No Fear

The New York Times (12/17, Bhanoo, http://tinyurl.com/fearamygdala) reportsIn the 1930s, researchers discovered that when a certain part of monkeys’ brains was removed, the animals became fearless.  Now, scientists have confirmed that a missing amygdala results in similar behavior in humans, according to a study in the journal Current Biology. Patient SM, because of a rare condition called lipoid proteinosis, has holes where her amygdala would normally reside. Researchers found that she, like the monkeys, has no fear of creatures like snakes and spiders, which ordinarily alarm most people.  SM put her life at risk several times.  In one instance, she walked through a park alone at night and was attacked by a man with a knife. The following day, she walked through the same park again.   Shw was exposed  to snakes and spiders at a pet store, shown clips of horror movies like The Shining and The Blair Witch Project, and taken through a haunted house in a former sanatorium.   SM’s fear response was nonexistent.   What’s more, she “relished cuddling snakes and had to be stopped from reaching for a tarantula.”   Understanding how the mind of a patient like SM works could help researchers develop therapies for individuals who express excessive amounts of fear, like war veterans.


The AP(10/29, http://tinyurl.com/latuda1) reports The Food and Drug Administration approved a new drug from Sunovion Pharmaceuticals to treat adults with schizophrenia.   Schizohrenia affects about 1 percent of the U.S. population, causing hallucinations, paranoia and delusions.  The FDA approved Sunovion’s drug Latuda based on four studies that showed patients taking the drug had fewer schizophrenia symptoms than patients taking a placebo pill.  Latuda is part of the atypical antipsychotics drug class, which also includes Eli Lilly & Co.’s Zyprexa, Johnson & Johnson’s Risperdal and AstraZeneca’s Seroquel.  Those drugs were the top-selling group of prescription drugs in the U.S. last year, with combined sales of $14.6 billion.  Sunovion Pharmaceuticals Inc. is based in Fort Lee, N.J. and is the U.S. subsidiary of Japanese drugmaker Dainippon Sumitomo Pharma Co.

“Latuda is an oral, once-daily atypical antipsychotic, offering a first-line treatment option for patients with schizophrenia and is expected to be available in the US during the first quarter of 2011,” Marlborough-based Sunovion said.  Sunovion recently changed its name from Sepracor, a company known for its Lunesta sleep aid. A year ago, Sepracor was acquired by Dainippon Sumitomo Pharma Co., a Japanese drug maker.

USA Today (10/15, Zoroya TBI) reports the Army says it has discovered a simple blood test that can diagnose mild traumatic brain damage or concussion. “This is huge,” said Gen. Peter Chiarelli, the Army vice chief of staff.Army Col. Dallas Hack, who has oversight of the research, says recent data show the blood test, which looks for unique proteins that spill into the blood stream from damaged brain cells, accurately diagnosing mild traumatic brain injury in 34 patients.  Doctors can miss these injuries because the damage does not show up on imaging scans, and symptoms such as headaches or dizziness are ignored or downplayed by the victims.  If the brain is not allowed time to recover and a second concussion occurs, permanent damage may result.  Brain injuries afflict 1.4 million Americans each year, says the National Brain Injury Association. Seventy percent are mild cases.  About 300,000 troops in Iraq and Afghanistan have suffered concussions, mostly from roadside bombs, according to a RAND Corp. study.  Hack says the new findings could rival the discovery of unique proteins in the 1970s that now help doctors identify heart disease.

The Chicago Tribune (10/18, Chan, http://tinyurl.com/SPD-DSM5) reported that the rate of Sensory Processing Disorder is on the rise.  To have sensory processing disorder, experts say there must be a significant effect on daily routine.  The disorder is usually found in children, though adults can have it, too.  “Everything’s coming in and getting messed up for them,” said Heidi Tringali, a Charlotte, N.C., occupational therapist who sees a lot of children with sensory issues.  “It tastes too strong, smells too strong.  They’re just disrupted – and their existence is so much more difficult than just a typical developing child.”

There have been few published studies on the prevalence of SPD.  But one study done in association with the Sensory Processing Disorder Foundation estimates that one in six children is affected by sensory issues, which can range from mild to severe.  However, SPD has not yet been officially recognized by the American Psychiatric Association. It’s important to note the differences between a child with sensory processing disorder and a child who’s just picky or problematic, experts say.  For example, a typical child who steps from an air-conditioned room outside into the heat may whine and complain for a bit.  But for a child with sensory problems, it can be almost unbearable.  Kids can be clumsy, but children with sensory problems may struggle in vain to write with a pencil because the motor skills are just so off. Academic and social problems often ensue.  Sensory processing problems occur when the brain’s neurons can’t correctly interpret incoming signals, said Lucy Jane Miller, executive director of the Sensory Processing Disorder Foundation in Colorado.  When the signals are mixed up, that affects the senses of touch, movement and balance, and space, she said.  In the sensory processing world, these are known as the tactile, vestibular and proprioceptive systems.  But there’s no cure for sensory processing disorder. Rather, occupational therapists help patients learn to cope.

The SPD Foundation is trying to get the disorder recognized in the “Diagnostic and Statistical Manual of Mental Disorders,” the official catalog of mental disorders. The next edition, known as the DSM-5, comes out in 2013.  Sensory processing disorder is divided into three categories.  The first comprises sensory over- and under-responders and sensory seekers _ people who may over react or under react to pain or noise, and people who may seek out bear hugs and crave lots of motion. The second includes people with sensory motor disorders, who may seem clumsy and uncoordinated.  The third encompasses people who have trouble discriminating between the different senses.  Recommended therapy includes weekly (if not more frequent) sessions and daily sensory “diets” that involve brushing the limbs with a surgical brush, putting tension on joints, doing exercises and doing heavy work to stimulate muscles and joints.

The Los Angeles Times (9/2, Roan, http://tinyurl.com/face-gaze) reported  that with autism rates soaring over the last decade, researchers are seeking the earliest clues of the disorder.  The quicker a child is diagnosed, the better the long-term outcome.  In the September issue of the Journal of Child Psychology and Psychiatry, leading autism researchers say they think infant gaze is among the first clues of social functioning.   Infants who don’t exhibit this fondness for human faces, may be exhibiting one of the first signs of autism, the inability to socialize .  The researchers, from the Kennedy Krieger Institute in Baltimore and the University of Delaware, observed 25 6-month-old infants who were siblings of children with autism.  They were compared with 25 infants from families with no history of autism.   They found that the infants in the low-risk group were more likely to have normal social gazing.  The high-risk siblings, however, spent less time looking at their caregivers and more time focused on the toy. The study provides more evidence for early diagnosis, the lead author of the study, Rebecca Landa, said in a news release.   The lack of interest in people’s faces is “a subtle difference that could be easily overlooked by both parents and some professionals.”


Medscape (6/24, Brauser, http://tinyurl.com/omega3-depression) reported Omega-3 fatty acid supplements significantly reduce symptoms of major depressive episodes (MDEs) for patients without comorbid anxiety disorders (ADs) compared with those taking placebo, according to a new study of more than 400 patients from 8 Canadian clinics.  Despite the availability of several newer antidepressants over the last 20 years, a substantial proportion of patients experiencing a depressive episode do not respond sufficiently to antidepressant treatment, are unable to tolerate antidepressants in order to obtain or maintain a clinical response, or refuse to take antidepressants despite substantial psychological suffering and disability notes the study author Dr. Lespérance.  Almost 54% of people with depression in the United States use some form of complementary treatment. In addition, the omega-3 supplements “seemed to be more efficacious for patients as a stand-alone treatment in comparison to adjuvant treatment,” reported Dr. Lespérance.

HealthDay (6/29, http://tinyurl.com/generic-eff-xr) reported the first generic version of Effexor extended release  (XR) capsules (venlafaxine hydrochloride) to treat major depressive disorder has been approved by the U.S. Food and Drug Administration.  Teva said it will start shipping its version of Effexor, or venlafaxine, on July 1st, 2020. The Israeli company originally sought approval for its generic in 2006, but as part of a patent settlement with Wyeth  it agreed not to sell its version until July 1, 2010. Pfizer acquired Wyeth last year.  As the first company to file an Abbreviated New Drug Application (ANDA) containing a paragraph IV certification for this product, Teva has been awarded a 180-day period of marketing exclusivity.  Teva said annual U.S. sales of Effexor XR are around $2.75 billion.