Tag: 20/8/25

Categories : Mental HealthTags :

People with High Sensitivity Have Greater Mental Health Risk

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Photo by Andrew Neel on Unsplash

New research, led by Queen Mary University of London and published in Clinical Psychological Science, has revealed that highly sensitive people (HSP) are more likely to experience mental health problems compared to individuals who are less sensitive. 

The meta-analysis of 33 studies, the first of its kind, looked at the relationship between sensitivity and common mental health problems such as depression and anxiety. Researchers found there was a significant, positive relationship between the two, concluding that highly sensitive people are more likely to experience depression and anxiety compared to those who are less sensitive.

In the study, sensitivity was defined as a personality trait that reflects people’s capacity to perceive and process environmental stimuli such as bright lights, subtle changes in the environment and other peoples’ moods. Often overlooked in mental health studies and clinical practice, which tend to focus on neuroticism and its association with mental health conditions, this research shows that understanding a person’s sensitivity level is important and can have therapeutic implications. 

People with sensitive personality traits may benefit from different treatment plans

For example, people with more sensitive personality traits may be more likely to benefit from treatment plans which involve techniques such as applied relaxation and mindfulness, which can also prevent relapse. 

Tom Falkenstein, a psychotherapist and a PhD student at Queen Mary University of London, said: “This is the most extensive systematic review on sensitivity and mental health in adolescents and adults to date, and is the first ever meta-analysis on the topic to estimate the impact of this relationship. We found positive and moderate correlations between sensitivity and various mental health problems such as depression, anxiety, post-traumatic stress disorder, agoraphobia and avoidant personality disorder. Our findings suggest that sensitivity should be considered more in clinical practice which could be used to improve diagnosis of conditions.”

“In addition, our findings could help improve treatment for these individuals. Around 31% of the general population are considered highly sensitive, and, as our findings show, are more likely to respond better to some psychological interventions than less sensitive individuals. Therefore, sensitivity should be considered when thinking about treatment plans for mental health conditions. Our work shows it is crucial that the awareness of sensitivity is improved among mental health care professionals, so clinicians and practitioners can recognise the trait in their patients, and tailor treatment to their sensitivity.”

Michael Pluess, Professor in Developmental Psychology at University of Surrey and Visiting Professor at Queen Mary University of London said: “This is the first meta-analysis providing robust evidence that highly sensitive people are more prone to common mental health problems. However, it is important to remember that highly sensitive people are also more responsive to positive experiences, including psychological treatment. Our results provide further evidence that sensitive people are more affected by both negative and positive experiences and that the quality of their environment is particularly important for their well-being.”

The systematic review and meta analysis of 33 studies was carried out by an academic team from several universities including Queen Mary University and the University of Surrey. 

Source: Queen Mary University London

Categories : Pain ManagementTags :

Off-label Use of Ketamine for Chronic Pain is Unsupported by Evidence

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Results show no clear evidence of benefit for ketamine in chronic pain and identified an increased risk of adverse effects such as delusions, delirium, paranoia, nausea, and vomiting

Photo by Towfiqu Barbhuiya on Unsplash

The off-label use of ketamine to treat chronic pain is not supported by scientific evidence, a new Cochrane review has found.

Ketamine is an anaesthetic commonly used for procedural sedation and short-term pain relief. Ketamine is also frequently prescribed off-label to manage chronic pain conditions such as nerve pain, fibromyalgia and complex regional pain syndrome. It is one of several NMDA receptor antagonists – a group of drugs thought to reduce pain by blocking certain brain receptors involved in pain signalling.

The review, conducted by researchers from UNSW Sydney, Neuroscience Research Australia (NeuRA), and Brunel University of London, examined 67 trials involving over 2300 adult participants. It assessed five NMDA receptor antagonists: ketamine, memantine, dextromethorphan, amantadine, and magnesium.

Results show no clear evidence of benefit for ketamine in chronic pain and identified an increased risk of adverse effects such as delusions, delirium, paranoia, nausea, and vomiting. Evidence was rated low to very low certainty, due to small study sizes and poor methodological quality.

“We want to be clear – we’re not saying ketamine is ineffective, but there’s a lot of uncertainty,” said Michael Ferraro, Doctoral Candidate at UNSW and NeuRA, first author of the review. “The data could point to a benefit or no effect at all. Right now, we just don’t know.”

Researchers looked at the effects across various chronic pain conditions and dosing strategies but found no clear evidence of benefit in any specific condition or dose. Side effects were a major concern, particularly with intravenous use.

“The most common adverse events we saw were psychotomimetic effects such as delusions, delirium and paranoia, as well as nausea and vomiting.” said Ferraro. “These effects are distressing for many patients. Clinicians often try to balance the dose for pain relief without triggering those symptoms, but this isn’t always achieved.”

The review also found no studies that reported on two key outcomes: whether ketamine reduced depressive symptoms or opioid use. This is notable, as ketamine is often proposed for patients with depressive symptoms or opioid tolerance.

“This group of drugs, and ketamine in particular, are in relatively common use for chronic pain around the world. Yet we have no convincing evidence that they are delivering meaningful benefits for people with pain, even in the short term,” said Neil O’Connell, Professor at Brunel University of London, co-senior author of the review. “That seems a good reason to be cautious in the clinic and clearly indicates an urgent need to undertake high quality trials.”

The authors hope the review will help inform patients and clinicians weighing up potential benefits and harms, and guide future research. While more evidence is needed, this review highlights the importance of high-quality trials to understand whether ketamine has a role in chronic pain care.

“We’ve seen the harm that can come from taking medicines developed for acute pain and applying them to chronic pain, opioids are a prime example. Now we’re seeing a similar pattern with ketamine,” said co-senior author James McAuley, Professor at UNSW and senior researcher at NeuRA . “As opioid prescribing is slowly reduced, there’s a growing demand for alternatives, but we need to be careful not to rush into widespread use without strong evidence.”

Source: Cochrane

Categories : NeurologyTags :

Discovery Offers Hope for Breathing Recovery After Spinal Cord Injuries

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Innovative research paves way for more effective treatment for ALS and other neurodegenerative diseases

View of the spinal cord. Credit: Scientific Animations CC4.0

Respiratory complications are the most common cause of illness and death for the 300 000 Americans living with spinal cord injury, according to the Christopher & Dana Reeve Foundation.  

But the results of a new study, led by researchers at Case Western Reserve University’s School of Medicine, show promise that a group of nerve cells in the brain and spinal cord, called interneurons, can boost breathing when the body faces certain physiological challenges, such as exercise and environmental conditions associated with altitude.

The researchers believe their discovery could lead to therapeutic treatments for patients with spinal cord injuries who struggle to breathe on their own. Their findings were recently published in the journal Cell Reports.

“While we know the brainstem sets the rhythm for breathing,” said Polyxeni Philippidou, an associate professor in the Department of Neurosciences at Case Western Reserve University School of Medicine and lead researcher, “the exact pathways that increase respiratory motor neuron output, have been unclear – until now.”

The research team included collaborators from the University of St. Andrews in the United Kingdom, the University of Calgary in Canada and the Biomedical Research Foundation Academy of Athens in Greece.

The study

By identifying a subset of interneurons as a new and potentially easy-to-reach point for treatment in spinal cord injuries and breathing-related diseases, the researchers believe doctors may be able to develop therapies to help improve breathing in people with such conditions.

The study showed that blocking signals from these spinal cord cells made it harder for the body to breathe properly when there was too much CO2 in the blood, a condition known as hypercapnia.

“These spinal cord cells are important for helping the body adjust its breathing in response to changes like high CO2 levels,” Philippidou said.

In this study, the team used genetically modified mouse models to explore the pathways involved in breathing. The researchers mapped neuron connections, measured neuron electrical activity, observed the models’ behaviour and used microscopy to visualise neuron structure and function – all focused on spinal cord nerve cells involved in breathing.

“We were able to define the genetic identity, activity patterns and role of a specialized subset of spinal cord neurons involved in controlling breathing,” Philippidou said.

The team is now testing whether targeting these neurons in neurodegenerative diseases like amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig’s disease, and Alzheimer’s disease can help restore breathing.

Source: Case Western Reserve University

Categories : CancerTags :

Ischaemia Speeds Tumour Growth by Aging the Immune System

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Immune cells (red) accumulating within a tumour (blue) and multiplying (green). When blood flow is blocked either in the heart or legs, these immune cells change in a way that enables tumour growth. Credit: NYU Langone

Cutting off blood flow can prematurely age the bone marrow, weakening the immune system’s ability to fight cancer, according to a new study from NYU Langone Health.

Published online August 19 in JACC: CardioOncology, the study showed that peripheral ischaemia, restricted blood flow in the arteries in the legs, caused breast tumours in mice to grow at double the rate seen in mice without restricted flow. These findings build on a 2020 study from the same team that found ischemia during a heart attack to have the same effect.

Ischaemia occurs when fatty deposits, such as cholesterol, accumulate in artery walls, leading to inflammation and clotting that restrict the flow of oxygen-rich blood. When this happens in the legs, it causes peripheral artery disease, which can increase the risk of heart attack or stroke.

“Our study shows that impaired blood flow drives cancer growth regardless of where it happens in the body,” says corresponding author Kathryn J. Moore, PhD, tProfessor of Cardiology at NYU Grossman School of Medicine. “This link between peripheral artery disease and breast cancer growth underscores the critical importance of addressing metabolic and vascular risk factors as part of a comprehensive cancer treatment strategy.”

Importantly, the research team found that restricted blood flow triggers a shift toward immune cell populations that cannot efficiently fight infections and cancer, mirroring changes seen with aging.

Systemic Skewing

To examine the mechanisms behind the link between cardiovascular disease and cancer growth, the study authors developed a mouse model with breast tumours and induced temporary ischaemia in one hind limb. The team then compared cancer growth in mice with and without impaired blood flow.

Their findings build on the nature of the immune system, which evolved to attack invading bacteria and viruses, and under normal conditions detects and eliminates cancer cells. These protective functions rely on stem cell reserves in the bone marrow, which can be activated as needed to produce key white blood cell populations throughout life.

Normally, the immune system responds to injury or infection by ramping up inflammation to eliminate threats, then scaling back to avoid harm to healthy tissue. This balance is maintained by a mix of immune cells that either activate or suppress inflammation. The researchers found that reduced blood flow disrupts this equilibrium. It reprograms stem cells in the bone marrow to favour the production of “myeloid” immune cells (monocytes, macrophages, neutrophils) that dampen immune responses, while reducing output of lymphocytes like T cells that help to mount strong antitumour responses.

The local environment within tumours showed a similar shift, accumulating more immune-suppressive cells, including Ly6Chi monocytes, M2-like F4/80+ MHCIIlo macrophages, and regulatory T cells, that shield cancer from immune attack.

Further experiments showed that these immune changes were long-lasting. Ischaemia not only altered the expression of hundreds of genes, shifting immune cells into a more cancer-tolerant state, but also reorganised the structure of chromatin, the protein scaffolding that controls access to DNA. This made it harder for immune cells to activate genes involved in fighting cancer.

“Our results reveal a direct mechanism by which ischemia drives cancer growth, reprogramming stem cells in ways that resemble aging and promote immune tolerance,” says first author Alexandra Newman, PhD, a postdoctoral scholar in Dr Moore’s lab. “These findings open the door to new strategies in cancer prevention and treatment, like earlier cancer screening for patients with peripheral artery disease and using inflammation-modulating therapies, to counter these effects.”

Moving forward, the research team hopes to help design clinical studies that evaluate whether existing inflammation-targeted therapies can counter post-ischaemic changes driving tumour growth.

Source:

Categories : Skeletal System Surgeries & ProceduresTags :

Minimally Invasive Procedure Relieves Painful Symptoms of Knee Osteoarthritis

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Photo by Towfiqu barbhuiya

A procedure that can be performed under mild sedation in less than two hours by an interventional radiologist relieves chronic knee pain caused by osteoarthritis, an NYU Langone Health study shows.

As they gradually break down, knee joints in people with osteoarthritis are known to become inflamed, which triggers the growth of small blood vessels (angiogenesis) and increased blood flow to joints. The study procedure, called genicular artery embolisation, kept this abnormal blood flow from ferrying in immune cells that cause the inflammation and related pain. 

For the new study, the researchers delivered chemical beads (biocompatible hydrogels) through an image-guided plastic tube to block blood flow in any of a half dozen arteries feeding the synovium lining in the knee. More than 60% of the 25 men and women who had the procedure at its facilities in Manhattan experienced significant improvements one year later.

Results of the study appear online in the Journal of Vascular Interventional Radiology.

“Our study shows that genicular artery embolisation is a safe and effective, minimally invasive treatment for those with moderate to severe symptomatic knee pain tied to osteoarthritis,” said study co-investigator and interventional radiologist Ryan M. Hickey, MD. “This work also provides evidence that genicular artery embolisation is offering more than just pain relief and could be modifying the disease process itself.”

“This procedure is particularly suited to those patients who are either not yet ready for knee replacement surgery or for whom surgery is not an option because of age or other risk factors, such as obesity, uncontrolled diabetes or heart disease, or smoking,” added Dr Hickey.

He says there is urgent need for alternative, less-invasive treatments for osteoarthritis. An estimated 24 million cases of osteoarthritis in a knee are diagnosed each year in the United States, a number he expects only to grow with the aging population.

Among the study’s other key results: significant, one-year postsurgical declines (on average 12%) in blood levels of vascular endothelial growth factor (VEGF), a protein that is needed to stimulate the formation of new blood vessels. Past research has also linked VEGF to other structural changes in the knee from osteoarthritis. Another protein biomarker, interleukin 1 receptor agonist (IL-1Ra), showed a similar decrease (15%). IL-1Ra is known for its role in countering inflammation. Tests of a half dozen other immune molecules involved in inflammation were inconclusive.

“Our research suggests that declines in vascular endothelial growth factor could serve as a valuable biomarker or chemical trace for determining success with genicular artery embolisation, offering a much-needed objective benchmark by which to measure its effectiveness,” said study principal investigator and lead author Bedros Taslakian, MD, MA.

“Our study findings also indicate that genicular artery embolisation may, if further larger clinical trials prove successful, slow down the progression of osteoarthritis by observing significant decreases in signalling proteins, specifically vascular endothelial growth factor and interleukin 1 receptor agonist, one year after the procedure,” said Dr Taslakian.

The improvements seen in the 25 patients in the current study were captured by standard patient survey scores for knee pain, stiffness, and the ability to bend, stand up, or walk up and down stairs freely. While subjective surveys are useful in monitoring disease progression, Dr Hickey says, independent blood tests like the NGF measure are more accurate and convenient for patients for tracking small declines or improvements over time.

The NYU Langone team has plans to further investigate precisely how embolisation alleviates inflammation and leads to pain relief.

Dr Hickey also says that more research is needed to establish how long the procedure’s benefits last and which osteoarthritis patients are most likely to benefit.

All study volunteers were diagnosed with moderate to severe osteoarthritis in the knee that had been unresponsive to first-line therapy. This includes knee injections of corticosteroids to reduce inflammation; fluid aspiration (arthrocentesis) to remove excess fluid from the joint; and injections of platelet-rich plasma to repair damaged tissue, as well as physiotherapy. Study participant ages ranged from 50 years old to 78 years old, with all having their embolisation procedures performed between January 2021 and January 2023.

As part of the procedure, interventional radiologists accessed each patient’s arteries through a small incision in the thigh, using video X-ray to guide the catheter to the precise knee artery selected earlier for embolisation. Study participants were then monitored during routine checkups for at least one year and across two dozen measures of pain, knee stiffness, and their ability to move about. Patients needed to achieve a four-point difference on a scale of 20 points to establish a clinically significant reduction in pain. Side effects from the procedure, the researchers say, were minimal and limited to dark skin blemishes on the knee and mild pain near the incision site.

Source: NYU Langone Health