Children with behavioural problems more at risk of chronic conditions

Karestan Koenen

Children with behavioural problems may be at risk of many chronic diseases in adulthood including heart disease, obesity, diabetes, as well as inflammatory illnesses (conditions which are caused by cell damage).

Analyzing data on more than 4,000 participants in the Children of the 90s study at the University of Bristol, researchers from Harvard and Columbia's Mailman School of Public Health found that children with behavioral problems at the age of 8, had higher levels of two proteins (C-reactive protein—CRP; and Interleukin 6—IL-6) in their blood when tested at the age of 10.

This was the case even after a large number of other factors, including sex, race, background, and medication use, were taken into account.

Having raised levels of CRP and IL-6 can be an early warning sign that a person may be at risk of chronic or inflammatory conditions later in life.

Previous research has shown that children with behavioural problems can go on to develop health problems during adulthood, but this is the first time that a link has been found between mental health and inflammation in childhood.

The researchers believe the link may be due to the fact that many behavioral problems are associated with how the hypothalamic pituitary adrenal (HPA) axis works.

The HPA axis plays a major role in controlling reactions to stress and the immune system and, if it malfunctions, it can stimulate the release of the two proteins that cause chronically elevated levels of inflammation, which is tissue's response to injury.

Speaking about the findings, Karestan Koenen, PhD, the report's senior author and associate professor of Epidemiology at Harvard, said:
"This new research shows for the first time that having behavioural problems in childhood can put children on the path to ill health much earlier than we previously realized." 

"The important message for healthcare professionals is that they need to monitor the physical health as well as the mental health of children with behavioural problems to identify those at risk as early as possible."

Findings are published in the journal Psychoneuroendocrinology.

More Information: article/pii/S030645301300262X

Down syndrome: Neurons grown from stem cells show signature problems - Oxidative Stress

Down syndrome, the most common genetic form of intellectual disability, results from an extra copy of one chromosome.

Although people with Down syndrome experience intellectual difficulties and other problems, scientists have had trouble identifying why that extra chromosome causes such widespread effects.

Anita Bhattacharyya

In new research published this week, Anita Bhattacharyya, a neuroscientist at the Waisman Center at the University of Wisconsin-Madison, reports on brain cells that were grown from skin cells of individuals with Down syndrome.

The research, published the week of May 27 in the Proceedings of the National Academy of Sciences (PNAS), was a basic exploration of the roots of Down syndrome.

"Even though Down syndrome is very common, it's surprising how little we know about what goes wrong in the brain," says Bhattacharyya. "These new cells provide a way to look at early brain development."

The study began when those skin cells were transformed into induced pluripotent stem cells, which can be grown into any type of specialized cell.

One significant finding was a reduction in connections among the neurons, Bhattacharyya says. "They communicate less, are quieter. This is new, but it fits with what little we know about the Down syndrome brain."

Brain cells communicate through connections called synapses, and the Down neurons had only about 60 percent of the usual number of synapses and synaptic activity.

"This is enough to make a difference," says Bhattacharyya. "Even if they recovered these synapses later on, you have missed this critical window of time during early development."

The researchers looked at genes that were affected in the Down syndrome stem cells and neurons, and found that genes on the extra chromosome were increased 150 percent, consistent with the contribution of the extra chromosome.

However, the output of about 1,500 genes elsewhere in the genome was strongly affected. "It's not surprising to see changes, but the genes that changed were surprising," says Bhattacharyya.

The predominant increase was seen in genes that respond to oxidative stress, which occurs when molecular fragments called free radicals damage a wide variety of tissues.

"We definitely found a high level of oxidative stress in the Down syndrome neurons," says Bhattacharyya.

"This has been suggested before from other studies, but we were pleased to find more evidence for that. We now have a system we can manipulate to study the effects of oxidative stress and possibly prevent them."

Down syndrome includes a range of symptoms that could result from oxidative stress, Bhattacharyya says, including accelerated aging.

"In their 40s, Down syndrome individuals age very quickly. They suddenly get gray hair; their skin wrinkles, there is rapid aging in many organs, and a quick appearance of Alzheimer's disease. Many of these processes may be due to increased oxidative stress, but it remains to be directly tested."

Oxidative stress could be especially significant, because it appears right from the start in the stem cells.

"This suggests that these cells go through their whole life with oxidative stress," Bhattacharyya adds, "and that might contribute to the death of neurons later on, or increase susceptibility to Alzheimer's."

More information: Deficits in human trisomy 21 iPSCs and neurons,www.pnas.org/cgi/d… s.1216575110

Overcoming Reading Problems: How Can We Stlil Raed Words Wehn Teh Lettres Are Jmbuled Up?

Researchers in the UK have taken an important step towards understanding how the human brain 'decodes' letters on a page to read a word.

The work, funded by the Economic and Social Research Council (ESRC), will help psychologists unravel the subtle thinking mechanisms involved in reading, and could provide solutions for helping people who find it difficult to read, for example in conditions such as dyslexia.

To read successfully, readers need not only to identify the letters in words, but also to accurately code the positions of those letters, so that they can distinguish words like CAT and ACT.

At the same time, however, it's clear that raeders can dael wtih wodrs in wihch not all teh leettrs aer in thier corerct psotiions.

"How the brain can make sense of some jumbled sequences of letters but not others is a key question that psychologists need to answer to understand the code that the brain uses when reading," says Professor Colin Davis of Royal Holloway, University of London, who led the research.

For many years researchers have used a standard psychological test to try to work out which sequences of letters in a word are important cues that the brain uses, where jumbled words are flashed momentarily on a screen to see if they help the brain to recognise the properly spelt word.

But, this technique had limitations that made it impossible to probe more extreme rearrangements of sequences of letters.

Professor Davis's team used computer simulations to work out that a simple modification to the test would allow it to question these more complex changes to words. This increases the test's sensitivity significantly and makes it far more valuable for comparing different coding theories.

"For example, if we take the word VACATION and change it to AVACITNO, previously the test would not tell us if the brain recognises it as VACATION because other words such as AVOCADO or AVIATION might start popping into the person's head," says Professor Davis.

"With our modification we can show that indeed the brain does relate AVACITNO to VACATION, and this starts to give us much more of an insight into the nature of the code that the brain is using - something that was not possible with the existing test."

The modified test should allow researchers not only to crack the code that the brain uses to make sense of strings of letters, but also to examine differences between individuals - how a 'good' reader decodes letter sequences compared with someone who finds reading difficult.

"These kinds of methods can be very sensitive to individual differences in reading ability and we are starting to get a better idea of some of the issues that underpin people's difficulty in reading," says Professor Davis.

Ultimately, this could lead to new approaches to helping people to overcome reading problems.

MS-Related Memory and Attention Problems Have Signs of Extensive Brain Damage

People with multiple sclerosis (MS) who have cognitive problems, or problems with memory, attention, and concentration, have more damage to areas of the brain involved in cognitive processes than people with MS who do not have cognitive problems, according to a study published in the March 6, 2013, online issue of Neurology, the medical journal of the American Academy of Neurology.

The study used a type of MRI brain scan called diffusion tensor imaging along with regular MRI scans to compare brain measurements in 20 people with MS who had related cognitive problems, 35 people with MS who did not have cognitive problems and 30 healthy participants.

The diffusion tensor images showed that, compared to the healthy control participants, 49 percent of the investigated brain white matter had impaired integrity in those with MS and no cognitive problems, while impaired integrity was evident in 76 percent of the investigated white matter of those with MS and related cognitive problems.

In the people with MS-related cognitive problems, the extra white matter dysfunction was particularly seen in areas important for cognitive skills, such as the thalamus.

"This state-of-the-art imaging technology confirms that cognitive symptoms in MS have a biological basis," said study author Hanneke E. Hulst, MSc, of VU University Medical Center in Amsterdam, the Netherlands.

"The consequence of this discovery is that imaging can now be used to capture a wider spectrum of changes in the brains of people with MS, and will therefore help determine more accurately whether new treatments are helping with all aspects of the disease."

Cognitive problems are common in MS, affecting up to 65 percent of people with the disease.

The study was supported by the Dutch MS Research Foundation.

The above story is reprinted from materials provided by American Academy of Neurology (AAN).

Sleep Apnea and Snoring in Children Linked to Behavioural Problems

Children with night-time breathing problems such as snoring or sleep apnea are more likely to develop behavioural problems such as hyperactivity, anxiety or aggressiveness and have problems with peer relationships, according to a new study in Pediatrics.

Children with "sleep-disordered breathing" such as snoring and sleep apnea were 40 percent to 100 percent more likely to develop behavioural issues by age 7 than the children who breathed normally through the night, researchers found.

The study surveyed 11,000 children over six years and found nearly over half of the children, 6,000 in total, had breathing disorders during sleep.

"This is the strongest evidence to date that snoring, mouth breathing, and apnea can have serious behavioural and social-emotional consequences for children," Karen Bonuck, lead author and professor of family and social medicine at Albert Einstein College of Medicine at Yeshiva University, said in a statement.

"Parents and pediatricians alike should be paying closer attention to sleep-disordered breathing in young children, perhaps as early as the first year of life," she said.

Sleep apnea and snoring decrease oxygen levels and increase carbon dioxide levels in the brain, according to the study.

The imbalanced brain chemistry interrupts the restorative process of sleep and leads to an inability to regulate emotion and impairs the ability to pay attention, plan ahead and organize, researchers said.

"We are sleeping to restore our brains, and sleep-disordered breathing interferes with that process," Bonuck reported. "For kids, these are critical periods in brain development."

Researchers saw symptoms of sleep-disordered breathing appear as early as 6 months in some children. Children who presented symptoms while very young, were between 40 and 50 percent more likely to experience behavioural problems.

"Although snoring and sleep apnea are relatively common in children, pediatricians and family physicians do not routinely check for sleep-disordered breathing," Bonuck said in a statement.

"In many cases, the doctor will simply ask parents, 'How is your child sleeping?' Instead, physicians need to specifically ask parents whether their children are experiencing one or more of the symptoms of SDB, i.e. snoring, mouth breathing or apnea." she said.

About one in 10 children snore regularly and 2 to 4 percent have sleep apnea, according to the American Academy of Otolaryngology-Head and Neck Surgery.

The journal Pediatrics published the study on Monday 5th March 2012.

People with sleep apnea take abnormally long pauses between breaths in their sleep. The pauses can last up to several minutes and may occur up to 30 times per hour, forcing them to wake up often during the night to take a breath, according to the National Heart Lung and Blood Institute (NHLBI), a division of the U.S. Department of Health and Human Services.

Sleep apnea can cause frequent headaches and mood swings and if left untreated increases the risk of heart attack, stroke and diabetes, according to the NHLBI. Enlarged tonsils, also commonly cause sleep-disordered breathing.

Being overweight is one of the largest risk factors for sleep apnea and snoring, according to the NHLBI. Losing weight helps to reduce the effects.

Other treatment for sleep-disordered breathing includes the use of a Continuous Positive Airway Pressure (CPAP) machine. A CPAP machine consists of a mask that fits over the user's mouth and/ or nose and blows air continuously into the throat, keeping the airway open and allowing the user to breathe easier.

Surgery is sometimes performed to remove excess tissue in the mouth and throat to reduce symptoms.

US Healthcare costs related to Sleep Apnea costs about $1,336 per year, for a total of $3 billion annually, according to a 1999 study published in the journal Sleep.

Childhood psychological problems create long-term economic losses

A first-of-its-kind study examining the long-term economic consequences of childhood psychological disorders finds the conditions diminish people's ability to work and earn as adults, costing $2.1 trillion over the lifetimes of all affected Americans.

People who suffer from childhood conditions such as depression and substance abuse are less likely to be married, attain less education and see their income reduced by about 20 percent over their lifetimes, according to findings published online by the journal Social Science & Medicine.

"This study shows childhood psychological disorders can cause significant long-lasting harm and can have far-reaching impact on individuals over their lifetimes," said James P. Smith, the study's lead author and corporate chair of economics at RAND, a nonprofit research organization. "Our findings illustrate what the enormous potential might be of identifying and treating these problems early in life."

Researchers examined information from a large study that has followed American families for more than 40 years and found evidence that the impact of childhood psychological problems have lasting impact across many measures of economic success. The study is unique because siblings from the same family were followed in the panel, allowing the researchers to compare one sibling with childhood psychological problems to a brother or sister who did not have such problems.

People who reported having psychological problems during childhood averaged $10,400 less income per year when compared to siblings who did not have similar problems. The lower income was partly a consequence of working an average of seven weeks fewer per year.

If about one in 20 adult Americans experienced these psychological problems during their childhood years (about the current prevalence), the total lifetime economic damages for all those affected would be $2.1 trillion. This estimate does not take into consideration the non-economic costs such has lower quality of life.

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Teaching self-control skills to children reduces classroom problems

Children taught skills to monitor and control their anger and other emotions improved their classroom behaviour and had significantly fewer school disciplinary referrals and suspensions, according to a study by University of Rochester Medical Centre researchers.

Children in a school-based mentoring program were about half as likely to have any discipline incident over the three-month period of the study, according to an article published online by the Journal of Abnormal Child Psychology. They also had a 43 percent decrease in mean suspensions as compared to the control group, which did not receive mentoring of the self-control skills.

In the four-month interval after the intervention began, 1.8 percent of children in the mentored group were suspended compared to 6.1 percent of the control group. Children taught the new skills also had a 46 percent decrease in mean office disciplinary referrals as compared to the children in the study's control group

"It is exciting that adult mentors, who are not mental health professionals, taught children a set of skills that significantly strengthened the children's ability to function well in their classrooms and meet school expectations," said Peter Wyman, Ph.D., lead author of the article and associate professor of Psychiatry at the Medical Centre.

"This study suggests that with appropriate guidance from a trained adult, young children are capable of learning a great deal about their emotions and skills for handling their emotions effectively and those skills can have direct, positive benefits for their functioning in school."

The study evaluated the effectiveness of the Rochester Resilience Project that was developed by Wyman and Wendi Cross, Ph.D., associate professor of Psychiatry and Paediatrics at the Medical Centre, to address the needs of young children with emerging behavioural and social-emotional problems by providing an accessible school-based intervention.

In a relationship with an intervention mentor over four months, children learn and practice behavioural and cognitive skills designed to strengthen their self-regulation of emotions and address specific goals to improve school adaptation.

"Our goal in developing the Rochester Resilience Project was to 'translate' findings from research about how children learn skills to be more resilient in relationships with adults into an accessible program in schools," Wyman said. "Being a successful student in elementary school classrooms establishes a foundation that makes healthy development more likely in the future."

Activities establish the Resilience Project mentor as an empathic adult informed about each child's life context, strengths and challenges. Through adult-led interactive learning and practice in natural settings, children are taught to monitor their own emotions and the emotion of others, using cues to identify feelings and intensities of feelings.

Mentors introduce 'feelings check-in' as a standard practice that serves as a teaching tool about feelings and a transition to skills focused on managing feelings.

Self-control and reducing escalation of emotions is taught through the concept of a "feelings thermometer" to depict intensity. Children learn to use "mental muscles" as a tool to monitor feelings and to stop feelings from entering a hot zone.

They also learn to maintain control and regain equilibrium through strategies such as taking a deep-breath, stepping back from emotionally intense situations, and using an imaginary umbrella as protection from hurtful words.

For each of the 14 weekly lessons, children met individually with their mentors for approximately 25 minutes in a private setting during the school day. The skills taught to children are labeled in simple terms suited to developmental level.

Reinforcement and feedback from mentors in settings in which children use new skills is also critical for children to successfully acquire the skills. Mentors collaborated with teachers to identify classroom situations in which the mentors could provide reminders to children to use new skills, and cues were provided, a sticker or button, for example, for the child to take as a reminder.

In the study, 226 children from kindergarten up to third grade in two urban elementary schools took part. They had manifested emerging behavioural, social-emotional, and/or on-task learning problems at school.

This population was selected due to evidence that those problems increase the likelihood that children will be less successful at school and may develop behavioural problems, such as substance abuse.

Children who received the intervention showed improved functioning in all domains of classroom behaviour rated by teachers.

The intervention had a positive impact on children's classroom behaviours and rates of disciplinary incidents, including fewer aggressive or disruptive problems, improved on-task learning behaviours and peer social skills, and less shy-withdrawn and more assertive behaviours, the researchers concluded.

After the study was completed, children in the control group also were mentored and taught the self-control skills. The mentoring improved peer social skills, more for girls, than for boys.

Link: www.urmc.rochester.edu

Mediterranean diet may lower risk of brain damage that causes thinking problems

Mediterranean diet may lower risk of brain damage that causes thinking problems

The study found that people who ate a Mediterranean-like diet were less likely to have brain infarcts, or small areas of dead tissue linked to thinking problems.

The Mediterranean diet includes high intake of vegetables, legumes, fruits, cereals, fish and monounsaturated fatty acids such as olive oil; low intake of saturated fatty acids, dairy products, meat and poultry; and mild to moderate amounts of alcohol.

Ambidextrous children more likely to have mental health, language and scholastic problems, say researchers

Mixed-handed children more likely to have mental health, language and scholastic problems, say Imperial College London researchers

Children who are mixed-handed, or ambidextrous, are more likely to have mental health, language and scholastic problems in childhood than right- or left-handed children, according to a new study published today in the journal Pediatrics.

The researchers behind the study, from Imperial College London and other European institutions, suggest that their findings may help teachers and health professionals to identify children who are particularly at risk of developing certain problems.

Around one in every 100 people is mixed-handed. The study looked at nearly 8,000 children, 87 of whom were mixed-handed, and found that mixed-handed 7 and 8-year old children were twice as likely as their right-handed peers to have difficulties with language and to perform poorly in school.

When they reached 15 or 16, mixed-handed adolescents were also at twice the risk of having symptoms of attention deficit/hyperactivity disorder (ADHD). They were also likely to have more severe symptoms of ADHD than their right-handed counterparts. It is estimated that ADHD affects between 3 to 9% of school-aged children and young people.

The adolescents also reported having greater difficulties with language than those who were left- or right-handed. This is in line with earlier studies that have linked mixed-handedness with dyslexia.

Little is known about what makes people mixed-handed but it is known that handedness is linked to the hemispheres in the brain. Previous research has shown that where a person's natural preference is for using their right hand, the left hemisphere of their brain is more dominant.

Some researchers have suggested that mixed-handedness indicates that the pattern of dominance is not that which is typically seen in most people, i.e. it is less clear that one hemisphere is dominant over the other. One study has suggested that ADHD is linked to having a weaker function in the right hemisphere of the brain, which could help explain why some of the mixed-handed students in today's study had symptoms of ADHD.

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