Cobbers on the Brain – Page 101 – Student Commentary on the Neurological Sciences

The Fallacy of Drug Scheduling

Posted on February 20, 2017 by / 0 Comment

And by drug scheduling, I mean that of the United States Food and Drug Administration. And by that of the United States Food and Drug Administration, I mean listing drugs as schedule I (i.e. ‘no medical uses’).
This is not a political rant, for even prescription drugs (in the wrong hands) can be illegal, and there are good reasons for making substances illegal. But just because a substance should not be used recreationally, does not imply that it has no medical uses. We know this, of course, from the legal (yet recreationally abused) drugs such as hydrocodone, oxycontin, Adderall, etc.
Drugs, by their very nature, affect body chemistry to elicit a response. Whether this response is the elevated awareness after a cup of morning coffee, or the stark opposite of a late-night’s beer, drugs are meant to change the way we feel about the world. To label any drug as having ‘no medical uses’ is to change the definition of drugs. While I may digress into philosophy, the Hedonists of ancient Greece would support the claim that all drugs are medicines, and are we truly so knowledgeable as to say we know every possible use for a single substance?

Okay, I sound like a hippie. I apologize. This is not where I mean to lead. Instead, I am arguing for more research on drugs, even illegal drugs. While ‘no medical uses’ may be the FDA’s criterion for schedule I, I argue that the new criterion should be ‘no medical uses yet discovered’. This criterion emphasizes that many compounds, in the right context, may have the ability to change lives for the better. By scheduling some compounds as illegal, we frighten researchers into avoiding life-saving chemicals.
Perhaps the most apt example of this is the recent upsurgence of medical marijuana, and its active compounds THC and CBD, the latter of which provides no ‘high’, but can still medicate many ailments.
Even further, Anxiety and PTSD are extremely prevalent ailments to our nation, and the drugs used to treat them are not always effective. PTSD has been shown to be treated with MDMA, but its legal status renders it nearly impossible to study, let alone administer. And while no illegal drugs have been found to alleviate anxiety as a blanket disorder, there are of course subsets to anxiety disorders. One of these, most often found in advanced stage cancer patients, is the anxiety associated with a fear of death.

A recent 2011 study observed the effects of psilocybin, the active ingredient in psychedelic mushrooms, on anxiety levels of advanced cancer patients with a fear of death. The results showed a significant reduction in the patient’s anxiety over the evaluated period as shown by the STAI (an anxiety test), which was sustained over 6 months from only a single treatment.[1]

Along with that, in 2010 a population of twenty individuals suffering from medium-to-severe PTSD were half given a placebo, and half given MDMA (the pure form of ecstasy/molly), and then participated in psychotherapy sessions. The control group was later allowed to participate in the MDMA-assisted sessions two months after the set of initial trials. There was a greater than 30% decrease in CAPS scores (a PTSD test) for MDMA-assisted psychotherapy, and the few who had earlier not been able to work because of PTSD were able to work after the study had finished.[2]

Both of these drugs are serotonin agonists, which means they bind and activate receptors in the brain that serotonin would have normally bound to. As such, realizing that these are treatment options for anxiety-related disorders can tell us something about anxiety itself: that it may result from specific brain regions having low serotonin levels. It is well-known that other anti-anxiety drugs also include serotonin agonists, but regardless, we see the positive effects of schedule I drugs on patients as well as their effects on increasing our knowledge of psychological disorders. It is for just this reason that I argue to, at the very least, change the criterion for scheduling drugs, and allowing more research to be performed on them.
The fallacy by which I title this post is as follows: An illegal drug is illegal because it has no medical uses. Because the drug is illegal, it cannot be studied. Because it cannot be studied, we cannot know if it has any medical uses. Therefore, it should be illegal.
Circular reasoning. Good job FDA.
_______________________________________________________________________
[1] Grob, Danforth, Chopra, Hagerty, McKay, Halberstadt, Greer. Archives of General Psychiatric. 2011.
[2] Mithoefer, Wagner, Mithoefer, Jerome, & Doblin. Journal of Psychopharmacology. 2010.

Health

How Stressful Memories Contribute to Anxiety

Posted on February 20, 2017 by / 0 Comment

Think back to your most vivid memory. I would guess you can remember just about every detail about that situation. What time of day it was, where you were, what happened, and how you felt. Chances are, it probably is a stressful memory.

We tend to remember stressful events in great detail but it is probably to our benefit for us to remember some stressful events. Knowing what put you in danger one time will help you to avoid that stressful situation a subsequent time. In fact, when experimental rats were given a substance that decreased their anxiety, they were able to remember less about a stressful situation when put in it again.
In your brain, there is an area called the hypothalamus, which is vital to forming memories, especially contextual ones, and plays some role in responding to stress. When you’re in a stressful situation, hormones called glucocorticoids are released into particular areas of the hypothalamus. The release of these glucocorticoids is vital for the formation of memories related to stressful situations that may keep us safe. The glucocorticoid release triggers effects in the cell that lead to a change in the shape of our DNA structure that makes it easer to read genes that contribute to memory formation.

That’s all fine and good when it goes right, but what about when it doesn’t? For people with anxiety, the glucocorticoid hormones are released more often and in higher concentrations, leading to stronger memory formations, even in non-stressful situations. These anxious people that are already forming stronger memories are more likely to develop PTSD as a response to events of extreme stress.
The good news is that there are ways to prevent this stressful memory formation. Anti-anxiety drugs like Lorazepam have been shown to reduce anxiety by blocking the changes to DNA structure elicited by stressful situations. Similarly, regular exercise has also been found to inhibit the changes in DNA that lead to stressful memory formation. I’m not suggesting that exercise is the ticket to treating anxiety but it certainly can’t hurt when it is in combination with drug treatment and therapy.

Understanding these molecular markers of anxiety will hopefully help scientists in the future to develop medications that may be more effective in treating anxiety disorders and PTSD. In the meantime, knowing that there are major structural changes to DNA in people with anxiety can help us to be more understanding to those living with anxiety when we are able to realize that they cannot do anything to control this phenomenon from happening.

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PTSD in the US Military

Posted on February 20, 2017 by / 0 Comment

PTSD is very common among military men and women. Because they are often found in high stress, intense life-or-death situation, they experience traumatic events at a higher rate than the average person.

PTSD uses a pathway in the brain that links fear to memories. This system is evolutionarily beneficial so that when we live through a stressful or traumatic event, we can process it and handle it better the next time. However, if this circuit is imbalanced, thinking about the traumatic events or a trigger stimulus can cause the body to go into stressor mode.

In the case of the military, each applicant must go through the military entrance processing station (MEPS) to get cleared for duty. This exam includes a mental health portion. However, after service according to the US Department of Veterans Affairs, 20/100 veterans from the Operations Iraqi Freedom and Enduring freedom have PTSD. It is important to note that sometimes PTSD symptoms can appear years after the traumatic event.

In order to treat PTSD, we have combination treatments involving therapy and medications such as benzodiazepines. In 2010, the DOD Pharmacoeconomic Center reported that 20% of the 1.1 active duty US troops are on some sort of antipsychotic medication. The problem with medication is that often times, because troops have many problems including insomnia, anxiety, depression, and PTSD, a cocktail of prescribed drugs can have adverse effects including substance abuse, homicidal and suicidal thoughts.

How come everyone does not experience PTSD?

This is a tough question to answer. Each person experiences different events in combat, some more traumatic than others. Some people are also more susceptible to mental illnesses such as anxiety and PTSD. This is because of something called epigenetics, or the way DNA is read and transcribed in the body. This differs in each person and is a result of their environment and exposure to different things such as stress, or second hand smoke.

What can we do about it?

We need to monitor and modify treatments for each person so that overmedicating does not occur and each patient individually. The hard thing about mental illnesses is that it varies for each person so it is important to find the right treatment plan.

We also need to continue to de-stigmatize mental illness among military populations. While in the last few years there has been a lot of progress in this area, we need to continue to reach out and educate about these issues. I think that incidents of mental illness in the military are underreported due to the stigma. If we can educate about mental illness and stomp out the stigma we can provide care and treatment plans to those that need it.

For more information: http://www.ptsd.va.gov/public/PTSD-overview/basics/how-common-is-ptsd.asp

Health

School Test = Bear Attack

Posted on February 18, 2017 by / 0 Comment

We are living in a higher state of anxiety than we were biologically made for. Our brains were made for us to remember stressful situations that would help us to save ourselves. Like if someone died, maybe you’d remember what berry they ate right before it. Or if a bear attacked, you’d remember what area of the woods to avoid and to run away fast. But what about all of the stressful situations we subject ourselves to now? Look at American students—we’re trained to be involved in everything, get the best grades, have friends, and still exercise and sleep. That can lend to a lot of stress! But is that stress actually helping us to survive better? Is that anxiety making us better students?

I don’t think so. With all of the stress and expectations, we just get higher strung and become really good students, but not necessarily very good learners. In the spirit of learning, let’s learn how stress affects memory!

Stress activates a signaling pathway in the brain called ERK (extracellular signal-related kinases).
ERK activates two transcription factors (substances that can start the copying of genes) called Elk-1 and MSK.
Elk-1 and MSK are both used to activate a dual histone tag. The dual histone tag opens up DNA so that it can be ready to copy.
Two immediate early genes (IEGs) and copied, which help to consolidate the stressful memory.

Since these stressful memories are consolidated, they are all associated with one another. That means if something reminds you of part of the memory, they are all called up, and your body prepares to react. This can mean that you become more anxious, and you can overreact to a situation that is not life threatening. Taking a test is not the same situation as being attacked by a bear, but your brain may not know the difference if you’re stressed.

Luckily there are some things we can do to help decrease this stressful memory creation. For example, exercising can help increase the activity of GABA in the brain. GABA is an inhibitory control, so it can help to stop the signaling pathway that makes stressful memories so powerful.

Community/Health

Locking Away Mental Illness

Posted on February 14, 2017 by / 0 Comment

In 1963, President John F. Kennedy signed into law a landmark piece of legislation titled the Community Mental Health Act (CMHA). Its purpose was to redirect funds from state-run asylums and into mental health centers within communities. The ultimate goal was for patients from these state-run institutions to be reintroduced into their communities and become contributing members of society. Riding on the waves of this legislation, other laws passed throughout the 1970’s and 80’s which ultimately dismantled state-run mental asylums altogether. Before these laws were passed, there was mounting evidence coming out that these institutions were riddled poor oversight and care for patients.
While these laws are hailed as major steps in mental health rights, these laws weren’t perfect by any means. While the CMHA had good intentions, funding for these community health centers never came and many patients became homeless as health centers became overburdened. Over the years, many of these patients were thrown in jail or prison. The Bureau of Justice Statistics estimated in 2007 that 705,600 people with mental illnesses were in either jail or prison. This includes people with severe mental illnesses such as schizophrenia or bipolar disorder. Furthermore, the environment of jail or prison only exacerbates many of the problems of mental illness instead of treating it. There are some mental illnesses such as paraphilias or borderline personality disorder coincide with criminality. However, the vast majority of people with mental illnesses are more likely to harm themselves than others.
Sources:

https://www.washingtonpost.com/news/wonk/wp/2015/04/30/a-shocking-number-of-mentally-ill-americans-end-up-in-prisons-instead-of-psychiatric-hospitals/?utm_term=.4361a89d90d6
http://www.huffingtonpost.com/dustin-demoss/prison-mental-illness_b_6867988.html

Uncategorized

An Alternate View of Schizophrenia

Posted on February 14, 2017 by / 0 Comment

Image result for schizophrenic art
The overall issue with Schizophrenia comes during development in many cases. Of course, there are always different cases that may involve drug use to induce this condition. After reading several articles covering the neural pathways involved, it can be concluded that the cause is not exactly known at this point. For those that develop Schizophrenia that is not induced by drug use, a great deal of the damage leading up to their conditions has been hypothesized to be acquired during development.

Image result for schizophrenia

It is important for those in the general public to be understanding of people that have Schizophrenia because this condition is not understood well enough in the science community for many of these people to receive the treatments they may be needing. Schizophrenia is an interesting disorder because it has such a broad range of symptoms and thresholds. Some people may be hearing voices and seeing objects or even people that aren’t present. Much research has contributed these hallucinations to overstimulation of the visual and auditory cortices of the brain. Furthermore, many of those struggling with Schizophrenia have an altered sense of reality which is extremely difficult for them to cope with because they do not view many situations in the same way others do. Currently, some of the best methods of treatment for Schizophrenia are rooted in coping methods along with the pharmaceuticals that aid in treating the manic episodes.
Image result for voices ryan reynolds netflix
After researching Schizophrenia, I happened to find a newer movie called, “Voices” featuring Ryan Reynolds which although entertaining and twisted, provided me with an alternative view of how to look at Schizophrenia. As a backstory, the character played by Reynolds in the movie was diagnosed with Schizophrenia and the entire movie was narrated from his perspective on how his interactions at work normally went and how he had an altered view of situations compared to his coworkers. To provide an example without ruining the movie, Reynolds’ character lives on his own and through his eyes, his apartment appears to be spotlessly clean and everything seems normal. When the perspective shifts to the people entering his apartment, we find that his apartment is a disorganized disaster. He also has another key symptom of Schizophrenia that with his ability to speak to his two pets that have two completely different personalities through his eyes. As other people meet his animals they are unable to speak and these conversations with the animals are uncontrolled hallucinations.
The most difficult part of Schizophrenia is that there is no definite cure for this disorder. Many people with Schizophrenia will live their whole life treating their symptoms but will never be free of this burden. Because of the many different areas of the brain associated with Schizophrenia, it is difficult for researchers to find a prominent treatment method because each patient is different therefore adding a great challenge. Going back to the beginning, another piece that adds difficulty with research is that because Schizophrenia is involved with development, researchers can’t study those with Schizophrenia until they are in their 20s which is the average age when most Schizophrenia cases are diagnosed. At this point, most development is finished and finding the culprit of the disorder is much more difficult. Where we stand right now, researchers have many hypotheses on what exactly is going wrong during development, but there is a great amount of work to be done yet.

Community/Disease/Health

Three Things You Probably Didn’t Know About Schizophrenia

Posted on February 14, 2017 by / 0 Comment

Up until recently, my knowledge of the psychiatric disease, schizophrenia, was pretty limited, and I think many others can relate. All I really knew was that common symptoms include hallucinations and that it’s commonly diagnosed later in life. Over the past year, I have taken up more of an interest in mental health and the associated stigmas attached to disorders. In doing so I have learned SO much about different mental illnesses that have completely changed how I now think about them and affected individuals. This knowledge is incredibly important in the reduction of negative stigmas revolving around mental health in our society. So, my goal is to contribute to the movement by sharing some information that might help change the way you think about a specific disorder that, arguably, has some of the most severe stereotypes attached to it.

Dysfunctional Wnt signaling is implicated in schizophrenia

Likely the most significant point – as well as with other psychiatric disorders, symptoms experienced by schizophrenic patients are NOT due to flaws in character, but rather a dysfunctional cell signaling pathway that results in significant changes in the brain. Specifically, schizophrenia has been associated with low activity or inhibition of the Wnt pathway. Normally, this pathway allows a protein called B-catenin to enter the nucleus of a cell and activate transcription of specific genes. During the transition from teenage to adult years, Wnt signaling and the expression of targeted genes play an important role in continued development, including in the brain. When this pathway is disrupted, B-catenin is destroyed before it can reach the nucleus, and those genes are not transcribed and expressed. If this occurs during that transition period, development is interfered with, and schizophrenic symptoms can result.

Not all affected by schizophrenia experience the same symptoms

This should be fairly obvious, but it should still be pointed out that symptoms of schizophrenia vary from person to person. Symptoms are divided into two different categories – Positive symptoms and Negative symptoms. Positive symptoms include extra behavior such as delusional or irrational thinking, hallucinations, and disorganized speech and behavior. The negative symptoms may be less familiar or harder to detect, but should not be forgotten about. These include a lack of interest or emotion, monotony, withdrawal, and suicidal thoughts (note how these are seen in many other psychiatric diseases as well). Someone suffering from schizophrenia may experience symptoms from both categories, only positive symptoms, or only negative symptoms. In other words, not all schizophrenic patients experience hallucinations or hear voices. Symptoms and severity of the disease should be seen more as a spectrum. Yes, there are severe cases that may resemble portrayals of movies and the media, but there are many others that are more than capable of functioning in society.

Concussions, and infections can induce schizophrenia

Before I get into this, I should start off by clarifying that genetic makeup is by far the biggest risk factor in developing schizophrenia. However, other factors or experienced events can also contribute to onset, such as sustained concussions and infections. For example, someone may have some gene expression associated with schizophrenia, but this does not guarantee development of the disorder will occur. Now, say this same individual sustained a concussion during their transition years. Studies suggest that the physical trauma added to genetic risk factors increases the odds of developing schizophrenia and other neurological disorders. Similarly, a woman who contracts an infection (i.e. influenza, rubella, respiratory) during pregnancy may also increase the risk of her child developing schizophrenia, as gestation is another crucial developmental period. I know, scary to think about as these situations can happen to anyone, but this again illustrates the onset of schizophrenia is multifactorial and out of the control of those who are affected.

Disease/Health

Stopping the Stigma of Schizophrenia

Posted on February 14, 2017 by / 0 Comment

How common is schizophrenia and what are some of the symptoms?
Schizophrenia is mental disorder that occurs throughout the world. It is estimated that about 1% of the global population has schizophrenia. That would equate to about 60-70 million people. According to the Schizophrenia and Related Disorders Alliance of America about 3.2 million people in the United States are suspected to have the disorder. The unusual aspect of schizophrenia is there are no “hot spots” for the disease. This means that it is found pretty universally around the planet regardless of race or ethnicity. Basically, someone is equally as likely to develop the disorder in the United States as someone who lives in Asia.
Schizophrenia has two different sets of symptoms that are divided into positive (extra behavior) and negative (reduced behavior). The positive symptoms would be symptoms such as delusions, hallucinations, and disorganized thinking or speech. So basically, these are symptoms that occur in the brain and the thought process. The negative symptoms would be things such as neglecting personal hygiene, not being able to make eye contact, and monotone speech. These symptoms can be seen by other people and are not constricted to the brain.

The breakdown of the Wnt pathway as a cause of schizophrenia
In the normal human brain the Wnt pathway allows β-catenin to be produced and bind to the transcription factors of TCF and LEF. These then allow transcription of Wnt genes that help in normal homeostatic processes. Β-catenin is allowed to bind because the destruction complex, which includes GSK3β is inhibited by DVL. Basically, GSK3β usually binds to β-catenin and marks it to be destroyed. However, when DVL is active it prevents GSK3β from marking β-catenin to be destroyed.

When the Wnt pathway is screwed up GSK3β is not deactivated, therefore β-catenin is destroyed and there are very low levels. This means that transcription of the Wnt genes are severely reduced, which is bad for the brain. Now there are many ways that this can occur, but it seems the most common is that excess amounts of dopamine are produced. These active the D2 (dopamine) receptors which prevents the AKT molecule from blocking GSK3β production. Thus leading to β-catenin suppression and schizophrenia.
The negative portrayal of schizophrenia and why that needs to change.
Now schizophrenia is a debilitating disease in the extreme forms and can cause people to become violent. However, those are just the most extreme cases. Most of the time people are able to manage the disease and can control themselves. The news and movies tend to portray the most extreme cases causing this to be the public perception. One example would be the movie American Psycho starring Christian Bale in which he goes on a killing spree as if that is the normal.

However, according the American Psychiatric Association, “Data indicates that severe mental illness alone does not predict future violence, but that violence is associated with substance abuse, lack of psychiatric treatment, and other factors.” From this it is clear to see that these violent episodes that are rare are not usually caused by the disorder itself, but rather some outside factor. It is time to raise awareness about mental disorders and change the stigma so people can get the help they need.

Community/Health

Schizophrenics Are Violent

Posted on February 13, 2017 by / 0 Comment

At least, that’s what the media will have you think. Many movies portray mental illness. I understand why—mental illness is different, and we don’t completely understand it yet, so it is interesting to explore it through movies. Movie makers often take the viewer to the extremes in order to illicit bigger reactions. Unfortunately, these movies often depict a rather unrealistic image of mental illness—consider this list.
Why does the media depict schizophrenia so negatively? In the movie The Voices the main character murders three people because he doesn’t take his medication. There are some criminal cases in which individuals that have schizophrenia are the perpetrators, but the vast majority of schizophrenics are not violent—more often they are withdrawn and introverted.
We still don’t know why schizophrenia occurs, or how to cure it. It is thought that schizophrenia occurs because one signaling method in the brain, called the Wnt pathway, is somehow inhibited. Without the Wnt pathway, an activator for brain developmental and growth (β-catenin) continually gets destroyed and never gets the chance to initiate proliferation.
Why not just use a pharmaceutical drug that always keep the Wnt pathway on? Well, this would then signal for different areas to keep growing without control… sound like a familiar problem? It sounds like tumor growth to me, which could lead to cancer. So more targeted drugs are needed to solve this problem.

You might ask then why some people have this uncontrollable Wnt signaling. Scientists don’t know yet, but there is a strong connection to genetics, mutations within cells, and external factors. It has been shown that having a family history increases the likelihood of having schizophrenia—two genes in particular, DISC1 and Akt can affect Wnt signaling. There are also cases in which different types of mutations within genes can lead to schizophrenia without a family history. External factors in the womb like prenatal infections and stressful events like famine, flood, or loss can even increase the risk of getting schizophrenia. It is most likely a combination of these factors that lead to schizophrenia.

Current drugs can help to regulate some of the positive symptoms (symptoms that increase behavior, like hallucinations), but there is no cure for schizophrenia. Therapy can sometimes help an individual cope with their disorder and help them to lead a more normal life. It isn’t that individual’s fault that they have this disorder, so why do we so often think of them as criminals?
Want to watch some movies where the media actually got mental disorders somewhat right? This list or this list might help you to change your view.

Disease/Health

Is Any of This Real? the Facts Behind Schizophrenia

Posted on February 13, 2017 by / 0 Comment

Is Any of This Real? The Facts Behind Schizophrenia

Many of us have seen movies or television shows that have portrayed someone with schizophrenia. However, the media portrays individuals with schizophrenia as someone who is “insane,” the “murderer,” or someone of whom to be afraid in general. But is this media portrayal anything like the truth? What exactly is schizophrenia? What causes it? Can it be treated? Here are some answers.
What is schizophrenia?
Schizophrenia is a mental illness. Just like autism, there is a spectrum of schizophrenic symptoms. Most diagnosed cases are in individuals that are 20 years or older. According to the Mayo Clinic, many symptoms of schizophrenia include hallucinations, delusions, abnormal behavior, and negative symptoms. Although these symptoms seem fairly straight forward, here’s a breakdown:
Hallucinations: These include seeing or hearing things that are not real, however, to the individual they seem completely real. Hearing voices is the most common.
Delusions: This is when the individual believes things that are not true. Some examples would be thinking that a catastrophe is about to happen, or thinking people are always talking about you.
Abnormal behavior: This includes non-goal oriented behavior, strange posture, or resistance to instructions.
Negative symptoms: This includes a lack of hygiene, social withdrawal, lack of emotion, and the inability to experience pleasure.
What causes Schizophrenia?
Schizophrenia is still being researched, however, a basic understanding has been found with a certain pathway in the brain. The Wnt pathway in the brain contains a transcription factor called β-catenin. This transcription factor is very important with development. In schizophrenic patients, the Wnt pathway is inhibited by β-catenin being tagged for deconstruction by the destruction complex GSK3β being over active. In the image below, the destruction complex normally gets inhibited by the Wnt pathway from the DVL protein, but in schizophrenia, the DVL complex does not inhibit the destruction complex and β-catenin gets destroyed. This can also happen with dopamine. The dopamine pathway inhibits a protein called AKT which also inhibits the same destruction complex. In schizophrenic patients, the dopamine pathway is overactive meaning AKT is inhibited. This doesn’t allow for the destruction complex to be turned off so β-catenin is also broken down
.
Can schizophrenia be treated?
Antipsychotic drugs that are currently used target the dopamine pathway. They specifically inhibit dopamine receptors to shut off the AKT inhibition. This allows for the destruction complex to be turned off and allow β-catenin to act normally. However, these drugs don’t always treat the negative symptoms. Lithium has also been used as a treatment in the past. It is used to inhibit the GSK3β directly. Since schizophrenia is still fairly new to research, treatment is not very advanced. Hopefully in the future, more research will develop a treatment that will be able to treat all symptoms of this illness.

Schizophrenia is a mental illness that not many people understand. The way it is portrayed in the media even makes it seem like something of which to be afraid. However, knowing the symptoms and what is happening in the brain allows us to understand that a patient with schizophrenia is not “insane” or “crazy.” It is a mental illness just like any other mental illness.