The Cognition of Musicians

The presentation by Dr. Toby Dye regarding whether or not musical experience has an effect on auditory attention was all about the differences in language processing and auditory attention for musicians and non-musicians. It has long since been assumed that musicians have higher cognitive function due to their practice and disciple learning the instrument they are a master at. One part of Dr. Dye’s talk I found most interesting was the part about his methods of determining a musician from a non-musician. Dr. Dye mentioned that in a lot of literature and studies that conclude that musicians have a different cognitive ability there is not a very strict guideline or determinate to defining a musician. He used M.U.S.E. to define his musicians. In an article from Time Magazine titled, “This Is How Music Can Change Your Brain” the author, Melissa Locker, talks about the differences in learning and development for children who are involved in music and not involved. Similar to Dr. Dye’s talk, the author of this article cites playing music as an advantage for kids to distinguish between sounds which ultimately makes them better in literacy. This article focuses on children which makes defining a “musician” more difficult due to their limited time spent “mastering” an instrument. Instead of using something like M.U.S.E. which Dr. Dye’s talk did, the article uses children who are currently involved in learning an instrument vs. children who are just in musical education classes. The second half of the article compares kids who just listen to music vs. kids who are actively involved in making music. This definition is relevantly loose and leads me to question the legitimacy behind the findings. Dr. Dye’s presentation make me skeptical of using different definitions. In the case of this article, how is the reader to know if one kid who is involved in instrument play doing twice as much practice, or less practice? The use of children as the subjects of the article also leaves much to be questioned in terms of development and language learning. The article says that kids who are actively engaged in learning music had improvements in how their brain processes speech and reading scores. It seems unequivocal that learning and knowing how to play an instrument improves at least some parts of cognition for adults and children alike.

 References:

Weiss, Michael & Bidelman, Gavin. (2015). Listening to the Brainstem: Musicianship Enhances Intelligibility of Subcortical Representations for Speech. Journal of Neuroscience. 35. 1687–1691. 10.1523/JNEUROSCI.3680-14.2015. 

Music Can Alter Your Child's Brain

Melissa Locker - https://time.com/3634995/study-kids-engaged-music-class-for-benefits-northwestern/

Adolescent Brain Surface Area Pre- and Post-Cannabis and Alcohol Initiation

 It has always been an important topic that has ingrained in our heads as we grow up the idea of drugs are not suitable for us, especially when it comes to impacting our brain. Despite the consequences, teenagers in this day and age are still using alcohol and cannabis at a young age. Studies have shown that alcohol and cannabis affect our gray matter volume and thickness in teenagers. In a healthy human growth, it’s important to emphasize that gray matter decreases and white matter increases. The purpose of this study is to show how these two types of drugs can mess with our brain before and after use. I decided to write on this study because it’s important to point out the significant issue in this day and age and it’s interesting to see what exactly happened to the brain before and after use of these two drugs. The purpose of this study is to gain more knowledge on the effect of alcohol and cannabis use on the surface of the brain. There are well known consequences that affect teens when it comes to alcohol and cannabis use. This study goes in-depth to better understand what happened to teenager’s brains after alcohol, cannabis, and a combination of both. In this study, it included participants ranging from ages 12 to 14 and group them into three categories, which includes, alcohol use initiators, alcohol use initiators, alcohol and cannabis use initiators, and individuals with minimal substance use.The method used is participants are followed for six years until they are 17-21. The result showed that there is a declined in surface area over time and a tremendous decrease in the bilateral medial orbitofrontal cortex in the alcohol category compared to the other two categories. This study showed that alcohol impacted the brain negatively and also shows that cannabis withholds the negative effects of alcohol on the brain. The results are shocking to me because I’ve always thought that these substances impact the brain negatively. But surprisingly, cannabis can help to prevent the decrease of the cerebral cortex. The most important results were the benefits of cannabis and how it can counter attack the negative impact of alcohol on the brain. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6308167

Video meets more than the eye

We live in an era where a significant amount of the information we process comes from watching videos. Most people would agree that watching to process information is dramatically less exhaustive than reading or listening. Although our complex system of image processing is fantastic, we have to be careful of how we translate this feature into our legal justice system. With all the technological advancements today, almost anyone can record a video. Thus, we would think that with all the wrongful convictions our society is facing today, videos would be an effective way of debunking wrongful convictions. Well, we might have to think again. 

In the article “In the Eyes of the Law: Perception Versus Reality in Appraisals of Video Evidence,” Yael Granot and her colleagues primarily focus on the numerous errors that occur because of videos used in trial. They argue that visual information is interpreted more dominantly than auditory information in respect of speed and memory. The regulations for how jurors should approach the representation of video evidence are unclear. Usually there are two main categories, substantive and illustrative evidence. The former being evidence intrinsically proving the facts, while the latter contextualizing the facts for better understanding towards a holistic view. The authors emphasize the importance of relevance, nonetheless the reliability of the video. They also propose three significant areas where interpretation can be flawed substantially; overbelief, failure to discriminate and lack of awareness. 

In her article “The Always-On Police Camera,” Sidney Fussel tells the story of a wrongful conviction due to the strategic manipulation of a video recording. A police officer was caught red-handed tampering with evidence, in specific, he placed a bag of pills inside a soup can in an attempt to frame an innocent person. He then proceeded to click record on his bodycam to arrest the “suspect.” The bodycam records and saves 30 seconds before you click the record button. The police officer was clueless about this; thus submitted evidence of himself committing a crime, which led to his suspension and arrest, and the suspect’s release. As pointed out in Granot’s article, “...research finds that camera angles that show events from another’s perspective may increase empathy with that person…whether the person is a victim or a perpetrator” (4-5). As police have extensive law enforcement training, we often believe that police are the “good guys” in a situation, following the law. So when we see from a police officer’s perspective, not only do we over believe the happening, but we have a tendency to sympathize with the police versus the suspect. If those 30 seconds weren’t captured, the police could have gotten away with their unjust actions. The following excerpt from Granot’s article particularly resonated with this news article: “Videos of police interrogations may be particularly susceptible to the camera perspective bias and its sequelae...(Kassin et al., 2010).” If someone is consistently in support of policemen, they are more likely to be biased towards the policeman in the video. In contrast, if someone has a negative outlook on policemen, they may sympathize more with the victim. 

This incident could have had completely different consequences if it weren’t for the reckless behavior of the police, this could have easily slipped through the cracks. It shows how powerful video evidence can be when manipulated and taken out of context. Therefore, it is of great importance to establish regulations to minimize the error of interpretation of video evidence.

Granot, Yael, et al. “In the Eyes of the Law: Perception versus Reality in Appraisals of Video Evidence.” Psychology, Public Policy, and Law, vol. 24, no. 1, 2018, pp. 93–104., doi:10.1037/law0000137.

Fussell, Sidney. “The Always-On Police Camera.” The Atlantic, Atlantic Media Company, 27 Sept. 2018, www.theatlantic.com/technology/archive/2018/09/body-camera-police-future/571402/.

Gulping vs Drinking: Where Can We Find Reward?

Dopamine, a word that might pop up whenever you think of pleasure and reward pathways. However, it’s broad influence has an irresistible lure for neuroscientists to research. Last year, and article was published by the New York Times titled” Why Gulping Down  A Cold Drink Feels So Rewarding”. In this article, Veronique Greenwood summarizes a study done by a group of scientists who have researched how thirst stimuli function in mammals claim that the feeling of reward based neural systems work independently of those involved in regulating water intake. The gulping motion made by the throat as liquid passes sends a message to the brain that water has been consumed has been found to decrease neuron activity responsible to remind the body to stay hydrated.

While research related to consumption and reward neurons, like the extensive work of Ted M. Hsu, has been done, findings suggest a considerable overlap between homeostatic and reward-related neural processes. Although both research find this relationship, researchers in the New York Times article study found that this decrease in neuronal activity is reduced no matter if the substance swallowed/ gulped has an effect in keeping us hydrated. These results suggest that our brains can be tricked into feeling rewarded when thirsty by the sole act of gulping even if there is no hydration. On a side note, is this the reason behind the common advice when someone is on a diet to chew slowly and swallow food in small portions so they can feel full with a smaller meal? Nevertheless, the body will eventually feel that there is no presence of water arriving and thirst will rise up again. With this idea in mind, scientists ran various experiments with different groups where one group mice were injected water directly to their stomach, the second group had artificially manipulated thirst neurons to feel the sensation of satiation, and a the third, the control, group drank water normally. 

Surprisingly, results showed that the second and third groups of mice showed a neuronal pathway that released of dopamine, creating the sensation of reward and satiation. Nonetheless, the first group, the group that did not have a gulping sensation due to the lack of swallowing, did not have a release of dopamine, therefore there was no reward or pleasure met. As this study concludes, we can infer that the act of hydration is not rewarding rather gulping the water is what produces a feeling reward.

AUD and Genetics

    Alcohol is a depressant and one of the most abused substances by veterans. The article from the Addiction Center titled, “Alcohol Addiction and Genetics” talks about a research that shows that genes account for half of the risk for developing AUD. They further stated, that there are certain combinations of genes that have a strong correlation with alcoholism. However, certain environmental factors can also lead to alcoholism, such as work-related stress. The article also mentioned that the mental illnesses increases the chances of developing alcoholism by twenty to fifty percent. 

     
   In the article “Alcohol use and craving among Veterans with mental health disorders and mild traumatic brain injury” researchers found out that the rates of alcohol misuse was high among veterans with mental health disorders and mild traumatic brain injuries. For this study they conducted a phone interview for up to six weeks where the participants completed questionnaires regarding alcohol use and alcohol cravings. The results showed that veterans with high alcohol cravings were more likely to develop an alcohol use disorder. 

     
    Both of the articles mentioned the fact that chances of alcohol use disorder increase with mental illnesses. For instance, for veterans suffering with post-traumatic stress disorder the chances of AUD increases. AUD is not only linked with genetics, but environmental factors also play a role. I am excited to see where the research regarding AUD goes in the future and I am excited to learn more about AUD.  

https://www.addictioncenter.com/alcohol/genetics-of-alcoholism/

https://www.dropbox.com/sh/hdluh1vfs2cphhz/AABHUOxPAP_XWzl0AL7lWWzga/(01.21.20)%20-%20Amy%20Herrold?dl=0&preview=Herrold+JRRD-2014-07-0170+alcohol+craving.pdf&subfolder_nav_tracking=1

Is Blue Light Really the Concern?

In Dan Cavanaugh’s presentation on circadian rhythm in flies, he explained his work thus far in uncovering the responsibility of neurons that are downstream from clock neurons. He explained how circadian rhythm affected not only sleep patterns, but hunger and activity as well. Most studies presented had the experimental group of flies’ circadian rhythm modified in some manner when compared to controls and it was evident that the flies only exhibited normal circadian promoted patterns when exposed to control environments (light/dark cycle and no genetic modifications). In today’s age, people are higher concerned of the effects their late-night studying / Netflix binging has on their overall health as we clearly saw in the concluding questions to Dr. Cavanaugh’s presentation. In the TIME article “Forget What You Think You Know About Blue Light and Sleep” by Jamie Ducharme discusses a paper released by the University of Manchester that challenges the notion that blue light emitted from electronic devices keeps us up later at night. The notion that blue light keeps us up has resulted in the creation of ‘night mode’ on most devices, however, this study suggests its only part of the problem. In previous studies, blue light has been shown to be a melatonin inhibitor as it is particularly good at being absorbed by melanopsin, a pigment that helps our eyes assess brightness. This study found something quite different though, that after exposing mice to different hues of bright colored light, yellow light seemed to disturb sleep the most. They reasoned that these warmer tones of light may trick the brain to think the sun is out, while blue in reality would be seen towards twilight. I think the most important thing the author noted was that this new research doesn’t necessarily mean that this behavior correlates in humans. The author reached out to a researcher at the University of Michigan Dr. Cathy Goldstein who said that this study cannot be logically extrapolated into the headline “blue light at night isn’t bad for you” and that if anything blue light has become a consumerist term used by marketing campaigns for products. The healthiest thing you can do is to just not look at a bright screen before bed if you want to sleep. I think the author did a good job not only presenting what was said in the research paper but also presenting the fact that just because this behavior occurs in mice doesn’t mean it occurs in humans. Most importantly, the author stated the problem with taking this information too far and how this notion of a certain color of light is bad doesn’t really make sense as all bright light is probably not too great when you’re trying to sleep.

https://time.com/5752454/blue-light-sleep/

Alcohol Misuse Within the Military

As times become stressful and hard, many people sometimes fall back on alcohol. This is often times seen in many military personal and veterans due to all the stress and PTSD they face while being in highly stressful situations such as war.

In the article, “Alcohol use and craving among Veterans with mental health disorders and mild traumatic brain injury” by Amy Herrold and collogues addresses the issue of mental health disorders and traumatic brain injury and how that effects alcohol usage in veterans from Iraq and Afghanistan. This study used the Alcohol Use Disorder Identification Test (AUDIT-C) and the Penn alcohol Craving Scale (PACS). The results of these test showed that the rates of alcohol usage were extremely high among the veterans who had mental health disorders and mild traumatic brain injury and those that just solely had a mental health disorder and no mild traumatic brain injury.  

Another article looked at something similar, but the subjects of this study were military personal compared to the general population and how alcohol affected these two groups. In the article, “Alcohol use in the military: associations with health and wellbeing” by Michael Waller and collogues examined three different variables in their research. They looked at the “prevalence of drinking in currently serving and former members of the Australian Defence Force (ADF) with nationally representative sample of civilians” (Waller). They also looked at what groups would report harmful drinking and what “the association between drinking and general health and the ability to function normally” (Waller). The researchers used the AUDIT scale like Amy Herrold did in her research and they also used social functioning scores (SF36 sub-scales). The results of this study showed that the general population had more risky drinkers than military personal, however this was mainly observed in military personal with younger age and lower ranks. These results also showed that alcohol misuse can harm the general health and lower our social functioning.

This being said, it is beneficial to keep in mind the effects of alcohol misuse and mental health disorders can play a role in misusing alcohol. However, this study focused on a very specific group of people that mainly consisted of being male therefore more research can be done to look at the effects of alcohol misuse among different groups of people.

References

Herrold, Amy A., et al. "Alcohol Use and Craving among Veterans with Mental Health Disorders and Mild Traumatic Brain Injury." Journal of Rehabilitation Research and Development, vol. 51, no. 9, 2014, pp. 1397-1410., doi:10.1682/jrrd.2013.07.0170.

Waller, Michael et al. “Alcohol use in the military: associations with health and wellbeing.” Substance abuse treatment, prevention, and policy vol. 10 27. 28 Jul. 2015, doi:10.1186/s13011-015-0023-4

Racial Biases in Death Penalties

      There have been so many wrongful convictions in the past mainly due to racial biases that exist within jurors. There are factors that play a role in convictions that are not right such as misinterpretations in visual information and racial biases due to in-groups and out-groups. This was studied in the study by Yael Granot titled “Looking for trouble: An attention intervention for group-based bias in appraisals of video evidence”. Through the research they conducted, they found that both of these factors contributed to the decisions that jurors made when finding a person guilty of a crime. Visual information can be interpreted differently by every individual leading them to see one individual as more guilty even if they may not be, especially when the video evidence or any other evidence is ambiguous. Racial bias also plays a role in people being more biased towards groups that are racially different than them (out-groups) versus the same or similar racial groups to them (in-groups)

     Racial justice acts have come out to defend individuals that have been sentenced if the sentence was driven by racial bias. The passing of these acts, in the past, has helped to remove inmates from death row and give them life without parole instead. However, since the repeal of this act in 2013 four inmates are back on death row. In 2017, a judge dismissed their cases without hearing the evidence claiming that since the Racial Justice Act had been overturned, the inmates racial bias cases should be overturned as well. In August of 2019, the cases were going to be back before the State supreme court to evaluate and have a debate on what should be done. This news article talks about how at the time of the convictions the jurors that convicted these individuals were mainly White and many Blacks were struck out of the jury. This article talked about how there was evidence of racial bias in each individual case. This racial bias needs to be accounted for when looking at how a jury decides on the sentence for an individual. When the jurors are more racially diverse this helps in diminishing racial biases that can occur.

                                                                   References

      https://time.com/5659100/north-carolina-death-penalty/

      Granot, Y., Balcetis, E., Schneider, K. E., & Tyler, T. R. (2014). Justice is not blind: Visual attention exaggerates effects of group identification on legal punishment. Journal of Experimental Psychology: General, 143(6), 2196-2208. doi: 10.1037/a0037893

Circadian Rhythm Disruption

Just about every living organism runs on a near 24-hour process called a circadian rhythm. These cycles determine sleep/wake cycles, metabolism, hormone release, and almost every other physiological process, as well as many behavioral processes. Because each of these processes are dependent on the same cycle, they are intertwined, and so maintenance of this cycle is detrimental to health and wellbeing.

 Dr. Daniel Cavanaugh discussed his research on the topic with our neuroscience class on January 28th. His focus is on feeding behavior in Drosophila, commonly known as fruit flies. His paper “A circadian output center controlling feeding:fasting rhythms in Drosophila” discusses his research. In his lab, he was able to map out neural pathways in flies related to circadian rhythms, and track how they responded to circadian rhythms. He was able to find pathways with circadian output areas which were active during specific processes. Metabolism interacts with sleep pathways, feeding:fasting interacts with sleep pathways, and rest:activity interacts with light pathways. All of this research shows just how intertwined physiological processes are due to circadian rhythms.

 Because they are so intertwined, disrupting one must also disrupt others. This disruption was explored in another article, “Effects of Chronic Social Defeat Stress on Sleep and Circadian Rhythms are Mitigated by Kappa-Opioid Receptor” where Dr. Audrey Wells discusses the effects of stress on circadian rhythms, especially sleep. This study was done on mice, stimulating them with CSDS, which was meant to mimic stressful situations for humans. She found that sleep and circadian rhythms were majorly disrupted when mice were affected with CSDS. The disruption to sleep and circadian rhythms was measured by tracking irregularities in body temperature and motor activity. These findings show that one disruptor, in this case stress, can affect multiple systems, such as sleep, body temperature, and regular motor activity.

 Although Dr. Cavanaugh’s feeding:fasting research and Dr. Well’s stress research were done on nonhuman organisms, their findings are extremely relevant. Because all animals have circadian rhythms, research showing the negative effects of disruption on certain animals should be thought of in terms of all organisms, even if the exact brain structures and neural pathways effected are not common to all. However, the results of this research should be taken as reasons to study human circadian rhythms more closely. It is already proven that these rhythms are commonly disrupted and vitally important. Looking at this research, humans should feel more inclined to pay attention to their sleep schedule, eating schedule, and the amount of artificial light they are exposed to when it is not light outside. Researchers should feel more inclined to study the real pathways in the central nervous system that are associated with circadian rhythms rather than coming to conclusions based only on correlation. Circadian rhythms effect all living organisms, and in order to be healthy, humans should pay more attention to how they support these systems and avoid disruption.

 Dreyer AP, Martin MM, Fulgham CV, Jabr DA, Bai L, Beshel J, et al. (2019) A circadian output center controlling feeding:fasting rhythms in Drosophila. PLoS Genet 15(11): e1008478. https://doi.org/10.1371/journal.pgen.1008478

 Wells AM, Ridener E, Bourbonais CA, Kim W, Pantazopolous H, Carroll FI, et al. (2017) Effects of Chronic Social Defeat Stress on sleep and circadian rhythms are mitigated by kappa-opioid receptor. Journal of Neuroscience 37(32): 7656-7668. https://doi.org/10.1523/JNEUROSCI.0885-17.2017

Hippocampus Hijinks: The Impacts of CA1 on Episodic Memory

            In 2017, a team of researchers at Columbia University’s Zuckerman Institute used a mouse model to investigate the biological sources of the severe memory deficit that is often a major symptom of schizophrenia. They focused on the CA1 region of the hippocampus, an area implicated in episodic memory as well as navigation and often showing alterations between normal brains and those of people with schizophrenia. Place cells, which are important for the brain’s internal mapping, navigation system, and spatial aspects of episodic memory, are housed in CA1 and were observed during the experiments using a two-photon microscope. Researchers genetically modified mice to mimic symptoms of schizophrenia and compared them to controls for experimentation. In the study, both groups of mice were placed on treadmills and introduced to different visual, auditory, and olfactory stimuli, to see how well the mice navigated environments, both new and familiar. Both control and experimental groups performed well when navigating a new environment, but the experimental group struggled remembering familiar ones, and found adapting to alterations in familiar environments challenging. The control mice’s place cells were found to fire more intensely as they approached a familiar landmark, and would drop back down in intensity after they moved away from it. The researchers would also move the location of those familiar landmarks, and once the control mice re-learned the new location, the same pattern was observed. Schizophrenia-like mice, however, did not show any alteration in place cell activation when familiar stimuli were moved to another location, showing that they were unable to adapt as well as normally developing mice, giving more insight into how the memory system may be affected by schizophrenia.

           

            This study relates to Dr. Molly Erickson’s talk on the neural mechanisms potentially underlying the memory deficits seen among patients with schizophrenia. Through her research, she has determined that the most likely step of the memory process that is defective in people with schizophrenia is the consolidation of the information, rather than the memory processing or storage itself. While she focused on the alpha and beta bands of the brain and how their responses differ between control patients and patients with schizophrenia, the results of this study could further identify more brain regions implicated in the memory deficits associated with the disorder, as the consolidation of memories may involve multiple regions of the brain.

References:

Erickson MA, Smith D, Albrecht MA, Silverstein S. Alpha-band desynchronization reflects memory-specific processes during visual change detection. Psychophysiology. 2019;00:e13442. https://doi.org/10.1111/psyp.13442

https://www.sciencedaily.com/releases/2017/09/170904120423.htm

Is ADHD a Circadian Rhythm Disturbance?

                  In the research conducted by Daniel Cavanaugh and colleagues, the study A circadian output center controlling feeding: fasting rhythms in Drosophila reports that fruit flies, like humans, have set neuronal pathways that control internal clocks which activate and synchronize certain behaviors based on whether it is day or night. We commonly know this as circadian rhythms, which act on basic homeostatic behaviors ranging from hunger, attention, but most importantly sleep. These behaviors in response to this cycle have a wide degree of fluctuation in a variety of neuropsychiatric disorders. In many cases, with regards to neuropsychiatric illness, this is not fully understood and oftentimes, disruptive sleep patterns and circadian rhythms can add to comorbidity. In children and adults diagnosed with Attention Deficit Hyperactivity Disorder (ADHD), one of the most prevalent symptoms that manifest is exhibited difficulties with sleep.

                 The relationship between circadian rhythm dysregulation in patients with ADHD is explored in more detail in an article posted by ScienceDaily. According to the article, 75% of both children and adults suffer from issues of not getting enough sleep, which entails both problems falling and staying asleep. Interestingly enough, the article also reports that those with ADHD tend to exhibit more activity and higher levels of alertness into the evening that persists throughout the night. Concerning Cavanaugh’s research, Professor Sandra Kooij claims that because the overall day and night cycle is disturbed, the following behaviors associated with circadian rhythms are offset, such as the timing of meals. Kooij also suggests lack of a circadian sleep pattern is now theorized to be the etiology of ADHD. The intriguing question remains; does ADHD cause sleeplessness, or does sleeplessness cause ADHD? If the latter is true, then the possibility exists that nonpharmacologic methods involving the circadian pathways can influence further treatments. Developing more on this understanding using elements from Cavanaugh’s research might provide more insight into specific mechanisms involved in ADHD, circadian rhythms, and sleep efficiency.

References

European College of Neuropsychopharmacology. (2017, September 4). Is ADHD really a sleep problem?. ScienceDaily. Retrieved February 28, 2020 from www.sciencedaily.com/releases/2017/09/170904093443.htm

Dreyer, A. P., Martin, M. M., Fulgham, C. V., Jabr, D. A., Bai, L., Beshel, J., & Cavanaugh, D. J. (2019). A circadian output center controlling feeding:fasting rhythms in Drosophila. PLoS genetics, 15(11), e1008478. https://doi.org/10.1371/journal.pgen.1008478

Treatment options for PTSD

Posttraumatic stress disorder (PTSD) is a condition that affects 8 million adults in the United States, and 8% of the population will suffer from some form of PTSD throughout their life. This disorder is characterized by consistent and often highly distressing memories that cue some aspect of a traumatic event in the past. Prevalence of PTSD is higher among women and combat veterans, with women are twice as likely as men to experience PTSD throughout their lifetime. This disorder is more impactful than simply having persistent uncomfortable flashbacks as most people might imagine. PTSD causes high degrees of disability in normal daily activities among those affected. These individuals are more likely to suffer from poor family relationships, and are associated with lower income, and less occupational success according to the DSM-5. Lastly, individuals diagnosed with PTSD are 80% more likely to suffer from another mental disorder.

            These data are supported in the article “Alcohol use and craving among Veterans with mental health disorders and mild traumatic brain injury” where Dr. Amy Herrold states that individuals suffering from PTSD or depression are 3 to 4 times more likely to suffer from alcohol use disorder (AUD). Dr. Herrold specializes in assessing potential treatments for cooccurring conditions which are common with PTSD. She points out that these cooccurring conditions such as a patient suffering from both PTSD and AUD makes it far more difficult for the patient to recover, and intensifies the symptoms of both disorder. Dr. Harold is investigating the use of transcranial magnetic stimulation (TMS) to treat cases of cooccurring disorders such as PTSD, AUD, and mild traumatic brain injury (mTBI). TMS has been shown to reduce symptoms of AUD in patients with these cooccurring conditions, which indicates that it could be a potential treatment option for these disorders.

While treatments aimed at modulating the neural activity of circuits involved in the symptoms of these disorders are becoming more popular, traditional methods of treating PTSD are pharmacological. The most common medications to treat PTSD are selective serotonin or serotonin-norepinephrine reuptake inhibitors (SSRIs/SNRIs) which are the go-to medication to treat depression and anxiety related disorders. This is evidenced by the fact that 13% of the population in the U.S. is on some sort of antidepressants. While these medications are effective in treating major symptoms for anxiety and depressive disorders, they are now being prescribed at lower rates due to concerns with major side effects that these medications often bring on. However, new experimental treatment options show promise, specifically as it relates to treating PTSD.

One of these new treatment options is ketamine, which has shown to reduce the negative symptoms of PTSD in a more targeted manner, and with greater effectiveness that traditional SSRIs. Ketamine was originally used as an anesthetic and works as an NDMA receptor antagonist. In normal conditions, this this receptor is activated by glutamate, and has a general effect of increasing the excitability of neurons. When ketamine acts to antagonize or reduce the excitatory effects of glutamate in the brain, the general result is a slowing down of these neural circuits. Understanding this mechanism is useful in the study of PTSD treatments, since a potential hypothesis is that ketamine treatment can disrupt fear conditioning in the hippocampus (the brain area most commonly associated with memory) which is dependent on the activity of the NMDA receptor to encode a situation that we perceive as harmful. In a human double-blind controlled study of 41 patients, researchers found that ketamine was more effective than a commonly prescribed benzodiazepine at reducing the severity of PTSD symptoms. Additionally, several specific case studies corroborate that ketamine treatment was effective in reducing PTSD symptoms when traditional SSRIs failed. One such example was from a 23-year old veteran with PTSD, who had previously been prescribed SSRIs, SNRIs, TCAs (tricyclic antidepressants), valproate, as well as numerous types of psychotherapies without a consistent positive result. After a brief ketamine treatment, he showed “an immediate drastic decrease in dysphoria that led to improved functioning.”

While this new experimental treatment shows promise, there are also areas of scrutiny, mainly being that the treatment itself can sometimes cause “transient dissociation.” While this has only been documented in rare cases, it is not a minor side effect, and more research should be conducted into the efficacy of the treatment, as well as the potential off-target effects such as dissociation events that have been reported. However, no experimental medication comes without its potential downsides. While ketamine might not be the treatment option best suited for a majority of patients, it is at the very least opening the door to exploring more potential options to treat this increasingly widespread mental health disorder.

References

Liriano, Felix, et al. “Ketamine as Treatment for Post-Traumatic Stress Disorder: a Review.” Drugs in Context, vol. 8, 2019, pp. 1–7., doi:10.7573/dic.212305.

Herrold, Amya, et al. “Transcranial Magnetic Stimulation: Potential Treatment for Co-Occurring Alcohol, Traumatic Brain Injury and Posttraumatic Stress Disorders.” Neural Regeneration Research, vol. 9, no. 19, 2014, p. 1712., doi:10.4103/1673-5374.143408.

Herrold, Amy A., et al. “Alcohol Use and Craving among Veterans with Mental Health Disorders and Mild Traumatic Brain Injury.” Journal of Rehabilitation Research and Development, vol. 51, no. 9, 2014, pp. 1397–1410., doi:10.1682/jrrd.2013.07.0170.