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Can the Ketogenic Diet Treat Mental Illness? | MedPage Today
Though 3 patients were unable to adhere to the diet for more than 14 days, the researchers concluded that following the ketogenic diet for treatment-refractory mental illness was "feasible, well-tolerated, and associated with significant and substantial improvements in depression and psychosis symptoms and multiple markers of metabolic health."
More than 40% of patients experienced remission from their diagnosis, Ede said, and 64% left the hospital on less psychiatric medication than when they entered.
Cortical signatures of sleep are altered following effective deep brain stimulation for depression | Translational Psychiatry
eep brain stimulation (DBS) of the subcallosal cingulate cortex (SCC) is an experimental therapy for treatment-resistant depression (TRD). Chronic SCC DBS leads to long-term changes in the electrophysiological dynamics measured from local field potential (LFP) during wakefulness, but it is unclear how it impacts sleep-related brain activity. This is a crucial gap in knowledge, given the link between depression and sleep disturbances, and an emerging interest in the interaction between DBS, sleep, and circadian rhythms. We therefore sought to characterize changes in electrophysiological markers of sleep associated with DBS treatment for depression. We analyzed key electrophysiological signatures of sleep—slow-wave activity (SWA, 0.5–4.5 Hz) and sleep spindles—in LFPs recorded from the SCC of 9 patients who responded to DBS for TRD. This allowed us to compare the electrophysiological changes before and after 24 weeks of therapeutically effective SCC DBS. SWA power was highly correlated between hemispheres, consistent with a global sleep state. Furthermore, SWA occurred earlier in the night after chronic DBS and had a more prominent peak. While we found no evidence for changes to slow-wave power or stability, we found an increase in the density of sleep spindles.
High Protein Diet Reduces Depression Symptoms - Neuroscience News
The results showed higher protein intake was associated with a reduction in symptoms of depression during the follow-up period.
How the brain changes during depression treatment -- ScienceDaily
The team found that by stimulating the dorsolateral pre-frontal cortex, several other regions of the brain were also activated. These other regions are involved in multiple functions -- from managing emotional responses to memory and motor control.
The participants then underwent another four weeks of rTMS treatment and the team assessed whether the activated regions were associated with patients having fewer symptoms of depression when their treatment ended.
"We found that regions of the brain that were activated during the concurrent rTMS-fMRI were significantly related to good outcomes," says Dr. Vila-Rodriguez.
With this new map of how rTMS stimulates different areas of the brain, Dr. Villa Rodriguez hopes the findings could be used to determine how well a patient is responding to rTMS treatments.
Experimental depression treatment is nearly 80% effective in controlled study | News Center | Stanford Medicine
In the study, the researchers first used MRI to locate the best location to target within each participant’s dorsolateral prefrontal cortex, which regulates executive functions, such as problem solving and inhibiting unwanted responses. They applied the stimulation in a subregion that has the strongest relationship with the subgenual cingulate, a part of the brain that is overactive in people experiencing depression. The transcranial magnetic stimulation strengthens the connection between the two regions, facilitating dorsolateral prefrontal cortex control of the activity in the subgenual cingulate.
The researchers also used 1,800 pulses per session instead of 600. (The larger amount has been used safely in other forms of brain stimulation for neurological disorders such as Parkinson’s disease.) And instead of providing one treatment a day, they gave participants 10 10-minute treatments, with 50-minute breaks in between.
Migraineurs Not Taking Advantage of an 'Effective Prophylactic'
Depression was reported by 47% of patients who reported no exercise compared with 25% of people who reported the recommended amount of weekly exercise.
Anxiety was reported by 39% of people who did not exercise compared with 28% of those who got the recommended 150+ minutes of exercise. Sleep problems were reported by 77% of the nonexercisers versus 61% of those who achieved the recommended exercise amount.
Exercise also appeared to reduce the risk for migraine attacks.
Seasonal variation in daylight influences brain function -- ScienceDaily
"In the study, we observed that the number of opioid receptors was dependent on the time of the year the brain was imaged. The changes were most prominent in the brain regions that control emotions and sociability. The changes in the opioid receptors caused by the variation in the amount of daylight could be an important factor in seasonal affective disorder," says Postdoctoral Researcher Lihua Sun from the Turku PET Centre and the University of Turku.
Day-to-day variability in sleep parameters and depression risk: a prospective cohort study of training physicians | npj Digital Medicine
Within individuals, increased TST (b = 0.06, p < 0.001), later wake time (b = 0.09, p < 0.001), earlier bedtime (b = − 0.07, p < 0.001), as well as lower day-to-day shifts in TST (b = −0.011, p < 0.001) and in wake time (b = −0.004, p < 0.001) were associated with improved next-day mood.
Landscapes of bacterial and metabolic signatures and their interaction in major depressive disorders | Science Advances
Gut microbiome disturbances have been implicated in major depressive disorder (MDD). However, little is known about how the gut virome, microbiome, and fecal metabolome change, and how they interact in MDD. Here, using whole-genome shotgun metagenomic and untargeted metabolomic methods, we identified 3 bacteriophages, 47 bacterial species, and 50 fecal metabolites showing notable differences in abundance between MDD patients and healthy controls (HCs). Patients with MDD were mainly characterized by increased abundance of the genus Bacteroides and decreased abundance of the genera Blautia and Eubacterium. These multilevel omics alterations generated a characteristic MDD coexpression network. Disturbed microbial genes and fecal metabolites were consistently mapped to amino acid (γ-aminobutyrate, phenylalanine, and tryptophan) metabolism. Furthermore, we identified a combinatorial marker panel that robustly discriminated MDD from HC individuals in both the discovery and validation sets. Our findings provide a deep insight into understanding of the roles of disturbed gut ecosystem in MDD.
Adjunctive Bright Light Therapy for Bipolar Depression: A Randomized Double-Blind Placebo-Controlled Trial | American Journal of Psychiatry
In seasonal affective disorder (27, 28) and nonseasonal depression (29), the response to morning light therapy is typically attributed to the phase-resetting effects (28). However, the mechanism of response is unclear in bipolar disorder. Combined with a prior night of sleep deprivation, morning (and possibly midday) light therapy can quickly reverse severe bipolar depression in carefully supervised chronotherapeutic protocols (30–32). Compared with morning light therapy, implementing bright light therapy at midday induced robust antidepressant effects and possibly subtle effects on the circadian system (12, 13) that might have mitigated the risk for hypomania or mixed symptoms, as observed in our earlier report (5). But whether the circadian effects of midday light therapy are detectable in bipolar depressed patients and correspond with an antidepressant response requires further investigation. Even so, this novel finding of a significant antidepressant effect from midday bright light therapy offers a real clinical advance and contributes an additional treatment option for bipolar depression.
Sitting still linked to increased risk of depression in adolescents -- ScienceDaily
The Lancet Psychiatry study found that an additional 60 minutes of light activity (such as walking or doing chores) daily at age 12 was associated with a 10% reduction in depressive symptoms at age 18.
"Our findings show that young people who are inactive for large proportions of the day throughout adolescence face a greater risk of depression by age 18. We found that it's not just more intense forms of activity that are good for our mental health, but any degree of physical activity that can reduce the time we spend sitting down is likely to be beneficial," said the study's lead author, PhD student Aaron Kandola (UCL Psychiatry).
Texas Psychiatrist Karen Wagner Under Scrutiny - AHRPAHRP
co-authored the notorious, ghostwritten Paxil pediatric study #329, whose lead author, Martin Keller, MD, was replaced last month as chairman of psychiatry at Brown University. The Glaxo-paid authors of study #329 helped the company promote the myth that Paxil was "safe and effective" for use in children as early as 1998: in a poster presentation, Dr. Wagner claimed "The results of this study demonstrate the safety ofparoxetine in the treatment of adolescent depression. Side effects were modest with paroxetine." [2] But internal Glaxo emails show the data from pediatric Paxil trials were negative.
Light works, Prozac ties placebo
A total of 122 patients were randomized (light monotherapy, 32; fluoxetine monotherapy, 31; combination therapy, 29; placebo, 30). The mean (SD) changes in MADRS score for the light, fluoxetine, combination, and placebo groups were 13.4 (7.5), 8.8 (9.9), 16.9 (9.2), and 6.5 (9.6), respectively. The combination (effect size [d] = 1.11; 95% CI, 0.54 to 1.64) and light monotherapy (d = 0.80; 95% CI, 0.28 to 1.31) were significantly superior to placebo in the MADRS change score, but fluoxetine monotherapy (d = 0.24; 95% CI, −0.27 to 0.74) was not superior to placebo.
Sauna Use as an Exercise Mimetic for Heart and Healthspan
Some of the positive benefits of the sauna on heart health may have to do with similar physiological changes that also occur during physical exercise. For example, there is a 50-70% redistribution of blood flow away from the core to the skin to facilitate sweating. You start to sweat. Heart rate increases up to 150 beats per minute which correspond to moderate-intensity physical exercise. Cardiac output (which is a measure of the amount of work the heart performs in response to the body’s need for oxygen) increases by 60-70%. Immediately after sauna use, blood pressure and resting heart rate are lower than baseline similar to physical activity.
Debunking a study by citing zero studies
Professor Helen Stokes-Lampard, Chair of the Royal College of GPs, said: “It is well-established that it often takes a while for patients to feel the full benefits of modern antidepressants and that they work best when taken for significant periods of time, which is one reason why doctors will often review patients after several weeks of use and then prescribe a fairly long course of the drugs, if they appear to be beneficial.”
Gut bacteria may be linked to high blood pressure and depression -- ScienceDaily
The researchers isolated DNA (deoxyribonucleic acid, the carrier of genetic information) from gut bacteria obtained from the stool samples of 105 volunteers. They used a new technique involving artificial-intelligence software to analyze the bacteria, which revealed four distinct types of bacterial genes and signature molecules. Surprisingly, the investigators discovered unique patterns of bacteria from people with 1) high blood pressure plus depression; 2) high blood pressure without depression; 3) depression with healthy blood pressure; or 4) healthy subjects without depression or high blood pressure.
Clinical Trials of Therapy versus Medication: Even in a Tie, Medication wins | The BMJ
However, disclosure of the relationship would not have changed the troubling end result: A researcher with a history of being funded by SSRI makers completes a 'gold-standard' federally-funded study of post stroke SSRI use, which is published in one of the most prestigious medical journals in the world, and is given a forum in the national media to tell the general public that anyone who has had a stroke, whether or not they have been diagnosed with depression, should start a prophylactic regimen of Lexapro ...even though non-medical approaches perform just as well.
Exercise: Psych patients' new primary prescription -- ScienceDaily
Tomasi, in collaboration with UVMMC's Sheri Gates and Emily Reyns, built a gym exclusively for roughly 100 patients in the medical center's inpatient psychiatry unit, and led and introduced 60-minute structured exercise and nutrition education programs into their treatment plans. The psychotherapists surveyed patients on their mood, self-esteem and self-image both before and after the exercise sessions to gauge the effects of exercise on psychiatric symptoms.
Patients reported lower levels of anger, anxiety and depression, higher self-esteem, and overall improved moods. Tomasi, Gates and Reyns found an average of 95 percent of patients reported that their moods improved after doing the structured exercises, while 63 percent of the patients reported being happy or very happy, as opposed to neutral, sad or very sad, after the exercises. An average of 91.8 of patients also reported that they were pleased with the way their bodies felt after doing the structured exercises.
Multiple brain regions moderate and link depressive mood and pain -- ScienceDaily
"We were very surprised about the expansive roles of these regions," said Zeidan. "Brain regions involved in facilitating pain were also associated with lower pain and depression. Brain regions involved in regulating pain where also associated with increasing depression. Perhaps it's not surprising after seeing the results. Why shouldn't specific aspects of the brain perform multiple roles?"
Perseverance toward life goals can fend off depression, anxiety, panic disorders: Looking on the bright side also acts as a safeguard, according to 18-year study -- ScienceDaily
At each interval, participants were asked to rate their goal persistence (e.g., "When I encounter problems, I don't give up until I solve them"), self-mastery (e.g., "I can do just anything I really set my mind to") and positive reappraisal (e.g., "I can find something positive, even in the worst situations"). Diagnoses for major depressive, anxiety and panic disorders were also collected at each interval.
People who showed more goal persistence and optimism during the first assessment in the mid-1990s had greater reductions in depression, anxiety and panic disorders across the 18 years, according to the authors.
Train your brain, change your brain - ScienceBlog.com
With this technique, the magnetic resonance equipment helps individuals to have access to their own brain activity in real time and quickly gain control over it.
Thirty-six healthy subjects participated in the study in which the goal was to increase the activity of brain regions involved in hand movements. However, instead of actually move their hand, participants were asked to only imagine the movement, in total rest. Nineteen of them received the real brain training and the remaining seventeen were trained with placebo neurofeedback, for comparisons purposes. Immediately before and after the brain training, which lasted around 30 minutes, their neural networks were scanned in order to investigate the impact of the neurofeedback (or placebo) on brain wiring and communication, also known as structural and functional connectivity, respectively.
The results show that the corpus callosum – the major cerebral bridge that connects the right and left hemispheres – exhibited increased integrity, and the neural network controlling the movements of the body became strengthened. It seems that the whole system became more robust. Likewise, the training also had a positive impact on the default mode network, a brain network which is impaired after stroke, Parkinson’s and depression, for example. These changes were not observed in the control group.
Note 'average' number of treatments?!
The 16 participants in the FORSEE-II study had suffered from severe depression for 8 to 22 years and had previously undergone an average of 18 drug therapies, 20 electroconvulsive therapies, and 70 hours of psychotherapy -- without success.
Prof. Dr. Volker A. Coenen, first author of the study and director of the Stereotactic and Functional Neurosurgery Unit at the Department of Neurosurgery of the Medical Center -- University of Freiburg, and his team implanted the deep brain stimulation systems in the patients medial forebrain bundle of the brain and used them to stimulate the medial forebrain bundle. This brain region is involved in the perception and regulation of pleasure and reward and is thus also significant for motivation and the perceived quality of life.
Clear Relief Often within Days
The doctors evaluated the success of the therapy monthly with the help of the established Montgomery-Asberg Depression Rating Scale (MADRS). The MADRS scores of ten study participants already decreased significantly within the first week and remained at a low level. All study participants reacted to the stimulation in the course of the study. Eight of the 16 patients had a MADRS score of under 10 points at the end of the study and thus were regarded as non-depressive. "Our patients had struggled with severe depression for years with no signs of improvement. Deep brain stimulation brought most of them significant relief within days, which lasted throughout the course of the therapy. Other forms of treatment like medication and psychotherapy often lose their effectiveness over the course of time. Absolutely sensational about the study data is that the effect seems to be long lasting, with the positive effects continuing for years," says Prof. Schläpfer.
"We know from a pilot study that the stimulation of this brain region is very promising and we are delighted about the replication of these significant effects," says Prof. Coenen.
Fast-acting psychedelic associated with improvements in depression/anxiety -- ScienceDaily
One of the unique properties of 5-MeO-DMT is the fast action and short duration of the psychedelic effects when compared to other psychedelics. "Research has shown that psychedelics given alongside psychotherapy help people with depression and anxiety. However, psychedelic sessions usually require 7 -- 8 hours per session because psychedelics typically have a long duration of action," says Alan K. Davis, Ph.D., a postdoctoral research fellow in the Behavioral Research Unit, at the Johns Hopkins University School of Medicine. "Because 5-MeO-DMT is short-acting and lasts approximately 30-90 minutes, it could be much easier to use as an adjunct to therapy because current therapies usually involve a 60 -- 90 minute session."
Inflammation links heart disease and depression -- ScienceDaily
This finding was given further support by the next stage of the team's research. They used a technique known as Mendelian randomisation to investigate 15 biomarkers -- biological 'red flags' -- associated with increased risk of coronary heart disease. Mendelian randomisation is a statistical technique that allows researchers to rule out the influence of factors that otherwise confuse, or confound, a study, such as social status.
Of these common biomarkers, they found that triglycerides (a type of fat found in the blood) and the inflammation-related proteins IL-6 and CRP were also risk factors for depression.
Both IL-6 and CRP are inflammatory markers that are produced in response to damaging stimuli, such as infection, stress or smoking. Studies by Dr Khandaker and others have previously shown that people with elevated levels of IL-6 and CRP in the blood are more prone to develop depression, and that levels of these biomarkers are high in some patients during acute depressive episode. Elevated markers of inflammation are also seen in people with treatment resistant depression. This has raised the prospect that anti-inflammatory drugs might be used to treat some patients with depression. Dr Khandaker is currently involved in a clinical trial to test tocilizumab, an anti-inflammatory drug used for the treatment of rheumatoid arthritis that inhibits IL-6, to see if reducing inflammation leads to improvement in mood and cognitive function in patients with depression.
While the link between triglycerides and coronary heart disease is well documented, it is not clear why they, too, should contribute to depression. The link is unlikely to be related by obesity, for example, as this study has found no evidence for a causal link between body mass index (BMI) and depression.
Serotonin can regulate gene expression inside neurons -- ScienceDaily
The study revolves around DNA and how it works to form each person's individual biological map. Each cell in the body contains two meters of DNA, the blueprint for all functions of all cells in the body. This DNA is wound around spools of histone proteins (proteins that package DNA in the nucleus of cells, and are heavily prone to chemical modifications that aid in the regulation of gene expression) into structures referred to as nucleosomes. When DNA encoding a specific gene is wound tightly within the spool, that gene is less likely to be expressed. When the gene is not wound as tightly, it is more likely to be expressed. This can affect many functions of a given cell.
Serotonin is a chemical that can transmit signals between neurons in the brain and is involved in the regulation of mood. Selective serotonin reuptake inhibitors, known as SSRIs, alter the amounts of serotonin in the brain, which enables mood changes. When small packages of serotonin are released from a neuron, the resulting signals set up a chain reaction of communication between different parts of the brain.
The research team discovered that a protein called tissue transglutaminase 2 can directly attach serotonin molecules to histone proteins (a process called histone serotonylation), which in turn loosens the spool to enable more robust gene expression. Specifically, they found that in developing rodent brains and human neurons, genes near the part of the spool loosened by the serotonin are more likely to be expressed. They also showed that a specific binding complex enables this process.
Drug Companies and Doctors Battle Over the Future of Fecal Transplants - The New York Times
Mark Smith, a microbiologist at M.I.T., was halfway through his pitch with a group of pharmaceutical executives when one of them interrupted to ask if the meeting was a prank. “I can’t believe you wasted my time with this crazy idea,” the man said, Dr. Smith later recalled.
That was 2012. Later that year he helped found OpenBiome, the nonprofit stool bank that now supplies most of the fecal matter for transplants in the United States. Three years ago, he started his own drug company, Finch Therapeutics, which has raised $77 million.
Over the past decade, tens of thousands of Americans with C. diff have been cured through fecal transplants, often with a single dose that can bring patients back from the brink of death. The treatment has more than an 80 percent success rate, according to several studies, and many patients feel better within hours of receiving the procedure, which is usually administered through colonoscopy or capsules containing desiccated fecal matter.
The F.D.A. has not formally approved the therapy but it has suspended enforcement of its rules for patients who have failed on antibiotics while it figures out the best way to regulate a regimen that, until recently, was sometimes performed at home by desperate patients using an enema, saline and a relative’s stool. Ms. Duff, the head of the C. diff patients group, credits her own recovery from the disease to a homemade concoction her husband created with his own stool in the kitchen blender.
