News and Announcements from the Semel Institute and Department of Psychiatry at UCLA

UCLA CART 4th Annual Autism Symposium

Dr. Candace J. Wilkinson — Thu, 15 Dec 2011 20:37:40 +0000

UCLA CART 4th Annual Autism Symposium

LIMITED SEATING - REGISTER TODAY - Friday, February 3, 2012 at UCLA NRB Auditorium

UCLA Center for Autism Research and Treatment (CART) 4th Annual Autism Research Symposium

"Autism 2012 - Autism Spectrum Disorders: Research Update and Evidence-Based Treatment Models"

This full-day continuing education symposium is for physicians, psychiatrists, psychologists, other health professionals, teachers, autism service providers, and any others interested in learning of the latest breakthroughs in research and treatment in autism spectrum disorders (ASD). Nationally-renowned CART faculty will provide an overview of the latest scientific findings about etiological factors, core deficits, biomarkers, early screening and diagnosis, and innovative treatment models for infants to young adults with ASD. The complex role of genetics, and the use of brain imaging, electrophysiology and eye-tracking as state-of-the-art methods for understanding and developing treatments for ASD also will be presented. In addition, a conceptual framework, highlighted by various case scenarios and consideration of community resources, will be presented on how to make a thorough assessment and individual treatment plan.

TO REGISTER, please call 310-794-2620 or go to www.cme.ucla.edu/courses and click on "Autism 2012". Program brochure with enrollment form is attached below (More Information).

This symposium has been approved for up to 6.5 hours of Category 1 Continuing Medical Education (CME) credit. Physicians, Psychologists and RNs can receive CME hours for their continuing education credit. Other practitioners should check with their licensing boards to confirm if CME credit is accepted. Teachers, other service providers, and other attendees will receive up to 6.5 professional development hours (as a letter certifying attendance).

Event detail

3 Feb 2012 - 08:00 - 17:00

Host/Organizer:

Candace J. Wilkinson

Neuroscience Research Building (NRB)

Neruoscience Research Building Auditorium (NRB)

635 Charles Young Drive South

Los Angeles 90024

Phone: 310-794-2620 to register

CART FEB3 Brochure CJW final STD print 12.15.11.pdf - 275.23 KB

Research at the Semel Institute

UCLA researchers suggest unconventional approach to control HIV epidemics

Semel Web Manager — Wed, 07 Dec 2011 09:00:00 +0000

A new weapon has emerged to prevent HIV infection. Called pre-exposure prophylaxis, or PrEP, it is a strategy of providing medications to at-risk people before they are exposed to the virus. Having shown great promise in recent phase 3 clinical trials, PrEP may soon be rolled out for public use.

Because PrEP is based on the same drugs used to treat HIV-infected individuals, the big public health fear is that the dual use of these drugs will lead to skyrocketing levels of drug resistance. But in a new study, UCLA researchers say the exact opposite is likely to happen.

Sally Blower, director of the UCLA Center for Biomedical Modeling and a professor at the Semel Institute for Neuroscience and Human Behavior at UCLA, and colleagues used sophisticated computer modeling to determine that a PrEP prevention program used alone, or current HIV treatment programs used alone, could indeed, separately, increase drug resistance. But if used together, the researchers say, resistance is likely to decrease.

Their findings appear in the current online edition of the peer-reviewed journal Scientific Reports, published by Nature Publishing Group.

"This was a very big surprise," said Blower, the study's senior author. "We found that this counterintuitive effect will only occur if adherence to the PrEP prevention program, where individuals have to take a daily pill, is very high. This counterintuitive effect occurs when the beneficial effect of PrEP in preventing infections is so great that it overcomes both its own detrimental effect on increasing resistance and the detrimental effect of current HIV treatments on increasing resistance."

Africa is ground zero for HIV and AIDS, a continent where the death rate is simply "awful," Blower said. Since the country of Botswana was one of the sites for the PrEP drug trial, Blower and her colleagues chose it for their modeling. Botswana has the best health care system in Africa, they said, yet 30 percent of women and 20 percent of men are infected with HIV.

"Botswana is likely to lead the way in rolling out PrEP," said Virginie Supervie, first author of the current study and a former postdoctoral fellow in Blower's laboratory. "So officials there are worried about increasing levels of resistance."

Most health officials feel that if you have a good treatment program in place, it makes sense to establish a good prevention program in the same place. Health officials plan to implement PrEP prevention programs only where treatment programs are highly successful and levels of resistance are low, the researchers said.

But in a second counterintuitive finding, the UCLA researchers say this conventional approach is actually the worst strategy. Instead, they suggest, PrEP programs should be rolled out around treatment programs that are having little success and where rates of resistance are high. Their model shows that this unconventional approach would prevent the maximum number of infections and result in the greatest decrease in drug resistance.

"By cutting down infections, the PrEP programs will decrease the number entering treatment programs, and therefore, fewer individuals will acquire drug resistance," Blower said. "So introducing PrEP around the worst treatment programs will have the most impact on reducing resistance."

A PrEP clinical trial that involved men who had sex with men and transgender women who had sex with men found that PrEP reduced the risk of acquiring HIV infection by 44 percent. Two other PrEP trials, which involved heterosexual men and women, showed significant reductions in risk, ranging as high as 73 percent.

"These results are very promising," Supervie said. "Our model shows that if the roll-out of PrEP is carefully planned, it could decrease resistance and increase the sustainability of treatment programs. But if it is not, resistance could increase, and the sustainability of treatment programs in resource-constrained countries could be compromised."

"The model we have designed is a very important health policy and planning tool," Blower said. "It can be used for any African country to decide where to roll out PrEP, as well as to predict the impact of PrEP on reducing their HIV epidemic. It is a critical time for decision-makers in Botswana and other African countries."

Other authors on the study included Meagan Barrett from UCLA; James S. Kahn from the University of California, San Francisco; and Godfrey Musuka, Themba L Moeti and Lesogo Busang from the African Comprehensive HIV/AIDS Partnerships in Gaborone, Botswana.

Funding for the study was provided by grants from the National Institute of Allergy and Infectious Diseases and the National Institutes of Health; the John Simon Guggenheim Foundation; and the African Comprehensive HIV and AIDS Partnership. The authors report no conflicts of interest.

The UCLA Department of Psychiatry and Biobehavioral Sciences is the home within the David Geffen School of Medicine at UCLA for faculty who are experts in the origins and treatment of disorders of complex human behavior. The department is part of the Semel Institute for Neuroscience and Human Behavior at UCLA, a world-leading interdisciplinary research and education institute devoted to the understanding of complex human behavior and the causes and consequences of neuropsychiatric disorders.

Author:

Mark Wheeler

Center for Biomedical Modeling

2 million Californians report mental health needs; most receive little or no treatment

Semel Web Manager — Wed, 30 Nov 2011 17:00:00 +0000

Nearly 2 million adults in California, about 8 percent of the population, need mental health treatment, but the majority receive no services or inadequate services, despite a state law mandating that health insurance providers include mental health treatment in their coverage options, a new report by the UCLA Center for Health Policy Research shows.

The report, which provides some of the first comprehensive data in recent years on the mental health of California's adult population, found that one in 12 Californians reported symptoms consistent with serious psychological distress and experienced difficulty functioning at home or at work.

Over half of these adults reported receiving no treatment for their disorders, and about one-quarter received "inadequate" treatment, defined as less than four visits with a health professional over the past 12 months or using prescription drugs to manage mental health needs.
The study draws on data from the 2007 California Health Interview Survey (CHIS), which is conducted by the center.

"There is a huge gap between needing help and getting help," said David Grant, the study's lead author and director of CHIS. "The data also shows large disparities in mental health status and treatment by demographic, economic and social factors. These findings can help direct the state's limited resources to those in greatest need of help."

Among the findings:
Insurance
Unsurprisingly, uninsured adults had the highest rate of unmet needs (87 percent), which includes receiving no treatment or receiving less than minimally adequate treatment; 66 percent of these adults received no treatment. By contrast, 77 percent of privately insured and 65 percent of publically insured Californians reported unmet needs. Although poverty and mental health needs are strongly correlated, the lower rate of unmet needs by public program participants suggests that these programs are more likely to effectively offer mental health services than even private insurance policies.
Single parents under stress
Single adults with children had more than double the rate of mental health needs (17 percent) when compared with all adults (8 percent). Single adults without children had the next highest rate (11 percent). Married adults with or without children had the lowest rates of mental health needs (6 percent and 5 percent, respectively.)
U.S.–born Latinos have greater need than immigrants
Nearly 12 percent of Latinos born in the U.S. needed mental health treatment, almost twice the level of Latino immigrants.
Racial groups
Approximately 17 percent of American Indians and Alaska Natives had mental health needs, the highest of all racial and ethnic groups. Native Hawaiian, Pacific Islander and multi-racial groups had the next highest rate, at 13 percent.
Lesbian, gay and bisexual adults
Nearly 20 percent of these adults needed mental health treatment — more than double the statewide rate.
Link to chronic health conditions
Compared to the general adult population, those with mental health needs had higher rates of chronic diseases such as high blood pressure, heart disease, diabetes and asthma. They were more than twice as likely to report fair or poor health status and five times more likely to report poor health.

The report was supported by a grant from the California Department of Mental Health Services. Read the report and related fact sheet, "Adult Mental Health Needs in California."
The California Department of Mental Health Services has oversight of the state's public mental health budget, provides leadership for local county mental health departments. and evaluates and monitors public programs, among its many duties.
The California Health Interview Survey (CHIS) is the nation's largest state health survey and one of the largest health surveys in the United States.
The UCLA Center for Health Policy Research is one of the nation's largest leading health policy research centers and the premier source of health-related information on Californians.

Author:

Gwen Driscoll

Semel Institute for Neuroscience and Human Behavior

Imaging technique IDs plaques, tangles in brains of severely depressed older adults

Semel Web Manager — Tue, 08 Nov 2011 16:20:00 +0000

Depression is one of the most common mental disorders in the elderly, but little is known about the underlying biology of its development in older adults.

In a small study published in the November issue of the peer-reviewed journal Archives of General Psychiatry, UCLA researchers used a unique brain scan to assess the levels of amyloid plaques and tau tangles in older adults with a type of severe depression called major depressive disorder (MDD).

Previous research has suggested that plaque and tangle deposits in the brain — hallmarks of Alzheimer's disease and many dementias — are associated not only with memory loss but also with mild symptoms of depression and anxiety in middle-aged and older individuals. The team wanted to see what the brain-scanning technique developed at UCLA would find in older people with MDD.

Image from UCLA FDDNP Depression Study

Abnormal protein deposits (green) in MDD brain

Brain images demonstrate higher FDDNP binding (yellow areas) and thus more abnormal proteins in a patient with major depressive disorder compared with a healthy control.

UCLA researchers have created a chemical marker called FDDNP that binds to both plaque and tangle deposits, which can then be viewed through a positron emission tomography (PET) brain scan, providing a "window into the brain." Using this method, researchers are able to pinpoint where in the brain these abnormal protein deposits are accumulating.

Researchers compared the FDDNP brain scans of 20 older adults between ages 60 to 82 who had been diagnosed with MDD with the scans of 19 healthy controls of similar age, education and gender.

They found that in patients with MDD, FDDNP binding was significantly higher throughout the brain and in critical brain regions, including the posterior cingulate and lateral temporal areas, that are involved in decision-making, complex reasoning, memory and emotions.

"This is the first study using FDDNP to assess the abnormal protein levels in brains of older adults with severe depression," said the study's senior author, Dr. Gary Small, UCLA's Parlow-Solomon Professor on Aging and a professor of psychiatry at the Semel Institute for Neuroscience and Human Behavior at UCLA. "The findings suggest that the higher protein load in critical brain regions may contribute to the development of severe depression in late life."

Researchers also found that similar protein deposit patterns in the lateral temporal and posterior cingulate areas in patients were associated with different clinical symptoms. Some patients demonstrated indicators of depression only, while others displayed symptoms of mild cognitive impairment as well.

Dr. Small noted that previous research has shown that depression may be a risk factor for or a precursor to memory loss, such as mild cognitive impairment, which can later lead to dementia.

"We may find that depression in the elderly may be an initial manifestation of progressive neurodegenerative disease," said the study's first author, Dr. Anand Kumar, the Lizzie Gilman Professor and department head of psychiatry at the University of Illinois at Chicago. "Brain scans using FDDNP allow us to take a closer look at the different types of protein deposits and track them to see how clinical symptoms develop."

According to Kumar and Small, more follow-up over time is needed to evaluate the significance of the outcomes of the study's patient subgroups. Such research will help further assess if depression later in life might be a precursor to mild cognitive impairment and dementia.

In addition, the researchers said, FDDNP used with PET may also be helpful in identifying new treatments and in tracking the effectiveness of current antidepressant therapy and medications designed to help reduce abnormal protein build-up in the brain.

The team is planning larger studies involving investigators at UCLA and the University of Illinois that will address the impact of the genetic marker APOE-4, which is a risk factor for dementia and Alzheimer's disease.

This study was supported by the National Institutes of Health and the U.S. Department of Energy.

UCLA owns three U.S. patents on the FDDNP chemical marker. The Office of Intellectual Property at UCLA is actively seeking a commercial partner to bring this promising technology to market. Small and study author Dr. Jorge R. Barrio, a professor of molecular and medical pharmacology at the David Geffen School of Medicine at UCLA, are among the inventors. Disclosures are listed in the full study.

Additional authors include Prabha Siddarth of the UCLA Department of Psychiatry and Biobehavioral Sciences; Vladimir Kepe of the UCLA Department of Molecular and Medical Pharmacology; and Vicki Manoukian and Virginia Elderkin-Thompson of the Semel Institute for Neuroscience and Human Behavior at UCLA.

Author:

Rachel Champeau

UCLA Longevity Center

UCLA researchers identify brain cells responsible for keeping us awake

Semel Web Manager — Thu, 03 Nov 2011 16:00:00 +0000

Bright light arouses us. Bright light makes it easier to stay awake. Very bright light not only arouses us but is known to have antidepressant effects. Conversely, dark rooms can make us sleepy. It's the reason some people use masks to make sure light doesn't wake them while they sleep.

Now researchers at UCLA have identified the group of neurons that mediates whether light arouses us — or not. Jerome Siegel, a professor of psychiatry at the Semel Institute for Neuroscience and Human Behavior at UCLA, and colleagues report in the current online edition of the Journal of Neuroscience that the cells necessary for a light-induced arousal response are located in the hypothalamus, an area at the base of the brain responsible for, among other things, control of the autonomic nervous system, body temperature, hunger, thirst, fatigue — and sleep.

These cells release a neurotransmitter called hypocretin, Siegel said. The researchers compared mice with and without hypocretin and found that those who didn't have it were unable to stay awake in the light, while those who had it showed intense activation of these cells in the light but not while they were awake in the dark.

This same UCLA research group earlier determined that the loss of hypocretin was responsible for narcolepsy and the sleepiness associated with Parkinson's disease. But the neurotransmitter's role in normal behavior was, until now, unclear.

"This current finding explains prior work in humans that found that narcoleptics lack the arousing response to light, unlike other equally sleepy individuals, and that both narcoleptics and Parkinson's patients have an increased tendency to be depressed compared to others with chronic illnesses," said Siegel, who is also a member of the UCLA Brain Research Institute and chief of neurobiology research at the Sepulveda Veterans Affairs Medical Center in Mission Hills, Calif.

Prior studies of the behavioral role of hypocretin in rodents had examined the neurotransmitter's function during only light phases (normal sleep time for mice) or dark phases (their normal wake time), but not both. And the studies only examined the rodents when they were performing a single task.

In the current study, researchers examined the behavioral capabilities of mice that had their hypocretin genetically "knocked-out" (KO mice) and compared them with the activities of normal, wild-type mice (WT) that still had their hypocretin neurons. The researchers tested the two groups while they performed a variety of tasks during both light and dark phases.

Surprisingly, they found that the KO mice were only deficient at working for positive rewards during the light phase. During the dark phase, however, these mice learned at the same rate as their WT littermates and were completely unimpaired in working for the same rewards.

Consistent with the data in the KO mice, the activity of hypocretin neurons in their WT littermates was maximized when working for positive rewards during the light phase, but the cells were not activated when performing the same tasks in the dark phase.

"The findings suggest that administering hypocretin and boosting the function of hypocretin cells will increase the light-induced arousal response," Siegel said. "Conversely, blocking their function by administering hypocretin receptor blockers will reduce this response and thereby induce sleep."

Further, Siegel noted, "The administration of hypocretin may also have antidepressant properties, and blocking it may increase tendencies toward depression. So we feel this work has implications for treating sleep disorders as well as depression."

Other authors on the study included Ronald McGregor (first author), Ming-Fung Wu, Grace Barber and Lalini Ramanathan, all of UCLA, the Veterans Affairs Greater Los Angeles Healthcare System and the UCLA Brain Research Institute.

The research was supported by the National Institutes of Health and the Medical Research Service of the Department of Veterans Affairs. The authors report no conflict of interest.

Author:

Mark Wheeler

Semel Institute for Neuroscience and Human Behavior

Study shows promise for teen suicide prevention

Semel Web Manager — Wed, 02 Nov 2011 18:00:00 +0000

Roughly 1 million people die by suicide each year. In the U.S., where nearly 36,000 people take their own lives annually, more than 4,600 victims are between the ages of 10 and 24, making suicide the third leading cause of death in this age group.

Youths treated at hospital emergency rooms for suicidal behavior remain at very high risk for future suicide attempts. But despite the urgent need to provide them with mental health follow-up care, many don't receive any such care after their discharge. Consequently, a major goal of the U.S. Department of Health and Human Service's National Strategy for Suicide Prevention has been to increase rates of follow-up care after discharge for patients who come to the emergency department (ED) due to suicidal behavior.

Now, a new study by UCLA researchers shows that a specialized mental health intervention for suicidal youth can help. Reporting in the November issue of the journal Psychiatric Services, Joan Asarnow, a professor of psychiatry at the Semel Institute for Neuroscience and Human Behavior at UCLA, and colleagues show that a family-based intervention conducted while troubled youths were still being treated in the ED led to dramatic improvements in linking these youths to outpatient treatment following their discharge.

"Youths who are treated for suicidal behavior in emergency departments are at very high risk for future attempts," said Asarnow, the study's first author. "Because a large proportion of youths seen in the ED for suicide don't receive outpatient treatment after discharge, the United States National Strategy for Suicide Prevention identifies the ED as an important suicide prevention site. So, a national objective is to increase the rates of mental health follow-up treatment for suicidal patients coming out of EDs."

But how to encourage this with youths when they are at their most vulnerable? The study involved 181 suicidal youths at two EDs in Los Angeles County, with a mean age of 15. Sixty-nine percent were female, and 67 percent were from racial or ethnic minority groups. For 53 percent of the participants, their emergency department visit was due to a suicide attempt. The remainder were seen because they had thoughts of suicide.

The youths were randomly assigned to either the usual ED treatment or an enhanced mental health intervention that involved a family-based crisis-therapy session designed to increase motivation for outpatient follow-up treatment and improve the youths' safety, supplemented by telephone contacts aimed at supporting families in linking to further outpatient treatment.

The results of the study show that the enhanced mental health intervention was associated with higher rates of follow-up treatment. Of the participants in the enhanced intervention, 92 percent received follow-up treatment after discharge, compared with 76 percent in the standard ED treatment arm — a clinically significant difference.

While the results are positive, the study is only a first step, according to Asarnow, who also directs UCLA's Youth Stress and Mood Program.

"The results underscore the urgent need for improved community outpatient treatment for suicidal youths," she said. "Unfortunately, the follow-up data collected at about two months after discharge did not indicate clinical or functioning differences among youths who received community outpatient treatment and those who did not."

Still, Asarnow said, the data from the new study underscores the critical importance of this work. To address the need for effective follow-up treatment for troubled youths, the UCLA Youth Stress and Mood Program has major research trials in progress aimed at evaluating outpatient treatments for preventing suicide and suicide attempts.

Funding for the study was provided by the Centers for Disease Control and Prevention, the National Institute of Mental Health and the American Foundation for Suicide Prevention.

Other authors included Larry Baraff, Robert Suddath, John Piacentini, Mary Jane Rotheram-Borus and Lingqi Tang, all of UCLA; Michele Berk and Charles Grob of Harbor–UCLA Medical Center, Los Angeles Biomedical Research Institute; Mona Devich-Navarro of Santa Monica College; and Daniel Cohen of Johns Hopkins University.

Asarnow reports receiving honoraria from Hathaways-Sycamores, Casa Pacifica, the California Institute of Mental Health and the Melissa Institute. Piacentini has received royalties from Oxford University Press for treatment manuals and from Guilford Press and the American Psychological Association Press for books on child mental health. In addition, he has received a consultancy fee from Bayer Schering Pharma. The other authors report no competing interests.

Author:

Mark Wheeler

Youth Stress and Mood Program

Autistic brains develop more slowly than healthy brains, UCLA researchers say

Semel Web Manager — Thu, 20 Oct 2011 16:00:00 +0000

Researchers at UCLA have found a possible explanation for why autistic children act and think differently than their peers. For the first time, they've shown that the connections between brain regions that are important for language and social skills grow much more slowly in boys with autism than in non-autistic children.

Reporting in the current online edition of the journal Human Brain Mapping, senior author Jennifer G. Levitt, a professor of psychiatry at the Semel Institute for Neuroscience and Human Behavior at UCLA; first author Xua Hua, a UCLA postdoctoral researcher; and colleagues found aberrant growth rates in areas of the brain implicated in the social impairment, communication deficits and repetitive behaviors that characterize autism.

Autism is thought to affect one in 110 children in the U.S., and many experts believe the numbers are growing. Despite its prevalence, little is known about the disorder, and no cure has been discovered.

Normally, as children grow into teenagers, the brain undergoes major changes. This highly dynamic process depends on the creation of new connections, called white matter, and the elimination, or "pruning," of unused brain cells, called gray matter. As a result, our brains work out the ideal and most efficient ways to understand and respond to the world around us.

Although most children with autism are diagnosed before they are 3 years old, this new study suggests that delays in brain development continue into adolescence.

"Because the brain of a child with autism develops more slowly during this critical period of life, these children may have an especially difficult time struggling to establish personal identity, develop social interactions and refine emotional skills," Hua said. "This new knowledge may help to explain some of the symptoms of autism and could improve future treatment options."

The researchers used a type of brain-imaging scan called a T1-weighted MRI, which can map structural changes during brain development. To study how the brains of boys with autism changed over time, they scanned 13 boys diagnosed with autism and a control group of seven non-autistic boys on two separate occasions. The boys ranged in age from 6 to 14 at the time of the first scan; on average, they were scanned again approximately three years later.

By scanning the boys twice, the scientists were able to create a detailed picture of how the brain changes during this critical period of development.

Besides seeing that the white-matter connections between those brain regions that are important for language and social skills were growing much slower in the boys with autism, they found a second anomaly: In two areas of the brain — the putamen, which is involved in learning, and the anterior cingulate, which helps regulate both cognitive and emotional processing — unused cells were not properly pruned away.

(Watch video demonstrating differences in brain changes between autistic and non-autistic boys.)

"Together, this creates unusual brain circuits, with cells that are overly connected to their close neighbors and under-connected to important cells further away, making it difficult for the brain to process information in a normal way," Hua said.

"The brain regions where growth rates were found to be the most altered were associated with the problems autistic children most often struggle with — social impairment, communication deficits and repetitive behavior," she added.

Future studies using alternative neuroscience techniques should attempt to identify the source of this white-matter impairment, the researchers said.

"This study provides a new understanding of how the brains of children with autism are growing and developing in a unique way," Levitt said. "Brain imaging could be used to determine if treatments are successful at addressing the biological difference. The delayed brain growth in autism may also suggest a different approach for educational intervention in adolescent and adult patients, since we now know their brains are wired differently to perceive information."

Other authors on the study included Paul M. Thompson, Alex D. Leow, Sarah K. Madsen, Rochelle Caplan, Jeffry R. Alger, Joseph O'Neill, Kishori Joshi, Susan L. Smalley and Arthur W. Toga, all of UCLA. Support was provided by the National Institutes of Health, the National Alliance for Autism Research, the National Institute of Mental Health and the National Institute of Neurological Disorders and Stroke. The authors report no conflict of interest.

(Video by Carlos Mena)

The UCLA Laboratory of Neuro Imaging, which seeks to improve understanding of the brain in health and disease, is a leader in the development of advanced computational algorithms and scientific approaches for the comprehensive and quantitative mapping of brain structure and function. The laboratory is part of the UCLA Department of Neurology, which encompasses more than a dozen research, clinical and teaching programs. The department ranks first among its peers nationwide in National Institutes of Health funding. For more news, visit the UCLA Newsroom and follow us on Twitter.

Author:

Mark Wheeler

Semel Institute for Neuroscience and Human Behavior

UCLA Neurosurgery gets $2M donation to establish endowed chair in epilepsy research

Semel Web Manager — Mon, 17 Oct 2011 21:00:00 +0000

Nadia and Thomas Davies (top) with Dr. Paul Crandall and Nina Davies.

Thomas and Nadia Davies have committed $2 million to the UCLA Department of Neurosurgery in memory of their late daughter Alfonsina (Nina) Q. Davies and in honor of Dr. Paul Crandall, the UCLA neurosurgeon who ended her epileptic seizures.

The Davies family invested more than a decade in seeking ways to stop the uncontrollable seizures that had assailed their daughter since birth. The neurologists they met offered only temporary solutions.

When the Davieses arrived at UCLA in 1977, they consulted with Crandall. The founder of UCLA's first epilepsy surgery research program, Crandall had been developing experimental treatments since the early 1960s. He is now retired and a professor emeritus of neurosurgery at the David Geffen School of Medicine at UCLA.

Crandall suggested an experimental surgery to control Nina's intractable epilepsy. At the time, few surgical programs for epilepsy existed in the U.S., and doctors were often reluctant to consider a surgical approach to treating the disease.

"Dr. Crandall's scientific knowledge and surgical skills saved our daughter's life," Nadia said. "We are eternally grateful for his lifelong study of surgical interventions to prevent epileptic seizures."

After her surgery, Nina completed college and realized her dream of becoming a teacher. She went on to earn a doctoral degree in education, eventually becoming assistant superintendent for the Santa Ana Unified School District. She helped many students with disabilities, both social and physical, relating firsthand to the difficulties they faced.

Sadly, in 2011, Nina died at 52 from what is known as sudden unexplained death in epilepsy (SUDEP), a rare outcome for those who suffer from the disease.

The Davieses have established the Alfonsina Q. Davies Endowed Chair in Honor of Paul Crandall, M.D., for Epilepsy Research to recognize Crandall's early research, which helped Nina and contributed to UCLA's reputation as a world leader in the surgical treatment of epilepsy.

"We are extremely grateful to the Davieses for their generosity and support," said Dr. Neil Martin, chairman of the UCLA Department of Neurosurgery. "This gift will pay tribute to Nina's life by benefiting other patients for generations. Hundreds of children and adults with epilepsy worldwide have been cured by physicians using the techniques and technologies developed at UCLA."

The UCLA Department of Neurosurgery is committed to providing the most comprehensive patient care through innovative clinical programs in minimally invasive brain and spinal surgery; neuroendoscopy; neuro-oncology for both adult and pediatric brain tumors; cerebrovascular surgery; stereotactic radiosurgery for brain and spinal disorders; surgery for movement disorders such as Parkinson's disease; and epilepsy surgery. For 20 consecutive years, the department has been ranked among the top 10 neurosurgery programs in the nation by U.S. News & World Report.

Author:

Elaine Schmidt

Semel Institute for Neuroscience and Human Behavior

UCLA events highlight integration of Eastern healing traditions, Western medicine

Semel Web Manager — Wed, 12 Oct 2011 18:00:00 +0000

UCLA has been at the forefront of integrative medicine research and education, incorporating traditional healing techniques and therapies from the East with Western medicine. Three upcoming UCLA–sponsored events will explore this intersection of East–West medicine. Media seeking more information on these and other events should contact Rachel Champeau of UCLA Health Sciences Media Relations (rchampeau@mednet.ucla.edu | 310-794-0777) or Sue Fan of the UCLA Center for East–West Medicine (sfan@mednet.ucla.edu | 310-794-0712).

Friday, Oct. 21 9 a.m.–5 p.m.
Workshop: Translation, dissemination of Chinese medical literature
Hacienda Room, UCLA Faculty Center (map)
Scholars, clinicians and researchers involved in both Chinese and integrative medicine, along with editors of medical literature, will convene at UCLA to participate in an international, interdisciplinary workshop aimed at developing methods to ensure continued high-quality translation of Chinese medical literature found in texts, databases and other core reference materials. This workshop is hosted by the UCLA Center for East–West Medicine and is jointly sponsored by the center and the UCLA Confucius Institute.

Saturday–Sunday, Oct. 22–23 11 a.m.–5:30 p.m. (Saturday) | 8 a.m.–2 p.m. (Sunday)
First National Student Conference on East–West Medicine
UCLA Neuroscience Research Building auditorium (map)
This first-of-its-kind conference, organized by students from academic medical centers across the country, focuses on reaching beyond the standard medical school curriculum to learn about the latest scientific findings and treatment strategies from a wealth of diverse Eastern healing traditions. Medical students will hear from world-renowned practitioners, scholars and researchers and learn hands-on integrative approaches to caring for patients with diseases such as inflammatory disorders and cancer. This event is sponsored by the UCLA Center for East–West Medicine. For more program information, directions and parking, visit http://caimucla.org.

Wednesday, Oct. 26 8 a.m.–5 p.m.
Conference of National Consortium of Academic Health Centers for Integrative Medicine (CAHCIM)
Hotel Palomar, 10740 Wilshire Blvd., Los Angeles 90024 (map)
The annual conference of CAHCIM, a network of 50 academic medical centers across the U.S. and Canada, will feature a daylong showcase of research projects on a wide variety of topics in integrative medicine. Consortium members include UCLA, Johns Hopkins, Stanford, Harvard, Duke, the University of Michigan and others. This event is sponsored by CAHCIM and the UCLA Center for East–West Medicine. For more program information, directions and parking, visit www.imconsortium.org/researchday/index.htm.

Author:

Rachel Champeau

Semel Institute for Neuroscience and Human Behavior

More insight into the secret life of the American teen

Semel Web Manager — Thu, 06 Oct 2011 15:20:00 +0000

Andrew Fuligni and his colleagues want to understand the secret life of the American teenager. Their research has examined whether stress in the teen years affects kids' health as adults (it does), whether teens maintain their religious ties and beliefs as adults (they do) and if ethnic minority–based stigmatization affects how they perform in school (it does). Now the researchers are looking at another big-ticket item for teens: arguments. Specifically, they're examining how arguments with friends at school may spill over and cause arguments at home, along with the reverse — how verbal fights at home affect things at school.

Reporting in the September–October edition of the journal Child Development, the researchers found that adolescents experienced more arguments with parents or other family members on days in which conflicts with peers took place, and vice versa. Family fights seemed to last longer as well; the effect of family conflict spilled over into peer relationships the next day and two days later, while peer conflict only affected fights at home on the following day.

"Every parent of a teen knows these years can get a little emotional," said Fuligni, a professor of psychiatry at the Semel Institute for Neuroscience and Human Behavior at UCLA. "So when disagreements occur, we wanted to know if there was a transmission of negative emotions between the two groups. "Adolescents tend to respond with more extreme and negative emotions than do pre-adolescents or adults, probably because it's the time in their lives when they are experiencing multiple transitions that might be stressful," he said, citing such things as puberty, dating and changing schools as examples. "Given this tendency among adolescents, emotional distress might potentially explain this idea of a family–peer spillover of conflict."

The researchers recruited 578 ninth-grade students from three public high schools in the Los Angeles metropolitan area. Ethnicities were mixed: 235 adolescents were from Mexican backgrounds, 172 from Chinese and 171 from European backgrounds. Students completed an initial background questionnaire at school and then completed a diary checklist at the end of each day for 14 days. In it, they recorded their emotions and whether various events had occurred that day, including arguing with parents and friends.

Besides finding there was emotional spillover between the two groups, the researchers also found that the effect of family conflict persisted longer than that of peer conflict. In addition, on days when teenagers argued with parents or other family members, girls experienced more peer conflict than boys. This, the researchers said, suggests that arguing with parents or other family members, as opposed to friends, may be a distinctly more stressful event for girls during this period. Finally, and contrary to the researcher's expectation, the daily family–peer link operated the same across ethnicities.

"The bottom line," said Fuligni, "is that adolescents' interactions in the home and with peers shape each other on a daily basis, at least in part, through emotional distress."

Other authors on the study included lead author Grace H. Chung from Seoul National University and Lisa Flook from the University of Wisconsin at Madison. Funding was provided by the Russell Sage Foundation and the National Institute of Mental Health. The authors report no conflict of interest.

For more news, visit the UCLA Newsroom and follow us on Twitter.

Author:

Mark Wheeler

Adolescence, Ethnicity and Immigration Research Program

Hysterectomy is associated with increased levels of iron in the brain

Semel Web Manager — Tue, 04 Oct 2011 17:00:00 +0000

The human body has a love-hate relationship with iron. Just the right amount is needed for proper cell function, yet too much is associated with brain diseases like Alzheimer's and Parkinson's. Science knows that men have more iron in their bodies and brains than women. These higher levels may be part of the explanation for why men develop these age-related neurodegenerative diseases at a younger age. But why do women have less iron in their systems than men? One possible explanation for the gender difference is that during menstruation, iron is eliminated through the loss of blood. Now, a new study by UCLA researchers confirms this suspicion and suggests strategies to reduce excess iron levels in both men and women.

Dr. George Bartzokis, a professor of psychiatry at the Semel Institute for Neuroscience and Human Behavior at UCLA, and colleagues compared iron levels in women who had undergone a hysterectomy before menopause — and thus, did not menstruate and lose iron — with levels in postmenopausal women who had not had a premenopausal hysterectomy. They found the women who had undergone a hysterectomy had higher levels of iron in their brains than the women who hadn't, and further, they had levels that were comparable to men. The research is reported in the current online edition of the journal Neurobiology of Aging.

The researchers used an MRI technique that can measure the amount of ferritin iron in the brain (ferritin is a protein that stores iron). They examined 39 postmenopausal women, 15 of whom had undergone a premenopausal hysterectomy. They looked at several areas in the brain — three white-matter regions and and five gray-matter regions. Fifty-four male subjects were also imaged for comparison. The researchers found that among the women, the 15 who had undergone a hysterectomy had concentrations of iron in the white-matter regions of the brain's frontal lobe that did not differ from the men's levels. Further, both the women who had a hysterectomy and the men had significantly higher amounts of iron than the women who had not undergone a hysterectomy. (Gray matter areas showed slight increases that were not statistically significant.)

Hysterectomy is the most common non-obstetrical surgery among women in the United States, with one in three having had a hysterectomy by age 60, said Bartzokis, who is also a member of the UCLA Laboratory of Neuro Imaging and the UCLA Brain Research Institute. The results of this study, he said, suggest that menstruation-associated blood loss may explain gender differences in brain iron. And of interest to both men and women, he said, is that it's possible that brain iron can be influenced by peripheral iron levels — that is, iron levels throughout the body — and may thus be a modifiable risk factor for age-related degenerative diseases.

"Iron accumulates in our bodies as we age," Bartzokis said, "and in the brain contributes to the development of abnormal deposits of proteins associated with several prevalent neurodegenerative diseases, such as Alzheimer's disease, Parkinson's disease and dementia with Lewy bodies. Higher brain iron levels in men may be part of the explanation for why men develop these age-related neurodegenerative diseases at a younger age, compared to women."

Bartzokis suggests it may be possible to reduce age-related brain iron accumulations by reducing the levels of iron throughout the body. This may have health benefits, especially in men, and may help counteract the negative effects of aging on the brain by reducing the iron available to catalyze, or speed up, damaging free-radical reactions. There are a few ways body stores of iron can be reduced naturally, especially for premenopausal women. Menstruation leads to the elimination of iron through loss of blood.

During pregnancy, iron is transferred from the woman to the fetus, and when women breast-feed, iron is transferred to the baby through the mother's milk. "But there are things postmenopausal women and especially men can do to reduce their iron levels through relatively simple actions," Bartzokis said. "These include not overloading themselves with over-the-counter supplements that contain iron, unless recommended by their doctor; eating less red meat, which contains high levels of iron; donating blood; and possibly taking natural iron-chelating substances, molecules that bind to and remove iron, such as curcumin or green tea, that may have positive health consequences."

Other study authors were Todd A. Tishler, Erika P. Raven, Po H. Lu and Lori L. Altshuler, all of UCLA. Funding was provided by the National Institutes of Health, the U.S. Department of Veterans Affairs and the RCS Alzheimer's Foundation. Bartzokis has consulted for and received funding from Janssen Pharmaceutical Inc. and Novartis. Lori L. Altshuler received honoraria from Abbott Laboratories, Bristol-Meyers Squibb, Forest Laboratories and GlaxoSmithKline and is currently on an advisory board for Forest Laboratories; she has been on the speaker's bureaus for Forest Laboratories, GlaxoSmithKline, and AstraZenec. All other authors declare no conflicts of interest.

For more news, visit the UCLA Newsroom and follow us on Twitter.

Author:

Mark Wheeler

The Bartzokis Group

Large study finds genetic 'overlap' between schizophrenia, bipolar disorder

Semel Web Manager — Wed, 21 Sep 2011 18:00:00 +0000

Knowledge about the biological origin of diseases like schizophrenia, bipolar disorder and other psychiatric conditions is critical to improving diagnosis and treatment. In an effort to push the field forward, three UCLA researchers, along with scientists from more than 20 countries, have been taking part in one of the largest collaborative efforts in psychiatry — a genome-wide study involving more than 50,000 study participants aimed at identifying which genetic variants make people susceptible to psychiatric disease.

This collaborative, the Psychiatric Genome-Wide Association Study Consortium (PGC), now reports in the current online edition of the journal Nature Genetics that it has discovered that common genetic variants contribute to a person's risk of schizophrenia and bipolar disorder. The PGC's studies provide new molecular evidence that 11 regions on the genome are strongly associated with these diseases, including six regions not previously observed. The researchers also found that several of these DNA variations contribute to both diseases.

The findings, the researchers say, represent a significant advance in understanding the causes of these chronic, severe and debilitating disorders. The UCLA researchers who contributed to the schizophrenia study are Roel A. Ophoff, a professor of psychiatry and human genetics and one of the founding principal investigators of the schizophrenia portion of the study; Dr. Nelson Freimer, a professor of psychiatry and director of the Center for Neurobehavioral Genetics at the Semel Institute for Neuroscience and Human Behavior at UCLA; and Rita Cantor, a professor of psychiatry and human genetics.

Schizophrenia and bipolar disorder are common and often devastating brain disorders. Some of the most prominent symptoms of schizophrenia are persistent delusions, hallucinations and cognitive problems. Bipolar disorder is characterized by severe, episodic mood swings. Both affect about 1 percent of the world's population and usually strike in late adolescence or early adulthood. Despite the availability of treatments, these illnesses are usually chronic, and patients' response to treatment is often incomplete, leading to prolonged disability and personal suffering. Family history, which reflects genetic inheritance, is a strong risk factor for both schizophrenia and bipolar disorder, and it has generally been assumed that dozens of genes, along with environmental factors, contribute to disease risk.

In the schizophrenia study, a total of seven locations on the genome were implicated in the disease, five of which had not been identified before. When similar data from the bipolar disorder study, which ran concurrently, were combined with results from the schizophrenia study, three gene locations were identified that proved to be involved in both disorders, suggesting a "genetic overlap" between schizophrenia and bipolar disorder.

"Genetic factors play an important role in the susceptibility to develop schizophrenia," Ophoff said, "but identifying these genetic factors has been very difficult. We know that schizophrenia is not caused by a single gene that explains everything but an interplay of many genetic and non-genetic factors." At the same time, he said, the disease itself is not uniform but manifests itself in different ways; currently, there is no objective biological marker or "sign" that can be used for diagnosis. "This so-called heterogeneity at the genetic and clinical level is the biggest challenge for genetic studies of neuropsychiatric disorders," Ophoff said. "One way to deal with these difficulties is to increase the size of the study so there is sufficient 'power' to detect genetic effects, even amidst this clinical and genetic diversity." The fact that even this large study resulted in a limited number of schizophrenia and bipolar genes demonstrates once again, he said, the complex nature of the disease.

Formed in 2007, the PGC is the largest consortium ever in psychiatry. Over 250 researchers from more than 20 countries have come together in an unparalleled spirit of cooperation to advance knowledge of the genetic causes of mental illness. Crucial to the success of the project was the willingness of many groups to share genetic data from tens of thousands of patients collected over many years.

The research was funded by numerous European, American and Australian funding bodies. Funds for coordination of the consortium were provided by the National Institute of Mental Health in the U.S.

For more news, visit the UCLA Newsroom and follow us on Twitter.

Author:

Mark Wheeler

Center for Neurobehavioral Genetics

UCLA scientists uncover potential target for treating common form of early-onset dementia

Semel Web Manager — Wed, 21 Sep 2011 16:00:00 +0000

No cure exists for frontotemporal dementia, which strikes between the ages of 40 and 64 and accounts for at least one in four cases of early-onset dementia. Caused by the death of cells in the front and sides of the brain, the disease can lead to dramatic changes in a patient's personality and behavior, including the loss of the ability to communicate. Now, UCLA scientists have discovered that a key signaling pathway plays an important role in the brain disorder and may offer a potential target for treatment. The journal Neuron publishes the findings in its Sept. 22 edition.

"A family history exists for nearly half of the frontotemporal dementia patients we see, suggesting a genetic component for the disease," said Dr. Daniel Geschwind, who holds the Gordon and Virginia MacDonald Distinguished Chair in Human Genetics and is a professor of neurology at the David Geffen School of Medicine at UCLA and a professor of psychiatry at the Semel Institute for Neuroscience and Human Behavior at UCLA. "Our goal was to reveal what happens on a molecular level that causes the neuron death leading to this devastating disease."

Earlier studies had linked the brain disorder with a mutation in the gene for a protein called granulin, which regulates cell growth and survival. Previous research showed that the gene mutation reduced the amount of granulin by half. "Until now, little has been known about granulin's function in the brain," Geschwind said. "We wanted to explore whether a granulin shortage kickstarts the cell death that precedes dementia. We also were searching for naturally occurring protective responses that we could target to help alleviate the disease's symptoms."

Geschwind and his colleagues examined granulin's role from three fronts: in cell culture, in a gene-knockout mouse model and in post-mortem brain tissue from dementia patients. "Cell death is easy to observe in brain tissue removed from patients after their death," Geschwind said. "We pursued two other approaches to determine the mechanism behind brain-cell survival and uncover how early it occurs in the disease."

The UCLA team performed a genetic analysis of granulin-deficient neurons made from human brain stem cells. They used a powerful technique that allowed them to see the entire genome and search for networks of highly correlated genes. "We discovered that a drop in granulin sabotaged brain cells' survival and boosted activity of Wnt, a major signaling pathway," Geschwind said. "Within this pathway, we identified a major increase in a specific receptor that Wnt binds to on the cell surface. This change occurred early in the disease process in both living mice and culture." The scientists found that Wnt signaling through the receptor FZD2 was heightened in granulin-deficient mice. They demonstrated that reducing the receptor resulted in greater cell death, while increasing it promoted neuron survival, indicating that Wnt signaling is likely a protective response to the disease.

"We believe that Wnt boosts FZD2 to help protect brain-cell survival during the early stages of dementia," Geschwind said. "Our findings suggest that increasing this receptor and other parts of the Wnt pathway may provide a new drug target to treat this disease."

Geschwind's co-authors included Ezra Rosen, Eric Wexler, Revital Versano, Giovanni Coppola, Fuying Gao, Kellen Winden and Michael Oldham, all of UCLA, and Lauren Herl Martens, Ping Zou and Robert Farese Jr., of UC San Francisco. The research was supported by grants from the Consortium for Frontotemporal Dementia, the National Institute of Aging, the National Institute for Neurological Disease and Stroke, the National Institute of Mental Health, and the John Douglas French Alzheimer's Foundation.

For more news, visit the UCLA Newsroom and follow us on Twitter.

Author:

Elaine Schmidt

Department of Psychiatry and Biobehavioral Sciences

Buyer beware: Advertising may seduce your brain, UCLA researchers say

Semel Web Manager — Tue, 20 Sep 2011 17:30:00 +0000

Are you wooed by advertising? Of course you are. After all, it's one thing to go out and buy a new washing machine after the old one exploded, quite another to impulse-buy that 246-inch flat screen TV that just maybe, in hindsight, you didn't really need. Advertisers come at you in two ways. There is the just-the-facts type of ad, called "logical persuasion," or LP ("This car gets 42 miles to the gallon"), and then there is the ad that circumvents conscious awareness, called "non-rational influence," or NI (a pretty woman, say, draped over a car). Despite research surrounding the notion of neuromarketing, which studies consumers' cognitive responses to marketing stimuli, the impact on brain function of these types of real-world advertisements was unknown. Now, researchers at UCLA and George Washington University have shown that different types of advertisements evoke different levels of brain activity, depending on whether they use elements of logical persuasion or non-rational influence.

Reporting in the current online edition of the Journal of Neuroscience, Psychology, and Economics, Dr. Ian Cook, a professor of psychiatry at the Semel Institute for Neuroscience and Human Behavior at UCLA, and colleagues found that brain regions involved in decision-making and emotional processing were more active when individuals viewed ads that used logical persuasion than when they viewed ads that used non-rational influence. These brain regions help us inhibit our responses to certain stimuli. In other words, "Watch your brain and watch your wallet," Cook said. "These results suggest that the lower levels of brain activity from ads employing NI images could lead to less behavioral inhibition, which could translate to less restraint when it comes to buying products depicted in the NI advertisements."

In the study, 24 healthy adults — 11 women and 13 men — viewed advertising images while electrical activity in their brains was recorded using electroencephalography (EEG). Each participant was shown 24 ads that had appeared in magazines and newspapers. Ads using LP images included a table of facts and figures about cigarette products, details about how to build a better toothbrush and suggestions about selecting food for dogs on the basis of their activity level.

In contrast, sample NI-type advertisements included beading water (liquor ad), an image of an attractive woman standing with legs apart (jeans ad) and a woman leapfrogging over a fire hydrant erupting with a water spray as a man enthusiastically grins behind her (cigarette ad). The researchers found that viewing LP images was consistently linked with significantly higher activity levels in the orbitofrontal and anterior cingulate regions, the amygdala, and the hippocampus, all areas of the brain involved in decision-making and/or emotional processing.

The finding reinforces the hypothesis that preferences for purchasing goods and services may be shaped by many factors, including advertisements presenting logical, persuasive information and those employing images or text that may modify behavior without requiring conscious recognition of a message. "Because the results showed that in response to non-rational sensory inputs, activity was lower in areas of the brain that help us inhibit responses to stimuli," said Cook, "the findings support the conjecture that some advertisers wish to seduce, rather than persuade, consumers to buy their products."

Other authors of the study included Sarah K. Pajot, David Schairer and Andrew F. Leuchter, all of UCLA, and Clay Warren, of George Washington University. Funding was provided by the International Consciousness Research Laboratories consortium. The authors report no conflict of interest.

For more news, visit the UCLA Newsroom and follow us on Twitter.

Author:

Mark Wheeler

Division of Adult Psychiatry

Awareness of ethnicity-based stigma found to start as early as second grade

Semel Web Manager — Wed, 31 Aug 2011 23:01:29 +0000

Students are stigmatized for any number of reasons, from the clothes they wear to what model cell phone they clench in their hands. Now, in a new report, researchers from UCLA show that youths from a range of ethnic-minority backgrounds have an added burden to contend with: ethnicity-based stigmatization. Even elementary school–aged children are aware of such stigmatization and, like older youths, they feel more anxious about school as a result. In the current online edition of the journal Child Development, senior author Andrew J. Fuligni, a UCLA professor of psychiatry, first author Cari Gillen-O'Neel, a graduate student working with Fuligni, and colleagues report that while children who are stigmatized are more likely to have less interest in school overall, ethnic-minority children, despite this hurdle, reported high interest in school. And for some of these students, feeling close to other students or school staff helps them maintain higher levels of interest in academics, despite the potentially negative effects of stigmatization.

The study included 451 second and fourth graders from New York City schools who belonged to one of the following ethnic groups: African American, Chinese, Dominican, Russian or European American. They ranged in age from 7 to 11 years old. European American students were not considered to be ethnic minorities. For the study, each student participated in three individual interview sessions lasting approximately 40 minutes each, which took place in a private room on the school's campus during school hours. Each interview was conducted by a female researcher who had the same racial or ethnic background as the student. Students were asked questions about their awareness of stigma, their anxiety about school, their interest in academics and their feelings of belonging in school.

"We found that differences in the young children's awareness of stigma were similar to differences among adults, with ethnic-minority children generally reporting more awareness than ethnic-majority children," Fuligni said. "There were few differences by grade, suggesting that even second graders are sensitive to ethnic attitudes in society." Ethnic-minority children also reported higher academic anxiety, he said, which the researchers attributed to their greater awareness of stigma.

But the study also found that some ethnic-minority students reported significantly higher interest in school than their ethnic-majority peers, despite past research by others that showed that awareness of stigmatization is associated with lower interest in school. For Dominican children in particular, this seemingly paradoxical finding was explained, in part, by their feelings about belonging: For these youngsters, feeling close connections to people at school accounted for their high levels of interest in school, despite their awareness of stigma. The study has implications for intervention efforts, Fuligni said. "Programs aimed at decreasing students' perceptions of group stigma, such as providing community role models, could help keep students' academic anxiety in check," he said. "And school-based interventions that foster close connections among individuals at school may help students stay interested in learning."

The other author on the study was Diane N. Ruble of New York University. The study was funded in part by the MacArthur Foundation, the Eunice Kennedy Shriver National Institute of Child Health and Human Development, and the National Science Foundation. The authors report no conflict of interest.

For more news, visit the UCLA Newsroom and UCLA News|Week and follow us on Twitter.

Author:

Mark Wheeler

Adolescence, Ethnicity and Immigration Research Program

UCLA memory fitness program improves memory abilities of oldest adults

Semel Web Manager — Mon, 29 Aug 2011 16:00:00 +0000

Who hasn't forgotten someone's name, misplaced their glasses or walked into a room and not remembered why they entered? Normal age-related memory decline affects more than half of all seniors, and those over 80 are the most vulnerable. A new UCLA study has found that a memory fitness program offered to older adults in their senior living communities helped improve their ability to recognize and recall words, benefitting their verbal learning and retention.

Published in the September issue of the American Journal of Geriatric Psychiatry, the study also found that as a result of the program, seniors' self-perceived memory improved, an important factor in maintaining a positive outlook on life while aging. The average age of participants in the study was 81. "It was exciting to see how much older adults participate in a memory fitness program and improve," said study author Dr. Karen Miller, an associate clinical professor at the Semel Institute for Neuroscience and Human Behavior at UCLA. "The study demonstrates that it's never too late to learn new skills to enhance one's life."

As people get older, it takes longer to learn new information and to retrieve it, including names, dates, the location of household objects, meetings, and appointments, according to the study's senior author, Dr. Gary Small, UCLA's Parlow-Solomon Professor on Aging and director of the UCLA Longevity Center.

The six-week, 12-session program differed from other cognitive training courses in that it offered not only memory-training techniques but also education about lifestyle factors that may impact memory ability and overall brain health. Participants learned stress-reduction exercises and were instructed about the importance of daily physical exercise and maintaining a healthy diet rich in antioxidants. "Lifestyle and environmental factors may play a role in cognitive decline, so our program included education about healthy living in addition to memory-training techniques," said Small, who is also a professor at the Semel Institute.

Although the UCLA team has offered similar programs in other settings, such as at senior centers and on the UCLA campus, this is one of the first times that such a comprehensive memory program has been designed for and offered in a retirement living community. This made participation easier, since seniors in most cases simply walked down a hallway rather than having to drive to a class off-site.

The study involved 115 seniors at two full-service retirement communities in Maryland that are part of Erickson Living, a leading continuing-care community developer and manager. Participants lived in the "independent" level of care in these communities and had memory complaints, but they had not been diagnosed with dementia and were not taking any medications for memory loss. Half the participants were enrolled in the memory fitness program and received memory testing before beginning the program and after completion to assess improvement. The other half were placed on a waiting list for the program and acted as study controls. Miller and Small developed a scripted curriculum for trainers who led the classes, and they provided a companion workbook for participants. Trainers in the study were employees of the Erickson Living retirement communities and had backgrounds in academia and health-related fields. The one-hour education sessions focused on memory enhancement. They included explanations of how memory works; offered quick strategies for remembering names, faces and numbers; and provided basic memory tools such as linking ideas and creating visual images. Trainers also discussed the role of a healthy lifestyle in protecting and maintaining memory.

Among the older adults attending the classes, the researchers found marked improvement in verbal memory, as well as improvements in how they perceived their memory, compared with the controls. "We found that the memory fitness program was readily accepted by residents in our senior living communities and that it directly benefited many of them," said John Parrish, Ph.D., executive director of the Erickson Foundation. "In fact, we are now offering the program in nearly all of our 16 communities across the nation." "The study suggests that the memory fitness program may be a cost-effective means of addressing some of the memory-related concerns of healthy older adults," Parrish added.

Most of the study participants were women, Caucasian and had attained a college degree or higher level of education. Researchers suggest that further study may address the impact of the program in additional older populations. The program is designed to address normal age-related memory loss rather than dementia or Alzheimer's disease.

The study was supported by the Fran and Ray Stark Foundation Fund for Alzheimer's Disease Research, the Judith Olenick Elgart Fund for Research on Brain Aging, and the Parlow-Solomon Professorship. The Erickson Foundation provided multiple contributions of "in-kind" manpower as trainers and researchers for the study. Erickson pays UCLA a licensing fee for use of the memory fitness program. Dr. Miller is paid for her time and travel to teach the program trainers at the community living sites.

Other study authors included Prabha Siddarth, Ph.D., and Linda Ercoli, Ph.D., from the division of geriatric psychiatry and the Memory and Aging Research Center at the Semel Institute for Neuroscience and Human Behavior at UCLA; Jean Gaines, Ph.D., Katherine Marx and Kasey Burke of the Erickson Foundation; Barbara Pilgrim, Nancy Barczak, R.N., and Bridget Babcok of the Erickson Retirement Communities; and Judah Ronch of the Erickson School at the University of Maryland–Baltimore.

For more news, visit UCLA Newsroom and UCLA News|Week and follow us on Twitter.

Author:

Rachel Champeau

UCLA Longevity Center

Study shows new evidence of age-related decline in the brain's master circadian clock

Semel Web Manager — Mon, 18 Jul 2011 21:15:00 +0000

A new study of the brain's master circadian clock — known as the suprachiasmatic nucleus, or SCN — reveals that a key pattern of rhythmic neural activity begins to decline by middle age. The study, whose senior author is UCLA Chancellor Gene Block, may have implications for the large number of older people who have difficulty sleeping and adjusting to time changes.

"Aging has a profound effect on circadian timing," said Block, a professor of psychiatry and biobehavioral sciences and of physiological science. "It is very clear that animals' circadian systems begin to deteriorate as they age, and humans have enormous problems with the quality of their sleep as they age, difficulty adjusting to time-zone changes and difficulty performing shift-work, as well as less alertness when awake. There is a real change in the sleep–wake cycle. "The question is, what changes in the nervous system underlie all of that? This paper suggests a primary cause of at least some of these changes is a reduction in the amplitude of the rhythmic signals from the SCN." The SCN, located in the hypothalamus, is the central circadian clock in humans and other mammals and controls not only the timing of the sleep–wake cycle but also many other rhythmic and non-rhythmic processes in the body.

The UCLA research team examined the SCN in mice and found that while critical neural activity rhythms were already disrupted in middle age, the molecular mechanisms that generate these rhythms were not significantly altered. "These results indicate that the outputs of the central circadian clock start to decline in middle age and suggest that the same may be true in humans," said study co-author Christopher Colwell, a UCLA professor of psychiatry and biobehavioral sciences who has conducted research with Block for many years. "Before this study, we did not know that the SCN was the site where the decline occurs." In a technical tour de force, the research team successfully recorded electrical activity from the brain's SCN — not in a Petri dish but in living animals. The research marks the first time this has been achieved in middle-aged animals and the first time scientists have watched the central biological clock of aging animals in action.

The study was published July 13 in the Journal of Neuroscience, the journal of the Society for Neuroscience. The scientists studied young mice, which were just a few months old, and middle-aged mice, which were more than a year old. SCN brain cells are electrically active during the day and electrically silent during the night in younger animals and younger people, the researchers said, but that difference is reduced with aging. "The changes we observed in the electrical rhythm between the young and middle-aged animals, which are quite dramatic, occur even though we do not see significant changes in the underlying molecular rhythm," Block said. "Our hypothesis is that the age-related changes in the circadian timing system are primarily occurring, at least initially, at the level of the electrical output signaling, perhaps mediated by changes in the cell-membrane properties of SCN clock cells. This is good news, because it points where in the cell to look for the age-related 'lesion' and thus helps inform what type of measures may be available to reduce these age-related deficits." Block and Colwell suspect the process is similar in humans. The SCN keeps the system of multiple distributed circadian oscillators in synchrony, but disruptions in the SCN lead to disrupted sleep, as well as dysfunction in memory, the cardiovascular system, and the body's immune response and metabolism. The SCN, Block said, can be imagined as a heavy pendulum that controls many light pendulums (oscillators), with rubber bands between them. "If the central clock weakens, it's effectively like making those rubber bands thinner and weaker," Block said. "When the SCN ages and those rubber bands become weaker, it becomes hard for the SCN to synchronize all of these other oscillators."

In the young mice, the scientists found high levels of activity during the day and much lower activity levels during the night. In middle-aged mice, there was not nearly as large a difference in activity between the day and the night. "In the middle-aged mice, they still have a circadian rhythm, but the amplitude is reduced," Block said. "During the nighttime, when electrical impulse activity levels are usually fairly low, the levels have increased. Thus, the difference between the highest levels of activity during the daytime and the lowest levels of activity during the nighttime is much smaller in the middle-aged mice." Large numbers of people over the age of 65 regularly take sleeping pills, but the effects of taking such pills over many years is not known, said Colwell, who hopes the new research will lead to other options for getting a good night's sleep.

Colwell, Block and their team plan to pursue follow-up research on treatment options that could enhance the function of the circadian system with aging. They are studying the specific membrane channel changes in the SCN that are responsible for the electrical rhythm and also are looking at the circadian regulation of the heart and the mechanisms underlying neural activity rhythms in the SCN. Their research could potentially lead to new ways of boosting the circadian output. It is possible, Colwell and Block said, that relatively simple approaches could be beneficial, such as exercising early in the morning, getting regular exposure to bright light, eating meals at consistent times and, when traveling, eating meals at the appropriate local time, regardless of whether one is hungry then. Possible interventions may involve discovering ways to improve the sleep cycle of aging people and their ability to better handle time-zone changes, perhaps by boosting the amplitude of the SCN. New pharmaceutical approaches may be developed, the scientists said. Future research may reveal which approaches are likely to be most effective.

Co-authors of the study included lead scientist Takahiro Nakamura, a former UCLA postdoctoral scholar in Colwell and Block's laboratory, who is currently on the faculty of Japan's Teikyo Heisei University; Takashi Kudo, a UCLA postdoctoral scholar; and Tamara Cutler, a UCLA undergraduate student who works in Colwell and Block's lab. The research was funded by the National Institutes of Health and by UCLA.

Implications for patients with neurological disorders such as Parkinson's

In related research, Colwell and his colleagues have documented that changes similar to those that occur as we age also occur in mouse models of neurodegenerative disorders like Huntington's disease and Parkinson's disease. "With many neurological disorders, patients have a hard time sleeping during the night and staying awake during the day," said Colwell, who was a postdoctoral fellow in Block's lab in the early 1990s at the University of Virginia. "One of the main clinical complaints of patients with Huntington's disease and Parkinson's disease is they cannot sleep and do not respond well to sleeping pills. We think the same dysfunction we see with normal aging occurs much earlier and more severely with these patients, and we hope that the treatment strategies we develop for aging can be applied to help patients with neurodegenerative diseases as well. If we learn what is going wrong, then we may be able to develop treatments." Colwell's research on Huntington's disease was published earlier this year in the journal Experimental Neurology, and his research on Parkinson's has been accepted for publication in the same journal.

Undergraduate works in laboratory of Colwell and Block

Tamara Cutler, a UCLA senior majoring in neuroscience and physiological science, co-authored the new SCN research. So what is it like for an undergraduate to conduct research with distinguished scientists, including the university's chancellor? "Working in the laboratory of Professor Colwell and Chancellor Block has been rewarding, demanding and priceless," Cutler said. "I joined the lab with the usual book knowledge of a life sciences student, a nearly boundless enthusiasm for research and a love for solving puzzles of every kind. Professor Colwell, Chancellor Block, the postdocs (Dawn Loh and Takshi Kudo) and the graduate students all invested time in my training and provided me with many fantastic opportunities to develop a strong set of skills. "Since joining the lab, I have learned numerous techniques and been allowed to perform my own experiments from start to finish while working on my honors thesis. I have been treated as a valuable member of the lab and have been encouraged to make intellectual contributions to our research, which I am certain has greatly accelerated my growth as a scientist. Being granted a co-authorship on this manuscript as an undergraduate is very meaningful to me because it is not handed out lightly here. "Dr. Colwell and Chancellor Block are really extraordinary scientists and renowned figures in the circadian research community, and it has been my great privilege to learn from them. I know my time here in the Colwell–Block lab has transformed me from someone who merely learns science into someone who can actually do science. I still have years of training ahead, but the journey thus far has been priceless."

UCLA is California's largest university, with an enrollment of more than 38,000 undergraduate and graduate students. The UCLA College of Letters and Science and the university's 11 professional schools feature renowned faculty and offer 328 degree programs and majors. UCLA is a national and international leader in the breadth and quality of its academic, research, health care, cultural, continuing education and athletic programs. Six alumni and five faculty have been awarded the Nobel Prize.

For more news, visit UCLA Newsroom and UCLA News|Week and follow us on Twitter.

Author:

Stuart Wolpert

Department of Psychiatry and Biobehavioral Sciences

Sweating the small stuff: Early adversity, prior depression linked to high sensitivity to stress

Semel Web Manager — Tue, 28 Jun 2011 19:00:00 +0000

We all know people who are able to roll with life's punches, while for others, every misfortune is a jab straight to the gut. Research examining this issue has found that although most people require significant adversity to become depressed — the death of a loved one, say, or getting fired — roughly 30 percent of people with first-time depression and 60 percent of people with a history of depression develop the disorder following relatively minor misfortunes. But no one knew why. Now, a new study led by UCLA researchers suggests that people become depressed more easily following minor life stress in part because they have experienced early life adversity or prior depressive episodes, both of which may make people more sensitive to later life stress.

George Slavich, an assistant professor at the UCLA Cousins Center for Psychoneuroimmunology, and colleagues assessed individuals' experiences with early adversity, clinical depression and recent life stress. Slavich found that individuals who experienced an early parental loss or separation and people who had more lifetime episodes of depression became depressed following lower levels of life stress than those who didn't have these predisposing factors.

The study appears in the current online edition of the Journal of Psychiatric Research. "We have known for a long time that some people are more likely to experience mental and physical health problems than others," Slavich said. "For example, while some people get depressed following a relationship breakup, others do not. In this study, we aimed to identify factors that are associated with this phenomenon and to examine whether increased sensitivity to stress might be playing a role."

The researchers recruited 100 individuals with depression, 26 men and 74 women, and interviewed them extensively to determine what types of adversity they were exposed to when they were young, how many episodes of depression they had experienced and what types of life stress they had encountered recently. The results showed that people who had lost a parent or had been separated from a parent for at least one year before the age of 18 and individuals who had experienced more episodes of depression over their lifetime became depressed following significantly lower levels of recent life stress. Additional analysis revealed that these effects were unique to stressors involving interpersonal loss.

"Researchers at UCLA and elsewhere have previously demonstrated that early adversity and depression history are associated with heightened sensitivity to stress," Slavich said. "The present study replicates this effect but suggests for the first time that these associations may be unique to stressors involving interpersonal loss. In other words, individuals who are exposed to early parental loss or separation and persons with greater lifetime histories of depression may be selectively sensitized to stressors involving interpersonal loss."

An important question raised by these findings is how adversity early in life and prior experiences with depression promote increased sensitivity to stress. One possibility, the researchers say, is that people who experience early adversity or depression develop negative beliefs about themselves or the world — beliefs that get activated in the face of subsequent life stress. Another possibility, which is not mutually exclusive, is that early adversity and depression influence biological systems that are involved in depression, perhaps by lowering the threshold at which depression-relevant processes like inflammation get triggered. "Although many factors impact stress sensitivity," Slavich said, "thoughts almost always play a role. For example, when your best friend doesn't call back, do you think she is angry at you or do you think it just slipped her mind? Our thoughts affect how we react emotionally and biologically to situations, and these reactions in turn greatly influence our health. Regardless of your prior experiences, then, it is always important to take a step back and make sure you are interpreting situations in an unbiased way, based on the information available."

Other authors on the study were Scott M. Monroe, the William K. Warren Foundation Professor of Psychology at the University of Notre Dame, and Ian H. Gotlib, the David Starr Jordan Professor of Psychology at Stanford University. The study was funded by a Society in Science: Branco Weiss Fellowship and by the National Institutes of Health. The authors report no conflicts of interest.

The UCLA Cousins Center for Psychoneuroimmunology encompasses an interdisciplinary network of scientists working to advance the understanding of psychoneuroimmunology by linking basic and clinical research programs and by translating findings into clinical practice. The center is affiliated with the Semel Institute for Neuroscience and Human Behavior and the David Geffen School of Medicine at UCLA.

For more news, visit the UCLA Newsroom and UCLA News|Week follow us on Twitter.

Author:

Mark Wheeler

Semel Institute for Neuroscience and Human Behavior

Teens maintain their religion as part of their identity during turbulent high school years

Semel Web Manager — Fri, 17 Jun 2011 17:15:00 +0000

High school is a turbulent time for adolescents. Every parent knows these are the years when teens begin to spread their wings, develop their own self-awareness and confirm their identification with specific social groups and cultures. In short, they find their niche. But a new finding out of UCLA shows there is one aspect of their lives that basically stays the course — religion. Andrew J. Fuligni, a UCLA professor of psychiatry, and colleagues found that teens, regardless of their ethnic background, retained their religious identity even as their participation in religious activities, such as attending church, declined. Further, they found that adolescents' ethnic background shaped their religious identity and participation.

The study appears in the current edition of the journal Child Development. The researchers examined three groups of teens — adolescents from Asian, Latin American and European backgrounds — and found that after controlling for ethnic differences in religious affiliation, socioeconomic background and generational status, religious identity remained stable throughout high school, even as religious participation declined. Teens from Latin American and Asian backgrounds reported higher levels of religious identity, while adolescents from Latin American backgrounds reported higher rates of religious participation. When changes in religious identity did occur in this age group, they were associated with changes in ethnic and family identities, suggesting important linkages in the development of these social identities during adolescence.

"Adolescence is a critical time for self-awareness and exploration," said Fuligni, whose research focuses on family relationships and adolescent development among culturally and ethnically diverse populations. "There's been a lot of research about adolescents' social identities in the areas of ethnicity and gender but very little on the role of religion, and even less work on the degree of religious identification and participation among adolescents from ethnic minority backgrounds."

The researchers recruited students from three ethnically diverse public high schools in the Los Angeles area. The first school consisted primarily of students from Latin American and Asian backgrounds whose parents had lower-middle-class to middle-class occupational and educational backgrounds. The second school consisted of students predominantly from Latin American and European backgrounds and from lower-middle-class to middle-class backgrounds. The third school consisted of students from families with Asian and European backgrounds, with middle-class to upper-middle-class backgrounds. In all, and after obtaining consent from parents, nearly 500 students completed an annual questionnaire during their sophomore, junior and senior high school years.

The results, said Fuligni, were not a complete surprise. Despite all the turmoil of those years, kids still have a routine and consistency to their day. "Greater change likely occurs at prominent points of transition, such as the upcoming transition to adulthood," he said. "Moving away from home, encountering new work environments, attending college, developing long-term romantic relationships — those markers in our lives — are all features of the period after high school that may cause more significant change in religious identity."

The drop-off in religious participation, such as church attendance, was not too surprising either, Fuligni said. "While there was a significant decline across the high school years, it's possible that teens were simply busy doing other things, perhaps a part-time job, taking part in extra-curricular activities or simply socializing with peers," he said. "Plus, kids are beginning to make their own decisions, and where attendance at religious services and activities is driven by parents earlier in childhood, parents may be allowing their teens to make their own decisions about participation as they progress through high school."

Other authors on the study included Virginia W. Huynh, a graduate student in Fuligni's lab, and lead author Anna B. Lopez, now at Loma Linda University. Support for this study was provided by the Russell Sage Foundation. The authors report no conflict of interest.

For more news, visit the UCLA Newsroom and UCLA News|Week and follow us on Twitter.

Author:

Mark Wheeler

Division of Adult Psychiatry

Brain scan identifies patterns of plaques and tangles in adults with Down syndrome

Semel Web Manager — Mon, 13 Jun 2011 20:00:00 +0000

In one of the first studies of its kind, UCLA researchers used a unique brain scan to assess the levels of amyloid plaques and neurofibrillary tangles — the hallmarks of Alzheimer's disease — in adults with Down syndrome. Published in the June edition of the Archives of Neurology, the finding may offer an additional clinical tool to help diagnose dementia in adults with Down syndrome, a genetic disorder caused by the presence of a complete or partial extra copy of chromosome 21.

Adults with this disorder develop Alzheimer's-like plaque and tangle deposits early, often before the age of 40. Previously, the only way to physically detect these abnormal proteins in this population was through an autopsy. Over the last decade, methods for identifying and imaging the neuropathology of Alzheimer's disease in living patients have been developed. UCLA researchers have created a chemical marker called FDDNP that binds to both plaque and tangle deposits, which can then be viewed through a positron emission tomography (PET) brain scan, providing a "window into the brain." Using this method, researchers are able to pinpoint where in the brain these abnormal protein deposits are accumulating. Due to individual variability and difficulty in obtaining baseline levels of cognitive function in adults with Down syndrome, such imaging may be useful in helping to diagnose dementia, say researchers.

"Neuroimaging may be a helpful tool in assessing and tracking plaque and tangle development over time in this population," said the study's senior author, Dr. Gary Small, a professor at the Semel Institute for Neuroscience and Human Behavior at UCLA who holds UCLA's Parlow-Solomon Chair on Aging. "Early detection can also lead to earlier interventions and treatments, often before symptoms begin." For this study, researchers administered the FDDNP chemical marker intravenously and then performed PET brain scans on 19 non-demented adults with Down syndrome (average age 37), 10 healthy controls (average age 43) and 10 patients with Alzheimer's disease (average age 66).

Analysis found significantly higher binding levels of the chemical marker in participants with Down syndrome in all brain regions, when compared with healthy controls. Compared with Alzheimer's disease patients, subjects with Down syndrome showed significantly higher binding levels in the parietal and frontal regions — areas involved in memory, behavior and reasoning. "The higher level of plaques and tangles may be reflecting the early and extensive accumulation of these deposits seen in individuals with Down syndrome," Small said.

The researchers also discovered significant associations between increased age in those with Down syndrome and higher FDDNP binding values in the parietal, lateral temporal and frontal regions. "This is one of the first times we've been able to visualize the neuropathology occurring in the living brains of adults with Down syndrome," said study author Dr. Jorge R. Barrio, a professor of molecular and medical pharmacology at the David Geffen School of Medicine at UCLA who holds UCLA's Plott Chair in Gerontology. "The age-related patterns and regional distribution of the plaques and tangles were consistent with the types of deposits that could only be identified previously through an autopsy."

While the FDDNP brain scans didn't differentiate between the two types of abnormal proteins, the areas of accumulation were consistent with earlier autopsy study findings, which had shown that while plaque and tangle pathologies are the same in both Down syndrome and Alzheimer's disease, the deposit patterns are different. Autopsy studies have also shown that all adults with Down syndrome eventually develop these accumulations of amyloid plaques and tau tangles. But rather than experiencing memory decline and other cognitive losses, as is common with Alzheimer's, aging Down syndrome patients tend to develop behavioral problems.

As part of the study, researchers performed cognitive and behavioral assessments of the Down syndrome subjects to see if FDDNP binding levels correlated with assessment results. They found several positive correlations with behavior abnormalities associated with these brain changes, including indifference and inappropriateness. "We found that the behavioral changes in the subjects with Down syndrome correlated with neurological changes in related areas of the brain consistent with the level of FDDNP binding levels to the abnormal proteins," Small said.

Small noted that cognitive skills in people with Down syndrome vary considerably and may not have been captured completely in the assessment, which primarily measured memory function. Larger future studies will compare other cognitive tests with FDDNP binding values, he said. In addition, researchers plan to determine the relative benefits of different forms of PET imaging using various chemical markers, including FDDNP.

This study was supported by the National Institutes of Health and the U.S. Department of Energy. UCLA owns three U.S. patents on the FDDNP chemical marker. The Office of Intellectual Property at UCLA is actively seeking a commercial partner to bring this promising technology to market. Small, Barrio and study author S.C. Huang are among the inventors. Disclosures are listed in the full study.

Additional UCLA study authors include Linda D. Nelson, Prabha Siddarth, Vladimir Kepe, S.C. Huang and Kevin E. Scheibel.

For more news, visit the UCLA Newsroom and UCLA News|Week and follow us on Twitter.

Author:

Rachel Champeau

UCLA Longevity Center

People with body-image disorders process 'big picture' visual information abnormally

Semel Web Manager — Thu, 26 May 2011 16:00:00 +0000

People suffering from body dysmorphic disorder, or BDD — a severe mental illness characterized by debilitating misperceptions that one appears disfigured and ugly — process visual information abnormally, even when looking at inanimate objects, according to a new UCLA study. First author Dr. Jamie Feusner, a UCLA assistant professor of psychiatry, and colleagues found that patients with the disorder have less brain activity when processing holistic visual elements that provide the "big picture," regardless of whether that picture is a face or an object. The research appears in the current online edition of the journal Psychological Medicine.

"No study until this one has investigated the brain's activity for visually processing objects in people with BDD," said Feusner, director of the Obsessive-Compulsive Disorder Intensive Treatment Program at UCLA. "This is an important step to figuring out what's going wrong in the brains of people with BDD so we can develop treatments to change their perceptions of themselves."

People with BDD tend to fixate on minute details, such as a single blemish or a slight crook to the nose, rather than viewing their face as a whole. The impact of the disorder can be debilitating. Sufferers think obsessively about their appearance and engage in repetitive, time-consuming behaviors, such as checking their appearance in the mirror. Many are too embarrassed to leave the house, some have repeated and unnecessary plastic surgeries, and still others can become suicidal. BDD affects an estimated 2 percent of the population and is thought to be especially common in people with obsessive-compulsive disorder.

The study compared 14 BDD patients, both men and women, with 14 healthy controls. Researchers used a type of brain scan called functional MRI (fMRI) to scan subjects while they viewed digital photographs of houses that were either unaltered or altered in ways to parse out different elements of visual processing. One altered set of images included very fine details, such as the shingles on the roof. The other altered images had very little detail and just showed things "holistically," such as the general shape of the house and the doors and windows.

The researchers found that the BDD patients had abnormal brain activation patterns when viewing pictures of the less-detailed houses: The regions of their brains that process these visual elements showed less activation than the healthy controls. In addition, the more severe their BDD symptoms, the lower the brain activity in the areas responsible for processing the image holistically.

"The study suggests that BDD patients have general abnormalities in visual processing," Feusner said. "But we haven't yet determined whether abnormal visual processing contributes as a cause to developing BDD or is the effect of having BDD. So it's the chicken-or-the-egg phenomenon.

"Many psychological researchers have long believed that people with body-image problems such as eating disorders only have distorted thoughts about their appearance, rather than having problems in the visual cortex, which precedes conscious thought. This study, along with our previous ones, shows that people with BDD have imbalances in the way they see details versus the big picture when viewing themselves, others and even inanimate objects."

Thirty percent of people with BDD also suffer from eating disorders, which are also linked to having a distorted self-image. Feusner is now enrolling anorexia nervosa patients to study whether they have abnormalities in the way they process visual information, to compare them with BDD patients. He plans to use this information to develop treatments to help people reconfigure the way they perceive themselves.

Other authors of the study were Hayley Moller and Teena Moody of UCLA, and Emily Hembacher of the University of California, Davis. Funding was provided by the National Institute for Mental Health. The authors report no conflict of interest.

For more news, visit the UCLA Newsroom and UCLA News|Week and follow us on Twitter.

Author:

Mark Wheeler

Division of Adult Psychiatry

Autism changes molecular structure of the brain, UCLA study finds

Semel Web Manager — Wed, 25 May 2011 17:00:00 +0000

For decades, autism researchers have faced a baffling riddle: how to unravel a disorder that leaves no known physical trace as it develops in the brain. Now a UCLA study is the first to reveal how the disorder makes its mark at the molecular level, resulting in an autistic brain that differs dramatically in structure from a healthy one. Published May 25 in the advance online edition of Nature, the findings provide new insight into how genes and proteins go awry in autism to alter the mind. The discovery also identifies a new line of attack for researchers, who currently face a vast array of potential fronts for tackling the neurological disease and identifying its diverse causes.

"If you randomly pick 20 people with autism, the cause of each person's disease will be unique," said principal investigator Dr. Daniel Geschwind, the Gordon and Virginia MacDonald Distinguished Chair in Human Genetics and a professor of neurology and psychiatry at the David Geffen School of Medicine at UCLA. "Yet when we examined how genes and proteins interact in autistic people's brains, we saw well-defined shared patterns. This common thread could hold the key to pinpointing the disorder's origins."

The research team, led by Geschwind, included scientists from the University of Toronto and King's College London. They compared brain tissue samples obtained after death from 19 autism patients and 17 healthy volunteers. After profiling three brain areas previously linked to autism, the group zeroed in on the cerebral cortex, the most evolved part of the human brain. The researchers focused on gene expression — how a gene's DNA sequence is copied into RNA, which directs the synthesis of cellular molecules called proteins. Each protein is assigned a specific task by the gene to perform in the cell. By measuring gene-expression levels in the cerebral cortex, the team uncovered consistent differences in how genes in autistic and healthy brains encode information.

"We were surprised to see similar gene expression patterns in most of the autistic brains we studied," said first author Irina Voineagu, a UCLA postdoctoral fellow in neurology. " From a molecular perspective, half of these brains shared a common genetic signature. Given autism's numerous causes, this was an unexpected and exciting finding." The researchers' next step was to identify the common patterns. To do this, they looked at the cerebral cortex's frontal lobe, which plays a role in judgment, creativity, emotions and speech, and at its temporal lobes, which regulate hearing, language and the processing and interpreting of sounds. When the scientists compared the frontal and temporal lobes in the healthy brains, they saw that more than 500 genes were expressed at different levels in the two regions. In the autistic brains, these differences were virtually non-existent.

"In a healthy brain, hundreds of genes behave differently from region to region, and the frontal and temporal lobes are easy to tell apart," Geschwind said. "We didn't see this in the autistic brain. Instead, the frontal lobe closely resembles the temporal lobe. Most of the features that normally distinguish the two regions had disappeared." Two other clear-cut patterns emerged when the scientists compared the autistic and healthy brains. First, the autistic brain showed a drop in the levels of genes responsible for neuron function and communication. Second, the autistic brain displayed a jump in the levels of genes involved in immune function and inflammatory response.

"Several of the genes that cropped up in these shared patterns were previously linked to autism," said Geschwind. "By demonstrating that this pathology is passed from the genes to the RNA to the cellular proteins, we provide evidence that the common molecular changes in neuron function and communication are a cause, not an effect, of the disease." The next step will be for the research team to expand its search for the genetic and related causes of autism to other regions of the brain.

Autism is a complex brain disorder that strikes in early childhood. The disease disrupts a child's ability to communicate and develop social relationships and is often accompanied by acute behavioral challenges. In the United States, autism spectrum disorders are diagnosed in one in 110 children — and one in 70 boys. Diagnoses have expanded tenfold in the last decade.

The study was funded by the National Institute of Mental Health, the Canadian Institutes of Health Research, and Genome Canada. Tissue samples were provided by the Autism Tissue Project, the Harvard Brain Bank and the Medical Research Council's London Brain Bank for Neurodegenerative Disease. Geschwind's and Voineagu's co-authors included Jennifer Lowe, Yuan Tian, Steve Horvath, Jonathan Mill, Rita Cantor and Benjamin Blencowe of UCLA; Xinchen Wang of the University of Toronto; and Patrick Johnston of King's College London.

The UCLA Center for Autism Research and Treatment provides diagnosis, family counseling, clinical trials and treatment for patients with autism. UCLA is one of eight centers in the National Institutes of Health–funded Studies to Advance Autism Research and Treatment network and one of 10 original Collaborative Programs for Excellence in Autism.

For more news, visit the UCLA Newsroom and UCLA News|Week and follow us on Twitter.

Author:

Elaine Schmidt

Center for Autism Research & Treatment

Latinas victimized by domestic violence much likelier to experience postpartum depression

Semel Web Manager — Wed, 04 May 2011 16:00:00 +0000

Latinas who endure violence at the hands of a partner during or within a year of pregnancy are five times more likely to suffer postpartum depression than women who have not experienced such violence, according to a new study by researchers at the UCLA Center for Culture, Trauma and Mental Health Disparities.
The study, published in the current issue of Archives of Women's Mental Health, suggests that recent exposure to intimate partner violence, or IPV, is a much stronger prenatal predictor of postpartum depression than even prenatal depression, which is generally considered the most significant predictor. In addition, recent partner violence has a stronger effect on postpartum depression than prior episodes of trauma from either partners or non-partners, the researchers said.

The authors suggest that pregnant women be screened for both prenatal depression and IPV. "The study brings attention to the role that partner violence plays in postpartum depression and is particularly unique in that it examines this problem in an understudied but high-risk population of pregnant and postpartum Latinas in Los Angeles," said lead study author Jeanette M. Valentine, a visiting associate researcher at the Center for Health Services and Society at the Semel Institute for Neuroscience and Human Behavior at UCLA. "It stresses the importance of prenatal screening for not only postpartum depression but partner violence as well, with such screening potentially contributing to interventions that could prevent the onset of postnatal depression and its adverse consequences for mother, infant and family."

This research derives from Proyecto Cuna (Baby Cradle), a study begun in 2003 to trace the effects of trauma on maternal and child health among Latinas. Participants were recruited from obstetric and gynecologic clinics at two private, nonprofit health care organizations in largely Latino communities. In total, 210 women, aged 18 and older, were enrolled in the current study. The researchers found that women who had experienced IPV during pregnancy or within the 12 months prior to pregnancy were 5.4 times more likely to suffer postpartum depression than women who had not experienced recent IPV. "This finding is true even after controlling for prenatal depression and low social support, which shows that recent IPV exposure during and close to the pregnancy is a very strong predictor of postpartum depression among Latinas," Valentine said.

The study also found that women who had experienced prenatal depression were 3.5 times likelier to experience postpartum depression than women who had not experienced prenatal depression. Among the other findings:

43.7 percent of the women (83 participants) met the criteria for depression during their first postpartum year.
33.2 percent (63) demonstrated depression symptoms during the prenatal period.
20.5 percent (39) experienced IPV within the prior 12 months.
23.2 percent (44) had experienced IPV further in the past.

According to the authors, the study does have some limitations, given that the subjects were largely Spanish-speaking, non-U.S. born, low-income Latinas, and the results may not be entirely applicable to other populations. Still, they said, the findings merit further study. The next step, according to Valentine, will be to "examine the impact of intimate partner violence on the behavioral and emotional well-being of the offspring and IPV's possible interaction with maternal depression in adversely affecting children's mental health."

"This research has significant implications for the prevention of and early intervention in children's mental health conditions," she said.

A grant from the National Institute of Mental Health to the UCLA Center for Trauma, Culture and Mental Health Disparities funded this study. Valentine's co-authors on the study are Michael Rodriguez and Muyu Zhang of UCLA, and Lisa M. Lapeyrouse of the University of Texas–El Paso.

The UCLA Center for Culture, Trauma and Mental Health Disparities is a unique interdisciplinary center that promotes research into the behavioral, biological, psychological and social factors associated with trauma among ethnic minorities with the aim of understanding how depression, post-traumatic stress disorder and other mental health outcomes affect men and women who may not seek or receive effective care. This understanding can help health care professionals create new strategies to reduce mental health disparities among these groups.

For more news, visit the UCLA Newsroom and follow us on Twitter.

Author:

Enrique Rivero

Collaborative Center for Trauma and Mental Health Disparities

Tai chi beats back depression in the elderly, study shows

Semel Web Manager — Wed, 16 Mar 2011 14:25:12 +0000

The numbers are, well, depressing: More than 2 million people age 65 and older suffer from depression, including 50 percent of those living in nursing homes. The suicide rate among white men over 85 is the highest in the country — six times the national rate. And we're not getting any younger. In the next 35 years, the number of Americans over 65 will double and the number of those over 85 will triple. So the question becomes, how to help elderly depressed individuals?

Researchers at UCLA turned to a gentle, Westernized version of tai chi chih, a 2,000-year-old Chinese martial art. When they combined a weekly tai chi exercise class with a standard depression treatment for a group of depressed elderly adults, they found greater improvement in the level of depression — along with improved quality of life, better memory and cognition, and more overall energy — than among a different group in which the standard treatment was paired with a weekly health education class.

The results of the study appear in the current online edition of the American Journal of Geriatric Psychiatry. "This is the first study to demonstrate the benefits of tai chi in the management of late-life depression, and we were encouraged by the results," said first author Dr. Helen Lavretsky, a UCLA professor-in-residence of psychiatry. "We know that nearly two-thirds of elderly patients who seek treatment for their depression fail to achieve relief with a prescribed medication."

In the study, 112 adults age 60 or older with major depression were treated with the drug escitalopram, a standard antidepressant, for approximately four weeks. From among those participants, 73 who showed only partial improvement continued to receive the medication daily but were also randomly assigned to 10 weeks of either a tai chi class for two hours per week or a health education class for two hours per week. All the participants were evaluated for their levels of depression, anxiety, resilience, health-related quality of life, cognition and immune system inflammation at the beginning of the study and again four months later. The level of depression among each participant was assessed using a common diagnostic tool known as the Hamilton Rating Scale for Depression, which involves interviewing the individual. The questions are designed to gauge the severity of depression. A cut-off score of 10/11 is generally regarded as appropriate for the diagnosis of depression. The researchers found that among the tai chi participants, 94 percent achieved a score of less than 10, with 65 percent achieving remission (a score of 6 or less). By comparison, among participants who received health education, 77 percent achieved scores of 10 or less, with 51 percent achieving remission.

While both groups showed improvement in the severity of depression, said Lavretsky, who directs UCLA's Late-Life Depression, Stress and Wellness Research Program, greater reductions were seen among those taking escitalopram and participating in tai chi, a form of exercise that is gentle enough for the elderly. "Depression can lead to serious consequences, including greater morbidity, disability, mortality and increased cost of care," Lavretsky said. "This study shows that adding a mind-body exercise like tai chi that is widely available in the community can improve the outcomes of treating depression in older adults, who may also have other, co-existing medical conditions, or cognitive impairment. "With tai chi," she said, "we may be able to treat these conditions without exposing them to additional medications."

Other authors on the study included Lily L. Alstein, Richard E. Olmstead, Linda M. Ercoli, Marquertie Riparetti-Brown, Natalie St. Cyr and Michael R. Irwin, all of UCLA. Funding for the study was provided by the National Institutes of Health, the General Clinical Research Centers Program, the UCLA Cousins Center at the Semel Institute for Neuroscience and Human Behavior, and the UCLA Older Americans Independence Center. The authors report no conflict of interest.

For more news, visit the UCLA Newsroom and follow us on Twitter.

Author:

Mark Wheeler

Division of Geriatric Psychiatry

Tobacco smoking impacts teens' brains, UCLA study shows

Semel Web Manager — Wed, 02 Mar 2011 19:00:00 +0000

Tobacco smoking is the leading preventable cause of death and disease in the U.S., with more than 400,000 deaths each year attributable to smoking or its consequences. And yet teens still smoke. Indeed, smoking usually begins in the teen years, and approximately 80 percent of adult smokers became hooked by the time they were 18. Meanwhile, teens who don't take up smoking usually never do. While studies have linked cigarette smoking to deficits in attention and memory in adults, UCLA researchers wanted to compare brain function in adolescent smokers and non-smokers, with a focus on the prefrontal cortex, the area of the brain that guides "executive functions" like decision-making and that is still developing structurally and functionally in adolescents. They found a disturbing correlation: The greater a teen's addiction to nicotine, the less active the prefrontal cortex was, suggesting that smoking can affect brain function.

The research appears in the current online edition of the journal Neuropsychopharmacology.

The finding is obviously not good news for smokers, said the study's senior author, Edythe London, a professor of psychiatry at the Semel Institute for Neuroscience and Human Behavior at UCLA. "As the prefrontal cortex continues to develop during the critical period of adolescence, smoking may influence the trajectory of brain development and affect the function of the prefrontal cortex," London said. In the study, 25 smokers and 25 non-smokers between the ages of 15 to 21 were asked to perform a test that activated the prefrontal cortex and required them to inhibit responding. The test, called the Stop-Signal Task (SST), was done while the participants were undergoing functional magnetic resonance imaging (fMRI). The Stop-Signal Task involves pressing a button as quickly as possible every time a lighted arrow appears — unless an auditory tone is played, in which case the participant must prevent himself from pressing the button. It is a test of a person’s ability to inhibit an action.

Prior to the fMRI test, the researchers used the Heaviness of Smoking Index (HSI) to measure the level of nicotine dependence in the smoking group. The HSI takes into account how many cigarettes a teen smokes in a day and how soon after waking he or she takes the first smoke. The results of the tests, London said, were interesting — and surprising. Among smokers, the researchers found that the higher the HSI — that is, the more a teen smoked — the lesser the activity in the prefrontal cortex. And yet, despite these lower levels of activation, the smoking group and the non-smoking group performed roughly the same with respect to inhibition on the Stop-Signal Task.

"The finding that there was little difference on the Stop-Signal Task between smokers and non-smokers was a surprise," said London, who is also a professor of molecular and medical pharmacology at the David Geffen School of Medicine at UCLA and a member of the UCLA Brain Research Institute. "That suggested to us that the motor response of smokers may be maintained through some kind of compensation from other brain areas."

Protracted development of the prefrontal cortex has been implicated as a cause of poor decision-making in teens, London said, caused by immature cognitive control during adolescence. "Such an effect can influence the ability of youth to make rational decisions regarding their well-being, and that includes the decision to stop smoking," she said. The key finding, London noted, is that "as the prefrontal cortex continues to develop during the critical period of adolescence, smoking may influence the trajectory of brain development, affecting the function of the prefrontal cortex. In turn, if the prefrontal cortex is negatively impacted, a teen may be more likely to start smoking and to keep smoking — instead of making the decision that would favor a healthier life."

On the other hand, the fact that adolescent smokers and non-smokers performed equally well during a response-inhibition test suggests that early interventions during the teen years may prevent the transition from a teen smoking an occasional cigarette in response to peer pressure to addiction in later adolescence.

In addition to London, study authors included lead author Adriana Galván, Christine M. Baker and Kristine M. McGlennen of UCLA, and Russell A. Poldrack, of the University of Texas at Austin.

Funding for this study was provided by Philip Morris USA, an endowment from the Thomas P. and Katherine K. Pike Chair in Addiction Studies, and a gift from the Marjorie M Greene Trust. None of the sponsors had any involvement in the design, collection, analysis or interpretation of data, the writing the manuscript, or the decision to submit the manuscript for publication.

The Semel Institute for Neuroscience and Human Behavior is an interdisciplinary research and education institute devoted to the understanding of complex human behavior, including the genetic, biological, behavioral and sociocultural underpinnings of normal behavior, and the causes and consequences of neuropsychiatric disorders. In addition to conducting fundamental research, the institute faculty seeks to develop effective strategies for prevention and treatment of neurological, psychiatric and behavioral disorder, including improvement in access to mental health services and the shaping of national health policy.

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Author:

Mark Wheeler

Adolescent Smoking Cessation Center