Multiple sclerosis drug may help with poor working memory

A USC study of prescription data shows that people with Medicaid or Medicare Part D may be missing out on powerful new obesity and diabetes drugs

Fampridine is currently used to improve walking ability in individuals with multiple sclerosis. A new study indicates that it may also assist people with reduced working memory, which is often observed in mental health conditions like schizophrenia or depression.

Working memory is essential for everyday tasks, such as remembering a code long enough to type it in and engaging in conversations by reacting appropriately to what others say. It allows us to retain information for a brief period actively, typically a few seconds. However, certain conditions, including schizophrenia, depression, and ADHD, can impair working memory. Individuals affected by these conditions may struggle to follow conversations and to organize their thoughts effectively.

Fampridine is a drug that could help in such cases, as researchers led by Professor Andreas Papassotiropoulos and Professor Dominique de Quervain at the University of Basel have shown.

Practical only if working memory is poor

In their study, the researchers tested the effectiveness of fampridine on working memory in 43 healthy adults. Fampridine showed a more pronounced effect in participants whose baseline working memory was low. After taking the active substance for three days, they scored better in the relevant tests than those who took the placebo. In contrast, the drug showed no effect in people with good baseline working memory.

The researchers also observed that fampridine increased brain excitability in all participants, thus enabling faster processing of stimuli. The study was randomized and double-blind.

The established drug, a new application

“Fampridine doesn’t improve everyone’s working memory. But it could be a treatment option for those with reduced working memory,” explains Andreas Papassotiropoulos. Dominique de Quervain adds: “That’s why, together with researchers from the University Psychiatric Clinics Basel (UPK), we’re planning studies to test the efficacy of fampridine in schizophrenia and depression.”

The drug is currently used to improve walking ability in multiple sclerosis (MS). Particularly in capsule form, which releases the active ingredient slowly in the body, fampridine has shown effects on cognitive performance in MS patients. For some, it alleviates the mental fatigue that can accompany MS.

The researchers did not select the drug at random. This study followed comprehensive analyses of genome data to find starting points for repurposing established drugs. Fampridine acts on specific ion channels in nerve cells that, according to the researchers’ analyses, also play a role in mental disorders such as schizophrenia.

Mental Health for People with Multiple Sclerosis

Rehabilitation psychologists Abbey Hughes and Meghan Beier discuss common mental health disorders often experienced by patients with multiple sclerosis (MS). They explain how these disorders are typically diagnosed in a primary care setting and outline the signs to look for when treating patients with MS.

Brain molecule makes neurons less selective, deepening understanding of human cognition

Excitatory neurons from the brains of mice

Excitatory neurons from mice’s brains are depicted in green, and PV inhibitory neurons are pictured in magenta. Cells in the deep hippocampus, which helps navigate space, are represented toward the left side of the image. Toward the right side, cells are defined in the visual cortex. Findings from Johns Hopkins Medicine may help scientists better understand the causes of autism, schizophrenia and epilepsy.

Neuroscientists from Johns Hopkins Medicine say they have determined how a brain cell surface molecule shapes certain neurons’ behaviour.

The research, which was published on October 2 in Nature, reveals how a molecule called the calcium-permeable (CP)-AMPA receptor suppresses a specific neuron’s ability to pay attention to specific external cues, such as your friend’s earrings. The study was conducted on genetically engineered mice. Understanding why some neurons are less “selective” about their response to certain cues may also help researchers study conditions such as schizophrenia, epilepsy, and autism, which are marked by the faulty processing of external cues and misfirings of neurons in the mammalian brain.

“We have found that the calcium-permeable subtype of AMPA receptors plays an additional role in suppressing the selectivity of a specific neuron,” says Dr. Ingie Hong, the first author and a neuroscience instructor at Johns Hopkins University School of Medicine. “Until now, the function of these particular receptors in the broader mammalian brain during everyday activities has been a mystery.”

AMPA receptors are critical to the fast transfer of information and memory formation in the brain, such as hearing and remembering a person’s name. The subtype of AMPA receptors in this study, CP-AMPA receptors, act as a “gate” that lowers the selectivity of parvalbumin (PV) neurons, which are inhibitory and thereby cast unselective inhibition to nearby neurons, the researchers say.

“Selective neurons will respond to something really specific, for example, your grandfather’s mustache, whereas less selective neurons will respond to different faces or people as well,” Hong says. “We’ve been looking for the mechanisms and molecules that control this specificity, or selectivity, and how it goes awry in conditions such as autism and epilepsy, where excitatory neurons can become overstimulated.”   

The researchers also found that mutations of GluA2, a protein subunit within the CP-AMPA receptor, are associated with intellectual disabilities.

“Human mutations in the GluA2 subunit of the AMPA receptors, which regulates the calcium permeability of the receptor, can lead to intellectual disability and autism,” says senior author Huganir. “This suggests tight control of AMPA receptor calcium permeability is essential for human cognition.”

Specifically, the investigators focused on CP-AMPA receptors in two distinct areas of the brain, the visual cortex, where neurons process visual information, and the hippocampus, where neurons respond to “where you are, where you are headed, or where you have been,” Hong says.

To conduct their research, the scientists developed novel adeno-associated virus vectors to replace calcium permeable AMPA receptors with impermeable counterparts and express them in the mouse brain. They say they hope these vectors can help treat disorders that arise from AMPA receptor mutations in the future.

To map out PV neuron selectivity, the scientists used advanced imaging techniques to observe neuron structure and activity deep within genetically engineered mice brains while showing them video stimuli.

“In most cases, we found that these PV neurons, which are typically less selective, became more selective to visual stimuli as well as spatial location when we swapped out CP-AMPA receptors for impermeable molecules, making inhibitory neurons act more like excitatory neurons,” Hong says.

The researchers say the high amount of CP-AMPA receptors in PV neurons is well-conserved across many species of mammals, including humans.

“Making neuron inhibition less selective makes our neural circuits more efficient than species that don’t have this molecular feature,” Hong says. “It probably also means that our neural networks are more stable.”

Hong says the new research may also have implications for machine learning used in artificial intelligence.

“In machine learning, there are many computerized ‘artificial’ neurons that are trained to be very selective or less selective,” he says. “We’re trying to find how specific and less specific units can work together to give us smarter machines and smarter AI.”

Credit David Cheon and Ingie Hong

Specially designed video games may benefit mental health of children and teenagers

Johns Hopkins Children’s Center researchers reviewed studies of video games designed as mental health interventions for anxiety, depression and ADHD
Johns Hopkins Children’s Center researchers reviewed studies of video games designed as mental health interventions for anxiety, depression and ADHD.

In a review of previous studies, a Johns Hopkins Children’s Center team concludes that some video games created as mental health interventions can be helpful – if modest – tools in improving the mental well-being of children and teens with anxiety, depression and attention-deficit/hyperactivity disorder (ADHD).

An estimated 20% of children and teenagers between the ages of three and 17 in the U.S. have a mental, emotional, developmental or behavioural disorder. Suicidal behaviours among high school students also increased by more than 40% in the ten years before 2019, according to a report by the Agency for Healthcare Research and Quality. Other studies provide evidence that the COVID-19 pandemic’s disruptions worsened these trends, and while research suggests parents and other care givers are seeking out mental health care for children, wait times for appointments have increased.

“We found literature that suggests that even doubling the number of pediatric mental health providers still wouldn’t meet the need,” says Barry Bryant, M.D., a resident in the Department of Psychiatry and Behavioral Sciences at the Johns Hopkins University School of Medicine and first author of the new study.

In a bid to determine if so-called “gamified digital mental health interventions,” or video games designed to treat mental health conditions, benefited those with anxiety, depression and ADHD, the research team analyzed their use in randomized clinical trials for children and adolescents.

Bryant and child and adolescent psychologist Joseph McGuire, Ph.D., identified 27 such trials from the U.S. and worldwide. The studies included 2,911 participants, about half of whom were boys and half of whom were girls, between the ages of six and 17.

The digital mental health interventions varied in content, but were all created with the intent of treating ADHD, depression and anxiety. For example, for ADHD, some games involve racing or splitting attention, which requires the user to pay attention to more than one activity to succeed in gameplay. For depression and anxiety, some of the interventions taught psychotherapy-oriented concepts in a game format. All games were conducted on technology platforms like computers, tablets, video game consoles and smartphones. The video games are available to users in various ways — some are available online, while others required access through specific research teams involved in the studies.

Outcome measurements varied depending on the study. However, the Johns Hopkins research team was able to standardize effect sizes using a random-effects model so that a positive result was indicated when interventions performed better than control conditions. Hedges g, a statistic used to measure effect size, was used to quantify treatment effects overall in the studies reviewed.

Researchers also examined factors that led to improved benefit from digital mental health interventions. Specific factors related to video game delivery (i.e., interventions on computers and those with preset time limits) and participants (i.e., studies that involved more boys) were found to positively influence therapeutic effects. Researchers say these findings suggest ways to improve the current modest symptom benefit.

“While the benefits are still modest, our research shows that we have some novel tools to help improve children’s mental health — particularly for ADHD and depression — that can be relatively accessible to families,” says Joseph McGuire, PhD, an author of the study and an associate professor of psychiatry and behavioural sciences in the school of medicine. “So if you are a paediatrician and you’re having trouble getting your pediatric patient into individual mental health care, there could be some gamified mental health interventions that could be nice first steps for children while waiting to start individual therapy.”

Significant impact of partners’ ADHD on women’s mental health and quality of life new study reveals

Is it ADHD - click here to find out!

A new study brings attention to the often-overlooked challenges faced by women in relationships with partners diagnosed with ADHD. The research reveals that the partners’ ADHD symptoms are associated with higher rates of depression and lower quality of life in women. However, women who engage in health-promoting activities experience fewer depressive symptoms and improved well-being. The findings suggest that ADHD treatment should not only focus on the individual with ADHD but also consider the well-being of their partners, offering new opportunities for supportive interventions. Further research is needed to explore the long-term effects and develop targeted solutions.

A recent study by researchers Dana Zeides Taubin, Haya Fogel-Grinvald, and Prof. Adina Maeir from the School of Occupational Therapy at Hebrew University brings attention to the often overlooked experiences of women in relationships with partners diagnosed with Attention Deficit Hyperactivity Disorder (ADHD). The research investigates the link between partners’ ADHD symptoms and women’s mental health and quality of life, providing valuable insights for both clinicians and couples.

The study’s results show that:

  • Women partnered with individuals diagnosed with ADHD may face an increased risk of depressive symptoms and reduced quality of life.
  • Partners with ADHD who have more difficulties in daily functioning are linked to higher levels of depression in women and a lower quality of life for them.
  • Engagement in health-promoting activities (HPA) by women is positively linked to their quality of life and negatively associated with depressive symptoms.
  • Women partnered with individuals diagnosed with ADHD may face an increased risk of depressive symptoms and reduced quality of life.
  • Partners with ADHD who have more difficulties in daily functioning are linked to higher levels of depression in women and a lower quality of life for them.
  • Engagement in health-promoting activities (HPA) by women is positively linked to their quality of life and negatively associated with depressive symptoms.

This research has important implications for clinical practice and emphasizes the need for a more comprehensive approach to treating adult ADHD. Clinicians are encouraged to take into account not only the individual diagnosed with ADHD but also the experiences and well-being of their partners.

The study suggests that integrating health-promoting activities into therapeutic approaches may benefit partners of individuals with ADHD. This discovery creates new opportunities for developing tailored supportive interventions for this often overlooked group.