0-1 star Wasted resources

Research that wasted resources

A gaping hole in a review of nutritional psychiatry

gettingwell4 0-1 star Wasted resources, Brain development, Cerebrum, Dopamine, Epigenetics, Glutamate, Hippocampus, Limbic system, Lower brain, Memory, Neurochemicals, Stress , , , , ,

This December 2016 Australian review published in September 2017 concerned:

“..the nutritional psychiatry field..the neurobiological mechanisms likely modulated by diet, the use of dietary and nutraceutical interventions in mental disorders, and recommendations for further research.”

The reviewers inexplicably omitted acetyl-L-carnitine, which I first covered in A common dietary supplement that has rapid and lasting antidepressant effects. A PubMed search on “acetyl carnitine” showed over a dozen studies from the past twelve months that were relevant to the review’s subject areas. Here’s a sample, beginning with follow-on research published in June 2016 of the study I linked above:

Reply to Arduini et al.: Acetyl-l-carnitine and the brain: Epigenetics, energetics, and stress

Dietary supplementation with acetyl-l-carnitine counteracts age-related alterations of mitochondrial biogenesis, dynamics and antioxidant defenses in brain of old rats

Neuroprotective effects of acetyl-l-carnitine on lipopolysaccharide-induced neuroinflammation in mice: Involvement of brain-derived neurotrophic factor

ALCAR promote adult hippocampal neurogenesis by regulating cell-survival and cell death-related signals in rat model of Parkinson’s disease like-phenotypes

Analgesia induced by the epigenetic drug, L-acetylcarnitine, outlasts the end of treatment in mouse models of chronic inflammatory and neuropathic pain

The cited references in these recent studies were older, of course, and in the time scope of the review. There’s no excuse for this review’s omission of acetyl-L-carnitine.

https://www.cambridge.org/core/journals/proceedings-of-the-nutrition-society/article/nutritional-psychiatry-the-present-state-of-the-evidence/88924C819D21E3139FBC48D4D9DF0C08 “Nutritional psychiatry: the present state of the evidence” (not freely available)

A one-sided review of stress

gettingwell4 0-1 star Wasted resources, Amygdala, Brain development, Cerebrum, Cortisol, Dopamine, Epigenetics, Glutamate, Hippocampus, Hypothalamus, Limbic system, Memory, Neurochemicals, Oxytocin, Primal Therapy, Serotonin, Stress, Vasopressin , , , , ,

The subject of this 2016 Italian/New York review was the stress response:

“The stress response, involving the activation of the hypothalamic-pituitary-adrenocortical [HPA] axis and the consequent release of corticosteroid hormones, is indeed aimed at promoting metabolic, functional, and behavioral adaptations. However, behavioral stress is also associated with fast and long-lasting neurochemical, structural, and behavioral changes, leading to long-term remodeling of glutamate transmission, and increased susceptibility to neuropsychiatric disorders.

Of note, early-life events, both in utero and during the early postnatal life, trigger reprogramming of the stress response, which is often associated with loss of stress resilience and ensuing neurobehavioral (mal)adaptations.”

The reviewers’ intentional dismissal of the role of GABA in favor of the role of glutamate was a key point:

“The changes in neuronal excitability and synaptic plasticity induced by stress are the result of an imbalance of excitatory (glutamatergic) and inhibitory (GABAergic) transmission, leading to long-lasting (mal)adaptive functional modifications. Although both glutamate and GABA transmission are critically associated with stress-induced alteration of neuronal excitability, the present review will focus on the modulation of glutamate release and transmission induced by stress and glucocorticoids.”

No particular reason was given for this bias. I inferred from the review’s final sentence that the review’s sponsors and funding prompted this decision:

“In-depth studies of changes in glutamate transmission and dendrite remodeling induced by stress in early and late life will help to elucidate the biological underpinnings of the (mal)adaptive strategies the brain adopts to cope with environmental challenges in one’s life.”

The bias led to ignoring evidence for areas the reviewers posed as needing further research. An example of relevant research the reviewers failed to consider was the 2015 Northwestern University study I curated in A study that provided evidence for basic principles of Primal Therapy that found:

“In response to traumatic stress, some individuals, instead of activating the glutamate system to store memories, activate the extra-synaptic GABA system and form inaccessible traumatic memories.”

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4812483/ “Stress Response and Perinatal Reprogramming: Unraveling (Mal)adaptive Strategies”

A skin study that could have benefited from preregistration

gettingwell4 0-1 star Wasted resources, Epigenetics ,

This 2016 German human skin study found:

“An age-related erosion of DNA methylation patterns that is characterized by a reduced dynamic range and increased heterogeneity of global methylation patterns. These changes in methylation variability were accompanied by a reduced connectivity of transcriptional networks.”

The study could have benefited from preregistration using an approach such as Registered Reports. As it was, the study gave the impression of a fishing expedition.

For example, the initial subjects were 24 women ages 18-27 and 24 women ages 61-78. The barbell shape of the subjects’ age distribution wouldn’t make sense if the researchers knew they were going to later use the epigenetic clock method.

The researchers did so, although the method’s instructive study noted:

“The standard deviation of age has a strong relationship with age correlation”

and provided further details in “The age correlation in a data set is determined by the standard deviation of age” section.

A second round of subjects were recruited, 60 women aged 20-79, “that also included intermediate ages.” No discrete numbers were provided, but from eyeballing Figure S1 in the supplementary material, the ages of the second group appeared to be evenly distributed.

The subject groups were lumped together to make findings such as:

“We observed a significant age-related hypermethylation of CpG island-associated probes. This effect was strongly enriched during two specific age windows, at 40–45 and 50–55 years.

Considering that our samples were exclusively derived from female volunteers, it seems reasonable to link the latter window to menopause, which is also known to distinctly accelerate skin aging.”

The study didn’t state that the second group of subjects were screened for menopause, or for use of hormone therapies or skin creams.

If the ages of the second group of subjects were evenly distributed, 6 of the 108 subjects would be ages 50-55. It wasn’t “reasonable to link” a small number of subjects to conditions for which they hadn’t been screened.

http://onlinelibrary.wiley.com/enhanced/doi/10.1111/acel.12470/ “Reduced DNA methylation patterning and transcriptional connectivity define human skin aging”

Problematic research into epigenetic effects of paternal stress on male offspring

gettingwell4 0-1 star Wasted resources, Cortisol, Epigenetics, Neurochemicals, Stress ,

This 2016 Chinese rodent study and its accompanying commentary Don’t stress dad — it’s bad for your kids’ health were caught up in an agenda.

The first problem I noticed was that the hyperglycemic effects found only in the male offspring weren’t consistently labelled as sex-specific. Try to find that fact in the paywalled commentary with its intentionally misleading headline, or in the news coverage with headlines such as “Stressed mouse dads give their offspring high blood sugar.”

That the effects were male-only was briefly noted in the study, yet “male” was absent from the “stress-F1 mice” label used after the initial mention.

2015年12月22日-陆炎模式图单独导出-v2

The researchers provided no mechanisms that plausibly linked the effects to offspring sex. There was plenty of time between the May 3, 2015 submission and the February 18, 2016 publication to clarify this and other items. I wonder what the reviewer noted.

The second problem was that the highest number of male “stress-F1 mice” tested was only six. I didn’t see any disclosures of what led to the scarcity of subjects, or of the likely impact of using so few.

A related limitation was that the male “stress-F1 mice” were killed as young adults. Whether or not the hyperglycemic effects carried through to old age or to another generation wasn’t determined.

I’m leery of studies like this one that didn’t have a Limitations section, and especially so when the news coverage overlooked obvious limitations. It was difficult to place the findings in a context other than promoting that a male’s stress may also adversely affect their offspring.

One of the problems that research caught up in an agenda create is that non-headline findings are overlooked. Other than sex-specific effects, the study found that the putative preconception cause of hyperglycemia didn’t cause other symptoms:

  • “No significant growth defects were observed in male offspring from stress-F0 fathers (stress-F1 mice) during their early lives.
  • Insulin sensitivity was not changed in stress-F1 mice.
  • Serum glucagon, leptin, and pro-inflammatory cytokines (tumor necrosis factor α [TNFα], interleukin-6 [IL-6]) were unaffected.
  • Body weight, food intake, locomotor activity, CO2 production, O2 consumption, and respiratory exchange ratios also remained unchanged.
  • Liver weight, liver weight/body weight ratios, hepatic triglyceride content, and the histological phenotypes were also comparable.
  • The methylation pattern and expression of microRNAs were not affected in the fetal brains of stress-F1 mice.”

The handling of the study reminded me of Transgenerational epigenetic programming with stress and microRNA where most of the news coverage similarly focused on it being a male’s stress, not a female’s, that affected the developing embryo. The important part lost from news coverage of that study was it demonstrated how a damaging influence can begin immediately after conception, but the symptoms didn’t present until adulthood!

http://www.sciencedirect.com/science/article/pii/S1550413116300067 “Paternal Psychological Stress Reprograms Hepatic Gluconeogenesis in Offspring”

What’s a good substitute for feeling loved?

gettingwell4 0-1 star Wasted resources, Memory, Primal Therapy , ,

A friend of mine sent a link to this TED talk yesterday. The speaker inspired my friend to change their life along the speaker’s guidelines:

“The very act of doing the thing that scared me undid the fear.

That feeling, you can’t help but strive for greatness at any cost.

The more I work to be successful, the more I need to work.”

I wasn’t similarly inspired.

For one thing, a fear memory isn’t undone by behavior that covers it over and tamps it down. Fear extinction is the learned inhibition of retrieval of previously acquired responses provided evidence for what happens with a fear memory.

What I saw expressed in the TED talk was an exhausting pursuit of substitutes for feeling loved.

This February 18, 2016 blog post by Dr Arthur Janov framed the TED talk in the context that I understood the speaker:

“Most of us thought that once we choose a profession and follow it and succeed at it, becoming an expert and well known, that would be fulfilling. We would feel like a success.

Success is not a feeling, loved is.

Fame is other people’s idea of success; it is in a way their feeling…admiration, humbling, important, etc.

And why does the person, even most accomplished, never feel satisfied nor fulfilled?”

What do you feel is the appropriate context of the TED talk?

What do you think are likely outcomes of a person following the speaker’s guidelines?

Publicly-funded researchers need to provide unqualified free access to their studies

gettingwell4 0-1 star Wasted resources, Hippocampus, Limbic system, Memory

Starting the second year of this blog with a magazine article New Clues to How the Brain Maps Time reviewed the findings of a 2015 Boston rodent study During Running in Place, Grid Cells Integrate Elapsed Time and Distance Run. The article’s information was mixed such that when the reader arrived at this phrase:

“Moreover, time cells rely on context; they only mark time when the animal is put into a situation in which time is what matters most.”

it wasn’t clear whether the “time cells” referred to grid cells located in the entorhinal cortex (per the referenced study) or some other cells located in the hippocampus.

The hippocampus also has “time cells.” One of the first studies I curated when I started this blog one year ago today was Our memories are formed within a specific context. That 2014 study’s Significance section included:

“A number of recent studies have shown that the hippocampus, a structure known to be essential to form episodic memories, possesses neurons that explicitly mark moments in time.

We add a previously unidentified finding to this work by showing that individual primate hippocampal neurons not only track time, but do so only when specific contextual information (e.g., object identity/location) is cued.”

I attempted to disambiguate the “time cells” location by reading the 2015 study, only to find it was behind a paywall for which the public doesn’t have unqualified free access.

I assert that the study was performed using public funds, and that the researchers’ infrastructure and facilities were paid in part by the US taxpayers. Only US government funding sources were disclosed on the organization Mission Statement page of the study’s lead researcher, whose position is Lab Chief.

I assume that whether or not the study had unqualified free access was the researchers’ decision. Here’s a typical US NIH statement:

“The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.”

There are multiple problems with placing publicly-funded studies behind paywalls. One pertinent to this study and article was the accurate presentation of the study’s findings in news coverage.

The article’s author gave her interpretation of the study and the lead researcher’s remarks. She solicited five other researchers’ opinions, and one researcher provided an appraisal in the Comments section.

Was this treatment of the study’s findings sufficient for the public to understand what the US taxpayers paid for?

It was nice to have interpretations and remarks and opinions and appraisals, but these may have diverged from what the study actually found. Without unqualified free access to the study, there was no base on which to compare and contrast the article’s POVs.

Other news coverage of the study provided further examples of why publicly funded research needs to be freely available without qualification:

  • NPR’s coverage also confused the cells’ location: “If grid cells in the hippocampus and entorhinal cortex..”
  • An article carried by multiple sites headlined the cells as “Odometer neurons.” Did the study find that grid cells operated cumulatively like an odometer that began at some stage of the subjects’ development? Or did it find that the grid cells operated more like a trip meter?
  • In the Discover Magazine coverage the lead researcher stated: “..could point to ways to treat memory loss, whether from old age or illness, like Alzheimer’s disease.” Did the study actually find anything about “memory loss?” Was there anything in it about “old age or illness, like Alzheimer’s disease?”

As the study’s news coverage discrepancies and ambiguities demonstrated, there’s every reason for researchers to provide all the details of their work. We’re well past the days when “wise old men” selectively gate information flows.

Using twins to estimate the extent of epigenetic effects

gettingwell4 0-1 star Wasted resources, Epigenetics ,

This 2015 international study of intellectual disability used human twins to estimate the impact of genetic, shared-environment, and non-shared-environment on the study’s subjects:

  1. “Estimate of 0.46 (95% CI: 0.32–0.60) can be ascribed to genetic factors.
  2. Estimate of 0.30 (95% CI: 0.19–0.41) may be due to environmental factors involved in growing up in the same environment.
  3. The remaining 24% (95% CI: 0.18–0.29) of the difference is due to error of measurement and nonshared environmental influences.”

The primary causes of individual differences in DNA methylation are environmental factors used analysis of the study’s twin subjects’ CpG methylation compared to “CpGs displaying differential methylation in a healthy population (pDMCs)” to estimate:

  1. “37 % of the pDMCs genetic effects
  2. 3 % of the pDMCs had shared environment
  3. The remaining proportion of the non-genetic variance was due to non-shared environment and/or stochastic factors.”

Those researchers performed several additional tests to find and confirm:

“Non-shared environmental DMCs account for 64% of all detected DMCs.”

Comparing the two studies, the current study’s 32%-60% estimate of genetic effects encompassed the second study’s 37% estimate. However, the current study’s researchers treated their 18%-29% non-shared environment estimate as a remainder not warranting further investigation, whereas the second study’s researchers validated their 64% non-shared environment estimate.

Bringing in a third study, a relevant citation from Epigenetic consequences of early-life trauma: What are we waiting for? confirmed the second study’s estimates with a 2000 twin study that found:

“Environmental effects specific to the individual (63%), whilst genetic effects accounted for 37%. Subsequent studies have produced similar results.”

The Increased epigenetic brain capacity is an evolved human characteristic study found:

“The human brain is extensively shaped by its environment no matter its genetics.”

The epigenetic effects of each of our unique experiences of our non-shared environment predominately determine our individual physiology.

http://www.pnas.org/content/early/2015/12/23/1508093112.full.pdf “Discontinuity in the genetic and environmental causes of the intellectual disability spectrum”

Who chooses whether research is important enough to be funded?

gettingwell4 0-1 star Wasted resources

This 2015 Chicago study of biomedical research published over a 30-year period found:

“Biomedical scientists pursue conservative research strategies exploring the local neighborhood of central, important molecules.

Although such strategies probably serve scientific careers, we show that they slow scientific advance, especially in mature fields, where more risk and less redundant experimentation would accelerate discovery of the network.”

“Importance” was determined as an objective variable in the study, then simultaneously emphasized and disavowed by the lead researcher in an interview:

“The trick is to find something really important, and not being attacked by thousands of other people around the globe.

One protein and all its connections is surely important, but what is the objective measure of importance?

You need to think about networks and interacting parts, not one protein.”

and in the study’s Discussion section:

“Efficient discovery of radically new knowledge in a mature field, including many areas of biomedicine, requires abandoning the current focus on important, nearby chemicals.”

A researcher who wasn’t involved in the study commented:

“Greater synthesis, and step-wise progress may sometimes be more important than disruptive innovation.”

Rationale that it was important for “scientific advance” to abandon studies in areas closely related to important chemicals disregarded researchers’ individual interests. It was implausible that the study’s recommendation to publish all research failures would be implemented without being forced, which would again disregard individual interests.

The researchers made recommendations as if these could be carried out by people who hypothetically acted independently of their personal histories and interests when making decisions important for “scientific advance.”

Who are these people? Just one example would suffice.

If these recommendations would be enforced by systems without people, who gets the funding to design and put such systems into place? Would scientists’ participation be voluntary, or essentially mandatory in order to work in covered areas?

There are many influences on which research proposal receives funding, of course. I didn’t see any coverage in the study or in the accompanying news articles of the influences discussed in How do we assess “importance” in our lives? An example from scientists’ research choices. That study was referenced, but only for its data distribution characteristics.

The current study assessed the importance of research choices as if each individual scientist had no motivating personal history. The researchers may have achieved actionable findings if the study’s design and methodology better incorporated the hypothesis that scientists’ career and personal choices were influenced by whether or not the work made them feel important.

http://www.pnas.org/content/112/47/14569.full “Choosing experiments to accelerate collective discovery”

The function of the dorsal ACC is to monitor pain in survival contexts

gettingwell4 0-1 star Wasted resources, Amygdala, Anterior cingulate cortex, Brain hemispheres, Hippocampus, Limbic system, Thalamus

This 2015 California human study was of the dorsal anterior cingulate cortex (dACC):

“No neural region has been associated with more conflicting accounts of its function than the dACC.

The best psychological description of dACC function was related to pain processing—not executive, conflict, or salience processing.

We conclude by considering that physical pain may be an instance of a broader class of survival-relevant goals monitored by the dACC, in contrast to more arbitrary temporary goals, which may be monitored by the supplementary motor area.”

A related brain area – the paracingulate sulcus (PCS) – and its impact on the study’s findings was discussed in the supplementary material:

“The PCS is present in a subset of the population and thus extends the dACC further in the dorsal direction. This possible additional sulcus is relevant because, for some individuals, the ventral portion of the SMA [supplementary motor area]/pre-SMA may actually be the PCS.

The vast majority of fMRI studies overlook most individual differences in neuroanatomy and depend on the probabilistic neuroanatomy averaged across a group of participants and then on standard atlases that typically don’t take these individual differences into account.

There are two structural forms of PCS. The “prominent” form extends through the entire dACC region; however the “present” form begins in the rostral ACC and ends near the anterior border of the dACC.

Men are significantly more likely than women to have unilateral or bilateral PCS.

Additionally, six morphology studies have indicated the existence of a PCS that is left-lateralized.”

How about that? A brain area that:

  • Assists in monitoring pain in the contexts of survival goals;
  • Size, form, and placement varies widely among individuals;
  • Is missing in some people!

Here’s a long critique of the study that included dialog with the authors:

http://www.talyarkoni.org/blog/2015/12/14/still-not-selective-comment-on-comment-on-comment-on-lieberman-eisenberger-2015/

“If you observe activation in dACC..your single best guess as to what process might be involved..should be ‘motor’ by a landslide. You could also guess ‘reward’ or ‘working memory’ with about the same probability as ‘pain.’

Of course, the more general message you should take away from this is that it’s probably a bad idea to infer any particular process on the basis of observed activity.”

And the authors’ “last comment”:

https://www.psychologytoday.com/blog/social-brain-social-mind/201601/more-evidence-pain-related-description-dacc

“Based on Neurosynth evidence, is more of the dACC selective for pain than for attention, autonomic, avoidance, conflict, emotion, error, executive, fear, negative affect, response inhibition, response selection, reward, and salience? Absolutely.”

http://www.pnas.org/content/112/49/15250.full “The dorsal anterior cingulate cortex is selective for pain: Results from large-scale reverse inference”

A review of genetic and epigenetic approaches to autism

gettingwell4 0-1 star Wasted resources, Beliefs, Brain development, Cerebrum, Cortisol, Epigenetics, Glutamate, Hippocampus, Immune system, Limbic system, Neurochemicals, Serotonin, Stress, Telomeres, Thalamus , , , , , , , ,

This 2015 Chicago review noted:

“Recent developments in the research of ASD [autistic spectrum disorder] with a focus on epigenetic pathways as a complement to current genetic screening.

Not all children with a predisposing genotype develop ASD. This suggests that additional environmental factors likely interact with the genome in producing ASD.

Increased risk of ASD is associated with mutations in genes that overlap with chromatin remodeling proteins, transcriptional regulators and synapse-associated proteins. Interestingly, these genes are also targets of environmentally induced changes in gene expression.”

Evidence was discussed for both broad and specific epigenetic ASD causes originating in the prenatal environment:

  • Maternal stress:

    “Prenatal stress exerts a profound epigenetic influence on GABAergic interneurons by altering the levels of proteins such as DNMT1 and Tet1 and decreasing the expression of various targets such as BDNF.

    Ultimately, this results in reducing the numbers of fully functional GABAergic neurons postnatally and a concomitant increased susceptibility toward hyperexcitability. The delayed migration of GABAergic interneuron progenitors results in reduced gene expression postnatally which is likely the consequence of increased amounts of DNA methylation.

    The net effect of stress during early development is to disrupt the balance of excitatory/inhibitory neuronal firing due to the loss of function associated with disrupted neuronal migration and maturation.”

  • Prenatal nutrition:

    “Exposure to a wide range of environmental toxins that impact neurodevelopment also result in global DNA hypomethylation. This model was extended to connect pathways between dietary nutrition and environmental exposures in the context of DNA hypomethylation. More recently, this hypothesis was expanded to show how dietary nutrients, environmental toxins, genome instability and neuroinflammation interact to produce changes to the DNA methylome.”

  • Maternal infections:

    “Inflammation, autoimmunity and maternal immune activation have long been suspected in the context of aberrant neurodevelopment and ASD risk.”

  • Exposure to pollutants, medications, alcohol

This was a current review with many 2015 and 2014 references. However, one word in the reviewers’ vernacular that’s leftover from previous centuries was “idiopathic,” as in:

“Idiopathic (nonsyndromic) ASD, for which an underlying cause has not been identified, represent the majority of cases.”

It wasn’t sufficiently explanatory to use categorization terminology from thousands of years ago.

Science has progressed enough with measured evidence from the referenced studies that the reviewers could have discarded the “idiopathic” category and expressed probabilistic understanding of causes. They could have generalized conditional origins of a disease, and not reverted to “an underlying cause has not been identified.”

Another word the reviewers used was “pharmacotherapeutic,” as in:

“The goal for the foreseeable future is to provide a better understanding of how specific genes function to disrupt specific biological pathways and whether these pathways are amenable to pharmacotherapeutic interventions.”

Taking “idiopathic” and “pharmacotherapeutic” together – causes for the disease weren’t specifically identified, but the goal of research should be to find specific drug treatments?

Of course reviewers from the Department of Psychiatry, The Psychiatric Institute, University of Illinois at Chicago are biased to believe that “the design of better pharmacotherapeutic treatments” will fulfill peoples’ needs.

Are their beliefs supported by evidence? Without using drugs, are humans largely incapable of therapeutic actions such as:

  • Preventing epigenetic diseases from beginning in the prenatal environment?
  • Treating epigenetic causes for and alleviating symptoms of their own disease?

http://www.futuremedicine.com/doi/full/10.2217/epi.15.92 “Merging data from genetic and epigenetic approaches to better understand autistic spectrum disorder”

Psychological therapy and DNA methylation

gettingwell4 0-1 star Wasted resources, Amygdala, Cerebrum, Cortisol, Epigenetics, Hippocampus, Hypothalamus, Limbic system, Neurochemicals, Stress ,

This 2015 worldwide human study was:

“The largest study to date investigating the role of HPA [hypothalamic–pituitary–adrenal] axis related genes in response to a psychological therapy. Furthermore, this is the first study to demonstrate that DNA methylation changes may be associated with response to psychological therapies in a genotype-dependent manner.

In this study, we tested the association between polymorphisms of FKBP5 [a gene that produces a protein that dampens glucocorticoid receptor sensitivity primarily in areas of the limbic system such as the hippocampus and amygdala] and GR [glucocorticoid receptor gene] and response to CBT [cognitive behavior therapy] in children with anxiety disorders (N = 1,152), and examined change in DNA methylation at specific regions of these genes during the course of CBT in a subset of the sample (n = 98).

No significant association was found between GR methylation and response. Allele-specific change in FKBP5 methylation was associated with treatment response.”

Regarding “treatment response:”

“Subjects aged 5–18 (mean: 9.8 years) met DSM-IV criteria for primary diagnosis of an anxiety disorder.

Clinical severity ratings (CSRs) were usually based on composite parent and child reports, and were assigned on a scale of 0–8. [36] [linked below]

Treatment response was defined as the change in primary anxiety disorder severity from pretreatment to follow-up. A diagnosis was made when the child met diagnostic criteria and received a CSR of 4 or more. Remission was regarded as the absence of the primary anxiety according to diagnostic criteria, as determined by the clinicians at the follow-up interview.”

Scenarios where nine-year-olds and their parents may have benefited from skewing their “composite parent and child reports” either way:

  1. Parents benefited from an anxious-child report (financial support provided, social services provided, avoided undesirable activities like going to work, continued psychological dependence, provided victim celebrity, enabled their own problems)
  2. Parents benefited from a well-child report (freed up time to pursue desirable activities, financial relief, relief from court-ordered or social-services-required activities, covered up their own contributions to the child’s problems)
  3. Nine-year-olds benefited from an anxious report (relief from undesirable activities like school attendance, continued psychological dependence, provided victim celebrity, activities structured around their condition, enabled the parents’ problems)
  4. Nine-year-olds benefited from a well report (symptom reduction, met parental expectations, freed up time to pursue desirable activities, covered up the parents’ contributions to the child’s problems).

I wonder what “treatment response” criteria were available other than self-serving reports and “diagnostic criteria, as determined by the clinicians.” Every day medical personnel hear patients self-report conditions where biological measurements may confirm or indicate something different. Did the “diagnostic criteria, as determined by the clinicians” include comparisons to relevant biological measurements?

The related study linked below points out:

“Although CBT has been established as an efficacious treatment, roughly 40% of children retain their disorder after treatment.”

Its focus was also on predictors (other than genetic) of CBT outcomes.

Neither study provided evidence of attempts to find originating causes for the children’s conditions. Were the international CBT approaches only interested in treating symptoms?

http://onlinelibrary.wiley.com/doi/10.1002/da.22430/full “HPA AXIS RELATED GENES AND RESPONSE TO PSYCHOLOGICAL THERAPIES: GENETICS AND EPIGENETICS”

Related 2015 study: http://www.jaacap.com/article/S0890-8567%2815%2900191-4/pdf “Clinical Predictors of Response to Cognitive-Behavioral Therapy in Pediatric Anxiety Disorders: The Genes for Treatment (GxT) Study”

Fetal exposure to sex hormones and female anxiety

gettingwell4 0-1 star Wasted resources, Amygdala, Brain development, Cortisol, Epigenetics, Glutamate, Hippocampus, Hypothalamus, Limbic system, Neurochemicals, Serotonin, Stress, Testosterone

This 2015 Swedish rodent study found:

“Women with polycystic ovary syndrome (PCOS) display high circulating androgen levels that may affect the fetus and increase the risk of mood disorders in offspring.

Although clinical data are inconsistent, there are indications that androgens play a crucial role in behavior and mood regulation in females.

Studies on the link between testosterone and anxiety behavior in males have generated inconsistent results.

Higher circulating testosterone has previously been reported in female rat PNA [prenatal androgen] offspring. This discrepancy may be a result of the higher doses of maternal testosterone (5 mg) used in the previous study compared with the present study (0.5 mg).

Although the anxiety-like behavior observed in the female PNA offspring in the present study cannot be directly explained by high circulating androgens, the reduced AR [androgen receptor] expression in the amygdala suggests a compensatory response to the high prenatal testosterone exposure, a result implicating the amygdala as the CNS site underlying the changes in anxiety in the PNA offspring. This idea is further strengthened by our experiment showing that subchronic testosterone exposure into amygdala is sufficient to produce anxiety-like behavior in adult females.

Maternal testosterone exposure causes anxiety-like behavior in female, and to a lesser extent male offspring, an effect that seems to occur during fetal life and to be mediated via AR in the amygdala, together with changes in ER [estrogen receptor] and in the serotonergic and GABAergic pathways in the amygdala and hippocampus of female PNA rats.”

The news coverage – too much testosterone caused anxiety-like symptoms in females whether they are adults or fetuses – was NOT what the study found. The headlines disregarded its caveat:

“The anxiety-like behavior observed in the female PNA offspring in the present study cannot be directly explained by high circulating androgens.”

I look forward to research on floor levels of testosterone, below which there are also adverse effects on females. There is such evidence, but would it play well with popular memes?

See Sex hormone exposure to the developing female fetus causes infertility in adulthood for another study that used the PCOS phenotype.

http://www.pnas.org/content/112/46/14348.full “Maternal testosterone exposure increases anxiety-like behavior and impacts the limbic system in the offspring”

Be human, not sheepish

Video gettingwell4 0-1 star Wasted resources

This 2015 study was of the collective behavior of sheep, to:

“Alternate slow group dispersion in space with rapid aggregation phenomena induced by a sudden behavioral shift at the individual level.

The behavioral shift occurs without any perceived threat in the neighborhood, resulting in a spontaneous transition at the collective level that can be interpreted as a consequence of random individual decisions.”

The researchers’ assertion that the “sudden behavioral shift” was due to “random individual decisions” had a lot to do with facilitating their model.

If the researchers had taken individual neurobiological measurements, they may have found that these were non-random actions, deterministically driven by instincts or needs, instead of “random individual decisions.”

http://www.pnas.org/content/112/41/12729.full “Intermittent collective dynamics emerge from conflicting imperatives in sheep herds”

A missed opportunity to study image-evoked emotional memories

gettingwell4 0-1 star Wasted resources, Hippocampus, Limbic system, Memory

This 2015 Ohio human study found that the:

“Hippocampus integrates distinct experiences, thereby providing a scaffold for encoding and retrieval of autobiographical memories.”

The researchers ignored the hippocampus’ role in emotional memories, although studies such as Emotional memories and out-of-body–induced hippocampal amnesia have shown emotional involvement to be desirable in order to properly study the hippocampus with human subjects.

The researchers missed quite a few good opportunities to advance science. Consider these opportunities:

  • All subjects were instructed during fMRI scans (here’s a video of one subject) to:

    “Try to remember the event depicted in each picture and relive the experience in their mind while viewing the photo for eight seconds.”

    The photos were taken during each subject’s day-to-day life by a smartphone hung around their neck. Following these instructions created an ideal situation for engaging the subjects’ emotions when they successfully remembered and relived. Although the experiment probably engaged the subjects’ emotions;

  • None of the subjects were asked anything that would lead the researchers to discover WHY the subjects remembered! The researchers had a perfect setup to make even a bare-bones inquiry, or to ask the subjects to immediately rate the emotional impact of each remembered event/relived experience, or to have them identify what emotions were evoked. But the researchers didn’t use any emotional measures to help understand how and why events were remembered or not.
  • Wouldn’t it also have potentially helped the subjects to become somewhat aware of how they processed memories, of how they felt with each remembered event/relived experience? They probably wouldn’t have remembered personally unimportant events, or forgotten personally significant ones.

  • “One subject recalled all of the items presented” and another had “very few unrecalled items.”

    Why? Weren’t the researcher interested in what was potentially the same between these two and different from the other subjects?

The researchers instead focused on rodent studies with statements such as:

“Validating the relevance of decades of rodent studies for human memory.”

They lost track of the reason rodent studies exist: to help humans.

In order for the research to help humans, move forward on the evolutionary scale, not backward! A rat or mouse can’t define and describe the emotional impact of an image of their life that evokes a memory.

http://www.pnas.org/content/112/35/11078.full “Human hippocampus represents space and time during retrieval of real-world memories”

Emotionless brain research that didn’t deal with human reality

gettingwell4 0-1 star Wasted resources, Amygdala, Anterior cingulate cortex, Brainstem, Cerebrum, Hippocampus, Limbic system, Lower brain, Thalamus

Are tasks you do at work and home never influenced by emotional content or contexts?

Does your ability to focus on a task always have nothing to do with your emotional state?

The researchers who designed this 2015 Boston human study acted as if both of your answers to these questions were “Yes” by stripping out any emotional content from their experiments. As a result, this study which purported to:

“Have the potential to provide additional insights into how inhibitory control may break down in a wide variety of individuals with neurological or psychiatric difficulties”

couldn’t achieve anything near its goal.

This study included fMRI scans of subjects’ entire brains. Limbic system areas were in 3 of the 5 modules, and lower brain areas were in one.

Functional MRI signals depend on changes in blood flow that follow changes in brain activity. Given this study’s goal, did it make sense for researchers to design experiments that didn’t actively engage scanned areas of subjects’ brains?

It wasn’t all that difficult to include emotional content that could potentially contribute to the purported goal. This 1996 review described studies that developed varieties of emotional content with the same test type (Stroop) used. Presumably these approaches had made progress since 1996 incorporating emotional content in Stroop tests given to normal people, who were subjects in this study.

http://www.pnas.org/content/112/32/10020.full “Flexible brain network reconfiguration supporting inhibitory control”