How Physical Exercise Prevents Dementia

NEUROSCIENCE NEWS          JULY 21, 2017

Summary: Researchers discover physical activity has an influence on brain metabolism, preventing an increase in choline. A new Translational Psychiatry report suggests physical exercise may help protect neurons and reduce symptoms of dementia in older people.

Source: Goethe University Frankfurt.

As expected, physical activity had influenced brain metabolism: it prevented an increase in choline. NeuroscienceNews.com image is for illustrative purposes only.

SMART study reveals changes in brain metabolism.

Numerous studies have shown that physical exercise seems beneficial in the prevention of cognitive impairment and dementia in old age. Now researchers at Goethe University Frankfurt have explored in one of the first studies worldwide how exercise affects brain metabolism.

In order to further advance current state of knowledge on the positive influence of physical activity on the brain, gerontologists and sports physicians at Goethe University Frankfurt have examined the effects of regular exercise on brain metabolism and memory of 60 participants aged between 65 and 85 in a randomised controlled trial. Their conclusion: regular physical exercise not only enhances fitness but also has a positive impact on brain metabolism.

As the researchers report in the current issue of the medical journal Translational Psychiatry, they thoroughly examined all the participants in the SMART study (Sport and Metabolism in Older Persons, an MRT Study) by assessing movement-related parameters, cardiopulmonary fitness and cognitive performance. In addition, magnetic resonance tomography (MRT) and magnetic resonance spectroscopy (MRS) were used to measure brain metabolism and brain structure. Following this examination, the participants mounted an exercise bike three times a week over a period of 12 weeks. 

The 30-minute training sessions were individually adapted to each participant’s performance level. The participants were examined again after the end of the programme in order to document the effects of this physical activity on brain metabolism, cognitive performance and brain structure. The researchers also investigated to what extent exercise had led to an improvement in the participants’ physical fitness. The study was conducted by the Gerontology Department of the Institute of General Medicine (headed by Professor Johannes Pantel) and the Department of Sports Medicine (led by Professor Winfried Banzer).

As expected, physical activity had influenced brain metabolism: it prevented an increase in choline. The concentration of this metabolite often rises as a result of the increased loss of nerve cells, which typically occurs in the case of Alzheimer’s disease. Physical exercise led to stable cerebral choline concentrations in the training group, whereas choline levels increased in the control group. The participants’ physical fitness also improved: they showed increased cardiac efficiency after the training period. Overall, these findings suggest that physical exercise not only improves physical fitness but also protects cells.

ABOUT THIS NEUROSCIENCE RESEARCH ARTICLE

Funding: The study was sponsored by the Else Kröner-Fresenius Foundation, the Cronstetten Foundation and the Schambach Family Foundation.

Source: Silke Matura – Goethe University Frankfurt
Image Source: NeuroscienceNews.com image is in the public domain.

Original Research: Full open access research for “Effects of aerobic exercise on brain metabolism and grey matter volume in older adults: results of the randomised controlled SMART trial” by S Matura, J Fleckenstein, R Deichmann, T Engeroff, E Füzéki, E Hattingen, R Hellweg, B Lienerth, U Pilatus, S Schwarz, V A Tesky, L Vogt, W Banzer & J Pantel in Translational Psychiatry. Published online July 18 2017 doi:10.1038/tp.2017.135

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Abstract

Effects of aerobic exercise on brain metabolism and grey matter volume in older adults: results of the randomised controlled SMART trial

There is mounting evidence that aerobic exercise has a positive effect on cognitive functions in older adults. To date, little is known about the neurometabolic and molecular mechanisms underlying this positive effect. The present study used magnetic resonance spectroscopy and quantitative MRI to systematically explore the effects of physical activity on human brain metabolism and grey matter (GM) volume in healthy aging. This is a randomised controlled assessor-blinded two-armed trial (n=53) to explore exercise-induced neuroprotective and metabolic effects on the brain in cognitively healthy older adults. Participants (age >65) were allocated to a 12-week individualised aerobic exercise programme intervention (n=29) or a 12-week waiting control group (n=24). 

The main outcomes were the change in cerebral metabolism and its association to brain-derived neurotrophic factor (BDNF) levels as well as changes in GM volume. We found that cerebral choline concentrations remained stable after 12 weeks of aerobic exercise in the intervention group, whereas they increased in the waiting control group. No effect of training was seen on cerebral N-acetyl-aspartate concentrations, nor on markers of neuronal energy reserve or BDNF levels.

Further, we observed no change in cortical GM volume in response to aerobic exercise. The finding of stable choline concentrations in the intervention group over the 3 month period might indicate a neuroprotective effect of aerobic exercise. Choline might constitute a valid marker for an effect of aerobic exercise on cerebral metabolism in healthy aging.

“Effects of aerobic exercise on brain metabolism and grey matter volume in older adults: results of the randomised controlled SMART trial” by S Matura, J Fleckenstein, R Deichmann, T Engeroff, E Füzéki, E Hattingen, R Hellweg, B Lienerth, U Pilatus, S Schwarz, V A Tesky, L Vogt, W Banzer & J Pantel in Translational Psychiatry. Published online July 18 2017 doi:10.1038/tp.2017.135

http://neurosciencenews.com/dementia-exercise-7144/

1 in 3 Cases of Dementia Are Preventable

NEUROSCIENCE NEWSJULY 20, 2017

Summary: Researchers have identified nine risk factors during different stages in life that may increase a person’s likelihood of developing dementia. At least 35% of dementia cases, researchers say, may be directly linked to these risk factors. By taking steps to reduce risks and by improving education, it is estimated that the incidence of dementia can be reduced by as much as 20%.

Source: USC.

One in three cases of dementia could be prevented by addressing nine lifestyle factors, according to a report from the first Lancet Commission on Dementia Prevention and Care. NeuroscienceNews.com image is credited to Keck Medicine of USC.

The first Lancet Commission on Dementia Prevention and Care identifies powerful tools to prevent dementia and touts the benefits of nonmedical interventions for people with dementia.

Managing lifestyle factors such as hearing loss, smoking, hypertension and depression could prevent one-third of the world’s dementia cases, according to a report by the first Lancet Commission on Dementia Prevention and Care. Presented at the Alzheimer’s Association International Conference (AAIC) 2017 and published in The Lancet, the report also highlights the beneficial effects of nonpharmacologic interventions such as social contact and exercise for people with dementia.

“There’s been a great deal of focus on developing medicines to prevent dementia, including Alzheimer’s disease,” says commission member and AAIC presenter Lon Schneider, MD, professor of psychiatry and the behavioral sciences at the Keck School of Medicine of USC. “But we can’t lose sight of the real major advances we’ve already made in treating dementia, including preventive approaches.”

The commission brought together 24 international experts to systematically review existing research and provide evidence-based recommendations for treating and preventing dementia. About 47 million people have dementia worldwide and that number is expected to climb as high as 66 million by 2030 and 115 million by 2050.

Reducing dementia risk, beginning in childhood

The commission’s report identifies nine risk factors in early, mid- and late life that increase the likelihood of developing dementia. About 35 percent of dementia — one in three cases — is attributable to these risk factors, the report says.

By increasing education in early life and addressing hearing loss, hypertension and obesity in midlife, the incidence of dementia could be reduced by as much as 20 percent, combined.

In late life, stopping smoking, treating depression, increasing physical activity, increasing social contact and managing diabetes could reduce the incidence of dementia by another 15 percent.

“The potential magnitude of the effect on dementia of reducing these risk factors is larger than we could ever imagine the effect that current, experimental medications could have,” Schneider says. “Mitigating risk factors provides us a powerful way to reduce the global burden of dementia.”

A nonpharmacologic approach to treating dementia

The commission also examined the effect of nonpharmacologic interventions for people with dementia and concluded that they had an important role in treatment, especially when trying to address agitation and aggression.

“Antipsychotic drugs are commonly used to treat agitation and aggression, but there is substantial concern about these drugs because of an increased risk of death, cardiovascular adverse events and infections, not to mention excessive sedation,” Schneider says.

The evidence showed that psychological, social and environmental interventions such as social contact and activities were superior to antipsychotic medications for treating dementia-related agitation and aggression.

The commission also found that nonpharmacologic interventions like group cognitive stimulation therapy and exercise conferred some benefit in cognition as well.

The commission’s full report provides detailed recommendations in the areas of prevention, treating cognitive symptoms, individualizing dementia care, caring for caregivers, planning for the future following a dementia diagnosis, managing neuropsychiatric symptoms and considering the end of life.

ABOUT THIS NEUROSCIENCE RESEARCH ARTICLE

The study will be presented at the Alzheimer’s Association International Conference (AAIC) 2017 in London.

Funding: This study was supported by the University College London, Alzheimer’s Society, UK, Economic and Social Research Council, Alzheimer’s Research UK.

Source: Meg Aldrich – USC

Image Source: NeuroscienceNews.com image is credited to Keck Medicine of USC.

Original Research: Abstract for “Dementia prevention, intervention, and care” by Prof Gill Livingston, MD, Andrew Sommerlad, MSc, Vasiliki Orgeta, PhD, Sergi G Costafreda, PhD, Jonathan Huntley, PhD, Prof David Ames, MD, Prof Clive Ballard, MD, Prof Sube Banerjee, MD, Prof Alistair Burns, MD, Prof Jiska Cohen-Mansfield, PhD, Claudia Cooper, PhD, Prof Nick Fox, MD, Laura N Gitlin, PhD, Prof Robert Howard, MD, Prof Helen C Kales, MD, Prof Eric B Larson, MD, Prof Karen Ritchie, PhD, Prof Kenneth Rockwood, MD, Elizabeth L Sampson, MD, Quincy Samus, PhD, Prof Lon S Schneider, MD, Prof Geir Selbæk, PhD, Prof Linda Teri, PhD, and Naaheed Mukadam, MSc in The Lancet. Published online July 19 2017 doi:10.1016/S0140-6736(17)31363-6

Abstract

Dementia prevention, intervention, and care

Acting now on dementia prevention, intervention, and care will vastly improve living and dying for individuals with dementia and their families, and in doing so, will transform the future for society.

“Dementia prevention, intervention, and care” by Prof Gill Livingston, MD, Andrew Sommerlad, MSc, Vasiliki Orgeta, PhD, Sergi G Costafreda, PhD, Jonathan Huntley, PhD, Prof David Ames, MD, Prof Clive Ballard, MD, Prof Sube Banerjee, MD, Prof Alistair Burns, MD, Prof Jiska Cohen-Mansfield, PhD, Claudia Cooper, PhD, Prof Nick Fox, MD, Laura N Gitlin, PhD, Prof Robert Howard, MD, Prof Helen C Kales, MD, Prof Eric B Larson, MD, Prof Karen Ritchie, PhD, Prof Kenneth Rockwood, MD, Elizabeth L Sampson, MD, Quincy Samus, PhD, Prof Lon S Schneider, MD, Prof Geir Selbæk, PhD, Prof Linda Teri, PhD, and Naaheed Mukadam, MSc in The Lancet. Published online July 19 2017 doi:10.1016/S0140-6736(17)31363-6

Parkinson’s DREAM Challenge Uses Mobile Sensor Data to Monitor Health Based on Movement

JULY 20, 2017   BY CAROLINA HENRIQUES IN NEWS.

The Parkinson’s Disease Digital Biomarker DREAM Challenge was just launched by Sage Bionetworks as the first of a series of open, crowd-funded projects designed to help researchers identify ways to use smartphones and remote sensing devices to monitor health and disease.

The first DREAM Challenge will focus on using sensors to identify aspects of Parkinson’s disease (PD) severity. Results, which are expected this fall, should provide best practices and tools to advance the development of Parkinson’s digital biomarkers, as well as to advance the mobile health community.

“While there are many projects that have successfully collected sensor data from people in the real-world setting, we still have a poor understanding of what the data can tell us about health,” Lara Mangravite, president of Sage Bionetworks, said in a press release.

Participants are encouraged to identify biomarkers of Parkinson’s severity from sensor data. Parkinson’s disease may cause patients to tremor, to have an impaired gait, or to suffer from speech or memory problems. These symptoms can change over time and can be measured using accelerometers, magnetometers, and gyroscopes.

“Remote sensor data capture can be used to objectively detect fluctuations in symptoms within a patient such as in response to medication,” said Larsson Omberg, vice president of systems biology at Sage. “But we are not yet very good at detecting differences between PD and non-PD participants. A major contributing factor is the naïve approaches to feature engineering that are currently being used.”

All data included in this challenge will include measurements taken from these tools, collected in two separate studies of Parkinson’s patients: the mPower and the Levodopa Response Trial.

mPower was an iPhone mobile app-based study of symptom variation in Parkinson’s patients. Launched in 2015, the study has enrolled more than 15,000 people so far and nearly 6,000 have already performed a remote test for gait and balance. mPower was one of the first studies to use Apple’s ResearchKit framework, a guideline developed specifically for researchers using iOS.

The second dataset included in the challenge results from the Levodopa Response Trial, in which people were monitored with three to eight accelerometer sensors while performing a series of activities. This trial captured continuous data in clinic visits and at-home days.

“Increasing the accuracy of remote health monitoring will expand our ability to better understand how our health is influenced by the context and choices of daily life,” said Paul Tarini, program officer at the Robert Wood Johnson Foundation (RWJF). “The challenge is designed to solve a major problem in the field – how best to process sensor data for health interpretations.”

The DREAM challenge is funded by the RWJF and The Michael J. Fox Foundation for Parkinson’s Research (MJFF). The MJFF will also award the $25,000 winning prize for the research team with the best methods for processing sensor data.

In addition to a monetary prize, the challenge has partnered with the scientific journal Nature Biotechnology to support the submission of an overview paper describing the challenge and broadly applicable insights stemming from the initiative.

https://parkinsonsnewstoday.com/2017/07/20/parkinsons-digital-dream-challenge-uses-smartphones-remote-sensing-data-monitor-health/

Key Parkinson’s Protein Gets Starring Research Role on International Space Station

JULY 21, 2017   BY CHARLES MOORE IN NEWS.

When a resupply mission lifts off in August bound for the International Space Station, it will be carrying an important cargo for researchers studying Parkinson’s disease: a protein considered  to be a key to potential future therapies.

The leucine-rich repeat kinase 2 (LRRK2) protein will be the focus of an experiment conducted on the Space Station. It is hoped that the microgravity conditions aboard the Space Station will allow growth of larger, more regular LRRK2 protein crystals, which would help scientists solve the protein’s structure — providing valuable information for the design of optimized therapies to fight Parkinson’s disease (PD).

The experiment is the result of a partnership between the Michael J. Fox Foundation for Parkinson’s Research and the Center for the Advancement of Science in Space (CASIS).

“We’re thrilled that PD research has been selected to travel to the International Space Station and honored to partner with CASIS on behalf of the PD community here on Earth,” said Michael J. Fox, the actor who started the foundation after he was diagnosed with Parkinson’s, in a video message played at the International Space Station Research and Development Conference held in Washington, DC, July 17 – 20.

The SpaceX CRS-12 cargo resupply mission scheduled for liftoff in August will carry LRRK2 protein to the Space Station to be used in the Crystallization of LRRK2 Under Microgravity Conditions (CASIS PCG 7) experiment.

In its role as manager of the Space Station’s U.S. National Laboratory, CASIS is responsible for coordinating transfer of scientific materials to and from the Space Station and oversight of work conducted in the laboratory. The Michael J. Fox Foundation, which initiated this project, has supported earthside preparation of the protein for growth in space.

Advancing Understanding of LRRK2 as a Key Parkinson’s Drug Target

LRRK2 is considered to be the greatest known genetic contributor to Parkinson’s disease, according to the Michael J. Fox Foundation. Most Parkinson’s cases are categorized as “idiopathic” — of unknown cause — with only about 10 percent of cases having been linked to a genetic cause. LRRK2 gene mutations are the most common cause of Parkinson’s in that minority, which represents only 1 to 2 percent of total Parkinson’s cases.

However, LRRK2 mutations account for a much higher proportion of Parkinson’s cases among people of certain ethnic groups, notably Ashkenazi Jews, North African Arab Berbers, and Basques, than they do in the general population.

The foundation notes that while estimates vary, it is believed that mutated LRRK2 (predominantly the mutation scientists refer to as G2019S) account for some 15 to 20 percent of Parkinson’s cases among Ashkenazi Jews, and about 40 percent of cases in North African Arab Berbers. Also, other genetic changes in LRRK2 have been found to increase risk of developing Parkinson’s among people of other ethnic backgrounds, such as in Asians of Chinese descent.

Because LRRK2 protein function is heightened in people with Parkinson’s disease, and is associated with a mutation in the LRRK2 gene, the foundation believes therapies targeting this gene could also accelerate development of treatments that can benefit a broader Parkinson’s population.

However, one obstacle holding back this line of drug development is the limited understanding of LRRK2’s exact structure. The foundation notes that greater understanding of a protein’s shape and structure can help developers design therapies more likely to engage a particular protein in treatment of disease.

Overcoming Gravitational Limitations

Earth’s gravitational field allows only low resolution versions of LRRK2 protein to be grown. However, the Crystallization of LRRK2 Under Microgravity Conditions (CASIS PCG 7) experiment will use automated biotechnology devices operating in the microgravity environment to grow larger, better-formed protein crystals with fewer defects that may yield higher resolution views of LRRK2. These will then be returned to Earth for postflight analysis.

Gregory H. Johnson, CASIS president
and executive director

Having a better detailed view of the precise shape and morphology of LRRK2’s crystalline structure would help scientists better understand Parkinson’s pathology, and accelerate development of LRRK2 inhibitor therapies designed to prevent, slow, or stop Parkinson’s disease progression.

“The unique environment of the International Space Station untethers research from restrictions imposed by gravity,” CASIS president and executive director, Gregory H. Johnson, said in a press release. “CASIS is glad to partner with The Michael J. Fox Foundation to explore the structure of this important piece of the Parkinson’s puzzle.”

https://parkinsonsnewstoday.com/2017/07/21/michael-j-fox-foundation-partners-with-casis-to-grow-key-parkinsons-protein-on-international-space-station/

GREAT MATCHMAKING ! : Israeli and Irish companies innovate healthcare at St. Louis summit

BYKAYLA STEINBERG    

 JULY 21, 2017 

People look for new partners at the GlobalSTL Health Innovation Summit in St. Louis, Missouri, last month. (photo credit:Courtesy)

Fourteen Israeli, Irish, and US innovators in medical technology came together in search of partnerships at a St. Louis conference, looking towards improving global healthcare.

While Israel is known for cultivating a strong start-up culture, partnership with Irish companies in the center of the US is unprecedented.

St. Louis has many strong hospital systems – including the headquarters of the largest nonprofit system in the US – and healthcare-focused Fortune 500 corporations,” said Donn Rubin, CEO and president of BioSTL, the umbrella organization whose GlobalSTL initiative hosted the summit.

“Not only are there tremendous assets in St. Louis, but we are able to provide access to strategic partners and decision-makers in a timely way beyond what most companies will experience in the larger metropolitan areas on the East Coast or West Coast. And because costs are lower in the middle of the country, opportunities are much more capital efficient,” he said.

The companies are innovators in various medical technologies, with capabilities such as managing medicines, monitoring vital signs, and assisting with emotional and behavioral health. More than $7.9 billion was invested in the digital health industry in the US in 2016, and GlobalSTL (along with the umbrella BioSTL) aspired to further business development in the industry with its summit.

Israeli company Telesofia realizes its mission of “making medical information clear” through short, personalized videos in English. The videos explain such topics as the medicine’s appearance, dosage, the patient’s medical problem, and treatment. Ninety nine percent of patients say that the technology is clear, concise, and relevant to them, and the videos are proven to reduce hospital readmissions.

Telesofia’s CEO Rami Cohen stated that Telesofia’s technology is “supporting about 10,000 different medication products that are updated on a weekly basis.” He added that Telesofia is probably the largest video library for medicines in the world.

Cohen described the video creation process as almost exclusively automatic, with technologies that read US Food and Drug Administration pamphlets weekly. Telesofia uses manual medical quality assurance, with people who make sure that any changes in the FDA weekly pamphlets are valid. Automatic processes are then responsible for updating the videos, should the FDA changes be valid. For example, if a pill switches from being round and white to oval and blue, Telesofia’s technology will automatically update videos to reflect such a change.

The videos and variations use algorithms that Cohen compares to “assembling Legos.” The company has developed a unique way to film its videos that allows the company to create and splice together different clips in one day. Filming and editing occur simultaneously, enabling Telesofia to create a lot of content in a few shooting days.

It sends its videos to healthcare companies and pharmacies, which pay for such technologies along with organizations such as the Bird Foundation who provide grant money.

These companies input patients’ medical information and then send the automatically generated videos to patients via text or email, with no app download necessary.

Telesofia has other videos that enable the patients to put in their own medical information. It collaborates with Tribune Content Agency in Chicago to develop a technology that allows users to learn more about wellness topics such as cardiovascular risk. The wellness videos, like the rest of Telesofia’s content, are personalized, with patients answering a few questions through an online wizard and then receiving videos moments later.

The company is also expanding its patient discharge instructions video library and creating video series. Its pneumonia discharge instruction videos alone consist of 106 quadrillion (15 zeros) variations, sent by healthcare companies and pharmacies to patients.

Telesofia Medical is the winner of the Frost & Sullivan 2016 New Product Innovation Award for best practice, receiving a whopping 9.5/10 score that topped the second-place competitor at 7.2/10. It was also ranked by Inc. magazine as number one on its list of 10 Tech Companies Impacting Humanity.

Cohen said that he is proud to represent Israel internationally through Telesofia and hopes to further his global connections, with plans to create videos in different languages.

Sixty percent of Telesofia’s current client base is in the United States.

One of the Irish companies who attended the summit, Beats Medical, has developed a smartphone application to provide specialized treatment for people with Parkinson’s disease.

CEO Ciara Clancy was inspired to start Beats Medical from her work as a physiotherapist and researcher who had cared for people with Parkinson’s.

Beats Medical’s app for Parkinson’s treatment features innovative technologies such as a built-in metronome that serves as a “beat” for people with Parkinson’s to walk to.

It also consists of speech and language therapy and dexterity training, helping people improve their vocal volume and handwriting. The app is currently available for use in 40 countries, including the US and Israel, and has been on the market for the last 2.5 years.

Its results have been life-changing.

One person walked the length of the UK, more than 1,000 km., with the app’s Parkinson’s technology.

Other users have been able to walk to shops again and resume many daily activities.

Clancy’s goal is that Beats Medical’s smartphone applications will allow people to “live independent lives through technology as long as they can.”

“We want them to live as people, not patients,” she said.

Beats Medical is currently developing apps for dyspraxia, multiple sclerosis, strokes, and cerebral palsy, aspiring to improve the lives of people with neurological conditions, which cost the US $800b. per year.

BioSTL had been bringing St. Louis delegations to Israel and vice versa for agricultural technology, healthcare, financial technology, and cyber security over the last three years. Already, five Israeli Agtech companies have established US headquarters in St. Louis.

http://www.jpost.com/Israel-News/Great-matchmaking-500294

Patient volunteers are being recruited to help train up the next generation of doctors and nurses

July 21, 2017

Patient volunteers are being recruited to help train up the next generation of doctors and nurses A UCLan student turning theory into practice with the help of a patient volunteer

PATIENT volunteers are being recruited to help train up the next generation of doctors and nurses.

The School of Medicine at the University of Central Lancashire (UCLan) is looking for patients happy to allow students to record their medical histories or, in some cases, carry out medical examinations.

Volunteers can attend sessions just once or twice a year as well as choosing to be more active participants.

Patients suffering from diabetes, chest diseases such as asthma, chronic obstructive pulmonary disease, pulmonary fibrosis or related illnesses, heart problems such as angina, previous heart attack or operations, valve diseases or related illnesses, as well as kidneys or bladder issues, conditions related to the gastrointestinal system or neurological problems such as epilepsy, Parkinson’s disease, previous stroke history, and previous surgeries on the spine or brain are particularly sought after.

Professor Cathy Jackson, head of the School of Medicine, said: “By giving us just a few hours a month members of the public can make a major difference.

"Our students learn the theory and knowledge that underpins their professional role in the classroom, but putting their knowledge into practice is an entirely different proposition.

“More than 80 per cent of the diagnosis procedure is based on listening to the patient so our student doctors really must have excellent communication, patient care and decision making skills.

"This is something they can only learn by working with real patients.

"We’d like our volunteers to provide feedback directly to students on their performance and behaviours.

“We’ve listed a number of areas where we’re looking for patient volunteers with specific conditions but we’re open to enquiries from patients with any disorder who would be interested in helping to train our doctors of the future, many of whom will work in Lancashire and Cumbria.”

To thank volunteers for giving up their time university bosses said they will pay the travel expenses for patients and offer volunteers a social gathering twice a year with staff from the school.

UCLan's five-year undergraduate medical programme, the Bachelor of Medicine and Bachelor of Surgery (MBBS), is the main source of new doctors across the orth West.

Students carry out clinical placements in secondary care at East Lancashire Hospitals NHS Trust (ELHT) at both the Royal Blackburn and Burnley General hospitals.

From September 2017, UCLan has partnered with East Lancashire Hospitals NHS Trust (ELHT) and North Cumbria University Hospitals NHS Trust (NCUHT) to offer scholarships for its medicine degree, aimed specifically at students residing in the East Lancashire and Cumbria regions.

Anyone interested in becoming a patient volunteer should emai: MedVolunteerPatient@uclan.ac.uk.

http://www.lancashiretelegraph.co.uk/news/15421742.Patient_volunteers_are_being_recruited_to_help_train_up_the_next_generation_of_doctors_and_nurses/

Can sleeping apart help your relationship?

July 22, 2017    Christine Ro

A few things that can wreck a good night's sleep? Caffeine, sure. Stress and anxiety, definitely. Being in a relationship? Well, yes, now that you mention it.

Specifically, it's the bed-sharing that messes things up. Simply put, sharing a bed means waking up more. In one 2007 study, nearly half of participants reported that they'd been woken up by their partner's movements, noises, or activities.

This presents an unfortunate predicament: You want to be able to sleep through the night, but you also want to keep on sleeping next to your partner. Ultimately, research suggests, most people end up choosing the latter, either because it's what's expected of couples or because they believe it's better for the relationship.

In some cases, that can mean sharing a bed with someone who's aggressive or violent during sleep, says Carlos Schenck, a psychiatry professor at the University of Minnesota who's written extensively about sleep disturbances.

 In his work, he's frequently encountered people who want to continue sleeping next to their significant other, even when that means getting (inadvertently) elbowed or punched all night. Much of the time, he says, it's because they want to help their partners deal with their sleep disturbances.

But this is one good intention that often backfires. Not getting enough sleep can easily turn someone into the worst version of themselves, and, by extension, make them a worse, less understanding partner: Sleep deprivation can take a toll on your sense of humor, your empathy, and your ability to make decisions, all of which can create additional relationship problems.

"It's definitely true that sleep problems can cause relationship distress," says Wendy Troxel, a clinical psychologist and behavioral sleep-medicine specialist. "Sleep problems have profound effects on daytime functioning, including how you get along with a partner." In her research, she explains, she's found that "more maritally satisfied couples were more likely to be in sync at night."

In some severe cases, sleep incompatibility doesn't just amp up the stress — it can directly lead to relationship breakdown. This includes cases where people with sleep issues are seriously troubled by the way their partners respond.

In 1986, Schenck was part of the Minnesota research team that first identified REM sleep behavior disorder (RBD). In RBD, sleepers lose the protective mechanism that keeps them essentially paralyzed. This means that their muscles are active rather than paralyzed during sleep, and they can act out their dreams, sometimes violently. (RBD has been linked to antidepressant use, and can be an early sign of Parkinson's disease and dementia.)

In 2004, Schenck co-authored a report on the first documented case of RBD leading to a suicide attempt. The case centered on a Taiwanese woman in her 30s, who had a long history of moving her arms and shouting during her sleep; eventually, after sustaining one too many punches, her husband began sleeping in a separate room. She felt so guilty about her troubled sleep, and its effects on her marriage, that she developed depression and eventually attempted suicide. Importantly, she said that troubled sleep was their only marital problem, and she had no other history of psychiatric instability. Thankfully, the tranquilizer clonazepam resolved her RBD — and by extension, her depression — and the couple was then able to go back to sharing a bed.

A different case, described in a 2010 report also co-authored by Schenck, involved an Italian man in his 20s who would punch his wife in his sleep. Numerous tests supported his diagnosis of RBD, but, as the report notes, his wife "really did not believe that he did not do this intentionally," eventually filing for divorce and bringing criminal charges against him. While the man was ultimately acquitted, the marriage ended.

Another sleep disturbance that can drive couples apart is sexsomnia, a disorder in which people initiate sexual activity while asleep and have no recollection of it when they wake up. As you might imagine, this one presents some particularly thorny legal issues: In a landmark 2013 case, for instance, a Danish man charged with groping two teenage girls sleeping in his apartment was acquitted after providing evidence that he suffered from sexsomnia. The disorder is recognized as a legitimate sleep condition, though some experts worry that it might be misconstrued or used disingenuously as a defense (Schenck and a colleague recently co-authored guidelines for sleep forensic experts). Even when a case of sexsomnia is genuine, it can be deeply troubling for all involved, partners included.

But it's important to remember that these aren't common cases. Schenck comments that only a small proportion of sleep-disorder cases involve aggression or violence. Troxel says that it's also rare to see a genuine "sleep divorce," and that in general, attributing a breakup just to sleep incompatibility "would oversimplify relationship rupture." Still, even for more run-of-the-mill sleep-related problems, it can be helpful to treat them as a proxy for relationship troubles — while some people may be reluctant to undergo couples therapy or psychotherapy, just about everyone wants better sleep.

http://theweek.com/articles/712558/sleeping-apart-help-relationship

How parasites pull the strings

July 21, 2017

Science fiction has long explored the terrifying possibility that we are devoid of free will, and that some unpleasant creature could control our minds or turn us into plodding zombies. But mind control is not just a literary trope. It is also a common method by which parasites gain access to environments where they can grow, reproduce, and complete their life cycles.

Consider the fungus Cordyceps, which interferes with the behaviour of ants in tropical rainforests in such a way as to make them climb high into the vegetation, and latch onto a leaf to die. The fungus then reproduces by dropping its spores all over the forest floor, to infect more ants below. Similarly, a virus that infects gypsy moth larvae prompts them to climb en masse to the tops of trees to die. The virus then multiplies, and rains viral particles down on the forest floor.

These parasites make their hosts seek a higher elevation, which expands the reach of their infectious spores or particles. But other species can induce far more complex behaviours. Nematomorph worms, for example, infect crickets, and drive them to commit suicide by jumping into various water sources, be it a puddle or swimming pool. It is precisely in such aquatic environments that nematomorph worms reproduce and complete their life cycles.

And parasites' mind-control abilities are not limited to invertebrates. Consider the rabies virus, which is transmitted among dogs, humans, and other mammals by biting. To maximize its chances of spreading to another host, the virus actually alters its host's mind to turn it into an angry, slavering, biting machine that will chomp at anything it encounters.

Another species that can affect human behaviour is the protozoan parasite Toxoplasma gondii, the causal agent of Toxoplasmosis. T. gondii is extremely common, with an infection rate of 15-85% across different countries, depending on climate and diet. Whereas Brazil and France have infection rates of around 80%, Japan's is only 7.0%.

T. gondii can find its way to humans through farm animals such as pigs, cows, and sheep. And, as it happens, raw-meat dishes are more common in French and Brazilian cuisines. But T. gondii naturally targets cats, by way of rats whose behaviour it has altered. Namely, the microbe increases the likelihood of its host rat being eaten by a cat, by reducing the rat's natural fear of light (photophobia) and cat urine.

Humans, too, can experience alarming behaviourial changes after becoming infected by T. gondii. Infected men can become jealous, distrusting of others, disrespectful of established rules, and less risk-averse; as a result, they are almost three times more likely to be involved in a car accident. Infected women, meanwhile, can become either suicidal or more warm-hearted, insecure, and moralistic.

Moreover, there is evidence that a T. gondii infection could play a role in mental disorders. More than 40 studies have shown that people suffering from schizophrenia test positive for T. gondii antibodies, indicating that they may have been previously infected. And T. gondii has also been tied to dementia, autism, Parkinson's disease, and brain cancer.

How can these puppet-master parasites control the brains of such diverse invertebrate and vertebrate species? One possibility is that they can change the levels of neurotransmitters such as dopamine and serotonin in the brain. Neurotransmitters are ancient molecules that have been conserved through the ages of evolution, and they are known to influence behaviour.

Thanks to genomics and proteomics, we have begun to understand the role that neurotransmitters play in allowing parasites to manipulate host behaviour. When researchers analyzed the T. gondii genome, they found the precursor to dopamine synthesis, L-DOPA, suggesting that the parasite might be able to synthesize and secrete dopamine directly into a host's brain. This would explain why rats infected with T. gondii have higher levels of dopamine, and why dopamine inhibitors can suppress their parasite-induced behavior.

Parasites that infect invertebrates can also manipulate neurotransmitter levels. For example, the emerald cockroach wasp injects its cockroach host with a venomous cocktail that contains the neurotransmitter octopamine. This puts the cockroach into a sleep-like state, at which point the wasp drags it off to its lair and lays eggs in its abdomen.

And like T. gondii in rats, acanthocephalan worms (also known as spiny-headed worms) overrides the natural photophobia of their freshwater crustacean hosts. As the crustacean gravitates toward the surface of the water, it is eaten by a duck, at which point the worm completes its lifecycle.

Researchers have found that when uninfected amphipods are injected with serotonin, they spend more time near the surface of the water, as if they had been infected. And protein analysis of grasshoppers infected with nematomorph worms shows a change in the proteins that are involved in releasing neurotransmitters.

We are only just beginning to understand how these diverse puppet-master parasites can manipulate invertebrate and vertebrate behaviour. But we already know that pulling on the strings of neurotransmitters is one common method. If further research vindicates some of the more seemingly outlandish imaginings of science fiction, it wouldn't be the first time.

Robbie Rae is a lecturer in genetics at Liverpool John Moores University, United Kingdom. Project Syndicate, 2017.  

http://www.thefinancialexpress-bd.com/2017/07/21/77618/How-parasites-pull-the-strings