HIGH-DOSE FLU VACCINE MORE EFFECTIVE IN ELDERLY
From FMS Global News Desk of Jeanne Hambleton 13-Aug-2014 Source: Vanderbilt University Medical Center Citations New England Journal of Medicine
Newswise — High-dose influenza vaccine is 24 percent more effective than the standard-dose vaccine in protecting persons ages 65 and over against influenza illness and its complications, according to a Vanderbilt-led study published today in the New England Journal of Medicine (NEJM).
The multi-center study enrolled 31,989 participants from 126 research centers in the U.S. and Canada during the 2011-2012 and 2012-2013 influenza seasons in the Northern Hemisphere in order to compare the high-dose trivalent vaccine versus the standard-dose trivalent vaccine in adults over 65 years of age.
“The study was done to see if using a high-dose vaccine protected older adults better than the usual vaccine. Until this trial came out we did not know if it was going to be clinically better or not and now we know it is better,” said lead author Keipp Talbot, M.D., assistant professor of Medicine, who served as coordinating investigator for the more than 100 study sites.
“Older adults are the most vulnerable to influenza; they become the sickest and have the most hospitalizations. This vaccine works better than the standard dose and hence I would tell my patients to get the high-dose vaccine every year. In the meantime, we will continue to work to find newer and better vaccines for older adults.”
Researchers concluded that the high-dose vaccine is safe, induces significantly higher antibody responses, and provides superior protection against laboratory-confirmed influenza illness compared to standard dose among persons over 65 years of age.
Study data also indicated that the high-dose vaccine may provide clinical benefit for the prevention of hospitalizations, pneumonia, cardio-respiratory conditions, non-routine medical visits, and medication use.
Between 1990 and 1999, seasonal influenza caused an average of 36,000 deaths and 226,000 hospitalizations per year in the U.S. Adults over 65 years old are particularly vulnerable to influenza complications, accounting for most seasonal influenza-related hospitalizations and deaths.
“Prevention of influenza should lower hospitalizations, deaths, heart attacks, and pneumonia,” Talbot said.
“This vaccine does have some more arm soreness than the usual vaccine because it is a higher dose. With this increased soreness comes greater protection.”
Known as the Fluzone High-Dose vaccine, and made by Sanofi Pasteur, the inactivated influenza vaccine contains four times the amount of antigen that is contained in the standard-dose Fluzone vaccine.
“Fluzone High-Dose vaccine is the only influenza vaccine in the U.S. that is designed specifically to address the age-related decline of the immune system in older adults,” said David P. Greenberg, M.D., vice president, Scientific & Medical Affairs, and chief medical officer, Sanofi Pasteur U.S.
Study authors said about one-in-four breakthrough cases of influenza could be prevented if the high-dose vaccine were used instead of the standard-dose vaccine.
“I see older adults hospitalized every year with influenza and many of them come into the hospital with pneumonias and heart failure because they had influenza,” Talbot said.
“But I have to say our seniors in Nashville are very good at getting vaccinated. Locally they are very good and they do much better than their counterparts who are less than 65 years old. About 76 percent of this community of older adults are vaccinated for influenza each year.”
SLOW TO MATURE, QUICK TO DISTRACT: ADHD BRAIN STUDY FINDS SLOWER DEVELOPMENT OF KEY CONNECTIONS
Brain networks to handle internal & external tasks mature more slowly in ADHD
From FMS Global News Desk of Jeanne Hambleton Embargoed: 15-Sep-2014
Source: University of Michigan Health System Citations Proceedings of the National Academy of Sciences, September 15 Early Edition
By examining hundreds of fMRI brain scans of children with ADHD and those without, the researchers identified key connections between brain networks that matured more slowly in ADHD brains.
Newswise — ANN ARBOR, Mich. — A peek inside the brains of more than 750 children and teens reveals a key difference in brain architecture between those with attention deficit hyperactivity disorder and those without.
Kids and teens with ADHD, a new study finds, lag behind others of the same age in how quickly their brains form connections within, and between, key brain networks.
The result: less-mature connections between a brain network that controls internally-directed thought (such as daydreaming) and networks that allow a person to focus on externally-directed tasks. That lag in connection development may help explain why people with ADHD get easily distracted or struggle to stay focused.
What is more, the new findings, and the methods used to make them, may one day allow doctors to use brain scans to diagnose ADHD — and track how well someone responds to treatment. This kind of neuroimaging “biomarker” does not yet exist for ADHD, or any psychiatric condition for that matter.
The new findings come from a team in the University of Michigan Medical School’s Department of Psychiatry. They used highly advanced computing techniques to analyze a large pool of detailed brain scans that were publicly shared for scientists to study. Their results are published in the Proceedings of the National Academy of Sciences.
Lead author Chandra Sripada, M.D., Ph.D., and colleagues looked at the brain scans of 275 kids and teens with ADHD, and 481others without it, using “connectomic” methods that can map interconnectivity between networks in the brain.
The scans, made using function magnetic resonance imaging (fMRI) scanners, show brain activity during a resting state. This allows researchers to see how a number of different brain networks, each specialized for certain types of functions, were “talking” within and amongst themselves.
The researchers found lags in development of connection within the internally-focused network, called the default mode network or DMN, and in development of connections between DMN and two networks that process externally-focused tasks, often called task-positive networks, or TPNs. They could even see that the lags in connection development with the two task-related networks — the frontoparietal and ventral attention networks — were located primarily in two specific areas of the brain.
The new findings mesh well with what other researchers have found by examining the physical structure of the brains of people with and without ADHD in other ways.
Such research has already shown alterations in regions within DMN and TPNs. So, the new findings build on that understanding and add to it.
The findings are also relevant to thinking about the longitudinal course of ADHD from childhood to adulthood. For instance, some children and teens “grow out” of the disorder, while for others the disorder persists throughout adulthood. Future studies of brain network maturation in ADHD could shed light into the neural basis for this difference.
“We and others are interested in understanding the neural mechanisms of ADHD in hopes that we can contribute to better diagnosis and treatment,” says Sripada, an assistant professor and psychiatrist who holds a joint appointment in the U-M Philosophy department and is a member of the U-M Center for Computational Medicine and Bioinformatics.
“But without the database of fMRI images, and the spirit of collaboration that allowed them to be compiled and shared, we would never have reached this point.”
Sripada (shown above) explains that in the last decade, functional medical imaging has revealed that the human brain is functionally organized into large-scale connectivity networks. These networks, and the connections between them, mature throughout early childhood all the way to young adulthood.
“It is particularly noteworthy that the networks we found to have lagging maturation in ADHD are linked to the very behaviors that are the symptoms of ADHD,” he says.
Studying the vast array of connections in the brain, a field called connectomics, requires scientists to be able to parse through not just the one-to-one communications between two specific brain regions, but the patterns of communication among thousands of nodes within the brain. This requires major computing power and access to massive amounts of data – which makes the open sharing of fMRI images so important.
“The results of this study set the stage for the next phase of this research, which is to examine individual components of the networks that have the maturational lag,” he says. “This study provides a coarse-grained understanding, and now we want to examine this phenomenon in a more fine-grained way that might lead us to a true biological marker, or neuromarker, for ADHD.”
Sripada also notes that connectomics could be used to examine other disorders with roots in brain connectivity – including autism, which some evidence has suggested stems from over-maturation of some brain networks, and schizophrenia, which may arise from abnormal connections. Pooling more fMRI data from people with these conditions, and depression, anxiety, bipolar disorder and more could boost connectomics studies in those fields.
Volunteers needed for research:
To develop such a neuromarker, Sripada has embarked on follow-up research. One study is enrolling children between the ages of 7 and 17 who have ADHD and a comparison group of those without it; information is at http://umhealth.me/adhdchild. Another study is enrolling adults between the ages of 18 and 35 who have ADHD and a comparison group of those without it; information is at http://umhealth.me/adhdadult. Of note, fMRI scans do not expose a person to radiation. Anyone interested in these studies can email Psychfirstname.lastname@example.org or call (734) 232-0353; for the study of children, parents should make the contact and consent to research on behalf of their children.
Besides Sripada, the study’s authors are Psychiatry computer specialists Daniel Kessler and Mike Angstadt. Kessler, a graduate of U-M with a degree in neuroscience and statistics, helped develop the key connectomic methods used in the study and plans to pursue this research further in a graduate program starting in 2015.
The research was funded by a National Institutes of Health grant (AA020297), a UMCCMB pilot grant, and the John Templeton Foundation. It used fMRI scans from the ADHD-200 and ABIDE projects.
STUDY FIRST TO USE BRAIN SCANS TO FORECAST EARLY READING DIFFICULTIES
Brain’s White Matter Highly Predictive of Reading Acquisition Beyond Effects of Genetic Predisposition
From the FMS Global News Desk of Jeanne Hambleton Released: 15-Sep-2014
Source Newsroom: University of California, San Francisco (UCSF) Citations Psychological Science, September 15, 2014
Newswise — UC San Francisco researchers have used brain scans to predict how young children learn to read, giving clinicians a possible tool to spot children with dyslexia and other reading difficulties before they experience reading challenges.
In the United States, children usually learn to read for the first time in kindergarten and become proficient readers by third grade, according to the authors. In the study, researchers examined brain scans of 38 kindergarteners as they were learning to read formally at school and tracked their white matter development until third grade. The brain’s white matter is essential for perceiving, thinking and learning.
The researchers found that the developmental course of the children’s white matter volume predicted the kindergarteners’ abilities to read.
“We show that white matter development during a critical period in a child’s life, when they start school and learn to read for the very first time, predicts how well the child ends up reading,” said Fumiko Hoeft, MD, PhD, senior author and an associate professor of child and adolescent psychiatry at UCSF, and member of the UCSF Dyslexia Center.
The research is published online in Psychological Science.
Doctors commonly use behavioral measures of reading readiness for assessments of ability. Other measures such as cognitive (i.e. IQ) ability, early linguistic skills, measures of the environment such as socio-economic status, and whether there is a family member with reading problems or dyslexia are all common early factors used to assess risk of developing reading difficulties.
“What was intriguing in this study was that brain development in regions important to reading predicted above and beyond all of these measures,” said Hoeft.
The researchers removed the effects of these commonly used assessments when doing the statistical analyses in order to assess how the white matter directly predicted future reading ability. They found that left hemisphere white matter in the temporo-parietal region just behind and above the left ear — thought to be important for language, reading and speech — was highly predictive of reading acquisition beyond effects of genetic predisposition, cognitive abilities, and environment at the outset of kindergarten. Brain scans improved prediction accuracy by 60 percent better at predicting reading difficulties than the compared to traditional assessments alone.
“Early identification and interventions are extremely important in children with dyslexia as well as most neurodevelopmental disorders,” said Hoeft. “Accumulation of research evidence such as ours may one day help us identify kids who might be at risk for dyslexia, rather than waiting for children to become poor readers and experience failure.”
According to the National Institute of Child and Human Development, as many as 15 percent of Americans have major trouble reading.
“Examining developmental changes in the brain over a critical period of reading appears to be a unique sensitive measure of variation and may add insight to our understanding of reading development in ways that brain data from one time point, and behavioral and environmental measures, cannot,” said Chelsea Myers, BS, lead author and lab manager in UCSF’s Laboratory for Educational NeuroScience.
“The hope is that understanding each child’s neurocognitive profiles will help educators provide targeted and personalized education and intervention, particularly in those with special needs.”
Co-authors include Maaike Vandermosten, PhD of KU Leuven; Emily Farris, PhD of University of Texas Permian Basin; Roeland Hancock, PhD, Paul Gimenez, BA, Brandi Casto, MS, Miroslav Drahos, MS, Mandeep Tumber, MS, and Robert Hendren, DO, all of the Department of Psychiatry at UCSF; Jessica Black, PhD of School of Social Work at Boston College; and Charles Hulme, DPhil of Department of Psychology at University College London.
The study was supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (K23 HD054720), Flora Family Foundation, UCSF Catalyst Award, UCSF Resource Allocation Program, Brain & Behavior Research Foundation Young Investigator Award, Stanford University Lucile Packard Foundation for Children’s Health, Spectrum Child Health & Clinical and Translational Science Award and the Extraordinary Brain Series of the Dyslexia Foundation.
UC San Francisco (UCSF), now celebrating the 150th anniversary of its founding, is a leading university dedicated to promoting health worldwide through advanced biomedical research, graduate-level education in the life sciences and health professions, and excellence in patient care. It includes top-ranked graduate schools of dentistry, medicine, nursing and pharmacy, a graduate division with nationally renowned programs in basic, biomedical, translational and population sciences, as well as a preeminent biomedical research enterprise and two top-ranked hospitals, UCSF Medical Center and UCSF Benioff Children’s Hospital San Francisco
See you Wednesday. Jeanne