Weekend Links

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We’ve hand-picked a mix of Massachusetts General Hospital and other research-related news and stories for your weekend reading enjoyment:

Tiny Marvels – Miniature versions of organs help scientists understand disease and fine-tune treatments in ways that work in mice can’t match.

Global C-Section Rates on the Rise – Caesarean section rates have increased in most countries during the past decade, with substantial variations between and within countries, Massachusetts General Hospital researchers reported.

Study links smartphone use with depression in teens – Research from Steven Schlozman, a child psychiatrist at Massachusetts General Hospital’s Clay Center for Young Healthy Minds, suggests excessive cell phone use by teens may be contributing to a mental health crisis in that age group.

Why teenagers eat Tide pods

A Mysterious Amnesia, Related to Opioid Overdose, Creeps Beyond New England

The Communicator’s Art – Richard Besser’s insights from a career talking public health to the public

top photo courtesy of Proto Magazine

Research Your Resolution: Reduce Your Stress and Anxiety with Meditation

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Sara Lazar, PhD

Sara Lazar, PhD, is an investigator in the Department of Psychiatry at Massachusetts General Hospital who is using brain imaging technology to measure the effects of meditation on brain structure. To learn more about her work, please visit her laboratory website.


If you want to reduce your level of stress and anxiety in 2018, our imaging studies have shown that the regular practice of meditation can change how the brain works.

When you engage in a behavior over and over again, it creates structural changes in your brain in a process known as neuroplasticity. You can detect these changes through MRI brain scans.

Our research team recruited participants who had no previous meditation experience and put them into an MRI scanner to get baseline readings of their brains.

One group participated in an eight-week mediation based stress reduction program where they were asked to spend 40 minutes each day practicing mindfulness exercises. We then compared them to another group of people who had signed up for the same class, but were willing to wait a few months to start the meditation program.

When we scanned both groups eight weeks later, we found that the participants in the meditation program had developed more gray matter in both the hippocampus, an area important for learning, memory and emotion regulation, and the tempo-parietal junction, an area important for perspective-taking, empathy and compassion.

The meditation participants also had a reduction in the amount of gray matter in the amydgala—the part of the body associated with the fight or flight response.

The results of these scans helped to confirm the reductions in stress and improvements in well being that the participants reported after participating in the mediation program.

It wasn’t just that they were telling us they felt better, or that they were experiencing the placebo effect. There was an actual neurobiological reason why they were feeling less stress.


Research Your Resolution

Do you have goals for improving your health in the New Year? This month, investigators from the Mass General Research Institute are discussing the science behind some common New Year’s resolutions, and offering tips and advice based on their research into exercise, diet, healthy aging, heart health, and much more.

Massachusetts General Hospital is home to the largest hospital-based research program in the United States, a community of more than 10,000 people working across 30 departments, centers and institutes. The Mass General Research Institute works to support, guide and promote these research initiatives.

Research Your Resolution: Focus on Your Mental Health, Especially As You Age

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Jennifer Gatchel, MD, PhD

Jennifer Gatchel MD, PhD, is a geriatric psychiatrist at Massachusetts General Hospital and McLean Hospital and an investigator in the Department of Psychiatry at Mass General. She works with adults ages 60 and over to help them cope with life’s transitions. Read more about her research.


Although dementia is on the rise, it is not an inevitable part of getting older.

While the number of individuals with dementia worldwide is on the rise as populations age, data are encouraging that a fraction of dementias may be preventable and that lifestyle interventions may have the potential to modify the course of changes in memory and thinking with aging¹.

Data in healthy older adults from the Harvard Aging Brain Study showed an association between subclinical depressive symptoms and tau—a marker of neurodegenerative change—in two brain regions vulnerable in aging and dementia².

While the direction and causality of this relationship is unknown, this and other data highlight the importance of maintaining awareness of changes in your mental health, seeking help and support for symptoms of depression and anxiety, and maintaining intellectual and social engagement¹ ².

¹Livingston G, Sommerlad A, Orgeta V, et al: Dementia prevention, intervention, and care. Lancet 2017; 390:2673-2734
²Gatchel JR, Donovan NJ, Locascio JJ, et al: Depressive Symptoms and Tau Accumulation in the Inferior Temporal Lobe and Entorhinal Cortex in Cognitively Normal Older Adults: A Pilot Study. J Alzheimers Dis 2017; 59:975-985


Research Your Resolution

Do you have goals for improving your health in the New Year? This month, investigators from the Mass General Research Institute are discussing the science behind some common New Year’s resolutions, and offering tips and advice based on their research into exercise, diet, healthy aging, heart health, and much more.

Massachusetts General Hospital is home to the largest hospital-based research program in the United States, a community of more than 10,000 people working across 30 departments, centers and institutes. The Mass General Research Institute works to support, guide and promote these research initiatives.

Gatchel Untangles the Causes of Mood and Anxiety Symptoms and Loss of Brain Function in Aging Populations

Jennifer Gatchel studying Alzheimer's disease

Massachusetts General Hospital researcher Jennifer Gatchel, MD, PhD, is using brain imaging technology to learn more about the connections between mental illness and cognitive decline in aging populations.


Often referred to as the golden years, life after retirement can sometimes turn out to be less than sunny.

Dramatic lifestyle changes such as admittance to an assisted care facility and loss of mobility or independence can take a toll on mental health.

In fact, twenty percent of people over 55 suffer from a mental disorder, and two-thirds of nursing home residents exhibit mental and behavioral problems.

As a geriatric psychiatrist at Massachusetts General Hospital and McLean Hospital, Jennifer Gatchel MD, PhD, works with adults ages 60 and over to help them cope with life’s transitions.

For many of her patients, symptoms of mental illness are often compounded by symptoms that indicate the onset of degenerative conditions like Alzheimer’s disease.

“These are conditions I see every day in my practice that I find highly compelling,” says Gatchel. “Could psychiatric symptoms in older adults be driven in part by Alzheimer’s disease pathology and proteins impacting brain circuitry? If so, it would represent an important shift in the way we think about treating older adults presenting with these symptoms.”

Gatchel is using a combination of neuroimaging, cognitive testing, clinical assessments, and her ongoing interactions with patients to inform her research on the relationships between mood and anxiety symptoms and dementia.

She ultimately hopes to improve care and brain health for older patients and help them make the most of their golden years. Continue reading “Gatchel Untangles the Causes of Mood and Anxiety Symptoms and Loss of Brain Function in Aging Populations”

Kamryn Eddy Finds Hope for Patients with Eating Disorders

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The people we encounter early in life can often have a profound impact on our future. For Massachusetts General Hospital psychologist Dr. Kamryn Eddy, a childhood friend influenced her career trajectory.

“I had a close friend in high school who had anorexia,” says Dr. Eddy. “As a result, she had a number of health concerns, including osteoporosis, and was told at age 16 that she would never be able to have children.”

She recalls being shocked that a doctor would give such a definitive and dire prognosis to someone so young. Eddy has kept in touch with her friend, who found help for her eating disorder and was eventually able to recover. Her friend now has a healthy young daughter.

“That early experience was one of my introductions to the world of eating disorders,” says Eddy. “Seeing my friend’s battle and eventual recovery from her illness also showed me that there can be hope for people suffering from eating disorders.” Continue reading “Kamryn Eddy Finds Hope for Patients with Eating Disorders”

Brain Imaging Studies Provide New Insights into Biological Basis of Behaviors in Schizophrenia and Autism

Researchers at Massachusetts General Hospital are using brain imaging technology to learn more about how individuals with autism and schizophrenia view the world through different lenses.

Imagine sitting alone in an empty movie theater. Just before the film starts, another person comes in and takes the seat right next to you, even though there are plenty of other seats available.

How would you react?

Presumably, you wouldn’t be very comfortable. It would probably be difficult to concentrate on the movie. Your fight or flight response might even kick in.

How would your reaction differ if you were in a crowded theater, and the same person took the seat next to you because it was the only one left? In that context, it seems much more reasonable.

We have similar unspoken rules about making eye contact. Too much eye contact can seem threatening or flirtatious, while too little can make the other person think you are bored or disinterested.

Most of us manage these behaviors by instinct. But what happens when the brain circuitry driving them misfires? When the simple act of making brief eye contact causes the same burning sensation as if someone is staring right at you, or when your personal space bubble becomes so enlarged that others can make you uncomfortable without realizing it?

Two researchers at the Athinoula A. Martinos Center for Biomedical Imaging at Massachusetts General Hospital are using brain imaging technology to gain new insights into how the brain systems that typically manage personal space and eye contact work differently in individuals with schizophrenia and autism.

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Nouchine Hadjikhani, MD, PhD, and Daphne Holt, MD, PhD

Daphne Holt, MD, PhD, is exploring how perceptions of personal space differ in individuals with schizophrenia, and how these differences contribute to symptoms such as isolation and withdrawal. Nouchine Hadjikhani, MD, PhD, is studying how individuals with autism respond to eye contact, and how this can influence their behavior and social interactions. 

Their findings could revolutionize the way we understand, treat and assess those who suffer from these disorders. Continue reading “Brain Imaging Studies Provide New Insights into Biological Basis of Behaviors in Schizophrenia and Autism”

More Than Just a Pastime: How Video Games Change Your Brain

Editor’s Note: This summer we have two communications interns working with us to write stories about research at the hospital and their experiences being part of the hospital community. This is a post by our intern Shika Lakshman, a student at Emerson College .

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Video games. We all play them, whether it’s Candy Crush on the way to work, or hours-long sessions of Call of Duty.

So when I recently read an article about a new research study detailing the positive and negative effects of playing video games, I decided to follow up. According to the lead author of the study, Marc Palaus, “It’s likely that video games have both positive (on attention, visual and motor skills) and negative aspects (risk of addiction), and it is essential we embrace this complexity”.

Paulus and a team of researchers from Catalonia University and Massachusetts General Hospital recently conducted an assessment of research studies looking at how brains change as a result of playing video games.

What did they find? Video games can change how you pay attention, improving sustained and selective attentions. It also means that the areas in the brain responsible for attention need less stimuli to activate. Additionally, video games can physically  change the structure of your brain, making the parts of your brain responsible for visuospatial skills bigger and more efficient.

So, video games make it easier for gamers to focus on specific stimuli (like games) for longer periods of time, while also allowing for better recognition of shapes, from faces to cars to trees. That’s the good part.

However, as you’ve probably heard, video games can also be addictive. It’s not just something your mom said to get you to do your homework, it’s called “internet gaming disorder”. It mostly affects men, ages 12-20, and primarily in Asia.

Addictive disorders can also cause structural changes to the brain, and gaming addictions are no different. The neural rewards system in your brain can be affected by “cravings” stemming from video games, and researchers say they are the same changes that other addictions cause.

Shika

What does the research tell us? From what I can gather, most video game studies are slanted towards reinforcing the idea that “video games are bad, they cause violence, antisocial behavior, etc.”

I wanted to get a more balanced opinion. So, I did what anyone my age would do: I posted on Facebook, and hoped for responses. I made a survey, asking people about their opinions on video games and some of the study results, and most responded positively.

A few respondents said video games helped them learn English. Many said it allowed them to make friends, and others said it helped with anxiety, stress and their mental wellbeing. Overall, people weren’t entirely shocked to learn that video games can physically change your brain, although they did think the positive effects of outweigh the negative ones. In fact, one respondent actually credited video games with healing a brain injury, “I have a brain injury that affects my coordination. Playing video games has helped me to regain back some of the hand-eye coordination that I feel like I lost.”

One respondent summed it up nicely. “As with anything, moderation is key. Sure, too much time in games stunts our social growth and tricks our brains into thinking we’ve accomplished things. But a moderate amount of time enjoying a favorite game and socializing with friends isn’t a negative thing”.

Here is the poll I used, thought it might be useful so people can see exactly what I asked: https://goo.gl/forms/sETvFUldAjZIPEKO2

What is your name? *

How old are you? *

What age did you start playing video games? *

How would you characterize your video game use? *

1 casual (mostly on your commute, only on your phone, etc.)

2

3

4

5 professional (you play/have played in competitions and/or earn money for playing)

Have you noticed any changes since you started playing video games, such as a change in attention span? *

How many hours a week do you spend playing video games? *

1-5

6-10

11-20

21+

If you selected 21+ above, please estimate the number of hours each week.

Would you be surprised if video games were physically changing your brain? *

Yes

No

Do you think there are more positive or negative effects of video games? *

Positive

Negative

They balance out

Any final thoughts on the effects of video games?

New Study Demonstrates the Benefits of Tai Chi in Chinese Americans Suffering From Depression

Summary: Tai chi has been found to be an effective and culturally acceptable treatment method for reducing symptoms of depression in Chinese Americans.

Tai chi.jpgMental illnesses such as depression are often associated with negative attitudes and beliefs. Previous research has found that these feelings of shame and discrimination are especially severe in the Chinese American community. Given the higher level of stigma, there’s a need to find culturally accepted treatment options for this traditionally under-treated population.

New research from Mass General has found that practicing the Chinese martial art tai chi significantly reduced symptoms of mild to moderate depression in Chinese Americans. “Finding that tai chi can be effective is particularly significant because it is culturally accepted by this group of patients who tend to avoid conventional psychiatric treatment,” explains Albert Yeung, MD, ScD, of the Depression Clinical and Research Program in the MGH Department of Psychiatry, lead and corresponding author of the pilot study recently published in the Journal of Clinical Psychiatry.

Tai chi is an ancient Chinese tradition that, today, is practiced as a graceful form of exercise. It involves a series of movements performed in a slow, focused manner and accompanied by deep breathing. Previous studies have suggested that tai chi may help treat anxiety and depression, but most of these studies used it as a supplement for treatment of other medical conditions.

Yeung and his team enrolled 50 Chinese-American adults with a diagnosis of mild to moderate major depressive disorder and randomized them into three groups. Members of the intervention group attended twice weekly tai chi sessions in which participants were taught and practiced basic traditional tai chi movements and were asked to practice at home three times a week. An active control group participated in educational sessions that included discussions on mental health and a passive control group participated only in repeated psychological assessments with no interventions in between.

The 12-week assessments showed that the tai chi group had significantly greater improvement in depression symptoms than did members of either control group. A follow-up assessment three months later showed sustained improvement among the tai chi group, with statistically significant differences remaining compared with the waitlist group.

“If these findings are confirmed in larger studies at other sites, that would indicate that tai chi could be a primary depression treatment for Chinese and Chinese American patients, who rarely take advantage of mental health services, and may also help address the shortage of mental health practitioners,” says Yeung.

Yeung also wants to investigate whether tai chi can have similar results for individuals from other racial and ethnic groups.

Research Teams at Mass General Explore Ways to Limit Alcohol-Induced Damage to the Liver and Better Understand Alcoholism’s Effect on the Brain

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Summer is almost upon us, which for many people means more outdoor time, cookouts, and for some—more drinking. While moderate alcohol consumption may have some health benefits, drinking too much can take a toll on our body. Researchers from Massachusetts General Hospital are investigating the long-term effects of excessive drinking on liver and brain function to find ways to reduce its impact on our health.

Enzyme treatment reduces alcohol-induced liver damage

Excessive drinking of alcohol can damage our liver in various ways. One way is through drinking more alcohol than the liver can process. And another is by making the gut’s intestinal membrane more permeable, which allows toxins to enter the blood stream and damage the liver.

Researchers in the lab of Richard Hodin, MD, in the Mass General Department of Surgery, reported in a new study that supplemental doses of an enzyme called intestinal alkaline phosphatase (IAP), which is known to stop bacterial toxins from entering the bloodstream through the gut, may also reduce liver damage from excess drinking.

In mouse models of binge drinking and chronic alcohol consumption, the research team found that feeding the mice a supplement of IAP reduced the amount of fat accumulation and inflammation in the liver and lessened signs of liver damage.

The enzyme appears to work in two ways. The first is by reducing the toxic effects of the lipopolysaccharide(LPS) molecule, which kills several important bacteria in the microbiome and can damage the liver if it passes through the intestinal membrane. The second is by reducing alcohol-induced membrane permeability in the intestine, which limits the overall amount of LPS that passes through the intestine. To be effective, the enzyme had to be administered before or at the same time as the alcohol. Administration after the fact had no effect. Human research is now being planned to confirm these results, and researchers plan to investigate other molecules that may have a role in liver inflammation.

“Liver damage is one of the most devastating effects of excess alcohol consumption, and so blocking this process could save millions of lives lost to alcohol-related liver diseases such as cirrhosis and liver cancer,” says Hodin, the study’s senior author. Read more here.

Imaging study reveals structural difference in brains of male and female alcoholics

It is known that alcoholic men and women have different psychological and behavioral profiles. Female alcoholics tend to have higher levels of anxiety, while male alcoholics tend to become more antisocial. But how do men and women’s brain structures that comprise the reward system that responds to alcohol compare? A collaborative study by researchers at Mass General and Boston University was the first to take a look.

The brain’s reward system includes the amygdala, which controls the fight or flight instinct, and the hippocampus, which controls long-term memory and emotional response.  The system is known to be involved in the development of substance abuse disorders like alcoholism.

In a study of 60 men and women with a history of alcoholism, along with a control group of non-alcoholics, researchers from the BU School of Medicine and the 3D Imaging Service and the Center for Morphometric Analysis in the Martinos Center for Biomedical Imaging at Mass General found that women with alcoholism tend to have a larger reward system than women without alcoholism—4.4 percent larger. It also confirmed previous studies that showed men with alcoholism tend to have smaller reward structures than those without—4.1 percent smaller.

It is not yet known if the differences in reward system size preceded the development of alcoholism or were a result of the disease. The results also suggest that alcohol works in different ways on the male and female brain, and that gender-specific approaches to treatment for alcoholism may be more effective than a one-size-fits-all approach. Learn more here.

Identifying Risky Behaviors for Mental Health Month

May is Mental Health Month, a time to raise awareness about mental illness and related issues.

Suicide is the tenth highest cause of death in the United States, and the rate remained roughly steady across the population for the last century, before rising somewhat during the last few decades. Read how Mass General researcher Matthew Nock, PhD, is studying self-harm to understand how we can better identify suicide risk and prevent it.

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Illustration by Davide Bonazzi