Tag Archives: research

How the brain’s daily clock controls mood

ANN ARBOR, Mich.—A math professor at the University of Michigan will lead an international, $1 million project examining the links between bipolar disorder and abnormalities in the circadian, or daily, rhythms of a mammal’s internal clock.

In humans, this grain-of-rice-sized timepiece is a cluster of 20,000 neurons right behind the eyes. It’s called the suprachiasmatic nucleas (SCN) of the brain’s hypothalamus, and it is responsible for keeping our bodies in synch with our planet’s 24-hour day.

Scientists believe it’s off kilter in patients with bipolar disorder. Some of the genes implicated in the disease are the same ones that regulate the biological clock. The common treatment drug lithium is known to change the period of that clock, and when manic patients are forced to stay on a 24-hour schedule, many experience a reprieve from the episode, said principal investigator Daniel Forger, an associate professor in the U-M Department of Mathematics.

Exactly how the brain’s clock controls mood remains a mystery, though. This new project aims to change that through complex mathematical modeling and experiments involving mice.

“We’re going to continuously monitor the state of the animals’ internal clock. We’ll watch it tick, use mathematics to understand its function and test how it controls mood,” Forger said.

The researchers will examine the brains of depressed and normal mice and look for abnormal electrical activity. The researchers aim to determine what state of the clock region corresponds with different moods in the animals.

“We’re going to learn an awful lot about the circadian clock, which could also, in addition to depression, play a role in Alzheimer’s, cancer and heart attacks,” Forger said.

via: Eurek Alert

Addiction Redefined

Addiction is a chronic brain disease, not just bad behavior or bad choices.

The American Society of Addiction Medicine (ASAM) has released a new definition of addiction, highlighting that addiction is a chronic brain disorder and not just a behavioral problem involving excess alcohol, drugs, gambling, or sex.  This marks the first occasion of ASAM stating addiction is not solely related to problematic substance use.

When people witness damaging and compulsive behaviors in friends, family, or public figures, the majority only focus on the actual substance use or behavior as the problem. According to ASAM, these outward behaviors are manifestations of an underlying disease that involves various areas of the brain.  

“At its core, addiction isn’t just a social, moral, or criminal problem. It’s a brain problem whose behaviors manifest in all these other ares,” said Dr. Micheal Miller, former president of ASAM. “Many behaviors driven by addiction are real problems and sometimes criminal acts. But the disease is about brains, not drugs. It’s about underlying neurology, not outward actions.”

The new definition resulted from an intensive four year process with more than 80 experts actively working on it, including: top addiction authorities, addiction medicine clinicians, and neuroscience researchers from across the country.

Addiction is described as a primary disease, meaning that it is not the result of other emotional causes or psychiatric problems. Addiction is also recognized as a chronic disease, like cardiovascular disease or diabetes, so therefore it must be treated, managed, and monitored over a life-time.

Two decades of advancements in neuroscience convinced ASAM that addiction needed to be redefined by what is going on in the brain. The disease of addiction affects neurotransmissions and interactions within the reward circuitry of the brain. This leads to addictive behaviors that supplant healthy behaviors, while memories of prior experiences (food, sex, alcohol, drugs) trigger cravings and renewal of addictive behaviors.

The brain circuitry that governs impulse control and judgment is also altered, resulting in the dysfunctional pursuit of rewards like drugs or alcohol. This area of the brain is still developing during teenage years, which may be why early exposure to alcohol or drugs is linked to a greater likelihood of addiction as an adult.

There has been a longtime controversy if people with addiction have choice over anti-social and dangerous behaviors. Dr. Raju Hajela, chair member of the ASAM committee, stated that “the disease creates distortions in thinking, feelings and perceptions, which drives people to behave in ways that aren’t understandable to others around them. Simply put, addiction is not a choice. Addictive behaviors are a manifestation of the disease, not a cause.”

“Choice still plays an important role in getting help. While the neurobiology of choice may not be fully understood, a person with addiction must make choices for a healthier life in order to enter treatment and recovery. Because there is no pill which alone can cure addiction, choosing recovery over unhealthy behaviors is necessary.”

Dr. Miller added, “Many chronic diseas require behavioral choices, such as people with heart disease choosing to eat healthier or begin exercising, in addiction to medical or surgical interventions. So, we have to stop moralizing, blaming, controlling, or smirking at the person with the disease of addiction and start creating opportunities for individuals and families to get help and providing assistance in choosing proper treatment.”

SAMHSA recently worked with the behavioral health field to develop a working definiton of recovery that captures the common experiences of those in recovery.

Some of the guiding principles are:

  • Recovery is person-driven
  • Recovery occurs via many pathways
  • Recovery is holistic
  • Recovery is supported by peers and allies
  • Recovery is supported through relationships and social networks
  • Recovery is culturally based and influenced
  • Recovery is supported by addressing trauma
  • Recovery involves individual, family, and community strengths and responsibility
  • Recovery is based on respect
  • Recovery emerges from hope

Addiction treatment, including therapy or Suboxone, is offered at Apex Behavioral Heatlh. Dr. Chung, Dr. Ramesh, and Dr. Kwon are our Suboxone providers.

Study Shows 1 in 4 Parents Think Vaccines Cause Autism

A new study revealed that 54% of parents are concerned about serious adverse effects from vaccines and 25% of parents think vaccines cause autism. While parents are concerned, 90% of parents feel getting their children vaccinated is a good way to prevent disease.

Pediatrics recently published the result of the study which was based on a 2009 online survey for parents with children aged 17 and younger. Questions revolved around asking parents their views on vaccinations and if they ever refused a vaccine for their child. Overall, 11.5% of parents refused at least one vaccine.

“While our country has its highest vaccinations rates ever, we have pockets of parents who choose not to vaccinate,” said Dr. Gary Freed, a professor and director of Pediatrics at the University of Michigan and co-author of the study. Dr. Freed said the parents choosing not to vaccinate are often highly educated and live in urban areas.

The choice not to vaccinate can have consequences beyond one’s own child. Dr. Freed views not vaccinating as a public health risk; a child could become infected with measles or another disease and spread the disease throughout the community.

In 2007, the Little League World Series had a measles outbreak. A 12 year-old boy from Japan who had unknowingly contacted measles traveled to Pennsylvania to participate in the baseball event. For the 265,000 people attended the event, the Center for Disease Control investigated if  other people also contacted the disease.  Measles had spread to six other people, including someone the boy sat next to on the air plane. A disease introduced by one person who wasn’t vaccinated can easily be spread and contacted by other people that also weren’t vaccinated.  

More recently, in 2008 San Diego reported a measles outbreak that left 12 children ill. Nine children had not been vaccinated due to their parent’s objections and the other 3 children were not old enough to be vaccinated. Four of these cases came from a single charter school and 17 children stayed home to avoid the outbreak.

According to a 2006 article in the Journal of The American Medical Association, there is a tendency to have groups of  geographic ‘exemptors’ in certain counties, neighborhoods, or even schools.  In California, the state’s exemption rate is 1.5%, but some in counties, their exemption rates were as high as 10% to 19% of kindergartners.

If there are clusters of children that have been exempted from vaccinations, there is an increased risk of exposing everyone in that community.

The New York Times reported, “The parents who objected to their children being inoculated are among a small but growing number of skeptics in California and other states who take advantage of exemptions to laws requiring vaccinations for school aged children.”

Children who aren’t vaccinated are more susceptible to illness and disease and more likely to pose a threat to other children who have been vaccinated, or children who are too young to be vaccinated. The measles vaccine is only 95% effective.  

Measles can cause brain swelling, pneumonia, and even death in rare cases. It is a highly contagious respiratory infection that causes a total body rash and flu-like symptoms, including a fever, cough, and runny nose.  The measles rash has a red or reddish brown blotchy appearance that starts on the forehead and spreads downward over the face and body until it reaches the feet.  90% of people who have not been vaccinated that live in a house with someone who has measles will contact it.

In the 1960’s, before a widespread vaccination for measles were available, there were more than 500,000 cases every year in the US. 90% of the measles cases in 2008 in the US were in children that did not get vaccinated.

“I don’t think parents understand the risk,” said Dr. Freed. “I don’t think pediatricians are spending enough time discussing the diseases these vaccinations are preventing their children from. These are diseases that children can die from.”

When parents meet a doctor who does not agree with not vaccinating or delaying vaccinations, parents are likely to move on and find a new doctor who does support their choice.

 Every state allows medical exemptions, like when religious practices are involved. Several states permit exemptions based on personal beliefs, such as California and Texas. There is an increasing number of exemptions on the basis of personal belief; the fear that vaccinations may cause autism.

The fear that vaccinations lead to autism originated from a 1998 article published in the Lancet by British scientist Andrew Wakefield. The study correlated MMR, which is an immunization shot found in measles, mumps, and rubella, with autism. The study only surveyed 12 children and has now been discredited by doctors across the world.  The Lancet has since retracted Wakefield’s article for unscientific methods and falsified data.

Dr. Freed thinks the media paid more attention to the article than to the retraction.

“The very success of immunizations has turned out to be an Achilles’ heel. Most of these parents have never seen measles, and don’t realize it could be a bad disease so they turn their concerns to unfounded risks. They do not perceive risk of the disease but perceive risk of the vaccine, ” said Dr. Mark Sawyer, pediatrician and infectious disease specialist at Rady’s Children Hospital in San Diego, CA.

It is the absence of measles, or close to an absence, that keeps parents from getting the shots for their children. Worldwide, child deaths from measles have dropped 68% from 2006 to 2008 because of the measles vaccination. One million children a year used to die from measles; the vaccination has decreased the number of deaths to 242,000 children.

Ask your doctor if you have any concerns over vaccinations or misinformation you may have heard.