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Many mental disorders have physical roots

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Many mental disorders have physical roots
While psychiatrists rarely deal with physical causes in the diagnosis of mental disorders, in many cases physical causes are the root of mental problems.

Many mental disorders have physical roots

Jessica Huston’s tics started when she was just 12 years old. Over time, his condition worsened until he had a seizure and was rushed to the hospital. Doctors at a local hospital in Durham, England, dismissed his condition and said he was suffering from anxiety and probably spent a lot of time watching TikTok videos.

Jessica actually suffers from an autoimmune disease caused by a streptococcal bacterial infection. His illness was a form of pediatric autoimmune neuropsychiatric disorder associated with streptococcal infections (PANDAS). When the infection was identified and treated, her symptoms eventually began to improve.

Ms. Huston is not the only person with a brain dysfunction that is mistaken for a mental disorder. A lot of evidence shows that a series of infections can cause conditions such as obsessive-compulsive disorder, tic, anxiety, and even psychosis. Inflammatory and metabolic disorders can also have significant effects on mental health, although they are rarely considered by psychiatrists.

Rethinking the cause of mental disorders could have profound implications for the millions of people with mental illnesses who are currently undertreated. For example, more than 90% of patients with bipolar disorder develop recurrent illnesses during their lifetime. More than 46% of children with obsessive-compulsive disorder do not recover. About 50 to 60 percent of patients with depression eventually recover after trying different drugs. A deeper understanding of the biological components of mental health can lead to more accurate diagnoses and more targeted treatments.

Infections can cause obsessive disorder, tic, anxiety, and even psychosis

For a long time, the field of psychiatry has focused on describing and classifying symptoms rather than on underlying causes. The Diagnostic and Statistical Manual of Mental Disorders (DSM) was published in 1952 and contains descriptions, symptoms, and diagnostic criteria. Although this guide has helped unify diagnoses, it groups patients without considering the underlying mechanisms of mental disorders.

There is a lot of overlap between the symptoms of depression and anxiety, and some question whether they are really separate illnesses. At the same time, depression and anxiety exist in different forms. For example, panic disorder with and without agoraphobia are different diagnoses, but we may not find significant differences between them. This can lead to a high diversity of patients participating in drug trials, and these trials do not achieve results due to the few commonalities and large differences among the participants.

Previous attempts to find causal mechanisms for mental illness have been challenging. In 2013, the National Institute of Mental Health tried to distance itself from research based on classifications based on DSM symptoms. Huge budgets have been spent on research into brain disease processes with the hope of linking genes directly to behaviors. But this idea ultimately failed and most of the genes discovered had small effects.

DNA

Although genes may play a role in mental disorders, they are not the only answer. Many disorders such as schizophrenia, attention deficit hyperactivity disorder, anxiety, and autism can be caused by genetic disorder 22q11.2, in which part of chromosome 22 is deleted, says Ludger Tebartz van Elst, professor of psychiatry and psychotherapy at Freiburg University Hospital in Germany.

In 2007, studies conducted at the University of Pennsylvania showed that 100 patients with psychiatric symptoms or cognitive deficits actually had some kind of autoimmune disease. Their bodies were making antibodies against a key receptor in nerve cells called the NMDA receptor. This leads to swelling of the brain and can cause a wide range of symptoms including paranoia, hallucinations, and aggression. The disease described was called anti-NMDA receptor encephalitis, and in many cases, it was treatable by removing the antibodies or using immunotherapy drugs or steroids. Studies conducted on patients who had the first episode of psychosis have shown that between 5 and 10 percent of them also had antibodies that attack the brain.

It seems that in rare cases obsessive-compulsive disorder can also be caused by the immune system. This condition is seen in childhood PANDAS, which Ms. Houston was diagnosed within 2021. This disorder is sometimes seen in adults as well. A 64-year-old man spent a lot of time mowing his lawn, but the next day he felt remorse and guilt. The researchers found that these symptoms are caused by antibodies attacking the neurons in his brain.

Recently, Belinda Lennox, director of the Department of psychiatry at the University of Oxford, conducted experiments on thousands of patients with psychosis. He has found antibodies in blood samples of about 6% of patients, which mainly target NMDA receptors. He says it’s not clear how a set of antibodies can cause clinical symptoms ranging from seizures to psychosis to encephalitis. It’s also not clear why these antibodies are made or if they can cross the blood-brain barrier (the membrane that controls access to the brain). He hypothesizes that antibodies cross the blood-brain barrier and affect memory by binding to the hippocampus, leading to delusions and hallucinations.

Studies have shown that some patients with psychological symptoms or cognitive defects have some kind of autoimmune disease

Dr. Lennox says a medical rethink is needed to understand the damage the immune system can do to the brain. He is conducting experiments in this field.

Studies of patients with immune-mediated psychosis show that a wider range of strategies, including the removal of antibodies and the use of immunotherapy drugs or steroids, can be effective treatments.

People with myalgic encephalomyelitis/chronic fatigue syndrome (an infectious disease associated with a range of cognitive problems such as difficulty concentrating and paying attention) were once neglected or diagnosed as retarded. New research shows that myalgic encephalomyelitis is related to both immune disorders and metabolic disorders.

Metabolic disorders can also affect mental health. The brain is an extremely energy-demanding organ, and metabolic changes related to energy pathways are involved in various disorders, including schizophrenia, bipolar disorder, psychosis, eating disorders, and major depressive disorder.

Diet and brain health

At Stanford University, there is a metabolic psychiatry clinic where patients are treated with diet and lifestyle changes along with medication. An active area of ​​research at this clinic is the potential benefits of a ketogenic diet, where carbohydrate intake is limited.

A ketogenic diet forces the body to burn fat for energy, creating chemicals known as ketones, which can be used as a fuel source in the brain when glucose is limited.

Metabolic disorders can affect mental health

Thirteen trials are underway around the world to examine the effects of metabolic therapies on serious mental illness, says Kirk Nylen, head of neuroscience at the US charity Bazoski Group, which funds brain research.

The preliminary results have shown that a large group of patients respond to these treatments in a meaningful way. Medicines, talk therapy, brain magnetic stimulation, and maybe electroshock therapy have not been effective for this group of patients.

It is not just the understanding of the immune and metabolic systems that is improving. Massive amounts of data are now being analyzed at unprecedented speed to reveal connections that were previously hidden from view. This could ultimately lead to more personalized and better treatments.

In early October 2023, the UK Biobank published data showing that people with depressive episodes had higher levels of inflammatory proteins such as cytokines in their blood. According to another study, about a quarter of depressed patients showed evidence of mild inflammation. Knowing this can be helpful because other research shows that patients with inflammation respond poorly to antidepressants.

There are new advances in understanding the underlying causes of mental disorders. A group of researchers are investigating different ways to improve the diagnosis of ADHD; Like classifying patients into different subgroups, some of which were previously unknown. Different groups of researchers announced in three different statements in February 2024 the discovery of biomarkers that can predict the risk of dementia, autism, and psychosis.

The search for better diagnostic tools is also likely to be accelerated by the use of artificial intelligence. A company called Cognoa is using artificial intelligence to diagnose autism in children by analyzing videos of their movement behaviors in doctors’ waiting rooms.

The Quantitative Biosciences Institute (QBI) in California has used artificial intelligence to create an entirely new map of the interactions between proteins and molecular networks involved in autism. This will greatly facilitate finding diagnostic and therapeutic tools.

The developments mentioned are promising. But many problems can be solved by reducing the gap that exists today between neurology and psychiatry. Neurology studies and treats physical, structural, and functional disorders of the brain, while psychiatry deals with mental, emotional, and behavioral disorders. Dr. Lennox envisions a future in which antibody testing is performed when a person who develops a sudden mental breakdown after a viral infection fails to recover with standard treatments.

According to Dr. Tebartz van Elst, the gap between neurology and psychiatry is greater in Anglo-Saxon countries (including the United States, Great Britain, Canada, and New Zealand). In Germany, psychiatry and neurology are closer together, so neurologists are trained in psychiatry and psychiatrists are trained in neurology for one year. This makes research work easier.

For most patients who are first diagnosed with psychosis or other severe psychiatric syndromes, Dr. Tebartz van Elst prescribes brain MRIs, electroencephalograms, laboratory tests for inflammation, and lumbar punctures in order to better treat them by finding clues to the cause of the illness. Submitted.

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Discovery of the brain circuit that manages inflammation

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Researchers believe that using this new brain circuit could lead to new treatments for many immune disorders.

Discovery of the brain super circuit that manages inflammation

Researchers have found that brainstem neurons act as regulators of inflammation. These neurons can increase or decrease inflammation in response to signals sent by the vagus nerve, a collection of thousands of nerve fibers that connect the brain and internal organs.

A new study in mice shows that a peripheral immune stimulus powerfully activates the body-brain axis to regulate immune responses, according to AI. Pro- and anti-inflammatory cytokines communicate with specific populations of vagal neurons to inform the brain of an emerging inflammatory response. The brain, in turn, strongly modulates this environmental immune response process.

Cytokines are a group of water-soluble protein molecules that are secreted from various cells in response to a stimulus and are responsible for transmitting messages between cells. The consequence of the presence of cytokines is a change in the behavior of cells with secreted cytokine receptors, including growth, change, or cell death. The action and effect of cytokine produced by one cell includes more cells around the same cell, but it can have a systemic action and effect on the whole organism.

Cytokine has the effect of changing the secreting cell itself and changes in other cells, and like a hormone, it can have effects on cells far away from it.

The vagus nerve is also the longest brain nerve and the tenth pair of brain nerves out of 12 pairs of brain nerves, which is involved in swallowing food, speaking, parasympathetic activities, and digestion. The motor part of this nerve is somatic and innervates the larynx, soft palate, and pharynx. This nerve is the longest cranial nerve, and like most cranial nerves, it starts from the brain stem and is divided into many branches that innervate most of the muscles of the pharynx and larynx, esophagus, stomach, and parasympathetic heart, lung, liver, spleen, etc.

Discovery of the neuro-immune axis

Based on this study, the researchers used single-cell RNA sequencing, combined with functional imaging, to identify circuit components of this neuro-immune axis and show that its selective manipulation can effectively suppress the pro-inflammatory response while maintaining an anti-inflammatory state. 

This new brain circuit, like a thermostat, helps increase or decrease inflammatory responses so the body responds in a healthy way, said Dr. Hao Jin, who began the study as a postdoctoral researcher in Dr. Zucker’s lab.

Looking at past research, it makes sense that a master regulator controls this critical response, the researchers say. Many psychosomatic effects can actually be related to brain circuits that tell your body something.

They believe that using this new brain circuit could lead to new treatments for many immune disorders.

Promising therapeutic potential

Brain-induced transformation of an immune response pathway offers new possibilities in modulating a wide range of immune disorders, from autoimmune diseases to cytokine shock.

“This new discovery could open up an exciting therapeutic area for controlling inflammation and immunity,” said Charles Zucker, senior author of the study.

Researchers believe that controlling this newly discovered brain circuit could lead to new treatments for common autoimmune diseases including rheumatoid arthritis, type 1 diabetes, multiple sclerosis, lupus, and inflammatory bowel disease.

Read more: Brain cancer vaccine success in human trials

This new control agent could also help treat other diseases such as prolonged COVID-19 syndrome, organ transplant rejection, and cytokine storms caused by COVID-19. According to the researchers, inhibiting the activity of this circuit could make a difference in a wide range of conditions that affect the immune system and help treat dysregulated inflammatory states in people suffering from diseases and immune disorders. This study was published in the journal Nature.

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Skin cancer: symptoms, prevention and treatment

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Skin cancer is the most common cancer in Iran. Do you know enough about this disease?

Skin cancer: symptoms, prevention and treatment

Skin cancer is the abnormal growth of skin cells. This problem generally occurs in areas of the skin that are exposed to sunlight, but sometimes it occurs in areas of the skin that are not normally exposed to light.

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The strange ways skin affects our health

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Skin not only reflects our lifestyle but also plays an active role in our physical health and is related to various diseases.

The strange ways skin affects our health

Worn-out or unhealthy skin is a major contributor to every age-related disease, from Parkinson’s to type 2 diabetes. BBC journalist Zarya Gorot explains how skin affects health and how to protect it.

I am boating in the Ardèche Strait in the south of France when I notice people’s strange looks. It is early afternoon on a scorching July day and the sky is blue and clear. Although there are high cliffs on both sides of the river, I have never felt the sun’s rays so strongly.

The sun’s rays have turned the surface of the water into a squiggly path of brilliant light that is impossible to look at. I have chosen my outfit with the seriousness of an explorer who is going to walk in the African desert. My clothes cover my whole body and protect me from the sun. I used a wide-brimmed fishing hat as well as plenty of high SPF sunscreen and I didn’t forget my sunglasses. I am determined to prevent further aging from the sun. But are there other hidden benefits to these extreme measures of mine?

The latest research shows that our skin is not just a mirror of our lifestyle that reflects the effects of years of smoking, drinking alcohol, and stress. According to the new view, the skin as the largest organ of the body is an active participant in our physical health, and wrinkled and dry skin itself causes aging.

Weird theory

In 1958, the Baltimore Longitudinal Study began, which was supposed to be a scientific study of aging with a bold and rather unorthodox hypothesis. Before that, scientists used to study donated cadavers to understand the physiology of living people. But this time the subjects were examined while their hearts were still beating and their bodies were fully alive. Researchers have followed thousands of men and women for decades to study how genes and environment affect their health.

Wrinkled and dry skin causes aging

In the two decades since the Baltimore study began, scientists have made interesting advances: from the discovery that men who were emotionally unstable were more likely to develop heart disease to the discovery that our problem-solving abilities decline slightly as we age. .

One of the most striking findings of the Baltimore study confirms what researchers have long suspected: how young you look is an accurate measure of how healthy you are inside. In 1982, researchers found that men who looked much older than their age at the start of the study were more likely to die.

In more recent studies, 99% of patients who looked at least 10 years older than their actual age had health problems. It appears that skin health can be used to predict a number of seemingly unrelated factors, from bone density to the risk of developing neurodegenerative diseases or death from cardiovascular disease. But is the skin merely a sign of damage that has accumulated in us, or is it something more complex: can it preserve the health of the healthy and worsen the condition of the unhealthy?

Chronological age and biological age

There are two main ways to measure people’s age. The first method is the standard method known as chronological age. But there is also biological age, which shows the speed of aging of the body. Biological age may vary between different people and even within the same body.

As we age, our chronological age eventually affects our appearance: skin becomes thinner and more uneven, and its elasticity decreases; Because the cells responsible for the production of pigment and collagen die or get old. But usually, the environment causes real damage to the skin.

Although UVB rays can damage our DNA and cause sunburns, mutations, and skin cancer, 95% of all UV radiation reaching the Earth’s surface is UVA. This part of the sun’s rays has a longer wavelength and can penetrate deep into the skin, break down collagen, and stimulate cells to produce melanin.

At the microscopic level, skin that has aged due to exposure to sunlight is thicker and has malformed collagen and elastin fibers. On the visible surface, such skin has an uneven color and is significantly more wrinkled.

Even the darkest skin can burn and is susceptible to photoaging, although it takes longer for wrinkles to appear.

SkinWhile UVB rays usually damage the surface of the skin, UVA penetrates deep into the skin and both can cause systemic inflammation.

Internal factors are thought to be responsible for a small part of skin aging, while UV light is responsible for more than 80% of visible skin changes.

Along with the physical effects described, the skin also undergoes a chemical transformation, and this is something that may have a profound effect on our general health.

Inflammatory aging

In 2000, a group of scientists from the University of Bologna in Italy proposed a new way of thinking about aging by observing how organisms react to stress.

In a healthy young person, the immune system normally functions to maintain order, that is, to repair damage and fight off infections. But when we age or when our health is not good, these inflammatory responses can cross a certain threshold and trigger the release of a cascade of powerful chemicals that travel throughout the body, destroying healthy cells and breaking DNA.

Even the darkest skin is susceptible to sun aging and can burn

The term inflammatory aging is used to describe the global inflammation that accompanies the aging process. Research shows that wrinkled, diseased, or damaged skin becomes part of the inflammatory system and releases chemicals that cause further damage and inflammation.

Higher levels of inflammatory cytokines and chemokines are observed in aged skin. These chemicals destroy collagen and elastin and cause thinning, wrinkling, and loss of skin elasticity. They also disrupt the skin barrier, increasing water loss and susceptibility to stressors. This feedback loop combines with aging cells in the skin, which in turn release their own inflammatory chemicals. Chemicals released by unhealthy skin enter the bloodstream and from there reach different tissues and damage them. The result of this is accelerated aging and a higher risk of various diseases.

So far, old or diseased skin has been associated with the onset of cardiovascular disease, type 2 diabetes and cognitive disorders, as well as Alzheimer’s and Parkinson’s disease.

The importance of skin protection

The first step to protecting your skin is to avoid the sun. In order to protect the skin, observe the following:

  • Wear protective clothing against sunlight.
  • Use sunscreen with a high protection factor.
  • Wear a brimmed hat.
  • Use sunglasses.
  • Do not stay in the sun as much as possible.

Protecting the skin from the sun is very effective in preventing the visible signs of aging. In a preliminary study, those who used a broad-spectrum sunscreen with an SPF of 15 every day for four and a half years showed no signs of further skin aging.

Rubbing the cream on the skinMoisturizing the skin reduces inflammation.

The important thing in choosing a sunscreen is to choose a product that is broad-spectrum. Broad-spectrum sunscreen not only absorbs or reflects UVB (indicated by SPF) but also protects against UVA. Dermatologists recommend that you always check the product label for UVA protection. Protection against UVA is usually indicated by UV-PF or PPD.

Sunscreen can prevent inflammation that occurs when the skin is exposed to the sun, and as previously mentioned, inflammation is the first step toward aging-related diseases. But using sunscreen is not the only way to maintain skin health.

The easiest way to improve skin health is to moisturize it. Moisturizing the skin reduces inflammation and may even help prevent dementia.

In addition to uneven color and wrinkling, skin that has aged due to exposure to sunlight and age is drier. The moisture level of human skin reaches its peak at the age of 40, and after that, it decreases drastically and produces less amounts of natural moisturizers, namely lipids, filaggrin, sebum, and glycerol.

Dry skin is problematic because when the skin is dry, its function as a barrier between the inside and the outside of the body is weakened. When our skin is dry and scaly, its natural functions (keeping out infectious agents, environmental toxins, and allergens while maintaining moisture) become more difficult.

Sunburn of the skinSun-damaged skin releases chemicals that contribute to systemic inflammation and increase the risk of age-related diseases.

Adding moisture to the skin is not a complicated task, and this simple intervention produces significant results.

A group of researchers asked elderly volunteers to use a topical moisturizer twice a day for a month. Compared to older participants who did not use moisturizer, their skin was significantly repaired and their skin levels of inflammatory chemicals were lower.

Even the simplest moisturizers can help prevent inflammatory aging

The promising results of the above study were followed by another study in which people over the age of 65 used a moisturizing cream twice a day for three years. The cognitive performance of the participants was measured at the beginning and at the end of the study. After three years, the cognitive performance of the participants in the control group had declined significantly, but the cognitive performance of the group that hydrated their skin had not.

Read more: Inventing a new drug to treat influenza

Dry skin usually has a higher level of inflammation and is often itchy. A decrease in the level of hydration of the stratum corneum (the outer layer of the epidermis) probably plays a major role in inflammatory aging. On the other hand, scratching the skin intensifies the inflammation.

Natural ingredients include glycerol, petroleum, hyaluronic acid, and lipids that are normally found in the outer layer of the skin and are also the natural components of the most basic moisturizers. Drinking more water may also help hydrate the skin, although the evidence is unclear.

To visualize how much skin can affect the rest of your body, think about how much skin you have. There is as much skin on the inside of your body as there is on the outside of your body. When skin is damaged, every inch of it can release toxic chemicals. Therefore, protecting the skin from the sun is a very effective solution, but don’t forget to use moisturizer as well.

Conclusion

The skin not only indicates the internal state of our body and our lifestyle but also plays a role in age-related diseases. When the skin is exposed to environmental factors, especially sunlight, in addition to changes in appearance, it undergoes chemical changes and contributes to various diseases by participating in global inflammation.

Use a broad-spectrum sunscreen to protect your skin from the sun. Using a moisturizer also helps prevent and reduce inflammation and prevent skin damage.

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