Kamryn Eddy Finds Hope for Patients with Eating Disorders

Eddy quoto (1).png

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.

Holt-Hadjikhani-profile-bb.jpg
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 .

candycrush-Shika-forblog

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

Hofbraeukeller_5906_2

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.

suicide risk
Illustration by Davide Bonazzi

Adhering to Treatment During Adolescence Keeps HIV-Positive Youth on Healthier Track

22384936 - hand holding yellow pills

As HIV therapies have improved in recent decades, we are now seeing the first generation of youth who were born with the disease, or acquired it shortly after birth, live to adulthood. As this population matures, researchers are looking to learn more about how these individuals have fared in managing their condition in order to improve long-term treatment and care.

A recent Massachusetts General Hospital study of 1,400 individuals between the ages of 7 and 30 born with HIV found that teens and young adults are more likely to have a difficult time managing their condition than they did as younger children. Those in the study group who had good HIV control generally experienced good overall health outcomes, while those who had poor HIV control – meaning higher levels of HIV virus and lower levels of CD4 immune cells had more physical and mental health conditions, a higher incidence of health complications, and a greater risk of death.

“Adolescents infected with HIV – either at birth or later in life – experience poorer health outcomes compared to adults with HIV in nearly every respect”, says Anne Neilan, MD, MPH, of the Division of Infectious Diseases and the Medical Practice Evaluation Center, who led the study. “We need to act to strengthen these services for youth, taking into account their developmentally specific needs. That might include youth-friendly services that consider the substantial stigma many of these patients face, novel approaches to antiretroviral therapy delivery, and improving support for youth transitioning from pediatric to adult health care providers.”

Andrea Ciaranello, MD, MPH, of the Massachusetts General Hospital Division of Infectious Diseases and the Medical Practice Evaluation Center, is senior author of the study. Anne Neilan, MD, MPH, of the Division of Infectious Diseases and the Medical Practice Evaluation Center, led the study. Read more about this study here.

The Secret to a Healthier, Happier Life is Priceless, According to Harvard Study

We’ve all been told that certain habits, like eating a well-balanced diet or getting enough sleep, are beneficial for our long-term health. But how do our relationships with others impact our overall well-being? A nearly 80-year-old Harvard study has some good news for social butterflies.

“Our relationships and how happy we are in our relationships has a powerful influence on our health,” said Robert Waldinger, MD, director of the study, and a psychiatrist at Massachusetts General Hospital.

The study found that close relationships, more than money or fame, are what keep people happy throughout their lives. Those ties protect people from life’s discontents, help to delay mental and physical decline, and are better predictors of long and happy lives than social class, IQ or even genes.

“The people who were the most satisfied in their relationships at age 50 were the healthiest at age 80,” said Waldinger. Several other studies have found that people’s level of satisfaction with their relationships at age 50 was a better predictor of physical health than their cholesterol levels were.

“Loneliness kills,” Waldinger said. “It’s as powerful as smoking or alcoholism. Taking care of your body is important, but tending to your relationships is a form of self-care too.”

You can read the full story in the Harvard Gazette.

Also check out Dr. Waldinger’s popular TED Talk.

Re-Thinking Mental Health Treatment: World Health Day 2017

Did you know that more than 300 million people worldwide live with depression? That number has increased 18% between 2005 and 2015, according to the World Health Organization (WHO). With such staggering numbers, it’s no surprise that WHO has chosen depression as its theme for this year’s World Health Day, which is celebrated today, April 7th. “These new figures are a wake-up call for all countries to re-think their approaches to mental health and to treat it with the urgency that it deserves,” says WHO Director-General, Dr. Margaret Chan.

Researchers at Massachusetts General Hospital are working hard to find new treatment options for those who suffer from mental illness. We thought we’d share just a few examples of recent depression-related research being conducted at Mass General:

A team of researchers is looking into a more nuanced approach to deep brain stimulation treatment that could help patients with traumatic brain injuries, treatment-resistant depression and post traumatic stress. (Here’s another great article on their research from Pacific Standard magazine).

Researchers are looking into new ways to treat suicide risk. Their findings suggest that drugs such as ketamine (typically used as an anesthetic) may alleviate suicidal thoughts.

This NIH-funded study is using smartphones to measure a person’s mental state by analyzing his or her voice, call patterns, location and text messages.

Lastly, the Depression and Clinical Research Program at Mass General is currently conducting a number of studies and seeking participants. Their focus is on testing novel antidepressant treatments and on developing new tools to understand the biological changes that occur in this condition.

Intravenous Ketamine May Rapidly Reduce Suicidal Thinking in Depressed Patients

A Massachusetts General Hospital research team recently found that intravenous treatment with low doses of the anesthetic drug ketamine quickly reduced suicidal thoughts in a small group of patients with treatment-resistant depression.

The study found that the ketamine injections, when combined with the patient’s current antidepressant medication, quickly decreased suicidal thinking in patients who had experienced suicidal thoughts for three months or longer.

Ketamine treatment could provide a viable alternative to medications such as lithium and clozapine, which are currently used to treat suicidal thoughts. Both of these drugs can have serious side effects, requiring the careful monitoring of blood levels.

More research will now be needed to test the ketamine treatment versus a placebo and to confirm the results in a larger study group.

READ MORE HERE