Oxytocin May Effectively Treat Autism Spectrum Disorder

A research team at Yale School of Medicine, which includes postdoctoral fellow Ilanit Gordon and Kevin Pelphrey, the Harris Associate Professor of Child Psychiatry and Psychology, have discovered that oxytocin increases function in specific regions of the brain associated with processing social information in children and adolescents with autism spectrum disorders (ASD).

"Our findings provide the first, critical steps toward devising more effective treatments for the core social deficits in autism, which may involve a combination of clinical interventions with an administration of oxytocin," said Gordon. "Such a treatment approach will fundamentally improve our understanding of autism and its treatment."

Autism spectrum disorder describes a range of conditions classified as pervasive developmental disorders in the Diagnostic and Statistical Manual of Mental Disorders (DSM). These include autism, Asperger syndrome and pervasive developmental disorder not otherwise specified (PDD-NOS). Childhood disintegrative disorder and Rett syndrome are sometimes included among these disorders. Autism spectrum disorders are characterized by social deficits, communication difficulties, stereotyped or repetitive behaviors and interests, and in some cases, cognitive delays. Individuals with these disorders are thought to be "on the spectrum" because of differences in severity across these domains.

• Autism is characterized by delays or abnormal functioning before the age of three years in one or more of the following domains: (1) social interaction; (2) communication; and (3) restricted, repetitive, and stereotyped patterns of behavior, interests, and activities. Social impairments are marked by poor use of nonverbal communication, difficulty in peer relations, lack of social-emotional reciprocity, and lack of shared enjoyment. Communication deficits may include failure to develop speech, use of stereotyped or delayed echolalia, and difficulties maintaining conversations. Social and communication impairments may also cause a lack of symbolic or imaginative play. Restricted and repetitive behaviors may include unusual preoccupations with narrow interests, inflexibility to nonfunctional routines, stereotyped and repetitive mannerisms, and preoccupations with parts of objections.


• Asperger syndrome can be distinguished from autism by the lack of delay or deviance in early language development. Additionally, individuals with Asperger syndrome do not have significant cognitive delays. An individual with Asperger syndrome typically demonstrates obsessive interest in a single topic or activity. Other symptoms include repetitive routines or rituals, peculiarities in speech and language, inappropriate affect or social behavior, problems with non-verbal communication, and clumsy or uncoordinated motor movements. Because of these difficulties, individuals with Asperger syndrome often have trouble interacting with others.


• Pervasive developmental disorder not otherwise specified (PDD-NOS) is considered "subthreshold autism" and "atypical autism" because it is often characterized by milder symptoms of autism or symptoms in only one domain (such as social difficulties). Persons with PDD-NOS may demonstrate pervasive deficits in the development of reciprocal social interaction or stereotyped behaviors, but do not meet the criteria for a specific pervasive developmental disorder or other psychological disorders (such as schizophrenia or avoidant personality disorder).

NB - Autism Spectrum Disorder (ASD) is a proposed revision to the Diagnostic and Statistical Manual of Mental Disorders 5 (DSM-5), which will be released in May 2013.

At present, there is no specific cause or specific causes of autism spectrum disorders, however many risk factors have been identified that may contribute to the development of an ASD, such as genetics, prenatal and perinatal factors, neuroanatomical abnormalities, and environmental factors.

In addition, although there has been significant progress in the field of autism research, there are still few effective treatments and none that specifically target the social characteristics of the disorder. That being said, the role of oxytocin in autism and its potential ability to treat social aspects of the disorder have been studied for some time, however more recent attention has been given to the hormone for its involvement in regulating social abilities.

“Oxytocin is a mammalian hormone that acts primarily as a neuromodulator in the brain. It is best known for its roles in sexual reproduction, in particular during and after childbirth. It is released in large amounts after distension of the cervix and uterus during labor, facilitating birth, and after stimulation of the nipples, facilitating breastfeeding.

Recent studies have begun to investigate oxytocin's role in various behaviors, including orgasm, social recognition, pair bonding, anxiety, and maternal behaviors. For this reason, it is sometimes referred to as the "love hormone." The inability to secrete oxytocin and feel empathy is linked to sociopathy, psychopathy, narcissism and general manipulativeness.”

As a result, the team decided to investigate oxytocin further by conducting a first-of-its-kind, double-blind, placebo-controlled study on children and adolescents between the ages of 7 and 18 with ASD. Each participant was administered a single dose of oxytocin in a nasal spray, while functional magnetic resonance brain imaging was used to observe its effect.

“The team found that oxytocin increased activations in brain regions known to process social information. Gordon said these brain activations were linked to tasks involving multiple social information processing routes, such as seeing, hearing, and processing information relevant to understanding other people.”

A clearer understanding and effective treatment is needed as “it is estimated that one in every 110 children is diagnosed with autism (and one (1) in every 70 boys), making it more common than childhood cancer, juvenile diabetes and pediatric AIDS combined. An estimated 1.5 million individuals in the U.S. and tens of millions worldwide are affected by autism.”

Oxytocin Improves Brain Function in Children With Autism
Autism spectrum
Oxytocin
The Arc

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Obesity During Pregnancy May Increase Risk of Autism

In recent news, it has been reported by the University of California Davis MIND (Medical Investigation of Neurodevelopmental Disorders) Institute that obese pregnant women are at higher risk of bearing children with autism than their healthy-weight counterparts.

“Autism is a disorder of neural development characterized by impaired social interaction and communication, and by restricted and repetitive behavior. For a diagnosis to be made, symptoms must become apparent before a child is three years old. Autism affects information processing in the brain by altering how nerve cells and their synapses connect and organize; how this occurs is not well understood. It is one of three recognized disorders in the autism spectrum (ASDs), the other two being Asperger syndrome, which lacks delays in cognitive development and language, and pervasive developmental disorder not otherwise specified (commonly abbreviated as PDD-NOS), which is diagnosed when the full set of criteria for autism or Asperger syndrome are not met.”

According to this study, nearly 60% of child-bearing women aged 20 to 39 in the U.S. are overweight and one-third are obese. Similarly, nearly 29% of Canadian women are overweight and 23% are obese as per Statistics Canada. In addition, obesity rates are on a rapid incline for women between the ages of 25 and 34 years and to the point that it is almost twice as high as it was 25 years ago.

At the same time, the prevalence of autism spectrum disorder (ASD) appears to be growing alongside these rates as approximately 1 in every 110 children is diagnosed with this disorder.

At present, the exact cause of autism is not known; however there is significant research to suggest that its development likely occurs in the womb, therefore lead author Paula Krakowiak wondered whether there might be a connection between obesity rates among women of child-bearing age and autism.

Researchers studied more than 1,000 children and their mothers to obtain evidence to support for their claim that obesity and diabetes during pregnancy could put children at increased risk for autism spectrum disorder and other neurodevelopmental problems. The team analyzed data gathered via telephone interviews and medical records from mothers with children aged 2 to 5 born in California and enrolled in the CHARGE (Childhood Autism Risks from Genetics and the Environment) Study between January 2003 and June 2010. Of those studied, 513 children had autism; 172 had other developmental disorders and 315 children were developing normally. Researchers took into account the mother’s age at the time of delivery, their education level and various other factors.

Results showed that “overall, obesity, diabetes and high blood pressure were more prevalent among mothers of children with autism or other developmental disorders than the "control" moms.” In addition, “obese women were 67 per cent more likely to have a child with autism compared to healthy-weight mothers. They were also about twice as likely to have a child with another developmental disorder.” Basically, 21.5% of the mothers with autistic children and 23.8% of the mothers with children with another developmental disorder were obese whereas only 14.3% of the mothers with normally developing children were considered obese. Furthermore, “mothers with diabetes were found to have nearly twice the chance of having a child with developmental delays as healthy mothers.”

If proven, imagine how this new discovery might impact public health…

Autism Linked To Obesity During Pregnancy
Autism

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Younger Classmates More Likely To Be Diagnosed With ADHD

Scientists at the University of British Columbia have released a study, which suggests that the youngest kids in a classroom are those that are most likely to be taking medication to treat attention deficit hyperactivity disorder.

“The study of almost one million B.C. schoolchildren ages six to 12 during an 11-year period found those born in December were 39% more likely to be diagnosed with ADHD and 48% more likely to be medicated than those born in January.”

However, researchers question whether these children have been diagnosed accurately or whether doctors may have confounded the fact that these kids are merely less mature and academically or athletically inclined due to the simple fact that they have not had those extra few months to develop as much as their peers. This gap in age within the same school grade creates what researchers call the “relative age effect” and it could be leading to many false diagnoses.

“Younger, less mature children are inappropriately being labelled and treated,” said lead author Richard Morrow of UBC’s Department of Anesthesiology, Pharmacology and Therapeutics.

Basically, children born closer to December can be almost a full year less developed than their classmates.

Although research suggests that boys are three times more likely to be treated for ADHD than girls, the age gap still applies to both genders. “Girls born in December and earlier within their grade were 70% more likely to be diagnosed with ADHD compared to January-born girls.”

Ultimately, a false diagnosis and treatment with unnecessary medications could potentially cause more harm than good. “Being been labelled ADHD can often cause children to be treated differently by teachers and parents, possibly leading to poor self-esteem and social issues.”

WHAT IS ADHD?

ADHD is a problem with inattentiveness, over-activity, impulsivity, or a combination. It is the most commonly diagnosed behavioral disorder of childhood. It affects about 3 - 5% of school aged children. It is also diagnosed much more often in boys than in girls.

Inattentive symptoms:

1. Fails to give close attention to details or makes careless mistakes in schoolwork
2. Has difficulty keeping attention during tasks or play
3. Does not seem to listen when spoken to directly
4. Does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace
5. Has difficulty organizing tasks and activities
6. Avoids or dislikes tasks that require sustained mental effort (such as schoolwork)
7. Often loses toys, assignments, pencils, books, or tools needed for tasks or activities
8. Is easily distracted
9. Is often forgetful in daily activities

Hyperactivity symptoms:

1. Fidgets with hands or feet or squirms in seat
2. Leaves seat when remaining seated is expected
3. Runs about or climbs in inappropriate situations
4. Has difficulty playing quietly
5. Is often "on the go," acts as if "driven by a motor," talks excessively

Impulsivity symptoms:

1. Blurts out answers before questions have been completed
2. Has difficulty awaiting turn
3. Interrupts or intrudes on others (butts into conversations or games)

DIAGNOSIS

For diagnosis, symptoms must be out of the normal range for a child's age and development as well as present in more than one setting:

• Children should have at least 6 attention symptoms or 6 hyperactivity/impulsivity symptoms, with some symptoms present before age 7.


• The symptoms must be present for at least 6 months, seen in two or more settings, and not caused by another problem.


• The symptoms must be severe enough to cause significant difficulties in many settings, including home, school, and in relationships with peers.

TREATMENT

Medication

A combination of medication and behavioral treatment works best. There are several different types of ADHD medications that may be used alone or in combination.

Psychostimulants (also known as stimulants) are the most commonly used ADHD drugs, such as:

• Amphetamine-dextroamphetamine (Adderall)
• Dexmethylphenidate (Focalin)
• Dextroamphetamine (Dexedrine, Dextrostat)
• Lisdexamfetamine (Vyvanse)
• Methylphenidate (Ritalin, Concerta, Metadate, Daytrana)

A nonstimulant drug called atomoxetine (Strattera) may work as well as stimulants, and may be less likely to be misused.

WARNING: Some ADHD medicines have been linked to rare sudden death in children with heart problems. Talk to your doctor about which drug is best for your child.

Behavior Therapy

Talk therapy for both the child and family can help everyone understand and gain control of the stressful feelings related to ADHD.

Parents should use a system of rewards and consequences to help guide their child's behavior. It is important to learn to handle disruptive behaviors. Support groups can help you connect with others who have similar problems.

Other tips to help your child with ADHD include:

• Communicate regularly with the child's teacher.
• Keep a consistent daily schedule, including regular times for homework, meals, and outdoor activities. Make changes to the schedule in advance and not at the last moment.
• Limit distractions in the child's environment.
• Make sure the child gets a healthy, varied diet, with plenty of fiber and basic nutrients.
• Make sure the child gets enough sleep.
• Praise and reward good behavior.
• Provide clear and consistent rules for the child.

Alternative Treatments

Herbs, supplements, and chiropractic treatments have become popular, however, there is little or no solid evidence that these actually work.

PROGNOSIS

ADHD is a long-term, chronic condition. If it is not treated appropriately, ADHD may lead to:

• Drug and alcohol abuse
• Failure in school
• Problems keeping a job
• Trouble with the law

About half of children with ADHD will continue to have troublesome symptoms of inattention or impulsivity as adults. However, adults are often more capable of controlling behavior and masking difficulties.

Talk to your doctor if you are concerned that your child may have ADHD.

Kids born later in the year more likely to be diagnosed with ADHD: Study
Attention deficit hyperactivity disorder (ADHD)

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Brief Opioid Therapy May Eliminate Chronic Pain

According to team leaders, Ruth Drdla-Schutting and Jürgen Sandkühler along with their research team at the MedUni Vienna's Department of Neurophysiology (Centre for Brain Research); opioids can be used for more than temporary pain relief. Apparently, a strong enough dose can actually erase our memory traces of pain in the spinal cord.

At the most basic level, opioids bind to specific sites, called µ-opiate receptors (MOR), which suppresses the stimulation of pain. Characteristically, opioids are only known to alleviate pain while bound to these sites, therefore once treatment is ceased, pain resumes.

Typically, for chronic pain, opioids are administered continuously in moderate doses in order to achieve a permanent binding. This method may result in pain relief, however the treatment is long-term and the cause of pain cannot be eliminated.

To test their theory, that memory traces of pain can be erased with a large enough dose of opioids over a short period, “scientists recreated a surgical procedure in vivo in which pain fibres were stimulated under controlled conditions”.

"Although deep anaesthesia prevents any sensations of pain, we were able to reserve long-term synaptic potentiation in the spinal cord. Despite anaesthesia, there appears to be a memory trace for pain and a pain amplifier has engaged."

“Long-term potentiation (LTP) is a long-lasting enhancement in signal transmission between two neurons that results from stimulating them synchronously.”

Researchers administered high doses of intravenous opioids over a period of an hour and discovered that this completely removed the long-term potentiation. By doing so, this can reverse the cellular changes that cause pain memories. As such, this could actually rid the memory of the sensation that pain is amplified and longer lasting than in actuality and avoid the development chronic pain syndrome.

If proven to be an effective method of treatment, this could mean more than pain management for many people suffering with chronic pain. Current methods temporarily relieve symptoms of pain and typically require long-term opioid use. This type of treatment could greatly reduce the risk of a rapidly growing form of addiction.

Opioids Erase Memory Traces of Pain
Long-term potentiation
mu Opioid receptor

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HAPPY ANNIVERSARY MENTAL HEALTH BLOG

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Stress and Depression Linked to Aging

Research reveals that people that experience recurring episodes of depression or those that are exposed to chronic stress have shorter telomeres in their white blood cells.

“A telomere is a region of repetitive DNA sequences at the end of a chromosome, which protects the end of the chromosome from deterioration or from fusion with neighboring chromosomes.” Consequently, as we age, telomeres, the outermost part of the chromosome, shorten.

Moreover, research suggests that oxidative stress and inflammation can accelerate this process. The lengths of telomeres are suggestive of our biological age and have been associated with age-related diseases, unhealthy lifestyle, and longevity. Additionally, new studies now show that the shortening of telomeres is also linked to recurrent depression and exposure to chronic stress.

To demonstrate, researchers studied 91 patients with recurrent depression and 451 healthy patients by measuring the telomere length in their white blood cells.

Results showed that telomeres were shorter among the patients with recurrent depression. Also, by examining the participants' stress regulation using a dexamethasone suppression test, researchers again revealed that cortisol levels, indicative of chronic stress, were also associated with shorter telomeres in both depressed participants and healthy ones.

“The fact that depressed patients as a group have shorter telomere lengths compared to healthy individuals can be largely explained by the fact that more depressed people than healthy people have disturbed cortisol regulation, which underscores that cortisol regulation and stress play a major role in depressive disorders” says Mikael Wikgren, a doctoral candidate in the research group.

Accordingly, people could experience age-related complications much earlier in life; therefore properly treating and managing stress and/or depression may significantly impact the quality of life throughout the lifetime.

Depression and Chronic Stress Accelerates Aging
Telomere

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Remembering 9/11

Although most of us remember 9/11 through media coverage, a vast amount of victims and heroes now remain permanently scarred from witnessing the tragedy first-hand. Many are still physically suffering from their exposure to a mix of fibers, metals, concrete, noxious chemicals and gases. Yet many others are suffering mentally from their experiences on that day and the days following.

“Officially, as many as 10,000 firefighters, police officers and civilians who were at the disaster site here have been diagnosed with post traumatic stress disorder (PTSD). Other figures suggest more than 60,000 of the 409,000 who were at Ground Zero have shown elements of PTSD.”

In the past 10 years, there has been more research and attention given to the very real PTSD and the stigma of mental illness and seeking treatment has also diminished somewhat.

So today, many of us are not only remembering where we were or what we were doing on that day, but those that perished, lost their lives trying to save lives and those still affected.

For more on PTSD, visit this past post: http://www.mentalhealthblog.com/2008/09/ptsd-victims-of-911.html

Our faded memories of 9-11

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