Glutamatergic-dopaminergic balance in the brain. Its importance in motor disorders and schizophrenia

Dopamine appears to be of less importance in the regulation of psychomotor functions than was previously thought. A central dopaminergic-glutamatergic balance may be important for both akinetic motor disorders and psychosis. In Parkinson's disease glutamate antagonists may counteract central glutamatergic hyperactivity and may be of value as anti-parkinsonian drugs. An increase of dopaminergic activity and/or a reduction of glutamatergic activity may contribute to the development of paranoid hallucinatory psychosis in schizophrenic patients and of pharmacotoxic psychosis in Parkinson's disease. Because of possibly severe side-effects of glutamatergic antagonists and agonists in the treatment of akinesia and psychosis, the development of partial glutamate agonists/antagonists could be an alternative strategy capable of producing antipsychotic or anti-kinetic effects with only mild adverse reaction

Bedeutung des Neurotoxins MPTP für Ätiologie und Therapie der idiopathischen Parkinsonkrankheit [Significance of the neurotoxin 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine for the etiology and therapy of idiopathic Parkinson disease]

Exposure of drug addicts to MPTP (1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine) has caused a Parkinsonian syndrome accompanied by a selective destruction of dopamine containing neurones in the pars compacta of the substantia nigra. MPTP in the human causes a severe irreversible state that very closely resembles idiopathic Parkinson's disease both in its clinical features and response to pharmacological treatment. Interest in potential environmental agents that might play a role in the aetiology of idiopathic Parkinson's disease is likely to increase as the result of the discovery of the relatively simple molecule MPTP which is highly toxic to the substantia nigra. Until the discovery of the neurotoxicity of MPTP there was no effective animal model of Parkinson's disease. Administration of PTP to monkeys induces persistent parkinsonism which responds to classical antiparkinsonian therapy. The morphological and biochemical changes in the brains of the animals are more limited and selective than those seen in idiopathic Parkinson's disease. The model of MPTP-treated monkeys appears to provide a useful testbed for the evaluation of future treatments for the disease. The precise mechanism of MPTP toxicity has yet to be determined and may provide the clue to the mechanism of neuronal death in Parkinson's disease. After entering the brain MPTP is oxidized to MPP+ (1-methyl-4-phenylpyridine) at an extraneuronal site.(ABSTRACT TRUNCATED AT 250 WORDS

Movement and nutrition in health and disease

Movement and nutrition play a pivotal role in the promotion of long-term health and the prevention of chronic disease. Obesity and physical inactivity are among the leading causes of premature death, while lifestyle factors such as exercise and healthy eating can reduce the risk of becoming obese and developing related diseases. Movement and nutrition may therefore be able to assist in the prevention and therapy of chronic diseases. Regular physical activity and better dietary choices are effective means of extending not only lifespan but also healthspan. Healthy nutrition is important throughout life, and diet is the most important risk factor of illness worldwide. Moreover, childhood obesity has become a global health crisis. While high body-mass index and high fasting plasma glucose contribute substantially to the rising burden of disease, they also provide promising opportunities for intervention. In addition, mounting evidence suggests vital relationships between nutritional quality and mental health. Approaches tackling dietary improvements include community-based health promotion, school-based interventions, mass media campaigns, open online platforms and policies sanctioning unhealthy food choices. The high prevalence of sedentary behavior and physical inactivity is a major health risk and a leading cause of death worldwide. The extensive health benefits of a physically active lifestyle are well established. Exercise is a viable way to help prevent and combat many chronic diseases, and an increase in physical activity could markedly improve health worldwide. A challenge in this context is the promotion of an active lifestyle, including the initiation of and adherence to effective exercise and sport programs

Mental health problems in COVID-19 and the need for reliable data

The effects of the coronavirus disease 2019 (COVID-19) pandemic on both physical and mental health are significant. While preventive measures against the spread of the novel coronavirus and the treatment of people with COVID-19 has been in the focus of health systems worldwide, the need for mental health care for patients and health professionals affected by the pandemic has been less well addressed. Mental health problems associated with the pandemic include the possibility of delirium in the acute stage of COVID-19, while depression, anxiety, fatigue and posttraumatic stress disorder may be found in the longer term. People with severe mental illness are at high risk during the COVID-19 pandemic and may be among the most vulnerable populations. In addition to an exacerbation of their mental condition, these individuals may show an increased susceptibility to COVID-19 infection and increased mortality rates, due primarily to high rates of overweight, obesity, smoking and bad diet. COVID-19 related mental health problems are not confined to those infected with the virus. Measures taken to slow the spread of the virus, such as physical distancing and business and school closures, which lead to greater isolation and potential financial distress, may result in disturbances of mental health in non-infected people. Social isolation and the uncertainties surrounding the novel coronavirus may lead to loneliness, despair, anxiety and depressive thoughts. As a consequence, psychiatric symptoms may emerge in individuals with no history of mental disorders, and pre-existing mental conditions may worsen.Given previous experiences with large-scale disasters and the SARS epidemic of 2003, the COVID-19 pandemic is likely to increase the prevalence of anxiety, depression, substance use, self-harm and domestic violence in the general population. Moreover, school closures may result in an increase in child abuse. At present, there is no epidemiological data on either the psychiatric morbidity of those diagnosed with COVID-19 or mental health problems of their health care providers. Data on the mental health effects related to the pandemic in the general population is also lacking.Public mental health interventions are needed during the COVID-19 pandemic in order to address the anticipated increases in the prevalence of mental disorders and poor mental health across populations. In this context, systematic information on the immediate psychosocial problems caused by the pandemic is important. Reliable data will also be required to measure the growing effects of COVID-19 on mental health and substance use. The increase in the need for mental health services may become a long-term issue even though new cases and deaths due to COVID-19 are declining.In summary, the implications of the COVID-19 pandemic for mental health call for a greater focus on the needs of those with mental disorders and on mental health issues affecting health care workers and the general population. However, little is known concerning the nature, extent, duration and distribution of the effects of the COVID-19 pandemic on mental health. The need to collect high-quality data on the mental health effects of COVID-19 on both vulnerable groups and whole populations is therefore pressing. Longitudinal data will be needed to track the prevalence of mental health problems and the associated need for treatment and public health measures. Reliable information, which can be gained only by random sampling from the entire population, is needed in order to reduce the risk of bias and erroneous conclusions and to avoid potentially damaging interventions

Mediterranean diet and Alzheimer’s disease

Alzheimer’s disease (AD), the most common form of dementia, is a progressive neurodegenerative disease with no effective cure. Lifestyle factors, including nutrition and diet, are attracting increasing attention in AD research. It has been suggested that the Mediterranean diet (MeDi) may protect against cognitive decline and dementia. People adhering to a MeDi showed a decrease in the risk of cognitive disorders in several epidemiological studies. While higher adherence to a MeDi was related to a reduced risk of incident cognitive impairment, lower adherence was associated with an increase in the incidence of AD and mild cognitive impairment. However, the majority of published studies on MeDi and AD are observational and cannot answer the question whether the association is causal. Cohort studies with long follow-up periods and large samples suggest an association between adherence to MeDi and a decrease in the risk of cognitive decline and AD. Lower MeDi adherence has been shown to be associated with progressive AD biomarker abnormalities in middle-aged adults. The lower risk of AD associated with the MeDi could be mediated through reduced vascular risk factors and beneficial effects on glucose and lipid metabolism. Certain components of the MeDi, such as its high fruit and vegetable content, relatively low level of carbohydrates and its use of extra-virgin olive oil as the main source of fat, could provide protective effects against cognitive decline, including AD. These findings call for further investigations of the potential of dietary interventions to protect against brain aging and AD. However, other factors of the Mediterranean lifestyle, such as regular physical exercise and strong social networks, may also contribute to the reduced risk of the disease. Long-term randomized controlled trials are needed to establish a causal relationship between MeDi and the prevention or improvement of cognitive decline in AD. At present, it is not possible to prescribe the MeDi as a preventive measure in AD, since knowledge of the type and quantity of individual food components and bioactives required for effective neuroprotection is lacking

Lifestyle and attention deficit/hyperactivity disorder

Attention deficit/hyperactivity disorder (ADHD) is a frequent diagnosis in childhood and adolescence and the disorder may also be found in adulthood. The core symptoms of ADHD, inattention, impulsivity and hyperactivity, frequently cause significant impairment in behavioral, social, academic, and occupational functioning. Short-term symptomatic benefits of the commonly used treatments, such as pharmacotherapy and behavior management techniques, have consistently been shown in many individuals with ADHD. However, it is unclear whether or not the currently available treatments improve the outcome in individuals with ADHD over an extended time period, and little is known about long-term safety of the medications administered in ADHD. Extended use of stimulant medication in ADHD from childhood through adolescence is associated with suppression of growth and consequent reduction in adult height with no reduction in symptom severity. Long-term administration of methylphenidate may result in the development of tolerance to the neurotransmitter changes induced by medication, lessening the effectiveness of the drug. These findings regarding the long-term management of ADHD and the failure of a “magic bullet†strategy targeting well-defined biological alterations in ADHD call for alternative research approaches. A wide range of lifestyle factors have been proposed as potential precursors or consequences of ADHD. Various nutrients have been linked to brain development and functioning, and diet may be an important factor in psychiatric disorders including ADHD. The role of vitamins and minerals in the etiology and treatment of ADHD is unclear, and benefits may be confined to individuals with respective deficiencies. The efficacy of polyunsaturated fatty acid supplementation in ADHD seems to be negligible. Clear evidence supporting a role of single nutrients in the etiology and therapy of ADHD has not been produced, and the interrelationship between diet in general and other lifestyle factors may be of greater importance. Emerging evidence suggests that physical activity may be a protective factor in ADHD. While exercise may be a promising alternative or additional treatment option for individuals with ADHD, the currently available studies assessing the impact of physical activity on ADHD symptoms have several limitations. Large-scale, well-designed studies investigating the effects of physical exercise on ADHD should be conducted, since exercise may have additional health benefits regarding cardiovascular function and the prevention of noncommunicable diseases such as diabetes and obesity. The well-established relationship between ADHD and insomnia, and the small but significant association between media use and ADHD-related behaviors call for further investigations. In summary, the interaction of environmental, social and societal factors in ADHD needs to be addressed. The consideration of lifestyles may contribute to a more holistic and interactive understanding of ADHD. Lifestyle research in regard to etiology and treatment appears to be a promising approach to ADHD, and the conducting of such research independent of commercial interests will be a future challenge. Furthermore, lifestyles associated with ADHD should be considered in clinical practic

The International Movement and Nutrition Society and the prevention of disease

oai:ojs.pkp.sfu.ca:article/1The International Movement and Nutrition Society (IMNS) was founded in Regensburg, Germany in May 2014. The society is a nonprofit association of scientists, clinicians, healthcare professionals and laypersons interested in the importance of lifestyle factors, such as physical activity and nutrition, in health and disease. The mission and major goals of the IMNS include promoting public awareness and debate, disseminating knowledge, supporting the exchange of information between scholars and the public, providing educational programs, initiating research projects and developing policies. The IMNS organised International Conferences on Movement and Nutrition in Health and Disease in June 2015, July 2016 and June 2017. Furthermore, the scientific open-access journal Movement and Nutrition in Health and Disease was established in March 2017 (Publisher: Regensburg University Press)

Red wine, resveratrol, and Alzheimer’s disease

Alzheimer’s disease (AD) is a progressive neurodegenerative disorder and the most common form of dementia. No effective therapies for AD are yet available, and potentially preventive lifestyle factors, including diet and physical activity, have become a focus of AD research. One such factor is moderate wine consumption, which has been claimed to be neuroprotective, and some studies have suggested a potential role for grapes and wine in retarding cognitive decline and other effects of aging. Polyphenols contained in grapes have been investigated as a preventive measure or potential therapy for dementia. The best-studied fruit polyphenol, the stilbenoid resveratrol (trans-3,5,4’-trihydroxystilbene), is known for its anti-oxidant and anti-inflammatory properties. The present short review evaluates the evidence regarding the role of red wine and resveratrol in the prevention and treatment of AD. Some research findings have suggested that resveratrol may be useful in the treatment of neurodegenerative diseases, including AD, due to its ability to reduce cognitive decline and to inhibit amyloid β aggregation in animal models of dementia. Studies in rodents have demonstrated neuroprotective effects of resveratrol on central features of AD, including decreased amyloid deposition and tau-hyperphosphorylation, enhanced hippocampal neurogenesis, and improved memory functions. The mechanisms through which resveratrol exerts neuroprotective efficacy in animals remain to be established. The potential of resveratrol to act as a nutraceutical targeting neuropathological changes in AD and exerting neuroprotective efficacy may be related to its anti-oxidant activities and its ability to antagonize amyloid aggregation, suppress neuroinflammation, decrease mitochondrial dysfunction, and modulate signaling pathways. In contrast to the neuroprotective activity of resveratrol in various in-vitro and in-vivo models, evidence of the ability of resveratrol to prevent age-associated neurodegeneration in humans and to improve cognitive deficits in AD is lacking. Thus, whether resveratrol has any beneficial effects in humans remains to be established. Pterostilbene (trans-3,5-dimethoxy-4’-hydroxystilbene), an analog of resveratrol, appears to be more effective than resveratrol in ameliorating brain alterations associated with aging and may be a more promising compound for future research. Moderate red wine intake is unable to provide resveratrol in amounts required for clinically relevant effects in AD. Were resveratrol proven to be effective in combatting AD, supplements or a drug should be substituted for wine as a source. Moreover, the toxic effects of alcohol should be considered, since recent evidence suggests that no level of alcohol consumption has beneficial health effects. In particular, long-term alcohol consumption, even in moderate quantities, is associated with multiple markers of abnormal brain structure, including hippocampal atrophy. Moderate drinking to promote brain health is not justified, and any claims regarding the potential efficacy of red wine in the prevention of AD are unsubstantiated and irresponsible