Medical Students Who Engage in the Arts Make Better Doctors

Medical Students Who Engage in the Arts Make Better Doctors

A new study finds that students who devoted more time to the arts and humanities during medical school had significantly higher levels of positive physician attributes like empathy, tolerance of ambiguity, wisdom, and emotional intelligence, while at the same time reporting lower levels of adverse traits like burnout.

“The humanities have often been pushed to the side in medical school curricula, but our data suggests that exposure to the arts are linked to important personal qualities for future physicians,” said senior author Marc Kahn, M.D., MBA, MACP, and Senior Associate Dean in the Tulane University School of Medicine. “This is the first study to show this type of correlation.”

Through an online survey of 739 students at five medical schools across the country, the researchers measured exposure to the humanities (music, literature, theater, and visual arts), positive personal qualities (wisdom, empathy, self-efficacy, tolerance for ambiguity, and emotional appraisal), and negative qualities associated with well-being (physical fatigue, emotional exhaustion, and cognitive weariness).

The researchers found that those who reported more interactions with the humanities also scored higher in openness, visual-spatial skills, and the ability to read their own and others’ emotions.

Those with fewer interactions scored higher for qualities associated with burnout, such as physical fatigue and emotional exhaustion, the researchers report.

“The fields of art and medicine have been diverging for the last 100 years,” said Salvatore Mangione, M.D., Associate Professor of Medicine in the Sidney Kimmel Medical College at Thomas Jefferson University and first author. “Our findings present a strong case for bringing the left and the right brains back together — for the health of the patient and the physician.”

At Jefferson, students are encouraged to pursue the arts and humanities to foster the essential skills related to healthcare including observation, critical thinking, self-reflection, and empathy, the researchers noted. The JeffMD curriculum, through the Medicine + Humanities Scholarly Inquiry track, is a formalized approach to embedding humanities into medical school.

Similarly Tulane offers an elective course in medical humanities, as well as student programming and community service opportunities that engage the arts, the researchers reported.

Tulane’s Creative Premedical Scholars Program offers early acceptance to undergraduate honor students in arts and humanities majors. Slightly less than half of the school’s first-year class of students earned undergraduate degrees in liberal arts, the researchers noted.

The study was published in the Journal of General Internal Medicine.

Source: Tulane University
 
Photo: Tulane University School of Medicine students Shuo Huang and Gabriela Aviles perform for patients at Tulane Medical Center as part of the hospital’s Music Mends program. New research from Tulane and Thomas Jefferson universities shows that medical students who spend more time engaging in the arts may also be bolstering the qualities that improve their bedside manner with patients.
Credit: Tulane Health System
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Wealth Accumulation Reduces Anxiety Among Seniors

Juggling Bills Often Accompanies Food Insecurity

New research suggests that financial literacy helps people make better saving and investment decisions. The financial activity often enhances wealth accumulation which appears to lessen anxiety about life in old age.

Investigators from Hiroshima University say the study is the first of its kind to examine how understanding about money influences anxiety about life in old age in the United States.

“Anxiety is bad for one’s health, and it is bad for the economy,” says Yoshihiko Kadoya, an Associate Professor of Health Economics and primary author of this study.

Indeed, nearly 75 percent of Americans report feeling anxious about old age.

“If you have a high level of anxiety about the future, you tend to spend less and be more cautious about saving money, which negatively affects the national economy. We predicted that financial literacy would help to reduce this anxiety.”

Kadoya and Mostafa Saidur Rahim Khan, who is a study coauthor and a Ph.D. student, looked at the answers of surveys sent to adults across the United States. Respondents answered questions that tested their financial literacy, including basic calculation skills and understanding the pricing behavior of bonds.

They also reported to what degree they felt anxious about life after turning 65 years old.

Taken as a whole, the researchers did not find a direct causal link between levels of financial literacy and anxiety about life in old age. So, in order to understand how the two are related, the researchers examined household characteristics like wealth, education, and number of children.

Kadoya’s group found that people with high financial literacy are significantly less anxious by way of accumulating assets, such as savings, bonds, and insurance.

Less financially literate people, meanwhile, are less likely to have gathered enough assets to reduce anxiety, possibly because they rely more on social security income for assurance in old age.

Additionally, the researchers found that having a child and doing regular exercise also reduced concern about life in old age.

In 2017, Kadoya’s group conducted a similar study on Japanese people. Even with differences in cultural orientations and social norms between Japan and the United States, results from both countries appear similar among gender, education, and age.

Financial literacy was higher among male, more educated, and older adults compared to female, less educated, and younger adults.

Interestingly, Japanese respondents reported anxiety differently than their American counterparts.

Kadoya and Khan classified the level of anxiety on a scale of one to five, with one being lowest. “In Japan, people tended to avoid one extreme answer, like one or five,” Kadoya said.

“In the US, on another hand, many people tended to pick an extreme answer. These answers may be strongly influenced by culture.” For both countries, though, financial literacy seems to play some role in reducing anxiety about life in the old age.

The relationships between financial literacy and economic outcomes are intricate. As such, having a better understanding of money does not cause low anxiety about life in old age. Rather, the two are associated with one another through wealth accumulation.

For Kadoya’s group, this study is the first in a series that seeks to investigate how financial literacy influences anxiety about life in old age and economic outcomes in the US.

Source: Hiroshima University/EurekAlert

Lack of Sleep May Harm Women’s Short-Term Memory More than Men

Sleepwalkers May Be Better at Multi-Tasking While Awake

While it is well acknowledged that sleep deficits are bad for the mind and body, a new study suggests short term sleep loss may affect women more than men.

Researchers looked at working memory — the ability to keep track of short-term information used to guide decision-making and behavior. Sleep scientists from Uppsala University discovered that acute sleep loss impacts working memory differently in women and men.

Investigators observed 24 young adults perform a working memory task in the morning following either a full night of sleep or a night of wakefulness. Half of the participants were females, and half were males.

The method used to assess of the working memory task was to learn and remember eight digit sequences.

Contrary to expectations, males’ working memory performance remained unaffected by sleep loss. In contrast, females remembered fewer digits after sleep loss than after a night of sleep.

Importantly, even though their performance was reduced, females were unaware of the drop in working performance when sleep-deprived.

A lack of awareness of impaired mental performance could increase the risk of accidents and mistakes, which can be dangerous in many private and occupational situations, both for the sleep-deprived person as well as for others.

“Our study suggests that particular attention should be paid to young women facing challenges in which they have to cope with both a high working memory load and a lack of sleep.

“However, it must be kept in mind that we have not tested whether the observed sex-dependent effects of sleep loss on working memory during morning hours would also occur at other time points of the day,” explains doctoral student Frida Rångtell, lead author of the study.

Moreover, researchers point out that while the data suggests sleep loss may result in a gender difference in short term memory, the finding does not imply that other mental or physical measures are equally affected.

Source: Uppsala University

Vaccine Skepticism Linked to Belief in Conspiracy Theories

New research finds that the belief in conspiracies is associated with antivaccination attitudes. Furthermore, the link was found among people residing in nations around the globe.

Investigators discovered people who believe Princess Diana was murdered or that John F. Kennedy’s assassination was an elaborate plot are more likely to think that vaccines are unsafe, despite scientific evidence to the contrary.

The study, “The Psychological Roots of Anti-Vaccination Attitudes: A 24-Nation Investigation,” appears in Health Psychology, published by the American Psychological Association.

“Vaccinations are one of society’s greatest achievements and one of the main reasons that people live about 30 years longer than a century ago,” said lead researcher Matthew Hornsey, Ph.D., of the University of Queensland.

“Therefore, it is fascinating to learn about why some people are so fearful of them.”

The study is the first to test the relationship between conspiracy beliefs and antivaccination attitudes among a global sample, according to Hornsey.

Hornsey and his co-authors surveyed 5,323 people from 24 countries on five continents using online questionnaires between March 31 and May 11, 2016, measuring antivaccination attitudes and belief in four conspiracy theories.

The theories included:

  • that Princess Diana was murdered;
  • that the American government knew about the 9/11 attacks in advance and chose to let them happen;
  • that a shadowy group of elites exist to plot a new world order;
  • and that John F. Kennedy was murdered as part of an elaborate plot.

Those with strong beliefs in conspiracies were most likely to hold antivaccination attitudes regardless of where they lived.

For example, the more people believed that Princess Diana was murdered, the more negative attitudes they had about vaccinations.

In contrast, level of education had a very small impact on antivaccination attitudes.

“People often develop attitudes through emotional and gut responses,” Hornsey said. “Simply repeating evidence makes little difference to those who have antivaccination attitudes.”

Large pharmaceutical companies, which profit from selling vaccines, are often targets for conspiracy theorists, said Hornsey. “For many conspiracy theorists, profits gained are a sign that the system is broken and the truth is being covered up by vested interests.”

“Trying to reduce people’s conspiracy beliefs is notoriously difficult,” Hornsey said.

“An alternative possibility is to acknowledge the possibility of conspiracies, but to highlight how there are vested interests on the other side too; vested interests that are motivated to obscure the benefits of vaccination and to exaggerate their dangers.”

Anti-vaccination attitudes were also associated with intolerance of those who limit their freedom, disgust toward blood and needles and an individualistic worldview, according to the study.

Source: American Psychological Association

IQ Decline in Childhood May Portend Psychosis in Adulthood

Emerging research suggests declines in IQ during early childhood and adolescence can lead to psychotic episodes in adulthood. Investigators theorize that declining IQ causes children and young adults to fall progressively behind their peers across a range of cognitive abilities.

Researchers from King’s College London’s Institute of Psychiatry, Psychology & Neuroscience (IoPPN), and Icahn School of Medicine at Mount Sinai in the United States believe educational interventions could potentially delay the onset of mental illness.

Psychotic disorders, such as schizophrenia, are severe mental illnesses affecting one to three percent of the population cause a range of abnormalities in perception and thinking. The study is the first to track IQ scores and cognitive abilities throughout the entire first two decades of life among individuals who develop psychotic disorders in adulthood.

“’For individuals with psychotic disorders, cognitive decline does not just begin in adulthood, when individuals start to experience symptoms such as hallucinations and delusions, but rather many years prior, when difficulties with intellectual tasks first emerge, and worsen over time. Our results suggest that among adults with a psychotic disorder, the first signs of cognitive decline are apparent as early as age four,” said Dr. Josephine Mollon.

The study appears in JAMA Psychiatry.

Previous studies have shown that deficits in IQ begin many years before hallucinations and delusions first appear in patients with psychotic disorders, but the timing of when these IQ deficits emerge has not been clear.

The new study provides the clearest evidence to date of early life cognitive decline in individuals with psychotic disorders.

The study included 4,322 U.K.-based individuals who were followed from 18 months to 20 years old. Those who developed psychotic disorders as adults had normal IQ scores in infancy, but by age four their IQ started to decline, and continued to drop throughout childhood, adolescence and early adulthood until they were an average of 15 points lower than their healthy peers.

As well as falling behind in IQ, individuals who developed psychotic disorders lagged increasingly behind their peers in cognitive abilities such as working memory, processing speed, and attention.

IQ scores fluctuate among healthy individuals, and not all children struggling at school are at risk of developing serious psychiatric disorders.

“It is important to bear in mind that many children will experience some difficulties with schoolwork or other intellectual tasks at some point in their lives, and only a small minority will go on to develop a psychotic disorder,” said senior author Dr. Abraham Reichenberg.

The results suggest that adults who develop psychotic disorders do not go through a deterioration in cognitive function, but instead they fail to keep up with normal developmental processes. Early interventions to improve cognitive abilities may potentially help stave off psychotic symptoms from developing in later life.

“There are early interventions offered to adolescents and young adults with psychosis,” said Reichenberg. “Our results show the potential importance of interventions happening much earlier in life. Intervening in childhood or early adolescence may prevent cognitive abilities from worsening and this may even delay or prevent illness onset.”

The researchers are now examining changes in the brains of individuals who go on to develop psychotic disorders, as well as potential environmental and genetic risk factors that may predispose individuals to poor cognition.

Source: King’s College London/EurekAlert

Domestic Abuse May Be More Common When Dating

New research suggests federal regulations and policies such as the Violence Against Women Act should be extended to include dating relationships.

Investigators from the University of Pennsylvania discovered the majority of intimate partner violence — more than 80 percent of incidents in one study population — involve boyfriends and girlfriends. What’s more, these partnerships result in the most physical violence.

Current policies are directed to keep guns away from abusive partners but they do not apply to dating relationships. The new study, published in the journal Preventive Medicine reveals that they likely should.

“Current boyfriends or girlfriends were more likely than current spouses to injure their victims,” said Dr. Susan B. Sorenson, professor of social policy in the School of Social Policy & Practice.

“They were more likely to push and shove, to grab, to punch. They were more likely to strangle — some pretty awful behaviors toward a partner. They were also more likely to use a knife, a bat, or another kind of weapon. We were not expecting to find this.”

For this research, Sorenson and 2017 graduate Devan Spear aimed to move beyond general victimization surveys to learn not just whether someone has ever experienced intimate partner abuse, but also to identify the abuser.

Was the person a current or former spouse, or a current or former girlfriend or boyfriend?

“Much of the intimate partner violence research has focused on lifetime experience, and that’s a reasonable place to start,” Sorenson said.

“Once we have an overall picture in research, we begin to drill down in order to discern whether there are differences by considerations such as the type of relationship.”

In 2011, Sorenson began collaborating with the Philadelphia Police Department to improve documentation of domestic violence in the city. As a result, an officer who responds to a such a call must fill out a form that includes a narrative description of the event. The officer must also include additional information such as victim-offender relationship and behavior regardless of whether an arrest occurs.

Analyzing 31,206 of these forms from the year 2013, the Penn researchers found that 82.1 percent of intimate partner violence incidents included current or former dating partners (44.3 percent and 37.8 percent, respectively).

Less than 15 percent involved current spouses, and just 3.5 percent involved ex-spouses. Nationally, more than half of intimate violence incidents are reported to police, with 54 percent involving current or former boyfriends or girlfriends.

Sorenson said there’s no single explanation for the Philadelphia-specific results.

For one, married and unmarried couples may experience domestic violence to the same degree, but those in the latter group may be quicker or more likely to call the police. Perhaps someone in a dating relationship who experiences abuse may opt not to marry the abuser.

Or, it might simply be that of the 10 largest cities in the United States, Philadelphia has the highest percentage of never-married adults, at 51.5 percent. By comparison, that figure in Chicago is 49.7 percent, and in Los Angeles, 46.5 percent.

She noted that protections against violent behavior like domestic abuse should expand to include broader definitions, particularly given the changing nature of relationships: From 1970 to 2009, the median age of first marriage for men rose from 22 to 28 years old, and for women increased from 20 to 25. Divorce rates also doubled during the same period for those aged 35 and older.

“People are less likely to marry, they marry later, they’re less likely to have children and when they get married, they’re more likely to get divorced,” Sorenson said. “Relationships today are more transitory and not necessarily traditional.”

The researchers said they recognize the limitations in using data from a single large U.S. city, and in relying on data they cannot independently verify.

However, Sorenson pointed out that relationship status was not the only demographic information collected. Police officers appear to have applied the law equally in terms of race, ethnicity, age, and gender, as well as the circumstances under which they gathered evidence, took statements, checked state registries and provided transportation to medical care.

Sorenson said she thinks the findings could have implications for policymaking and data collection at the national level.

“The federal policy focuses on people who are married, live together or have a child in common. We know that abuse occurs in addition to those kinds of relationships,” she said.

“Unfortunately, the federal policy doesn’t address that, and the policy is from nearly a generation ago by now. It might be time to revisit.”

That could happen soon: The Violence Against Women Act, originally passed in 1994, comes up for reauthorization again in 2018.

Editor’s note: An astute reader pointed out to Psych Central News that the 2000 re-authorization of the Violence Against Women Act was expanded to include dating violence. (See Title I section 1109 of the legislation.) We apologize for this error.

Source: University of Pennsylvania

Why Are Kids with Autism Less Social Than Peers?

In a new study, researchers set out to investigate why children with autism spectrum disorder (ASD) tend to be less socially communicative than their typically developing (TD) peers. Their findings, published in the journal Molecular Autism, provide a glimpse into the brain mechanisms behind autism.

In recent years, scientists have proposed several hypotheses to help explain why ASD kids tend to pull away from social interactions: One popular theory is known as the social motivation hypothesis. This theory suggests that ASD kids aren’t inherently motivated to interact with others because they aren’t neurologically “rewarded” by social interactions the same way TD kids are.

“Most of us get a hit of dopamine when we interact with other people, whether it’s through making eye contact or sharing something good that’s happened to us — it feels good to be social,” said Dr. Katherine Stavropoulos, an assistant professor of special education in the Graduate School of Education at the University of California, Riverside (UCR).

“The social motivation hypothesis says kids with autism don’t get that same reward from social interaction, so they don’t go out of their way to engage with people because it’s not rewarding for them.”

Another major theory is called sensory over-responsivity — also known as the overly intense world hypothesis. This theory posits that because kids with ASD interpret sensory cues more strongly than their TD peers, those with ASD tend to shy away from interactions they feel are overwhelming or negative.

“Kids with autism often find noises too loud or lights too bright, or they find them not intense enough,” Stavropoulos said. “Most of us wouldn’t want to talk to someone whom we perceive as screaming, especially in a room that was already too bright, with ambient noise that was already too loud.”

Rather, this theory suggests that such interactions would drive ASD children to withdraw from socialization as a self-soothing behavior.

But according to Stavropoulos, who also serves as assistant director of UCR’s SEARCH Family Autism Resource Center, it may be possible for these seemingly competing theories to exist in tandem.

For the study, Stavropoulos, who is also a licensed clinical psychologist with a background in neuroscience, and University of California, San Diego’s Leslie Carver, used electrophysiology to observe the neural activity of 43 children (20 ASD and 23 TD) aged seven to 10. They used a guessing game-style simulation that offered participants both social and nonsocial rewards.

Each child, wearing a cap with 33 electrodes, sat in front of a computer screen which showed pairs of boxes containing question marks. Much like the format of the “pick a hand” guessing game, the children then chose the box he or she believed was the correct one (in reality, the answers were randomized).

Stavropoulos said it was vital to design a simulation that would reveal the children’s neural reactions to both social and nonsocial rewards during two stages: reward anticipation, or the period before the child knew whether he or she had chosen the correct answer, and reward processing, or the period immediately after.

“We structured the game so that the kids would pick an answer, and then there would be a brief pause,” Stavropoulos said. “It was during that pause that the kids would begin to wonder, ‘Did I get it?’ and we could observe them getting excited; the more rewarding something is to a person, the more that anticipation builds.”

Each child played the game in two blocks. During the social block, children who chose the correct box saw a smiling face and kids who chose the wrong box saw a sad, frowning face. During the nonsocial block, meanwhile, the faces were scrambled and reformed in the shapes of arrows pointing up to denote correct answers and down to denote incorrect ones.

“After the kids saw whether they were right or wrong, we were then able to observe the post-stimulus reward-related activity,” Stavropoulos said of the process, which involved comparing participants’ neural oscillation patterns.

The findings reveal that the TD kids anticipated social awards — in this case, the pictures of faces — more strongly than kids with ASD.

In addition, not only did ASD children have less interest in social rewards compared to their TD peers, but within the ASD group, children with more severe ASD were anticipating the nonsocial rewards, or the arrows, the most.

During reward processing, or the period right after the children learned whether they had chosen the right or wrong box, the researchers observed more reward-related brain activity in TD children but more attention-related brain activity among ASD children. Stavropoulos suggests this may be related to feelings of sensory overload in kids with ASD.

Kids with more severe ASD also exhibited greater responsiveness to positive social feedback, which Stavropoulos said may indicate hyperactivity, or the state of being overwhelmed by “correct” social feedback that is often related to sensory over-responsivity.

Stavropoulos said the findings provide support for both the social motivation hypothesis and the overly intense world hypothesis.

“Kids with autism might not be as rewarded by social interactions as typically developing kids are, but that doesn’t mean their reward systems are entirely broken,” she said. “This research makes the case for developing clinical interventions that help children with autism better understand the reward value of other people — to slowly teach these kids that interacting with others can be rewarding.

“But, it is critical to do this while being sensitive to these kids’ sensory experiences,” she said. “We don’t want to overwhelm them, or make them feel sensory overload. It’s a delicate balance between making social interactions rewarding while being aware of how loudly we speak, how excited our voices sound, and how bright the lights are.”

Source: University of California- Riverside

Online Support Can Improve Quality of Life for Cancer Patients

New research finds that an online stress management program can significantly improve an individual’s quality of life and improve care after a cancer diagnosis.

Researchers from the University of Basel and University Hospital Basel in Swtizerlan said a cancer diagnosis always causes psychological distress. If the mental component of the diagnosis is not managed, quality of life may suffer and even more, the negative psychological state may have a negative impact on treatment and disease progression.

Ideally cancer treatment is coupled with psychological support. However, currently only a minority of cancer patients receive professional psychological support, particularly during the difficult time immediately after diagnosis.

In order to reach cancer patients early after diagnosis and offer a low-threshold tool to overcome distress, researchers developed the online stress management program STREAM.

During the eight week online program, patients were provided with information, individual exercises on downloadable audio-files, and specific strategies on managing life with cancer. Patients logged in using a secured personal account. Once a week, they participated in a written exchange with a psychologist via an integrated email platform.

The study, which appears in the Journal of Clinical Oncology, is the first to show that newly diagnosed cancer patients significantly benefit from a web-based intervention and report better quality of life and less distress.

In total, 129 patients from Switzerland, Germany, and Austria were allocated to either an intervention or a control group within 12 weeks of starting their cancer treatment. The control group only received access to the program after an eight-week waiting period, enabling a comparison between the two groups.

People who completed the STREAM program (mostly breast cancer patients) assessed their quality of life as significantly higher than the control group. Also, distress, measured on a scale from zero to 10, was significantly lower in the online group than in the control group after the intervention.

“The results show that web-based self-help with regular email contact with a psychologist has the potential to efficiently support newly diagnosed cancer patients and thereby decisively improves cancer care,” said Professor Viviane Hess, Professor of Medical Oncology and Senior Oncologist in Basel.

Online interventions present new opportunities to support people affected by cancer who previously could not be reached. “Digital natives are reaching the age at which the risk for age-related diseases such as cancer increases. Approaches that integrate the internet into patient care will therefore continue to increase in importance,” said Hess.

Source: University of Basil

Using Mindfulness Strategies to Curb Cravings

Unhealthy Foods are Distracting

A new study from the U.K. suggests mindfulness strategies may help prevent or interrupt cravings for food, cigarettes, and alcohol.

Craving can be defined as an intense, conscious desire, usually to consume a specific drug or food. There is also a significant body of research that suggests it is causally linked to behavior.

Investigators reviewed experimental studies that addressed the effects of different types of mindfulness strategies on cravings. They discovered that in many instances these strategies brought about an immediate reduction in craving.

For example, craving predicts relapse episodes in substance use, and food cravings predict both eating and weight gain. As such, cravings are often considered an appropriate target for intervention.

Researchers from City, University of London believe the mindfulness techniques works by occupying short-term memory which in turn lead to clinically relevant changes to behavior. Their findings appear in the journal Clinical Psychology Review.

Mindfulness meditation has a long tradition of being used to address cravings. According to ancient Buddhist texts, craving leads to suffering but can be avoided through meditation practice.

Mindfulness interventions typically employ a range of strategies. Some techniques include exercises designed to promote greater awareness of bodily sensations, while others help to develop an attitude of acceptance toward uncomfortable feelings.

Additionally, a mindfulness objective may be to help individuals see themselves as separate from their thoughts and emotions.

However, there is currently a limited understanding of the ways in which these different types of strategy may influence craving-related outcomes, either independently, or in combination.

As a result, the review aimed to address these limitations by reviewing studies that have examined the independent effects of mindfulness on craving.

Looking at 30 studies which met the criteria, it was found that some of the beneficial effects seen for mindfulness strategies in relation to craving are likely to stem from interrupting cravings by loading working memory. Working memory is a part of  short-term memory concerned with immediate conscious perceptual and linguistic processing.

In addition, it was also seen that mindfulness reduced craving over the medium term, most likely due to “extinction processes,” essentially strategies that result in the individual inhibiting craving-related responses and behaviors which eventually lead to reduced cravings.

Dr. Katy Tapper, author of the review and a Senior Lecturer in the Department of Psychology at City, University of London, said, “The research suggests that certain mindfulness-based strategies may help prevent or interrupt cravings by occupying a part of our mind that contributes to the development of cravings. Whether mindfulness strategies are more effective than alternative strategies, such as engaging in visual imagery, has yet to be established.

“However, there is also some evidence to suggest that engaging in regular mindfulness practice may reduce the extent to which people feel the need to react to their cravings, though further research is needed to confirm such an effect,” she said.

Source: City University London

Brain Implant Appears to Slow Alzheimer’s

Considering Intentions of Others Tied to Structural Brain Changes

A landmark new research study found that surgically inserting electrical wires into the frontal lobes of the brains of patients with Alzheimer’s disease appears to slow functional decline and improve quality of life.

Scientists at the Ohio State University Wexner Medical Center said their research was aimed at slowing the decline of problem-solving and decision-making skills among Alzheimer’s patients, rather than on improving memory.

The intervention is the first to determine if using a “brain pacemaker”could improve cognitive, behavioral, and functional abilities in patients with this form of dementia.

The deep brain stimulation (DBS) implant is similar to a cardiac pacemaker device, except that the pacemaker wires are implanted in the brain rather than the heart.

Findings of the study appear online in the Journal of Alzheimer’s Disease.

“We have many memory aides, tools and pharmaceutical treatments to help Alzheimer’s patients with memory, but we don’t have anything to help with improving their judgments, making good decisions, or increasing their ability to selectively focus attention on the task at hand and avoid distractions. 

“These skills are necessary in performing daily tasks such as making the bed, choosing what to eat and having meaningful socializing with friends and family,” said Dr. Douglas Scharre, co-author of the study and director of the Division of Cognitive Neurology at Ohio State’s Wexner Medical Center.

“The frontal lobes are responsible for our abilities to solve problems, organize and plan, and utilize good judgments. By stimulating this region of the brain, the Alzheimer’s subjects cognitive and daily functional abilities as a whole declined more slowly than Alzheimer’s patients in a matched comparison group not being treated with DBS,” he said.

The pilot study found that DBS targeting frontal brain regions can reduce the overall performance decline typically seen in people with mild or early stage Alzheimer’s, Scharre said.

Scharre is a neurologist who focuses on treating patients with Alzheimer’s and other dementias. He collaborated with Dr. Ali Rezai, a neurosurgeon who specializes in neuromodulation, to conduct this clinical trial.

“This same technology has been successfully used to treat more than 135,000 patients worldwide with Parkinson’s disease. Our findings suggest that frontal network modulation to improve executive and behavioral deficits should be further studied in patients with Alzheimer’s disease,” said Rezai.

All three study participants showed improvement, including LaVonne Moore, 85, of Delaware, Ohio. When she entered the study in 2013, she was not doing any meal preparation. After two years of deep-brain stimulation, she could independently initiate preparations of a simple meal, assemble ingredients, and cook the meal.

She was able to organize an outing, including arranging transportation and destination, planning for the weather and bringing the needed money. She also regained independence to select her clothing attire, researchers noted.

Her 89-year-old husband, Tom Moore, said her Alzheimer’s disease has progressed, but more slowly than he expected. “LaVonne has had Alzheimer’s disease longer than anybody I know, and that sounds negative, but it’s really a positive thing because it shows that we’re doing something right,” Moore said.

She didn’t hesitate to volunteer for the study, he added.

He said she told him, “I will do anything to help others not go through what I’m going through.”

Next, Ohio State researchers want to explore non-surgical methods to stimulate the frontal lobe, which would be a less invasive treatment option to slow down the symptoms of Alzheimer’s disease.

Alzheimer’s disease is the most common form of degenerative dementia, affecting more than five million Americans. By 2050, this number could rise as high as 16 million, according to the Alzheimer’s Association.

The disease — which has no cure and is not easily managed — becomes progressively disabling with loss of memory, cognition, and worsening behavioral function, in addition to a gradual loss of independent functioning, Scharre said.

Source: The Ohio State University Wexner Medical Center