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Psychiatry Newsletter - The Bench. The Bedside.

Hopkins BrainWise Fall 2010

The Bench. The Bedside.

Date: November 29, 2010

Old woman looking at pictures

Having a biomarker for Alzheimer’s disease (AD) that you could sample from blood would beat out newer icons of the illness—seen in neuroimaging or spinal fluid—by being far less costly and invasive. Now a study by Michelle Mielke and colleagues showed that blood plasma levels of particular ceramides—long chain lipid molecules—can clearly mark the onset and progress of AD. The team tested healthy people with mild cognitive impairment and those with early, probable Alzheimer’s. Unusual ceramide levels in the mildly impaired group predicted a downhill turn a year later. A further bonus is that altered ceramides probably reflect early events in AD—just what you want in a biomarker.  E-mail:

Jennifer Payne’s team wanted to see if adoptive mothers experience any of the same signs of depression as post-partum women. At three different intervals, they studied 112 adoptive mothers of infants less than a year old, using a standard depression scale and questionnaire on medical and psychiatric history. Roughly a quarter of the mothers showed depressive symptoms in the first month after adoption, largely due to stress.  Call: 410-502-2586

Some 44 percent of patients with Alzheimer’s suffer sleep disturbances and insomnia—a sad fact both for them and their caregivers. What approach offers the most help? Vani Rao and colleagues reviewed research on 38 sleep-promoting options, from medications to bright light therapy (BLT), holding each to high evidence-based medicine criteria. No treatment brought huge relief, including antidepressants or antipsychotics. Melatonin helped some, apparently. But the methods of choice were non-drug-based therapies such as better sleep hygiene and BLT; improvement there came with a low risk of side effects.  Call: 410-550-0019

Autism spectrum disorder (ASD) reflects a derailment of childhood mental development that, in adults, can bring problems with social sensitivity, attention and aggression, among others. Risperidone, the only approved medication, has significant side effects. Now, Eric Samstad is conducting trials of memantine, a more benign, anti-Alzheimer’s drug, in adults with ASD. Certain brain circuits in Alzheimer’s and autism likely overlap. Earlier tests suggested memantine benefited children with ASD. The drug may improve social behavior and language, areas untouched by risperidone. Call: 410-913-3216

Should I drink that cocktail?  Eat that donut?  Intuition tells us psychiatric illnesses that turn on decision-making, like alcoholism or anorexia, should be less under genes’ influence than those whose symptoms seem to surface spontaneously, like mania or schizophrenia. But Joseph Bienvenu took advantage of the many genetic epidemiological studies on psychiatric disease  now ripe for review and they suggest otherwise. His surveys of studies of twins suggest “behavioral” ills are every bit as grounded in biology. It’s just that gene effects on temperament, reward systems, sensation-seeking and the like are harder to pin down.  Call: 410-614-9063

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