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Your Teen

Mental Health Clues Found in Teen Brain Scans

1:30

If you’ve ever wondered why there are so many ups and downs in your teenager’s moods- there’s a very good reason; their brain is still developing. Brain scans from a research team at the University of Cambridge identified the areas of the brain that change the most during the teen years. It’s no surprise that areas associated with complex thought and decision-making are the ones going through a growth spurt during this time.

The scientists also discovered a link between teenage brain development and mental illness, such as schizophrenia.

The team from Cambridge's department of psychiatry scanned the brains of 300 people between the ages of 14 and 24.

They found that basic functions such as vision, hearing and movement were fully developed by adolescence. However, complex thinking processes and decision-making were still in a growth stage.

These areas are nerve centers with lots of connections to and from other key areas.

You can think of the brain as a global airline network that's made up of small infrequently used airports and huge hubs like Heathrow where there is very high traffic.

The brain uses a similar set up to co-ordinate our thoughts and actions.

During adolescence, this network of big hubs is consolidated and strengthened. It's a bit like how Heathrow or JFK have become gradually busier over the years.

Researchers found that genes involved in the “hub” were similar to those associated with mental illnesses, including schizophrenia.

The discovery is in line with the observation that many mental disorders develop during adolescence, according to researcher Dr Kirstie Whitaker.

"We have shown a pathway from the biology of cells in the area through to how people who are in their late teenage years might then have their first episode of psychosis," she told the BBC.

Genetics are not the only reason for mental illnesses. Older studies have also linked stress during childhood and the teenage years as a possible contributor. Recent findings have shown an association between maltreatment, abuse and neglect and brain development during childhood and adolescence. In addition, these types of stressors may also contribute to the emergence of mental illness.

Lead researcher, Professor Ed Bullmore, whose work was funded by the Wellcome Trust, believes the discovery of a biological link between teenage brain development and the onset of mental illness might help researchers identify those most at risk of becoming ill.

"As we understand more about what puts people at risk for schizophrenia, that gives us an opportunity to try to identify individuals that are at risk of becoming schizophrenic in the foreseeable future, the next two to three years, and perhaps to offer some treatment then that could be helpful in preventing the onset of clinical symptoms. "

The study also sheds light on the mood and behavioral changes experienced by teenagers during normal brain development.

"The regions that are changing most are those associated with complex behavior and decision making," says Dr. Whitaker.

"It shows that teenagers are on a journey of becoming an adult and becoming someone who is able to pull together all these bits of information.

This is a really important stage to go through. You wouldn't want to be a child all your life.

This is a powerful and important stage that you have to go through to be the best and the most capable adult that you can be."

The study was published in the Proceedings of the National Academy of Science.

Story source: Pallab Ghosh, http://www.bbc.com/news/health-36887224

 

Your Child

Students Do Better on Tests After Short Break

2:00

As the school day wears on, kids can begin to suffer from mental exhaustion. A new study suggests that students do better on test scores if the testing starts earlier in the day or they are allowed a short break before testing begins.

The study found that students aged 15 and under suffered from mental fatigue as the school day progressed, and that their test scores dipped later in the day. The effect appeared to be the greatest on those who scored the poorest; a hint that tests later in the day might hurt struggling students the most.

They also found that kids who were given a short break before they took the test scored higher.

Many school administrations have toyed with the idea of extending the school day.

"If policymakers want to have longer days, then they should consider having more frequent breaks," said study co-author Francesca Gino, a professor of business administration at Harvard Business School in Boston.

The researchers also suggested that standardized tests be given at the same time of day to avoid giving some students an advantage over others and skewing the results in favor of children who are tested earlier in the day. If testing times must be spread out, then the study’s author recommend that students who test later in the day be given time to relax and recharge before the test begins.

The new study is unusual because it's so large and because it explores the role played by breaks during the day, Gino said.

The researchers reviewed results from about 2 million national standardized tests taken by kids aged 8 to 15. The children attended public schools in Denmark from 2009-2010 and 2012-2013.

The findings revealed that test performance decreased as the day progressed. As each hour went by, scores declined. But they improved after breaks of 20 minutes to 30 minutes, the research showed.

Gino described the effect as "small, but significant."

"We found that taking the test one hour later affects the average child the same way as having 10 days less of schooling," she said.

Gino blames "cognitive fatigue" -- essentially, tiredness that affects thinking. "But a break can counterbalance this negative effect. For example, during a break, children can have something to eat, relax, play with classmates or just have some fresh air. These activities recharge them."

Even though the test score differences were not huge, Christoph Randler, a professor of biology at the University of Tubingen in Germany, believes they were still significant. They could be consequential if they affect a student’s chances of getting into college, he said.

Other academic experts also found the findings had an important message. Pamela Thacher, an associate professor of psychology at St. Lawrence University in Canton, N.Y., endorsed the study. She agreed with Randler that small differences in test scores could be important to a student's future.

As for the value of breaks, she said the findings make sense. "Rest restores the ability to perform," she said. "These results are consistent with virtually every study we have that has spoken to the brain's requirements for best performance."

The study appears in the February issue of the Proceedings of the National Academy of Sciences.

Source: Randy Dotinga, http://consumer.healthday.com/kids-health-information-23/adolescents-and-teen-health-news-719/kids-score-better-on-tests-earlier-in-day-study-finds-708062.html

 

 

 

 

Daily Dose

Teens & Headaches Go Together

I just read an interesting study about teenagers with headaches. About one to two percent of adolescents have chronic daily headaches, defined as greater than 15 headache days per month for greater than three months.

Once school begins, teens stress levels increase with each week of school, and with that come more complaints of chronic headaches. It is not unusual for me to see several teens a week who complain that they have headaches every day. Despite these persistent headaches, the majority of adolescents continue to participate in their school activities, sleep well once they fall asleep and spend their weekends doing whatever it is that teens all do. I see very few teens who look like they are in “severe” pain, although they state that their head is “killing” them while they chatter away about where it hurts, and how often it hurts etc. It is quite reassuring to watch their faces and expressions as they go into detail about their headaches. In these cases it is important to obtain a good history to rule out any underlying pathology, as well as to inquire about family history of migraines. In this study the authors followed adolescents ages 12 – 14 years who met criteria for chronic daily headaches. They followed the group after both one and two years, and then again after eight years. The results showed that after one year 40 percent of adolescents still complained of chronic headaches. After two years, only 25 percent reported headaches. After eight years, only 12 percent reported chronic headaches. Most participants reported substantial or some improvement in headache intensity and frequency during the eight-year follow-up. The most significant predictor for ongoing problems with headaches was onset of chronic headaches before the age of 13 years. For the most part 75 percent of adolescents with chronic daily headaches improved over the eight-year period, which is quite reassuring. This study just seemed to confirm that teens and headaches go together. If a good history and physical exam is performed and there seem to be no underlying problems that contribute to their headaches, it is best to discuss the natural history of chronic headaches. I think it is important to spend time with adolescents to explore ways to alleviate stress as a trigger for chronic daily headaches. Basic changes in lifestyle such as healthy eating, regular exercise, and a good night’s sleep will often help reduce headaches. Relaxation techniques and cognitive behavioral therapy may also be utilized. At least we know that the headaches reduce with time, maybe just a maturational process, like many things! That’s your daily dose, we’ll chat again tomorrow.

Your Child

Kid’s Head Injury Linked to Long Term Attention Problems

1:45

Even mild brain injuries may cause children to have momentary gaps in attention long after an accident occurs, according to a new study.

The study of 6- to 13-year-olds found these attention lapses led to lower behavior and intelligence ratings by their parents and teachers.

"Parents, teachers and doctors should be aware that attention impairment after traumatic brain injury can manifest as very short lapses in focus, causing children to be slower," said study researcher Marsh Konigs, a doctoral candidate at VU University Amsterdam in the Netherlands.

This loss of focus was apparent even when brain scans showed no obvious damage, the researchers said.

The study’s results are being released as schools gear up for a new academic year combined with some sports programs that can put children at risk for head injuries.

Traumatic brain injury can occur from a blow to the head caused by a fall, traffic accident, and assault or sports injury.

Concussion is one type of traumatic brain injury. In 2009, more than 248,000 teens and children were treated in U.S. emergency rooms for sports- and recreation-related traumatic brain injuries or concussions, according to the U.S. Centers for Disease Control and Prevention.

Here’s how the study was conducted.  Researchers compared 113 children who had been hospitalized with a traumatic brain injury with 53 children who had a trauma injury not involving the head. The injuries, which ranged from mild to severe, occurred more than 18 months earlier on average.

The researchers tested mental functioning and evaluated questionnaires completed by parents and teachers at least two months after the injuries.

The head-injured group had slower processing speed, the researchers found. And their attention lapses were longer than those noted in the other children. But unlike other research, no differences were reported in other types of attention, such as executive attention -- the ability to resolve conflict between competing responses.

As is typical with most studies, the results do not prove a cause and effect relationship, but an association.

The take-home message from this study is that even mild head injury can lead to problems, said Dr. Andrew Adesman, chief of developmental and behavioral pediatrics at Cohen Children's Medical Center of New York in New Hyde Park, N.Y. He was not involved with the research.

"This study provides further evidence of the importance of trying to minimize brain trauma, since even when there is no visible damage on CAT scans or MRIs, there can still be a significant adverse effect on attention span and behavior," Adesman said.

This research underscores the need to protect children from head injuries through proper supervision, consistent use of child car seats and seat belts, as well as headgear when bike riding and playing contact sports, he added.

The study was published in the journal Pediatrics.

More information on brain injury in children can be found at the Brain Injury Association of America’s website, http://www.biausa.org/brain-injury-children.htm.

Source: Kathleen Doheny,  http://consumer.healthday.com/cognitive-health-information-26/brain-health-news-80/head-injury-may-trigger-attention-issues-in-kids-701821.html

Your Baby

Gap Between Pregnancies Linked to Autism

2:00

Does it make a difference how long a woman waits between pregnancies in the health of her newborn?  According to a new large study, the closer the pregnancies, the higher the risk that her child will have autism or other neurodevelopmental disabilities.

"Based on the current best available evidence, it appears that the ideal inter-pregnancy interval -- the time elapsed between the birth of the immediate older sibling and the conception of the younger sibling -- is 2 to 5 years, in order to reduce the risk of autism," said study author Dr. Agustin Conde-Agudelo. He is a researcher at the World Health Organization Collaborating Center in Human Reproduction at the University of Valle in Cali, Colombia.

Researchers looked at existing studies involving more than 1.1 million children and also found that waiting too long between pregnancies (5 years or more) could raise the odds of autism.

The reasons for the link between short pregnancy spacing and autism are not known noted Conde-Agudelo. He said that scientists believe nutrition and other factors may play a role.

The study doesn’t prove that either long or short intervals between pregnancies actually causes autism, just that there seems to be an association between the two.

Conde-Agudelo and his team reviewed seven large studies reporting a link between short birth spacing and autism. The investigators found that children born to women with less than 12 months between pregnancies were nearly twice as likely to develop autism as children born to women with three years or longer between pregnancies.

Three of those studies also reported a significant link between long pregnancy spacing and autism, especially for two milder types, which were formerly called Asperger's syndrome and pervasive developmental disorder.

Meanwhile, the findings also suggested that shorter pregnancy spacing was associated with an increased risk of developmental delays and cerebral palsy, which can affect body movement, muscle coordination and balance.

Conde-Agudelo and other researchers conjectured that the mother’s depleted levels of folic acid between closely spaced pregnancies might play a role in the rise of autism risk.

The B vitamin folic acid is necessary for proper brain and spinal cord development in fetuses, and women are typically advised to take folic acid supplements during pregnancy.

As for longer pregnancy intervals also potentially linked to autism, Conde-Agudelo said it's been hypothesized that related factors such as infertility, unintended pregnancy and maternal inflammation levels may affect autism possibility.

Most neurodevelopmental disabilities, including autism, are thought to be caused by a complex mix of factors. These include genetics, environment, parental health and behaviors during pregnancy, and complications during birth, the researchers said in background notes.

The study was published in the April online edition of the journal Pediatrics, and will appear in the May print issue.

Story source: Maureen Salamon,  http://consumer.healthday.com/cognitive-health-information-26/autism-news-51/pregnancies-close-together-may-raise-autism-risk-study-says-709733.html

Your Child

Obesity Related Heart Disease Found in Children as Young as 8

2:00

All you have to do is look around, wherever children are gathered, to see that there are far too many kids that are overweight in this country.  And sadly, some of these children may already be developing heart disease according to a new study.

The study reports that obese children as young as 8 years of age, are beginning to show signs of heart abnormalities.

"It is both surprising and alarming to us that even the youngest obese children in our study who were 8 years old had evidence of heart disease," said study lead author Linyuan Jing, a postdoctoral fellow with Geisinger Health System in Danville, Pa.

"Ultimately, we hope that the effects we see in the hearts of these children are reversible," Jing added. "However, it is possible that there could be permanent damage."

Researchers conducted MRI scans of 40 children between 8 and 16 years old. Half of the participants were obese; the other half was of normal weight for their age and height.

They found that the obese children had an average of 27 percent more muscle mass in the left ventricle region their heart, and 12 percent thicker heart muscle overall. Both are considered indicators of heart disease, Jing said.

Among 40 percent of the obese children, scans showed thickened heart muscle had already translated into a reduced ability to pump blood. The children with this reduced heart capacity were considered to be at “high risk” for adult cardiac strain and heart disease.

"This should be further motivation for parents to help children lead a healthy lifestyle," Jing said.

Dr. Gregg Fonarow, a professor of cardiology at the University of California, Los Angeles, called the findings "alarming."

Some of the obese children in the study were struggling with health complications often associated with excess weight, including asthma, high blood pressure and depression, the researchers said. But none displayed customary warning signs of heart disease such as fatigue, dizziness or shortness of breath, Jing said.

The study did not include kids with diabetes or those that were too large to fit inside the MRI scanning machine. Jing noted that the study might actually underestimate how many children are suffering from heart related problems associated with obesity.

Jing said it’s up to parents to help their children maintain a healthy weight. They should buy healthy foods instead of cheap fast food and fruit juice, "which is high in sugar but low in fiber," she said.

She also recommended that parents limit TV, computer and video game time and encourage more physical outdoor activities.

Childhood obesity isn’t just an American problem; it’s a global problem as well.  The World Heart Federation says that one in 10 school-aged children worldwide are estimated to be overweight. However, in the USA, the number of overweight children has doubled and the number of overweight adolescents has tripled since 1980.

The researchers believe that schools can play a role in helping families understand the health problems associated with obesity.

“…Schools and communities need to do a better job at educating both the parents and children about the health risks of overweight and obesity," said Jing.

Fonarow agreed adding, "Substantially increased efforts are needed to prevent and treat childhood obesity."

The findings were presented at the annual meeting of the American Heart Association in Orlando, Fla.

Data and conclusions presented at meetings are usually considered preliminary until published in a peer-reviewed medical journal.

Source: Alan Mozes, http://consumer.healthday.com/cardiovascular-health-information-20/misc-stroke-related-heart-news-360/obese-kids-as-young-as-8-show-heart-disease-signs-705099.html

 

 

 

Your Child

Adult and Childhood ADHD Two Different Disorders?

1:45

A couple of recent studies are taking a new look at the differences in adult and childhood ADHD.

They suggest that adult ADHD is not just a continuation of childhood ADHD, but that the two are different disorders entirely.

In addition, the researchers say that adult-onset ADHD might actually be more common than childhood onset.

The two studies used similar methodology and showed fairly similar results.

The first study, conducted by a team at the Federal University of Rio Grande do Sul in Brazil, evaluated more than 5,000 individuals born in the city of Pelotas in 1993. Approximately 9 percent of them were diagnosed with childhood ADHD — a fairly average rate. Twelve percent of the subjects met criteria for ADHD in adulthood — significantly higher than the researchers expected — but there was very little overlap between the groups. In fact, only 12.6 percent of the adults with ADHD had shown diagnosable signs of the disorder in childhood.

The second study, which looked at 2,040 twins born in England and Wales from 1994-5, found that of 166 subjects who met the criteria for adult ADHD, more than half (67.5 percent) showed no symptoms of ADHD in childhood. Of the 247 individuals who had met the criteria for ADHD in childhood, less than 22 percent retained that diagnosis into adulthood.

These reports support findings from a third study from New Zealand, published in 2015. Researchers followed subjects from birth to age 38. Of the patients who showed signs of ADHD in adulthood in that study, 90 percent had demonstrated no signs of the disorder in childhood.

While the results from these studies suggests that the widely accepted definition of ADHD – a disorder that develops in childhood, is occasionally “outgrown” as the patient ages- may need to be reassessed.

However, not everyone is on board with the recent findings. Some experts suggest that the study’s authors may have simply missed symptoms of ADHD in childhood in cases where it didn’t seem to become apparent until adulthood.

“Because these concerns suggest that the UK, Brazil, and New Zealand studies may have underestimated the persistence of ADHD and overestimated the prevalence of adult-onset ADHD, it would be a mistake for practitioners to assume that most adults referred to them with ADHD symptoms will not have a history of ADHD in youth,” write Stephen Faraone, Ph.D., and Joseph Biederman, M.D., in an editorial cautioning the ADHD community to interpret the two most recent studies with a grain of salt. They called the findings “premature.”

In both of these studies and in previous research, adult ADHD has been linked to high levels of criminal behavior, substance abuse, traffic accidents and suicide attempts. These troubling correlations remained even after the authors adjusted for the existence of other psychiatric disorders — proving once again that whether it develops in childhood or adulthood, untreated ADHD is serious business.

Both of the studies challenge conventional beliefs that childhood onset ADHD is more likely to continue into adulthood. Many experts would like to see more research on this topic to verify these findings

The two studies were published in the July 2016 issue of JAMA Psychiatry.

Story source: Devon Frye, http://www.additudemag.com/adhdblogs/19/12040.html

Your Teen

Acetaminophen, No Threat To Child's Liver

2.00 to read

With more than eight million American kids taking the drug every week, acetaminophen is the nation's most popular drug in children. It's toxic to the liver in high doses, and can be fatal if taken in excess. Very rarely, adults may also get liver damage at normal doses, so doctors had worried if the same was true for kids. Concerns about liver injuries in children who take the common painkiller acetaminophen, sold as Tylenol in the U.S. are unfounded, researchers said on Monday. "None of the 32,000 children in this study were reported to have symptoms of obvious liver disease," said Dr. Eric Lavonas of the Rocky Mountain Poison and Drug Center in Denver. "The only hint of harm we found was some lab abnormalities." With more than eight million American kids taking the drug every week, acetaminophen is the nation's most popular drug in children. It's toxic to the liver in high doses, and can be fatal if taken in excess. Very rarely, adults may also get liver damage at normal doses, so doctors had worried if the same was true for kids. "This drug is used so commonly that even a very rare safety concern is a big concern," said Lavonas, whose findings appear in the journal Pediatrics. Some researchers suspect there is a link between long-term use of acetaminophen and the global rise in asthma and allergies, but the evidence is far from clear at this point. For the new report, researchers pooled earlier studies that followed kids who had been given acetaminophen for at least 24 hours. There were no reports of liver injuries leading to symptoms such as stomachache, nausea or vomiting, in the 62 reports they found. Ten kids, or about three in 10,000, had high levels of liver enzymes in their blood, which usually means their livers have been damaged. In most cases, however, those elevations were unrelated to acetaminophen. And even if they were caused by the drug, they don't indicate lasting damage, according to Lavonas. "Acetaminophen is extremely safe for children when given correctly," he said. "Parents should not be afraid to give acetaminophen to their children when they need it, but they should be very careful about giving the right dose." "If you suspect that you have given a child an overdose, call your state's poison center," he added. The Rocky Mountain Poison and Drug Center receives funding from McNeil Consumer Healthcare, the Johnson & Johnson subsidiary that sells Tylenol, but the researchers said the company did not support this study.

Your Baby

Benefits of Waiting to Clamp the Umbilical Cord

2:00

Could waiting just three minutes before clamping the umbilical cord after childbirth make a difference in your child’s motor and social skills? According to a new Swedish study, children of mothers that delay cord clamping, reap the benefits later in life – especially for boys.

Delaying cord clamping is already known to benefit babies by increasing iron levels in their blood for the first few months of life, researchers write in the most recent edition of JAMA Pediatrics.

“There is quite a lot of brain development just after birth,” said lead author Dr. Ola Andersson of Uppsala University in Sweden. “Iron is needed for that process.”

For the study, researchers followed up on 263 Swedish children born at full term to healthy mothers about four years earlier.

As newborns, the children had been part of a larger study in which a total of 382 babies were randomly assigned to either early cord clamping (within 10 seconds of birth) or late cord clamping (at least three minutes after birth).

Four years later, the children were similarly intelligent regardless of when their cords had been clamped, but there were some notable differences.

“When you just meet a child, you wouldn’t see or notice any differences,” Andersson told Reuters Health. “But we could see the differences in fine motor function.”

The children were tested for IQ, motor skills and behavior. Parents also reported on their children’s communication, problem solving and social skills.

Results of the study showed that overall brain development and behavior scores were similar for both groups, and there was no significant difference in IQ scores.

However, more children in the delayed cord clamping group had a mature pencil grip on the fine motor skills test and better skills on some social aspects compared to those whose cords were clamped early.

Researchers found that boys benefitted much more than girls.

Iron deficiency is much more common among male infants than among females, Andersson said.

“Girls have higher iron stores when they are born,” he said.

Delaying cord clamping by three minutes allows an extra 3.5 ounces of blood to transfuse to the baby, which is equivalent to a half a gallon of blood for an adult, Andersson said.

“There’s a lot of iron in that volume,” he said. “Even three minutes can have quite a lot of effect on the iron in the blood in the body for a long time after birth.”

The new study provides evidence of benefit for full-term babies in a developed country where nutritional deficiency is extremely rare, Andersson said.

“When a baby transitions from inside the womb to outside the womb, if you think about what nature does, it is not to clamp the cord immediately,” said Dr. Heike Rabe of the Brighton and Sussex Medical School and University Hospitals in the UK.

Why do doctors traditionally clamp the cord quickly? About 60 years ago, doctors began clamping the cord almost immediately because it was thought that it would reduce the risk of hemorrhage for the mother. Doctors now know that is not the case.

Even though the scientific understanding behind cord clamping has changed, it’s still difficult for some doctors to change how they’ve always done things.  Today, parents can have more say in how their baby is born and whom they choose to deliver their child.

Parents-to-be should discuss their wishes with their OB/GYN or family doctor ahead of time and weigh the pros and cons of delaying cord clamping for their particular birthing process.

Source: Kathryn Doyle, http://www.reuters.com/article/2015/05/26/us-gynecology-pediatrics-cord-neurodevel-idUSKBN0OB2ET20150526

 

 

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DR SUE'S DAILY DOSE

New report says not enough babies are getting much needed tummy time!

DR SUE'S DAILY DOSE

New report says not enough babies are getting much needed tummy time!

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