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HealthDay (3/22, Preidt, http://tinyurl.com/MCI-Alzheimer) reported that “memory and thinking skills can deteriorate quickly in people with mild cognitive impairment, the stage before Alzheimer’s disease.”  The study involved 1,158 people, who averaged 79 years old. The group included 149 people with Alzheimer’s disease, 395 with mild cognitive impairment and 614 with no thinking or memory problems.  The scores of people with mild cognitive impairment declined twice as fast each year as did scores of those with no memory problems. The scores for people with Alzheimer’s declined four times as fast as those of participants with no cognitive problems.  The results are in the March 23 issue of Neurology.  “The changes in rate of decline occur as the brain atrophies due to the disease, first mainly in the hippocampus during the initial symptomatic stage, referred to as mild cognitive impairment, then in the temporal, parietal and frontal cortex during the dementing illness phase of Alzheimer’s disease,” said Dr. David S. Knopman, of the Mayo Clinic in Rochester, Minn., who wrote an editorial accompanying the study.

AmphetamineMedWire (3/9, Grasm, http://tinyurl.com/bipolar-ADD) reports that, according to a study published in the Journal of Clinical Psychiatry researchers found that adults with bipolar disorder often present with co-morbid attention-deficit/hyperactivity disorder (ADHD).   “We suggest that in clinical practice, adult patients diagnosed with bipolar disorder [BD] should be assessed for possible underlying or comorbid ADHD, and vice versa,” say Anne Halmøy (University of Bergen, Norway) and colleagues.  A significant linear relationship between current symptoms of ADHD as measured by the ASRS and lifetime symptoms of Bipolar Disorder was observed. The researchers say that this finding may “support the hypothesis that mood symptoms are an inherent part of a syndrome shared a by a subgroup of adult ADHD patients.”  As mood instability appears to be an important clinical feature of ADHD in adults, diagnostic criteria may need to be revised to account for bipolar-like symptoms,” concludes the team in the Journal of Clinical Psychiatry.

The St. Petersburg Times (3/3, Stein, http://tinyurl.com/TMS-depression) reports that for patients who don’t respond to drugs and counseling, TMS (transcranial magnetic stimulation) offers an alternative to electric shock therapy, still used to treat depression despite its reputation in popular culture as a barbaric treatment.  Many physicians consider ECT the gold standard treatment for severe depression that doesn’t respond to other remedies.  It is considered safe, but side effects can include short-term memory loss.  TMS involves using an electromagnetic coil to beam pulsations through the skull to stimulate a part of the brain thought to be involved in depression.  By contrast, the primary discomfort associated with TMS is a staccato tapping noise.  Another consideration is cost, which can reach $10,000 and isn’t routinely covered by insurance since it is relatively new and its availability limited. At USF, the treatment costs about $350 per session, and patients need about 10 to 20 procedures.  Clinical trials on TMS have yielded mixed results, and the U.S. Food and Drug Administration received some criticism when it approved the therapy for use in treatment-resistant depression over a year ago.  At least some questions may be settled in May, when the results of a five-year study sponsored by the NIH will be published in the Archives of General Psychiatry.

Trouble With Tribbles.

WebMD (2/16, DeNoon, http://tinyurl.com/tribbles-narcolepsy) reported that a major cause of narcolepsy appears to be trouble with tribbles.  The tribbles in question are bits of RNA amusingly named after the cute and furryanimals  in a Star Trek TV episode.  New findings strongly suggest that anti-tribbles antibodies kill a population of brain cells that regulates sleep.  This triggers narcolepsy, particularly the severe manifestation of narcolepsy called cataplexy, in which strong emotions trigger paralysis. “We have identified reactive autoantibodies in human narcolepsy, providing evidence that narcolepsy is an autoimmune disorder,” conclude Vesna Cvetkovic-Lopes and colleagues of the University of Geneva, Switzerland.   People with narcolepsy have a dramatic loss of brain cells that produce hypocretin (also known as orexin), a chemical messenger crucial to normal sleep.  Using mice engineered to overproduce tribbles, Cvetkovic-Lopes and colleagues found that hypocretin-producing brain cells make a large amount of a specific type of tribbles — tribbles homolog 2 or Trib2.  Then they looked for the antibodies in people who had narcolepsy and people who didn’t.  Sure enough, the researchers found narcolepsy patients — but not other people — have a lot of antibodies against Trib2.  The findings appear in the Feb. 15 online issue of the Journal of Clinical Investigation.

BBC News (2/10, http://tinyurl.com/sweetteeth) reports that certain children are especially drawn to very sweet tastes.  These were children who had a close relative with an alcohol problem or who themselves had symptoms of depression.  But it is unclear if the preference for the very sweet is down to genuine chemical differences or environmental effects.  The researchers say sweet taste and alcohol trigger many of the same reward circuits in the brain.  Certain groups of children may be especially attracted to the intense sweetness due to their underlying biology.  In the latest study, the scientists at the Monell Chemical Senses Center asked 300 children aged five to 12, of whom half had a family member with alcohol dependency, to taste five sweet water drinks containing different amounts of sugar.  The children were asked to say which tasted the best and were also asked questions to check for depressive symptoms.  A quarter had symptoms that the researchers believed suggested they might be depressed.  Liking for intense sweetness was greatest in the 37 children who had both a family history of alcoholism and reported depressive symptoms.

The Tampa Tribune (2/3, http://tinyurl.com/parkinsons-hotspots) reports people with Parkinson’s disease are more likely to be found in the Northeast and Midwest.   “Finding clusters in the Midwest and the Northeast is particularly exciting,” said Dr. Allison Wright Willis, assistant professor of neurology at the Washington University School of Medicine.  “These are the two regions of the country most involved in metal processing and agriculture, and chemicals used in these fields are the strongest potential environmental risk factors for Parkinson’s disease that we’ve identified so far.”   Genetic factors can explain only a small percent of Parkinson’s cases, Willis believes.  Environmental factors such as prolonged exposures to agricultural herbicides and insecticides and metals such as copper, manganese and lead, are likely more common contributors.   Willis and her colleagues are now planning to studies how exposure to single or combined environmental factors influences Parkinson’s disease risk. 

HealthDay (2/2, http://tinyurl.com/lead-ADHD) reported lead may play a role in the development of attention-deficit hyperactivity disorder (ADHD).   Genes are believed to account for as much as 70 percent of ADHD in children.  Researchers consider lead a prime suspect, among possible environmental causes, contributing to the other 30 percent .  Lead, a neurotoxin, is present in trace amounts in such things as soil, drinking water, children’s costume jewelry and imported candies.   In one of two recent studies examining the possible link between lead and ADHD, the researchers found that children with ADHD had slightly higher levels of lead in their blood than did children without ADHD.  The second study showed an association between elevated levels of lead in children’s blood and parent/teacher ratings of ADHD symptoms, including both hyperactivity and attention problems.  The findings strongly suggest that lead may be a cause of ADHD, according to Joel Nigg, a psychological scientist at Oregon Health & Science University.  He said that lead might disrupt brain activity in a way that leads to hyperactivity and attention problems. 

WebMD (2/1, DeNoon http://tinyurl.com/fishy-psychosis) reported that twelve weeks of fish oil pills made teens at high risk of psychosis much less likely to become psychotic for at least one year.   A year after entering the study, 11 of the 40 teens treated only with placebo pills developed a psychotic disorder.  This happened to only two of 41 teens who began the year with 12 weeks of fish oil capsules rich in omega-3 fatty acids.    “The finding that treatment with a natural substance may prevent or at least delay the onset of psychotic disorder gives hope that there may be alternatives to antipsychotics for the prodromal phase”, Amminger and colleagues suggest.    People with schizophrenia tend to have low levels of omega-3 fatty acids, suggesting that the mental illness could be linked to a defect in the ability to process fatty acids.  There’s also evidence that fatty acids interact with chemical signaling in the brain and that omega-3 fatty acids protect brain cells from oxidative stress.  The study appears in the February issue of Archives of General Psychiatry.

According to HealthDay (1/28, Dotinga, http://tinyurl.com/crf-EtOH), researchers are reporting that blocking a stress hormone could become a strategy to help treat alcoholism.  Lead researcher Marisa Roberto, an associate professor at the Scripps Research Institute, said in a Scripps news release:  “Our study explored  the compulsion to drink, not because it is pleasurable — which has been the focus of much previous research — but because it relieves the anxiety generated by abstinence and the stressful effects of withdrawal.  “The hormone, known as corticotropin-releasing factor, plays a role in the body’s response to stress and is found in the brain.  Romero said it’s possible that blocking the hormone “may prevent excessive alcohol consumption under a variety of behavioral and physiological conditions.”  The researchers also found that rats exposed to the hormone-suppressing chemical didn’t become immune to the chemical’s effects over time.  That suggests that people might be able to take it repeatedly without facing a loss of effectiveness.