Pesticides May Be Linked to ‘Havana Syndrome’

A new study finds that overexposure to pesticides was a likely cause for the condition known as “Havana Syndrome,” a set of neurological symptoms seen among Canadian diplomats residing in Havana, Cuba in 2016.

Beginning in August 2017, reports surfaced that American and Canadian diplomatic personnel in Cuba had suffered a variety of health problems including headaches and loss of balance, as well as sleep, concentration, and memory difficulties. The condition was initially believed to be acoustic attacks on U.S. and Canadian embassy staff.

The study, led by Alon Friedman, M.D., of Ben-Gurion University of the Negev (BGU) in Israel and Dalhousie University Brain Repair Center in Nova Scotia, Canada, will be presented at the “Breaking the Barriers of Brain Science” symposium in New York.

To ensure Friedman and his team’s findings are properly interpreted and understood, Friedman elected to discuss his research in advance of peer-reviewed publication with the Canadian Broadcasting Service, which obtained a draft report to the Canadian government, leaked by an unknown source.

The study details the nature of the injury, specifies the brain regions involved, including the blood-brain barrier and suggests a possible cause in the form of “cholinesterase inhibitors,” with “organophosphorus insecticides” being a likely source. Cholinesterase (ChE) is one of the key enzymes required for the proper functioning of the nervous systems of humans, invertebrates and insects.

The study involved 26 Canadian participants: 23 Canadian diplomats and their family members who lived in Havana, as well as individuals who didn’t live in Cuba.

“We were also able to test several of the subjects before and after they returned from Cuba,” Friedman says. “Our team saw changes in the brain that definitely occurred during the time they were in Havana.”

The researchers attribute the study’s findings to multidisciplinary research methods, in particular, their use of new brain imaging tools including advanced Magnetic Resonance Imaging (MRI) techniques and magnetoencephalography.

“We followed the science, and with each discovery we asked ourselves more questions,” said Friedman. “Pinpointing the exact location of where the brain was injured was an important factor that helped lead us to perform specific biochemical and toxicological blood tests and reach the conclusion that the most likely cause of the injury was repeated exposure to neurotoxins.”

The researchers involved also represented a wide range of disciplines, including neuroscience, neurology, psychiatry, audio-vestibular, ophthalmology, toxicology and even veterinary medicine.

“The study validates the need for us to continue to learn more about the use of pesticides and other toxins,” said Friedman. “It is a global health issue that reminds us how much we still have to learn about the impact that toxins have on our health.”

Source: American Associates, Ben-Gurion University of the Negev


Behavioral Approach Can Prevent Childhood Accidents

Injuries are the leading cause of death for children worldwide, having recently overtaken infectious disease.

“Many different factors contribute to unintentional injuries, so if we are able to stop just one of these risk factors, the injury could be prevented,” said David C. Schwebel, Ph.D., of the University of Alabama Birmingham.

“By using novel behavioral strategies, we can possibly prevent injuries that have previously been seen as unavoidable accidents.”

Schwabel presented his research findings at the annual convention of the American Psychological Association.

Injuries were responsible for the deaths of over 11,000 and emergency room visits by more than 6.7 million American children in 2017, according to the Centers for Disease Control and Prevention. The Global Burden of Disease project estimates that more than 2 million children under age 19 worldwide died as a result of injuries in 2017.

While these numbers represent all injuries, the presentation focused on only unintentional injuries (i.e., accidents) instead of intentional injuries such as suicide, homicide and abuse.

Schwebel outlined a model that psychologists could use to reduce accidental injuries in children.

The model groups risk factors in three categories: environment-based, caregiver-based and child-based factors. Each category contributes in some form to almost every incident, according to Schwebel, and preventing just one risk factor could stop an injury from occurring.

Environment-based factors can include many different aspects of the environment with which children interact. For example, children could choke on toys if they are not designed well or be harmed in a car accident due to an incorrectly installed car seat.

Schwebel described one case where he and his colleagues reduced an environmental risk by comparing the look and shape of bottles containing either juice or torch fuel.

Children were shown many bottles, some with torch fuel and others with juice, and were asked if they would drink them or not. Children tended to identify liquids in clear plastic bottles as drinks and those in opaque containers as not drinks.

After the findings were published, there were evident changes in the torch fuel industry as fuel began to be sold in dark opaque bottles.

Caregiver-based factors can involve anyone who is supervising a child, including parents, teachers, babysitters or even lifeguards.

According to Schwebel, preschool teachers can often be underpaid and fatigued from the intense work of supervising children all day and sometimes use outdoor playground time as a break for themselves, allowing children to run free, even though the majority of injuries at preschools occur on playgrounds.

“To solve this problem, we developed the Stamp in Safety Program where children wear a nametag, and teachers have stamps to reward the children on their nametags for engaging in safe behavior,” he said.

“While on the surface this seems to focus on rewarding children for safe behavior, its primary goal is to get teachers engaged and paying attention.”

Child-based factors include motor skills, how children perceive their environment and how they interact with others. These skills vary greatly by age, so different approaches are needed when confronting risks.

For example, 7-year-olds struggle more with the cognitive demands of crossing the street than 14-year-olds. Interventions for child-based factors can include reinforcing common parenting practices such as teaching children how to cross the street safely or showing them how to interact with stray dogs.

How the specific situations targeted for interventions are chosen can be a mixed bag, said Schwebel. An idea for a program on drowning prevention came after Schwebel observed lifeguards while his own kids were playing at a pool. Other intervention ideas are drawn from the personal experiences and ideas brought to him by his students, such as the Stamp in Safety program.

And while psychological researchers are essential, this work will require collaboration across a variety of disciplines, said Schwebel. Throughout his research, Schwebel has worked with a multidisciplinary team of experts including computer scientists, visual artists, electrical engineers, biostatisticians, physicians, epidemiologists and others.

Source: American Psychological Association

Study: Esketamine Nasal Spray Safe and Effective for Depression

Emerging research supports the use of Esketamine nasal spray in treating depression among people who have not responded to previous treatment. Esketamine is revolutionary as it provides fast-acting treatment for people that have not responded to other depression treatments.

The study, published online in the American Journal of Psychiatry, is one of the key studies that led to the recent Food and Drug Administration (FDA) approval of esketamine nasal spray, in conjunction with an oral antidepressant, for use in people with treatment-resistant depression.

Depression is common, and as many as one-third of people with depression are considered treatment resistant — not finding relief from symptoms even after trying several antidepressants.

Details on the phase 3, double-blind, active-controlled study were presented by Michael Thase, MD, during the Annual Meeting of the American Psychiatric Association. Thase, a study author, explained that the research was conducted at 39 outpatient centers from August 2015 to June 2017 and involved nearly 200 adults with moderate to severe depression and a history of not responding to at least two antidepressants.

Participants were randomly assigned to one of two groups. One group was switched from their current treatment to esketamine nasal spray (56 or 84 mg twice weekly) plus a newly initiated antidepressant (duloxetine, escitalopram, sertraline, or extended-release venlafaxine).

The improvement in depression among those in the esketamine group was significantly greater than the placebo group at day 28. Similar improvements were seen at earlier points in time.

Adverse events in the esketamine group generally appeared shortly after taking the medication and resolved by 1.5 hours later while patients were in the clinic.

The most common side effects included dissociation, nausea, vertigo, dysgeusia (distortion of the sense of taste) and dizziness. Seven percent of patients in the esketamine group discontinued the study due to side effects.

“This trial of esketamine was one of the pivotal trials in the FDA’s review of this treatment for patients with treatment resistant depression. Not only was adjunctive esketamine therapy effective, the improvement was evident within the first 24 hours,” Thase said.

“The novel mechanism of action of esketamine, coupled with the rapidity of benefit, underpin just how important this development is for patients with difficult to treat depression.”

Despite the promising results and the approval by the FDA, some critical questions regarding the use of esketamine remain unanswered. In an accompanying commentary in the American Journal of Psychiatry, Alan Schatzberg, MD, at Stanford University School of Medicine, explains that information about the best use of esketamine is lacking, such as how long and how often to prescribe it. Use of the nasal spray also raises concerns about the potential for abuse.

While he notes that esketamine could be useful for many patients with depression, he cautions that “there are more questions than answers with intranasal esketamine, and care should be exercised in its application in clinical practice.”

The commentary describes esketamine’s relationship to ketamine, an anesthetic in use for decades that has also been used recreationally as a party drug.

While ketamine administered intravenously at sub-anesthetic doses is an effective treatment being used for refractory depression, at present, intravenous ketamine for the treatment of depression has not been approved by the FDA, although it can be prescribed off-label.

Ketamine is composed of molecules that are mirror images of each other (S-ketamine and R-ketamine). It is the intranasal formulation of the S-ketamine molecule (i.e., esketamine) that received FDA approval.

Source: American Psychiatry Association

Brain Scans Show Cognitive Benefits of Exercise Over Time

In new work presented this week about the effects of exercise on the brain, researchers found that brain changes that occur after a single workout are predictive of what happens with sustained physical training over time.

Just as in training for a marathon, individual running workouts add up over time to yield a big improvement in physical fitness. So it should not be surprising that the cognitive benefits from workouts also accumulate to yield long-term cognitive gains.

The new study, presented at the Cognitive Neuroscience Society (CNS) annual conference in San Francisco, fills a research void by quantifying the underlying neurobiology associated with how exercise enhances brain health.

“There is a strong and direct link between physical activity and how your brain works,” said Dr. Wendy Suzuki of New York University (NYU. “People still do not link physical health to brain and cognitive health; they think about fitting into a bikini or losing that last pound, not about all the brain systems they are improving and enhancing every time they work out.”

But as new research comes out to illuminate how different types, amounts, and intensities of physical activity improve brain function, cognitive neuroscientists hope to see a sea change in how the general public views exercise. Investigators wish to educate the public on the benefits of long-term training including the positive effects of physical activity for socioeconomically disadvantaged communities.

The new study showing that immediate cognitive effects from exercise mirror long-term ones is the first of its kind, as short- and long-term effects are typically examined in different studies, said Dr. Michelle Voss of the University of Iowa, who led the study.

Her team’s initial findings are good news for the field of cognitive neuroscience, as they suggest that the brain changes observed after a single workout study can be a biomarker of sorts for long-term training.

Study participants underwent fMRI brain scans and working memory tests before and after single sessions of light and moderate intensity exercise and after a 12-week long training program. The researchers found that those who saw the biggest improvements in cognition and functional brain connectivity after single sessions of moderate intensity physical activity also showed the biggest long-term gains in cognition and connectivity.

Researchers used recumbent cycles that had motorized pedals — allowing the participants to either apply their own force to turn the pedals or to let the pedals do the work.

“This feature allowed us to keep pedal speed constant while only changing heart rate between conditions of light and moderate intensity activity,” Voss said. “This is novel for acute exercise paradigms, which often use sitting as a control condition.”

Voss looks forward to replicating this first study with larger samples. Her lab is currently recruiting participants for a similar study that will include 6 months of training instead of 3 months, to give participants more time to improve cardiorespiratory fitness.

But in the meantime, she said, “Think about how physical activity may help your cognition today and see what works. Day by day, the benefits of physical activity can add up.”

Dr. Michelle Carlson of Johns Hopkins University is working to bring that message to socioeconomically disadvantaged communities through a novel program called Experience Corps Program. This effort embeds physical activity into weekly volunteering for older adults to mentor children in local elementary schools.

“We need to address socioeconomic barriers like cost and accessibility to motivate older adults to regularly engage in healthful behaviors,” Carlson said. “And many people don’t appreciate the power of physical activity for our brains.”

Multiple studies from the Experience Corps Program have found that the regular walking and other physical activity generated from the volunteering experience has resulted in improved memory and other cognitive functions. In fact, the training is associated with changes to the prefrontal cortex that mirror those seen after 6 months of exercise in cognitively at-risk older adults.

“These and related findings in my lab and others have contributed to our understanding that targeting low-intensity lifestyle activity is increasingly being recognized as important and scalable intervention to promote any physical activity,” Carlson said.

Her team has also developed a 3-D game to simulate real-world activity for both cognition and mobility. “What is cool is that most participants, regardless of baseline cognitive and physical limitations, learn and improve steadily over sessions,” she said.

“We want to help a large segment of the aging population that is sedentary or unable to tap into volunteer opportunities by providing opportunities to increase meaningful physical activity.”

Suzuki has experienced the transformative power of exercise on the brain firsthand. When working out to lose weight, she noticed her memory improving over time. She became so fascinated by the link between physical activity and brain function that she transformed her lab entirely, from one that studied the hippocampus in nonhuman primates to one that focused solely on human cognition and exercise.

“I’ve really gone all in,” she said.

There are a whole host of questions cognitive neuroscientists can help answer, from how much and what types of exercise are optimal for brain health to how to translate findings from young, healthy populations to older, at-risk ones. Suzuki hopes to see improved neuroimaging techniques in the coming years that better capture what happens in the brain during and after exercise.

Source: Cognitive Neuroscience Society/EurekAlert

Survey: Most Americans Prefer Female Politicians

A new survey reveals that both women and men prefer female politicians, with men in particular rating female politicians significantly higher than male politicians. The nationally diverse survey included a sample of 1,400 Americans of voting age.

“These results came as a real surprise,” said study co-leader Lindsey Cormack, Ph.D., from Stevens Institute of Technology in New Jersey. “It could signal a backlash given the current political environment, in the sense that there is a rebalancing in favor of women.”

Cormack and political science professor Kristyn Karl, Ph.D., recently unveiled the findings at the American Political Science Association’s annual meeting in Boston.

The survey was distributed by Survey Sampling International, the world’s leading provider of market research, to U.S. citizens aged 18 years or older. The sample was designed to mirror U.S. census benchmarks in terms of gender, age, race and political affiliation.

Survey respondents were presented with articles showing politicians making sorrowful or angry appeals in response to fictitious policy failures or concerns, on topics ranging from education to defense.

The researchers then asked the respondents to score how favorably they viewed the politicians and to evaluate their leadership, competence, intelligence, compassion and sincerity (on a scale from 1 to 4). The gender of the politicians, their appeals, and the issues varied across articles.

The results reveal that both men and women tend to favor female politicians, but men repeatedly rated them significantly higher, regardless of tone or topic they addressed in the article. When broken down into political parties, Democrat men evaluated women politicians significantly more favorably than male politicians. Republican men and women, on the other hand, evaluated men and women politicians similarly.

In addition to the overall preference for women over men in politics, the researchers discovered  that male politicians faced the steepest judgment when communicating in sorrowful and emotional ways about defense issues.

“We expected that women politicians would be viewed negatively for violating gender norms about emotionality but in reality, it was men who were punished most severely,” says Karl.

“While women politicians were not clearly punished for expressing anger or sadness, men politicians who talked about masculine topics such as defense policy in an ‘unmanly’ way — with sadness — faced significantly more negative evaluations.”

As midterm elections approach with an unprecedented number of women candidates running for Congress, some urge caution in evaluating these elections as evidence of a sea change.

Indeed, the “pink wave” is also very blue, as Democrats make up a large share of women candidates this cycle. But instead of attributing success to individual candidates or district conditions, the research suggests that the public may simply be ready for women to lead.

Source: Stevens Institute of Technology


Brief CBT Can Benefit Women Caring for Kids with Severe Health Issues

A new study finds that brief cognitive-behavioral therapy (CBT) can significantly improve the mental health of women overwhelmed by caring for children with severe chronic health conditions, such as cerebral palsy or cystic fibrosis.

Brief CBT, a short-term goal-oriented form of psychotherapy, offers a hands-on practical approach to problem-solving and focuses on changing patterns of thinking or behavior to help alleviate negative thoughts and improve recognition of one’s own ability to cope.

“Women caring for children with chronic conditions such as cerebral palsy and cystic fibrosis are at high risk for depressive symptoms,” said Lynne Hall, Dr.P.H., R.N., associate dean of research and professor at the University of Louisville (UofL) School of Nursing.

“They have many things to juggle, including caring for the child, administering medications and coordinating physician and therapy visits. They’re stressed and overwhelmed by the amount of care their children require and the number of hours a day it takes.”

The findings show that, after five therapy sessions, study participants reported significantly decreased depressive symptoms, negative thinking and chronic stressors, and experienced improved sleep quality.

The study also suggests that women caring for children with serious health conditions should be screened for depression and that CBT can be an important treatment for this population, Hall said.

The study involved 94 female caregivers with high levels of depressive symptoms. Each was randomly assigned to either a control group or an intervention group which received five 45 to 60-minute sessions of CBT.

The participants were given homework that focused on examples of cognitive distortions with positive substitutions, a thoughts log and instructions for practicing relaxation.

“A lot of these women said they felt very isolated and there was no one who would listen to them,” said Catherine Batscha, D.N.P., a psychiatric-mental health nurse practitioner who provided CBT to the study participants.

“Because of their child’s care requirements, the women had difficulty getting together with friends because they couldn’t hire a babysitter who knows about medical equipment or complex health conditions, so people were cut off from a lot of social support.”

About 15 million children in the United States have special health care needs and women constitute 72 percent of the caregivers of those children.

Hall presented the study findings at the Council for the Advancement of Nursing Science at the State of the Science Congress on Nursing Research in Washington, D.C.

Source: University of Louisville