Medical Bulletin 21/ December/ 2024
Here are the top health news for the day:
How Mental Health Conditions Are Treated with Brain Stimulation Therapy?
Research team from University of Minnesota Medical School, developed a preclinical model of a human brain stimulation therapy and found this therapy works by enhancing the brain’s ability to process conflicting pieces of evidence — thus improving human cognition by making people more flexible in their decision-making. The findings are published in Science Translational Medicine
Brain stimulation therapy is a treatment where electrical signals are used to stimulate specific parts of the brain.
Lack of flexibility is a major factor in multiple mental health conditions, including depression, ADHD and addiction. Treatments to improve flexibility have traditionally been difficult to develop because of the lack of preclinical models. This new model directly pulls from work the team had previously conducted which demonstrated its effectiveness on humans, and now will help them understand why and how brain stimulation works. They intend to use those insights to discover treatments that work more reliably and help more patients.
“This work is a true translational story. We found an effect in humans, developed a preclinical model and then showed that the learnings from that model actually tell us how a human clinical intervention works,” said Alik Widge, MD, PhD, an associate professor at the U of M Medical School and psychiatrist with M Physicians. “Now, we're working to build a clinical trial around this idea of enhancing decisional flexibility. If we're right, that could be transformative for a wide range of disorders, from depression to addiction to PTSD and maybe even autism.”
Reference: Adriano E. Reimer et al.,Striatal stimulation enhances cognitive control and evidence processing in rodents and humans.Sci. Transl. Med.16,eadp1723(2024).DOI:10.1126/scitranslmed.adp1723
Urgent Need for Diet Improvement During and After Pregnancy: Researchers
New research from the University of Massachusetts Amherst finds a pervasive low-quality diet among pregnant and postpartum individuals, reflecting “an urgent need for widespread improvement.”
The study, recently published in the American Journal of Clinical Nutrition, assessed diet quality in the same individuals from the beginning of pregnancy through one year postpartum. Researchers used the USDA’s Healthy Eating Index (HEI), which is based on federal dietary guidelines, to develop a diet quality score for participants in the Pregnancy Eating Attributes Study (PEAS).
The overall average Healthy Eating Index score for the study participants’ diets was ranked on a 0-100 scale at 61.6. On a traditional A-F scale, the grade would be barely passing, a D, although that score is 10% higher than the average Healthy Eating Index score of the overall U.S. adult population. The Healthy Eating Index score is based on the adequate consumption of nine foods – total fruit, whole fruit, total vegetables, greens and beans, whole grains, dairy, total protein, seafood, plant proteins, as well as fatty acids — and the consumption of four foods in moderation — refined grains, sodium, added sugars and saturated fats.
Among all the study participants, Healthy Eating Index scores were stable from early pregnancy through one year postpartum. But researchers noted differences in scores according to sociodemographic characteristics, weight status, lactation duration and tobacco smoking.
Unmarried study participants and those participating in more than one federal assistance program recorded the lowest mean Healthy Eating Index scores. In addition, a higher body mass index (BMI) was associated with a lower-quality diet. The highest mean Healthy Eating Index scores were seen in participants with higher education and among those who reported never smoking.
The study participants’ diets were assessed at six points — in each trimester of pregnancy and two months, six months and one year postpartum. Overall, they scored high — A+ (100) — on eating enough whole fruits, total protein and greens and beans. They scored lowest — a failing grade — on eating adequate whole grains and fatty acids, and lower on dairy products. On the moderation side, they scored a lower grade on sodium intake and saturated fats than on added sugars and refined grains, though there were no high scores.
Reference: Lipsky, L. M., Wright, B., Lin, T. C., Liu, A., Abbott, C., Siega-Riz, A. M., & Nansel, T. R. (2024). Diet quality from early pregnancy through 1-y postpartum: a prospective cohort study. The American Journal of Clinical Nutrition, 120(5), 1284-1293.
Can Music Reduce Distress in Advanced Dementia Care?
A new study published in the journal Nature Mental Health, reveals the different benefits of music therapy, identifies mechanisms to explain why music can have these effects, and provides a blueprint for implementing effective music therapy for people with advanced dementia.
The research shows that if music therapy is designed to individual needs, it can deliver an immediate, short-term reduction in agitation and anxiety for individuals with advanced dementia, and improvements in attention, engagement, alertness and mood. Musical interactions can help people feel safer and more orientated in their surroundings, which can lower levels of distress and improve wellbeing.
The study recommends that music therapists train other professionals, ensuring all staff involved in the care of people with advanced dementia can use music, regardless of their experience. Resources, including musical instruments and information about how to produce personalised playlists, should be available, and families should be encouraged to use music to support their relatives.
Engaging in music may also benefit care staff and family members by reducing their levels of stress and improving their wellbeing.
The study involved interviews with staff and music therapists on inpatient mental health dementia wards at the Cambridgeshire and Peterborough NHS Foundation Trust, a systematic review of published research, and a national survey of healthcare professionals. The researchers also collaborated with the dementia specialist nursing charity Dementia UK.
Reference: Thompson, N., Odell-Miller, H., Underwood, B.R. et al. How and why music therapy reduces distress and improves well-being in advanced dementia care: a realist review. Nat. Mental Health 2, 1532–1542 (2024). https://doi.org/10.1038/s44220-024-00342-x
Study Reveals Protocol For Assessing Lung Health in Preterm Infants
Existing methods to evaluate lung function in premature infants such as spirometry are limited by the need to perform forced exhalations. While impulse oscillometry (IOS), a non-invasive alternative, permits the measurement of lung respiratory mechanics without requiring forced expiration, there has been no report of an effective multicenter study design utilizing impulse oscillometry to assess the lung function in ELGANs.
A recent study, led by researchers from the Department of Pediatrics at Children’s Hospital of Philadelphia, USA and published in Pediatric Investigation, sheds important light on the suitability of impulse oscillometry for testing lung function in a large multicenter ELGAN population. “Despite the non-invasive nature of IOS, it has not been widely utilized to evaluate lung health in the ELGAN population. This motivated us to report our methods and success in implementing a multicenter protocol for obtaining research-quality oscillometry data in extremely preterm children,” explains Dr. Katharine Tsukahara, the lead author of the study.
In their study, the researchers recruited early school-age preterm children with a high risk of BPD from the Hydrocortisone for Bronchopulmonary Dysplasia Respiratory and Developmental (HYBRiD) Outcomes Study, along with preterm children with minimal BPD or no lung disease from the Transfusion of Prematures Early School Age Follow-Up (TOP 5) study. Additionally, full-term children with healthy lungs were utilized to enable effective comparison across different study groups.
A 6-minute walk test and the International Study of Asthma and Allergies in Childhood questionnaire were employed across five Neonatal Research Network (NRN) centers to evaluate respiratory function in the study participants. impulse oscillometry was performed according to the Childhood Asthma Research and Education (CARE) Network procedures. To ensure the research quality of oscillometry data, the impulse oscillometry reports were reviewed based on five quality criteria from the CARE Network for oscillometry studies in pediatric asthma.
Around 98% of the study participants attempted the oscillometry test. The technical acceptability of IOS across the three study groups was high and varied between 85%–90% of the attempted tests. Moreover, the acceptability across the five NRN centers remained high.
Additionally, the researchers investigated whether any clinical factor hindered the likelihood of producing acceptable oscillometry data in the study population. They found that lower birth weight, number of days requiring ventilation during neonatal intensive care unit course, and neuromotor comorbidities were associated with a higher rate of failure during impulse oscillometry testing.
Reference: Tsukahara, K., Ren, C. L., Allen, J., Bann, C., McDonough, J., Ziolkowski, K., ... & DeMauro, S. B. (2024). Design and implementation of a multicenter protocol to obtain impulse oscillometry data in preterm children. Pediatric Investigation.
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