In an exercise study conducted by researchers at the Oregon Research Institute, tai chi training resulted in improved postural stability and walking ability, as well as reduced falls in the participants.

“These results are clinically significant because they suggest that Tai Chi, a low-to-moderate impact exercise, may be used as an add-on to current physical therapies, to address some of the key clinical problems in Parkinson’s disease, such as postural and gait instability,” said Fuzhong Li, Ph.D.

“Since many training features in the program are functionally oriented, the improvements in the balance and gait measures that we demonstrated highlight the potential of tai chi-based movements in rehabilitating patients with these types of problems and, consequently, easing cardinal symptoms of Parkinson’s disease and improving mobility, flexibility, balance, and range of motion.”

In the four-year project funded by the National Institute of Neurological Disorders and Stroke, researchers randomly assigned 195 patients to one of three exercise groups: tai chi, resistance training, or stretching. The patients participated in 60-minute exercise sessions twice a week for 24 weeks.

The results of the study showed that the tai chi group performed consistently better than the stretching group in how far they could lean in any direction without losing balance, as well as demonstrating better levels of directional control of the body and walking ability, such as longer stride length. tai chi participants also outperformed those in the resistance training group on the balance and stride length measures.

Finally, tai chi training was shown to significantly lower the incidence of falls compared to stretching, and was as equally effective as resistance training in reducing falls.

As Parkinson’s disease progresses, patients lose stability and have trouble walking, difficulty managing activities required of daily living, and experience frequent falls. Exercise is an important part of the management of Parkinson’s disease because physical activity has been shown to retard the deterioration of motor function and to prolong functional independence. However, research on alternative forms of exercise, such as tai chi, that could improve balance, gait, and function in patients with Parkinson’s disease is scarce, the researcher notes.

The program developed by Li consisted of six tai chi movements integrated into a routine that focused on weight-shifting, controlled-displacement of the center of gravity over the base of support, ankle sway, and front-to-back and sideways stepping. Natural breathing was integrated into the training routine.

“There are a number of practical advantages to using tai chi to improve motor dysfunction of Parkinson’s disease,” he said. “It is a low-cost activity that does not require equipment, it can be done anywhere, at any time, and the movements can be easily learned. It can also be incorporated into a rehabilitation setting as part of existing treatment. Similarly, because of its simplicity, certain aspects of this tai chi program can also be prescribed to patients as a self-care/home activity.”

Source: Oregon Research Institute

Elderly man performing tai chi photo by shutterstock.

The research on brain activity during competitive social interactions is described in a paper in the Proceedings of the National Academy of Sciences.

Experts say this is the first investigation to use a computational approach to analyze differing patterns of brain activity during these interactions.

“When players compete against each other in a game, they try to make a mental model of the other person’s intentions, what they’re going to do and how they’re going to play, so they can play strategically against them,” said University of Illinois postdoctoral researcher Kyle Mathewson, Ph.D. “We were interested in how this process happens in the brain.”

Previous studies have tended to consider only how one learns from the consequences of one’s own actions, called reinforcement learning, Mathewson said.

These studies have found heightened activity in the basal ganglia, a set of brain structures known to be involved in the control of muscle movements, goals and learning. Many of these structures signal via the neurotransmitter dopamine.

“That’s been pretty well studied and it’s been figured out that dopamine seems to carry the signal for learning about the outcome of our own actions,” Mathewson said.

“But how we learn from the actions of other people wasn’t very well characterized.”

Researchers call this type of learning “belief learning.”

Investigators used functional magnetic resonance imaging (fMRI) to track activity in the brains of participants while they played a competitive game, called a Patent Race, against other players.

The goal of the game was to invest more than one’s opponent in each round to win a prize (a patent worth considerably more than the amount wagered), while minimizing one’s own losses (the amount wagered in each trial was lost). The fMRI tracked activity at the moment the player learned the outcome of the trial and how much his or her opponent had wagered.

A computational model evaluated the players’ strategies and the outcomes of the trials to map the brain regions involved in each type of learning.

“Both types of learning were tracked by activity in the ventral striatum, which is part of the basal ganglia,” Mathewson said. “That’s traditionally known to be involved in reinforcement learning, so we were a little bit surprised to see that belief learning also was represented in that area.”

Belief learning also spurred activity in the rostral anterior cingulate, a structure deep in the front of the brain. This region is known to be involved in error processing, regret and “learning with a more social and emotional flavor,” Mathewson said.

The findings offer new insight into the workings of the brain as it is engaged in strategic thinking, says co-author Ming Hsu. This in turn may aid the understanding of neuropsychiatric illnesses that undermine those processes.

“There are a number of mental disorders that affect the brain circuits implicated in our study,” Hsu said.

“These include schizophrenia, depression and Parkinson’s disease. They all affect these dopaminergic regions in the frontal and striatal brain areas. So to the degree that we can better understand these ubiquitous social functions in strategic settings, it may help us understand how to characterize and, eventually, treat the social deficits that are symptoms of these diseases.”

Source: University of Illinois

Woman playing cards photo by shutterstock.

The finding, reported in the online version of The Lancet Neurology journal is published by researchers at the University of Florida and 14 additional medical centers.

In the study, sponsored by a manufacturer of DBS devices, researchers found a constant current device helped to manage the symptoms of Parkinson’s.

Investigators say the device is designed to reduce tremors, improve the slowness of movement, decrease the motor disability of the disease and reduce involuntary movements that often are a side-effect of Parkinson medications.

After treatment, researchers analyzed 136 patient diaries and discovered longer periods of effective symptom control — known as “on time” — without involuntary movements.

“On time” for patients who received stimulation increased by an average of 4.27 hours compared with an increase of 1.77 hours in the group without stimulation.

Patients also noted overall improvements in the quality of their daily activities, mobility, emotional state, social support and physical comfort.

“I think it is safe to say since dopamine treatment emerged in the 1960s, DBS has been the single biggest symptomatic breakthrough for Parkinson patients who have experienced the fluctuations associated with levodopa therapy,” said Michael S. Okun, M.D., first author of the study, and the National Medical Director for the National Parkinson Foundation.

“This study validates the use of mild electrical currents delivered to specific brain structures in order to improve Parkinson’s disease in select patients with advanced symptoms, and additionally, it explored a new stimulation paradigm. Future improvements in devices and the delivery systems for DBS will hopefully provide exciting new opportunities for Parkinson’s sufferers.”

Researchers studied the effects of DBS on patients who have had Parkinson’s disease for five years or more. They were randomly assigned to a control group that delayed the onset of stimulation for three months, or a group whose stimulation began shortly after surgery.

All patients were followed for 12 months.

The deep brain stimulation procedure involves surgeons implanting small electrodes into an area of the patient’s brain that controls movement. The electrodes are connected to a device precisely programmed to use mild electrical current to modulate problematic brain signals that result in movement problems.

Technological advances over the past decade have greatly improved the ability to deliver and control DBS.

In the current study, voltage-controlled DBS devices delivered pulses of current that varied slightly with surrounding tissue changes.

Researchers believe the current system enables patients to have better motor control and an improvement in their quality of life when compared to the control group. The U.S. Food and Drug Administration approved the use of DBS for Parkinson’s disease in 2002.

At least 500,000 people in the United States suffer from Parkinson’s with about 50,000 new cases reported annually, according to the National Institute of Neurological Disorders and Stroke. These numbers are expected to increase as the average age of the population rises.

“The study answered some very important questions concerning cognition and mood with lead implantation (alone) versus implantation with stimulation. It also refutes the hypothesis that DBS increases depressive symptoms,” said Gordon H. Baltuch, M.D., Ph.D.

“The group’s results also showed a decrease in the infection rate to 4 percent from previously published 10 percent. It shows that American neurosurgeons and neurologists with their industry partners are improving the safety of this procedure and working in a collaborative fashion.”

Comparable with other large DBS studies, the most common serious adverse event revealed was infection, which occurred in five patients. Likewise, some participants also reported an increase in the occurrence of slurred speech, known as dysarthria.

“Technology is on the move, and we expect to see continued improvements to DBS approaches, equipment and materials,” said Okun. “DBS has set the bar high for the development of new therapies for advanced Parkinson’s disease patients.”

Source: University of Florida

PET technology is an advanced radiological method that provides functional images of biological processes. In the analysis, researchers discovered a molecular imaging technique that combines PET with an injected biomarker called 18F-FDG helps to pinpoint key areas of metabolic decline in the brain indicating dementia.

Researchers believe use of PET will provide clinicians with physiological evidence of neurodegenerative disease. This knowledge will expedite and improve the accuracy of physician diagnosis.

“The new data support the role of 18F-FDG PET as an effective addition to other diagnostic methods used to assess patients with symptoms of dementia,” said Nicolaas Bohnen, M.D., Ph.D., lead author of the study.

“The review also identified new literature showing the benefit of this imaging technique for not only helping to diagnose dementia but also for improving physician confidence when diagnosing a patient with dementia. This process can be difficult for physicians, especially when evaluating younger patients or those who have subtle signs of disease.”

Dementia is a challenging diagnosis because it is not a specific illness but a pattern of symptoms characterized by a loss of cognitive ability. Cognitive decline may be caused by injury or progressive disease affecting areas of the brain that control attention, memory, language and mobility.

Alzheimer’s is most commonly associated with progressive memory impairment, although dementia with Lewy bodies can be associated with symptoms of Parkinson’s and prominent hallucinations. Another disorder, called frontotemporal dementia, is found in patients showing uncharacteristic personality changes and difficulties in relating and communicating.

Researchers believe expanded use of FDG-PET will help physicians diagnose dementia and help differentiate between disorders.

Already, the diagnosis of dementia includes a criteriion that physicians use evidence from molecular imaging studies.

“For the first time, imaging biomarkers of Alzheimer’s disease are included in the newly revised clinical diagnostic criteria for the disease,” said Bohnen.

“This is a major shift in disease definition, as previously an Alzheimer’s diagnosis was based mainly on a process of evaluating patients to exclude possible trauma, hemorrhage, tumor or metabolic disorder. Now it is becoming a process of inclusion based on biomarker evidence from molecular imaging.”

“The earlier we make a diagnosis, the more we can alleviate uncertainty and suffering for patients and their families.”

The biomarker 18F-FDG is among a variety of imaging agents being investigated for its efficacy in Alzheimer’s imaging.

As treatments for dementia become available for clinical use, PET will no doubt play an important role in not only the diagnosis of these diseases, but also the assessment and monitoring of future therapies.

According to the World Health Organization, an estimated 18 million people worldwide are currently living with Alzheimer’s disease. That number is projected to almost double by 2025.

The research is found in the current issue of The Journal of Nuclear Medicine.

Source: Society of Nuclear Medicine

Low levels of vitamin D already are associated with a range of health condition including osteoporosis, cardiovascular diseases, neurological ailments and many other disorders. However, experts do not agree on the ideal level of the vitamin and even if supplements can improve health.

In the new study — published in Mayo Clinic Proceedings – researchers believe they have confirmed that an inverse relationship does exist between vitamin D and depression. The issue turned muddy after smaller studies produced conflicting results about the relationship between vitamin D and depression.

Major depressive disorders affect nearly one in 10 adults in the U.S.

“Our findings suggest that screening for vitamin D levels in depressed patients – and perhaps screening for depression in people with low vitamin D levels – might be useful,” said Dr. E. Sherwood Brown, professor of psychiatry at UT Southwestern and senior author of the study. “But we don’t have enough information yet to recommend going out and taking supplements.”

Researchers examined the results of almost 12,600 participants from late 2006 to late 2010. Brown and colleagues found that higher vitamin D levels were associated with a significantly decreased risk of current depression, particularly among people with a prior history of depression.

This could reflect the fact that vitamin D levels are influenced by getting ultraviolet-light exposure, often by exercising in the outdoors — a behavior that reduces depression. Further, high Vitamin D levels could occur because a person has a strong self-worth and follows a healthy diet.

Among the study participants, researchers discovered low vitamin D levels were associated with depressive symptoms, particularly those with a history of depression. Because of this, investigators believe assessing Vitamin D levels among primary care patients with a history of depression may be an effective screen for potential relapse.

The study did not address whether increasing vitamin D levels reduced depressive symptoms. And, experts have not determined the exact relationship — whether low vitamin D contributes to symptoms of depression, whether depression itself contributes to lower vitamin D levels, or chemically how that happens.

However, vitamin D may affect neurotransmitters, inflammatory markers and other factors, which could help explain the relationship with depression, said Brown.

Vitamin D levels are now commonly tested during routine physical exams, and they already are accepted as risk factors for a number of other medical problems: autoimmune diseases; heart and vascular disease; infectious diseases; osteoporosis; obesity; diabetes; certain cancers; and neurological disorders such as Alzheimer’s and Parkinson’s diseases, multiple sclerosis, and general cognitive decline.

Source: UT Southwestern Medical Center

Woman drinking milk photo by shutterstock.

Researchers say the evidence suggest that young women who display signs of either depression or binge eating should be screened for both disorders.

“Binge-eating prevention initiatives should consider the role of depressive symptoms and incorporate suggestions for dealing with negative emotions,” say the authors.

This study could provide important new opportunities to address the nation’s obesity epidemic, according to senior author Alison Field, Sc.D., an epidemiologist at Harvard Medical School and the Harvard School of Public Health.

Researchers say the new investigation is the largest to look at the relationship between binge eating and depression during adolescence, when most eating disorders develop.

The study authors defined binge eating as eating a large amount of food in a short amount of time and feeling a lack of control over eating during the episode. Researchers labeled girls who ate large amounts of food but did not feel out of control “overeaters.”

The findings rely on surveys conducted as part of the nationwide Growing Up Today Study.

The authors focused on girls because eating disorders and depression are more common in females than in males. Investigators analyzed data from nearly 5,000 girls aged 12 to 18 who answered questions in 1999, with follow-up surveys in 2001 and 2003.

Teens and young women who reported in the first survey that they always or usually felt “down in the dumps” or “depressed” were about twice as likely as others were to start overeating or binge eating during the following two years.

“The most common approach to obesity has been to focus on eating better and exercising more, but many pathways can lead to being overweight,” said Marian Tanofsky-Kraff, Ph.D., who studies eating disorders, told the Health Behavior News Service. 

“There is a group of people where it may be more psychologically driven. Targeting some of these psychological factors might help prevent obesity.”

“Binge eaters or overeaters can be very secretive, so parents may be unaware that there’s a problem. That’s a really important message for clinicians,” added Field. “If they have patients who are depressed, they need to ask about disordered eating patterns and vice versa.”

Source: Health Behavior News Service

Teenager with mirror photo by shutterstock.

Researchers from Boston University and Case Western Reserve University showed that changing the way something looks — in this case, the cards in the game Bingo — can enhance performance. Their paper discussing the investigation is published online in the journal Aging, Neuropsychology, and Cognition.

The paper, entitled “Bingo! Externally supported performance intervention for deficient visual search in normal aging, Parkinson’s disease, and Alzheimer’s disease,” was published in a special issue on cognitive and motivational mechanisms.

Researchers focused on interventions that help individuals compensate for age-related or disease-induced limitations related to performance of complex cognitive tasks. The researchers chose to investigate the game of Bingo because it is a popular and familiar leisure activity.

For the activity, players generally try to keep track of multiple cards at once to increase their odds of winning — but this is made difficult by the fact that Bingo cards used in community games are rather small and faint in print.

As such, players use aspects of vision that have been shown to be impaired to varying degrees in normal aging and in the common neurodegenerative disorders of Parkinson’s disease and Alzheimer’s disease.

The researchers investigated whether players’ Bingo performance could be improved by making the cards larger and the numbers on them bolder, and by decreasing the amount of cards played at one time.

Participants in the study were 19 healthy younger adults, 33 healthy older adults, 14 individuals with probable Alzheimer’s disease, and 17 non-demented individuals with Parkinson’s disease.

The researchers found that increasing card size and decreasing visual complexity through reducing the number of cards to search resulted in improvements in performance by all groups.

“It is basic and simple to increase the size and decrease the complexity of the visual aspects of an everyday task, yet it helped each of the groups we studied,” said researcher Thomas Laudate, Ph.D., lead author of the study.

Researchers believe the participants with Alzheimer’s disease received additional benefit from increased the visual boldness of the numbers on the cards, which presumably compensated for the patients’ reduced contrast sensitivity.

A important finding from the study is the benefit of focusing on a variety of sensory inputs to improve performance.

“This research helps show that those with Alzheimer’s disease have visual deficits that interfere with functioning but they can be helped by increasing the contrast, or boldness, of the things they see,” said Laudate.

Researcher Alice Cronin-Golomb, Ph.D., concurred. “We focus so much on memory impairments that we sometimes forget that older adults can have impairments in other domains, too, such as in vision. We can’t fix memory very well but we have a whole arsenal of techniques to improve vision, and with that comes an improved quality of life.”

The study confirms prior findings that enhancing visual aspects of the environment improves the ability to engage in a wide range of vital everyday activities including reading, eating, taking medication and recognizing faces and objects, even in those with cognitive difficulties.

The improved functioning observed in healthy elders and in those with Parkinson’s or Alzheimer’s suggests the value of external visual support as an effective, easy-to-apply intervention to compensate for visual impairments.

Source: Boston University College of Arts & Sciences

Man wearing glasses photo by shutterstock.

The substance, called “phosphorylated alpha-synuclein,” is common in people with Parkinson’s disease.

“A blood test for Parkinson’s disease would mean you could find out if a person was in danger of getting the disease, before the symptoms started,” said David Allsop, Ph.D. “This would help the development of medicines that could protect the brain, which would be better for the quality of life and future health of older people.”

To develop the blood test for Parkinson’s disease, Allsop and colleagues studied a group of people diagnosed with the disease and a second group of healthy people of a similar age.

Blood samples from each group were analyzed to determine the levels of phosphorylated alpha-synuclein present. They found those with Parkinson’s disease had increased levels of the substance.

Based upon these findings, researchers developed a blood test that detects the presence of phosphorylated alpha-synuclein, which could allow for diagnosis of the disease well before symptoms appear but when brain damage has already begun to occur.

“When most people think of Parkinson’s disease, they think of the outward symptoms, such as involuntary movements,” said Gerald Weissmann, M.D., Editor-in-Chief of the FASEB Journal, “but many people with Parkinson’s also develop neurological problems that may be more difficult to detect right away.

“Having a blood test not only helps doctors rule out other possible causes of the outward symptoms, but it also allows for early detection which can help patients and their caregivers prepare for the possibility of the mental, emotional, and behavioral problems that the disease can cause.”

The report explaining the discovery and test development process is found in the FASEB Journal.

Source: Federation of American Societies for Experimental Biology

Man getting blood test photo by shutterstock.

Biochemists Drs. Marco Prado and Vania Prado, and a team of researchers at the Schulich School of Medicine & Dentistry’s Robarts Research Institute used genetically modified mice and high-level behavior and imaging techniques to study the function of neurons and neurotransmitters in the striatum, the region of the brain affected in Parkinson’s, Huntington’s, and other motor diseases.

The research team was particularly interested in the neurotransmitter acetylcholine and its effect on brain function.

By using genetic techniques to eliminate the secretion of acetylcholine in mice, the researchers were able to show that neurons that use acetylcholine are also responsible for a secondary function.

“The surprise was that these neurons in the striatum actually do two different jobs,” said Marco Prado.

These neurons release acetylcholine, but they also secrete a neurotransmitter called glutamate. Prado and his colleagues found that they could get rid of acetylcholine secretion without disturbing brain function.

“This suggests that perhaps glutamate secreted by these neurons plays a more important role in this part of the brain than was originally suspected,” he said.

The researchers also showed that acetylcholine, glutamate and dopamine have a special relationship and that the elimination of acetylcholine secretion boosted the actions of dopamine. This may have important applications to Parkinson’s disease because increased function of dopamine has been shown to improve motor symptoms in the disease, the researchers note.

Prado says the next steps in their research will be to eliminate acetylcholine secretion in Parkinson’s disease mouse models to see if there are improvements in the motor symptoms.

“We suspect there will be improvement because in Parkinson’s disease, in addition to the loss of dopamine, this group of neurons that secrete acetylcholine becomes abnormally hyperactive,” he said.

The hope is to eventually produce a drug to block acetylcholine release selectively in the striatum. If their suspicions are correct, this should help in Parkinson’s disease by blocking the activity of these neurons without having any other negative effects on brain function.

Source: The University of Western Ontario

Paola Dazzan, Ph.D., and Janaina Mourao-Miranda, Ph.D., reported using computer algorithms to analyze magnetic resonance imaging (MRI) scans and assess a mental health patient’s outcome.

The use of computer technology to quantify the risk of further episodes of disease is common in areas of medicine such as cardiovascular medicine and oncology, but no accurate tests were available to psychiatrists. Historically, brain imagining by MRIs to detect the subtle and difficult changes in the brain associated with psychosis have been of limited benefit for clinical practice.

“This is the first step towards being able to use brain imaging to provide tangible benefit to patients affected by psychosis,” said Dazzan.

Psychosis refers to an abnormal condition of the mind and is a term often used for more severe forms of psychiatric disorder, during which hallucinations and delusions and impaired insight may occur.

The most common forms are part of mental health conditions such as schizophrenia and bipolar disorder, but symptoms of psychosis can also occur in conditions such as Parkinson’s disease and alcohol or drug abuse.

Many patients recover from psychosis with minimal symptoms, but for others, the psychosis can be persistent and can affect their ability to function and lead a normal life.

Currently, physicians are generally unable to predict a person’s risk of future episodes of psychosis. Uncertainty over the course of the illness compromises patient counseling and development of a treatment plan.

Dazzan and colleagues worked with a cohort of 100 patients, taking MRI brain scans when they presented to clinical services with a first psychotic episode.

In addition, the researchers scanned the brains of a control group of 91 healthy individuals. The patients were followed up around six years later and classified as having developed a continuous, episodic or intermediate illness course, depending on whether their symptoms remitted or not during this time.

From this larger sample, the researchers then analyzed scans from 28 subjects with a continuous course of illness, the same number from patients with an episodic course and again, the same number from healthy controls.

The scans were then used to develop pattern recognition software to distinguish between the different severities of the illness. The algorithm, applied to the scans collected at the first episode of psychosis, was able to differentiate between patients who then went on to develop continuous psychosis and those who went on to develop a more benign, episodic psychosis in seven out of 10 cases.

“Although we have some way to go to improve the accuracy of these tests and validate the results on independent large samples, we have shown that in principle it should be possible to use brain scans to identify at the first episode of illness both patients who are likely to go on to have a continuous psychotic illness and those who will develop a less severe form of the illness,” said Mourao-Miranda.

“This suggests that even by the time that they have their first episode of psychosis, significant changes have already occurred to their brains.”

According to Dazzan, “This could in future offer a fast and reliable way of predicting the outcome for an individual patient allowing us to optimize treatments for those most in need, while avoiding long-term exposure to antipsychotic medications in those with very mild forms.

“Structural MRI scans can be obtained in as little as 10 minutes and so this technique could be incorporated into routine clinical investigations. The information this provides could help inform the treatment options available to each patient and help us better manage their illness.”

The study findings are found in the journal Psychological Medicine.

Source: Wellcome Trust

Researchers are using genetic engineering and growth factors to reprogram the skin cells of patients with schizophrenia, autism, and other neurological disorders and grow them into brain cells in the laboratory.

Researchers using these new techniques can also detect inherent defects in how neurons develop or function. They can also more closely see and measure what environmental toxins or other factors prod neurons and synpases to misbehave in the petri dish.

With these “diseases in a dish” they also can test the effectiveness of drugs that can right missteps in development, or counter the harm of environmental insults.

One outgrowth of the research is to measure the impact psychiatric medications have on specific disorders. Not fully matured cultured neurons are taken from people who have been diagnosed with a mental disorder, such as schizophrenia. Then a psychiatric drug is applied to these cells and the result is studied.

“One surprise is that neurons appear to undergo structural changes when they are given neuropsychiatric drugs,” says neuroscientist Fred Gage, a professor of genetics at the Salk Institute for Biological Studies and member of the executive committee of the Kavli Institute for Brain and Mind (KIBM).

“This is unexpected, as since the 1970’s companies have developed neuropsychiatric drugs on the premise that you modulate mood by regulating the amount of chemical signals available in the brain. These chemical signals are called neurotransmitters, and consequently the drugs have focused on modulating neurotransmitters such as dopamine and serotonin.

Researchers say that it’s not just the moment-to-moment regulation of dopamine and other neurochemicals that may be affecting the symptoms of a mental disorder. It may be, more importantly, how these synapses are structured and interact with one another.

“As we accumulate models for these diseases — bipolar disease, schizophrenia, depression, autism — we are going to be able to explore if there are really differences between them that exist on a cellular or gene expression level,” says Gage.

Source: The Kavli Foundation

The comment by a group of neurologists is found in this week’s New England Journal of Medicine.

As described in a Letter to the Editor, such medical misinformation may confuse patients suffering from devastating neurological disorders and seeking health information and advice online.

In this instance, dozens of YouTube videos show people who supposedly have movement disorders such as Parkinson’s disease, dystonia or tremor demonstrating and talking about their symptoms.

“Many of the videos seemed to us to be atypical for the specific form of movement disorder the person in the video was purported to have,” researchers wrote.

Neurologists at University College London began the study in January 2011 when patients alerted them that online videos often proposed a diagnosis and suggested therapies.

Seven neurologists from different countries and medical institutions searched YouTube and found videos allegedly depicting various movement disorders. They then independently reviewed the top three percent most-watched videos that were of sufficient quality to review patient symptoms.

Out of 29 videos, the majority (66 percent) were identified by the neurologists as showing “psychogenic” disorders, meaning that the abnormal movement originates from a psychological condition or mental state rather than a disease with a physical cause, such as Parkinson’s. The doctors reviewing the videos did so independently, yet their diagnoses agreed in 87 to 100 percent of all cases.

Of these videos, more than half contained advice about specific therapies to treat what they identified as a movement disorder.

YouTube happens to be the third most visited website on the Internet, and is often a platform for patients to share personal medical stories and experiences. The doctors’ review should remind individuals to seek credible sites when searching for health information.

“Patients and doctors have to be very thoughtful and careful when looking for information on YouTube, as well as the Internet in general,” commented Mark Hallett, M.D., senior investigator at the National Institute of Neurological Disorders and Stroke (NINDS) at the National Institutes of Health.

“There is a great deal of good information on the Internet, but one has to be careful.”

Source: NIH/National Institute of Neurological Disorders and Stroke

The study is published in the American Journal of Human Genetics.

Scientists say the study offers a direct insight into how a gene can lead to death of brain cells, resulting in Parkinson’s disease and related neurodegenerative disorders.

This particular gene, EIF4G1, is unique because unlike others that have been found to cause Parkinson’s disease, it controls the levels of proteins that help a cell cope with different forms of stress, such as those routinely found in aging cells.

Given the function of this gene, the discovery opens up a new area of research within Parkinson’s disease and other neurodegenerative diseases, reports study co-author Owen Ross, Ph.D., a Mayo Clinic neuroscientist.

The insights gained from how mutations in EIF4G1 lead to cell death might assist the development of new therapies to treat or slow Parkinson’s disease.

This study began with the identification by French researchers of a large family in northern France with inherited Parkinson’s disease. Researchers discovered the EIF4G1 mutation in the French family and in other affected families in the U.S., Canada, Ireland, and Italy.

Investigators know the protein EIF4G1 helps a cell cope with stress by stimulating the production of other proteins (to help the cell manage stress).

Such stresses occur naturally as people age, and if a brain cell cannot adequately respond, it will die. That inability to adapt led to Parkinson’s disease in the families studied, said Justus C. Daechsel, Ph.D., a Mayo neuroscientist and the study’s co-lead investigator.

This is the third gene that Mayo researchers have found which causes Parkinson’s disease, according to Ross. He adds that Mayo researchers have also identified a number of genetic variants that increase a person’s risk of developing the more common sporadic late-onset form of the disease.

The Mayo experts believe that many of the genes implicated in familial Parkinson’s disease may be playing a role in the sporadic form of the disease, because as many as 20 percent of individuals with Parkinson’s report a first-degree relative with the disorder.

The investigators say this latest finding adds another piece to the complex Parkinson’s puzzle.

Source: Mayo Clinic

However, the new report shows a slight decrease in the rate of mental disorders it tracked from 6 years ago, suggesting little has changed in actual prevalence of mental disorders in Europe. What changed the most is how much more data the researchers decided to collect in this research update, studying more disorders and greater age ranges.

Experts from the European College of Neuropsychopharmacology (ECNP) also report that the majority of the mental disorders are untreated.

The three-year study included 30 countries (the European Union plus Switzerland, Iceland and Norway) and a population of 514 million people. Researchers included all major mental disorders for children and adolescents (2-17), adults (18-65), and the elderly (65+ years), as well as several neurological disorders.

Unlike America, the nations studied have a nationalized or socialized health care system which conceptually should improve access and care for individuals.

However, study authors discovered significant challenges and limitations for mental and neurological research and practice. Researchers discovered care is fragmented with marginalization and stigmatization toward disorders of the brain.

Further, the existence of low public awareness about the full range of disorders of the brain and their burden on society limits appropriate diagnosis and treatment.

Each year, 38.2 percent of the EU’s population — or about 165 million people — suffers from a mental disorder. Mental disorders are prevalent in all age groups and affect the young as well as the elderly, revealing though differences in what diagnoses are the most frequent.

The most frequent mental disorders among Europeans are anxiety disorders (14 percent), insomnia (7 percent), major depression (nearly 7 percent), somatoform disorders (6.3 percent), alcohol and drug dependence (>4 percent), attention-deficit and hyperactivity disorders (ADHD, 5 percent in the young), and dementia (1 percent among those aged 60-65, 30 percent among those aged 85 and above).

No indications for increasing overall rates of mental disorders were found, when compared with the previous comparable study in 2005, which covered a restricted range of 13 diagnoses in adults only. The notable exception is an increase of dementia due to increased life expectancy.

The researchers found no improvements in the notoriously low treatment rates for mental disorders in comparison with the 2005 data. Still, only one-third of all cases receive treatment.

Those few receiving treatment do so with considerable delays of an average of several years and rarely with appropriate, state-of-the-art therapies.

Additionally, many millions of patients in the EU suffer from neurologic disorders such as stroke, traumatic brain injuries, Parkinson’s disease and multiple sclerosis, cases that may have to be counted on top of the above estimates.

As the result, disorders of the brain, as measured by disability-adjusted life years (DALYs), are the largest contributor to the EU’s total morbidity burden, accounting for 26.6 percent of the total disease burden, covering the full spectrum of all diseases. The four most disabling single conditions were depression, dementias, alcohol use and stroke.

Researchers noted that a 2005 study found 27.4 percent of the population suffered from a mental disorder. But the current study’s numbers did not indicate an overall increase in prevalence of illness; rather, the new higher figure reflected the inclusion of some 14 new diagnoses not tracked in the earlier study, such as ADHD, mental retardation, sleep disorders such as insomnia and sleep apnea, dementia and personality disorders.

Dementia and sleep problems accounted for most of the additional change.

The study concludes that “Concerted priority action is needed at all levels, including substantially increased funding for basic and clinical as well as public health research in order to identify better strategies for improved prevention and treatment for disorders of the brain as the core health challenge of the 21st century.”

Source: European College of Neuropsychopharmacology

Parkinson’s typically affects people over 50, but is known to show in people in their 20s (about 5 to 10 percent of cases). This form of early-onset Parkinson’s affects actor, author, and Parkinson’s activist Michael J. Fox.

Parkin mutations are present in about 37 percent of individuals with early-onset Parkinson’s. However, in laboratory studies, mice with Parkin deformities did not show obvious symptoms of the disease. The preliminary study, published online in the Journal of Clinical Investigation, suggests that Parkin mutations may be an indirect contribution to some early-onset Parkinson’s cases by creating differences in the amount and types of fat in the body.

“This discovery shows that the clues to understand Parkinson’s disease may not necessarily be in the brain,” said study leader Michael Sack, M.D., chief of the Laboratory of Mitochondrial Biology in Cardiometabolic Syndromes at the NIH’s National Heart, Lung, and Blood Institute.

The research team, composed of scientists from the National Heart, Lung and Blood Institute (NHLBI) and the NIH’s National Institute of Neurological Disorders and Stroke, found that mice with mutated Parkin did not gain weight from a high-fat laboratory diet, as average mice typically do.

As scientists examined the organs of the Parkin-defective mice, they found that the cells had lower levels of certain proteins responsible for transporting fat. On the other hand, average mice who ate the same high-fat diet had high levels of these fat-carrying proteins, as well as high levels of Parkin, suggesting that Parkin is involved in the transportation of fats.

A similar pattern was found when researchers analyzed blood cells from patients enrolled in the NIH Parkinson’s Clinic. In lab tests, cells from people with Parkin mutations had more fat absorption problems. These results show that these findings could be applicable to humans.

Regarding fat and its relation to Parkinson’s, Sack notes that the destroyed brain cells are found in a region called the substantia nigra, which controls movement, among other roles. Sack and his team will continue to conduct early-stage clinical studies to test the link between fat metabolism and Parkinson’s.

“The neurons in this part of the brain are extremely active. Each one has over 300,000 connections and is continuously transmitting information,” said Sack.

“These neurons require good support in the form of their fat and cholesterol membrane. If the right types of fat aren’t available, then cell integrity will be sub-par and they could be prone to damage.”

Source:   NIH