Recovery Michigan

Identifying and treating metabolic deficiencies in patients with treatment-resistant depression can improve symptoms and in some cases even lead to remission, according to new research from the University of Pittsburgh School of Medicine published online in the American Journal of Psychiatry.

Searching for answers, Dr. Pan contacted Jerry Vockley, M.D., Ph.D., chair of genetics, Children's Hospital of Pittsburgh of UPMC, and David Finegold, M.D., professor of human genetics at Pitt's Graduate School of Public Health, and through a series of biochemical tests, the three discovered that the patient had a cerebrospinal fluid deficiency in biopterin, a protein involved in the synthesis of several brain signaling chemicals called neurotransmitters.

After receiving an analogue of biopterin to correct the deficiency, the patient's depression symptoms largely disappeared and today he is a thriving college student.

The success prompted the researchers to examine other young adults with depression who were not responding to treatment, explained Dr. Pan.

In the published trial, the researchers looked for metabolic abnormalities in 33 adolescents and young adults with treatment-resistant depression and 16 controls. Although the specific metabolites affected differed among patients, the researchers found that 64 percent of the patients had a deficiency in neurotransmitter metabolism, compared with none of the controls.

Neuroscientists at the University of Pittsburgh have identified the neural networks that connect the cerebral cortex to the adrenal medulla, which is responsible for the body's rapid response in stressful situations. These findings, reported in the online Early Edition of the journal Proceedings of National Academy of Sciences (PNAS), provide evidence for the neural basis of a mind-body connection.

Specifically, the findings shed new light on how stress, depression and other mental states can alter organ function, and show that there is a real anatomical basis for psychosomatic illness. The research also provides a concrete neural substrate that may help explain why meditation and certain exercises such as yoga and Pilates can be so helpful in modulating the body's responses to physical, mental and emotional stress.

Another surprising result was that motor areas in the cerebral cortex, involved in the planning and performance of movement, provide a substantial input to the adrenal medulla. One of these areas is a portion of the primary motor cortex that is concerned with the control of axial body movement and posture. This input to the adrenal medulla may explain why core body exercises are so helpful in modulating responses to stress. Calming practices such as Pilates, yoga, tai chi and even dancing in a small space all require proper skeletal alignment, coordination and flexibility.

Firth and colleagues suggest aerobic exercise should be added to the treatment regimens of patients with schizophrenia, after finding it could improve their cognitive functioning.

The analysis revealed that schizophrenia patients who completed around 12 weeks of aerobic exercise - alongside their usual schizophrenia treatment - had better cognitive functioning than those who did not engage in aerobic exercise.

In detail, the team found aerobic exercise significantly improved the attention, social cognition - the ability to understand social situations - and working memory of individuals with schizophrenia.

Aerobic exercise refers to physical activity in which the large muscles of the body move in a rhythmic manner for a sustained period, such as walking, swimming, and cycling.

The researchers note that individuals with schizophrenia who engaged in greater amounts of aerobic exercise showed the biggest improvements in cognitive functioning, and exercise programs that were best for improving physical fitness were also most beneficial for cognition.

About one in five of the patients tested positive for gabapentin (Neurontin), but didn't have a prescription for the drug. Of the patients taking gabapentin illicitly, 56 percent were taking it with an opioid, 27 percent with an opioid and muscle relaxant or anxiety medication, and the rest were taking it with other substances.

"The high rate of misuse of this medication is surprising and it is also a wakeup call for prescribers," study author Poluru Reddy said in an AACC news release. Reddy is medical director of ARIA Diagnostics and ARCTIC Medical Labs.

Restorative justice programs, such victim-offender mediation and community impact panels, are more effective in reducing recidivism rates among juvenile offenders than traditional court processing, a study by researchers at Sam Houston State University found.

"Our results generally not only support the effectiveness of RJ (restorative justice) programming as compared to traditional juvenile court processing but also suggest that each type of RJ intervention, even those that are minimally involved, reduces recidivism risk relative to juvenile court proceedings," said Jeffrey Bouffard, a Professor in the Department of Criminal Justice and Criminology and Research Director for the Correctional Management Institute of Texas at Sam Houston State University. "This pattern of results would suggest that in many cases, it may be possible to use less intensive RJ approaches and still receive promising results."

The study, published in Youth Violence and Juvenile Justice, examined four types of restorative justice programs for juvenile offenders in a small, mostly rural area in the upper Midwest. These interventions include face-to-face mediation between victims and offenders, indirect communication between victims and offenders, community panels who stand in for the victim, and even minimal RJ interventions that simply educate offenders about the restorative justice process.

I had absolutely no control over my brain. I panicked even more.

It was like someone had switched my brain with the brain of someone wicked, someone evil, and I was in constant internal battles with myself.

It took me three weeks after the impact to fathom that I could have actually sustained another concussion — this one would be my third major one over the span of 10 years.

But I pushed myself because that’s what I’ve been taught to do. As a competitive athlete all my life, I’ve learned how to push through injuries, playing both basketball and softball in high school and college.

I’ve had dislocated shoulders, high ankle sprains, and eye surgery. With a partially torn Achilles and a slipped disc in my spine, I was determined to finish my senior year of college basketball regardless of the pain I was causing my body. Physically, I wouldn’t let anything stop me from playing.

Not even collecting one too many hits to the head playing basketball and softball.

So this time, once again, I pushed myself.

For the next three weeks I continued going to work, all the dark emotions still very much on my mind. I tried my hardest to ignore them.

Mr. Shinseki resigned in 2014, undone by health care scandals on his watch, but the administration, undaunted, announced another campaign that year, called the Mayors Challenge to End Veteran Homelessness. New name, new strategic emphasis — enlisting state and local governments and philanthropies — but the same promise: a home for all down-and-out veterans in all 50 states by 2015.

The program has succeeded in only two states, Virginia and Connecticut, and a number of localities.

The good news is that the V.A., like states and cities around the country, has at least come to understand what works: “housing first” strategies that avoid the red tape and restrictive conditions that have left too many of the hardest-to-help veterans, unmoored by illness and addiction, in shelters and on the street.

A housing-voucher program that the V.A. runs with the Department of Housing and Urban Development has had much success. In Los Angeles, epicenter of the crisis, the V.A. is finally planning to build 1,200 units of supportive housing for a population it has neglected for generations. It took legal action by local advocates and the cooperation of the new V.A. secretary, Robert McDonald, to get the ball moving there, though the shovel-ready project awaits the passage of legislation stalled in Congress.

The study confirmed genes previously identified as being linked to alcoholism and uncovered new genes and neurological pathways, some of which could be promising targets for treatment. But the sheer number of genes that contribute to the trait suggests pharmaceutical treatments for alcoholism could be difficult to develop, said William Muir, professor of genetics.

“It’s not one gene, one problem,” he said. “This trait is controlled by vast numbers of genes and networks. This probably dashes water on the idea of treating alcoholism with a single pill.”

One of the best predictors of alcoholism in humans is the drinking behavior of their families. But to what extent this link can be chalked up to inherited genetics – versus a shared environment – has been poorly understood and a challenge to study: Parsing out the influence of genetics on drinking habits from other factors such as stress, boredom or peers who drink is not possible in humans.

“It’s very difficult to tease out the difference between what your genes are telling you to do and what you choose to do,” Muir said.

The results highlighted 930 genes associated with excessive drinking behavior, the vast majority of which are in genetic regulatory regions, not coding regions, as many researchers previously expected. Muir compared coding regions to a car and regulatory regions to the gas and brake pedals that determine the car’s speed.

“We all have the genes for alcoholism, but our genetic abilities to control it differ,” he said.

While the researchers stressed that the genetic complexity of alcoholism complicates potential treatments, they pinpointed the glutamate receptor signaling pathway – which can control a sense of reward in the brain – might be a possible target for treatments due to the number of alcoholism-associated genes it contains.

Emotions and breathing have historically been associated in both animal and human studies. More recent research has shown that a number of respiratory characteristics (speed of breathing, depth, etc.) can vary based on emotional experience. The sigh (a distinct deep breath) is a specific form of respiratory action that is expressed during both positive and negative emotional states, such as those of contentment and frustration, respectively. However, the motivations for sighing have only recently come under examination, and little research has been conducted on the physiological and psychological aspects of the action.

Published online in Physiology & Behavior, the described experiment included 34 participants (17 female). They first completed a survey designed to measure trait anxiety, and were then fitted with electrodes and other equipment necessary to track respiration and physiological measures of anxiety/relaxation (skin conductivity, muscle tension, CO2 concentration).

Each subject took part in three different session blocks. No breathing instructions were given in the first block, while the following two included either deep breath (sighing) prompts or breath holding (not sighing) instructions. Instances of spontaneous sighing were also recorded for the instructed sigh group. Relief was self-reported continuously throughout all trials.

Statistical analyses of biological and psychological measures revealed two significant effects of sighing. Reported relief increased in the five seconds following sighs, but not after breath holding or without instructions. Muscle tension decreased moderately in the post-sigh measurement period, signifying a reduction in anxiety and/or increased relaxation.