Altered hippocampal morphology in unmedicated patients with major depressive illness

Despite converging evidence that major depressive illness is associated with both memory impairment and hippocampal pathology, findings vary widely across studies and it is not known whether these changes are regionally specific. In the present study we acquired brain MRIs (magnetic resonance images) from 31 unmedicated patients with MDD (major depressive disorder; mean age 39.2±11.9 years; 77% female) and 31 demographically comparable controls. Three-dimensional parametric mesh models were created to examine localized alterations of hippocampal morphology. Although global volumes did not differ between groups, statistical mapping results revealed that in MDD patients, more severe depressive symptoms were associated with greater left hippocampal atrophy, particularly in CA1 (cornu ammonis 1) subfields and the subiculum. However, previous treatment with atypical antipsychotics was associated with a trend towards larger left hippocampal volume. Our findings suggest effects of illness severity on hippocampal size, as well as a possible effect of past history of atypical antipsychotic treatment, which may reflect prolonged neuroprotective effects. This possibility awaits confirmation in longitudinal studies

Prefrontal gray matter increases in healthy individuals after lithium treatment: A voxel-based morphometry study

The objective of this study was to test the hypothesis that 4 weeks of lithium administration would be associated with changes in brain gray and white matter volumes in healthy individuals. Thirteen right-handed healthy volunteers (6 females, mean age = 25.9 ± 10.0 y) were studied. 3D SPGR MRIs (TR = 25ms, TE = 5ms, slice-thickness = 1.5mm) were acquired using a 1.5 T GE Signa Imaging System, at baseline and after 4 weeks of lithium administration at therapeutically relevant doses. Optimized voxel based morphometry (VBM) analyses were conducted. Left and right dorsolateral prefrontal cortex and left anterior cingulate gray matter volumes increased significantly following lithium administration. Total white matter volume was increased, whereas total brain volume and total gray matter volume were not significantly changed following 4 weeks of lithium. Lithium treatment resulted in prefrontal regional gray matter volume increases in healthy volunteers, as well as increases in total white matter volume. Whether these changes are mediated by neurotrophic/neuroprotective or osmotic effects remains unknown

Three-Dimensional Mapping of Hippocampal Anatomy in Adolescents With Bipolar Disorder

Early-onset bipolar disorder is thought to be a particularly severe variant of the illness. Continuity with the adult form of illness remains unresolved, but preliminary evidence suggests similar biological underpinnings. Recently, we observed localized hippocampal decreases in unmedicated adults with bipolar disorder that were not detectable with conventional volumetric measures. Using the same three-dimensional mapping methods, we sought to investigate whether a similar pattern exists in adolescents with bipolar disorder

Intervention trial with calcium montmorillonite clay in a south Texas population exposed to aflatoxin

South Texas currently has the highest incidence of hepatocellular carcinoma (HCC) in the United States, a disease that disproportionately affects Latino populations in the region. Aflatoxin B(1) (AFB(1)) is a potent liver carcinogen that has been shown to be present in a variety of foods in the U.S., including corn and corn products. Importantly, it is a dietary risk factor contributing to a higher incidence of HCC in populations frequently consuming AFB(1)-contaminated diets. In a randomized double-blind placebo controlled trial, we evaluated the effects of a three-month administration of ACCS100 (refined calcium montmorillonite clay) on serum AFB(1)-lysine adduct level and serum biochemistry in 234 healthy men and women residing in Bexar and Medina Counties, Texas. Participants recruited from 2012–2014 received either a Placebo, 1.5 g, or 3 g ACCS100 each day for three months, and no treatment during the 4(th) month. Adverse event rates were similar across treatment groups and no significant differences were observed for serum biochemistry and hematology parameters. Differences in levels of AFB(1)-lysine adduct at 1, 3, and 4 months were compared between Placebo and active treatment groups. Although serum AFB(1)-lysine adduct levels were decreased by month 3 for both treatment groups, the Low dose was the only treatment that was significant (p=0.0005). In conclusion, the observed effect in the Low dose treatment group suggests that the use of ACCS100 may be a viable strategy to reduce dietary AFB(1) bioavailability during aflatoxin outbreaks and potentially in populations chronically exposed to this carcinogen

Pregnancy Intentions and Birth Outcomes in Southern States

Objective: Adolescents \u3c20 years old and women 35+ years old are at increased risk for preterm birth (PTB), low birth weight (LBW), and infant mortality (IM). Unintended pregnancy (UP) is significantly associated with infants being born preterm or LBW. The geographic region most burdened by high adolescent birth rates and UP rates is in the Southern U.S. However, there is little evidence of the demographic profile of women that experienced a PTB, LBW infant or an IM among those in Southern states. Moreover, little is known about the effect of pregnancy intentions on these outcomes in highly burdened Southern states. Methods: Two studies were conducted. The aim of study 1 was to create a demographic profile of women that experienced a PTB, LBW, or IM. The aim of study 2 was to determine the association between pregnancy intentions and PTB, LBW, and IM. Both studies used the Pregnancy Risk Assessment Monitoring System data for women ages 15-44 that gave birth in Oklahoma, Arkansas, Texas, Georgia, and West Virginia during 2009-2011. Univariate, chi-square, and multivariable logistic regression were performed for both studies. Results: The prevalence of IM was similar to the national rate, while PTB and LBW were below the rates for 2011. Women with an IM were significantly more likely to be of lower socioeconomic status and from Arkansas or Texas. Women 35+ years old, blacks and Asians, and those that had a previous PTB had greater odds of PTB and LBW infants. Respondents from Oklahoma and Texas had greater odds of LBW. Young maternal age (≤19 years old) was associated with lower odds for PTB, and pregnancy morbidities were associated with greater odds for all outcomes. A total of 48.3% of participants reported an unintended pregnancy (UP). Participants that were black (66.9%) and those that were 35 + years old (65.7%) had the highest rates of UP. Minorities, younger, lower income, higher parity, and smoking during pregnancy had lower odds of an intended pregnancy. Pregnancy intention was not significant in any modeling; however, women 35+ years old with an UP had a 93% lower odds of an IM. Conclusions: Maternal age and race remain significant determinants of adverse birth outcomes; however, this study challenges prior work suggesting women of younger age have greater odds of IM, PTB, and LBW. Moreover, UP has a differential effect on IM, depending on maternal age. Study findings can help identify the demographic profile of women most at risk for all three outcomes, and results emphasize the need for a validated measure of pregnancy intentions. Future studies aimed at preventing pregnancy morbidities could help alleviate the impact on poor birth outcomes, and more research should focus on risk factors associated with term infants born LBW. Finally, studies should further investigate interactions with pregnancy intentions among older women to identify factors that contribute to IM

Intervention trial with calcium montmorillonite clay in a south Texas population exposed to aflatoxin.

South Texas currently has the highest incidence of hepatocellular carcinoma (HCC) in the United States, a disease that disproportionately affects Latino populations in the region. Aflatoxin B1 (AFB1) is a potent liver carcinogen that has been shown to be present in a variety of foods in the United States, including corn and corn products. Importantly, it is a dietary risk factor contributing to a higher incidence of HCC in populations frequently consuming AFB1-contaminated diets. In a randomised double-blind placebo controlled trial, we evaluated the effects of a 3-month administration of ACCS100 (refined calcium montmorillonite clay) on serum AFB1-lysine adduct (AFB-Lys) level and serum biochemistry in 234 healthy men and women residing in Bexar and Medina counties, Texas. Participants recruited from 2012 to 2014 received either a placebo, 1.5 g or 3 g ACCS100 each day for 3 months, and no treatment during the fourth month. Adverse event rates were similar across treatment groups and no significant differences were observed for serum biochemistry and haematology parameters. Differences in levels of AFB-Lys at 1, 3 and 4 months were compared between placebo and active treatment groups. Although serum AFB-Lys levels were decreased by month 3 for both treatment groups, the low dose was the only treatment that was significant (p = 0.0005). In conclusion, the observed effect in the low-dose treatment group suggests that the use of ACCS100 may be a viable strategy to reduce dietary AFB1 bioavailability during aflatoxin outbreaks and potentially in populations chronically exposed to this carcinogen

Three-dimensional mapping of hippocampal anatomy in unmedicated and lithium-treated patients with bipolar disorder

Declarative memory impairments are common in patients with bipolar illness, suggesting underlying hippocampal pathology. However, hippocampal volume deficits are rarely observed in bipolar disorder. Here we used surface-based anatomic mapping to examine hippocampal anatomy in bipolar patients treated with lithium relative to matched control subjects and unmedicated patients with bipolar disorder. High-resolution brain magnetic resonance images were acquired from 33 patients with bipolar disorder ( 21 treated with lithium and 12 unmedicated), and 62 demographically matched healthy control subjects. Three-dimensional parametric mesh models were created from manual tracings of the hippocampal formation. Total hippocampal volume was significantly larger in lithium-treated bipolar patients compared with healthy controls (by 10.3%; p=0.001) and unmedicated bipolar patients ( by 13.9%; p=0.003). Statistical mapping results, confirmed by permutation testing, revealed localized deficits in the right hippocampus, in regions corresponding primarily to cornu ammonis vertical bar subfields, in unmedicated bipolar patients, as compared to both normal controls (p=0.01), and in lithium-treated bipolar patients (p=0.03). These findings demonstrate the sensitivity of these anatomic mapping methods for detecting subtle alterations in hippocampal structure in bipolar disorder. The observed reduction in subregions of the hippocampus in unmedicated bipolar patients suggests a possible neural correlate for memory deficits frequently reported in this illness. Moreover, increased hippocampal volume in lithium-treated bipolar patients may reflect postulated neurotrophic effects of this agent, a possibility warranting further study in longitudinal investigations