Archive for category University Of California San Francisco

Artery Disease Linked to Depression


Artery Disease Linked to DepressionA new research study has discovered that peripheral artery disease often accompanies depression.

Researchers at the San Francisco VA Medical Center and the University of California, San Francisco, discovered the relationship during a study of more than one thousand men and women with heart disease.

Peripheral artery disease (PAD) is a circulatory problem in which blood flow is reduced to the extremities – usually the legs and feet. Blood flow is reduced because of arterial narrowing with the condition often resulting in pain, reduced mobility and, in extreme cases, gangrene and amputation.

The study may be found online in the Journal of the American Heart Association.

Researchers followed men and women with coronary artery disease over a seven-year period. The 1,024 participants were members of the Heart and Soul Study.

“We discovered that there was an association between depression and PAD at baseline, and also found that the patients who were depressed at the beginning of the study had a higher likelihood of developing PAD during follow-up at seven years,” said Marlene Grenon, M.D., C.M., a vascular surgeon at UCSF.

“These findings add to the growing body of research showing the importance of depression in both the development and progression of PAD,” said senior author Beth Cohen, M.D., M.A.S. “This also emphasizes the need for medical providers to be attentive to the mental health of their patients who have developed, or who are at risk for, PAD.”

Researchers discovered that some of the risk for PAD was associated with modifiable risk factors such as smoking and reduced physical activity.

“We still don’t know which comes first,” said Grenon. “Is it that patients with PAD become depressed because their mobility is impaired, or that people who are depressed engage in unhealthy behaviors such as smoking and lack of exercise, and are thus more at risk of developing PAD? Or might it be a vicious cycle, where one leads to the other?”

Further research is needed to tease out cause and effect, she said.

Researchers believe that whatever the initial cause, improving healthy habits such as being more physically active, eating better, quitting smoking and improving stress management might reduce both PAD and depression.

“These lifestyle changes would be considered healthy for anyone, and would also help overall cardiovascular health,” said Grenon.

“As providers, we can help patients recognize the connections between mental and physical health,” added Cohen.

“This may help reduce the stigma of mental health diagnosis and encourage patients to seek treatment for problems such as depression.”

Source: University of California – San Francisco

Abstract of man’s heart photo by shutterstock.

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Increased Dopamine Can Reduce Impulsivity


Increased Dopamine Can Reduce ImpulsivityResearchers have discovered that elevating the level of the neurotransmitter dopamine in the frontal lobe of the brain can significantly decrease impulsivity in healthy adults.

The finding is important as impulsiveness is a risk factor for substance abuse.

“Impulsivity is a risk factor for addiction to many substances, and it has been suggested that people with lower dopamine levels in the frontal cortex tend to be more impulsive,” said lead author Andrew Kayser, Ph.D.

Researchers from the Ernest Gallo Clinic and Research Center at the University of California, San Francisco performed a double-blinded placebo study. The study has been published in the Journal of Neuroscience.

In the research, 23 adult research participants were given either tolcapone, a medication approved by the Food and Drug Administration (FDA) that inhibits a dopamine-degrading enzyme, or a placebo.

Investigators then gave the participants a task that measured impulsivity, asking them to make a hypothetical choice between receiving a smaller amount of money immediately (“smaller sooner”) or a larger amount at a later time (“larger later”).

Each participant was tested twice, once with tolcapone and once with placebo.

More impulse (at baseline) participants were more likely to choose the less impulsive “larger later” option after taking tolcapone than they were after taking the placebo.

Magnetic resonance imaging conducted while the participants were taking the test confirmed that regions of the frontal cortex associated with decision-making were more active in the presence of tolcapone than in the presence of placebo.

“To our knowledge, this is the first study to use tolcapone to look for an effect on impulsivity,” said Kayser.

The study is a proof-in-concept investigation and was not designed to investigate the reasons that reduced dopamine is linked with impulsivity.

However, explained Kayser, scientists believe that impulsivity is associated with an imbalance in dopamine between the frontal cortex, which governs executive functions such as cognitive control and self-regulation, and the striatum, which is thought to be involved in the planning and modification of more habitual behaviors.

“Most, if not all, drugs of abuse, such as cocaine and amphetamine, directly or indirectly involve the dopamine system,” said Kayser.

“They tend to increase dopamine in the striatum, which in turn may reward impulsive behavior. In a very simplistic fashion, the striatum is saying ‘go,’ and the frontal cortex is saying ‘stop.’ If you take cocaine, you’re increasing the ‘go’ signal, and the ‘stop’ signal is not adequate to counteract it.”

Kayser and his research team plan a follow-up study of the effects of tolcapone on drinking behavior.

“Once we determine whether drinkers can safely tolerate this medication, we will see if it has any effect on how much they drink while they’re taking it,” said Kayser.

Currently, Tolcapone is approved as a medication for Parkinson’s disease — a disease in which a chronic deficit of dopamine inhibits movement.

Source: University of California – San Francisco

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