Anxiety and depression linked to migraines

October 18, 2017

Science Daily/Wiley

In a study of 588 patients who attended an outpatient headache clinic, more frequent migraines were experienced by participants with symptoms of anxiety and depression. In the Headache study, poor sleep quality was also found to be an independent predictor of more severe depression and anxiety symptoms.

The study's investigators noted that factors such as emotional distress and frequency of headache may influence each other through a common pathophysiological mechanism. For example, emotional responses have the potential to alter pain perception and modulation through certain signaling pathways.

"These findings potentially suggest that adequate medical treatment to decrease headache frequency may reduce the risk of depression and anxiety in migraine patients," said Dr. Fu-Chi Yang, corresponding author of the study and an investigator in the Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taiwan.

https://www.sciencedaily.com/releases/2017/10/171018090209.htm

Screening for depression recommended for adults, including pregnant and postpartum women

January 26, 2016

Science Daily/The JAMA Network Journals

The US Preventive Services Task Force is recommending screening for depression in the general adult population, including pregnant and postpartum women, and that screening should be implemented with adequate systems in place to ensure accurate diagnosis, effective treatment, and appropriate follow-up.

This recommendation is a USPSTF grade B recommendation, meaning that there is high certainty that the net benefit is moderate, or there is moderate certainty that the net benefit is moderate to substantial.

Depression is among the leading causes of disability in persons 15 years and older. It affects individuals, families, businesses, and society and is common in patients seeking care in the primary care setting, and also common in postpartum and pregnant women. The U.S. Preventive Services Task Force (USPSTF) reviewed the evidence in the medical literature on the benefits and harms of screening for depression in adult populations, including older adults and pregnant and postpartum women; the accuracy of depression screening instruments; and the benefits and harms of depression treatment in these populations. The USPSTF is an independent, volunteer panel of experts that makes recommendations about the effectiveness of specific preventive care services such as screenings, counseling services, and preventive medications. This report is an update of a 2009 USPSTF recommendation statement. The USPSTF continues to recommend that adults 18 and older be screened for depression.

Detection, and Benefits of Early Detection, Intervention and Treatment

The USPSTF found convincing evidence that screening improves the accurate identification of adult patients with depression in primary care settings, including pregnant and postpartum women, and found adequate evidence that programs combining depression screening with adequate support systems in place improve clinical outcomes (i.e., reduction or remission of depression symptoms) in adults, including pregnant and postpartum women. The USPSTF found convincing evidence that treatment of adults and older adults with depression identified through screening in primary care settings with antidepressants, psychotherapy, or both decreases clinical morbidity. The USPSTF also found adequate evidence that treatment with cognitive behavioral therapy (CBT) improves clinical outcomes in pregnant and postpartum women with depression.

Harms of Early Detection, Intervention and Treatment

The USPSTF found adequate evidence that the magnitude of harms of screening for depression in adults is small to none and that the magnitude of harms of treatment with CBT in postpartum and pregnant women is small to none. The USPSTF found that second-generation antidepressants (mostly selective serotonin reuptake inhibitors [SSRIs]) are associated with some harms, such as an increase in suicidal behaviors in adults age 18 to 29 years and an increased risk of upper gastrointestinal bleeding in adults older than 70 years, with risk increasing with age; however, the magnitude of these risks is, on average, small. The USPSTF also found evidence of potential serious fetal harms from pharmacologic treatment of depression in pregnant women, but the likelihood of these serious harms is low. Therefore, the USPSTF concludes that the overall magnitude of harms is small to moderate.

Screening

The optimal timing and interval for screening for depression is not known. A pragmatic approach might include screening all adults who have not been screened previously and using clinical judgment in consideration of risk factors, comorbid conditions, and life events to determine if additional screening of high-risk patients is warranted. Positive screening results should lead to additional assessment that considers severity of depression and comorbid psychological problems, alternate diagnoses, and medical conditions.

Treatment and Interventions

Effective treatment of depression in adults generally includes antidepressants or specific psychotherapy approaches, alone or in combination. Given the potential harms to the fetus and newborn child from certain pharmacologic agents, clinicians are encouraged to consider evidence-based counseling interventions when managing depression in pregnant or breastfeeding women.

USPSTF Assessment

The USPSTF concludes with at least moderate certainty that there is a moderate net benefit to screening for depression in adults 18 years and older, including older adults, who receive care in clinical practices that have adequate systems in place to ensure accurate diagnosis, effective treatment, and appropriate follow-up after screening. The USPSTF also concludes with at least moderate certainty that there is a moderate net benefit to screening for depression in pregnant and postpartum women who receive care in clinical practices that have CBT or other evidence-based counseling available after screening.

Editorial: Recommendations for Screening for Depression in Adults

Michael E. Thase, M.D., of the University of Pennsylvania, Philadelphia, comments on the USPSTF recommendations in an accompanying editorial.

"Until there are better methods to match patients with specific forms of treatment, the best hope to improve on a B grade for patients with depression may be to adapt care systems to respond more flexibly and decisively to key events that are associated with nonadherence or treatment failure. For example, if the clinicians working within a collaborative care model could rapidly incorporate the information that an initial prescription was not filled or was not refilled, it may be possible to diminish the chances that nonadherence will compromise treatment outcome."

"Likewise, given evidence that nonresponse is predicted by a lack of symptom improvement during the first 14 days of therapy, web-based monitoring of symptoms early in the course of therapy may enable physicians and other mental health professionals to intervene more rapidly and reduce the chances of treatment failure. The same approach to ongoing care could be used to facilitate a more timely transition through treatment algorithms and more expeditious referral to specialty care."

http://www.sciencedaily.com/releases/2016/01/160126125228.htm

Drinking makes you older at the cellular level

June 26, 2017

Science Daily/Research Society on Alcoholism

The more alcohol that people drink, the more their cells appear to age. Researchers found that alcoholic patients had shortened telomere lengths, placing them at greater risk for age-related illnesses, such as cardiovascular disease, diabetes, cancer and dementia..

"Telomeres, the protein caps on the ends of human chromosomes, are markers of aging and overall health," said Naruhisa Yamaki, M.D., a clinical fellow at the Kobe University Graduate School of Medicine. Yamaki explained that every time a cell replicates, a tiny bit of telomere is lost, so they get shorter with age. But some groups may have shorter telomeres for reasons other than aging.

"Our study showed that alcoholic patients have a shortened telomere length, which means that heavy drinking causes biological aging at a cellular level," he said. "It is alcohol rather than acetaldehyde that is associated with a shortened telomere length." Yamaki will present this research at the RSA meeting on June 25.

Yamaki and his co-authors recruited 255 study participants from alcoholism treatment services at Kurihama National Hospital in Yokosuka, Japan: 134 alcoholic patients and 121 age-matched controls or non-alcoholics, ranging in age from 41 to 85 years old. DNA samples, as well as drinking histories and habits, were collected from all participants.

"We also found an association between telomere shortening and thiamine deficiency (TD)," said Yamaki. "TD is known to cause neuron impairments such as Wernicke-Korsakoff Syndrome. Although how exactly TD can cause neural impairments is unclear, it is well known that oxidation stress cause telomere shortening and, thus, it is possible that oxidation stress may also cause neuron death."

Yamaki added that it's important for the public to understand that heavy drinking causes telomere shortening because "awareness of this fact provides important information necessary for people to live healthier."

https://www.sciencedaily.com/releases/2017/06/170626105322.htm

Greater muscle strength, better cognitive function for older people

June 26, 2017

Science Daily/University of Eastern Finland

Greater muscle strength is associated with better cognitive function in ageing men and women, according to a new study. The association of extensively measured upper and lower body muscle strength with cognitive function was observed, but handgrip strength was not associated with cognitive function.

The study population comprised 338 men and women with an average age of 66 years. Their muscle strength was measured utilising handgrip strength, three lower body exercises such as leg extension, leg flexion and leg press and two upper body exercises such as chest press and seated row. Sum scores to depict lower body and upper body muscle strength were calculated separately, and cognitive function was assessed using the CERAD neuropsychological test battery with calculated total score.

Handgrip strength is relatively easy and fast to measure, and it has been widely used as a measure of muscle strength in various studies. However, this new study could not demonstrate an association between muscle strength and cognitive function when using a model based on mere handgrip strength and age. Instead, an association between muscle strength and cognitive function was observed only when sum scores depicting upper or lower body muscle strength were included in the model.

"The findings suggest that it may be justified to go beyond the handgrip and to include the upper and lower body when measuring muscle strength, as this may better reflect the association between muscle strength and cognition," says Early Stage Researcher Heikki Pentikäinen, the first author of the article, who is currently preparing a PhD thesis on the topic for the University of Eastern Finland.

Exercise is known to have various health benefits, and strength training is a way for practically everyone to increase muscle mass and enhance muscle strength. However, the association of muscle strength with various aspects of cognitive function is a relatively under-researched area. The study provided new insight into the methodology of measuring muscle strength and into the role of muscle strength in cognitive function. The study constituted part of the extensive, population-based DR's EXTRA study, which was a four-year randomised and controlled intervention study analysing the effects of exercise and nutrition on endothelial function, atherosclerosis and cognition. The study was carried out at Kuopio Research Institute of Exercise Medicine in 2005-2011 and it involved more than 1,400 men and women living in the eastern part of Finland.

https://www.sciencedaily.com/releases/2017/06/170626093546.htm

Lack of sleep fuels harmful inflammatory response to marital stress

June 26, 2017

Science Daily/Ohio State University Wexner Medical Center

A lack of sleep doesn’t just leave you cranky and spoiling for a fight. Researchers say it also puts you at risk for stress-related inflammation.

This type of inflammation is associated with higher risk of cardiovascular disease, diabetes, arthritis and other diseases.

"We know sleep problems are also linked with inflammation and many of the same chronic illnesses. So we were interested to see how sleep related to inflammation among married couples, and whether one partner's sleep affected the other's inflammation," said Stephanie Wilson, lead researcher on the study.

Results of the study were published in the journal Psychoneuroendocrinology.

The research team recruited 43 couples who completed two study visits. Each time, the couples provided blood samples and said how many hours they had slept the previous two nights. Then researchers had the couples try to resolve a topic that sparks conflict in their marriage. Blood samples were taken again following the discussion.

"We found that people who slept less in the past few nights didn't wake up with higher inflammation, but they had a greater inflammatory response to the conflict. So that tells us less sleep increased vulnerability to a stressor," Wilson said.

If both partners got less than seven hours of sleep the previous two nights, the couple was more likely to argue or become hostile. For every hour of sleep lost, the researchers noted that levels of two known inflammatory markers rose 6 percent. Couples who used unhealthy tactics in their disagreement had an even greater inflammatory response -- about a 10 percent increase with each hour of less sleep.

"Any increase isn't good, but a protracted increase that isn't being addressed is where it can become a problem," Wilson said. "What's concerning is both a lack of sleep and marital conflict are common in daily life. About half of our study couples had slept less than the recommended seven hours in recent nights."

That's higher than the current national average. The CDC reports 35 percent of Americans get less than seven hours of sleep per night.

"Part of the issue in a marriage is that sleep patterns often track together. If one person is restless, or has chronic problems, that can impact the other's sleep. If these problems persist over time, you can get this nasty reverberation within the couple," said Janice Kiecolt-Glaser, senior author and director of the Institute for Behavioral Medicine Research.

Researchers were encouraged to see that there was a protective effect if one of the partners was well-rested, or discussed conflict in a healthy way. They tended to neutralize the disagreement that might be stirred by the sleep-deprived partner.

"We would tell people that it's important to find good ways to process the relationship and resolve conflict -- and get some sleep," Kiecolt-Glaser said.

https://www.sciencedaily.com/releases/2017/06/170626105142.htm

Lights out: The neural relationship between light and sleep

June 23, 2017

Science Daily/California Institute of Technology

While a great deal is known about how light affects circadian rhythms, little is known about the direct effects of light on sleep: Why do we tend to wake up if the lights are flipped on in the middle of the night? Why does darkness make us sleepy? Researchers say they have discovered at least part of the answer: a specific protein in the brain that responds to light and darkness to set the correct balance between sleep and wakefulness.

Humans are diurnal animals, meaning that we usually sleep at night and are awake during the day, due at least in part to light or the lack thereof. Light is known to affect sleep indirectly by entraining -- modifying the length of -- our circadian rhythms and also rapidly and directly due to a phenomenon known as masking. But while a great deal is known about how light affects circadian rhythms, little is known about the direct effects of light on sleep: Why do we tend to wake up if the lights are flipped on in the middle of the night? Why does darkness make us sleepy? Caltech researchers in the laboratory of Professor of Biology David Prober say they have discovered at least part of the answer: a specific protein in the brain that responds to light and darkness to set the correct balance between sleep and wakefulness.

Their work is described in a paper appearing online in the journal Neuron on June 22.

"Researchers had previously identified the photoreceptors in the eye that are required for the direct effect of light on wakefulness and sleep," says Prober. "But we wanted to know how the brain uses this visual information to affect sleep."

The Prober laboratory uses zebrafish as a model organism for studying sleep. The animals are optically transparent, allowing for noninvasive imaging of their neurons; they also have a diurnal sleep/wake pattern like that of humans. To investigate how their sleep responds to light, Wendy Chen, a former graduate student in Prober's lab, led studies examining a particular protein in the zebrafish brain called prokineticin 2 (Prok2).

Chen genetically engineered zebrafish to overexpress Prok2, resulting in an abundance of the protein. She found that in contrast to normal zebrafish, these animals were more likely to fall asleep during the day and to wake up at night. Surprisingly, the effects did not depend on the engineered fish's normal circadian sleep/wake cycle but rather depended only on whether the lights were on or off in their environment. These observations suggest that an excess of Prok2 suppresses both the usual awakening effect of light and the sedating effect of darkness.

Chen then generated zebrafish with mutated forms of Prok2 and its receptor, and observed light-dependent sleep defects in these animals. For example, Chen found that zebrafish with a mutated Prok2 receptor were more active when the lights were on and less active when the lights were off, the opposite of what she had observed in animals that overexpressed Prok2 and had functional Prok2 receptors.

"Though diurnal animals such as zebrafish spend most of their time asleep at night and awake during the day, they also take naps during the day and occasionally wake up at night, similar to many humans," Prober says. "Our study's results suggest that levels of Prok2 play a critical role in setting the correct balance between sleep and wakefulness during both the day and the night."

Next, the researchers wanted to know how Prok2 was modulating light's effects on sleep. To answer this question, they decided to examine whether other proteins in the brain that are known to affect sleep were required for the effects of Prok2 on sleep behavior. They found that the sedating effect of Prok2 overexpression in the presence of light requires galanin, a known sleep-promoting protein. They also found that Prok2 overexpression increased the level of galanin expression in the anterior hypothalamus, a key sleep-promoting center in the brain. But in animals that were engineered to lack galanin, overexpression of Prok2 did not increase sleep.

These findings provide the first insights into how light may interact with the brain to affect sleep and provide a basis for scientists to begin exploring the genes and neurons that underlie the phenomenon. However, further work is needed to fully explain how light and dark directly affect sleeping and waking, and to determine whether Prok2 has a similar function in humans. If it does, this work might eventually lead to new sleep- and wake-promoting drugs.

https://www.sciencedaily.com/releases/2017/06/170623155526.htm

Even moderate drinking linked to a decline in brain health

Results have important public health implications for a large sector of the population

June 6, 2017

Science Daily/BMJ

Alcohol consumption, even at moderate levels, is associated with increased risk of adverse brain outcomes and steeper decline in cognitive (mental) skills, finds a new study.

These results support the recent reduction in alcohol guidance in the UK and raise questions about the current limits recommended in the US, say the authors.

Heavy drinking is known to be associated with poor brain health, but few studies have examined the effects of moderate drinking on the brain -- and results are inconsistent.

So a team of researchers based at the University of Oxford and University College London set out to investigate whether moderate alcohol consumption has a beneficial or harmful association -- or no association at all -- with brain structure and function.

They used data on weekly alcohol intake and cognitive performance measured repeatedly over 30 years (1985-2015) for 550 healthy men and women who were taking part in the Whitehall II study.

This study is evaluating the impact of social and economic factors on the long term health of around 10,000 British adults.

Participants had an average age of 43 at the start of the study and none were alcohol dependent. Brain function tests were carried out at regular intervals and at the end of the study (2012-15), participants underwent an MRI brain scan.

Several factors that could have influenced the results (known as confounding) were taken into account, such as age, sex, education, social class, physical and social activity, smoking, stroke risk and medical history.

After adjusting for these confounders, the researchers found that higher alcohol consumption over the 30 year study period was associated with increased risk of hippocampal atrophy -- a form of brain damage that affects memory and spatial navigation.

While those consuming over 30 units a week were at the highest risk compared with abstainers, even those drinking moderately (14-21 units per week) were three times more likely to have hippocampal atrophy compared with abstainers.

There was no protective effect of light drinking (up to 7 units per week) over abstinence.

Higher consumption was also associated with poorer white matter integrity (critical for efficient cognitive functioning) and faster decline in language fluency (how many words beginning with a specific letter can be generated in one minute).

But no association was found with semantic fluency (how many words in a specific category can be named in one minute) or word recall.

The authors point out that this is an observational study, so no firm conclusions can be drawn about cause and effect, and say some limitations could have introduced bias. However, key strengths include the information on long term alcohol consumption and the detailed available data on confounding factors.

As such, they say their findings have important potential public health implications for a large sector of the population.

"Our findings support the recent reduction in UK safe limits and call into question the current US guidelines, which suggest that up to 24.5 units a week is safe for men, as we found increased odds of hippocampal atrophy at just 14-21 units a week, and we found no support for a protective effect of light consumption on brain structure," they write.

"Alcohol might represent a modifiable risk factor for cognitive impairment, and primary prevention interventions targeted to later life could be too late," they conclude.

In a linked editorial, Killian Welch, consultant neuropsychiatrist at the Royal Edinburgh Hospital, says these findings "strengthen the argument that drinking habits many regard as normal have adverse consequences for health."

This is important, he adds. "We all use rationalisations to justify persistence with behaviours not in our long term interest. With publication of this paper, justification of "moderate" drinking on the grounds of brain health becomes a little harder."

https://www.sciencedaily.com/releases/2017/06/170606201359.htm

Half of adults with anxiety or depression report chronic pain

May 31, 2017

Science Daily/Columbia University's Mailman School of Public Health

In a survey of adults with anxiety or a mood disorder like depression or bipolar disorder, about half reported experiencing chronic pain, according to researchers.

"The dual burden of chronic physical conditions and mood and anxiety disorders is a significant and growing problem," said Silvia Martins, MD, PhD, associate professor of Epidemiology at the Mailman School of Public Health, and senior author.

The research examined survey data to analyze associations between DSM-IV-diagnosed mood and anxiety disorders and self-reported chronic physical conditions among 5,037 adults in São Paulo, Brazil. Participants were also interviewed in person.

Among individuals with a mood disorder, chronic pain was the most common, reported by 50 percent, followed by respiratory diseases at 33 percent, cardiovascular disease at 10 percent, arthritis reported by 9 percent, and diabetes by 7 percent. Anxiety disorders were also common for those with chronic pain disorder at 45 percent, and respiratory at 30 percent, as well as arthritis and cardiovascular disease, each 11 percent. Individuals with two or more chronic diseases had increased odds of a mood or anxiety disorder. Hypertension was associated with both disorders at 23 percent.

"These results shed new light on the public health impact of the dual burden of physical and mental illness," said Dr. Martins. "Chronic disease coupled with a psychiatric disorder is a pressing issue that health providers should consider when designing preventive interventions and treatment services -- especially the heavy mental health burden experienced by those with two or more chronic diseases."

https://www.sciencedaily.com/releases/2017/05/170531133242.htm

Moderate drinking may not ward off heart disease

May 22, 2017

Science Daily/Journal of Studies on Alcohol and Drugs

Many people believe that having a glass of wine with dinner -- or moderately drinking any kind of alcohol -- will protect them from heart disease. But a hard look at the evidence finds little support for that. That's the conclusion of a new research review in the May 2017 issue of the Journal of Studies on Alcohol and Drugs.

That's the conclusion of a new research review in the May 2017 issue of the Journal of Studies on Alcohol and Drugs.

Over the years, studies have found that adults who drink moderately have lower heart disease rates than non-drinkers. That has spurred the widespread belief that alcohol, in moderation, does a heart good.

But the new analysis, of 45 previous cohort studies, reveals the flaws in that assumption: A central issue is that "non-drinkers" may, in fact, be former drinkers who quit or cut down for health reasons.

Furthermore, seniors who are healthy may be more likely to keep enjoying that glass of wine with dinner.

"We know that people generally cut down on drinking as they age, especially if they have health problems," said researcher Tim Stockwell, Ph.D., director of the Centre for Addictions Research at the University of Victoria, in British Columbia, Canada.

"People who continue to be moderate drinkers later in life are healthier," Stockwell said. "They're not sick, or taking medications that can interact with alcohol."

And in studies, that can lead to a misleading association between moderate drinking and better health.

In their analysis, Stockwell's team found that overall, "current" moderate drinkers (up to two drinks per day) did, in fact, have a lower rate of heart disease death than non-drinkers.

However, that was not the case in studies that looked at people's drinking habits at relatively young ages -- age 55 or earlier -- and followed them to their older years when heart disease might strike. Similarly, studies that rigorously accounted for people's heart health at baseline indicated no benefits from moderate drinking.

According to Stockwell, it all suggests that "abstainers" tend to be less healthy than moderate drinkers -- but not because they never drank. Instead, their health may influence their drinking choices. That is, they may not drink because their health is poor.

"We can't 'prove' it one way or the other," Stockwell noted. "But we can say there are grounds for a healthy skepticism around the idea that moderate drinking is good for you."

A second study in the same issue supports that.

That research followed more than 9,100 U.K. adults from the age of 23 to 55. Overall, researchers found that people's drinking habits evolved over time -- and few were actually lifelong "abstainers." Nearly all people who were non-drinkers at age 55 had given up

alcohol.

What's more, non-drinkers -- even those in their 20s -- tended to be in poorer physical and mental health compared with those who drank moderately and did not smoke. They were also, on average, less educated, and education is an important factor in lifetime health.

However, no one is saying that people who enjoy alcohol in moderation should stop.

"The risks of low-level drinking are small," Stockwell said. But, he added, people should not drink solely because they believe it wards off disease.

"The notion that one or two drinks a day is doing us good may just be wishful thinking," Stockwell said.

https://www.sciencedaily.com/releases/2017/05/170522080805.htm

Air pollution may disrupt sleep

May 22, 2017

Science Daily/American Thoracic Society

High levels of air pollution over time may get in the way of a good night's sleep, according to new research.

"Prior studies have shown that air pollution impacts heart health and affects breathing and lung function, but less is known about whether air pollution affects sleep," said lead author Martha E. Billings, MD, MSc, assistant professor of medicine at the University of Washington. "We thought an effect was likely given that air pollution causes upper airway irritation, swelling and congestion, and may also affect the central nervous system and brain areas that control breathing patterns and sleep."

The researchers analyzed data from 1,863 participants (average age 68) in the Multi-Ethnic Study of Atherosclerosis (MESA) who also enrolled in both MESA's Sleep and Air Pollution studies. The researchers looked at two of the most common air pollutants: NO2 (traffic-related pollutant gas) and PM2.5, or fine-particle pollution. Using air pollution measurements gathered from hundreds of MESA Air and Environmental Protection Agency monitoring sites in six U.S. cities, plus local environment features and sophisticated statistical tools, the research team was able to estimate air pollution exposures at each participant's home at two time points: one year and five years.

Wrist actigraphy, which measures small movements, provided detailed estimates of sleep and wake patterns over seven consecutive days. This was used to calculate "sleep efficiency" -- a measure of the percentage of time in bed spent asleep vs. awake. Researchers found that the sleep efficiency of the lowest 25 percent of participants was 88 percent or less. The research team studied if pollution exposures differed among those in this low sleep efficiency group.

The population was divided into "fourths" according to levels of pollution. The quarter of those who experienced the highest levels of pollution was compared to the quarter with the lowest levels.

The study found:

The group with the highest levels of NO2 over five years had an almost 60 percent increased likelihood of having low sleep efficiency compared to those with the lowest NO2 levels. The group with the highest exposures to small particulates (PM2.5) had a nearly 50 percent increased likelihood of having low sleep efficiency.

The authors adjusted for a range of factors, including age, body mass, obstructive sleep apnea, race/ethnicity, income and smoking status. They also adjusted for neighborhood socioeconomic status.

The researchers were particularly interested in chronic exposure to air pollution and what that long-term exposure might mean for sleep health. "There may be acute sleep effects to short-term exposure to high pollution levels as well, but we lacked the data to study that link," Dr. Billings said, noting that the parent MESA study is investigating the chronic effects of air pollution on cardiovascular health.

"These new findings indicate the possibility that commonly experienced levels of air pollution not only affect heart and lung disease, but also sleep quality. Improving air quality may be one way to enhance sleep health and perhaps reduce health disparities," Dr. Billings said.

Future studies, she added, need to explore the association between other air pollutants and sleep, the mechanisms by which these pollutants may disrupt sleep patterns and whether traffic noise is the driving factor contributing to poor sleep quality.

https://www.sciencedaily.com/releases/2017/05/170522080830.htm

To improve chronic pain, get more sleep (coffee helps too)

In sleep-deprived mice, caffeine and other drugs to promote wakefulness ease pain better than analgesics

May 8, 2017

Science Daily/Boston Children's Hospital

New research shows that chronic sleep loss increases pain sensitivity. It suggests that chronic pain sufferers can get relief by getting more sleep, or, short of that, taking medications to promote wakefulness such as caffeine.

Pain physiologist Alban Latremoliere, PhD, of Boston Children's and sleep physiologist Chloe Alexandre, PhD, of BIDMC precisely measured the effects of acute or chronic sleep loss on sleepiness and sensitivity to both painful and non-painful stimuli. They then tested standard pain medications, like ibuprofen and morphine, as well as wakefulness-promoting agents like caffeine and modafinil. Their findings reveal an unexpected role for alertness in setting pain sensitivity.

Keeping mice awake, through custom entertainment

The team started by measuring normal sleep cycles, using tiny headsets that took electroencephalography (EEG) and electromyography (EMG) readings. "For each mouse, we have exact baseline data on how much they sleep and what their sensory sensitivity is," says Latremoliere, who works in the lab of Clifford Woolf, PhD, in the F.M. Kirby Neurobiology Center at Boston Children's.

Next, unlike other sleep studies that force mice to stay awake walking treadmills or falling from platforms, Alexandre, Latremoliere and colleagues deprived mice of sleep in a way that mimics what happens with people: They entertained them.

"We developed a protocol to chronically sleep-deprive mice in a non-stressful manner, by providing them with toys and activities at the time they were supposed to go to sleep, thereby extending the wake period," says Alexandre, who works in the lab of Thomas Scammell, MD, at BIDMC. "This is similar to what most of us do when we stay awake a little bit too much watching late-night TV each weekday."

To keep the mice awake, researchers kept vigil, providing the mice with custom-made toys as interest flagged while being careful not to overstimulate them. "Mice love nesting, so when they started to get sleepy (as seen by their EEG/EMG pattern) we would give them nesting materials like a wipe or cotton ball," says Latremoliere. "Rodents also like chewing, so we introduced a lot of activities based around chewing, for example, having to chew through something to get to a cotton ball."

In this way, they kept groups of six to 12 mice awake for as long as 12 hours in one session, or six hours for five consecutive days, monitoring sleepiness and stress hormones (to make sure they weren't stressed) and testing for pain along the way.

Pain sensitivity was measured in a blinded fashion by exposing mice to controlled amounts of heat, cold, pressure or capsaicin (the agent in hot chili peppers) and then measuring how long it took the animal to move away (or lick away the discomfort caused by capsaicin). The researchers also tested responses to non-painful stimuli, such as jumping when startled by a sudden loud sound.

"We found that five consecutive days of moderate sleep deprivation can significantly exacerbate pain sensitivity over time in otherwise healthy mice," says Alexandre. "The response was specific to pain, and was not due to a state of general hyperexcitability to any stimuli."

Analgesics vs. wake-promoting agents

Surprisingly, common analgesics like ibuprofen did not block sleep-loss-induced pain hypersensitivity. Even morphine lost most of its efficacy in sleep-deprived mice. These observations suggest that patients using these drugs for pain relief might have to increase their dose to compensate for lost efficacy due to sleep loss, thereby increasing their risk for side effects.

In contrast, both caffeine and modafinil, drugs used to promote wakefulness, successfully blocked the pain hypersensitivity caused by both acute and chronic sleep loss. Interestingly, in non-sleep-deprived mice, these compounds had no analgesic properties.

"This represents a new kind of analgesic that hadn't been considered before, one that depends on the biological state of the animal," says Woolf, director of the Kirby Center at Boston Children's. "Such drugs could help disrupt the chronic pain cycle, in which pain disrupts sleep, which then promotes pain, which further disrupts sleep."

A new approach to chronic pain?

The researchers conclude that rather than just taking painkillers, patients with chronic pain might benefit from better sleep habits or sleep-promoting medications at night, coupled with daytime alertness-promoting agents to try to break the pain cycle. Some painkillers already include caffeine as an ingredient, although its mechanism of action isn't yet known. Both caffeine and modafinil boost dopamine circuits in the brain, so that may provide a clue.

"This work was supported by a novel NIH program that required a pain scientist to join a non-pain scientist to tackle a completely new area of research," notes Scammel, professor of neurology at BIDMC. "This cross-disciplinary collaboration enabled our labs to discover unsuspected links between sleep and pain with actionable clinical implications for improving pain management."

"Many patients with chronic pain suffer from poor sleep and daytime fatigue, and some pain medications themselves can contribute to these co-morbidities," notes Kiran Maski, MD, a specialist in sleep disorders at Boston Children's. "This study suggests a novel approach to pain management that would be relatively easy to implement in clinical care. Clinical research is needed to understand what sleep duration is required and to test the efficacy of wake-promoting medications in chronic pain patients."

https://www.sciencedaily.com/releases/2017/05/170508112447.htm

Poor sleep in anxiety, depression may make it harder to see positive

April 18, 2017

Science Daily/University of Illinois at Chicago

The dorsal anterior cingulate cortex may have to work harder to modify negative emotional responses in people with poor sleep who have depression or anxiety, new research suggests.

People with anxiety and depression often have sleep problems. But little has been known about whether or how their poor sleep affects a specific region of the brain known to be involved in regulating negative emotional responses.

Researchers at the University of Illinois at Chicago College of Medicine have found that this area of the brain, the dorsal anterior cingulate cortex, may have to work harder to modify negative emotional responses in people with poor sleep who have depression or anxiety. The finding is reported in the journal Depression and Anxiety.

The research team, led by Heide Klumpp, assistant professor of psychiatry at UIC, used functional MRI to measure the activity in different regions of the brain as subjects were challenged with an emotion-regulation task. Participants were shown disturbing images of violence -- from war or accidents -- and were asked to simply look at the images and not to try to control their reaction or to "reappraise" what they saw in a more positive light.

An example of reappraisal would be to see an image of a woman with a badly bruised face and imagine her as an actress in makeup for a role, rather than as a survivor of violence, Klumpp said.

"Reappraisal is something that requires significant mental energy," she said. "In people with depression or anxiety, reappraisal can be even more difficult, because these disorders are characterized by chronic negativity or negative rumination, which makes seeing the good in things difficult."

The participants -- 78 patients, 18 to 65 years of age, who had been diagnosed with an anxiety disorder, a major depressive disorder, or both -- also completed a questionnaire to assess their sleep over the previous month. A motion-sensing device called an actigraph measured their awake time in bed, or "sleep efficiency," over a six-day period. The questionnaire results indicated that three out of four participants met criteria for significant sleep disturbance, and the actigraph results suggested the majority had insomnia.

Participants who reported poorer sleep on the questionnaire were seen to have less brain activity in the dorsal anterior cingulate cortex during the reappraisal task, while those with lower sleep efficiency based on the actigraph data had higher activity in the DACC.

"Because the questionnaire and actigraph measure different aspects of the sleep experience, it is not surprising that brain activity also differed between these measures," said Klumpp. "The questionnaire asks about sleep over the previous month, and answers can be impacted by current mood. Plus, respondents may not be able to accurately remember how they slept a month ago. The actigraph objectively measures current sleep, so the results from both measurements may not match."

"Higher DACC activity in participants with lower levels of sleep efficiency could mean the DACC is working harder to carry out the demanding work of reappraisal," Klumpp said.

"Our research indicates sleep might play an important role in the ability to regulate negative emotions in people who suffer from anxiety or depression."

https://www.sciencedaily.com/releases/2017/04/170418151243.htm

Music has powerful (and visible) effects on the brain

April 12, 2017

Science Daily/Wake Forest Baptist Medical Center

It doesn’t matter if it’s Bach, the Beatles, Brad Paisley or Bruno Mars. Your favorite music likely triggers a similar type of activity in your brain as other people’s favorites do in theirs, new research has found.

That's one of the things Jonathan Burdette, M.D., has found in researching music's effects on the brain.

"Music is primal. It affects all of us, but in very personal, unique ways," said Burdette, a neuroradiologist at Wake Forest Baptist Medical Center. "Your interaction with music is different than mine, but it's still powerful.

"Your brain has a reaction when you like or don't like something, including music. We've been able to take some baby steps into seeing that, and 'dislike' looks different than 'like' and much different than 'favorite.'"

To study how music preferences might affect functional brain connectivity -- the interactions among separate areas of the brain -- Burdette and his fellow investigators used functional magnetic resonance imaging (fMRI), which depicts brain activity by detecting changes in blood flow. Scans were made of 21 people while they listened to music they said they most liked and disliked from among five genres (classical, country, rap, rock and Chinese opera) and to a song or piece of music they had previously named as their personal favorite.

Those fMRI scans showed a consistent pattern: The listeners' preferences, not the type of music they were listening to, had the greatest impact on brain connectivity -- especially on a brain circuit known to be involved in internally focused thought, empathy and self-awareness. This circuit, called the default mode network, was poorly connected when the participants were listening to the music they disliked, better connected when listening to the music they liked and the most connected when listening to their favorites.

The researchers also found that listening to favorite songs altered the connectivity between auditory brain areas and a region responsible for memory and social emotion consolidation.

"Given that music preferences are uniquely individualized phenomena and that music can vary in acoustic complexity and the presence or absence of lyrics, the consistency of our results was unexpected," the researchers wrote in the journal Nature Scientific Reports (Aug. 28, 2014). "These findings may explain why comparable emotional and mental states can be experienced by people listening to music that differs as widely as Beethoven and Eminem."

Not surprising to Burdette was the extent of the connectivity seen in the participants' brains when they were listening to their favorite tunes.

"There are probably some features in music that make you feel a certain way, but it's your experience with it that is even more important," said Burdette, who also is professor of radiology and vice chairman of research at Wake Forest School of Medicine. "Your associations with certain music involve many different parts of the brain, and they're very strong.

"In some cases, you might not even like the particular song, but you like the memories or feelings that you associate with it."

In other research projects, Burdette and colleagues at the School of Medicine and the University of North Carolina-Greensboro have found that trained music conductors are likely to be better at combining and using auditory and visual clues than people without musical training; that activity in brain areas associated with vision decreases during tasks that involve listening; and that different levels of complexity in music can have different effects on functional brain connectivity.

"I find this type of work fascinating, because I think music is so important," Burdette said. "If science can help get more people to recognize what music does to and for us, great."

Music is just a small part of Burdette's research activities -- his most recently published study, for example, showed that brain volume could be an accurate predictor of success in weight-loss attempts by the elderly -- but it has long been a big of part his life.

Burdette grew up playing viola, piano and guitar. He has been singing since childhood and continues to do so, including in the chorus in productions staged by the Piedmont Opera, of which he has been a board member for more than 10 years. He's also done some conducting. His wife, Shona Simpson, plays piano. Their three teenage daughters -- Fiona, Ellie and Jessie -- perform professionally as the Dan River Girls. His brother, Kevin, is a singer who has appeared as a soloist with the Metropolitan Opera, Los Angeles Philharmonic and other top-tier opera companies and symphony orchestras.

"Music is my avocation," the physician in the family said. "Radiology is my vocation."

Burdette additionally has deep interest, if not direct involvement, in music's clinical applications.

"Music isn't going to cure anything, but it definitely can play a therapeutic role," he said.

In countries such as Germany, Burdette noted, music therapy is commonly an integral part of the rehabilitation process for people who have had strokes, brain surgery or traumatic brain injuries.

"If you're trying to restore neuroplasticity in the brain, to re-establish some of the connections that were there before the injury, music can be a big help, and I'd like to see it used more widely in this country," he said.

Burdette also is a proponent of programs that help people with Alzheimer's, dementia and other cognitive and physical problems re-connect with the world through music. One such program is Music & Memory, which employs iPods with customized playlists featuring songs popular when the participating individual was under 30 years old.

"You can actually see the power of music," Burdette said. "People who were just sitting there, not engaged in anything, light up when they start hearing music from when they were 25.

"It's fantastic. What else can do that? I can't think of anything other than music."

https://www.sciencedaily.com/releases/2017/04/170412181341.htm

Late sleep-wake time preference linked to depression in individuals with diabetes

April 3, 2017

Science Daily/Endocrine Society

People with type 2 diabetes who are “night owls” and prefer the evening for activity report having more symptoms of depression than those who are early to bed and early to rise, regardless of the quality of their sleep, a new study finds.

"These findings are important because depression is common in patients with type 2 diabetes," said lead investigator Sirimon Reutrakul, M.D., an associate professor at Mahidol University Faculty of Medicine, Bangkok, Thailand. "Also, previous studies show that untreated depression is related to worse patient outcomes, including diabetes self-care, blood glucose control and diabetes complications."

In the general public, people with a later "chronotype," meaning a preference to go to bed late and wake up late, tend to have more symptoms of depression than do people who go to bed early and wake up early (early chronotype or morning preference), past studies have found. Reutrakul and her co-investigators wanted to study people with type 2 diabetes, who have an increased risk of depression, to learn whether a later chronotype, or preference for evening activity, was independently associated with greater depression symptoms.

Because chronotype may differ by geographic location, with a greater morning preference near the equator, the investigators studied diabetic patients from two different geographic regions: Chicago and Thailand. They received research funding from Rush University Medical Center in Chicago, Mahidol University Faculty of Medicine Ramathibodi Hospital in Bangkok and the Endocrine Society of Thailand.

The U.S. group consisted of 194 patients, 70 percent of whom were women. Similarly, in the Thai group, women comprised 67 percent of 282 patients. All participants answered questionnaires regarding symptoms of depression, sleep quality and preferred times for activity and sleep. Chicago patients answered the questionnaires between February and early April, whereas in Thailand, which has little seasonal variation, patients participated throughout the year, Reutrakul said.

For both groups, those who preferred the evening reported more depression symptoms than did those with a morning preference. This result remained even after the researchers adjusted their statistical analyses for sleep quality, age, sex and other factors that could affect depression.

Their findings, Reutrakul said, support an association between circadian regulation and psychological functioning in patients with type 2 diabetes. She pointed out, however, that they did not prove cause and effect and that the strength of the association was "only modest."

"We need further research to explore a combination of interventions that help with circadian timing, such as light therapy and melatonin," she said. "Learning more about the relationship between depression and circadian functioning might help us figure out strategies to improve physical and mental health for patients with diabetes."

https://www.sciencedaily.com/releases/2017/04/170403140602.htm

Prolonged sleep disturbance can lead to lower bone formation

April 2, 2017

Science Daily/The Endocrine Society

Insufficient sleep, a common problem that has been linked to chronic disease risk, might also be an unrecognized risk factor for bone loss.

The study investigators found that healthy men had reduced levels of a marker of bone formation in their blood after three weeks of cumulative sleep restriction and circadian disruption, similar to that seen in jet lag or shift work, while a biological marker of bone resorption, or breakdown, was unchanged.

"This altered bone balance creates a potential bone loss window that could lead to osteoporosis and bone fractures," lead investigator Christine Swanson, M.D., an assistant professor at the University of Colorado in Aurora, Colo., said. Swanson completed the research while she was a fellow at Oregon Health & Science University in Portland, Ore., with Drs. Eric S. Orwoll and Steven A. Shea.

"If chronic sleep disturbance is identified as a new risk factor for osteoporosis, it could help explain why there is no clear cause for osteoporosis in the approximately 50 percent of the estimated 54 million Americans with low bone mass or osteoporosis," Swanson said.

Inadequate sleep is also prevalent, affecting more than 25 percent of the U.S. population occasionally and 10 percent frequently, the Centers for Disease Control and Prevention report.

The 10 men in this study were part of a larger study that some of Swanson's co-authors conducted in 2012 at Brigham and Women's Hospital in Boston, Mass. That study evaluated health consequences of sleep restriction combined with circadian disruption. Swanson defined circadian disruption as "a mismatch between your internal body clock and the environment caused by living on a shorter or longer day than 24 hours."

Study subjects stayed in a lab, where for three weeks they went to sleep each day four hours later than the prior day, resulting in a 28-hour "day." Swanson likened this change to "flying four time zones west every day for three weeks." The men were allowed to sleep only 5.6 hours per 24-hour period, since short sleep is also common for night and shift workers. While awake, the men ate the same amounts of calories and nutrients throughout the study. Blood samples were obtained at baseline and again after the three weeks of sleep manipulation for measurement of bone biomarkers. Six of the men were ages 20 to 27, and the other four were ages 55 to 65. Limited funding prevented the examination of serum from the women in this study initially, but the group plans to investigate sex differences in the sleep-bone relationship in subsequent studies.

After three weeks, all men had significantly reduced levels of a bone formation marker called P1NP compared with baseline, the researchers reported. This decline was greater for the younger men than the older men: a 27 percent versus 18 percent decrease. She added that levels of the bone resorption marker CTX remained unchanged, an indication that old bone could break down without new bone being formed.

"These data suggest that sleep disruption may be most detrimental to bone metabolism earlier in life, when bone growth and accrual are crucial for long-term skeletal health," she said. "Further studies are needed to confirm these findings and to explore if there are differences in women."

https://www.sciencedaily.com/releases/2017/04/170402111317.htm

Insomnia associated with increased risk of heart attack and stroke

March 31, 2017

Science Daily/European Society of Cardiology

Insomnia is associated with increased risk of heart attack and stroke, according to new research.

"Sleep is important for biological recovery and takes around a third of our lifetime, but in modern society more and more people complain of insomnia," said first author Qiao He, a Master's degree student at China Medical University, Shenyang, China. "For example, it is reported that approximately one-third of the general population in Germany has suffered from insomnia symptoms."

"Researchers have found associations between insomnia and poor health outcomes," continued Miss He. "But the links between insomnia and heart disease or stroke have been inconsistent."

The current meta-analysis assessed the association between insomnia symptoms and incidence or death from cardiovascular disease (acute myocardial infarction, coronary heart disease, heart failure), stroke, or a combination of events. Insomnia symptoms included difficulty initiating sleep, difficulty maintaining sleep, early-morning awakening, and non-restorative sleep.

The authors analysed 15 prospective cohort studies with a total of 160 867 participants. During a median follow-up of three to 29.6 years, there were 11,702 adverse events.

There were significant associations between difficulty initiating sleep, difficulty maintaining sleep, and non-restorative sleep and the risk of heart disease and stroke, with increased relative risks of 1.27, 1.11, and 1.18, respectively, compared to those not experiencing these insomnia symptoms. There was no association between early-morning awakening and adverse events.

Miss He said: "We found that difficulty initiating sleep, difficulty maintaining sleep, or non-restorative sleep were associated with 27%, 11%, and 18% higher risks of cardiovascular and stroke events, respectively."

"The underlying mechanisms for these links are not completely understood," continued Miss He. "Previous studies have shown that insomnia may change metabolism and endocrine function, increase sympathetic activation, raise blood pressure, and elevate levels of proinflammatory and inflammatory cytokines -- all of which are risk factors for cardiovascular disease and stroke."

Women with insomnia symptoms had a slightly higher risk of cardiovascular and stroke events than men, especially for non-restorative sleep, but the difference between sexes did not reach statistical significance.

Miss He said: "We cannot conclude that insomnia is more dangerous for women, given the limitations of meta-analyses and the lack of a statistically significant difference between sexes. However, we do know that women are more prone to insomnia because of differences in genetics, sex hormones, stress, and reaction to stress. It may therefore be prudent to pay more attention to women's sleep health."

Miss He concluded: "Sleep disorders are common in the general population and sleep health should be included in clinical risk assessment. Health education is needed to increase public awareness of insomnia symptoms and the potential risks, so that people with sleep problems are encouraged to seek help."

https://www.sciencedaily.com/releases/2017/03/170331120337.htm

Moderate drinking linked to lower risk of some -- but not all -- heart conditions

A more nuanced approach to role of alcohol in heart health is needed, researchers say

March 24, 2017

Science Daily/BMJ

Moderate drinking is associated with a lower risk of several, but not all, cardiovascular diseases, finds a large study of UK adults. The finding that moderate drinking is not universally associated with a lower risk of all cardiovascular conditions suggests a more nuanced approach to the role of alcohol in prevention of cardiovascular disease is necessary.

The finding that moderate drinking is not universally associated with a lower risk of all cardiovascular conditions suggests a more nuanced approach to the role of alcohol in prevention of cardiovascular disease is necessary, say the researchers.

Moderate drinking is thought to be associated with a lower risk of developing cardiovascular disease compared with abstinence or heavy drinking.

In the UK, moderate drinking is defined as no more than 14 units (112 grams) of alcohol a week.

To put this into context, one unit of alcohol is about equal to half a pint of ordinary strength beer, lager or cider (3.6% alcohol by volume) or a small pub measure (25 ml) of spirits. There are one and a half units of alcohol in small glass (125 ml) of ordinary strength wine (12% alcohol by volume). [Source: NHS Choices]

There is, however, a growing scepticism around this observation, with some experts pointing out several shortcomings in the evidence. For example, grouping non-drinkers with former drinkers, who may have stopped drinking due to poor health.

So researchers at the University of Cambridge and University College London set out to investigate the association between alcohol consumption and 12 cardiovascular diseases by analysing electronic health records for 1.93 million healthy UK adults as part of the CALIBER (ClinicAl research using LInked Bespoke studies and Electronic health Records) data resource.

All participants were free from cardiovascular disease at the start of the study, and non-drinkers were separated from former and occasional drinkers to provide additional clarity in this debate.

After several influential factors were accounted for, moderate drinking was associated with a lower risk of first presenting to a doctor with several, but not all, cardiovascular conditions, including angina, heart failure and ischaemic stroke, compared with abstaining from alcohol.

However, the authors argue that it would be unwise to encourage individuals to take up drinking as a means of lowering their cardiovascular risk over safer and more effective ways, such as increasing physical activity and stopping smoking.

Heavy drinking (exceeding recommended limits) conferred an increased risk of first presenting with a range of such diseases, including heart failure, cardiac arrest and ischaemic stroke compared with moderate drinking, but carried a lower risk of heart attack and angina.

Again, the authors explain that this does not mean that heavy drinkers will not go on to experience a heart attack in the future, just that they were less likely to present with this as their first diagnosis compared with moderate drinkers.

This is an observational study, so no firm conclusions can be drawn about cause and effect. Added to which, the authors point to some study limitations that could have introduced bias.

Nevertheless, they say it is the first time this association has been investigated on such a large scale and their findings have implications for patient counselling, public health communication, and disease prediction tools.

In a linked editorial, researchers at Harvard Medical School and Johns Hopkins School of Public Health in the US say this study "does not offer a materially new view of the associations between alcohol consumed within recommended limits and risk of cardiovascular disease.

"This work, however, sets the stage for ever larger and more sophisticated studies that will attempt to harness the flood of big data into a stream of useful, reliable, and unbiased findings that can inform public health, clinical care, and the direction of future research," they conclude.

https://www.sciencedaily.com/releases/2017/03/170324135815.htm

Anxiety is a stronger harbinger of alcohol problems than stress

March 10, 2017

Science Daily/Research Society on Alcoholism

Stress and anxiety are widely believed to contribute to drinking. Alcohol is thought to reduce tension caused by stress (the "flight or fight" response) as well as alleviate the unpleasant symptoms of anxiety (anticipation of the unpredictable, impending threats). Prior research, however, has yielded inconsistent findings as to the unique relations between stress and anxiety, on the one hand, and alcohol consumption and alcohol use disorders, on the other hand. This study was designed to examine how differences in self-reported levels of anxiety, anxiety sensitivity, and perceived stress impact the frequency and intensity of drinking, alcohol craving during early withdrawal, and alcohol craving and stress reactivity.

Recent drinking was assessed in 87 individuals (70 men, 17 women) with alcohol use disorders (AUDs). Three distinct measures were used to evaluate anxiety, anxiety sensitivity, and perceived stress. A subset of 30 subjects was admitted to a medical center to ensure alcohol abstinence for one week: measures of alcohol craving were collected twice daily. On day 4, subjects participated in a public speaking/math challenge, before and after which measures of cortisol and alcohol craving were collected.

In these heavy drinkers, measures of anxiety as compared with perceived stress were more strongly associated with a variety of alcohol-related measures. While alcohol studies often use the terms anxiety, anxiety sensitivity, and stress interchangeably, this study showed the importance of differentiating among the three terms given their unique relationships with drinking, craving, and stress reactivity among individuals with AUDs.

https://www.sciencedaily.com/releases/2017/03/170310092337.htm

Probiotic found in yogurt can reverse depression symptoms

Lactobacillus affects mood, anxiety in mice; researchers optimistic findings should hold true in humans

March 8, 2017

Science Daily/University of Virginia Health System

Researchers have reversed depression symptoms in mice by feeding them Lactobacillus, a probiotic bacteria found in live-cultures yogurt. Further, they have discovered a specific mechanism for how the bacteria affect mood, providing a direct link between the health of the gut microbiome and mental health.

Based on their findings, the researchers are optimistic that their discovery will hold true in people and are planning to confirm their findings in patients with depression.

"The big hope for this kind of research is that we won't need to bother with complex drugs and side effects when we can just play with the microbiome," explained lead researcher Alban Gaultier, PhD. "It would be magical just to change your diet, to change the bacteria you take, and fix your health -- and your mood."

Treating Depression

Depression is one of the most common mental health conditions in the United States, with up to 7 percent of people experiencing a major depressive episode, Gaultier noted. "It's a huge problem and the treatments are not very good, because they come with huge side effects," he said.

The role of the gut microbiome -- the bacteria that live inside us -- has been of tremendous interest to researchers studying depression and other health conditions, both mental and physical. Gaultier, of the UVA Department of Neuroscience and its Center for Brain Immunology and Glia, set out to see if he could find a concrete link between depression and gut health. "When you're stressed, you increase your chance of being depressed, and that's been known for a long, long time," he said. "So the question that we wanted to ask is, does the microbiome participate in depression?"

The answer appears to be yes. Looking at the composition of the gut microbiome before and after mice were subjected to stress, Gaultier's team found that the major change was the loss of Lactobacillus. With the loss of Lactobacillus came the onset of depression symptoms. Feeding the mice Lactobacillus with their food returned them to almost normal. "A single strain of Lactobacillus," Gaultier observed, "is able to influence mood."

He and his team then went on to determine the mechanism by which Lactobacillus influences depression. They found that the amount of Lactobacillus in the gut affects the level of a metabolite in the blood called kynurenine, which has been shown to drive depression. When Lactobacillus was diminished in the gut, the levels of kynurenine went up -- and depression symptoms set in.

"This is the most consistent change we've seen across different experiments and different settings we call microbiome profiles," explained researcher Ioana Marin, a graduate student who is finishing up her PhD. work. "This is a consistent change. We see Lactobacillus levels correlate directly with the behavior of these mice."

Testing in Humans

Gaultier was careful to call the symptoms seen in mice as "depressive-like behavior" or "despair behavior," as mice have no way to communicate that they are feeling depressed. But those symptoms are widely accepted as the best available model for looking at depression in creatures other than humans.

Based on the new findings, Gaultier plans to begin studying the effect in people as soon as possible. He intends to examine the effects of Lactobacillus on depression in patients with multiple sclerosis, a group in which the disorder is common. Promisingly, the same biological substances and mechanisms Lactobacillus uses to affect mood in mice are also seen in humans, suggesting the effect may be the same.

In addition to looking at the effects in people, the researchers are continuing to explore the important role of kynurenine. "There has been some work in humans and quite a bit in animal models talking about how this metabolite, kynurenine, can influence behavior," Marin said. "It's something produced with inflammation that we know is connected with depression. But the question still remains: How? How does this molecule affect the brain? What are the processes? This is the road we want to take."

While there is no harm in people with depression eating yogurt, people receiving treatment for depression should not stop taking their medications without consulting their physicians. More studies, the researchers noted, are needed.

https://www.sciencedaily.com/releases/2017/03/170308114709.htm

Watching birds near your home is good for your mental health

People living in neighborhoods with more birds, shrubs and trees are less likely to suffer from depression, anxiety and stress

February 25, 2017

Science Daily/University of Exeter

People living in neighborhoods with more birds, shrubs and trees are less likely to suffer from depression, anxiety and stress, according to new research

The study, involving hundreds of people, found benefits for mental health of being able to see birds, shrubs and trees around the home, whether people lived in urban or more leafy suburban neighbourhoods.

The study, which surveyed mental health in over 270 people from different ages, incomes and ethnicities, also found that those who spent less time out of doors than usual in the previous week were more likely to report they were anxious or depressed.

After conducting extensive surveys of the number of birds in the morning and afternoon in Milton Keynes, Bedford and Luton, the study found that lower levels of depression, anxiety and stress were associated with the number of birds people could see in the afternoon. The academics studied afternoon bird numbers -- which tend to be lower than birds generally seen in the morning -- because are more in keeping with the number of birds that people are likely to see in their neighbourhood on a daily basis.

In the study, common types of birds including blackbirds, robins, blue tits and crows were seen. But the study did not find a relationship between the species of birds and mental health, but rather the number of birds they could see from their windows, in the garden or in their neighbourhood.

Previous studies have found that the ability of most people to identify different species is low (e.g. Dallimer et al. 2012), suggesting that for most people it is interacting with birds, not just specific birds, that provides well-being.

University of Exeter research fellow Dr Daniel Cox, who led the study, said: "This study starts to unpick the role that some key components of nature play for our mental well-being."

Birds around the home, and nature in general, show great promise in preventative health care, making cities healthier, happier places to live."

The positive association between birds, shrubs and trees and better mental health applied, even after controlling for variation in neighbourhood deprivation, household income, age and a wide range of other socio-demographic factors.

Recent research by Dr Cox and Professor Kevin Gaston, who are based at the Environmental Sustainability Institute at the Penryn Campus at the University of Exeter, found that watching birds makes people feel relaxed and connected to nature (Cox and Gaston 2016).

https://www.sciencedaily.com/releases/2017/02/170225102113.htm