Biomed Radio - Washington University School Of Medicine In St. Louis

Adults and teenagers with clinical depression don’t respond to rewards in a normal manner. Their moods are less enthusiastic, and their brains don’t act the same way as those in adults and adolescents who are not depressed. Although depression has been diagnosed in children as young as 3, it hasn’t been clear whether the responses of very young children to rewards also may be blunted. So Washington University researchers studied kids ages 4 to 7 and found that, like adults, when these young children were depressed, their brains were less likely to respond to rewards. The researchers say that could mean insensitivity to rewards may serve as a “red flag” for depression in young children. PAST RESEARCH HAS FOUND THAT THE BRAINS OF DEPRESSED ADULTS AND ADOLESCENTS OFTEN DON’T RESPOND AS MUCH TO REWARDS AS THE BRAINS OF PEOPLE WHO DON’T HAVE DEPRESSION. NOW, CHILD PSYCHIATRY RESEARCHERS AT WASHINGTON UNIVERSITY SCHOOL OF MEDICINE IN ST. LOUIS HAVE FOUND THE SAME THING IS TRUE IN VERY YOUNG CHILDREN. JIM DRYDEN HAS

Vision problems can be caused by neurofibromatosis. Kids with mutations in the NF1 gene that causes neurofibromatosis often develop tumors on the optic nerve, but not all of them develop vision problems. Interestingly, Washington University researchers previously had learned that girls with tumors on the nerve were five to 10 times more likely to lose vision than boys with tumors of about the same size. Now those same researchers have found, in mice, that estrogen is the reason that females with these tumors are more likely to lose vision. Further study showed that cells called microglia are more common and more active in the tumors females develop. Those cells make substances that are more toxic to nerve cells and, therefore, damage vision. The researchers say strategies to temporarily lower estrogen levels in children with tumors on the optic nerve may make it possible to preserve vision without the need for chemotherapy to shrink such tumors. TUMORS ON THE OPTIC NERVE ARE A COMMON FEATURE OF A GENETIC CON

Using MRIs, researchers at Washington University School of Medicine in St. Louis have identified areas in the brains of children with Tourette’s syndrome that appear markedly different from the same areas in the brains of children who don’t have the neuropsychiatric disorder. RESEARCHERS AT WASHINGTON UNIVERSITY SCHOOL OF MEDICINE IN ST. LOUIS HAVE IDENTIFIED A FEW AREAS IN THE BRAINS OF CHILDREN WITH TOURETTE’S SYNDROME THAT APPEAR TO BE DIFFERENT FROM THE SAME AREAS IN THE BRAINS OF KIDS WHO DON’T HAVE THE NEUROLOGICAL DISORDER. AND THE REGIONS THAT THEY IDENTIFIED ARE ONES WHERE THEY HADN’T REALLY EXPECTED TO SEE DIFFERENCES. JIM DRYDEN HAS THE STORY… THE RESEARCHERS USED MAGNIETIC RESONANCE IMAGING IN THE LARGEST STUDY OF ITS KIND EVER DONE ON PATIENTS WITH TOURETTE’S SYNDROME. IT INVOLVED RESEARCH TEAMS AT SEVERAL CENTERS AROUND THE UNITED STATES. PRINCIPAL INVESTIGATOR KEVIN BLACK, A PSYCHIATRIST AT WASHINGTON UNIVERSITY SCHOOL OF MEDICINE IN ST. LOUIS, SAYS THE RESEARCHERS ANALYZED MRI BRAIN SCANS C

As part of the White House Brain Initiative, researchers at Washington University School of Medicine in St. Louis have received two grants to develop tools to map and activate pathways in the brain with light. With $3.8 million in funding from the National Institutes of Health (NIH), the researchers, with collaborators at the University of California, San Diego School of Medicine and the University of Illinois at Urbana-Champaign, will study how light-sensitive proteins can be used to control specific brain circuits with the goal of understanding how the brain is wired to regulate behaviors, such as stress, anxiety and depression. THE WHITE HOUSE BRAIN INITIATIVE HELPS FUND CUTTING-EDGE PROJECTS THAT HELP SCIENTISTS BETTER UNDERSTAND THE WORKINGS OF THE BRAIN. A TEAM OF RESEARCHERS AT WASHINGTON UNIVERSITY SCHOOL OF MEDICINE IN ST. LOUIS HAS RECEIVED A PAIR OF GRANTS FROM THE INITIATIVE TO FUND THE DEVELOPMENT OF TOOLS ALLOWING ALLOW THEM TO USE LIGHT-SENSING PROTEINS FROM OTHER ORGANISMS, BIND THOSE PROTEIN

Treatment-resistant depression is a big problem for older adults. More than half of seniors with clinical depression don’t get relief from standard antidepressant medications. To address that problem, psychiatrists at Washington University School of Medicine in St. Louis are helming a multicenter study to evaluate the efficacy of supplementing current therapies with additional drugs, or changing medications altogether. The study will follow 1,500 people with depression from St. Louis and rural Missouri, Los Angeles, Western Pennsylvania, New York City, Toronto and rural Ontario. Study subjects will be 60 or older, and all will have failed to respond to treatment involving at least two antidepressants. Some subjects will take additional drugs during the study, and others will be switched to different medications. After treatment, the researchers will attempt to evaluate which types of patients respond best to specific treatment strategies. TREATMENT-RESISTANT DEPRESSION IS A PARTICULAR PROBLEM FOR OLDER ADULT

Children with sickle cell disease frequently have painful episodes that can require hospitalization for a few days. Physicians want to treat those episodes quickly to eliminate pain and get a child back home and back to school as quickly as possible, and now, researchers at Washington University School of Medicine in St. Louis have found that using the drug methadone might eliminate the pain more quickly. Methadone frequently is used to treat cancer pain and is a well-known treatment for addiction. But it also may be useful treating the severe pain associated with sickle cell disease. TREATING PAIN FROM SICKLE CELL DISEASE CAN BE DIFFICULT. CHILDREN WITH THE DISEASE OFTEN HAVE SEVERE PAIN EPISODES THAT CAN REQUIRE HOSPITALIZATION. BUT NOW RESEARCHERS AT WASHINGTON UNIVERSITY SCHOOL OF MEDICINE AND ST. LOUIS CHILDREN’S HOSPITAL HAVE FOUND THAT ADDING METHADONE TO OTHER PAIN KILLERS CAN RELIVE SICKLE CELL PAIN MORE QUICKLY IN CHILDREN AND MAY BE ABLE TO HELP YOUNGER PATIENTS GET HOME FROM THE HOSPITAL SOONER.

Researchers at Washington University School of Medicine in St. Louis will play a major role in the largest long-term study of brain development and child health in U.S. history. The landmark study will follow the biological and behavioral development of more than 10,000 children, beginning when the kids are 9 to 10 years old. Scientists studying the adolescents will use advanced brain imaging, interviews and behavioral testing to see how childhood experiences can affect a child’s changing biology, brain development and, ultimately, social, behavioral, academic and health outcomes. If the researchers can get a better understanding of the relationships between such factors, they may be able to predict and prevent, or even reverse, potential problems in development. WE AREN’T BORN WITH FULLY-DEVELOPED BRAINS. IN FACT, BRAIN DEVELOPMENT CONTINUES FOR YEARS. AND RESEARCHERS AT WASHINGTON UNIVERSITY IN ST. LOUIS WILL PLAY A BIG ROLE IN A NEW NIH-FUNDED STUDY OF BRAIN DEVELOPMENT IN ADOLESCENTS. THE SO-CALLED ABCD

Quitting smoking improves health and lowers odds of developing lung cancer. But a new study shows that even among smokers with a genetic predisposition to smoking heavily and developing young cancer at a young age, the benefits of quitting are significant. An international study led by researchers at Washington University School of Medicine in St. Louis and the Siteman Cancer Center indicates that in these high-risk smokers, quitting cuts lung cancer risk in half and delays the age at which the disease is diagnosed. AN INTERNATIONAL STUDY, LED BY RESEARCHERS AT WASHINGTON UNIVERSITY SCHOOL OF MEDICINE IN ST. LOUIS AND THE SITEMAN CANCER CENTER, SHOWS THAT QUITTING SMOKING IMPROVES HEALTH AND LOWERS THE ODDS OF DEVELOPING LUNG CANCER, EVEN AMONG SMOKERS WHO ARE GENETICALLY PREDISPOSED TO SMOKE HEAVILY AND TO DEVELOP CANCER AT A YOUNGER AGE. JIM DRYDEN HAS THE STORY… THE NEW FINDINGS SUGGEST THAT DOCTORS MIGHT WANT TO REQUEST DNA ANALYSIS FROM SMOKERS IN ORDER TO EMPLOY THE MOST EFFECTIVE THERAPIES TO HELP

In search of genetic clues regarding autism spectrum disorder, researchers at Washington University School of Medicine in St. Louis are launching a study focused on grandmothers. Autism has a strong genetic basis, and rates of the disorder may be higher in the grandchildren of women who had at least one child with an autism spectrum disorder than in the population as a whole. To test that hypothesis, the researchers plan to recruit a minimum of 500 grandmothers and soon-to-be grandmothers to complete questionnaires about their own children with autism, their other biological children and their biological grandchildren. The researchers want to better understand how to support families and help them understand the odds that some of their children may inherit the disorder. AUTISM SPECTRUM DISORDERS HAVE A STRONG GENETIC COMPONENT, AND RESEARCHERS AT WASHINGTON UNIVERSITY SCHOOL OF MEDICINE IN ST. LOUIS ARE SURVEYING GRANDMOTHERS TO FIND OUT MORE ABOUT HOW IT’S PASSED DOWN IN FAMILIES. THE RESEARCHERS ARE RECRUI

A new study reveals that some eye specialists who receive money from pharmaceutical companies are more likely to use drugs promoted by those companies than similar drugs that are equally effective but less expensive. Although the data can’t confirm a cause and effect between money from industry and the prescribing habits of some physicians, researchers at Washington University School of Medicine in St. Louis report in the journal JAMA Ophthalmology that they have identified a “positive association between reported pharmaceutical payments and increased use” of drugs prescribed to treat several retinal problems. AN ANALYSIS OF RECORDS MADE PUBLIC BY THE U.S. PHYSICIANS PAYMENTS SUNSHINE ACT, SHOWS THAT THERE IS AN ASSOCIATION BETWEEN REPORTED PAYMENTS FROM PHARMACEUTICAL COMPANIES AND THE DRUGS THAT SOME RETINA SPECIALISTS USE IN THEIR PATIENTS WHO HAVE MACULAR DEGENERATION AND OTHER RETINAL DISEASES. OPHTHALMOLOGY RESEARCHERS AT WASHINGTON UNIVERSITY SCHOOL OF MEDICINE IN ST. LOUIS IDENTIFIED THAT ASSOCIATION

Researchers have found how sensory nerve cells work together to transmit itch signals from the skin to the spinal cord, where neurons then carry those signals to the brain. Their discovery may explain why some people experience various types of itching, including chronic itching, and help scientists find ways to make some types of itching stop. The researchers report that by interfering with the activity of sensory neurons, they may be able to inhibit multiple types of itching. THERE ARE SPECIFIC NEURONS IN THE SPINAL CORD THAT CARRY ITCH SIGNALS TO THE BRAIN, BUT BEFORE THOSE CELLS CAN BE ACTIVATED, OTHER SENSORY CELLS MUST PROCESS AND TRANSMIT ITCH SIGNALS. NOW, RESEARCHERS AT WASHINGTON UNIVERSITY SCHOOL OF MEDICINE IN ST. LOUIS HAVE IDENTIFIED CHANNELS IN NERVE CELLS THAT CARRY DIFFERENT TYPES OF ITCH SIGNALS TO THE SPINAL CORD. AND THE FINDINGS MAY GIVE SCIENTISTS NEW TARGETS TO HELP BLOCK OR RELIEVE ITCHING IN SOME PATIENTS. JIM DRYDEN HAS MORE… THE RESEARCHERS STUDIED HOW ITCH SIGNALS ARE PROCESSED

Scientists’ understanding of the genetic roots of breast cancer is based largely on research conducted in women of European ancestry. But that knowledge does little to explain why African-American women with breast cancer are more likely to be diagnosed at younger ages and with more aggressive tumors than their white counterparts. Researchers at Washington University School of Medicine in St. Louis are launching a major study involving 600 African-American women with breast cancer to learn whether their genetic risks are influenced by the same gene mutations that affect white women or if their mutations are altogether different. Such information may lead to new ways to prevent or treat breast cancer in African-American women. AS SCIENTISTS HAVE MADE BIG ADVANCES IN GENETIC TESTING FOR BREAST CANCER, NOT ALL WOMEN HAVE GOTTEN THE BENEFITS. MOST OF THAT RESEARCH HAS BEEN DONE IN WOMEN OF EUROPEAN ANCESTRY, AND MUCH LESS IS KNOWN ABOUT THE GENETICS OF BREAST CANCER IN AFRICAN-AMERICAN WOMEN. NOW, A TEAM OF RES

A program aimed at helping abused and neglected children and their families is improving short-term outcomes for kids and providing children with stable home environments as their cases move through the courts. The program is for children and families whose cases ended up in court. Researchers at Washington University School of Medicine in St. Louis have found that kids whose families received psychiatric help and educational support through the program have better-than-expected outcomes compared to kids comparably matched for level of risk whose cases went through the court system before the program was launched. WHEN YOUNG CHILDREN SUFFER ABUSE OR NEGLECT, THEY ARE AT RISK FOR BIG PROBLEMS LATER ON IN LIFE, SUCH AS PSYCHIATRIC DISORDERS, SUBSTANCE ABUSE AND BECOMING ABUSERS THEMSELVES AS ADULTS. BUT A PROJECT INVOLVING THE ST. LOUIS COUNTY COURTS AND WASHINGTON UNIVERSITY CHILD PSYCHIATRISTS IS WORKING TO BREAK THAT PATTERN BY OFFERING SERVICES BOTH TO CHILDREN AND TO THEIR PARENTS. JIM DRYDEN HAS MORE…

As young people reach adulthood, their preferences for sweet foods typically decline. But for people with obesity, new research suggests that the drop off may not be as steep and that the brain’s reward system is operating differently in obese people than in thinner people, which may play a role in this phenomenon. AS WE GET OLDER, WE TEND TO HAVE LESS OF A PREFERENCE FOR SWEET THINGS. DURING THAT SAME TIME IN LIFE, THE NUMBER OF A PARTICULAR TYPE OF DOPAMINE RECEPTOR IN OUR BRAINS BEGINS TO DECLINE, AND THERE IS A STRONG RELATIONSHIP BETWEEN RECEPTORS, AGE AND SWEET TASTE PREFERENCES IN PEOPLE WHO DON’T HAVE OBESITY. BUT SCIENTISTS AT WASHINGTON UNIVERSITY SCHOOL OF MEDICINE IN ST. LOUIS HAVE FOUND THAT THINGS DON’T WORK THAT WAY IN PEOPLE WHO DO HAVE OBESITY. JIM DRYDEN HAS THE STORY… WHEN WE EAT, OUR BRAINS RELEASE CHEMICALS THAT MAKE US FEEL GOOD, AND WHEN WE EAT SOMETHING REALLY GOOD, THE SAME THING HAPPENS, ONLY MORESO. A BRAIN CHEMICAL CALLED DOPAMINE IS WHAT MAKES US FEEL GOOD, AND TO MEASURE DOPA

With more U.S. states legalizing or decriminalizing marijuana use, the number of adults using the drug has increased. But a survey of more than 216,000 adolescents from all 50 states indicates the rates of marijuana use are falling among the young. Researchers at Washington University School of Medicine in St. Louis examined data on drug use collected from young people and found that the number of adolescents who had problems related to marijuana declined by 24 percent between 2002 and 2013. Over the same period the number of kids reporting they used marijuana at all fell by 10 percent. AS SEVERAL STATES HAVE MADE USING MARIJUANA LEGAL, AT LEAST FOR MEDICINAL PURPOSES, SOME HAVE WORRIED THAT THE NUMBER OF YOUNG PEOPLE USING MARIJUANA WILL INCREASE, BUT RESEARCHERS AT WASHINGTON UNIVERSITY SCHOOL OF MEDICINE IN ST. LOUIS HAVE FOUND THAT THE NUMBER OF AMERICAN KIDS BETWEEN 12 AND 17 WHO USE MARIJUANA IS ACTUALLY DECLINING. SO IS THE NUMBER OF ADOLESCENTS WHO HAVE MARIJUANA-RELATED PROBLEMS. JIM DRYDEN HAS THE

People who suffer itching with no clear cause may have defects in their immune systems that haven’t been recognized. In a small study of patients who struggle with itching but have no known cause, researchers from the Center for the Study of Itch at Washington University School of Medicine in St. Louis identified several immune system irregularities that may underlie the urge to scratch. The patients suffer from what doctors call chronic idiopathic pruritis. Studying blood samples and skin biopsies, the researchers have found some very unusual things in the immune systems of these patients. SOME PEOPLE SUFFER HAVE BAD PROBLEMS WITH ITCHING BECAUSE THEY HAVE A RASH OR SOME OTHER SKIN CONDITION. BUT OTHERS HAVE ITCHING PROBLEMS WITH NO KNOWN CAUSE. NOW RESEARCHERS FROM THE CENTER FOR THE STUDY OF ITCH AT WASHINGTON UNIVERSITY SCHOOL OF MEDICINE IN ST. LOUIS HAVE IDENTIFIED DEFECTS IN THE IMMUNE SYSTEMS OF SOME PATIENTS WITH THAT TYPE OF ITCHING THAT MAY UNDERLIE THE URGE TO SCRATCH. JIM DRYDEN HAS MORE… ALT

There is news almost every day about the epidemic of opioid drug use in the United States. Some 65 percent of heroin users report that they used prescription opioids first and then made the switch to heroin. And current estimates are that 4-20 percent of all opioid pills prescribed in the United States actually are taken for nonmedical reasons. Now, an anesthesiologist and a surgeon at Washington University School of Medicine in St. Louis are proposing ways to reduce the availability of opioid drugs by eliminating some of them from the pipeline. Among other things, they’re proposing that doctors prescribe fewer pills for patients after they undergo surgery and that pharmaceutical companies initiate turn-in programs for unused opioids. RELATED FEATURE: Inside an epidemic: Overcoming America’s opioid crisis starts with understanding abuse patterns THE U.S. CENTERS FOR DISEASE CONTROL AND PREVENTION IS RECOMMENDING THAT DOCTORS TRY TO AVOID PRESCRIBING OPIOID PAINKILLERS FOR MANY PATIENTS, AND NOW EXPERTS

State laws designed to help teens gradually ease into full driving privileges may have an unintended benefit: They appear to lower rates of teen alcohol consumption and binge drinking. Researchers at Washington University School of Medicine in St. Louis have found that in states with stricter graduated driver licensing laws, there not only is less drinking and driving among teens, there also is less total alcohol consumption by teenagers. MANY STATES HAVE ADOPED LAWS IN RECENT YEARS THAT ARE DESIGNED TO MAKE THE ROADS SAFER BY ALLOWING TEEN DRIVERS TO GRADUALLY EASE IN TO FULL DRIVING PRIVILEGES. BUT NEW RESEARCH FROM WASHINGTON UNIVERSITY SCHOOL OF MEDICINE IN ST. LOUIS FINDS THAT THOSE LAWS ALSO APPEAR TO BE HAVING AN UNINTENDED EFFECT: THEY APPEAR TO BE HELPING LOWER THE RATES OF TEEN ALCOHOL CONSUMPTION AND BINGE DRINKING. JIM DRYDEN REPORTS … SO-CALLED GRADUATED DRIVER LICENSING LAWS, OR GDLs, MIGHT RESTRICT THE NUMBER OF PASSENGERS A NEW DRIVER CAN HAVE IN THE CAR AT ONE TIME. SOME LAWS ALSO KEEP YOU

Going to the doctor can be a frightening experience for some kids, and a visit to the psychiatrist can be even more unnerving. So a Washington University psychiatrist has written a children’s book about what happens on a visit to the psychiatrist’s office and why some kids receive psychiatric care. The idea is to make the experience of going to the psychiatrist less stressful and to inform healthy children that getting psychiatric care isn’t all that different from visiting the pediatrician or the dentist. A GOOD DEAL OF RESEARCH IS NOW SUGGESTING THAT EARLY ASSESSMENT AND DIAGNOSIS OF PSYCHIATRIC DISORDERS IS VERY IMPORTANT TO GOOD OUTCOMES IN CHILDREN, AND A WASHINGTON UNIVERSITY CHILD PSYCHIATRIST HAS WRITTEN A CHILDREN’S BOOK THAT’S DESIGNED TO HELP GET THAT WORD OUT, AS WELL AS TO MAKE KIDS MORE COMFORTABLE WITH THE IDEA OF SEEING A MENTAL HEALTH PROFESSIONAL. JIM DRYDEN HAS THE STORY… THERE ARE CHILDREN’S BOOKS ABOUT ALL KINDS OF MEDICAL EXPERIENCES: VISITING THE DOCTOR, GOING TO THE DENTIST, GETTING

Some cases of diabetes are caused by mutations to a single gene, In studies of such cases, a team of Washington University researchers has identified the way that those genetic mutations cause problems. Although most people with the genetic form of diabetes called Mature-Onset Diabetes of the Young 1, seem to have clinical symptoms that are very close to the symptoms that affect people with type 2 diabetes, these studies show that the underlying mechanisms are very different. Most treatments for type 2 diabetes are designed to excite insulin-secreting cells into making more insulin, but that’s not the problem in the genetic form of the disorder. The study finds that insulin-secreting cells are under stress in the genetic form of diabetes, and those treatments that work in type 2 diabetes can increase stress, eventually killing the cells. So the researchers say say their findings suggest that patients with that genetic form of diabetes may need a different type of therapy. ALMOST 30 MILLION AMERICANS HAVE DIA