Men suffering from depression who have social support less likely to seek mental health treatment

Researchers, led by Alan Teo, M.D., assistant professor of psychiatry at OHSU, and researcher at the VA Portland Health Care System, sought to determine whether support from a loved one encourages people experiencing depression to seek treatment from a health provider or whether that support, by serving as informal treatment, inadvertently discourages people from seeking mental health services.Closeup of a thoughtful young man seen through a window

Their findings show that men experiencing moderate or severe depression who had social support from family or friends were likely to see a primary care or other non-mental health care providers, but only rarely saw a mental health specialist.

The less social support that men reported, the more likely they were to seek help from a mental health provider.

Women, on the other hand, were relatively consistent in their use of mental health services. The researchers studied a nationally representative sample of more than 1,000 middle-aged and older adults in the United States.

Social support can take the form of emotional (someone serving as a confidant), informational (a friend providing facts on depression) or instrumental (a family member driving someone to an appointment) help.

Dr. Alan Teo

Dr. Alan Teo

Depression is the leading cause of disability and a significant risk factor for suicide.

Fewer than half of severely depressed people receive drug or behavioral treatment.

Just one in 10 with persistent depression receive both appropriate medication and counseling, and older adults with depression are especially unlikely to use mental health services.

The study authors hope to raise awareness among general practitioners that they’re likely to encounter men with clinical depression who are unlikely to seek mental health treatment themselves. The researchers encourage proactive treatment with an antidepressant, psychotherapy, or collaboration with mental health providers.

The paper was published in the journal General Hospital Psychiatry.

Diabetes drug may prevent recurring strokes and heart attacks

Wayne Clark, M.D.

The OHSU Stroke Center was an integral part of an NIH-funded global study that has shown that a diabetes drug may prevent a second stroke or heart attack in patients with insulin resistance.

The study was conducted at 167 institutions in seven countries, with the Oregon Stroke Center enrolling the second highest number of participants across the globe.

Wayne Clark, M.D. was a co-author of the paper.

The following press release was originally published by the NIH on February 17, 2016:

NIH-funded global study suggests novel approach for preventing repeated cardiovascular events

Pioglitazone, a drug used for type 2 diabetes, may prevent recurrent stroke and heart attacks in people with insulin resistance but without diabetes.

The results of the Insulin Resistance Intervention after Stroke (IRIS) trial, presented at the International Stroke Conference 2016 in Los Angeles and published in the New England Journal of Medicine, suggest a potential new method to prevent stroke 20160217-ischemic-strokeand heart attack in high-risk patients who have already had one stroke or transient ischemic attack.

This large, international study was supported by the National Institutes of Health’s National Institute of Neurological Disorders and Stroke (NINDS).

The IRIS trial is the first study to provide evidence that a drug targeting cell metabolism may prevent secondary strokes and heart attacks even before diabetes develops.

Insulin regulates metabolism and keeps blood sugar levels from getting too high, along with many other processes, in the body. Insulin resistance is a condition in which the body produces insulin but does not use it effectively.

“This study represents a novel approach to prevent recurrent vascular events by reversing a specific metabolic abnormality thought to increase the risk for future heart attack or stroke,” said Walter J. Koroshetz, M.D., director of the NINDS.

Read more…

Discover how alcohol, gaming, and marijuana impact your brain

Indulging in pleasurable activities is sometimes characterized as a dichotomy of good or bad. But is it all or nothing when it comes to the brain? When are healthy pleasures susceptible to harmful effects?

Our 2016 Brain Awareness Season will delve into the brain science behind three very popular pastimes: alcohol, gaming, and marijuana.

Held at the Newmark Theater in downtown Portland (sometimes called “Brains on Broadway”), this series features nationally known neuroscience experts and authors.

 

Alcohol and the brain
Monday, February 22
7–8:30 p.m.

grant-head-banner600x600The positive health benefits of red wine have been popular news headlines for many years. In moderation, alcohol has been seen to improve cardiovascular health, immune system response, and even prevent gallstones.

On the other hand, the negative health and social impacts of alcoholism are apparent in just as much news coverage. Dr. Kathleen Grant will explore how behavioral neuroscience informs how, why, and when the risks of alcohol may outweigh the benefits.

Buy your tickets now

Gaming and the brain
Monday, February 29
7–8:30 p.m.

gazzaley-head-banner600x600The generation just coming of age has been exposed to more electronic technology than any one prior to it. Video games in particular have drawn scrutiny as influencing the obesity epidemic, attention deficits, and pronounced violence of our youth.

They also show promise as educational tools, memory enhancers, and improving high-level thinking. Dr. Adam Gazzaley will present the science behind your brain on games.

Buy your tickets now

Marijuana and the brain
Monday, March 7
7–8:30 p.m.

stella-head-banner600x600Oregon recently joined only three other states to legalize recreational marijuana. As consumption of the plant’s products becomes more a mainstream activity, its health benefits and risks will be at the forefront of policy discussions.

Dr. Nephi Stella will explain the role marijuana plays in cutting edge neuroscience research.

Buy your tickets now

 

The Season also includes the always popular Brain Fair and Teacher Workshop. Don’t miss these free opportunities to learn about the brain.

OHSU Brain Institute Brain Fair
Saturday, March 12, 2016
10 a.m.–5 p.m.brain-fair-03-1200x628

The OHSU Brain Fair is an annual event at the Oregon Museum of Science & Industry (OMSI). The Brain Fair is held each spring.

This year’s Brain Fair includes interactive exhibits, real human and animal brains, prizes and dozens of OHSU Brain Institute neuroscientists explaining and demonstrating their groundbreaking research in a way that will be fascinating for all ages.

No museum admission is required to attend.

Brain Awareness Teacher Workshop
Saturday, April 16, 2016

Let a teacher in your life know about this  special day for classroom teachers featuring presentations on the adolescent brain and early-life nutrition and a highly interactive resource fair.

Speakers include Bonnie Nagel, Ph.D. and Susan Bagby. M.D. who will touch on how addiction manifests itself  in the brains of youth, among other telling research.

Register now

Special delivery: Discovery of viral receptor bodes better gene therapy

There is much hope for gene therapy’s future potential to treat a number of human diseases. The use of adeno-associated virus (AAV) vectors to transport genetic material into cells has been critical to the initial success of experimental gene therapy treatments of hereditary diseases, including hemophilia B.  But in order to develop gene therapy cures for additional diseases and conditions, like diabetes and heart disease, it will be necessary to deliver the treatment to specific tissues. Achieving this required an understanding of how AAV enters cells. 

Michael_Chapman

Michael Chapman, Ph.D.

Now, for the first time, researchers at OHSU and Stanford have identified the protein (KIAA0319L) to which AAV adheres on the outside of human cells and uses to gain entry, a discovery published in the journal Nature

The paper, “An essential receptor for adeno-associated virus infection,” is jointly authored by Michael Chapman, Ph.D., R.T. Jones Professor of Structural Biology, OHSU School of Medicine, and Jan Carette, Ph.D., Assistant Professor, Microbiology & Immunology, Stanford University School of MedicineMajor contributors to the study include Sirika Pillay, Ph.D., Stanford University School of Medicine, and Nancy Meyer, M.S., Research Associate, OHSU.  

The following post about the study originally appeared on Stanford Medicine’s blog, Scope.

Special delivery: Discovery of viral receptor bodes better gene therapy
Written by Bruce Goldman
Photo by Loco Steve

Photo by Loco Steve

Gene therapy, whereby a patient’s disorder is treated by inserting a new gene, replacing a defective one, or disabling a harmful one, suffered a setback in 1999, when Jesse Gelsinger, an 18-year-old with a genetic liver disease, died from immense inflammatory complications four days after receiving gene therapy for his condition during a clinical trial. It was quite a while before clinical trials in gene therapy resumed.

But what Stanford virologist Jan Carette, PhD, describes as “intense interest” in the field is once again in full bloom. Gene therapies for several inherited genetic disorders have been approved in Europe, and a gene-therapy approach for countering congenital blindness is close to approval in the United States.

That a virologist would be paying such close attention to this topic isn’t odd, as the most well-worked-out method for introducing genetic material to human cells involves the use of a domesticated virus.

If there’s one thing viruses are really good at, it’s infecting cells. Another viral trick is transferring their genes into cellular DNA — it’s part of their modus operandi: hijacking cells’ replicative machinery and diverting it to production of numerous copies of themselves. Scientists have become increasingly adept at taming viruses, tweaking them so they retain their ability to infect cells and insert genes, but no longer contain factors that wreck tissues or taunt the infected victim’s immune system into a rage destructive to virus and victim alike.

Adenovirus-associated virus — ubiquitous in people and not associated with any disease – makes a great workhorse. Properly bioengineered, it can infect all kinds of cells without replicating itself inside of them or triggering much of an immune response, instead obediently depositing medically relevant genes into the infected cells to repair a patient’s defective metabolic, enzymatic, or synthetic pathways.

Figuring out how to tailor this viral servant so it will invade cells more efficiently, or invade some kinds of cells and tissues but not others, would broaden gene therapy’s utility and appeal. In a series of experiments described in a study in Nature, Carette’s group, with collaborators from Oregon Health & Science University and the Netherlands, used a sophisticated method pioneered by Carette to bring that capability a step closer.

A virus can attach itself to a target cell by latching onto a molecule embedded in that cell’s surface. In the case of adenovirus-associated virus, that viral-receptor molecule is already known. (The molecule obviously is there for some constructive purpose, which doesn’t stop the invading virus from taking advantage of the mutual attraction.) Simply glomming on to the cell’s surface isn’t enough, though. To get to the all-important nucleus, where the genetic jewelry is ensconced, the virus has to penetrate the cell as well. Until now, the molecule on which adenovirus-associated virus hops a ride downtown was anybody’s guess.

In the new study, Carette and his colleagues identified, in human cells, precisely that transport molecule. This discovery could lead to ways of raising or lowering the molecule’s expression in different tissues so that therapeutic genes get delivered to their intended addresses, and nowhere else.

 

Read more:
Portland Business Journal: OHSU researchers reach major gene therapy breakthrough
MedCity News: Researchers in Oregon are changing the face of gene therapy with new breakthrough

Neurosurgery resident waltzes through joys of ballroom dance

There may be a joke out there somewhere about how ballroom dancing is hardly brain surgery, but Kunal Gupta isn’t likely going to be the person to make it. Instead, Gupta, a native of the United Kingdom, is actually someone with an affinity for and a connection to both brain surgery and ballroom dancing.

Now in his fourth of seven years as a neurosurgery resident at Oregon Health & Science University, Gupta, MBChB, PhD, grew up in Birmingham, England, where he took a fair amount of acting classes. To complement those, his parents also enrolled him in a few dance classes at a local recreation center.

Though he never fully dove into the pastime as a youngster, the exposure to dance did leave an impression.ballroom-02

“It was just one of those experiences that kind of stuck with me,” said Gupta, now 32. In fact, it stuck with him so much that when he arrived at the University of Cambridge for medical school, Gupta decided to try out for the Cambridge University Dancesport Team.

The team represents the university at national competitions across the country, competing in five ballroom dances — waltz, quickstep, foxtrot, Viennese waltz and tango — and five Latin American dances, including jive, samba, rumba, paso doble and cha cha.

Gupta didn’t make the first team on his first try, but a year later he did, which set the stage for his enjoyment of competitive ballroom dancing to take off.

“It’s not so much fun when you’re a 12-year-old kid,” Gupta said, “but it gets much more interesting when you’re an adult.” As part of the team at Cambridge, Gupta built up his dancing deftness and moved his way up in the ranks.

While studying for a time in Edinburgh, Gupta wanted to keep his dancing sharp and needed to find a partner. He found one in a young researcher and dancer who also happened to be studying in Edinburgh just two labs away from Gupta.

The two began dancing together and, eventually, they married. “It’s funny, but it’s how I met my wife,” Gupta said.

In addition to his wife, Gupta danced with many different partners while he competed at Cambridge and in a few amateur competitions. He described the competitions as “these amazing round robins” where 20 different couples all dance and are judged at the same time.

“You spend half the time trying to dance and half the time trying not to trip over or run into everyone else around you,” he said. “It’s really fun.” Gupta also said he enjoys the music that accompanies ballroom dancing — plenty of big band music from the 1920s and 1930s — and the social interaction that dancers share.

In addition, he said that at Cambridge, many of the dancers were in fields more closely related to science than, say, the humanities, so there has been that connection for him as well.

“There are a lot of technical steps involved to do it right, so I think that is very appealing,” Gupta said. When he was competing, Gupta and his partners did fairly well, winning some competitions or at least making a solid showing.

At the more advanced level, however, Gupta said it’s hard to compete against people who have been dancing seriously since they were children. “You can’t compete with that,” he said, “but it’s an honor to be dancing beside people who are that good.”

ballroom-01Though Gupta and his wife, E. Jolanda Muenzel, MD, PhD, a post-doctoral fellow in neuroscience at OHSU, still dance occasionally, they have found that their time is monopolized these days by work and study.

Gupta, who has a bachelor of medicine and a bachelor of surgery and also a PhD from Cambridge, is at a point in his residency where he is taking care of critical patients and assisting surgeons.

He is also gaining more autonomy in the operating room as he works toward ever more complex surgical procedures.

While his earlier research focused, according to an OHSU bio, on “the novel discoveries he made around glial-neuronal interaction under molecular paradigms of traumatic brain injury, using a human stem cell platform,” Gupta’s main interest these days is in epilepsy, as it is an affliction where a strong case for surgical treatment, rather than pharmaceutical treatment, can be made.

He said he plans to use his sixth year of residency for epilepsy research, followed by his seventh and final year of surgery.

After that, Gupta, who also enjoys tennis, skiing and snowboarding, is hopeful that eventually his schedule may free up time for a little more dancing. “I’d love to because it really is a lot of fun,” he said. “Maybe when I have more control over my schedule.”

***

This article was originally published in The Scribe, a publication from the Medical Society of Metropolitan Portland.

Your health questions answered: Is pain a part of Parkinson’s disease?

You ask. OHSU experts answer.

Q: I was once told that pain is not a part of Parkinson’s disease. Is that true?

A: Pain is a common symptom in people with Parkinson’s Disease (PD) and people with PD are more likely to have pain than those without PD.

86810406It is unclear what causes this increase of painful symptoms, however.

There are several theories including loss of dopamine or other neurotransmitters (natural chemicals) in the brain, alterations of nerves in the skin, or the general muscle stiffness and reduced movement caused by PD.

Pain in PD is commonly divided into five categories:

• musculoskeletal (inflammation of muscles, tendons, ligaments and bones as in arthritis)

• dystonic (an abnormal pulling or twisting of muscles)

• central (related to changes in the brain)

• akathitic (a restless or uncomfortable feeling)

• radicular/neuropathic (caused by damage to nerves in the back or limbs)

Due to the lack of understanding of the mechanisms of pain in PD there are no guidelines for the optimal way to treat it; however, there are many treatments that can be considered including physical therapy, optimizing PD medications, and using analgesics (medications that treat pain).

Treatment is individualized based on the type and location of the pain. If you suffer from pain, please talk to your neurologist about how they can help.

***

keiran-tuck

 

Keiran Tuck, M.B.B.S.
Fellow, OHSU Parkinson Center

Study hopes to clarify the link between sleep problems and Alzheimer’s disease

An upcoming study led by Jeffrey Iliff, Ph.D. and Bill Rooney, Ph.D. hopes to clearly determine the relationship between a lack of sleep and Alzheimer’s disease. The team received funding from the Paul G. Allen Foundation to test their approach. They hope to begin scanning the brains of participants within a year, using a 7-Tesla MRI (pictured below).

Iliff and Rooney recently spoke to Jon Hamilton at NPR’s Morning Edition about the upcoming study and the importance of adequate sleep.

Listen to the full NPR interview here.

MRI Photos_7

MRI Photos_24

Jeffrey Illiff and Bill Rooney with the 7-Tesla MRI.

Jeffrey Illiff and Bill Rooney with the 7-Tesla MRI.

Year in review: The most popular “On the Brain” posts of 2015

As we welcome in the new year, here’s a look back at the brain-related news you may have missed; a round-up of our most read blog posts of 2015:

1. Acupuncture and diet changes to treat neuropathic pain

Peripheral Neuropathy is a common neurologic condition, which affects the peripheral nerves. The most common symptoms associated with peripheral neuropathy are burning, tingling pain, which often feels like sharp electric sensation. More…painful_feet_L-286x300

2. Dietary and lifestyle modifications for migraine prevention

Years ago, my headache mentor at Columbia, Dr. Green, compared a migraineur’s brain to a fancy sports car’s engine.

He meant that the brain becomes sensitized to the slightest stimulation and like the engine of a fine sports car, it revs up with the slightest stimulation. More…

3.  Five things you should know when caring for a loved one with dementia

Caregiving for a loved one with dementia can be challenging to your family dynamics, your finances, and more. 

But did you know, it can also be hard on your emotional and physical health? More…

4. Healthy aging and preserving community memories

swimming dive copyThe Layton Aging and Alzheimer’s Disease Center in partnership with the Center for Healthy Communities is launching a first-of-its kind study around brain health intervention.

The innovative program aims to boost cognitive health within the African-American community in Portland. More…

5. Sleep expert shares his secrets for easing into the upcoming time change

The end of daylight saving time is soon approaching, and while most of us look forward to that “extra” hour of sleep, there are a few things to think about when society’s clock changes, but our biological clock doesn’t. More…

6. Early diagnosis of Alzheimer’s disease is key goal for OHSU researchers

Alzheimer’s disease is the most common form of dementia and is the sixth leading cause of death in the United States. Symptoms include memory loss, personality changes and trouble thinking, and the disease typically worsens over time. More…

7. Research affirms use of thrombectomy procedure for stroke treatment

Stroke is the fifth leading cause of death in America and a leading cause of adult disability, according to the National Stroke Association. For patients who experience strokes and the physicians who treat them, time is brain. More…

8. Researcher seeks better ways to care for people post-concussion

The research surrounding concussions has been a heavy topic of discussion and strides are being taken to incorporate research findings into clinical and practical care of people post-concussion. More…

9. The White House BRAIN Initiative in Oregon

Just over two years ago, President Obama made a dedication to support and enhance neuroscience research through the Brain Research through Advancing Innovative Neurotechnologies, or BRAIN, Initiative.

The ultimate goal, a comprehensive map of the human brain under normal conditions and in various disease states, is a daunting and perhaps unattainable task. More…backstrokes-group

10.  Stroke survivors continue to heal through the power of music

Back in early 2013, we heard about a group of stroke survivors who found their voice and some healing through music in a group known as The Backstrokes.

We’re pleased to report that the music group continues to play together. More…

Miss Oregon an important voice for traumatic brain injury

ali-wWhen I was a freshman in high school, I suffered a traumatic brain injury due to a cheerleading accident.

As someone who had no prior knowledge of brain injuries, it was difficult to understand what I was going through and why I felt so different during my recovery process.

Because of the adversities I overcame as a result of my traumatic brain injury, I wanted to advocate for this serious and often ignored issue.

After meeting with doctors and learning more about traumatic brain injuries, I got involved in volunteering and talking to students about my experiences and recovery process through OHSU’s ThinkFirstOregon program.

Screen Shot 2015-12-16 at 9.40.57 AM

Miss Oregon 2015, volunteering for a Doernbecher Children’s Hospital fundraiser

It was important to me to shed light on an overlooked issue that has not only affected me but so many others.

At the Miss America 2016 competition, I had the opportunity to represent the traumatic brain injury community with a national spotlight.

While at Miss America, I was overwhelmed with the support I received from the TBI community reaching out to me and being thankful for the attention I was able to bring to the issue.

With the constant messages, letters and phone calls from so many who were excited to hear that traumatic brain injuries were finally able to get their due, I realized one voice can really make a difference.

***
Ali Wallace
Miss Oregon 2015 

onward

Donate to the OHSU Brain Institute
With your support, our scientists can decode the genetic mysteries of neurological disease and create a new standard of care for patients affected by autism, ADHD and other neurodevelopmental disorders.

Learn more at onwardohsu.org/neuro.

Neurology residents teach Milwaukie 5th graders about the brain

Alison Christy, Ittai Bushlin, and Madeline Nguyen at Linwood Elementary in Milwaukie.

Alison Christy, Ittai Bushlin, and Madeline Nguyen in a 5th grade classroom at Linwood Elementary in Milwaukie, OR.

“What have you learned about the brain so far today?”

Hands shot into the air all around the 5th grade classroom at Linwood Elementary.

“I learned that you have to wear a helmet.”

“I knew this already, but that the right side of the brain controls the left side of the body.”

It was an unusual day. As a resident in pediatric neurology, I usually spend my days seeing patients in the hospital or in the clinic, talking about seizures and headaches, medications and MRIs.

That Tuesday, I found myself instead at Linwood Elementary, with neurology resident Madeline Nguyen, M.D.; pediatric neurology resident Ittai Bushlin, M.D., Ph.D.; and Mark Rutledge-Gorman, Ph.D., a researcher who works with the Portland Alcohol Research Center and is active in outreach to local schools.

We were having a blast.

“What kinds of things can a baby do?”

“Eat!” “Cry!” “Sleep!”

“Right, a baby’s brain only has to do a few things. But it’s learning and growing all the time. What can you do? What can your brain do?”

“Learn!” “Play sports!” “Read and write!”

“What about your teacher? What does her brain have to do?”

“She has to teach us!” “She has to make us stop talking!” “She has responsibilities!”

A few weeks before that day, Madeline, Ittai and I met with Mark to plan our time with the kids. Mark has been teaching kids about science, the brain, and the dangers of addiction for fifteen years. He has Powerpoint slides and a big plastic bin with modeling clay, brain coloring pages (for making brain hats) and other activities.

The aim, he said, was to teach them that their brains are still developing, and that they can influence how it develops. There are other aims too, like learning decision-making, or developing empathy.

If your little sister is annoying, maybe that’s just because her brain is less developed than yours. If your teacher is telling you to sit in your seat, maybe that’s because her brain is more developed than yours, and because she is responsible for your safety and your education.

While Ittai squished and rolled clay brains with half the class, I gathered the other half around a blue bucket.

"Have you ever touched a brain?"

“Have you ever touched a brain?”

“What will happen if you drop this egg into the bucket?”

“I know! I know! It will break.”

“Is that our hypothesis? What’s a hypothesis?”

“It’s a test!” “No, it’s a question!”

A brown-haired girl dropped the egg. It cracked, but didn’t break. Hypothesis tested.

“Let’s come up with another hypothesis. What will happen if I wrap this egg in newspaper and bubble wrap and put it in this box, then drop it into the bucket?”

The same girl dropped the wrapped egg. No cracks!

“Now let’s talk about helmets. How does a helmet protect your brain?”

Why did we all choose to spend that rainy Tuesday afternoon at Linwood Elementary?

First of all, we were there to help the kids learn about ways to protect their brains, by wearing helmets and avoiding alcohol and drugs.

There isn’t always enough time in a doctor’s appointment to explain not only what a child should do to be healthy, but why it’s necessary.

Hopefully, some of those children will think twice before getting on a bicycle without a helmet, or taking a first sip of alcohol.

Mark, Madeline, Ittai and I are also people who love science and the incredible things the brain can do, and we hope that our love might be infectious.

It never occurred to me that I could get a Ph.D. until I met professors when I was in high school. I didn’t think about getting a medical degree until I met doctors who did science and realized that those things could work together.

Maybe some of the kids in this class will see these doctors and scientists who are clearly very excited about brains, and start thinking that they, too, could study medicine or science.

And there’s another ulterior motive.

“Does anyone have any last questions?”

A boy stood up, his hand raised high.

“Have you ever touched a brain?”

I have. It was pretty cool. Sometimes I forget that what I get to do, every day, is amazing. There is nothing like the enthusiasm of a 5th grader to remind me that I am so lucky to have this awesome job.

I hope he gets to touch a brain someday.

***

Alison Christy, M.D., Ph.D.
Pediatric neurology resident
Oregon Health & Science University

onward

Donate to the OHSU Brain Institute
With your support, our scientists can decode the genetic mysteries of neurological disease and create a new standard of care for patients affected by autism, ADHD and other neurodevelopmental disorders.

Learn more at onwardohsu.org/neuro.

 

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