. This is why scientists sometimes say that drug abuse is something we learn to do very, very well.

Long-term drug abuse impairs brain functioning.

What happens to your brain if you keep taking drugs?

For the brain, the difference between normal rewards and drug rewards can be described as the difference between someone whispering into your ear and someone shouting into a microphone. Just as we turn down the volume on a radio that is too loud, the brain adjusts to the overwhelming surges in dopamine (and other neurotransmitters) by producing less dopamine or by reducing the number of receptors that can receive signals. As a result, dopamine’s impact on the reward circuit of the brain of someone who abuses drugs can become abnormally low, and that person’s ability to experience any pleasure is reduced.

This is why a person who abuses drugs eventually feels flat, lifeless, and depressed, and is unable to enjoy things that were previously pleasurable. Now, the person needs to keep taking drugs again and again just to try and bring his or her dopamine function back up to normal—which only makes the problem worse, like a vicious cycle. Also, the person will often need to take larger amounts of the drug to produce the familiar dopamine high—an effect known as tolerance.

Decreased Dopamine Transporters in a Methamphetamine Abuser

How does long-term drug taking affect brain circuits?

We know that the same sort of mechanisms involved in the development of tolerance can eventually lead to profound changes in neurons and brain circuits, with the potential to severely compromise the long-term health of the brain. For example, glutamate is another neurotransmitter that influences the reward circuit and the ability to learn. When the optimal concentration of glutamate is altered by drug abuse, the brain attempts to compensate for this change, which can cause impairment in cognitive function. Similarly, long-term drug abuse can trigger adaptations in habit or non-conscious memory systems. Conditioning is one example of this type of learning, in which cues in a person’s daily routine or environment become associated with the drug experience and can trigger uncontrollable cravings whenever the person is exposed to these cues, even if the drug itself is not available. This learned “reflex” is extremely durable and can affect a person who once used drugs even after many years of abstinence.

What other brain changes occur with abuse?

Chronic exposure to drugs of abuse disrupts the way critical brain structures interact to control and inhibit behaviors related to drug use. Just as continued abuse may lead to tolerance or the need for higher drug dosages to produce an effect, it may also lead to addiction, which can drive a user to seek out and take drugs compulsively. Drug addiction erodes a person’s self-control and ability to make sound decisions, while producing intense impulses to take drugs.

Researchers pinpoint brain’s happiness region

12 Wednesday Apr 2023

Posted by RichardB in brain, Depression

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depression, Happiness, research

Happiness is the meaning and the purpose of life, the whole aim and end of human existence,” the ancient Greek philosopher Aristotle once said. But how does one reach this goal? According to a new study by researchers from Japan, a person’s happiness may depend on the size of a specific brain region.

Researchers found people who were happier had larger gray matter volume in the precuneus region of the brain.

Study leader Dr. Wataru Sato, of Kyoto University in Japan, and colleagues publish their findings in the journal Scientific Reports.

The definition of happiness has been debated for centuries. In recent years, psychologists have suggested that happiness is a combination of life satisfaction and the experience of more positive than negative emotions – collectively deemed “subjective well-being.”

But according to Dr. Sato and his colleagues, the neurological mechanisms behind a person’s happiness were unclear.

“To date, no structural magnetic resonance imaging (MRI) investigation of the construct has been conducted,” they note.

“Identification of the neural substrates underlying subjective happiness may provide a complementary objective measure for this subjective construct and insight into its information-processing mechanism.”

Meditation may boost happiness by targeting precuneus brain region

To address this research gap, the team used MRI to scan the brains of 51 study participants.

After the scans, subjects were asked to complete three short questionnaires that asked them how satisfied they are with their lives, how happy they are and how intensely they feel positive and negative emotions.

The researchers found that individuals who had higher happiness scores had larger gray matter volume in the precuneus of the brain – a region in the medial parietal lobe that plays a role in self-reflection and certain aspects of consciousness – than their unhappy counterparts.

What is more, the researchers found that one’s happiness may be driven by a combination of greater life satisfaction and intensity of positive emotion – supporting the theory of subjective well-being.

“These results indicate that the widely accepted psychological model postulating emotional and cognitive components of subjective happiness may be applicable at the level of neural structure,” they add.

These findings, the researchers say, indicate that individuals may be able to boost their happiness through practices that target the precuneus, such as meditation:

“Previous structural neuroimaging studies have shown that training in psychological activities, such as meditation, changed the structure of the precuneus gray matter.

Together with these findings, our results suggest that psychological training that effectively increases gray matter volume in the precuneus may enhance subjective happiness.”

Dr. Sato adds that, while further research is required, these current findings may be useful for developing psychological programs that boost a person’s happiness

Why We Get Addicted

01 Wednesday Mar 2023

Posted by RichardB in Addiction, brain

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addicted, biopsychosocial

Think about an experience that makes you feel good. It could be successfully completing a project at work, eating a warm chocolate chip cookie or taking a swig of whiskey. It could be a puff of a cigarette or a shopping trip. A dose of Vicodin or a hit of heroin.

Those experiences don’t automatically lead to addiction. So, what makes a particular habit or substance an addiction? What propels some people to seek out these experiences, even if they are costly or detrimental to their health and relationships?

“Addiction is a biopsychosocial disorder. It’s a combination of your genetics, your neurobiology and how that interacts with psychological and social factors,” said Maureen Boyle, a public health advisor and director of the science policy branch at the National Institute on Drug Abuse. That means it’s a lot like any other chronic disorder, such as type 2 diabetes, cancer and heart disease. And just like other chronic diseases, addiction is both preventable and treatable, Boyle said, but added that if left untreated, it can last a lifetime.

Though everyone’s path to addiction is different — whether he or she tries a drug or a behavior because it’s what that person’s parents or peer do, or just out of curiosity — what’s common across all substance and behavioral addictions is their stunning ability to increase levels of an important chemical in the brain called dopamine,Dopamine is a molecule that ferries messages across the brain’s reward center. It’s what gives people the feeling of pleasure and reinforces behaviors critical for survival, such as eating food and having sex.

When someone uses a drug or engages in a pleasurable experience, the same natural reward circuitry is activated. “The problem with drugs is that they do the job better than natural rewards,” said Dr. Hitoshi Morikawa, an associate professor of neuroscience at the University of Texas at Austin.

Different drugs tap into the dopamine reward system in different ways. Marijuana and heroin have a chemical structure similar to another neurotransmitter and can trick some brain cells into activating neurons that use dopamine. Cocaine and amphetamines, on the other hand, prolong the effect of dopamine on its target neurons, disrupting normal communication in the brain.

How quickly each drug can get into the brain, and how powerfully it activates neural circuits, determines how addictive it will be, Morikawa told Live Science. Some modes of use, like injecting or snorting a drug, make the drug’s effects almost immediate. “That’s why heroin, for example, is the last drug you want to take,” he said. “It’s very addictive.”

As individuals continue with addictive habits or substances, the brain adapts. It tries to reestablish a balance between the dopamine surges and normal levels of the substance in the brain, Morikawa said. To do this, neurons begin to produce less dopamine or simply reduce the number of dopamine receptors. The result is that the individual needs to continue to use drugs, or practice a particular behavior, to bring dopamine levels back to “normal.” Individuals may also need to take greater amounts of drugs to achieve a high; this is called tolerance.

Without dopamine creating feelings of pleasure in the brain, individuals also become more sensitive to negative emotions such as stress, anxiety or depression, Morikawa said. Sometimes, people with addiction may even feel physically ill, which often compels them to use drugs again to relieve these symptoms of withdrawal.

Eventually, the desire for the drug becomes more important than the actual pleasure it provides. And because dopamine plays a key role in learning and memory, it hardwires the need for the addictive substance or experience into the brain, along with any environmental cues associated with it — people, places, things and situations associated with past use. These memories become so entwined that even walking into a bar years later, or talking to the same friends an individual had previously binged with, may then trigger an alcoholic’s cravings, Morikawa said.

Brain-imaging studies of people with addiction reveal other striking changes as well. For example, people with alcohol-, cocaine- or opioid-use disorders show a loss in neurons and impaired activity in their prefrontal cortex, according to a 2011 review of studies published in the journal Nature Reviews Neuroscience. This erodes their ability to make sound decisions and regulate their impulses.

Some people are more susceptible to these extreme neurobiological changes than others, and therefore more susceptible to addiction. Not everyone who tries a cigarette or gets morphine after a surgery becomes addicted to drugs. Similarly, not everyone who gambles becomes addicted to gambling. Many factors influence the development of addictions, Boyle said, from genetics, to poor social support networks, to the experience of trauma or other co-occurring mental illnesses.

One of the biggest risk factors is age. “The younger someone is, the more vulnerable they are to addiction,” Boyle said. In fact, a federal study from 2014 found that the majority (74 percent) of 18- to 30-year-olds admitted to treatment programs had started using drugs at age 17 or younger.

Additionally, like most behavioral and mental health disorders, there are many genes that add to a person’s level of risk or provide some protection against addiction, Boyle said. But unlike the way in which doctors can predict a person’s risk of breast cancer by looking for mutations in a certain gene, nobody knows enough to be able to single out any gene or predict the likelihood of inheriting traits that could lead to addiction, she said.

How The Brain Maintains Memories

01 Wednesday Feb 2023

Posted by RichardB in brain

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memories, research

A team of neuroscientists at the University of Toronto in Canada has discovered a reason why we often struggle to remember small details of past experiences.

Many events in our lives resemble experiences we have had before, without being identical to them.

Whenever you attend a party, for example, you may well take along a gift, such as a bottle of wine or a box of chocolates, but the gift will differ on each occasion.

Researchers believe that as our memories for such events become older, the incidental details unique to each event (such as the identity of the gift) are mostly forgotten.

However, the common underlying patterns (what parties are like in general) are retained. This allows us to accumulate knowledge to guide our behavior in similar situations in the future.

Studies in rodents and people have shown that a region of the brain called the medial prefrontal cortex (mPFC) stores long-term memories about experiences.

But to what extent do neurons in this region represent abstract generalized knowledge as opposed to the specific incidental details?

“Memories of recent experiences are rich in incidental detail but, with time, the brain is thought to extract important information that is common across various past experiences,” said Dr. Kaori Takehara-Nishiuchi, senior author of the study.

“We predicted that groups of neurons in the mPFC build representations of this information over the period when long-term memory consolidation is known to take place, and that this information has a larger representation in the brain than the smaller details.”

To test their prediction, Dr. Takehara-Nishiuchi and her colleagues studied how two different memories with overlapping associative features are coded by neuron groups in the mPFC of rat brains, and how these codes change over time.

Rats were given two experiences with an interval between each: one involving a light and tone stimulus, and the other involving a physical stimulus. This gave them two memories that shared a common stimulus relationship.

The researchers then tracked the neuron activity in the animals’ brains from the first day of learning to four weeks following their experiences.

“This experiment revealed that groups of neurons in the mPFC initially encode both the unique and shared features of the stimuli in a similar way,” said Mark Morrissey, first author on the study.

“However, over the course of a month, the coding becomes more sensitive to the shared features and less sensitive to the unique features, which become lost.”

Further experiments also revealed that the brain can adapt the general knowledge gained from multiple experiences immediately to a new situation.

“This goes some way to answering the long-standing question of whether the formation of generalized memory is simply a result of the brain’s network ‘forgetting’ incidental features,” Morrissey said.

“On the contrary, we show that groups of neurons develop coding to store shared information from different experiences while, seemingly independently, losing selectivity for irrelevant details.”

“The unique coding property of the mPFC identified in the study may support its role in the formation, maintenance, and updating of associative knowledge structures that help support flexible and adaptive behavior in rats and other animals,” he said. 

BBC REEL – Why you’re not stuck with the brain you’re born with

30 Friday Dec 2022

Posted by RichardB in brain

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brain, change, research

Brain Scan May Help Decide Treatment for Depression

07 Wednesday Dec 2022

Posted by RichardB in brain, Depression

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research

New research from Emory University in Atlanta has found that specific patterns of activity on brain scans may help clinicians identify whether psychotherapy or antidepressant medication is more likely to help individual patients recover from depression.

The study, called PReDICT, randomly assigned patients to 12 weeks of treatment with one of two antidepressant medications or with cognitive behavioral therapy (CBT).

At the start of the study, patients underwent a functional MRI brain scan, which was then analyzed to see whether the outcome from CBT or medication depended on the state of the brain prior to starting treatment.

The MRI scans identified that the degree of functional connectivity between an important emotion processing center — the subcallosal cingulate cortex — and three other areas of the brain was associated with the treatment outcomes, according to the researchers.

Specifically, patients with positive connectivity between the brain regions were significantly more likely to achieve remission with CBT, while patients with negative or absent connectivity were more likely to benefit from antidepressant medication.

“All depressions are not equal and like different types of cancer, different types of depression will require specific treatments. Using these scans, we may be able to match a patient to the treatment that is most likely to help them, while avoiding treatments unlikely to provide benefit,” said Helen Mayberg, M.D., a professor of psychiatry, neurology and radiology at Emory University School of Medicine.

Mayberg and her co-investigators, Boadie Dunlop, M.D., director of the Emory Mood and Anxiety Disorders Program, and W. Edward Craighead, Ph.D., a professor of psychiatry and behavioral sciences, sought to develop methods for a more personalized approach to treating depression.

Current treatment guidelines for major depression recommend that a patient’s preference for psychotherapy or medication be considered in selecting the initial treatment approach. However, in the PReDICT study, patients’ preferences were only weakly associated with outcomes — preferences predicted treatment drop-out, but not improvement, the study found.

These results are consistent with prior studies, suggesting that achieving personalized treatment for depressed patients will depend more on identifying specific biological characteristics in patients rather than relying on their symptoms or treatment preferences, the researchers noted.

The results from PReDICT suggest that brain scans may offer the best approach for personalizing treatment going forward, they add.

The researchers recruited 344 patients for the study from across the metro Atlanta area. Researchers note they were able to convene a more diverse group of patients than other previous studies, with roughly half of the participants self-identified as African American or Hispanic.

“Our diverse sample demonstrated that the evidence-based psychotherapy and medication treatments recommended as first-line treatments for depression can be extended with confidence beyond a white, non-Hispanic population,” said Dunlop.

“Ultimately our studies show that clinical characteristics, such as age, gender, etc., and even patients’ preferences regarding treatment, are not as good at identifying likely treatment outcomes as the brain measurement,” concluded Mayberg.

The study results were published in the American Journal of Psychiatry.

Arts appear to play role in brain development

09 Wednesday Nov 2022

Posted by RichardB in brain

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arts, research

Brain research in the past several years is just beginning to uncover some startling ideas about how students learn. First came the proof, some years ago, that our brains do not lose brain cells as we get older, but are always capable of growing.

Now neuroscientists are investigating how training students in the arts may change the structure of their brains and the way they think. They are asking: Does putting a violin in the hands of an elementary school student help him to do math better? Will learning to dance or paint improve a child’s spacial ability or ability to learn to read?

Research in those areas, Harvard professor Jerome Kagan said, is “as deserving of a clinical trial as a drug for cancer that has not yet been shown to be effective.”

There aren’t many conclusions yet that can be translated into the classroom, but there is an emerging interdisciplinary field between education and neuroscience. Like Hopkins, Harvard also has created a center to study learning and the brain.

Much of the research into the arts has centered on music and the brain. One researcher studying students who go to an arts high school found a correlation between those who were trained in music and their ability to do geometry. Yet another four-year study, being conducted by Ellen Winner of Boston College and Gottfried Schlaug of Harvard, is looking at the effects playing the piano or the violin has on students who are in elementary school.

Winner said she was quite skeptical of claims that schools that had introduced the arts had seen an increase in test scores and a generally better school climate. She had previously looked at those claims and found they couldn’t be backed up by research.

However, she is in the midst of a four-year study of elementary students that has shown some effects: One group is learning an instrument, and another is not. “It is the first study to demonstrate brain plasticity in young children related to music playing,” Schlaug said.

The study Winner is working on has shown that children who receive a small amount of training — as little as half an hour of lessons a week and 10 minutes of practice a day — do have structural changes in their brains that can be measured. And those students, Winner said, were better at tests that required them to use their fingers with dexterity.

About 15 months after the study began, students who played the instrument were not better at math or reading, although the researchers are questioning whether they have assessments that are sensitive enough to measure the changes. They will continue the study for several more years.

Charles Limb, a Johns Hopkins doctor and a jazz musician, studied jazz musicians by using imaging technology to take pictures of their brains as they improvised. He found that they allowed their creativity to flow by shutting down areas that regulated inhibition and self-control. So are the most creative people able to shut down those areas of the brain?

Most of the new research is focusing on the networks of the brain that are involved in specific tasks, said Michael Posner, a researcher at the University of Oregon. Posner has studied the effects of music on attention. What he found, he said, was that in those students who showed motivation and creativity, training in the arts helped develop their attention and their intelligence. The next great focus in this area, he said, is on proving the connection that most scientists believe exists between the study of music and math ability.

The imaging is now so advanced that scientists can already see the difference in the brain networks of those who study a string instrument and those who study the piano intensely.

The brain research, while moving quickly by some measures, is still painfully slow for educators who would like answers today. Morgan, the Washington County schools chief, said some research did help her support the drive to build the Barbara Ingram School for the Arts in Hagerstown.

Mariale Hardiman, the former principal of Roland Park Elementary/Middle School, was once one of those principals who focused a lot of attention on reading and math scores. But she saw what integrating the arts into classrooms could do for students, she said, and she then began her own research into the subject.

She is now the co-director of the Hopkins Neuro-Education Initiative. She said there are a myriad of questions that could be answered in the research that is just starting, but there are two she would like to see approached: Do children who learn academic content through the arts tend to hold onto that knowledge longer? And are schools squeezing creativity out of children by controlling so much of their school day?

Even without research though, Kagan of Harvard said there is ample evidence of the value of an arts education because so many children who aren’t good at academics can gain self-confidence through the arts.

“The argument for an arts education is based not on sentimentality but on pragmatism,” he said. “If an arts program only helped the 7 million children in the bottom quartile, the dropout rate would drop.”

Self-Care for Depression

02 Wednesday Nov 2022

Posted by RichardB in brain, Coping Skills, Depression

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care, Coping Skills, depression

As a clinical psychologist, Mary Pipher, PhD, designed “healing packages” for her patients: activities, resources, and comforts to help them recover from trauma. Then, after Dr. Pipher’s book Reviving Ophelia became a runaway best-seller, she herself suffered from an episode of major depression and designed a healing package of her own. “The essence of my personal healing package,” she describes in her book Seeking Peace, “was to keep my life as simple and quiet as possible and to allow myself sensual and small pleasures.” She created a mini-retreat center in her home and modified the ancient ways of calming troubled nerves to fit her lifestyle. Pipher’s healing package looked like this:

She accessed the healing power of water by walking at Holmes Lake Dam, swimming at the university’s indoor pool, and reading The New Yorker magazine in the bathtub every morning.

She cooked familiar foods, dishes that reminded her of home: jaternice, sweetbreads, and perch; and cornbread and pinto beans with ham hocks.

She unpacked her childhood teacup collection and displayed it near her computer desk to remind her of happy times and of people who loved her.

She reconnected with the natural world by walking many miles every week on the frozen prairie, watching the yellow aconites blossom in February and the daffodils and jonquils in March, following the cycles of the moon, and witnessing sunrises and sunsets.

She read biographies of heroes like Abe Lincoln, and read the poetry of Billy Collins, Robert Frost, Mary Oliver, and Ted Kooser.

She found role models for coping with adversity.

She limited her encounters with people and gave herself permission to skip holiday gatherings and postpone social obligations. She erased calendar engagements until she had three months of “white space” in her future.

She embraced her body through yoga and massage. She started to pay attention to tension in her neck and other cues from her body and let those signals teach her about herself.

She meditated every day.

These activities were exactly what she needed to emerge from the other side of depression. She writes:

“After taking care of my body for several months, it began to take good care of me. My blood pressure improved and my heart problems disappeared. After a few months of my simple, relatively stress-free life and my healing package of activities, I felt my depression lifting. I enjoyed the return of positive emotions: contentment, joy, calmness and new sparks of curiosity and energy. I again felt a great tenderness toward others.”

Psychiatrist James Gordon, MD, discusses similar healing packages in his best-selling book Unstuck. At the end of his first meetings with all of his patients, he will write out a “prescription of self-care,” which includes instructions on changing diet, advice about specific recommended meditations or exercises, and a list of supplements and herbs. “Among my recommendations, there are always actions, techniques, approaches, and attitudes that each person has told me — which she already knows — are helpful,” he explains. At the end of his introduction, he suggests each reader take some time to write out his or her own prescription. He supplies a form and everything.

Each person’s healing package is unique. Many people have benefited from more meditation and mindfulness exercises, psychotherapy sessions, and therapies like Eye Movement Desensitization and Reprocessing (EMDR) that help unclog the brain of painful memories. Some people do better with more physical exercise and nutritional changes. While mindfulness and meditation have certainly helped many become aware of my rumination patterns, the most profound changes in others recovery have come from the bags of dark, green leafy vegetables, yoga, and breathing exercises.

It’s empowering to know that we don’t need a doctor or any mental health professional to design a healing package for us. We are perfectly capable of writing this prescription ourselves. Sometimes (not always), all it takes are a few simple tweaks to our lifestyle over a period to pull us out of a crippling depression or unrelenting anxiety.

Opioid Addiction – Brain Functions

19 Wednesday Oct 2022

Posted by RichardB in Addiction, brain

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Addiction, brain, opioid

Substance addiction is a perplexing phenomenon for those who fortunately do not suffer from it. Although it is incredible to believe that people would willfully engage in behaviors that create problems with their lives on so many levels, substance addiction is a reality for millions of people. According to data published by NIDA (National Institutes of Drug Abuse) nearly 20 million Americans have undergone opioid de-addiction therapy in 2010. What makes some people so susceptible to substance abuse while others are able to protect themselves? A study of brain images of heroin addicts, conducted by Gold, Liu and colleagues, shows significant differences in brain activity even in resting state, without heroin use. Functional MRI (fMRI) images from opioid addicted patients were compared with similar images from health people.

Resting state fMRI images of men undergoing opioid substitution therapy showed that areas of the brain engaged in reward perception, motivation, memory and self-control show significantly different activity than comparable regions in healthy individuals. Areas like the orbitofrontal cortex, cingulate gyrus and hippocampus show consistently different resting state activities in heroin-dependent and healthy subjects. The prefrontal cortex of dependent patients was less active than that of healthy patients in the resting state, during de-addiction therapy. However, this area which controls motivation as well as degree of inhibition, was observed to be highly active during periods of opioid use. Other areas of the brain like the hippocampus which regulates memory, also showed activity patterns that were different from those in healthy subjects, in the resting state in addicted individuals. These images shed light on the mechanism of addiction in people and the areas of the brain that are engaged, perhaps constitutively, in sustaining addiction.

Given that study participants were enrolled from de-addiction clinics, episodes of heroin abuse had already taken place in their life. It is unclear whether the same areas of the brain would show similar activity in naive individuals. If this possibility is validated by comparative studies, these fMRI imaging techniques may have tremendous diagnostic potential in identifying people who are at high risk for addiction. One drawback of this investigation is that only male patients were included in this study. Therefore, we do not know whether there are gender-based differences in the resting state brain activity of female opioid addicts.

The study does throw up interesting possibilities. It is possible to enroll naive subjects, possibly teenagers or pre-teens, and obtain baseline brain images before these people have tried out any addictive substance like tobacco, heroin or alcohol. Follow-up studies with the same people can indicate whether experience of addictive substances can change the baseline pattern of activity. This kind of long-term and long-range study may help to identify brain markers for specific addiction disorders. The study also indicates why counseling fails to have an impact on some patients. It is likely that profound changes in resting state brain activity resulting from addiction may override the effects of received and processed advice.

Reference

Zhang Y, Tian J, Yuan K, Liu P, Zhuo L, Qin W, Zhao L, Liu J, von Deneen KM, Klahr NJ, Gold MS, & Liu Y (2011). Distinct resting-state brain activities in heroin-dependent individuals. Brain research, 1402, 46-53 PMID: 21669407

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