Inflammation links heart disease and depression

March 18, 2019

Science Daily/University of Cambridge

People with heart disease are more likely to suffer from depression, and the opposite is also true. Now, scientists believe they have identified a link between these two conditions: inflammation -- the body's response to negative environmental factors, such as stress.

While inflammation is a natural response necessary to fight off infection, chronic inflammation -- which may result from psychological stress as well as lifestyle factors such as smoking, excessive alcohol intake, physical inactivity and obesity -- is harmful.

The link between heart disease and depression is well documented. People who have a heart attack are at a significantly higher risk of experiencing depression. Yet scientists have been unable to determine whether this is due to the two conditions sharing common genetic factors or whether shared environmental factors provide the link.

"It is possible that heart disease and depression share common underlying biological mechanisms, which manifest as two different conditions in two different organs -- the cardiovascular system and the brain," says Dr Golam Khandaker, a Wellcome Trust Intermediate Clinical Fellow at the University of Cambridge. "Our work suggests that inflammation could be a shared mechanism for these conditions."

In a study published today in the journal Molecular Psychiatry, Dr Khandaker and colleague Dr Stephen Burgess led a team of researchers from Cambridge who examined this link by studying data relating to almost 370,000 middle-aged participants of UK Biobank.

First, the team looked at whether family history of coronary heart disease was associated with risk of major depression. They found that people who reported at least one parent having died of heart disease were 20% more likely to develop depression at some point in their life.

Next, the researchers calculated a genetic risk score for coronary heart disease -- a measure of the contribution made by the various genes known to increase the risk of heart disease. Heart disease is a so-called 'polygenic' disease -- in other words, it is caused not by a single genetic variant, but rather by a large number of genes, each increasing an individual's chances of developing heart disease by a small amount. Unlike for family history, however, the researchers found no strong association between the genetic predisposition for heart disease and the likelihood of experiencing depression.

Together, these results suggest that the link between heart disease and depression cannot be explained by a common genetic predisposition to the two diseases. Instead, it implies that something about an individual's environment -- such as the risk factors they are exposed to -- not only increases their risk of heart disease, but at the same time increases their risk of depression.

This finding was given further support by the next stage of the team's research. They used a technique known as Mendelian randomisation to investigate 15 biomarkers -- biological 'red flags' -- associated with increased risk of coronary heart disease. Mendelian randomisation is a statistical technique that allows researchers to rule out the influence of factors that otherwise confuse, or confound, a study, such as social status.

Of these common biomarkers, they found that triglycerides (a type of fat found in the blood) and the inflammation-related proteins IL-6 and CRP were also risk factors for depression.

Both IL-6 and CRP are inflammatory markers that are produced in response to damaging stimuli, such as infection, stress or smoking. Studies by Dr Khandaker and others have previously shown that people with elevated levels of IL-6 and CRP in the blood are more prone to develop depression, and that levels of these biomarkers are high in some patients during acute depressive episode. Elevated markers of inflammation are also seen in people with treatment resistant depression. This has raised the prospect that anti-inflammatory drugs might be used to treat some patients with depression. Dr Khandaker is currently involved in a clinical trial to test tocilizumab, an anti-inflammatory drug used for the treatment of rheumatoid arthritis that inhibits IL-6, to see if reducing inflammation leads to improvement in mood and cognitive function in patients with depression.

While the link between triglycerides and coronary heart disease is well documented, it is not clear why they, too, should contribute to depression. The link is unlikely to be related by obesity, for example, as this study has found no evidence for a causal link between body mass index (BMI) and depression.

"Although we don't know what the shared mechanisms between these diseases are, we now have clues to work with that point towards the involvement of the immune system," says Dr Burgess. "Identifying genetic variants that regulate modifiable risk factors helps to find what is actually driving disease risk."

The research was funded by Wellcome and MQ: Transforming Mental Health.

Dr Sophie Dix, Director of Research at MQ, says: "This study adds important new insight into the emergence and risk of depression, a significantly under researched area.

"Taking a holistic view of a person's health -- such as looking at heart disease and depression together -- enables us to understand how factors like traumatic experiences and the environment impact on both our physical and mental health.

"This research shows clearly the shared biological changes that are involved. This not only opens opportunities for earlier diagnosis, but also create a solid foundation for exploring new treatments or using existing treatments differently. We need to stop thinking about mental and physical health in isolation and continue this example of bringing sciences together to create real change."

https://www.sciencedaily.com/releases/2019/03/190318222147.htm

Neurofeedback gets you back in the zone

New study from biomedical engineers demonstrates that a brain-computer interface can improve your performance

March 12, 2019

Science Daily/Columbia University School of Engineering and Applied Science

Researchers have shown -- for the first time -- that they can use online neurofeedback to modify an individual's arousal state to improve performance in a demanding sensory motor task, such as flying a plane or driving in suboptimal conditions.

Our state of arousal -- being fearful, agitated, or calm -- can significantly affect our ability to make optimal decisions, judgments, and actions in real-world dynamic environments. Imagine, for instance, walking across a balance beam. Your performance -- speed across the beam and the odds of making it across without falling off -- are dramatically better if the beam sits a mere six inches off the ground and you are relaxed rather than terror-stricken on a beam 60 feet higher. To keep you in the zone of maximum performance, your arousal needs to be at moderate levels, not so high that it pushes you over the edge.

Biomedical engineers at Columbia Engineering have shown -- for the first time -- that they can use online neurofeedback to modify an individual's arousal state to improve performance in a demanding sensory motor task, such as flying a plane or driving in suboptimal conditions. The researchers used a brain computer interface (BCI) to monitor, through electroencephalography (EEG) in real time, the arousal states of the study participants when they were engaged in a virtual reality aerial navigation task. The system generated a neurofeedback signal that helped participants to decrease their arousal in particularly difficult flight situations, which in turn improved participants' performance. The study was published today by Proceedings of the National Academy of Sciences.

"The whole question of how you can get into the zone, whether you're a baseball hitter or a stock trader or a fighter pilot, has always been an intriguing one," says Paul Sajda, professor of biomedical engineering (BME), electrical engineering, and radiology, who led the study. "Our work shows that we can use feedback generated from our own brain activity to shift our arousal state in ways that significantly improve our performance in difficult tasks -- so we can hit that home run or land on a carrier deck without crashing."

The 20 subjects in the study were immersed in a virtual reality scenario in which they had to navigate a simulated airplane through rectangular boundaries. Known as a boundary avoidance task, this demanding sensory-motor task model created cognitive stresses, such as making the boxes narrower every 30 seconds, that escalated arousal and quickly resulted in task failure -- missing or crashing into the boundary. But when the researchers used neurofeedback, the subjects did better, were able to fly longer while performing the difficult tasks that required high levels of visual and motor coordination.

There were three feedback conditions (BCI, sham, and silence) randomly assigned for every new flight attempt. In the BCI condition, subjects heard the sound of a low-rate synthetic heartbeat that was continuously modulated in loudness as a function of the level of inferred task-dependent arousal, as decoded from the EEG. The higher that level of arousal, the louder the feedback and vice versa. Participants' task performance in the BCI condition, measured as time and distance over which the subject can navigate before failure, was increased by around 20 percent.

"Simultaneous measurements of pupil dilation and heart rate variability showed that the neurofeedback indeed reduced arousal, causing the subjects to remain calm and fly beyond the point at which they would normally fail," says Josef Faller, the study's lead author and a postdoctoral research scientist in BME. "Our work is the first demonstration of a BCI system that uses online neurofeedback to shift arousal state and improve task performance in accordance with the Yerkes-Dodson law."

The Yerkes-Dodson law is a well-established and intensively studied law in behavioral psychology about the relationship between arousal and performance. Developed in 1908, it posits an inverse-relationship between arousal and task performance, that there is a state of arousal that is optimal for behavioral performance in a given task. In this new study, the researchers showed that they could use neurofeedback in real time to move an individual's arousal from the right side of the Yerkes-Dodson curve to the left, toward a state of improved performance.

"What's exciting about our new approach is that it is applicable to different task domains," Sajda adds. "This includes clinical applications that use self-regulation as a targeted treatment, such as mental illness."

The researchers are now studying how neurofeedback can be used to regulate arousal and emotion for clinical conditions such as PTSD. They are also exploring how they might use online monitoring of arousal and cognitive control to inform human-agent teaming, when a robot and a human work together in a high-stress situation like a rescue. If the robot has information on the human's arousal state, it could choose its tasks in a way that reduces its teammate's arousal, pushing her/him into an ideal performance zone.

"Good human-agent teams, like the Navy SEALS, do this already, but that is because the human-agents can read facial expressions, voice patterns, etc., of their teammates to infer arousal and stress levels," Sajda says. "We envision our system being a better way to communicate not just this type of information, but much more to a robot-agent."

https://www.sciencedaily.com/releases/2019/03/190312143206.htm

Smoking, high blood pressure, diabetes and obesity each linked to unhealthy brains

March 11, 2019

Science Daily/European Society of Cardiology

Factors that influence the health of our blood vessels, such as smoking, high blood and pulse pressures, obesity and diabetes, are linked to less healthy brains. The strongest links are with areas of the brain known to be responsible for our more complex thinking skills, and which deteriorate during the development of Alzheimer's disease and dementia.

The study examined the associations between seven vascular risk factors and differences in the structures of parts of the brain. The strongest links were with areas of the brain known to be responsible for our more complex thinking skills, and which deteriorate during the development of Alzheimer's disease and dementia.

The researchers, led by Dr Simon Cox, a senior research associate at the Centre for Cognitive Ageing and Cognitive Epidemiology at the University of Edinburgh (UK), examined MRI scans of the brains of 9,772 people, aged between 44 and 79, who were enrolled in the UK Biobank study -- one of the largest groups of people from the general population to have data available on brain imaging as well as general health and medical information. All had been scanned by a single scanner in Cheadle, Manchester, and most of the participants were from the north-west of England. This is the world's largest single-scanner study of multiple vascular risk factors and structural brain imaging.

The researchers looked for associations between brain structure and one or more vascular risk factors, which included smoking, high blood pressure, high pulse pressure, diabetes, high cholesterol levels, and obesity as measured by body mass index (BMI) and waist-hip ratio. These have all been linked to complications with the blood supply to the brain, potentially leading to reduced blood flow and the abnormal changes seen in Alzheimer's disease.

They found that, with the exception of high cholesterol levels, all of the other vascular risk factors were linked to greater brain shrinkage, less grey matter (tissue found mainly on the surface of the brain) and less healthy white matter (tissue in deeper parts of the brain). The more vascular risk factors a person had, the poorer was their brain health.

Dr Cox said: "The large UK Biobank sample allowed us to take a comprehensive look at how each factor was related to many aspects of brain structure. We found that higher vascular risk is linked to worse brain structure, even in adults who were otherwise healthy. These links were just as strong for people in middle-age as they were for those in later life, and the addition of each risk factor increased the size of the association with worse brain health.

"Importantly, the associations between risk factors and brain health and structure were not evenly spread across the whole brain; rather, the areas affected were mainly those known to be linked to our more complex thinking skills and to those areas that show changes in dementia and 'typical' Alzheimer's disease. Although the differences in brain structure were generally quite small, these are only a few possible factors of a potentially huge number of things that might affect brain ageing."

Smoking, high blood pressure and diabetes were the three vascular risk factors that showed the most consistent associations across all types of brain tissue types measured. High cholesterol levels were not associated with any differences in the MRI scans.

To quantify the size of the differences they observed, Dr Cox explained: "We compared people with the most vascular risk factors with those who had none, matching them for head size, age and sex. We found that, on average, those with the highest vascular risk had around 18ml, or nearly 3%, less volume of grey matter, and one-and-a-half times the damage to their white matter -- the brain's connective tissue -- compared to people who had the lowest risk; 18ml is slightly more than a large tablespoon-full, or a bit less than a small, travel-sized toothpaste tube."

He said that the findings showed the potential of making lifestyle changes to improve brain and cognitive ageing.

"Lifestyle factors are much easier to change than things like your genetic code -- both of which seem to affect susceptibility to worse brain and cognitive ageing. Because we found the associations were just as strong in mid-life as they were in later life, it suggests that addressing these factors early might mitigate future negative effects. These findings might provide an additional motivation to improve vascular health beyond respiratory and cardiovascular benefits."

Limitations of the study include the fact that it does not include people over the age of 79 and that UK Biobank participants tend to live in less deprived areas, which may restrict how the findings can be generalised to other populations. As the researchers were measuring brain structures only, and were not carrying out functional brain imaging or tests of thinking skills, they cannot show in this study how the changes in brain structure might impact cognitive function, but other studies have shown the relationship between increased numbers of vascular risk factors and worse or declining thinking skills, and dementia.

Now the researchers plan to measure the links between vascular risk factors and thinking skills in the UK Biobank participants and in other groups too. In addition, they are following older people, and carrying out multiple scans and tests of thinking skills. They hope this will tell them more about the role that vascular risk factors play in the decline of different types of thinking skills and which areas of the brain are implicated. They also hope that the findings will motivate future work to understand the biological mechanisms through which different sources of vascular risk might be related to different brain areas and tissues.

https://www.sciencedaily.com/releases/2019/03/190311081944.htm

Seven moral rules found all around the world

Is it good to cooperate? Testing the theory of morality-as-cooperation in 60 societies

March 4, 2019

Science Daily/University of Chicago Press Journals

What is morality? And to what extent does it vary around the world? The theory of 'morality-as-cooperation' argues that morality consists of a collection of biological and cultural solutions to the problems of cooperation recurrent in human social life. These solutions or cooperative behaviors are plausible candidates for universal moral rules, and that morality-as-cooperation could provide the unified theory of morality that anthropology has hitherto lacked.

Anthropologists at the University of Oxford have discovered what they believe to be seven universal moral rules.

The rules: help your family, help your group, return favors, be brave, defer to superiors, divide resources fairly, and respect others' property, were found in a survey of 60 cultures from all around the world.

Previous studies have looked at some of these rules in some places -- but none has looked at all of them in a large representative sample of societies. The present study, published in volume 60, no. 1 issue of Current Anthropology, by Oliver Scott Curry, Daniel Austin Mullins, and Harvey Whitehouse, is the largest and most comprehensive cross-cultural survey of morals ever conducted.

The team from Oxford's Institute of Cognitive & Evolutionary Anthropology (part of the School of Anthropology & Museum Ethnography) analyzed ethnographic accounts of ethics from 60 societies, comprising over 600,000 words from over 600 sources.

Dr Oliver Scott Curry, lead author and senior researcher at the Institute for Cognitive and Evolutionary Anthropology, said: "The debate between moral universalists and moral relativists has raged for centuries, but now we have some answers. People everywhere face a similar set of social problems and use a similar set of moral rules to solve them. As predicted, these seven moral rules appear to be universal across cultures. Everyone everywhere shares a common moral code. All agree that cooperating, promoting the common good, is the right thing to do."

The study tested the theory that morality evolved to promote cooperation, and that -- because there are many types of cooperation -- there are many types of morality. According to this theory of 'morality as cooperation', kin selection explains why we feel a special duty of care for our families, and why we abhor incest. Mutualism explains why we form groups and coalitions (there is strength and safety in numbers), and hence why we value unity, solidarity, and loyalty. Social exchange explains why we trust others, reciprocate favors, feel guilt and gratitude, make amends, and forgive. And conflict resolution explains why we engage in costly displays of prowess such as bravery and generosity, why we defer to our superiors, why we divide disputed resources fairly, and why we recognize prior possession.

The research found, first, that these seven cooperative behaviors were always considered morally good. Second, examples of most of these morals were found in most societies. Crucially, there were no counter-examples -- no societies in which any of these behaviors were considered morally bad. And third, these morals were observed with equal frequency across continents; they were not the exclusive preserve of 'the West' or any other region.

Among the Amhara of Ethiopia, "flouting kinship obligation is regarded as a shameful deviation, indicating an evil character." In Korea, there exists an "egalitarian community ethic [of] mutual assistance and cooperation among neighbors [and] strong in-group solidarity." "Reciprocity is observed in every stage of Garo life [and] has a very high place in the Garo social structure of values." Among the Maasai, "Those who cling to warrior virtues are still highly respected," and "the uncompromising ideal of supreme warriorhood [involves] ascetic commitment to self-sacrifice...in the heat of battle, as a supreme display of courageous loyalty." The Bemba exhibit "a deep sense of respect for elders' authority." The Kapauku "idea of justice" is called "uta-uta, half-half... [the meaning of which] comes very close to what we call equity." And among the Tarahumara, "respect for the property of others is the keystone of all interpersonal relations."

The study also detected 'variation on a theme' -- although all societies seemed to agree on the seven basic moral rules, they varied in how they prioritized or ranked them. The team has now developed a new moral values questionnaire to gather data on modern moral values, and is investigating whether cross-cultural variation in moral values reflects variation in the value of cooperation under different social conditions.

According to co-author Professor Harvey Whitehouse, anthropologists are uniquely placed to answer long-standing questions about moral universals and moral relativism. "Our study was based on historical descriptions of cultures from around the world; this data was collected prior to, and independently of, the development of the theories that we were testing. Future work will be able to test more fine-grained predictions of the theory by gathering new data, even more systematically, out in the field."

"We hope that this research helps to promote mutual understanding between people of different cultures; an appreciation of what we have in common, and how and why we differ," added Curry.

https://www.sciencedaily.com/releases/2019/03/190304134216.htm

Daily intake of nutritional supplements cannot prevent depression

March 6, 2019

Science Daily/European Association for the Study of Obesity

MooDFOOD, the largest randomized clinical trial to study the effects of nutritional strategies on the prevention of major depressive disorder concludes that daily intake of nutritional supplements cannot prevent depression.

Over 1000 participants who were overweight or had obesity and were identified as being at elevated risk for depression but who were not currently depressed, from four European countries -the Netherlands, the United Kingdom, Germany and Spain, took part in the study. Participants were randomized to either take nutritional supplements containing folic acid, vitamin D, zinc, selenium or to a pill placebo, and half of participants also received a behavioural lifestyle intervention intended to change dietary behaviours and patterns.

Researcher Mariska Bot from Amsterdam UMC reported: "Daily intake of nutritional supplements over a year does not effectively prevent the onset of a major depressive episode in this sample. Nutritional supplements were not better than placebo. Therapeutic sessions aimed at making changes towards a healthy dietary behaviour did also not convincingly prevent depression." Dr. Bot is first author of a paper showing these results in today's issue of the Journal of the American Medical Association (JAMA).

Depression is a common disorder

More than 40 million Europeans experience a major depressive disorder. One in ten men and one in five women suffer from clinical depression at least once during their lifetime. Depression is one of the most prevalent and disabling disorders in the EU.

Given the increasing prevalence of depression, more people are actively searching for ways to decrease their risk through lifestyle modification, but are often overwhelmed by confusing and contradictory information. To help European citizens the MooDFOOD project has developed evidence-based nutritional strategies to help prevent depression.

Prevention of depression through a healthy diet

The MooDFOOD prevention trial formed a crucial part of the five year MooDFOOD project, which investigated the relationship between nutrition and depression. MooDFOOD was funded by the European Commission and led by the Vrije Universiteit Amsterdam.

Although the behavioural therapy to encourage a healthy dietary behavior and improve diet was not effective at preventing depression overall, there was some evidence that it prevented depressive episodes in those participants who attended a recommended number of sessions. This may suggest the food behavioural therapy only works if the participants get sufficient exposure and are able to sufficiently improve their diet and dietary behaviour.

MooDFOOD project coordinators professor Marjolein Visser and professor Ingeborg Brouwer of the Vrije Universiteit Amsterdam said:

"Several studies within, and outside the five year MooDFOOD project show that consuming a healthy dietary pattern is important for European citizens, not only for physical health, but it may also help to prevent depressive symptoms. " Based on a large number of studies and careful analysis, MooDFOOD researchers have come to three important conclusions at the end of their project. First, a healthy dietary pattern, typified by a Mediterranean style diet high in fruit, vegetables, whole grains, fish, pulses and olive oil, and low in red meat and full-fat dairy products, may reduce the risk of developing depression. Second, in people with obesity, weight loss can lead to a reduction in depressive symptoms. Third, current evidence does not support the use of nutritional supplements in order to prevent depression.

Practical tools

These recent results have important implications for all Europeans. The MooDFOOD team has translated these findings into tools for the general population, health professionals (GPs, dieticians and psychologists), researchers and policy makers.

https://www.sciencedaily.com/releases/2019/03/190306100545.htm

Blue-enriched white light to wake you up in the morning

March 6, 2019

Science Daily/The Korea Advanced Institute of Science and Technology (KAIST)

Here is good news for those who have difficulty with morning alertness. A research team proposed that a blue-enriched LED light can effectively help people overcome morning drowsiness. This study will provide the basis for major changes in future lighting strategies and thereby help create better indoor environments.

Considerable research has been devoted to unmasking circadian rhythms. The 2017 Nobel Prize in Physiology or Medicine went to Jeffrey C. Hall, Michael Rosbash, and Michael W. Young for unveiling the molecular mechanisms that control circadian rhythms. In particular, the relationship between light and its physiological effects has been investigated since the discovery of a novel, third type of photoreceptor in the human retina in the early 2000s. Rods and cones regulate visual effects, while the third type, photosensitive retinal ganglion cells, regulate a large variety of biological and behavioral processes including melatonin and cortisol secretion, alertness, and functional magnetic resonance imaging (fMRI).

Initial studies on light sources have shown that blue monochromatic, fully saturated lights are effective for stimulating physiological responses, but the relative effectiveness of commercially available white light sources is less well understood. Moreover, the research was more focused on the negative effects of blue light; for instance, when people are exposed to blue light at night, they have trouble achieving deep sleep because the light restrains melatonin secretion.

However, Professor Hyeon-Jeong Suk and Professor Kyungah Choi from the Department of Industrial Design and their team argue that the effects of blue-enriched morning light on physiological responses are time dependent, and that it has positive effects on melatonin levels and the subjective perception of alertness, mood, and visual comfort compared with warm white light.

The team conducted an experiment with 15 university students. They investigated whether an hour of morning light exposure with different chromaticity would affect their physiological and subjective responses differently. The decline of melatonin levels was significantly greater after the exposure to blue-enriched white light in comparison with warm white light.

Professor Suk said, "Light takes a huge part of our lives since we spend most of our time indoors. Light is one of the most powerful tools to affect changes in how we perceive and experience the environment around us."

Professor Choi added, "When we investigate all of the psychological and physiological effects of light, we see there is much more to light than just efficient quantities. I believe that human-centric lighting strategies could be applied to a variety of environments, including residential areas, learning environments, and working spaces to improve our everyday lives."

This research was collaborated with Professor Hyun Jung Chung from the Graduate School of Nanoscience and Technology.

https://www.sciencedaily.com/releases/2019/03/190306100602.htm

Broken heart' syndrome may originate in the brain

March 4, 2019

Science Daily/European Society of Cardiology

Scientists have shown for the first time that the brain is involved in the development of a heart condition called Takotsubo syndrome (TTS). They found that regions of the brain responsible for processing emotions and controlling the unconscious workings of the body, such as heart beat, breathing and digestion, do not communicate with each other as well in TTS patients as in healthy people.

The study is published in the European Heart Journal today (Tuesday) and the researchers say that although, at this stage, they cannot show that the reduced brain functions definitely cause TTS, their findings suggest that these alterations in the central nervous system may be part of the mechanism involved and they are linked with the onset of TTS in response to stressful or emotional triggers.

TTS is known as "broken heart" syndrome and is characterised by a sudden temporary weakening of the heart muscles that causes the left ventricle of the heart to balloon out at the bottom while the neck remains narrow, creating a shape resembling a Japanese octopus trap, from which it gets its name. Since this relatively rare condition was first described in 1990, evidence has suggested that it is typically triggered by episodes of severe emotional distress, such as grief, anger or fear, or reactions to happy or joyful events. Patients develop chest pains and breathlessness, and it can lead to heart attacks and death. TTS is more common in women with only 10% of cases occurring in men. [1]

In an unusual example of collaboration between neuroscientists and cardiologists, researchers carried out MRI brain scans in 15 TTS patients taken from the InterTAK Registry, established at the University Hospital Zurich, Switzerland, in 2011 [2]. They compared the scans with those from 39 healthy people. The scans were performed between July 2013 and July 2014 and the average time between TTS diagnosis and the MRI scans was about a year.

Professor Christian Templin, principle investigator at the Registry and professor of cardiology at University Hospital Zurich, said: "We were interested in four specific brain regions that are spatially separate from one another but functionally connected, meaning they share information. We found that TTS patients had decreased communication between brain regions associated with emotional processing and the autonomic nervous system, which controls the unconscious workings of the body, compared to the healthy people.

"For the first time, we have identified a correlation between alterations to the functional activity of specific brain regions and TTS, which strongly supports the idea that the brain is involved in the underlying mechanism of TTS. Emotional and physical stress are strongly associated with TTS, and it has been hypothesised that the overstimulation of the autonomic nervous system may lead to TTS events."

The regions of the brain that the researchers looked at included the amygdala, hippocampus and cingulate gyrus, which control emotions, motivation, learning and memory. The amygdala and cingulate gyrus are also involved in the control of the autonomic nervous system and regulating heart function. In addition, the cingulate gyrus is involved in depression and other mood disorders that are common among TTS patients.

"Importantly, the regions we've identified as communicating less with one another in TTS patients are the same brain regions that are thought to control our response to stress. Therefore, this decrease in communication could negatively affect the way patients respond to stress and make them more susceptible to developing TTS," said Professor Templin.

A limitation of the study is that the researchers did not have MRI scans of patients' brains before or at the time they developed TTS, so cannot say for certain that the decreased communication between brain regions caused the TTS or vice versa.

Co-author, Dr Jelena Ghadri, a senior research associate at the University Hospital Zurich and co-principle investigator of the InterTAK Registry, said: "Our results suggest that additional studies should be conducted to determine whether this is a causal relationship. We hope this study offers new starting points for studying TTS in terms of understanding that it much more than 'broken heart' syndrome and clearly involves interactions between the brain and the heart, which are still not fully understood. We are at the beginning of learning more about this complex disorder. Hopefully, one day new findings can be translated into developments in preventive, therapeutic and diagnostic strategies to improve patient care.

"Of note, this study presents the results of a collaboration between neuroscientists and cardiologists. One problem in TTS research is that usually cardiologists only focus on the heart; we believe that approaching TTS in a multidisciplinary way might help to uncover the real nature and causes of this disease. The methods we used are mainly neuroscientific in nature, but the findings we uncovered are, in our view, of major importance for cardiologists in understanding TTS."

[1] TTS affects less than 3% of people who suffer a heart attack and tends to occur between the ages of 60-75.

[2] The InterTAK Registry is a worldwide network, including more than 40 different cardiology centres in more than 18 countries. The University Hospital Zurich has become a centre of excellence, specialising in the care of TTS patients, while also carrying out translational and basic science research.

https://www.sciencedaily.com/releases/2019/03/190304195238.htm

Cocoa may help curb fatigue typically associated with multiple sclerosis (MS)

May offer easy, safe approach to persistent symptom, if confirmed in larger studies, suggest researchers

March 4, 2019

Science Daily/BMJ

Cocoa may help curb the fatigue that is typically associated with multiple sclerosis (MS), suggest the results of a small feasibility trial, published online in the Journal of Neurology Neurosurgery & Psychiatry.

Cocoa, like dark chocolate, is rich in flavonoids -- substances found abundantly in fruit and vegetables and associated with anti-inflammatory properties.

If the findings are confirmed in larger studies, it may offer a simple dietary approach to a persistent and hard to treat symptom, which affects nine out of 10 people with MS, suggest the researchers.

The causes of mental and physical fatigue experienced by people with MS are complex, and likely to include neural, inflammatory, metabolic, and psychological factors. None of the currently available approaches offers long term relief, say the researchers.

Previous research suggests that dark chocolate, containing between 70 and 85 per cent cocoa solids, is associated with an improvement in subjectively assessed fatigue in people with chronic fatigue syndrome (ME).

This prompted the researchers to see if it might also be worth exploring its potential in helping to tackle the fatigue associated with MS.

They randomly assigned 40 adults recently diagnosed with the relapsing remitting form of MS and fatigue to drink a cup of either high flavonoid cocoa powder mixed with heated rice milk (19) or a low flavonoid version (21) every day for six weeks.

Participants were instructed to wait 30 minutes before taking any prescribed medication or eating or drinking anything else, but otherwise to stick to their usual diet.

Fatigue and fatigability-the speed with which mental and physical fatigue set in-were formally assessed before the start, at the mid-point, and at the end of the trial.

And participants also subjectively rated their fatigue on a scale of 1 to 10, at 10.00, 15.00, and 20.00 hours each day, and monitored their activity with a pedometer.

After six weeks there was a small improvement in fatigue in 11 of those drinking high flavonoid cocoa compared with eight of those drinking the low flavonoid version.

And there was a moderate effect on fatigability, with those drinking high flavonoid cocoa able to cover more distance during the 6 minute walk test.

Those drinking the high flavonoid version showed a 45 per cent improvement in subjectively assessed fatigue and an 80 per cent improvement in walking speed.

Although not objectively measured, pain symptoms also improved more in the high flavonoid group.

"Our study establishes that the use of dietary interventions is feasible and may offer possible long-term benefits to support fatigue management, by improving fatigue and walking endurance," write the researchers.

Given the anti-inflammatory properties of flavonoids, they could be used alongside other approaches, such as exercise, drug treatment, and physiotherapy, to treat fatigue, they suggest.

"The use of dietary approaches to reduce fatigue and associated factors in people with MS may be an easy, safe, and cost-effective way to have an impact on quality of life and independence, allowing people to feel more in control of their condition.

"A full evaluation, including wider geography, longer follow up and cost effectiveness is now indicated," they conclude.

In a linked editorial, Dr Paolo Ragonese, University of Palermo, points out that the treatment and management of MS related fatigue "still represents a challenge...because its mechanisms are multifactorial."

And diets rich in flavonoids are linked to longer life and a lower risk of cardiovascular disease as well as positive changes to the volume and diversity of gut bacteria (the microbiome), he points out.

"Although [this] study is an exploratory trial, it adds further interesting suggestions to the possible positive effects of flavonoid intake on the management of fatigue in patients with MS," he concludes.

https://www.sciencedaily.com/releases/2019/03/190304195240.htm

Does extra sleep on the weekends repay your sleep debt? No, researchers say

February 28, 2019

Science Daily/Cell Press

Insufficient sleep and untreated sleep disorders put people at increased risk for metabolic problems, including obesity and diabetes. But is extra sleep on the weekends enough to reduce those risks? The short answer, according to new findings is 'no.'

"The key take-home message from this study is that ad libitum weekend recovery or catch-up sleep does not appear to be an effective countermeasure strategy to reverse sleep loss induced disruptions of metabolism," says Kenneth Wright of the University of Colorado Boulder.

People often sleep more on weekends than they do during the week. Yet it wasn't known how returning to an insufficient sleep schedule during the workweek after a weekend of recovery sleep influences a person's metabolic health.

To find out, in the new study, researchers led by Christopher Depner and Wright enlisted healthy young adults. Each participant was randomly assigned to one of three groups. The first had plenty of time to sleep -- 9 hours -- each night for 9 nights. The second had just 5 hours to sleep each night over that same period. Finally, the third slept 5 hours for 5 days followed by a weekend in which they slept as much as they liked before returning to another 2 days of restricted sleep.

In the two sleep-restricted groups, insufficient sleep led to an increase in snacking after dinner and weight gain. During ad libitum weekend recovery sleep in the third group, study participants slept an hour longer on average than they usually would. They also consumed fewer extra calories after dinner than those who got insufficient sleep.

However, when they went back to getting insufficient sleep after the weekend, their circadian body clock was timed later. They also ate more after dinner as their weight continued to rise.

The sleep restriction in the first group of participants was associated with a decrease in insulin sensitivity of about 13 percent. But the group that had a chance to sleep more on the weekend still showed less sensitivity to insulin. The insulin sensitivity of their whole bodies, liver, and muscle decreased by 9 to 27 percent after they got insufficient sleep again, once the weekend was over.

"Our findings show that muscle- and liver-specific insulin sensitivity were worse in subjects who had weekend recovery sleep," Depner says, noting that those metabolic aberrations weren't seen in the people who got less sleep all along. "This finding was not anticipated and further shows that weekend recovery sleep is not likely [to be] an effective sleep-loss countermeasure regarding metabolic health when sleep loss is chronic."

The Sleep Research Society and American Academy of Sleep Medicine recommends 7 or more hours of sleep nightly for adults, to promote optimal health. The new findings add to evidence that insufficient sleep is a risk factor for metabolic disorders. It also shows that catching up on weekends isn't the solution to chronic sleep loss during the week.

Wright says that it's not yet clear whether weekend recovery sleep can be an effective health countermeasure for people who get too little sleep only occasionally -- a night or two per week, perhaps. They hope to explore the fine details of these dynamics in future studies, including the influence of daytime napping and other strategies for getting more Zzzs.

https://www.sciencedaily.com/releases/2019/02/190228113534.htm

Not all sleep is equal when it comes to cleaning the brain

February 27, 2019

Science Daily/University of Rochester Medical Center

New research shows how the depth of sleep can impact our brain's ability to efficiently wash away waste and toxic proteins. Because sleep often becomes increasingly lighter and more disrupted as we become older, the study reinforces and potentially explains the links between aging, sleep deprivation, and heightened risk for Alzheimer's disease.

"Sleep is critical to the function of the brain's waste removal system and this study shows that the deeper the sleep the better," said Maiken Nedergaard, M.D., D.M.Sc., co-director of the Center for Translational Neuromedicine at the University of Rochester Medical Center (URMC) and lead author of the study. "These findings also add to the increasingly clear evidence that quality of sleep or sleep deprivation can predict the onset of Alzheimer's and dementia."

The study, which appears in the journal Science Advances, indicates that the slow and steady brain and cardiopulmonary activity associated with deep non-REM sleep are optimal for the function of the glymphatic system, the brain's unique process of removing waste. The findings may also explain why some forms of anesthesia can lead to cognitive impairment in older adults.

The previously unknown glymphatic system was first described by Nedergaard and her colleagues in 2012. Prior to that point, scientists did not fully understand how the brain, which maintains its own closed ecosystem, removed waste. The study revealed a system of plumbing which piggybacks on blood vessels and pumps cerebral spinal fluid (CSF) through brain tissue to wash away waste. A subsequent study showed that this system primarily works while we sleep.

Because the accumulation of toxic proteins such as beta amyloid and tau in the brain are associated with Alzheimer's disease, researchers have speculated that impairment of the glymphatic system due to disrupted sleep could be a driver of the disease. This squares with clinical observations which show an association between sleep deprivation and heightened risk for Alzheimer's.

In the current study, researchers conducted experiments with mice that were anesthetized with six different anesthetic regimens. While the animals were under anesthesia, the researchers tracked brain electrical activity, cardiovascular activity, and the cleansing flow of CSF through the brain. The team observed that a combination of the drugs ketamine and xylazine (K/X) most closely replicated the slow and steady electrical activity in the brain and slow heart rate associated with deep non-REM sleep. Furthermore, the electrical activity in the brains of mice administered K/X appeared to be optimal for function of the glymphatic system.

"The synchronized waves of neural activity during deep slow-wave sleep, specifically firing patterns that move from front of the brain to the back, coincide with what we know about the flow of CSF in the glymphatic system," said Lauren Hablitz, Ph.D., a postdoctoral associate in Nedergaard's lab and first author of the study. "It appears that the chemicals involved in the firing of neurons, namely ions, drive a process of osmosis which helps pull the fluid through brain tissue."

The study raises several important clinical questions. It further bolsters the link between sleep, aging, and Alzheimer's disease. It is known that as we age it becomes more difficult to consistently achieve deep non-REM sleep, and the study reinforces the importance of deep sleep to the proper function of the glymphatic system. The study also demonstrates that the glymphatic system can be manipulated by enhancing sleep, a finding that may point to potential clinical approaches, such as sleep therapy or other methods to boost the quality of sleep, for at-risk populations.

Furthermore, because several of the compounds used in the study were analogous to anesthetics used in clinical settings, the study also sheds light on the cognitive difficulties that older patients often experience after surgery and suggests classes of drugs that could be used to avoid this phenomenon. Mice in the study that were exposed to anesthetics that did not induce slow brain activity saw diminished glymphatic activity.

"Cognitive impairment after anesthesia and surgery is a major problem," said Tuomas Lilius, M.D., Ph.D., with the Center for Translational Neuromedicine at the University of Copenhagen in Denmark and co-author of the study. "A significant percentage of elderly patients that undergo surgery experience a postoperative period of delirium or have a new or worsened cognitive impairment at discharge."

https://www.sciencedaily.com/releases/2019/02/190227173111.htm

How listening to music 'significantly impairs' creativity

February 27, 2019

Science Daily/Lancaster University

The popular view that music enhances creativity has been challenged by researchers who say it has the opposite effect. Psychologists investigated the impact of background music on performance by presenting people with verbal insight problems that are believed to tap creativity. They found that background music 'significantly impaired' people's ability to complete tasks testing verbal creativity -- but there was no effect for background library noise.

Psychologists from the University of Central Lancashire, University of Gävle in Sweden and Lancaster University investigated the impact of background music on performance by presenting people with verbal insight problems that are believed to tap creativity.

They found that background music "significantly impaired" people's ability to complete tasks testing verbal creativity -- but there was no effect for background library noise.

For example, a participant was shown three words (e.g., dress, dial, flower), with the requirement being to find a single associated word (in this case "sun") that can be combined to make a common word or phrase (i.e., sundress, sundial and sunflower).

The researchers used three experiments involving verbal tasks in either a quiet environment or while exposed to:

• Background music with foreign (unfamiliar) lyrics

• Instrumental music without lyrics

• Music with familiar lyrics

Dr Neil McLatchie of Lancaster University said: "We found strong evidence of impaired performance when playing background music in comparison to quiet background conditions."

Researchers suggest this may be because music disrupts verbal working memory.

The third experiment -- exposure to music with familiar lyrics- impaired creativity regardless of whether the music also boosted mood, induced a positive mood, was liked by the participants, or whether participants typically studied in the presence of music.

However, there was no significant difference in performance of the verbal tasks between the quiet and library noise conditions.

Researchers say this is because library noise is a "steady state" environment which is not as disruptive.

"To conclude, the findings here challenge the popular view that music enhances creativity, and instead demonstrate that music, regardless of the presence of semantic content (no lyrics, familiar lyrics or unfamiliar lyrics), consistently disrupts creative performance in insight problem solving."

https://www.sciencedaily.com/releases/2019/02/190227081542.htm

New parents face 6 years of disrupted sleep

February 25, 2019

Science Daily/University of Warwick

The birth of a child has drastic short-term effects on new mothers' sleep, particularly during the first three months after birth. Researchers have also found sleep duration and satisfaction is decreased up to six years after giving birth for both parents.

A new study by researchers from the University of Warwick shows that after birth of the first child and up to 6 years after birth mothers and fathers sleep duration and sleep satisfaction do not fully recover to the levels before pregnancy.

In the paper 'Long-term effects of pregnancy and childbirth on sleep satisfaction and duration of first-time and experienced mothers and fathers', a collaboration with the German Institute for Economic Research and the West Virginia University studied sleep in 4,659 parents who had a child between 2008 and 2015.

During these years parents also reported on their sleep in yearly interviews. In the first 3 months after birth mothers slept on average 1 hour less than before pregnancy while fathers sleep duration decreased by approximately 15 minutes.

Dr Sakari Lemola, from the Department of Psychology at the University of Warwick comments:

"Women tend to experience more sleep disruption than men after the birth of a child reflecting that mothers are still more often in the role of the primary caregiver than fathers"

However, when the children were 4-6 years old sleep duration was still about 20 minutes shorter in mothers and 15 minutes shorter in fathers compared to their sleep duration before pregnancy. A similar time course was also observed for their satisfaction with sleep.

Sleep effects were more pronounced in first-time parents compared with experienced parents. In the first half a year after birth the sleep effects were also somewhat stronger in breastfeeding compared with bottle-feeding mothers.

Higher household income and psychosocial factors such as dual vs. single parenting did not appear to protect against these changes in sleep after childbirth.

Dr Sakari Lemola, from the Department of Psychology at the University of Warwick comments:

"While having children is a major source of joy for most parents it is possible that increased demands and responsibilities associated with the role as a parent lead to shorter sleep and decreased sleep quality even up to 6 years after birth of the first child."

https://www.sciencedaily.com/releases/2019/02/190225192116.htm

Urban parks could make you happier

February 25, 2019

Science Daily/University of Alabama at Birmingham

Researchers found spending 20 minutes in an urban park will make someone happier -- whether they are engaging in exercise or not during the visit.

According to the study, published in International Journal of Environmental Health Research, urban parks have been recognized as key neighborhood places that provide residents with opportunities to experience nature and engage in various activities. Through contact with the natural environment and engagement in health-promoting and/or social and recreational activities in parks, users experience physical and mental health benefits such as stress reduction and recovery from mental fatigue.

Principle investigator Hon K. Yuen, Ph.D., OTR/L, professor in the UAB Department of Occupational Therapy, said the original intent of the project was to validate previous research findings on the impact of park visit on emotional well-being, and evaluate the contribution of choosing to participate in physical activity in the park in relation to emotional well-being after the park visit.

"Overall, we found park visitors reported an improvement in emotional well-being after the park visit," said Yuen. "However, we did not find levels of physical activity are related to improved emotional well-being. Instead, we found time spent in the park is related to improved emotional well-being."

Co-author and chair of the department Gavin R. Jenkins, Ph.D., OTR/L, said this means that potentially all people can benefit from time in a park. If you cannot be physically active due to aging, a disability or any other limitations, the study implies a person can still gain health benefits just from a visit to a local park.

Participants of the study were adult visitors to one of the three urban parks -- Overton, Jemison and Cahaba River Walk Parks -- in Mountain Brook, Alabama. Data were collected from 98 adult park visitors; four visitors reported that they participated in this study twice. Data from the second participation were excluded, resulting in 94 unique participants participating in the study. These parks were selected for the study because they were the three main public parks in Mountain Brook and had a relatively high volume of visitors daily.

Yuen said several limitations of the study included the lack of objective data to measure emotional health and confining the study to just three urban parks in a six-month data collection period.

Although a small study, Jenkins said the significance of these findings helps reinforce the need for more urban parks and the conservation of those that already exist.

"There is increasing pressure on green space within urban settings," said Jenkins. "Planners and developers look to replace green space with residential and commercial property. The challenge facing cities is that there is an increasing evidence about the value of city parks but we continue to see the demise of theses spaces."

https://www.sciencedaily.com/releases/2019/02/190225123030.htm

Live better with attainable goals

February 15, 2019

Science Daily/University of Basel

Those who set realistic goals can hope for a higher level of well-being. The key for later satisfaction is whether the life goals are seen as attainable and what they mean to the person, as psychologists report in a study with over 970 participants.

Wealth, community, health, meaningful work: life goals express a person's character, as they determine behavior and the compass by which people are guided. It can therefore be assumed that goals can contribute substantially to how satisfied people are in life -- or how dissatisfied if important goals are blocked and cannot be achieved.

A team of psychologists from the University of Basel conducted a detailed examination on how life goals are embedded in people's lives across adult; the results are now published in the European Journal of Personality. The researchers used data from 973 people between 18 and 92 years old living in German-speaking parts of Switzerland; more than half of the participants were surveyed again after two and four years. The participants had to assess the importance and the perceived attainability of life goals in ten areas -- health, community, personal growth, social relationships, fame, image, wealth, family, responsibility/care for younger generations, and work -- using a four-point scale.

Life goals with predictive power

The findings of the study revealed that perceiving one's personal goals as attainable is an indicator for later cognitive and affective well-being. This implies that people are most satisfied if they have a feeling of control and attainability. Interestingly, the importance of the goal was less relevant for later well-being than expected.

Life goals also hold predictive power for specific domains: Participants who set social-relation goals or health goals were more satisfied with their social relationships or their own health. The link between life goals and subsequent well-being appeared to be relatively independent of the age of the participants.

Younger people want status, older people want social engagement

What are the goals that people value the most in a respective age period? The goals that people value in a particular life stage depend on the development tasks that are present at this stage: the younger the participants were, the more they rated personal-growth, status, work and social-relation goals as important. The older the participants were, the more they rated social engagement and health as important.

"Many of our results confirmed theoretical assumptions from developmental psychology," says lead author and PhD student Janina Bühler from the University of Basel's Faculty of Psychology. Life goals were strongly determined by age: "If we examine, however, whether these goals contribute to well-being, age appears less relevant." Hence, adults, whether old or young, are able to balance the importance and attainability of their goals.

https://www.sciencedaily.com/releases/2019/02/190215092845.htm

How sleep can fight infection

February 12, 2019

Science Daily/Rockefeller University Press

Researchers have discovered why sleep can sometimes be the best medicine. Sleep improves the potential ability of some of the body's immune cells to attach to their targets, according to a new study. The study helps explain how sleep can fight off an infection, whereas other conditions, such as chronic stress, can make the body more susceptible to illness.

T cells are a type of white blood cell that are critical to the body's immune response. When T cells recognize a specific target, such as a cell infected with a virus, they activate sticky proteins known as integrins that allow them to attach to their target and, in the case of a virally infected cell, kill it. While much is known about the signals that activate integrins, signals that might dampen the ability of T cells to attach to their targets are less well understood.

Stoyan Dimitrov and colleagues at the University of Tübingen decided to investigate the effects of a diverse group of signaling molecules known as G?s-coupled receptor agonists. Many of these molecules can suppress the immune system, but whether they inhibit the ability of T cells to activate their integrins and attach to target cells was unknown.

Dimitrov and colleagues found that certain G?s-coupled receptor agonists, including the hormones adrenaline and noradrenaline, the proinflammatory molecules prostaglandin E2 and D2, and the neuromodulator adenosine, prevented T cells from activating their integrins after recognizing their target. "The levels of these molecules needed to inhibit integrin activation are observed in many pathological conditions, such as tumor growth, malaria infection, hypoxia, and stress," says Dimitrov. "This pathway may therefore contribute to the immune suppression associated with these pathologies."

Adrenaline and prostaglandin levels dip while the body is asleep. Dimitrov and colleagues compared T cells taken from healthy volunteers while they slept or stayed awake all night. T cells taken from sleeping volunteers showed significantly higher levels of integrin activation than T cells taken from wakeful subjects. The researchers were able to confirm that the beneficial effect of sleep on T cell integrin activation was due to the decrease in G?s-coupled receptor activation.

"Our findings show that sleep has the potential to enhance the efficiency of T cell responses, which is especially relevant in light of the high prevalence of sleep disorders and conditions characterized by impaired sleep, such as depression, chronic stress, aging, and shift work," says last author Luciana Besedovsky.

In addition to helping explain the beneficial effects of sleep and the negative effects of conditions such as stress, Dimitrov and colleagues' study could spur the development of new therapeutic strategies that improve the ability of T cells to attach to their targets. This could be useful, for example, for cancer immunotherapy, where T cells are prompted to attack and kill tumor cells.

https://www.sciencedaily.com/releases/2019/02/190212094839.htm

Groundbreaking test for PTSD developed

March 12, 2019

Science Daily/Indiana University

Researchers have developed a groundbreaking blood test that could help more accurately diagnose those suffering from post-traumatic stress disorder.

A cutting-edge blood test discovered by Indiana University School of Medicine researchers could help more accurately diagnose military veterans and other people experiencing post-traumatic stress disorder, and potentially provide more precise treatments and prevention.

A study led by psychiatry professor Alexander Niculescu, MD, PhD, and published this week in the high-impact SpringerNature journal Molecular Psychiatry, tracked more than 250 veterans in over 600 visits at the Richard L. Roudebush VA Medical Center in Indianapolis to identify molecules in the blood that can help track stress intensity. According to Niculescu's findings, the blood test can accurately identify people who are at risk of stress disorders or are experiencing them severely.

"PTSD is a disorder that affects a lot of veterans, especially those involved in combat. It's also an underappreciated and underdiagnosed disorder among the civilian population, whether it be the result of abuse, rape, violence or accidents" said Niculescu, who worked with other Department of Psychiatry and VA researchers on the study, as well as collaborators at The Scripps Research Institute and University of California Irvine. "Countless people are underdiagnosed with stress disorders, which may manifest themselves by drinking more, other addictions, suicide or violence. Our research has broader relevance for not just veterans but the general public."

The decade-long study looked at the expression of genes in the blood, starting with the entire genome, which has over 20,000 genes. Over the course of multiple visits, researchers tested participants in both low- and high-stress states -- their blood analyzed for detectable changes in expression of genes between those two different states that could serve as biological markers (biomarkers) for stress. Researchers were able to narrow the study's focus down to 285 individual biomarkers (related to 269 genes) that can objectively help diagnose patients with PTSD, as well as determine the severity of their stress and predict future hospitalizations.

They also compared these biomarkers with other well-known markers of stress and aging, such as telomer length. The biomarker signature helped identify new potential medications and natural substances to treat stress disorders that could be paired in a personalized way with individuals.

"There are similar tests like this in other fields, like cancer, where a physician can biopsy the affected part of the body to determine the stage of disease. But when it comes to mental health, biopsying the brain isn't an option," Niculescu said "Our research is applying similar concepts from other areas of medicine, but we're engineering new ways that will allow us to track mental symptoms objectively, including stress, using blood, or so-called 'liquid biopsies.'"

Much like with his recent breakthrough in developing a blood test to measure pain, and his past work on suicide, Niculescu said this research could be life-changing for individuals who have been exposed to or are about to enter high-stress environments. Such biomarkers will allow doctors to classify people in terms of their current severity or risk for future stress disorders, which can guide career choices as well as treatment options. Additionally, the biomarkers could measure response to treatment in an objective, quantifiable manner.

"Untreated pain and stress can lead to suicide, that's how we became interested in these disorders, and decided to move upstream and see if we can better understand, treat and prevent them," Niculescu said. "We think that one of the key uses of our research would be to test people before they have symptoms of an illness to see who's at risk and possibly treat them early. It's much better to prevent things for the person, and for the health care system, than to treat somebody who is in an acute crisis."

With this study, Niculescu said the ultimate goal is prevention -- pairing the ability to better predict those predisposed to PTSD with a more targeted approach to medicating those suffering from its affects. It's preventive medicine done in a precise way, which aligns with the IU Grand Challenge Precision Health Initiative launched in 2016.

"We want to prevent the needless tragedy and suffering in people's lives. By understanding in a biological way a patient's illnesses and their mental health challenges, we could treat what they have better, preventing future episodes," Niculescu said. "I have an excellent team and group of collaborators, and we are excited to partner with other groups of experts and people who can carry this forward. There is a lot of good work being done in the field right now."

The study was supported by an NIH Director's New Innovator Award and a VA Merit Award. Moving forward, Niculescu's group looks to secure more funding through grants and private donations, as well collaborate with other institutions and organizations to advance these studies -- with the hope that ultimately the cutting-edge tests developed at IU School of Medicine be implemented in clinical settings.

"If you treat a medical disorder in general, you improve someone's quality of life; sometimes you save lives. But if you treat a mental health disorder, you can change somebody's destiny," said Niculescu, who is also a practicing psychiatrist. "You can help change someone from being a person who suffers, is unhappy, is unemployed -- maybe goes down the route of addiction, violence or suicide -- to somebody who can become a happy, well adjusted, productive member of society. That's the challenge and the privilege -- we can really change people's destinies if we do our job."

https://www.sciencedaily.com/releases/2019/03/190312092510.htm

Stimulating the vagus nerve in the neck might help ease pain associated with PTSD

February 13, 2019

Science Daily/University of California - San Diego

In a randomized, controlled pilot trial, researchers found that participants pre-treated with noninvasive vagus nerve stimulation experienced less pain after heat stimulus than mock-treated participants.

Post-traumatic stress disorder, or PTSD, is a mental condition caused by a traumatic event. People with PTSD may experience intrusive memories, negative thoughts, anxiety and chronic pain. The condition is typically treated with a combination of psychotherapy, anti-depressants and anti-anxiety medications.

It's this connection between mental health and pain that interests Imanuel Lerman, MD, associate professor at University of California San Diego School of Medicine, Jacobs School of Engineering and Qualcomm Institute, and a pain management specialist at UC San Diego Health and Veterans Affairs San Diego Healthcare System.

Lerman especially wants to know how the emotional pain experience may be influenced by the vagus nerve, which runs down both sides of our necks from the brainstem to the abdomen. The vagus nerve also plays a critical role in maintaining heart rate, breathing rate, digestive tract movement and many other basic body functions.

In a study published February 13, 2019 in PLOS ONE, Lerman and colleagues tested noninvasive vagus nerve stimulation as a method for dampening the sensation of pain.

"It's thought that people with certain differences in how their bodies -- their autonomic and sympathetic nervous systems -- process pain may be more susceptible to PTSD," Lerman said. "And so we wanted to know if we might be able to re-write this 'mis-firing' as a means to manage pain, especially for people with PTSD." Lerman led the study with Alan N. Simmons, PhD, director of the fMRI Research Laboratory at Veterans Affairs San Diego Healthcare System and associate professor of psychiatry at UC San Diego School of Medicine.

The team used functional magnetic resonance imaging (fMRI) to get a look at the brains of 30 healthy study participants after a painful heat stimulus was applied to their legs. To determine how the body's sympathetic nervous system responds to pain, they also measured the sweat on the skin of participants before the heat was applied, and at several points as the heat increased.

Half the participants were treated with noninvasive vagus nerve stimulation for two minutes -- via electrodes placed on the neck -- approximately 10 minutes before the heat stimulus. The other half received a mock stimulation.

Lerman and colleagues report three main findings from this study. First, vagus nerve stimulation blunted peak response to heat stimulus in several areas of the brain known to be important for sensory and discriminative pain processing, as well as in emotional pain centers. The treatment also delayed the pain response in these brain regions -- pain-related brain regions were activated ten seconds later in participants pre-treated with vagus nerve stimulation than in sham-treated participants.

Second, the sweat measurements revealed that vagus nerve stimulation altered autonomic responses to painful heat stimulus. For participants pre-treated with vagus nerve stimulation, the sweat response decreased over time, in contrast to the sham-treatment group.

Third, vagus nerve stimulation dampened the usual brainstem centers critical for the fight-or-flight-type responses, which are also known to control the sweat response to pain.

"Not everyone is the same -- some people may need more vagus nerve stimulation than others to achieve the same outcomes and the necessary frequencies might change over time -- so we'll need to personalize this approach," Lerman said. "But we are hopeful and looking forward to the next steps in moving this approach toward the clinic."

Next, Lerman and colleagues will launch a Veterans Affairs Healthcare System-funded clinical trial in San Diego with military veterans, with and without PTSD. They want to determine if at-home vagus nerve stimulation can reduce emotional pain and underlying neural inflammation associated with PTSD. To learn how to participate, please call 858-552-8585.

Vagus nerve stimulation is a form of neuromodulation, an approach to pain management that also includes spinal cord and dorsal root ganglion (DRG) stimulation. The U.S. Food and Drug Administration (FDA) has approved noninvasive vagus nerve stimulator for the treatment of episodic and chronic cluster headache and acute migraine, as well as an implantable device for epilepsy. An implanted vagus nerve stimulator is now being tested in a clinical trial for the treatment of rheumatoid arthritis. Side effects of implanted vagus nerve stimulation can include hoarseness, shortness of breath and nausea.

https://www.sciencedaily.com/releases/2019/02/190213142700.htm

Brain wave stimulation may improve Alzheimer's symptoms

Noninvasive treatment improves memory and reduces amyloid plaques in mice

March 14, 2019

Science Daily/Massachusetts Institute of Technology

By exposing mice to a unique combination of light and sound, neuroscientists have shown they can improve cognitive and memory impairments similar to those seen in Alzheimer's patients.

This noninvasive treatment, which works by inducing brain waves known as gamma oscillations, also greatly reduced the number of amyloid plaques found in the brains of these mice. Plaques were cleared in large swaths of the brain, including areas critical for cognitive functions such as learning and memory.

"When we combine visual and auditory stimulation for a week, we see the engagement of the prefrontal cortex and a very dramatic reduction of amyloid," says Li-Huei Tsai, director of MIT's Picower Institute for Learning and Memory and the senior author of the study.

Further study will be needed, she says, to determine if this type of treatment will work in human patients. The researchers have already performed some preliminary safety tests of this type of stimulation in healthy human subjects.

MIT graduate student Anthony Martorell and Georgia Tech graduate student Abigail Paulson are the lead authors of the study, which appears in the March 14 issue of Cell.

Memory improvement

The brain's neurons generate electrical signals that synchronize to form brain waves in several different frequency ranges. Previous studies have suggested that Alzheimer's patients have impairments of their gamma-frequency oscillations, which range from 25 to 80 hertz (cycles per second) and are believed to contribute to brain functions such as attention, perception, and memory.

In 2016, Tsai and her colleagues first reported the beneficial effects of restoring gamma oscillations in the brains of mice that are genetically predisposed to develop Alzheimer's symptoms. In that study, the researchers used light flickering at 40 hertz, delivered for one hour a day. They found that this treatment reduced levels of beta amyloid plaques and another Alzheimer's-related pathogenic marker, phosphorylated tau protein. The treatment also stimulated the activity of debris-clearing immune cells known as microglia.

In that study, the improvements generated by flickering light were limited to the visual cortex. In their new study, the researchers set out to explore whether they could reach other brain regions, such as those needed for learning and memory, using sound stimuli. They found that exposure to one hour of 40-hertz tones per day, for seven days, dramatically reduced the amount of beta amyloid in the auditory cortex (which processes sound) as well as the hippocampus, a key memory site that is located near the auditory cortex.

"What we have demonstrated here is that we can use a totally different sensory modality to induce gamma oscillations in the brain. And secondly, this auditory-stimulation-induced gamma can reduce amyloid and Tau pathology in not just the sensory cortex but also in the hippocampus," says Tsai, who is a founding member of MIT's Aging Brain Initiative.

The researchers also tested the effect of auditory stimulation on the mice's cognitive abilities. They found that after one week of treatment, the mice performed much better when navigating a maze requiring them to remember key landmarks. They were also better able to recognize objects they had previously encountered.

They also found that auditory treatment induced changes in not only microglia, but also the blood vessels, possibly facilitating the clearance of amyloid.

Dramatic effect

The researchers then decided to try combining the visual and auditory stimulation, and to their surprise, they found that this dual treatment had an even greater effect than either one alone. Amyloid plaques were reduced throughout a much greater portion of the brain, including the prefrontal cortex, where higher cognitive functions take place. The microglia response was also much stronger.

"These microglia just pile on top of one another around the plaques," Tsai says. "It's very dramatic."

The researchers found that if they treated the mice for one week, then waited another week to perform the tests, many of the positive effects had faded, suggesting that the treatment would need to be given continually to maintain the benefits.

In an ongoing study, the researchers are now analyzing how gamma oscillations affect specific brain cell types, in hopes of discovering the molecular mechanisms behind the phenomena they have observed. Tsai says she also hopes to explore why the specific frequency they use, 40 hertz, has such a profound impact.

The combined visual and auditory treatment has already been tested in healthy volunteers, to assess its safety, and the researchers are now beginning to enroll patients with early-stage Alzheimer's to study its possible effects on the disease.

The research was funded, in part, by the Robert and Renee Belfer Family Foundation, the Halis Family Foundation, the JPB Foundation, the National Institutes of Health and the MIT Aging Brain Initiative. 

https://www.sciencedaily.com/releases/2019/03/190314111004.htm

The Best Daily Journal Routine for Mental Health

Guest post by: Paige A. Mitchell

Struggling with mental health can be a tough mountain to climb. Living with anxiety, depression, bipolar, or even struggling with anger management can leave you feeling isolated and drowning in your feelings. It doesn’t need to be that way, however. With the right tools and support system, you can manage your mental health to live a happy and healthy life. 

Journaling is a great way to start or end your day or even use as a mental release in the middle of the day. The key is to find a journaling routine that works well for you and your lifestyle. To get started, here are a few tips on how to find the best journal routine for your mental health. 

Routines are Great for Mental Health

Creating a daily routine offers a wide variety of benefits. It helps boost productivity, helps keep you organized, and it great for maintaining mental health. Consider tying in a daily journaling session each day to help document your feelings, create affirmations for yourself, and help set future goals.

For example, if you’re a morning person, consider starting your day with daily affirmations or a daily devotional to have yourself placed on the right foot for the rest of the day. If you’re an evening person, you may want to document how your day went, the feelings you had paired with certain situations you were placed in, or even create a gratitude journalto help keep your life in perspective and allow you to rest easy each night.

Find a Quiet Place - Void of Any Distractions

Ensuring you are distracted when journaling each day is essential. No matter your location, be it the park, home, a quiet corner at work, or a peaceful coffee shop, make sure you don’t find yourself distracted by the movement around you.

If you are home, make sure you aren’t in a noisy place that could make you lose focus. Make sure the kids aren’t able to interrupt you and all your appliances have been fixed with your home warrantyso that the noise of a faulty washer or dryer doesn’t distract you. If you decide to journal during a break at work, make sure you don’t take any technology with you that would allow a coworker to ask you any work-related questions.

Create A Daily Tracker

For those struggling with depression, having a daily tracker could prove to be a very successful journaling style. While this is something that should be tracked throughout the day, be sure to still spend three minutes in a quiet place contemplating your feelings and why you’re feeling them. Then, at the end of the day, spend a little extra time reflecting on your daily tracker. 

Why did you feel a certain way at a certain time? What caused these feelings? Were they unwarranted? Is there a pattern? This strategy could help put your feelings into perspective and also help pinpoint patterns and relationships between different circumstances and your feelings. Maybe there is a meeting each day that makes you anxious. Maybe there is a drink or food item that causes you to feel certain emotions. Evaluate your tracker and if you see an unhealthy pattern, consider adjusting accordingly.

Don’t Spend Too Much Time Each Day On It

Be sure to not spend too much time journaling each day. Carve out no more than an hour each day for journaling and reflection. Spending more than that could cause you to over-analyze your emotions and put too much focus on how you’re feeling, instead of living your life.

Consider this hour each day as a time to relax and focus on mental healing, instead of a chore. That way, your time will be spent purposefully and you will finish your journaling session feeling refreshed, instead of bogged down.

Explore What Journaling Style Works Best

There are a wide variety of journaling techniques that can be practiced. Daily devotionals are typically used in conjunction with scripture. Daily tracking is a journaling style that allows you to document your feelings throughout the day. You can create a gratitude journal that documents a number of items you are grateful for each day. You can also try a stream of consciousness journaling style that unleashing what you are feeling in that given moment.

Try exploring a number of journaling style to determine what works best for you.

Discover the Best Time to Journal

Not all of us are morning people, just like not all of us are night owls. Try and figure out a good time to dedicate to journaling each day, and make sure you journal at that time. Routine is keyhere. The most typical times to journal are right when you wake up or right before you go to sleep, to help avoid any distractions such as the kids being awake, having to take on daily tasks, or work.

Discover the best time to incorporate a journaling routine. Whether it is in the morning or at night, or even if you know you have an hour each day in the afternoon to dedicate to journaling. Carve out that time for a journaling routine to better your mental health.

Drug & Alcohol Addiction Support Groups

Submitted By:

Pinnacle Peak Recovery

866.954.0524
info@pinnaclepeakrecovery.com
8070 East Morgan Trail
Suite 200
Scottsdale, AZ 85258

https://www.pinnaclepeakrecovery.com/drug-alcohol-addiction-support-groups/

Support groups for all types of addictions allow people to join together with others who share similar experiences, backgrounds, and struggles. Drug and alcohol substance abuse groups are helpful whether you are interested in a support group as a first step in your journey to recovery from a drug or alcohol addiction or if you want to participate in a group to remain sober and help newer members.

There are hundreds of support groups full of compassionate members around the United States for you to consider. People who live in rural areas or prefer to not leave home to get help from peers have the option of joining many online communities that will be happy to welcome you as a member. There are general groups for any kind of addiction, for specific substance recoveries, for people who are religious or non-religious, and more, so no matter your circumstances and background, there is a community waiting to help you live a happy, healthy, sober life.

Use these menus to jump directly to the groups of interest to you:

National Substance Addiction Support Groups

1. Drug & Alcohol Addiction Hotlines

2. Online Groups

3. In-Person Groups

4. Men’s Groups

5. Women’s Groups

6. LGBT Groups

7. Teen Groups

8. Veterans Groups

9. Religious Groups

10. Secular Groups

11. Interactive Map of Drug Overdose Deaths

Addiction Support Groups by Substance

1. Alcohol Groups

2. Cocaine & Crack Groups

3. Heroin & Opiates Groups

4. Marijuana Groups

5. Meth & Crystal Meth Groups

6. Prescription Drug Groups

Drug & Alcohol Addiction Hotlines

In the event of an immediate crisis, call 911 for emergency services. 

Boys Town National Hotline

This hotline for young men and young women is available every minute of each year to help children and youth who are struggling with a variety of issues.

800-448-3000 | Website

Crystal Meth Anonymous 24 Hour Helpline

If you are struggling with an addiction to crystal meth, this 24/7 hotline will help you or your loved one, connect you with resources, and more.

855-638-4373 | Email

Lesbian, Gay, Bisexual and Transgender National Hotline

While the GLBT hotline isn’t just for help with drug and alcohol addiction, they can offer resources in this regard tailored specifically for the LGBT community. This hotline is available Monday through Friday, 4pm – 12am EST (1pm – 9pm PST) and Saturday from 12pm – 5pm EST (9am – 2pm PST).

888-843-4564 | Website | Email

National Drug Helpline

The National Drug Helpline is available 24/7, 365 days a year to assist anyone who has a substance abuse problem find help and treatment information.

866-236-1651 | Website

SAMHSA’s National Helpline (English & Spanish)

This hotline is available 24/7 every day of the year. Compassionate staff will help you find the resources you need to start your journey to recovery.

800-662-HELP (4357) | Website

Your Life Your Voice Hotline

In addition to their main hoteline, Your Life Your Voice from Boys Town also offers text (available 12pm to 12am CST), chat (available Monday through Friday, 6pm to 12am CST), and email support (available anytime for responses within 48 hours) for pre-teens, teenagers, and young adults. 

800-448-3000 | Text VOICE to 20121 | Chat | Website | Email Contact Form

Online Drug & Alcohol Addiction Support Groups

5th Dimension Online Alcoholics Anonymous Group

An online Alcoholics Anonymous meeting specifically for teens and young people that meets Monday and Wednesday evenings. The Wednesday meetings are translated by an ASL interpreter. They also have a secret Facebook group where you can interact with other members. 

Find an Online Meeting | Email

Al-Anon: Sharing Experience Strength & Hope Yahoo Group

An Al-Anon Yahoo Group for people who want to share their experiences with others who are in recovery.

Website

Alcoholics Anonymous Online Intergroup

An Alcoholics Anonymous directory that lists general online Alcoholics Anonymous meetings as well as specialized meetings such as men only, women only, LGBT, veterans, atheists and agnostics, and more.

Find a Meeting | Contact

Alcohol Support Group at SupportGroups.com

An active online community for people who have struggled or are struggling with alcohol addiction.

Website

Alcoholism Support Group at DailyStrength.org

A community of people who connect with each other online to provide support to others and get help for alcohol addiction or alcohol abuse.

Website

Cocaine Anonymous Online

The online sector of Cocaine Anonymous, featuring email meetings and phone meetings via Skype.

Find a Meeting | Email | Phone

Cocaine Support Group at DailyStrength.org

An online community for recovery from cocaine abuse where people can share their experiences, receive guidance, and help others on their path to sobriety. 

Website

Cocaine Support Group at SupportGroups.com

An online network for people with a cocaine addiction to communicate with each other about any issues, struggles, victories, and more.

Website

The Daily Pledge

An online recovery community for people who have been affected personally by addiction or know someone who has been affected by substance abuse.

Find a Meeting

Drug/Alcohol Addiction Support Facebook Group

A Facebook group for people looking to become sober or maintain their recovery from drug or alcohol addiction.

Go to Facebook Group

Drug Support Group at SupportGroups.com 

A general drug use community that allows members to give and receive help for many different substance abuse problems.

Website

In The Rooms

An online social network for people who are struggling with addiction, in recovery, and their friends and family members who have been affected by a loved one’s substance dependence.

Sign Up

Lifering Secular Recovery

In addition to face-to-face meetings, Lifering has 24/7 online meetings and dedicated communities for people looking to connect with others in a secular environment.

Online Meetings | Email Group | Email | Phone

Marijuana Anonymous

The headquarters of Marijuana Anonymous, an organization that helps people struggling with marijuana use and their families find help.

Online Meetings | Phone Meetings | Contact | Phone

Marijuana Support Group at DailyStrength.org

For people struggling with marijuana addiction, this online community comprised of members with similar issues can be accessed from any internet connected device.

Website

Men’s One Day At A Time Al-Anon Yahoo Group

An Alcoholics Anonymous online-only Yahoo Group just for men with a small community of very active members.

Website

Meth Support Group at SupportGroups.com

SupportGroups.com offers this online community specifically for people who want to overcome or maintain sobriety from a meth addiction.

Website

Methadone Support Group at SupportGroups.com

It can often be difficult to find in-person, local methadone help, but you can access this community of like-minded people who will support you during your journey no matter where you are located.

Website

My Recovery

As an online support community, My Recovery offers a social recovery network, online journal, forums, and more. Online AA and NA dedicated meetings are scheduled regularly.

Sign Up

Prescription & Synthetic Drug Support Group at DailyStrength.org

A more general community for people who have abused prescription or synthetic drugs and are looking toward recovery.

Website

Recoveries Anonymous

This network of smaller communities for people with any problem or troubling behavior is focused on “sanity recovery” instead of full abstinence.

Find an Online Meeting

Secular Alcoholics Anonymous

An AA community for people who wish to participate in the 12 steps without the religious belief component with meetings online and in person across the USA.

Find an Online Meeting | Contact

SMART Recovery Teen & Youth Support Program

The Teen & Youth SMART (Self Management and Recovery Training) Recovery program utilizes a 4-point program to help people with addictions to any substance or activity. Online meetings specifically for teens and youth are held regularly.

Find an Online Meeting | Contact

Drug & Alcohol Addiction Support Groups with In-Person Meetings

All Addictions Anonymous

Similar to AA, this twelve step program is based on healing from all addictions, no matter the type.

Find a Meeting | Contact

Celebrate Recovery

The headquarters for Celebrate Recovery, a network with an annual rally and individual meetings in many locations throughout the country. Specific subsects for students, veterans, pastors, Native Americans, bikers, and more are also available.

Find a Meeting

Chemically Dependent Anonymous

CDA is a community for people who are or have been addicted to drugs or alcohol. 

Find a Meeting | Contact | Phone

Learn to Cope

The national headquarters of Learn to Cope, a recovery network for people who are struggling with or in recovery from an addiction to opiates or other drugs.

Find a Meeting | Contact

Moderation Management

Created for problem drinkers, not necessarily people with alcohol addictions, Moderation Management (MM) focuses on limiting and controlling the amount of alcohol people consume instead of abstinence. 

Find a Meeting

Recoveries Anonymous

This network of communities for people with any problem or troubling behavior is focused on “sanity recovery” instead of full abstinence.

Find a Meeting

SMART Recovery

SMART (Self Management and Recovery Training) Recovery utilizes a 4-point program to help people with addictions to any substance or activity. SMART places an emphasis on evidence-based and scientifically-backed recovery techniques.

Find a Meeting | Contact

Substance Abuse and Mental Health Services Administration

Government resources for recovery from drug and alcohol addictions.

Find a Meeting | Contact

The Phoenix

The headquarters of The Phoenix, a national organization that encourages people to live a fulfilling life in sobriety.

Find a Meeting | Contact | Phone

Men’s Drug & Alcohol Addiction Support Groups

AAmen Online Group

An online Alcoholics Anonymous community for men from anywhere in the world that meets through email.

Website | Email

Men’s One Day At A Time Al-Anon Yahoo Group

An Alcoholics Anonymous online-only Yahoo group for men with a small community of very active members.

Website

Men’s Online Serenity Alcoholics Anonymous Group

A weekly audio & video men’s only meeting that discusses an assigned reading each meeting.

Email

Women’s Drug & Alcohol Addiction Support Groups

Alcoholics Anonymous Serenity Online Group

An AA group just for women that meets through email and discusses the twelve steps, offers newcomer meetings, and more.

Email

AAChatcorner@Topica.com Online Group

An online-only women’s AA group that applies traditional AA topics to women’s issues.

Email

KISS Group Alcoholics Anonymous Online Group

Keep It Simple Sisters (KISS) is an online email meeting for women only.

Email

Ladies Alcoholics Anonymous Meeting Online Group

The Ladies AA Meeting is an online support community just for women where they can discuss sobriety from alcohol and other issues as they pertain to women. 

Website | Email

Sisters in Sobriety (SIS) Alcoholics Anonymous Online Group

A community just for women who meet virtually each week to discuss a pre-selected topic.

Email

Sober She Devils Alcoholics Anonymous Online Group

A secular, women-only meeting for women around the world.

Email

Women for Sobriety

In addition to face-to-face meetings, Lifering has 24/7 online meetings and dedicated groups for people looking to connect with others in a secular environment.

Find a Meeting | Email | Phone

Women in the Solution (WITS) Alcoholics Anonymous Online Group

A community that meets via email each week to discuss two topics for women only.

Email

Women’s Sober Living Alcoholics Anonymous Online Group

A telephone meeting for women who wish to share and hear about AA literature.

Email

LGBT Drug & Alcohol Addiction Support Groups

A Safe Place Online Alcoholics Anonymous Meeting

An AA meeting that provides a welcoming environment full of people who identify as LGBT.

Email

AA4gaymen Online Group

An Alcoholics Anonymous online-only group for gay men to help each other through their recoveries from alcohol addiction.

Email

Alcoholics Anonymous Lesbian 3 Online Group

A small group of alcoholic lesbians who discuss topics each week through email.

Email

LGBTQ Friendly Open Discussion Alcoholics Anonymous Online Group

An exclusively online Alcoholics Anonymous group where LGBTQ people can reach out to each other.

Email

Rainbow Serenity Alcoholics Anonymous Online Group

Online group for LGBT members that discuss a select topic each week but sharing anything else is encouraged.

Email

TG-AA Alcoholics Anonymous Online Group

An online Alcoholics Anonymous group for transgender people looking to connect and help other members through their recovery.

Website

Teen Drug & Alcohol Addiction Support Groups

Most support groups meant specifically for teens and young people are area-specific, so please navigate to your state to see more detailed results.

5th Dimension Online Alcoholics Anonymous Group

An online Alcoholics Anonymous meeting specifically for teens and young people that meets Monday and Wednesday evenings. The Wednesday meetings are translated by an ASL interpreter. They also have a secret Facebook group where you can interact with other members. 

Find an Online Meeting | Email

SMART Recovery Teen & Youth Support Program

The Teen & Youth SMART (Self Management and Recovery Training) Recovery program utilizes a 4-point program to help people with addictions to any substance or activity. Online meetings specifically for teens and youth are held regularly.

Find an Online Meeting | Contact

Veteran Drug & Alcohol Addiction Support Groups

Alcoholics Anonymous Online Intergroup

An Alcoholics Anonymous directory that lists general online Alcoholics Anonymous meetings as well as specialized meetings such as men only, women only, LGBT, veterans, atheists and agnostics, and more.

Find a Meeting | Contact

Celebrate Recovery

The headquarters for Celebrate Recovery, a support network with an annual rally and individual meetings in many locations throughout the country. Specific meetings for students, veterans, pastors, Native Americans, bikers, and more are also available.

Find a Meeting

Religious Drug & Alcohol Addiction Support Groups

Alcoholics for Christ

A non-denominational Christian community with chapters across the nation for people with substance abuse problems, their family members, and their adult children.

Find a Meeting | Email | Phone

Alcoholics Victorious

Alcoholics Victorious is a Christian faith recovery community that has local meetings in many states.

Find a Meeting

Buddhist Recovery Network

A network of communities that are guided by Buddhist principles. Meetings are open to people of any faith, background, and recovery path.

Find a Meeting | Contact

The Calix Society

The Calix Society provides help for Catholics who are already well along the path to recovery and are currently maintaining their sobriety from alcohol.

Find a Meeting | Contact

Indigenous Sobriety Alcoholics Anonymous Online Group

An online-only Alcoholics Anonymous community for Indigenous and Aboriginal people who want to interact with and help others through their sobriety.

Forum | Email

Millati Islami

The main website for Millati Islami, a community for Muslims recovering from substance abuse.

Find a Meeting | Email

re:generation

The main headquarters of a network of Christian faith recovery groups that are based on biblical principles.

Find a Meeting | Email | Phone

White Bison

A recovery community created for and by the Native Americans and Alaska Native communities.

Find a Meeting

Secular Drug & Alcohol Addiction Support Groups

A Spiritual Recovery Online Alcoholics Anonymous Meeting

A Spiritual Recovery caters to people such as freethinkers, atheists, and agnostics who prefer an approach to sobriety that doesn’t contain more traditional religious aspects of AA.

Forum

Alcoholics Anonymous Atheists and Agnostics Online Meeting

An Alcoholics Anonymous online community where people are accepting of non-belief in God. Members can participate from anywhere in the world through Google Groups.

Forum | Email

Alcoholics Anonymous Freethinkers Group Online Meeting

An online Alcoholics Anonymous community for freethinkers that meets through Yahoo groups.

Forum

Atheist-Alcoholics Anonymous Online Meeting

An online Alcoholics Anonymous community specifically for Atheists, who often struggle with some of the spiritual concepts of traditional AA, that meets through Google Groups.

Forum | Email

Alcoholics Anonymous

With thousands of recovery support networks across the United States, AA can be easily accessed no matter your location. 

Find a Meeting

Alcoholics Anonymous Online Intergroup

An Alcoholics Anonymous directory that lists general online Alcoholics Anonymous meetings as well as specialized meetings such as men only, women only, LGBT, veterans, atheists and agnostics, and more.

Find a Meeting | Contact

Lifering Secular Recovery

Lifering offers meetings across the United States for people who prefer a non-religious approach to sobriety. 

Find a Meeting | Contact

Secular Alcoholics Anonymous

An AA community for people who wish to participate in the 12 steps without the religious belief component with meetings online and in person across the USA.

Find a Meeting | Contact

Secular Organizations for Sobriety (S.O.S)

The national head of SOS which offers general information and connections to local SOS meetings.

Find a Meeting | Email | Phone

Alcohol Addiction Support Groups

5th Dimension Online Alcoholics Anonymous Group

An online Alcoholics Anonymous meeting specifically for teens and young people that meets Monday and Wednesday evenings. The Wednesday meetings are translated by an ASL interpreter. They also have a secret Facebook group where you can interact with other members. 

Find an Online Meeting | Email

Alcoholics Anonymous

With thousands of recovery support networks across the United States, AA can be easily accessed no matter your location.

Find a Meeting

Alcoholics Anonymous Online Intergroup

An Alcoholics Anonymous directory that lists general online Alcoholics Anonymous meetings as well as specialized meetings such as men only, women only, LGBT, veterans, atheists and agnostics, and more.

Find a Meeting | Contact

Alcoholics for Christ

A non-denominational Christian support community with chapters across the nation for people with substance abuse problems, their family members, and their adult children.

Find a Meeting | Email | Phone

Alcoholics Victorious

Alcoholics Victorious is a Christian faith recovery support community that has local meetings in many states.

Find a Meeting

A Spiritual Recovery Online Alcoholics Anonymous Meeting

A Spiritual Recovery caters to people such as freethinkers, atheists, and agnostics who prefer an approach to sobriety that doesn’t contain more traditional religious aspects of AA.

Forum

Alcoholics Anonymous Atheists and Agnostics Online Meeting

An Alcoholics Anonymous online community where people are accepting of non-belief in God. Members can participate from anywhere in the world through Google Groups.

Forum | Email

Alcoholics Anonymous Freethinkers Group Online Meeting

An online Alcoholics Anonymous community for freethinkers that meets through Yahoo Groups.

Forum

Atheist-Alcoholics Anonymous Online Meeting

An online Alcoholics Anonymous community specifically for Atheists, who often struggle with some of the spiritual concepts of traditional AA, that meets through Google Groups.

Forum | Email

AAChatcorner@Topica.com Online Group

An online-only women’s AA community that applies traditional AA topics to women’s issues.

Email

AAmen Online Group

An online Alcoholics Anonymous community for men from anywhere in the world that meets through email.

Website | Email

Al-Anon: Sharing Experience Strength & Hope Yahoo Group

A Yahoo group for people who want to share their experiences with others who are in recovery.

Website

Alcoholics Anonymous Online Intergroup

An Alcoholics Anonymous directory that lists general online Alcoholics Anonymous meetings as well as specialized meetings such as men only, women only, LGBT, veterans, atheists and agnostics, and more.

Find a Meeting | Contact

A Safe Place Online Alcoholics Anonymous Meeting

An AA meeting that provides a welcoming environment full of people who identify as LGBT.

Email

AA4gaymen Online Group

An Alcoholics Anonymous online-only community for gay men to help each other through their recoveries from alcohol addiction.

Email

Alcoholics Anonymous Lesbian 3 Online Group

A small community of alcoholic lesbians who discuss topics each week through email.

Email

Alcoholics Anonymous Serenity Online Group

An AA community just for women that meets through email and discusses the twelve steps, offers newcomer meetings, and more.

Email

Alcohol Support Group at SupportGroups.com

An active online community for people who have struggled with alcohol addiction.

Website

Alcoholism Support Group at DailyStrength.org

A community of people who connect with each other online to provide support to others and get help for alcohol addiction or alcohol abuse.

Website

Drug/Alcohol Addiction Support Facebook Group

A Facebook group for people looking to become sober or maintain their recovery from drug or alcohol addiction.

Website

Indigenous Sobriety Alcoholics Anonymous Online Group

An online-only Alcoholics Anonymous community for Indigenous and Aboriginal people who want to interact with and help others through their sobriety.

Group Forum | Email

KISS Group Alcoholics Anonymous Online Group

Keep It Simple Sisters (KISS) is an online email group for women only.

Email

Ladies Alcoholics Anonymous Meeting Online Group

The Ladies AA Meeting is an online community just for women where they can discuss sobriety from alcohol and other issues as they pertain to women. 

Website | Email

LGBTQ Friendly Open Discussion Alcoholics Anonymous Online Group

An exclusively online Alcoholics Anonymous community where LGBTQ people can help each other.

Email

Men’s One Day At A Time Al-Anon Yahoo Group

An Alcoholics Anonymous online-only Yahoo community for men with a small community of very active members.

Website

Men’s Online Serenity Alcoholics Anonymous Group

A weekly audio & video men’s only meeting that discusses an assigned reading each meeting.

Email

Moderation Management

Created for problem drinkers, not necessarily people with alcohol addictions, Moderation Management (MM) focuses on limiting and controlling the amount of alcohol people consume instead of abstinence. 

Find a Meeting

Rainbow Serenity Alcoholics Anonymous Online Group

Online community for LGBT members that discuss a select topic each week but sharing anything else is encouraged.

Email

Secular Alcoholics Anonymous

An AA community for people who wish to participate in the 12 steps without the religious belief component with meetings online and in person across the USA.

Find an Online Meeting | Contact

Sisters in Sobriety (SIS) Alcoholics Anonymous Online Group

A community just for women who meet virtually each week to discuss a pre-selected topic.

Email

Sober She Devils Alcoholics Anonymous Online Group

A secular, women-only meeting for women around the world.

Email

TG-AA Alcoholics Anonymous Online Group

An online Alcoholics Anonymous community for transgender people looking to connect and help other members through their recovery.

Website

Women for Sobriety

In addition to face-to-face meetings, Lifering has 24/7 online meetings for people looking to connect with others in a secular environment.

Find a Meeting | Email | Phone

Women in the Solution (WITS) Alcoholics Anonymous Online Group

A community that meets via email each week to discuss two topics for women only.

Email

Women’s Sober Living Alcoholics Anonymous Online Group

A telephone meeting for women who wish to share and hear about AA literature.

Email

Cocaine & Crack Addiction Support Groups

Cocaine Anonymous

World headquarters of Cocaine Anonymous with resources and links to local, in-person meetings.

Find a Meeting | Phone

Cocaine Anonymous Online

The online sector of Cocaine Anonymous, featuring email meetings and phone meetings via Skype.

Find a Meeting | Email | Phone

Cocaine Support Group at DailyStrength.org

An online community for recovery from cocaine abuse where people can share their experiences and help others on their path to sobriety. 

Website

Cocaine Support Group at SupportGroups.com

The Cocaine Support Group is an online network that helps people with a cocaine addiction.

Website

Heroin & Opiates Addiction Support Groups

Narcotics Anonymous

The main headquarters of Narcotics Anonymous which provides resources and a list of local meetings.

Find a Meeting | Contact

Opiates Anonymous World Services

Find meetings around the entire country using the world services website of Opiates Anonymous.

Find a Meeting | Email

Marijuana Addiction Support Groups

Marijuana Anonymous

The headquarters of Marijuana Anonymous, an organization that helps people struggling with marijuana use and their families find help.

Online Meetings | Phone Meetings | Contact| Phone

Marijuana Support Group at DailyStrength.org

For people struggling with marijuana addiction, this online community comprised of members with similar issues can be accessed from any internet connected device.

Website

Leaves Subreddit

AAn online space with over 70,000 subscribers on Reddit for people who have, would like to, or are quitting the use of marijuana to discuss their journey anonymously.

Website 

Meth & Crystal Meth Addiction Support Groups

Crystal Meth Anonymous

The main website of Crystal Meth Anonymous, an organization that has literature, resources, and can connect people with local meetings.

Find a Meeting | Contact

Meth Support Group at SupportGroups.com

SupportGroups.com offers this online community specifically for people who want to overcome or maintain sobriety from a meth addiction.

Website

Methadone Support Group at SupportGroups.com

It can often be difficult to find in-person, local methadone recovery help, but you can access this community of like-minded people who will help you during your journey no matter where you are located.

Website

Prescription Drug Addiction Support Groups

Nar-Anon

The world services of Narcotics Anonymous which provides resources and a list of local meetings.

Find a Meeting | Contact | Phone

Pills Anonymous

Pills Anonymous offers support for people who are recovering from prescription medication addictions.

Find a Meeting | Contact

Prescription & Synthetic Drug Support Group at DailyStrength.org

A more general group for people who have abused prescription or synthetic drugs and are looking toward recovery.

Website