Winter depression: What causes seasonal affective disorder and how you can beat it

By Michael Walsh15 hours ago

There ain’t no cure for those summertime blues — but you might be able to kick that winter funk.

If you start to feel down when the days get shorter and the temperature drops, you’re not alone. Winter depression is so common that it has a name: seasonal affective disorder, or SAD.

Common symptoms include anxiety, irritability, fatigue, and sadness. Sufferers might find themselves craving more carbohydrates and sleep, while withdrawing from social activities.

About half a million Americans suffer from SAD and an additional 10 to 20 percent of the U.S. population are hit by a milder form of the winter blues, according to the Cleveland Clinic.

People at high altitudes or cloudier regions are at a greater risk for SAD.

But what is it about the supposedly “most wonderful time of the year” that bums out so many people?

The exact cause is unknown, but several factors may come into play.

Dr. Ani Kalayjian, professor of psychology at Columbia University, says that the lack of sunshine robs us of the vitamin D3 in ultraviolet B rays.

“It’s about the light and the deficiency in vitamin D3,” she said in an interview with Yahoo News. “Even when it’s not winter, most of us are lacking vitamin D3, which can result in signs of depression.”

After all, if you work long hours in an office with few windows, you could suffer from SAD all year round.

Experts say the dearth of sunlight can also disrupt your body’s internal clock (or circadian rhythm) and cause a decrease in serotonin (a neurotransmitter that affects one’s mood) — both of which can trigger depression.

Additionally, the seasonal change can bump melatonin levels off-balance, affecting sleep patterns and mood, according to the Mayo Clinic.

There are several ways someone can tackle these problems. Not surprisingly, eating green leafy vegetables and avoiding starchy, sugary foods can go a long way in fighting SAD — as can staying active.

“Exercise is very important because it releases endorphins, which bring us joy,” Kalayjian said. “Yoga, tai chi, tae kwon do, or other activities that focus on the breath — in a slow and attentive way — can add oxygen, which relaxes us and makes us feel good.”

Kalayjian recommends using vacation days during colder months to visit warmer climates, where we can soak up vitamin D3.

If these strategies do not work, sufferers can opt for light therapy, or phototherapy. Patients sit several feet from a special light that emulates natural sunshine and appears to relieve symptoms.

Doctors may also recommend psychotherapy or antidepressants, depending on the severity of the disorder.

http://news.yahoo.com/winter-depression--what-causes-seasonal-affective-disorder-and-how-can-you-beat-it-215008967.html

Study suggests link between gut microbiota and Parkinson's disease

Parkinson's disease sufferers have a different microbiota in their intestines than their healthy counterparts, according to new research.

Very good article:

Study suggests link between gut microbiota and Parkinson's disease

Mendelian genes for Parkinson's disease contribute to the sporadic forms of the disease.

by: Nino Spataro, Francesc Calafell, Laura Cervera, Ferran Casals, Javier Pagonabarraga, Berta Pascual-Sedano, Antònia Campolongo, Jaime Kulisevsky, Alberto Lleó, Arcadi Navarro, Jordi Clarimón, Elena Bosch

Human molecular genetics (11 December 2014), doi:10.1093/hmg/ddu616  Key: citeulike:13462968

Abstract

Parkinson's disease (PD) can be divided in familial (Mendelian) and sporadic forms. A number of causal genes have been discovered for the Mendelian form, which constitutes 10-20% of the total cases. Genome-wide association studies (GWASs) have successfully uncovered a number of susceptibility loci for sporadic cases but those only explain a small fraction (6-7%) of PD heritability. It has been observed that some genes that confer susceptibility to PD through common risk variants also contain rare causing mutations for the Mendelian forms of the disease. These results suggest a possible functional link between Mendelian and sporadic PD and led us to investigate the role that rare and low-frequency variants could have on the sporadic form. Through a targeting approach, we have resequenced at 49X coverage the exons and regulatory regions of 38 genes (including Mendelian and susceptibility PD genes) in 249 sporadic PD patients and 145 unrelated controls of European origin. Unlike susceptibility genes, Mendelian genes show a clear general enrichment of rare functional variants in PD cases, observed directly as well as with Tajima's D statistic and several collapsing methods. Our findings suggest that rare variation on PD Mendelian genes may have a role in the sporadic forms of the disease. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

http://www.citeulike.org/user/zivganor/article/13462968

Sleep disturbances in drug naïve Parkinson's disease (PD) patients and effect of levodopa on sleep.

by: Teresa Ferreira, Sudesh Prabhakar, Parampreet S. Kharbanda

Annals of Indian Academy of Neurology, Vol. 17, No. 4. (October 2014), pp. 416-419  Key: citeulike:13462980

Parkinson's disease (PD) is associated with sleep disturbances, attributed to the neurodegenerative process and therapeutic drugs. Studies have found levodopa to increase wakefulness in some patients while increasing sleepiness in others. To confirm sleep disturbances in drug naïve PD patients and understand the impact of levodopa on their sleep. Twenty-three drug naïve PD patients and 31 age-gender matched controls were compared using the Parkinson's Disease Sleep Scale (PDSS) and Epworth Sleepiness Scale (ESS). A polysomnogram objectively compared sleep quality. Of the 23 patients, the 12 initiated on levodopa were reassessed subjectively and through polysomnography after 2 months of therapy. Data was expressed as mean ± standard deviation, median, and range. Continuous variables were analyzed by Student's T test for normally distributed data and Mann-Whitney U test for skewed data. Discrete variables were compared by Chi Square tests (Pearson Chi square Test or Fisher's Exact Test). Wilcoxon signed ranks test was applied in the analysis of paired data pre- and post-levodopa. A P value < 0.05 was considered as statistically significant. Statistical analysis of the data was done using the Statistical Package for the Social Sciences (SPSS) version 12. Drug naïve PD patients had lower PDSS scores than controls. The sleep architecture changes observed on polysomnogram were reduced NREM Stage III and REM sleep and increased sleep latency and wake after sleep onset time. Following levodopa, improved sleep efficiency with reduced sleep latency and wake after sleep onset time was noted, coupled with improved PDSS scores. However, NREM Stage III and REM sleep duration did not increase. PD patients take longer to fall asleep and have difficulty in sleep maintenance. Sleep maintenance is affected by nocturia, REM behavioral disorder, nocturnal cramps, akinesia, and tremors, as observed in PDSS scores. Levodopa improves sleep efficiency by improving motor scores without altering sleep architecture. Poor sleep quality and sleep architecture changes occur secondary to the neurodegenerative process in PD patients. Though levodopa improves sleep quality by reducing rigidity and tremor, it does not reverse sleep architecture changes.

First Real-time MRI-guided Brain Surgery for Parkinson’s in Southern California

Released: 16-Dec-2014 1:00 PM EST 
Source Newsroom: University of California, San Diego Health Sciences

Newswise — Neurosurgeons at UC San Diego Health System are the first in Southern California to implant a deep brain stimulator (DBS) in a patient with Parkinson’s disease using real-time 3-D magnetic resonance image (MRI) guidance. 

Parkinson’s disease is a progressive disorder of the nervous system that affects movement. Symptoms include shaking, slowness of movement and difficulty walking. These unpredictable movements are caused by abnormal nerve cell activity in the brain. DBS therapy, like a heart pacemaker, transmits electrical signals to help restore normal activity.

Traditionally, DBS surgery is conducted while the patient is awake, and under pain management. This approach allows surgeons to continuously monitor the patient’s brain function and to ensure accurate placement of the device. 

“Now, for some patients, this surgery can be performed in the MRI suite under general anesthesia so that a patient can sleep during the placement of the DBS electrodes,” David Barba, MD, director of functional neurosurgery, UC San Diego Health System. “Within a few days of DBS therapy, many patients can resume life’s everyday activities.”

“Placing a DBS device while a patient is awake can be exhausting for the patient due to the length of the procedure and the need to perform neurologic testing in the operating room,” added Clark Chen, MD, PhD, director of stereotactic and radiosurgery, UC San Diego Health System. “Fortunately, with continuous real-time MRI monitoring, we can now place the electrode in a safe location that provides maximal neurological benefit while the patient is under the comfort of general anesthesia.”

Bob S. Carter, MD, PhD, professor and chief of neurosurgery, and co-director of the UC San Diego Neurological Institute said the collaborative endeavor introduces a new technology strategy to improve the care of patients with Parkinson’s and other diseases. 

“Our capacity to perform these procedures will be further enhanced in the new A. Vassiliadis Family Hospital for Advanced Surgery at Jacobs Medical Center which opens in 2016,” said Carter.

DBS can also be used to treat other movement disorders, including dystonia, essential tremor and obsessive compulsive disorder. It is in clinical trial testing as treatment for depression.

UC San Diego Health System is an internationally recognized leader in functional neurosurgery. Barba is a pioneer in the neurosurgical treatment of patients affected with movement disorders. Chen is an expert in MRI guided neurosurgery.

http://health.ucsd.edu/specialties/neuro/specialty-programs/movement

Traditionally, DBS surgery is conducted while the patient is awake, and under pain management. This approach allows surgeons to continuously monitor the patient’s brain function and to ensure accurate placement of the device. 

“Now, for some patients, this surgery can be performed in the MRI suite under general anesthesia so that a patient can sleep during the placement of the DBS electrodes,” David Barba, MD, director of functional neurosurgery, UC San Diego Health System. “Within a few days of DBS therapy, many patients can resume life’s everyday activities.”

“Placing a DBS device while a patient is awake can be exhausting for the patient due to the length of the procedure and the need to perform neurologic testing in the operating room,” added Clark Chen, MD, PhD, director of stereotactic and radiosurgery, UC San Diego Health System. “Fortunately, with continuous real-time MRI monitoring, we can now place the electrode in a safe location that provides maximal neurological benefit while the patient is under the comfort of general anesthesia.”

Bob S. Carter, MD, PhD, professor and chief of neurosurgery, and co-director of the UC San Diego Neurological Institute said the collaborative endeavor introduces a new technology strategy to improve the care of patients with Parkinson’s and other diseases. 

“Our capacity to perform these procedures will be further enhanced in the new A. Vassiliadis Family Hospital for Advanced Surgery at Jacobs Medical Center which opens in 2016,” said Carter.

DBS can also be used to treat other movement disorders, including dystonia, essential tremor and obsessive compulsive disorder. It is in clinical trial testing as treatment for depression.

UC San Diego Health System is an internationally recognized leader in functional neurosurgery. Barba is a pioneer in the neurosurgical treatment of patients affected with movement disorders. Chen is an expert in MRI guided neurosurgery.

To learn more about MRI-guided DBS placement, please visit: http://health.ucsd.edu/specialties/neuro/specialty-programs/movement-disorders/Pages/deep-brain-stimulation.aspx

Parkinson’s Disease Infographic

According to a study, people who have used amphetamines such as dexedrine and benzedrine appear to be at an increased risk of developing Parkinson’s disease.

Dexedrine and Benzedrine are amphetamines frequently prescribed to enhance focus for individuals having attention deficit hyperactivity disorder as well as narcolepsy, a condition that can result in excessive daytime sleepiness and also unexpected episodes of sleep. They’re also used for treatment of traumatic brain injuries.

The research involved 66,348 individuals with an average age at the beginning of the study of 36 years old. 1,154 individuals had been diagnosed with Parkinson’s by the conclusion of the study.

Exposure to amphetamines was established by 2 questions: 1 on the use of drugs for losing weight and a 2nd question on whether people often made use of Dexedrine or Benzedrine. Amphetamines were among the drugs regularly used for losing weight when this information was collected.

According to the research, those individuals who reported using Dexedrine or Benzedrine were nearly 60% more likely to develop Parkinson’s than those who did not take the drugs. There wasn’t any increased risk found for those individuals who used drugs for losing weight.

If further research confirms these results, the potential risk of developing Parkinson’s disease from these kinds of amphetamines will have to be considered by doctors prior to prescribing these drugs and also be incorporated into amphetamine abuse programs.

Amphetamines affect the release and uptake of dopamine, the main neurotransmitter involved in Parkinson’s.

http://www.ahealthblog.com/parkinsons-disease-infographic.html

Smart shoes with lasers make strides in mobility

• 17 December 2014 by Aviva Rutkin

THE right shoes can do more than complement your outfit. A new mobility aid named Path helps people who have trouble walking – simply by being fitted to their shoes.

Lise Pape, an engineer at InnovationRCA at the Royal College of Art in London, was inspired to build the system by her father, who was diagnosed with Parkinson's disease more than 10 years ago. Like many people with Parkinson's, he falls occasionally and experiences freezing of gait, the temporary impression that his feet are glued to the ground.

Visual cues have been shown to improve the pace and extend the stride of people with Parkinson's. So a laser that Path adds to the tip of the shoe projects parallel lines onto the next 50 centimetres of the floor. Each shoe lays down a guide for the opposite foot, keeping the grid steady until the wearer is ready to take the next step.

In addition, pressure sensors inserted into the soles of the shoes trigger vibrations when a foot hits the ground. This active feedback is designed to compensate for loss of sensation in the feet, another common symptom of Parkinson's. The soles and the toe projectors can easily be fitted to an ordinary pair of shoes.

Earlier this year, Pape tested Path on one person with Parkinson's and two with multiple sclerosis, another disease that impairs movement. The preliminary results were presented on 10 December at the Footwear Health Tech Conference in Eindhoven, the Netherlands. "I've had a lot of encouraging feedback from patients," Pape says. She plans to run a clinical trial early next year and wants to explore how the shoes can help people with spinal cord injuries.

"It's a great idea," says Peter Schmidt of the National Parkinson Foundation in Miami, Florida. He says projected lines are a great aid, but up until now they've only been built into canes and walkers.

This article appeared in print under the headline "Smart shoes with lasers make strides in mobility"

http://www.newscientist.com/article/mg22430002.800-smart-shoes-with-lasers-make-strides-in-mobility.html?cmpid=RSS%7CNSNS%7C2012-GLOBAL%7Cmagcontents#.VJGulLgALg

Meth users face substantially higher risk for getting Parkinson's disease

 news on december 16, 2014 - 5:30pm

(SALT LAKE CITY)--In addition to incurring serious dental problems, memory loss and other physical and mental issues, methamphetamine users are three times more at risk for getting Parkinson's disease than non-illicit drug users, new research from the University of Utah and Intermountain Healthcare shows. 

The researchers also observed that women who use methamphetamine may be nearly five times more likely to get Parkinson's disease compared to women who don't use drugs. Although findings suggest the risk in women may be higher than that in men, additional studies are needed to corroborate a gender difference. 

"Typically, fewer females use meth than males do," says Glen R. Hanson, D.D.S., Ph.D., a nationally recognized expert in drug addiction, professor and interim dean of the University of Utah School of Dentistry and professor of pharmacology and toxicology, the study's senior author. "Even though women are less likely to use it, there appears to be a gender bias toward women in the association between meth use and Parkinson's."

Published Dec. 11, 2014, in Drug and Alcohol Dependence, the study looked at more than 40,000 records in the Utah Population Database (UPDB), a unique compilation of genealogical, medical, and government-provided information on Utah families that is managed by the Huntsman Cancer Institute at the University of Utah. Karen Curtin, Ph.D., research assistant professor of medicine at the University and associate director of the UPDB, is the study's first author. Records from University of Utah Health Care and Intermountain Healthcare also provided unidentified patient data that was essential for getting a statewide perspective on the research.

The study confirms an earlier one that looked at nearly 250,000 California hospital discharge records and found a similar risk for Parkinson's among meth users. That study, however, did not report risks based on gender and looked only at records of hospital inpatients. Hanson and Curtin's study included both Utah inpatient and outpatient clinic records, capturing a wider segment of the population.

Parkinson's disease is a progressive movement disorder, with onset typically at age 60 or older, that affects nerve cells in the brain. Its symptoms include tremor, or shaking, often starting in a hand or fingers; slowed movement, such as walking; rigid muscles; loss of automatic movements-blinking or smiling, for example-and speech changes. There is no cure for Parkinson's, but medications and surgery can alleviate symptoms. It is estimated that 4 million to 6 million people worldwide have the condition. 

Hanson, Curtin and their colleagues examined medical records, dating from 1996 through 2011, separated into three groups: those of nearly 5,000 people whose health records indicated they had used meth (including amphetamines), more than 1,800 records indicating cocaine use, and records of a control group of more than 34,000 people selected at random whose health and other records showed no use of illicit drugs. The control group was matched to the meth and cocaine users according to age and sex. The researchers made sure that the group of meth users did not have a medical history of taking other illicit drugs or abusing alcohol, which might have influenced the risk for Parkinson's. 

Cocaine users, who provided a non-meth illicit drug comparison, were not at increased risk for Parkinson's. "We feel comfortable that it's just the meth causing the risk for Parkinson's, and not other drugs or a combination of meth and other drugs," Hanson says. 

All identifying information was removed from the records, so people counted in the study remained anonymous. 

The reason female meth users are more at risk for Parkinson's is not clear. Symptoms of the disease appeared in both female and male meth users in their 50s or later, indicating that the effects of meth may manifest years after initial use. "Oftentimes, we think about what drugs do in the short term, but we don't tend to give much thought to long-term consequences," Hanson says. 

Meth has become in some ways the drug of choice in the West, where it's used more commonly than in other parts of the country. In Utah, the trend toward meth use is particularly pronounced in women their late 20s and older who start taking the drug because of pressure from a partner or spouse.

"Female users in Utah may also get involved with meth because it's seen as a relatively cheap and effective way to lose weight and have more energy," Curtin says. Previous studies show that when women begin using drugs, they take smaller amounts than men, but escalate more rapidly to addiction and are at greater risk for relapse. "Normally, women develop Parkinson's less often than men; however, women may not achieve the same improvement in symptoms from medications or surgery. "If meth addiction leads to sharply increased incidence of Parkinson's disease in women, we should all be concerned."

Source: University of Utah Health Sciences

Identifying early signs of cognitive decline which are already present in some individuals during midlife

Signs of cognitive decline related to aging populations, and even the severe cognitive losses seen in Alzheimer's disease and neurodegenerative disorders, may emerge many years earlier, according to a report presented at the American College of Neuropsychopharmacology annual meeting in Phoenix (Arizona). The study suggests that early signs of cognitive decline are already present for some individuals during midlife, and that they are linked with risk factors such as elevated blood pressure. It is possible that if these risk factors are identified and modified early on, it will be possible to help detect and prevent the progression of cognitive deficits later in life.

As the population in developed countries ages, dementia and other conditions related to significant cognitive decline, and neurodegenerative disorders, such as Alzheimer's disease and Parkinsonism are becoming the major causes of disability in the elderly, and are a major public health concern. Although many of these conditions take decades to develop, a key step to prevent the downward spiral of cognitive decline is to identify risk factors earlier in life, so that they can be targeted and modified.

Studying a cohort of 3,499 biracial adults (the Coronary Artery Risk Development in Young Adults Study (CARDIA), who were followed since early adulthood (ages 18-30 years) through midlife (ages 43-55 years), Kristine Yaffe and colleagues at the University of California San Francisco examined the role of chronic exposure to cardiovascular risk factors (e.g. high blood pressure and fasting glucose levels) and lifestyle behaviors (e.g. diet, exercise) as predictors of cognitive decline during midlife. They found that the cumulative exposure to some of these risk factors, including clinical subthreshold (that is, within the normal range), but elevated, blood pressure, and low physical activity over the 25 years of the study was associated with worse cognitive performance in midlife, based on tests such as the Stroop Interference Score, the Digit Symbol Substitution Test and the Rey Auditory Verbal learning Test.

What is unique about these findings is that they provide evidence that changes in cognition can be detected during midlife (or even in young adults), and that they are associated with cumulative exposure to modifiable risk factors. Thus, these findings suggest that prevention strategies should target these risk factors to stop or reduce the progression of cognitive decline as early as possible.

These studies represent a critical step in the identification of antecedents of diseases of aging, in this case, cognitive impairment and neurodegenerative disorders, many years before they are diagnosed. The understanding that processes of cumulative risk for cognitive diseases of aging start early in adulthood provides a real opportunity for early identification and the use of prevention interventions for those at risk. Dr. Yaffe plans to continue imaging this CARDIA cohort for another 5+ years, to examine predictors of cognitive decline and correlations with brain findings.

Adapted by MNT from original media release

http://www.medicalnewstoday.com/releases/286889.php

Consider Restless Genital Syndrome in Parkinson's

the Neurology Advisor take:

Parkinson’s disease (PD) is rarely associated with discomfort in the genital region; however, researchers suggest that restless genital syndrome should be a part of the differential diagnosis in PD patients, according to a study published in JAMA Neurology. 

Restless genital syndrome, sometimes also referred to as persistent genital arousal disorder (PGAD), causes feelings of pain, discomfort, tingling and burning sensations in the genital region and can be disabling and very distressing to patients. 

A woman aged 65 years with PD complaining of severe and persistent discomfort in the genital region. Symptoms occurred at night and were often triggered by sitting or lying down for periods of time. During examination, no gynecological abnormalities were observed. She was treated with a low dose of a dopamine agonist and reported improvement.

Although the disorder is rare, researchers suggest that restless genital syndrome be included in the differential diagnosis of genital symptoms and restlessness, as well as nonmotor wearing off and akathisia. Treatment with dopamine agonists can improve symptoms. 

In PD, Restless Genital Syndrome Should Be Considered

In this case study, Camila C. Aquino, MD, MSc, of the Morton and Gloria Shulman Movement Disorders Center at Toronto Western Hospital in Ontario, Canada, and colleagues observed a female Parkinson's disease patient complaining of severe and disabling symptoms in the genital region, including burning sensations, tingling and pain. Previous rare cases were attributed to nonmotor off symptoms.

While restless genital syndrome is rare, researchers suggest that it be included in the differential diagnosis of genital symptoms and restlessness, and recommend treatment with a dopamine agonist. 

http://www.neurologyadvisor.com/restless-genital-syndrome-in-parkinsons-disease/article/376826/