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Archive for November, 2011

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New Research Offers Anorexia Relief

Tuesday, November 29th, 2011

EuroNews (Nov. 21, 2011)- Katherine Damazer was at school doing exams when she became anorexic. Previously on holiday with her family in Tibet she caught a virus, became very ill and lost a lot of weight.

At first she enjoyed being thin, then dieting took over her life.

“I used to feel faint all the time and every morning I woke up and blacked out for a while every time I got out of bed, and I used to be freezing, constantly freezing and shivering and having funny heart palpitations and having this constant feeling like your stomach was eating itself. You’re just so hungry and it kind of becomes enjoyable and satisfying because you know you’re doing a really good job at having an eating disorder,” she laughs.

But it is no laughing matter. Anorexia nervosa is a complex condition.

A London-based team is investigating whether repetitive transcranial magnetic stimulation could help sufferers. They are targeting the part of the brain that is implicated in the experience of craving.

“We found that one session of Trans Cranial Magnetic Stimulation as we deliver it may reduce cravings in people with bulimia nervosa, food cravings. In people with anorexia nervosa we found that reduces their sense of fullness and fatness when they’re exposed to foods and it also reduces their anxiety,” says Consultant Psychiatrist at King’s College, London, Frederique Van den Eynde.

Professor of Eating Disorders Ulrike Schmidt says anorexia takes an enormous toll on the body.

“They have, typically, after a period of time, lots of physical disabilities, the bones crumble, osteoporosis develops, people have problems with all their internal organs,” she says.

Around a million people in the UK suffer from eating disorders and experts do not really know what causes them. Up to 20 per cent of sufferers will die from their illness, so any new potential therapy has to be good news for patients and their families.

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TMS May Help Reduce Cigarette Cravings

Monday, November 7th, 2011

THURSDAY, Nov. 3 (HealthDay News) — In smokers, stimulating the brain in certain ways can manipulate their cravings for cigarettes, researchers have found.

The finding could lead to new treatments to help people kick the habit, according to the authors of the study published in the Oct. 15 issue of Biological Psychiatry.

Using brain imaging technology, researchers from Duke University Medical Center identified several regions of the cerebral cortex and the limbic system, which is involved in emotion, that are activated during cravings. Based on these studies, they used noninvasive magnetic stimulation of these areas of the brain in an attempt to manipulate these cravings.

“We directly stimulated a frontal brain region using magnetic fields and showed that it exaggerated smokers’ craving for cigarettes when they viewed smoking-related cues. By gaining a better understanding of how the brain influences craving responses, strategies for blocking these responses can be devised and ultimately, more effective smoking cessation treatments may be developed,” explained one of the study authors, Dr. Jed Rose, in a journal news release.

Although low-frequency stimulation did not reduce smokers’ cravings, high-frequency stimulation did have this effect when participants were viewing nonsmoking cues, the researchers found. They also noted that high-frequency stimulation reduced the ability of cigarettes to satisfy smokers’ cravings, an effect that helps keep them addicted.

More research is needed to explore how this could lead to new treatments to help smokers quit, the authors pointed out.

“This elegant study implicates the superior frontal gyrus in controlling the activity of the craving circuit,” Dr. John Krystal, editor of Biological Psychiatry, said in the news release. “Additional research will be needed to determine the potential value of repetitive [transcranial magnetic stimulation] as a treatment for smoking.”

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Mal de Deparquement Syndrome and TMS

Thursday, November 3rd, 2011

Dr. Yoon-Hee Cha, with UCLA’s Department of Neurology, answers the most commonly asked questions about Mal de Debarquement Syndrome:  

What is Mal de Debarquement Syndrome?

Mal de debarquement syndrome is a term used to describe the persistent sensation of motion that people feel after they have been passively moved for a long time. It can happen with all kinds of travel but is most common after sea and air travel. It is a disorder of adulthood, with the average age of a first episode being about age 40, with women affected much more frequently than men, by at least a 3 to 1 ratio.

How can you treat it?

There is no cure for the disorder but benzodiazepines and antidepressants that raise serotonin tone can help manage symptoms in some people. For those people for whom medications don’t help and who have persistent symptoms, we are investigating neuromodulation tools like transcranial magnetic stimulation to see whether we can change the connectivity between different brain regions that may be driving the symptoms.

Can anything be done to prevent MdDS?

Overall, persistent MdDS lasting over a month is uncommon, but there are many people who are prone to experiencing recurrent episodes of MdDS. Some of the common factors include sleep deprivation and stress during travel. So, I advise my patients to plan their trips so that they are not sleep deprived when traveling. In some people who tend to get MdDS very frequently, I have them take a small dose of valium during travel.

What kind of research are you doing?

A few years ago, I did a clinical study involving about 100 patients. Now we have about 300 people in our database. It was clear that there were no structural brain or inner ear abnormalities in these patients. And, why should they? All they did was to step off of a boat or plane and developed their symptoms. So, I decided that we needed to study this disorder with functional neuroimaging like PET and functional MRI to see changes in glucose metabolism, functional connectivity, and really fine volume changes. And, it was clear that many if not most people with MdDS were not responding to medication. Which is why I decided that we needed to use external neuromodulation to treat these patients.

What is neuromodulation?

Many disorders do not respond well to medication or other more traditional therapies. So, a growing body of researchers are trying induce brain activity changes externally. The most common form of neuromodulation practiced is transcranial magnetic stimulation, or TMS. TMS is one form of neuromodulation in which a changing magnetic field placed over the head is used to induce either an inhibitory or excitatory physiological change in the brain. The effects obtained depend on the frequency, intensity, and location of the stimulation. Other forms are transcranial direct current stimulation, or stimulating peripheral nerves as a window into altering brainstem activity.

We did a pilot study using 4 different TMS conditions and there was one condition that was associated with very significant reduction in symptoms in some of the participants. So, we are testing longer exposure to TMS to see whether can induce a longer duration of symptom relief.

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