Psychedelics improve mental health, cognition in special ops veterans
Chart review reports effects of 2-drug treatment at Mexico clinic
October 5, 2023
Science Daily/Ohio State University
One treatment each of two psychedelic drugs lowered depression and anxiety and improved cognitive functioning in a sample of U.S. special operations forces veterans who sought care at a clinic in Mexico, according to a new analysis of the participants' charts.
The treatment included a combination of ibogaine hydrochloride, derived from the West African shrub iboga, and 5-MeO-DMT, a psychedelic substance secreted by the Colorado River toad. Both are designated as Schedule I drugs under the U.S. Controlled Substances Act.
In addition to relieving symptoms of post-traumatic stress disorder (PTSD), the combined treatment also alleviated cognitive impairment linked to traumatic brain injury -- which stood out to researchers from The Ohio State University who led the chart-review analysis. Many special operations forces veterans seeking treatment for complex psychiatric symptoms do not respond to more traditional therapies.
"What sets this group apart from some other veterans and civilians is that often, they are exposed to repeated traumatic events as a routine part of their jobs. This build-up of exposure to these difficulties seems to produce a cluster of challenges that include traumatic brain injury, which we know in and of itself predisposes people to mental health problems," said lead author Alan Davis, associate professor and director of the Center for Psychedelic Drug Research and Education (CPDRE) in Ohio State's College of Social Work.
"So the fact that we saw that there were improvements in cognitive functioning linked to brain injury were probably the most striking results, because that's something we didn't predict and it's very new and novel in terms of how psychedelics might help in so many different domains."
The study is published in the American Journal of Drug and Alcohol Abuse.
Most of the veterans attending the clinic retreat program had been on active duty after 9/11 and reported seeking care for memory problems, brain injury, depression, anxiety, PTSD, sleep problems, anger and fatigue. Head injuries were reported by 86% of attendees, most of whom attributed memory problems, irritability, disordered sleep and ringing in the ears to those long-ago head traumas.
Eighty-six veterans completed pre-treatment questionnaires assessing a range of mental health symptoms as well as satisfaction with life, anger levels and suicidality. Each attendee received a single oral ibogaine hydrochloride dose and, on a separate day, at least three incremental inhalation doses adding up to 50 milligrams of 5-MeO-DMT, also commonly called Five or Bufo. Preparation and reflection sessions preceded and followed each treatment.
Overall, participants reported large improvements in self-reported PTSD symptoms, depression, anxiety, insomnia severity and anger, as well as a significant increase in satisfaction with life, from pre-treatment to the one-month follow-up, and sustained benefits at the three- and six-month follow-ups. Additional reported improvements that continued for six months included reductions in disability and post-concussive symptoms, and very large increases in psychological flexibility and cognitive functioning.
Davis said the improved cognitive functioning warrants more research into whether better thinking results from lowered mental health symptoms or biological changes to signaling in the brain, or a mixture of both types of effects. And they noted that changes to psychological flexibility -- one's capacity to act in ways that are consistent with their values regardless of whatever internal or external experience they might have -- have been found in previous research to be connected to insightful and mystical psychedelic experiences.
"I think we're seeing a similar picture emerging here where the more one is psychologically flexible, the more likely it is that one's mental health symptoms will be reduced or ameliorated," Davis said.
Most attendees also reported moderate to strong desirable changes across a range of attitudes, behaviors and relationships. One month after treatment, almost half reported the psychedelic experience was the most spiritually significant (48.6%) or psychologically insightful (42.9%) of their lives, and 17.1% called it the most difficult or challenging experience in their life.
Davis and colleagues took a conservative approach to analyzing outcome data, building in an assumption that attendees who didn't complete all of the follow-up surveys may not have gotten the relief they had hoped for from the treatment. But they said finding that a population of veterans with complicated trauma histories can benefit from psychedelic therapy supports the importance of continuing to test psychedelic-assisted therapies in U.S. clinical trials.
Psilocybin-assisted therapy is currently being studied at Ohio State for the treatment of PTSD among military veterans.
https://www.sciencedaily.com/releases/2023/10/231005110741.htm
Coaching program reduces burnout in medical residents
A pilot program aimed at female physicians was expanded to a national level with significant results in all aspects of burnout
October 4, 2023
Science Daily/University of Colorado Anschutz Medical Campus
A pilot program that successfully reduced burnout among female medical residents has shown even greater results on a national level, according to researchers at the University of Colorado Anschutz Medical Campus.
The study was published today in the journal JAMA Network Open.
"We did a pilot program in 2021to see if it would work and it did," said study co-author Tyra Fainstad, MD, associate professor at the University of Colorado School of Medicine. "Then we expanded it to 26 graduate medical institutions in 19 states. There were 1,017 participants. We saw significant improvement in every wellbeing outcome we assessed including all three subscales involved in burnout."
Burnout within the health care community is a national epidemic disproportionally affecting women. Last year, the U.S. Surgeon General declared it a `crisis' deserving 'bold, fundamental change' though little was known about scalable, effective solutions to the problem.
Women are hit harder by burnout for reasons that include bias and sexism at work, pay disparities as well as a disproportionate burden of home management and child/elder care, the researchers said.
Fainstad and co-author Adrienne Mann, MD, both faculty in the CU Department of Medicine, created the web-based Better Together Physician Coaching Program at CU Anschutz with the goal of reducing that burnout. Then they replicated it to a national level and published their findings.
While the pilot program saw improvements in `imposter syndrome' (feeling as if you don't really belong in the job') and self-compassion, the expanded national study also showed significant improvements in outcomes across the board including moral injury and flourishing, offering actual evidence that the program works.
"Physician trainees who received online group coaching over four months had substantial reductions in multiple dimensions of professional distress (burnout, moral injury and imposter syndrome) and improvements in well-being (self-compassion and flourishing)," said Mann.
Mann and Fainstad are both certified life coaches. Better Together is owned and operated by the University of Colorado. It's not a business, they said, and they don't personally profit financially from it. The program is available to any heath care institution, school of medicine, department, or residency program wishing to meaningfully support the wellbeing of their clinicians and trainees.
Better Together is web-based. Participants take part in two videoconferencing coaching calls per week where up to five people can be coached live on any topic with an unlimited audience. Calls are recorded for later listening on a private podcast.
Participants can also access unlimited, anonymous written coaching in a forum by submitting a narrative reflection and receive a coach's response published to Better Together's secure, members-only website. There are also weekly self-study sessions using videos and worksheets. They focus on topics pertinent to the physician lifestyle such as goal setting, cultivating a growth mindset, receiving critical feedback, imposter syndrome and perfectionism.
The researchers use the Maslach Burnout Inventory (MBI) to measure their work. The MBI has three subscales: emotional exhaustion (EE) or feeling emotionally exhausted from work; Depersonalization (DP), detached and impersonal treatment of patients; Professional accomplishment (PA), beliefs around competence and success at work.
The EE score is a key construct in health care related burnout. A one point increase in the EE scale has been associated with a 7% increase in suicidal ideation and a 5-6% increase in major medical errors.
The researchers said a reduced mean EE score among those that took part in the training and an increased EE score in those that did not.
"From what we see in this study, coaching helps in every aspect of burnout," Fainstad said. "The multi-modal nature of our program is unique. You can interact in many ways. That partially explains the powerful impact -that and the group nature of our coaching."
Mann said the majority are watching others being coached and share in the experience.
"That is deeply connecting. They try to see themselves in someone else's story," she said. "When someone is on a view screen you have compassion and empathy for them and, by extension, learn to practice compassion and empathy for yourself."
While few strategies to address burnout have shown much overall effect, Fainstad said this study demonstrates that group coaching works.
"We're now showing that we have an actual evidence-based answer to burnout," she said.
Fainstad and Mann said burnout is a product of the current, often toxic, medical culture pervading every aspect of the profession.
"Culture is a belief system," Fainstad said. "And while structural changes are absolutely necessary to fix our medical system, working with individuals who have been harmed along the way will be imperative to healing."
Mann suggested a step towards healing the culture would be making coaching programs like Better Together accessible to everyone -- not necessarily mandatory but at least made available by institutions.
"There are other coaching programs in this space but this one is rigorously evidence-based. We studied it," Mann said. "There are no downsides. It helps in all aspects of burnout."
https://www.sciencedaily.com/releases/2023/10/231004132427.htm
Brain biometrics help identify sports concussions
October 2, 2023
Science Daily/University of South Australia
Novel brain biometrics could help inform whether an athlete is ready to return to play following a concussion, according to new research from the University of South Australia.
Conducted in partnership with the University of California San Francisco (UCFC), researchers found that changes in micromovements of the brain -- termed 'headpulses' -- could detect the lasting impacts of a concussion.
Using a custom-designed headset* to evaluate headpulse biometrics among 101 amateur male and female Australian Rules Football players in South Australia, researchers identified brain abnormalities in 81% of players inflicted by concussion, signalling sustained injury beyond expected recovery times.
These headpulse alterations lasted 14 days beyond concussion symptoms and were exacerbated by return-to-play or unsupervised physical activity.
UniSA Professor of Exercise Science Kevin Norton says that headpulse measures could complement current return-to-play protocols.
"Traumatic brain injury inflicts more than 60 million people every year, with a third of these being sports-related," Prof Norton says.
"While we know that Australia's sports sector takes concussions seriously -- via considered return-to-play protocols -- we also know that objective measures of concussion recovery are not fully established.
"In this research, we used headpulses -- a normal measure of brain 'wobble' aligned with each heartbeat -- to assess any changes in frequency resulting from a concussion.
"We discovered that almost all players who received a concussion had a 'disconnect' between their symptoms and the headpulse, such that even when the players said they felt good, the headpulse still showed evidence of brain injury."
While most players felt that they'd recovered 10-14 days after their injury, the research showed that some players took up to four weeks to recover and return to normal headpulse patterns.
Australian Football concussion recovery protocols require 24 to 48 hours of strict physical and cognitive rest, followed by graded individual then team training, provided there is no symptom exacerbation; the earliest allowed return-to-play after protocol completion and medical clearance is 12 days after a concussion.
The Australian Senate Committee's report Concussions and repeated head trauma in contact sports released this month, recommends that national sporting associations should explore further rule modifications for sports to prevent and reduce the impact of concussions and repeated head traumas.
This research contributes to the growing body of knowledge that informs concussion protocols.
Notes
• *The headset is patented by UCSF and licensed by medical technology company MindRhythm.
• Data for sport-related concussions and repeated head trauma is under-reported in Australia, however the most recent AIHW data shows that 2305 sports-related concussions occurred between 2019-20. Men incurred 70% of concussions and more than a third of those hospitalised were young sportspeople aged 15-24 years.
• About 730 of concussions occurred while playing some form of football; and approximately 440 occurred while cycling
https://www.sciencedaily.com/releases/2023/10/231002211341.htm
Posttraumatic brain activity predicts resilience to PTSD
September 21, 2023
Science Daily/Elsevier
After a traumatic experience, most people recover without incident, but some people -- between 2% and 10%- develop posttraumatic stress disorder (PTSD), a mental health condition that can cause debilitating symptoms of anxiety due to emotional dysregulation. PTSD symptoms are present in up to 40% of trauma survivors in the acute aftermath of trauma, but full-blown PTSD develops in only a small subset of cases. Early identification of those at risk is critical for both early treatment and possible prevention.
A new study led by Israel Liberzon, MD, at Texas A&M University, aimed to do just that. The study appears in Biological Psychiatry: Cognitive Neuroscience and Neuroimaging, published by Elsevier.
Researchers have long understood that PTSD involves altered brain processing in areas associated with emotion processing and modulation, including the amygdala, insula, and prefrontal cortex. But, it has remained unclear when the PTSD-associated differences arise. In this work, the researchers collected brain scans from 104 survivors of trauma -- usually a car accident -- at 1, 6, and 14 months after the accident. By looking at brain activity so soon after the trauma, the researchers hoped to identify predictors of who would be more at risk or resilient to developing chronic PTSD.
Dr. Liberzon said of the findings, "In this largest-to-date, prospective study of early post-trauma survivors, greater activation in right inferior frontal gyrus, a region linked to cognitive control and emotional reappraisal, predicts better recovery from early PTSD symptoms. These findings highlight the key roles of cortical/cognitive regions in regulation of fear and in PTSD development."
Importantly, the researchers saw changes in the patients' brain activity change over time, reflecting an ongoing, perhaps pathological process.
Cameron Carter, MD, Editor of Biological Psychiatry: Cognitive Neuroscience and Neuroimaging, said of the study, "These findings highlight the key role that the prefrontal cortex may play in conferring resilience to the harmful effects of trauma, through its function representing contextual information and regulating emotional responses."
Dr. Liberzon added, "Understanding brain circuits linked to the progression of PTSD from an acute to a chronic condition is critical for understanding its pathophysiology, and eventually for the development of mechanism-informed treatment. The results might also help clinicians to start identifying and treating early trauma survivors at greater risk of developing chronic PTSD a year after the traumatic event."
https://www.sciencedaily.com/releases/2023/09/230921154511.htm
College athletes experience worse post-injury outcomes for concussions suffered outside of sports
Female athletes also had more severe symptoms associated with these injuries
September 20, 2023
Science Daily/Children's Hospital of Philadelphia
Researchers from Children's Hospital of Philadelphia (CHOP) found that college athletes had worse post-injury outcomes related to concussions they experienced outside of sports than those they experienced while playing sports. Additionally, female athletes who sustained their injury outside of sports had more severe symptoms and more days in sports lost to injury relative to male athletes. These findings suggest the need for improved concussion recognition, reporting, and monitoring outside of sports.
The study was recently published online by the Journal of Athletic Training.
Concussions have the potential to impact the daily function and quality of life of those who sustain them. Prompt recognition of symptoms and early access to care can help minimize those effects. Most concussion research has primarily focused on injuries that occur while playing sports, but those studies often exclude concussions that can happen outside of sports, usually the result of falls or car crashes. Some research has indicated that patients with non-sports-related concussions have worse outcomes, but research into those effects in college-age patients is very limited.
"Patients who experience a concussion outside of sports may lack the resources that athletes who sustain their injury on the field have for concussion care, like immediate access to health care providers such as athletic trainers," said study first author Patricia Roby, PhD, an injury scientist who conducted this research while she was a postdoctoral fellow at CHOP.
To help address this gap in knowledge, researchers analyzed data from the National Collegiate Athletic Association-Department of Defense Concussion Assessment, Research, and Education (CARE) Consortium. A total of 3,500 college athletes were included in the study, including 555 that experienced a non-sports-related concussion. More than 40% of athletes included were female so that potential differences in recovery between males and females could be explored.
The study found that athletes who experienced non-sports-related concussions were less likely to report their injuries immediately, potentially due to lack of recognition of symptoms outside of the sport setting or hesitation to report the injury caused by unusual or careless mechanisms. Athletes who sustained non-sports-related concussions reported greater severity of their symptoms, more days with symptoms, and more days in sports lost to injury relative to patients who experienced sports-related concussions, and these findings were even more true in female patients compared with male patients.
"Our findings show that non-sports mechanisms of injury for concussion are an important consideration in college age young adults, something we had already described in our research in younger children. There is an opportunity to improve clinical outcomes by increasing awareness and education around concussions that happen outside of sports and reducing healthcare reporting barriers in this older age group as well," said senior study author Christina L. Master, MD, clinical director of the Minds Matter Concussion Program at CHOP. "Additionally, our findings related to sex differences in the trajectory of these injuries warrant additional investigation to see the extent to which reporting behaviors and access to medical teams are contributing to this disparity in outcomes."
https://www.sciencedaily.com/releases/2023/09/230920152424.htm
Potential new approach to PTSD treatment
September 13, 2023
Science Daily/Louisiana State University Health Sciences Center
A research study has found that cerebellar inhibitory interneurons are essential for fear memory, a type of emotional memory formation. Inhibitory interneurons within the cerebellar circuitry act as gatekeepers and control the output of the cerebellar cortex. The formation of fear memory requires the activity of these interneurons. The findings may lead to a novel treatment approach for post-traumatic stress disorder.
An LSU Health New Orleans research study led by Siqiong June Liu, PhD, Professor of Cell Biology and Anatomy, has found that cerebellar inhibitory interneurons are essential for fear memory, a type of emotional memory formation. Inhibitory interneurons within the cerebellar circuitry act as gatekeepers and control the output of the cerebellar cortex. The formation of fear memory requires the activity of these interneurons. The findings, which may lead to a novel treatment approach for post-traumatic stress disorder, are published in Cell Reports.
"While synaptic plasticity is considered the basis of learning and memory, modifications of the intrinsic excitability of neurons can amplify the output of neuronal circuits and consequently change behavior," notes Dr. Liu. "In the cerebellum, we find that silencing molecular layer interneurons completely abolishes fear memory, revealing their critical role in memory consolidation."
The cerebellum is a brain region that is known to control motor coordination. Recent work has shown that it is also critical for the formation of memory, but not how the cerebellar circuitry accomplishes this function.
The research team found that fear conditioning suppresses hyperpolarization-activated cyclic nucleotide-gated (HCN) channels and enhances cerebellar interneuron excitability. HCN currents are similar to pacemakers in the brain because they help regulate rhythmic activity and communication between brain cells. HCN loss is driven by a learning-induced decrease in endocannabinoid levels. When the activity of these neurons is suppressed, experimental animals do not remember the experience a few hours after learning.
"Our study reveals that activity in cerebellar interneurons drives fear memory formation via a learning-specific increase in intrinsic excitability," Liu concludes. "This highlights the importance of moving beyond traditional synaptic plasticity-focused investigations of memory formation and suggests a novel therapeutic approach for the treatment of PTSD."
https://www.sciencedaily.com/releases/2023/09/230913122754.htm
Concussions early in life tied to late life cognitive decline
September 6, 2023
Science Daily/American Academy of Neurology
A study of twins shows that having a concussion early in life is tied to having lower scores on tests of thinking and memory skills decades later as well as having more rapid decline in those scores than twins who did not have a concussion, or traumatic brain injury (TBI). The study is published in the September 6, 2023, online issue of Neurology®, the medical journal of the American Academy of Neurology.
"These findings indicate that even people with traumatic brain injuries in earlier life who appear to have fully recovered from them may still be at increased risk of cognitive problems and dementia later in life," said study author Marianne Chanti-Ketterl, PhD, MSPH, of Duke University in Durham, North Carolina. "Among identical twins, who share the same genes and many of the same exposures early in life, we found that the twin who had a concussion had lower test scores and faster decline than their twin who had never had a concussion."
The study involved 8,662 men who were World War II veterans. The participants took a test of thinking skills at the start of the study when they were an average age of 67 and then again up to three more times over 12 years. Scores for the test can range from zero to 50. The average score for all participants at the beginning of the study was 32.5 points.
A total of 25% of the participants had experienced a concussion in their life.
Twins who had experienced a concussion were more likely to have lower test scores at age 70, especially if they had a concussion where they lost consciousness or were older than 24 when they had their concussion. Those twins with traumatic brain injury with loss of consciousness, more than one traumatic brain injury and who had their injuries after age 24 were more likely to have faster cognitive decline than those with no history of traumatic brain injury.
For example, a twin who experienced a traumatic brain injury after age 24 scored 0.59 points lower at age 70 than his twin with no traumatic brain injury, and his thinking skills declined faster, by 0.05 points per year.
These results took into account other factors that could affect thinking skills, such as high blood pressure, alcohol use, smoking status and education.
"Although these effect sizes are modest, the contribution of TBI on late life cognition, in addition to numerous other factors with a detrimental effect on cognition, may be enough to trigger an evaluation for cognitive impairment," Chanti-Ketterl said. "With the trend we are seeing with increased emergency room visits due to sports or recreation activity injuries, combined with the estimated half million members of the military who suffered a TBI between 2000 and 2020, the potential long-term impact of TBI cannot be overlooked. These results may help us identify people who may benefit from early interventions that may slow cognitive decline or potentially delay or prevent dementia."
A limitation of the study was that traumatic brain injuries were reported by the participants, so not all injuries may have been remembered or reported accurately.
https://www.sciencedaily.com/releases/2023/09/230906161815.htm
Playing tackle football may increase the risk for Parkinson's disease
New study shows risk increases with more years of play, even in high school and college players
August 11, 2023
Science Daily/Boston University School of Medicine
Identification of risk factors for Parkinson's disease (PD) is essential for early diagnosis. Dating back to the 1920s, Parkinson's disease and parkinsonism -- an umbrella term that refers to motor symptoms found in Parkinson's disease and also other conditions -- have long been described in boxers. Repetitive head impacts from tackle football can also have long-term neurological consequences like chronic traumatic encephalopathy (CTE). But research on the association between participation in tackle football and PD is limited.
In the largest study to describe the association between participation in football and the odds for having a reported diagnosis of PD, researchers from the BU CTE Center used a large online data set of people concerned for having PD and found participants with a history of playing organized tackle football had a 61% increased odds of having a reported parkinsonism or PD diagnosis.
In this study, the researchers evaluated 1,875 sport participants -- 729 men who played football, predominantly at the amateur level, and 1,146 men who played non-football sports who served as the control group. Participants were enrolled in Fox Insight, a longitudinal online study of people with and without PD sponsored by The Michael J. Fox Foundation for Parkinson's Research.
Notably, researchers found a link between playing football and increased odds for having a parkinsonism or PD diagnosis even after accounting for known risk factors for PD. Additionally, the data revealed that players who had longer careers and played at higher levels of competition experienced increased odds for having a reported diagnosis of parkinsonism or PD. Football players who played at the college or professional level were at 2.93 increased odds for having a PD diagnosis compared with those who just played at the youth or high school level. Age of first exposure to football was not associated with odds for having a reported parkinsonism or PD diagnosis.
"Playing tackle football could be a contributing risk factor to PD, particularly among people already at risk due to other factors (e.g., family history). However, the reasons for this relationship are not clear and we also know that not everyone who plays tackle football will develop later-life neurological conditions, meaning many other risk factors are at play," says corresponding author Michael L. Alosco, PhD, associate professor of neurology at Boston University Chobanian & Avedisian School of Medicine.
The researchers also emphasized that they compared the football players to another group of athletes, a noteworthy strength of the study. Furthermore, most of the participants played tackle football only at the amateur level, which is contrast to most of the research to date that has focused on professional athletes.
"Previous research has focused on the association between American football and risk for CTE. However, similar to what has historically been seen in boxers, American football might also affect risk for other neurodegenerative conditions such as PD," says Hannah Bruce, MSc, first author and research specialist at Boston University Chobanian & Avedisian School of Medicine.
https://www.sciencedaily.com/releases/2023/08/230811115422.htm
AI-guided brain stimulation aids memory in traumatic brain injury
July 18, 2023
Science Daily/University of Pennsylvania
AI-guided electrical stimulation in the brains of patients with traumatic brain injury improved memory, a collaborative new study shows. This builds on previous research involving epilepsy patients without traumatic brain injury. Brain injuries can result in profound memory loss, and the current study provides a proof-of-concept for future AI-guided brain stimulation therapies.
Traumatic brain injury (TBI) has disabled 1 to 2% of the population, and one of their most common disabilities is problems with short-term memory. Electrical stimulation has emerged as a viable tool to improve brain function in people with other neurological disorders.
Now, a new study in the journal Brain Stimulation shows that targeted electrical stimulation in patients with traumatic brain injury led to an average 19% boost in recalling words.
Led by University of Pennsylvania psychology professor Michael Jacob Kahana, a team of neuroscientists studied TBI patients with implanted electrodes, analyzed neural data as patients studied words, and used a machine learning algorithm to predict momentary memory lapses. Other lead authors included Wesleyan University psychology professor Youssef Ezzyat and Penn research scientist Paul Wanda.
"The last decade has seen tremendous advances in the use of brain stimulation as a therapy for several neurological and psychiatric disorders including epilepsy, Parkinson's disease, and depression," Kahana says. "Memory loss, however, represents a huge burden on society. We lack effective therapies for the 27 million Americans suffering."
Study co-author Ramon Diaz-Arrastia, director of the Traumatic Brain Injury Clinical Research Center at Penn Medicine, says the technology Kahana and his team developed delivers "the right stimulation at the right time, informed by the wiring of the individual's brain and that individual's successful memory retrieval."
He says the top causes of TBI are motor vehicle accidents, which are decreasing, and falls, which are rising because of the aging population. The next most common causes are assaults and head injuries from participation in contact sports.
This new study builds off the previous work of Ezzyat, Kahana, and their collaborators. Publishing their findings in 2017, they showed that stimulation delivered when memory is expected to fail can improve memory, whereas stimulation administered during periods of good functioning worsens memory. The stimulation in that study was open-loop, meaning it was applied by a computer without regard to the state of the brain.
In a study with 25 epilepsy patients that was published the following year, they monitored brain activity in real time and used closed-loop stimulation, applying electrical pulses to the left lateral temporal cortex only when memory was expected to fail. They found a 15% improvement in the probability of recalling a word from a list.
But the new study specifically focuses on eight people with a history of moderate-to-severe TBI, who were recruited from a larger group of patients undergoing neurosurgical evaluation for epilepsy. Seven of the eight are male, and Diaz-Arrastia says 80% of people who get hospitalized for traumatic brain injury overall are male.
Kahana emphasizes the importance of addressing TBI-related memory loss, noting, "These patients are often relatively young and physically healthy, but they face decades of impaired memory and executive function."
The researchers' primary question was whether stimulation could improve memory across entire lists of words when only some words were stimulated, whereas prior studies only considered the effect of stimulation on individual words. Ezzyat says this development is important because "this suggests that an eventual real-life therapy could provide more generalized memory improvement -- not just at the precise moment when stimulation is triggered."
The study notes that more work remains before this kind of stimulation can be applied in a therapeutic setting, and scientists need to study physiological responses to stimulation to better understand the neural mechanisms behind improved memory performance. Diaz-Arrastia says, "these are still early days in the field."
"I think eventually what we would need," he says, "is a self-contained, implantable system, where you could implant the electrodes into the brain of someone who had a brain injury."
https://www.sciencedaily.com/releases/2023/07/230718164310.htm
Children's IQs not diminished by concussion
July 17, 2023
Science Daily/University of Calgary
A new study finds concussions don't reduce the IQ of children. Findings may help to reduce parental fears regarding these common and concerning head injuries. Researchers looked at socioeconomic status, patient sex, severity of injuries, concussion history, and whether there was a loss of consciousness at the time of injury. None of these factors made a difference. Across the board, concussion was not associated with lower IQ.
The angst parents feel when their children sustain injuries is surely one of the universal conditions of parenthood. That anxiety is heightened greatly when those injuries involve concussions. But a new study led out of the University of Calgary, published today in the medical journal Pediatrics, may set worried parental minds slightly at ease.
The findings -- taken from emergency room visits in children's hospitals in Canada and the United States -- show that IQ and intelligence is not affected in a clinically meaningful way by pediatric concussions.
The study compares 566 children diagnosed with concussion to 300 with orthopedic injuries. The children range in age from eight to 16 and they were recruited from two cohort studies. The Canadian cohort encompasses data collected from five children's hospital emergency rooms, including Alberta Children's Hospital in Calgary, along with those in Vancouver, Edmonton, Ottawa, and Montreal (CHU Sainte-Justine). In the Canadian hospitals, patients completed IQ tests three months postinjury.
The U.S. cohort was conducted at two children's hospitals in Ohio, wherein patients completed IQ tests three to 18 days, postinjury.
"Obviously there's been a lot of concern about the effects of concussion on children, and one of the biggest questions has been whether or not it affects a child's overall intellectual functioning," says Dr. Keith Yeates, PhD, a professor in UCalgary's Department of Psychology and senior author of the Pediatrics paper. Yeates is a renowned expert on the outcomes of childhood brain disorders, including concussion and traumatic brain injuries.
"The data on this has been mixed and opinions have varied within the medical community," says Yeates. "It's hard to collect big enough samples to confirm a negative finding. The absence of a difference in IQ after concussion is harder to prove than the presence of a difference."
Combining the Canadian and U.S. cohorts gave the Pediatrics study an abundant sample and it allowed Yeates and his co-authors -- from universities in Edmonton, Montreal, Vancouver, Ottawa, Atlanta, Utah, and Ohio, along with Calgary's Mount Royal University -- to test patients with a wide range of demographics and clinical characteristics.
"We looked at socioeconomic status, patient sex, severity of injuries, concussion history, and whether there was a loss of consciousness at the time of injury," says Yeates. "None of these factors made a difference. Across the board, concussion was not associated with lower IQ."
The children with concussion were compared to children with orthopedic injuries other than concussion to control for other factors that that might affect IQ, such as demographic background and the experience of trauma and pain. This allowed the researchers to determine whether the children's IQs were different than what would be expected minus the concussion.
The findings of the study are important to share with parents, says Dr. Ashley Ware, PhD, a professor at Georgia State University and lead author of the paper. While the Pediatrics research was underway, Ware was a Killam Postdoctoral Fellow at UCalgary, where Yeates was her supervisor.
"Understandably, there's been a lot of fear among parents when dealing with their children's concussions," Ware says. "These new findings provide really good news, and we need to get the message to parents."
Dr. Stephen Freedman, PhD, co-author of the paper, a professor of pediatrics and emergency medicine at the Cumming School of Medicine, agrees. "It's something doctors can tell children who have sustained a concussion, and their parents, to help reduce their fears and concerns," says Freedman. "It is certainly reassuring to know that concussions do not lead to alterations in IQ or intelligence."
Another strength of the Pediatrics research is that incorporates the two cohort studies, one testing patients within days of their concussions and the other after three months.
"That makes our claim even stronger," says Ware. "We can demonstrate that even in those first days and weeks after concussion, when children do show symptoms such as a pain and slow processing speed, there's no hit to their IQs. Then it's the same story three months out, when most children have recovered from their concussion symptoms. Thanks to this study we can say that, consistently, we would not expect IQ to be diminished from when children are symptomatic to when they've recovered."
She adds: "It's a nice 'rest easy' message for the parents."
https://www.sciencedaily.com/releases/2023/07/230717115826.htm