Getting Medical Help for the Mind
Some helpful ideas even three years later but the article does not address the issue of quality mental health diagnosis and proper choice of treatment.
In Anxious Times, Medical Help for the Mind as Well as the Body
via Patient Money – Getting Medical Help for the Mind as Well as the Body – NYTimes.com.
Very useful compendium from the University of Wisconsin Dept. of Family Medicine web site.
The relevance of much of the material especially regarding anti-inflammation goes well beyond the treatment of headache.
An Integrative Approach to Recurring Headaches
via Treating Headaches – Podcasts & Handouts for Patients & Clinicians | UW Family Medicine.
TBI and PTSD Get $100 Million in Research Money
Traumatic Brain Injury TBI and Post Traumatic Stress Disorder PTSD are diagnosed and treated is about to get a major overhaul. Or at least that is the hope as the Department of Veterans Affairs and the Department of Defense announced they are investing more than $100 million in research to improve diagnosis and treatment of mild Traumatic Brain Injury and Post-traumatic Stress Disorder.After some major drama and confusion within the Army channels where up to 40 percent of PTSD diagnosis were overturned, the DOD and VA have teamed up with a common goal to deliver improved diagnosis and quality of care.That common goal comes at a price of $100 million…just in the research to improve the care. According to Defense News, “more than 15 percent of service members and veterans suffer impaired functioning as a result of PTSD.” What does that work out to for each affected Veteran? If my calculations are correct, roughly $300 per veteran. Not bad in my opinion; but we’ve not yet talked about the cost of the actual care.At the end of the day, can one really put a price on a potential cure that will improve the lives of those affected service members and their families after they’ve sacrificed so much?Two groups, The Consortium to Alleviate PTSD and the Chronic Effects of Neurotrauma Consortium will be jointly managed by VA, and by the Congressionally Directed Medical Research Programs, on behalf of the DOD. Assistant Secretary of Defense for Health Affairs Dr. Jonathan Woodson stated, “These consortia will bring together leading scientists and researchers devoted to the health and welfare of our nation’s service members and veterans.”As a side note, this year alone, approximately 3,400 researchers will work on more than 2,300 projects with nearly $1.9 billion in funding.
via TBI and PTSD Get $100 Million in Research Money | The Military Wire – seattlepi.com.
Articles
Effects of APOE on brain white matter microstructure in healthy adults
Lars T. Westlye, PhD,
Ivar Reinvang, PhD,
Helge Rootwelt, PhD and
Thomas Espeseth, PhD
+ Author Affiliations
From the Department of Psychology (L.T.W., I.R.), Center for the Study of Human Cognition, University of Oslo, Oslo; Centre for Advanced Study (L.T.W., I.R., T.E.), Oslo; and Department of Medical Biochemistry (H.R.), Division of Mental Health and Addiction (T.E.), Oslo University Hospital, Oslo, Norway.
Correspondence & reprint requests to Dr. Westlye : l.t.westlye@psykologi.uio.no.
View Complete Disclosures
Abstract
Objectives: APOE is related to cholesterol transport and clearance and brain white matter (WM) properties involving myelin, of which cholesterol is a major component. Diffusion tensor imaging enables in vivo investigations of brain WM, and could increase our understanding of the pathways leading to Alzheimer disease. The main objective was to investigate the association between APOE and diffusion tensor imaging–derived indices of WM microstructure.
Methods: Healthy participants were assessed on a range of neuropsychological measures, genotyped, and underwent MRI. A total of 203 volunteers (aged 21.1–69.9 years, mean = 47.6, SD = 14.9) with APOE genotypes ϵ2/ϵ3 (n = 30), ϵ3/ϵ3 (n = 113), and ϵ3/ϵ4 (n = 60) were included.
Results: There were widespread increases in mean and radial diffusion in carriers of the ϵ3/ϵ4 alleles compared with ϵ3/ϵ3 with medium to strong effect sizes (Cohen’s d = 0.77–0.79). No interactions between genotype and age were observed, indicating relatively stable differences from early adulthood. The results were independent of presence of dementia in close family. We also observed increased mean and radial diffusion and decreased fractional anisotropy in carriers of the ϵ2/ϵ3 alleles compared with ϵ3/ϵ3 carriers. No significant differences were found between ϵ2/ϵ3 and ϵ3/ϵ4.
Conclusions: APOE affects microstructural properties of the brain WM from early adulthood, but the specific allelic effects do not directly reflect the associated risk of developing Alzheimer disease. The role of APOE in cholesterol transport, the high density of cholesterol in myelin, and the specific effects on radial diffusivity support a putative functional role of APOE in modulating myelin-related processes in the brain.
Footnotes
Study funding: Supported by the Research Council of Norway (grant 204966/F20 to L.T.W., grant 177458/V50 to T.E., and grant 154313/V50 to I.R.) and the Centre for Advanced Study at the Norwegian Academy of Sciences and Letters (I.R., T.E., and L.T.W.). The funding organizations had no role in the design or conduct of the study; in the collection, analysis, or interpretation of the data; or in the preparation, review, or approval of the manuscript.
via Effects of APOE on brain white matter microstructure in healthy adults.
Another dent in the tired old tale of the role of (Mendelian) heredity in neuropsychiatry. More good stuff published in Neurology this week to follow.
Articles
Neurodegenerative causes of death among retired National Football League players
Everett J. Lehman, MS,
Misty J. Hein, PhD,
Sherry L. Baron, MD and
Christine M. Gersic
+ Author Affiliations
From the Centers for Disease Control and Prevention, The National Institute for Occupational Safety and Health, Division of Surveillance, Hazard Evaluations and Field Studies, Cincinnati, OH.
Correspondence & reprint requests to Mr. Lehman: elehman@cdc.gov
View Complete Disclosures
Abstract
Objective: To analyze neurodegenerative causes of death, specifically Alzheimer disease (AD), Parkinson disease, and amyotrophic lateral sclerosis (ALS), among a cohort of professional football players.
Methods: This was a cohort mortality study of 3,439 National Football League players with at least 5 pension-credited playing seasons from 1959 to 1988. Vital status was ascertained through 2007. For analysis purposes, players were placed into 2 strata based on characteristics of position played: nonspeed players (linemen) and speed players (all other positions except punter/kicker). External comparisons with the US population used standardized mortality ratios (SMRs); internal comparisons between speed and nonspeed player positions used standardized rate ratios (SRRs).
Results: Overall player mortality compared with that of the US population was reduced (SMR 0.53, 95% confidence interval [CI] 0.48−0.59). Neurodegenerative mortality was increased using both underlying cause of death rate files (SMR 2.83, 95% CI 1.36−5.21) and multiple cause of death (MCOD) rate files (SMR 3.26, 95% CI 1.90−5.22). Of the neurodegenerative causes, results were elevated (using MCOD rates) for both ALS (SMR 4.31, 95% CI 1.73−8.87) and AD (SMR 3.86, 95% CI 1.55−7.95). In internal analysis (using MCOD rates), higher neurodegenerative mortality was observed among players in speed positions compared with players in nonspeed positions (SRR 3.29, 95% CI 0.92−11.7).
Conclusions: The neurodegenerative mortality of this cohort is 3 times higher than that of the general US population; that for 2 of the major neurodegenerative subcategories, AD and ALS, is 4 times higher. These results are consistent with recent studies that suggest an increased risk of neurodegenerative disease among football players.
Footnotes
Study funding: Supported by the Intramural Research Program of the National Institute for Occupational Safety and Health. The findings and conclusions in this report are those of the authors and do not necessarily represent the views of the National Institute for Occupational Safety and Health. The sponsor reviewed and approved final submission but did not have a role in design and conduct of the study, in the collection, analysis, and interpretation of the data, or in the preparation of the manuscript.
Received April 24, 2012.
Accepted July 9, 2012.
Copyright © 2012 by AAN Enterprises, Inc.
via Neurodegenerative causes of death among retired National Football League players.
Maurice Preter, MD is a European and U.S. educated psychiatrist, psychotherapist, psychopharmacologist, neurologist, and medical-legal expert in private practice in Manhattan. He is also the principal of Fifth Avenue Concierge Medicine, PLLC, a medical concierge service and health advisory for select individuals and families.
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