Ritalin shows promise in treating addiction | Science Codex

A single dose of a commonly-prescribed attention deficit hyperactivity disorder (ADHD) drug helps improve brain function in cocaine addiction, according to an imaging study conducted by researchers from the Icahn School of Medicine at Mount Sinai. Methylphenidate (brand name Ritalin?) modified connectivity in certain brain circuits that underlie self-control and craving among cocaine-addicted individuals. The research is published in the current issue of JAMA Psychiatry, a JAMA network publication.

Previous research has shown that oral methylphenidate improved brain function in cocaine users performing specific cognitive tasks such as ignoring emotionally distracting words and resolving a cognitive conflict. Similar to cocaine, methylphenidate increases dopamine (and norepinephrine) activity in the brain, but, administered orally, takes longer to reach peak effect, consistent with a lower potential for abuse. By extending dopamine's action, the drug enhances signaling to improve several cognitive functions, including information processing and attention.

"Orally administered methylphenidate increases dopamine in the brain, similar to cocaine, but without the strong addictive properties," said Rita Goldstein, PhD, Professor of Psychiatry at Mount Sinai, who led the research while at Brookhaven National Laboratory (BNL) in New York. "We wanted to determine whether such substitutive properties, which are helpful in other replacement therapies such as using nicotine gum instead of smoking cigarettes or methadone instead of heroin, would play a role in enhancing brain connectivity between regions of potential importance for intervention in cocaine addiction."

Anna Konova, a doctoral candidate at Stony Brook University, who was first author on this manuscript, added, "Using fMRI, we found that methylphenidate did indeed have a beneficial impact on the connectivity between several brain centers associated with addiction."

Dr. Goldstein and her team recruited 18 cocaine addicted individuals, who were randomized to receive an oral dose of methylphenidate or placebo. The researchers used functional magnetic resonance imaging (fMRI) to measure the strength of connectivity in particular brain circuits known to play a role in addiction before and during peak drug effects. They also assessed each subject's severity of addiction to see if this had any bearing on the results.

Methylphenidate decreased connectivity between areas of the brain that have been strongly implicated in the formation of habits, including compulsive drug seeking and craving. The scans also showed that methylphenidate strengthened connectivity between several brain regions involved in regulating emotions and exerting control over behaviors?connections previously reported to be disrupted in cocaine addiction.

"The benefits of methylphenidate were present after only one dose, indicating that this drug has significant potential as a treatment add-on for addiction to cocaine and possibly other stimulants," said Dr. Goldstein. "This is a preliminary study, but the findings are exciting and warrant further exploration, particularly in conjunction with cognitive behavioral therapy or cognitive remediation."

Source: http://www.sciencecodex.com/ritalin_shows_promise_in_treating_addiction-114847

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Have a brain injury? You may be at higher risk for stroke

June 26, 2013 ? People who have a traumatic brain injury (TBI) may be more likely to have a future stroke, according to research that appears in the June 26, 2013, online issue of Neurology?, the medical journal of the American Academy of Neurology.

"Both stroke and traumatic brain injury are common, costly, and leading causes of severe disability in adults, and approximately 20 percent of strokes occur in adults under age 65," said study author James F. Burke, MD, MS, of the University of Michigan and the Ann Arbor VA Healthcare System and a member of the American Academy of Neurology. "A large proportion of stroke risk is unexplained, especially in the young, so if we can identify new risk factors, we have the potential to prevent more strokes and improve outcomes."

For the study, researchers looked at the records of adults who went to the emergency department or were admitted to a hospital for TBI or other trauma with no brain injury in the state of California during a five-year period.

A total of 435,630 people with traumatic brain injury were studied, along with 736,723 people with trauma with no brain injury. Over an average of 28 months following the injury, 11,229 people, or 1 percent, had an ischemic stroke. A total of 1.1 percent of those with TBI suffered a stroke, compared to 0.9 percent of those with trauma with no brain injury. With an ischemic stroke, blood flow to part of the brain is blocked. Eighty percent of strokes are ischemic.

After adjusting for factors that can affect stroke risk, such as age, high blood pressure and high cholesterol, as well as other disorders such as heart disease and the severity of the trauma, the researchers found that people with traumatic brain injury were 30 percent more likely to develop a stroke than those with trauma with no brain injury.

"While the stroke risk of one person with TBI is small, the overall link between TBI and stroke was substantial -- as large as the link between the strongest stroke risk factor, high blood pressure, and stroke," Burke said. "If further research establishes TBI as a new risk factor for stroke, that would stimulate research to help us understand what causes stroke after TBI and help us learn how to prevent these strokes." The study was supported by an advanced fellowship through the Department of Veterans Affairs.

Source: http://feeds.sciencedaily.com/~r/sciencedaily/health_medicine/heart_disease/~3/uGaGMsBWMnA/130626162618.htm

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CNN bringing 'Crossfire' back on the air

NEW YORK (AP) ? CNN is bringing its political show "Crossfire" back on the air this fall with Newt Gingrich as one of the combatants.

The original political talk show on cable news aired on CNN from 1982 until 2005. The new version will air on weekdays, although CNN said Wednesday that the show has no time slot yet.

Gingrich, the former House speaker and presidential candidate, is one of two hosts "from the right" matched against two liberal voices. Conservative commentator S. E. Cupp, who also works at The Blaze, is Gingrich's conservative partner.

Stephanie Cutter, who is a former campaign spokeswoman for President Barack Obama, will be speaking "from the left." She'll be joined by Van Jones, an advocate for green projects.

Source: http://news.yahoo.com/cnn-bringing-crossfire-back-air-133912676.html

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Scientists Sequence the Oldest Ever Genome--of a 700,000-Year-Old Horse

Scientists have managed to sequence the genome of a 700,000-year-old horse?in the process generating the oldest complete DNA sequence yet.

A team of researchers from the University of Copenhagen, Denmark, worked with a horse bone found in the permafrost of north-west Canada all the way back in 2003 to achieve the result. Previously, the oldest complete genome came from 110,000-year-old polar bear remains.

Sequencing the genome of the 700,000-year-old horse was no simple task. Over that length of time, the DNA had degraded to such an extent that little was left to go on?which meant that the team had to develop new techniques especially. In particular, they used weighty computational techniques to rebuild the genome from many tiny scraps of data, some just 25 letters long. They also had to use clever software tricks to sift out DNA from microbes that had infested the fossil.

The eventual result was a genome?published today in Nature?that the team could compare with others. By considering Przewalski's horse (pictured above, a wild species found in Mongolia), donkeys, and other domestic breeds, the researchers have estimated that the last common ancestor across the entire Equine species lived between 4 and 4.5 million years ago?before the last ice age. That's about twice as long ago as experts previously thought.

Perhaps more interesting than the horse result, though, is the promise that it holds for other research. Being able to sequence a 700,000-year-old horse genome means we could do the same?perhaps even better?with human remains. Sure, there's a limit to how old DNA can be before it's completely unintelligible, but clearly DNA-reading techniques are allowing us to see farther back into history than ever before. [Nature via New Scientist]

Image by Traveller_40 under Creative Commons license

Source: http://gizmodo.com/scientists-sequence-the-oldest-ever-genome-of-a-700-00-595905519

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DSM-5 enters the diagnostic fray

Fifth edition of the widely used psychiatric manual focuses attention on how mental disorders should be defined

Fifth edition of the widely used psychiatric manual focuses attention on how mental disorders should be defined

By Bruce Bower

Web edition: June 14, 2013
Print edition: June 29, 2013; Vol.183 #13 (p. 5)

Enlarge

A thermometer for the psyche

View larger image | The American Psychiatric Association's Diagnostic and Statistical Manual has grown from a basic attempt to codify mental illnesses into a complex classification system that is used throughout health care.

Credit:

To a cacophony of boos, so-whats and even a few cheers, the American Psychiatric Association released the fifth edition of its Diagnostic and Statistical Manual of Mental Disorders, DSM-5, on May 18 at its annual meeting in San Francisco.

Controversy always flares when psychiatrists redefine which forms of human suffering will count as real and reimbursable by medical insurance. This time, though, the stakes are raised by competing efforts to classify mental disorders.

The World Health Organization plans to release a new version of its own system for identifying mental ailments in 2015 as part of the 11th edition of the International Classification of Diseases. It?s not clear how much the ICD will mirror DSM-5.

Some differences have already emerged. Clinicians working on the international classification report in the May 11 Lancet that they plan to pare down the number and types of symptoms needed to diagnose post-traumatic stress disorder, or PTSD, and add a severe form of the condition triggered by long-lasting or frequent harrowing events. These departures from DSM-5 would make it easier for mental health workers to help victims of conflict and natural disasters in poor, non-Western countries, say psychologist Andreas Maercker of the University of Zurich and his colleagues.?

Meanwhile, the National Institute of Mental Health in Rockville, Md., has launched the Research Domain Criteria, or RDoC, a 10-year effort to define mental disorders based on behavioral and brain measures. DSM?s approach, by contrast, relies on rulings by groups of psychiatrists about which symptoms characterize particular disorders. The approach has yielded imprecise diagnostic labels that advance neither treatment nor research, argued psychiatrist and NIMH director Thomas Insel in an April 29 blog post.

Insel?s statement raised hackles at the psychiatric association. On May 13, Insel and American Psychiatric Association president Jeffrey Lieberman together released a conciliatory statement declaring that DSM-5 and RDoC complement each other on the path to better diagnoses for mental disorders.

RDoC will fund research that examines how lots of factors ? fear, attention, parenting styles and neighborhood qualities, to name a few ? interact to produce symptoms that may or may not jibe with DSM-5 categories, said the RDoC project?s director, psychologist Bruce Cuthbert, at the Association for Psychological Science annual meeting in Washington, D.C., on May 23. Not everyone with, say, autism spectrum disorder or PTSD has the same underlying problems, he says.

?RDoC is about understanding the biology and the psychology of mental illness,? Cuthbert says. ?DSM-5 is sloppy on both accounts.?

DSM-5 has also gotten hammered ? especially by psychiatrist Allen Frances, chair of the task force that produced the previous DSM ? for allegedly turning some common forms of distress into medical conditions, encouraging physicians to prescribe unneeded psychoactive medications.

Normal grief will become an illness in DSM-5, Frances says. Mourning and eventual acceptance of a loss will be replaced, in his view, by ?pills and superficial medical ritual.?

As with any highly upsetting event, a loved one?s death triggers major depression in some people, responds University of Pittsburgh psychiatrist David Kupfer, who chaired the psychiatry association?s DSM-5 task force. The new manual makes clear that in grief, painful feelings come in waves and self-esteem is preserved; in depression, dark moods endure and include feelings of worthlessness and self-loathing. Clinicians should be able to separate grief from depression, Kupfer says.

When the process of developing DSM-5 started 14 years ago, those involved were optimistic that biological markers of mental disorders were just around the corner. To their disappointment, scientific validation of DSM-5 categories, from schizophrenia to major depression, remains a distant goal.

?DSM-5 isn?t perfect, but it is the best we can do with the science available,? Kupfer says.

Field trials leading up to the final version of DSM-5 assessed the extent to which 279 clinicians trained in the new manual and prompted by a computerized checklist agreed on diagnoses for nearly 2,000 patients at seven adult and four child psychiatric hospitals. Results were mixed.

Good agreement existed about which patients qualified for conditions such as PTSD, the most severe form of bipolar disorder, borderline personality disorder, autism spectrum disorder and attention-deficit hyperactivity disorder. But discord reigned when the clinicians tried to determine which patients met DSM-5 criteria for major depression, generalized anxiety disorder, antisocial personality disorder and several other ailments.

Many psychiatric disorders include symptoms of depression and anxiety that can complicate diagnostic and treatment decisions. Fuzzy boundaries separating many mental ailments mean that, as with previous manuals, most people deemed to have one DSM-5 disorder will also have one or more additional disorders, Kupfer says.

Kupfer and his colleagues faced intense scrutiny for revising how autism and related conditions are diagnosed. A tightened autism definition in DSM-5 has raised fears among advocacy groups that some children with this condition will go undiagnosed and be denied special school services. DSM-5 folds four previously separate categories on the autism spectrum, including Asperger syndrome, into an umbrella term, autism spectrum disorder. Under DSM-5, individuals with this diagnosis get rated on the severity of their social problems, the restrictiveness of their interests, and the extent to which they engage in repetitive behaviors. Language difficulties can coexist with these symptoms.

No one knows how, or whether, these changes will affect autism rates.

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Back Story | Changing notions of autism

As autism rates have climbed, physicians and parents have taken an increasing interest in how the DSM defines the condition. Before 1980 the book didn?t offer separate criteria for autism, but mentioned it within the entry for childhood schizophrenia.

DSM-I
The final sentence in the entry for ?Schizophrenic reaction, childhood type,? dictates that ?psychotic reactions in children, manifesting primarily autism, will be classified here.?

DSM-II
The second edition of the manual takes a similar approach to that of the first. Autism appears in the entry for ?Schizophrenia, childhood type,? which notes that ?the condition may be manifested by autistic, atypical and withdrawn behavior.?

DSM-III
Autism is broken out as its own disorder in an entry headed ?Infantile Autism.? There are six criteria for the diagnosis, including onset before 30 months of age, pervasive lack of responsiveness to other people and gross deficits in language development.

DSM-III-R
Now called autistic disorder, the requirements for diagnosis are much more complex. The manual specifies 16 characteristics grouped into three categories. At least eight of the 16 are required for a diagnosis, with at least two from one category and one from each of the other two.

DSM-IV and DSM-IV-TR
These editions require six or more characteristics from three categories, with at least two from the first and one from each of the second two, for an autism diagnosis. The criteria primarily focus on impairments in social interaction, communication and behavior.

DSM-5
Previous editions identified a number of developmental disorders similar to autism, including Asperger syndrome, childhood disintegrative disorder and pervasive developmental disorder not otherwise specified. This edition largely combines those categories into a single entity labeled autism spectrum disorder, though a separate diagnosis called social communication disorder also exists.

Source: http://www.sciencenews.org/view/generic/id/351036/title/DSM-5_enters_the_diagnostic_fray

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