Cobbers on the Brain

As the National Institute of Mental Health says, “Schizophrenia is a chronic and severe mental disorder that affects how a person thinks, feels, and behaves. People with schizophrenia may seem like they have lost touch with reality. Although schizophrenia is not as common as other mental disorders, the symptoms can be very disabling.”
Okay, so schizophrenia is complicated, and people today sometimes don’t take the time to educate themselves on mental disorders like this one. Even the basics of schizophrenia are misconceived, and that’s why I think writing about common misconceptions is beneficial to everyone. Many assumptions can present themselves when talking about mental illnesses because simply, its tough stuff to understand!
Probably the biggest misconception of schizophrenia lies in itself. If you google what “schizo” means, you find “split” and if you type in “phrenia”, it means “mind”. People who like to define words based on their prefixes or suffixes can possibly misinterpret what this mental disorder really is. When most people think of “split-mind” you may think that there is two minds or two different personalities presented, but that’s wrong. People that have schizophrenia sometimes have episodes of hallucinations and this is misconceived as a different separate personality, but this is something different called Dissociative Identity Disorder .
In many cases, people will think schizophrenics are violent and that violence goes hand in hand with this mental disorder. Well, according to Schizophrenic.com, media over exaggerates criminals who happen to have schizophrenia, thus, associating violence and crime to schizophrenia. The NIH states that violence correlates highly in schizophrenics who had “childhood conduct problems”. More on that is found here.
The third misconception to mention is that once you get schizophrenia, there is no going back. Multiple sources I found break this and states that there is no return to “normal life” in only select individuals with this disorder. Rethink.org states that 30% of people with the disorder have a lasting recovery, and a man by the name of Howard Trachtman had recovered from schizophrenia, check his story out.
In my opinion, these three misconceptions are crucial to understanding even just the tip of the iceberg to schizophrenia. Defining a word is one the most common things to google. The word crazy typically goes with schizophrenics and I argue that crazy implies violence, thus, creating a misunderstanding. Finally, the general public understands the brain and its disorders are difficult to understand. They are “incurable” to many people and not so obvious like your blackened lungs from long-term smoking use leading to lung disease. Understanding there is still hope for individuals with schizophrenia or family and friends who live and communicate with schizophrenics is important and typically misconceived. Maybe our treatments aren’t the greatest now, but they will be. They will be. Disorders in the brain are going to need to involve a multi-factor mechanistic drug because its not as easy as just shutting off a signal or two up in the brain—there is too much association in the brain at the molecular level.
Here’s a short video that covers some misconceptions I mentioned as well as some others.

A 2015 study in the American Journal of Psychiatry provided exciting evidence of a novel treatment’s effectiveness in treating schizophrenia. The new treatment changes the way medical providers respond to first time psychotic episodes and emphasizes early treatment, as well as collaboration among the healthcare team and the patient. This team-based approach demonstrates the benefits of providing care that is individualized and communicated with the patient.
Schizophrenia affects more than 2 million people in the United States and accounts for almost 30 percent of all spending on mental health according to the National Institutes of Health. Currently, the most common treatment for schizophrenia involves high doses of antipsychotic drugs, but for many people these treatments fail to effectively manage the symptoms and instead leave them to deal with debilitating side effects such as violent tremors and excessive weight gain. That’s why effective alternative treatments are greatly needed.
Dr. Kim Mueser, who is a clinical psychologist and executive director of the Center for Psychiatric Rehabilitation, developed the psychosocial portion of the new treatment called NAVIGATE. This regiment has three main goals: providing tools for building social relationships and dealing with a first psychotic episode, working with a counselor to integrate back into society as soon as possible, and educating family members about schizophrenia. Most importantly, the NAVIGATE program must begin within six months of the first psychotic episode. This is in stark contrast to our current timeline for the treatment of schizophrenia where the average time between the first psychotic episode and treatment is about a year and half.
Along with providing tips for managing positive symptoms of schizophrenia, the program also stresses the importance of helping people to not define themselves based on their illness. Researcher Jennifer Gottlieb says that after one psychotic episode, people can feel instantly pathologized and their identity becomes that of a patient. The program helps these “patients” to harness positive characteristics that they’ve always had in order to recover from the episodes and move forward as a person.
At the conclusion of the two-year study, the results were very positive. Compared to the experimental group that received a medication driven treatment, the NAVIGATE group displayed more improvement in quality of life and lessening of symptoms. It appears that keeping doses of medication as low as possible and supplementing with well planned and individualized interventions like NAVIGATE really can make a difference in the lives of schizophrenic patients. Dr. Kenneth Duckworth of the National Allienace on Mental Illness has called it a “game changer for the field.”
In my opinion, this new approach is successful largely because it emphasizes communication between healthcare providers. According to Mueser, the care team met regularly to plan and coordinate on the best plan of action. In the end, the decisions were based on the patient’s personal goals, which were then communicated with the patient’s family and the NAVIGATE team to help make it happen.
This collaborative approach to providing care is the best option going forward and should be a point of emphasis for new doctors entering the field. It can be easy for a doctor to feel like they’re alone in the responsibility to make a final decision, but this new early intervention program provides room for other care providers like counselors and psychologists to weigh in on the best direction of action.
In the end, I think this leads to a better decision for the patient’s health and better care from the team as a whole. It also reflects the Association of American Medical College’s emphasis on training a new kind of doctor: one that possesses more than just scientific knowledge, including the skills to treat the entire individual and promote understanding in how people think, interact, and make decisions. As a healthcare system, we are finally beginning to realize how important mental health is in relation to the rest of the physical body and effective treatments like NAVIGATE are a testament to that.
 

With the introduction of pizza vending machines and more fast food restaurants in a community than schools, obesity in the US has become an epidemic of sorts. According to the National Institute of Diabetes and Digestive and Kidney Diseases, more than 35.7% of adults are considered to be obese; over 6.3% have extreme obesity.
We’ve all heard similar statistics before, or at the very least we know obesity is a growing problem – literally. You’d think the stigma of becoming a part of that statistic would be enough to inspire a person adopt a healthy life style. If not, perhaps the list of serious health concerns associated with obesity: diabetes, heart disease, stroke, high blood pressure, osteoarthritis, gout, gallbladder disease and gall stones, various cancers, sleep apnea, asthma – long as it may be, this is not an exhaustive list.
What would it take to inspire a change? Is adding one more risk to an already exceedingly long list really going to call people’s attention to the seriousness of this issue? Perhaps not.
But what if people were told obesity could lead to memory loss? That obesity, down the road, could be the reason they can no longer recall a loved ones name or remember the events of their wedding day.
Scientists have been connecting the dots together, indicating that this may be what we are seeing with the rise of obesity paralleling that of Alzheimer’s Disease (AD). In fact, in many cases AD is becoming better known as Type III Diabetes.
What is the connection and why does this happen?
It is well understood that diabetes is one of the greatest risk factors that accompanies obesity. Overeating causes an over intake of nutrients, overwhelming the cell structure that processes these nutrients. This structure then sends out an alarm signal, weakening the affinity of insulin receptors on the cell surface so it can catch up. Eventually, this leads to insulin resistance, resulting in an increase in blood glucose levels, a hallmark symptom of diabetes.
New information suggests that insulin resistance is not a characteristic unique to our periphery, but has been observed occurring in our central nervous system as well. Insulin resistance in the brain is where and how AD becomes referred to as Type III Diabetes.
Most of the brain does not require insulin for uptake of glucose into its cells; however, certain regions do, specifically the hippocampus and the frontal cortex – both areas of the brain important in learning and memory. Insulin resistance in these areas may be cause for beginning symptoms of AD.
Additionally, the PI3K pathway in the brain is responsible for successful aging and it is activated by insulin. A “Goldilocks pathway,” very strict regulation is essential. If its function is nonexistent, it’s lethal; if the pathway is over activated, it can result in AD.  As it is triggered by insulin, this pathway is also affected by insulin resistance, although later in the pathway and not at the receptor level.
Not all cases of obesity are self-treatable. There has been research to suggest that for some individuals, similar to drug addicts, food becomes an addiction. There are binge eating disorders and oral fixations that may need medication or therapy to fix the problem. But in most situations, this is not the case. Obesity is a result of collective conscious decisions to disregard the necessity for physical activity, to eat poorly, whether out of choice or convenience, and to ignore or refuse to take action in regards to increased weight gain accompanying these lifestyle choices.
So how do we treat this Type III Diabetes?
To date, more research must be done to confirm that caloric restriction leads to later onset or decreased effects of AD. In the meantime, however, the destructive effects of caloric overload are evident. One could confidently say that practicing a healthy lifestyle has more positive effects, in regards to AD development, than the alternative and decreases overall health risks.
Wouldn’t you rather eat a few carrots now than one day forget the last meal you ate entirely? Was that cheeseburger and French fries really worth it if you can’t remember what it tasted like or that you even ate it? These questions are direct and perhaps oversimplifications, but it is evident that a change needs to be made to counter the rise of both obesity and AD in the US. Making these connections and considering the serious, if extreme, consequences may be just what is needed to inspire this change.

         Hypothesizing about the environmental triggers of Alzheimer’s disease (AD) can quickly lead down a proverbial rabbit hole. Such a discussion occurred last week in my Neurochemistry course at Concordia College as we discussed the role that obesity, insulin resistance, and genetics play in the development of AD.
        And while I won’t reach any foregone conclusion today about how Alzheimer’s arises, I will share concerning new research about a possible link between air pollution and AD. This research is important because in today’s world, whether you live in Fargo, ND or Los Angeles, we all experience some level of air pollution. The findings are important to acknowledge for the sake of our health and should leave us to reconsider the safety of our current means of energy production.
        In July of 2016, a study from the Lancaster Environment Center at the University of Lancaster in England provided evidence of exogenous magnetite nanoparticles in the human brain. The study used common imaging and chemical analysis techniques to examine the composition of the nanoparticles from the brains of about 40 human subjects who had previously lived in either Mexico City or Manchester, England.
        Endogenous biological processes can actually form angular nanoparticles composed of iron oxide that are similar to the exogenous nanoparticles found by Lancaster. What was unique, however, concerning the aforementioned study was the identification of nanoparticles with more rounded shapes.
        While the rounded particles were a new finding in the human brain, the particles themselves were recognizable. That’s because the rounded particles in the brain share a striking resemblance with nanoparticles in our air that arise from high-temperature (combustion-derived) particulate matter (PM). But how could the nanospheres in the air around us also appear in our brains?
        It turns out that nanoparticles less than 200 nanometers in diameter have a direct route into the brain through the axons of the olfactory bulb. And although some of the highest levels of nanoparticles were found in the oldest subjects from Manchester, equivalent and even higher levels have been found in many young Mexico City residents. In previous studies, these increased metal concentrations have corresponded to hallmarks of AD. All of this, then, provides compelling evidence that nanoparticles from external sources can end up in the brain, but what role does this play in AD?
        The most common neuropathology of AD is the accumulation of beta-amyloid plaques in the brain. Research has shown that magnetite nanoparticles are sometimes associated with beta-amyloid plaques and that the particles work to enhance the toxicity of beta-amyloid. That’s because when beta-amyloid is associated with the nanoparticles, it can generate dangerous reactive oxygen species that cause oxidative brain damage. Consequently, oxidative brain damage is an early feature of AD.
        With the incidence of AD increasing, it’s important that efforts are ramped up to identify early risk factors. Most importantly, we must be impartial in our inquiries towards possible risk factors, even if those factors could be arising from our most necessary forms of transportation. It might seem like a tall (and frankly unlikely) task for an unbiased review of our air pollution’s effects on AD, but it is definitely necessary. In the end, it could finally provide a nonpartisan reason to invest in cleaner and less nanoparticle forming energy sources. Most importantly, it could save lives.
 

Alzheimer’s Disease is a neurodegenerative disorder characterized by progressive memory loss, cognitive decline, and eventual impairment in daily living tasks. According to the National Alzheimer’s Association, more than 5 million Americans are living with Alzheimer’s Disease, with it being the 6^th leading cause of death in the United States. Though there is currently no known cure due to the complexity in understanding this disease, treatments for symptoms are available to slow the progression and onset of the disease
 
Past Research
Previously, research has focused mainly on the beta-amyloid plaques found in brain tissue of patients’ brains at autopsy or in brain-imaging studies. These plaques are insoluble aggregates of the A-beta protein and have been thought to contribute to the cell death and neuronal loss in the brain. Recent literature, though, has identified plaques as not directly toxic and are often found in patients without any cognitive symptoms of Alzheimer’s Disease. Similarly, recent research has found that Alzheimer’s Disease starts long before the beta-amyloid plaques even begin to appear, almost 10-20 years before symptoms appear.
 
How is this possible?
Research is now pointing to the smaller soluble clumps of A-beta, called oligomers, as the toxic component of the disease. In the presymptomatic stage of Alzheimer’s Disease, beta-amyloid clumps begin to form in particular brain regions. Though the exact effects of the oligomers on the brain are not fully known, the leading hypothesis suggests that the oligomers affect neuronal connections at the synapse so that it is harder for the brain to form new memories and recall old ones. Eventually in the progression of the disease, the oligomers go on to form the larger, insoluble plaques. However, once the plaques are formed, the disease has often reached its worst and there is little that can be done to help.
 
So what can you do?
Today there are efforts being made worldwide to increase our knowledge on preventative techniques to delay the onset and prevent Alzheimer’s Disease from developing altogether. Although many risk factors such as aging and genetics cannot be changed, other risk factors such high blood pressure and lack of exercise can be changed to help prevent Alzheimer’s Disease. Here are few ideas for those of you ready to make change:

• Stay Active
  • Regular exercise serves many benefits for our overall health. Concerning Alzheimer’s Disease, it is important in reducing the vascular risk factors that can contribute to brain cell loss and damage. Exercise may also directly benefit the brain by increasing oxygen and blood flow.
• Eat a Healthy Diet
  • Recently research has identified a link between obesity and diabetes to Alzheimer’s Disease. It is important then, that we start to eat healthier diets to prevent some of the co-occurring diseases.
• Keep Mentally Active
  • A number of studies suggest that keeping mentally active by partaking in intellectual and cognitive exercises can curb the onset of Alzheimer’s Disease. Though scientists are not certain of the exact association between the two, it is known that with mental stimulation comes the strengthening of connections between nerve cells in the brain.