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Tag: Hyperactivity

  • UC Riverside professor receives NIH grant for neurodevelopmental disorder study

    UC Riverside professor receives NIH grant for neurodevelopmental disorder study

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    Iryna Ethell, a professor of biomedical sciences in the School of Medicine at the University of California, Riverside, has been awarded a five-year grant of $2.4 million from the National Institutes of Health to study mechanisms of hyperexcitability and seizures in neurodevelopmental disorders such as such as attention-deficit/hyperactivity disorder and autism.

    In this project we will address critical gaps in our knowledge, such as what role do astrocytes play in inhibitory synapse development in the hippocampus. We expect our work will lead to the development of novel therapeutic targets to treat neurodevelopmental disorders, including autism spectrum disorder, schizophrenia, and epilepsy.”

    Iryna Ethell, professor of biomedical sciences, School of Medicine, University of California, Riverside

    Astrocytes are star-shaped cells in the brain that are actively involved in brain function. They regulate synaptic connections between neurons. Each neuron in the brain receives numerous excitatory and inhibitory synaptic inputs. The balance between excitation and inhibition in neuronal circuits can play a role in causing many neurological disorders.

    Ethell’s lab has studied a protein called ephrin-B1, which spans the membrane surrounding the cell and plays a role in maintaining the nervous system. Preliminary findings from her lab show that loss of astrocytic ephrin-B1 increases susceptibility to seizures and reduces sociability in mice. 

    EphB receptor signaling is a cellular pathway that regulates many developmental processes and is necessary for distributing and organizing synapses. Ethell explained that ephrin-B/EphB receptor signaling in the brain controls the development of inhibitory networks, that control brain excitability in a timely and special manner to ensure orderly brain functions and preventing seizures. 

    “If you compare the brain to driving a car, your excitatory network is a gas pedal that initiates the brain responses, but inhibitory networks are the brakes to ensure it does not crash,” Ethell said.

    The research will use mouse models as well as state-of-art analysis and imaging approaches.

    “We think this project will further our understanding of the mechanisms which lead to neurodevelopmental disorders and will allow us to discover novel interventions for treating these disorders by fixing abnormal inhibitory networks,” Ethell said.

    Source:

    University of California – Riverside

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  • Understanding giggle incontinence: Causes, symptoms, and management

    Understanding giggle incontinence: Causes, symptoms, and management

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    A recent review published in the journal Pediatric Research discusses the historical background and current understanding of giggle incontinence, which is a bladder storage disorder.

    Study: Giggle incontinence: a scoping review. Image Credit: Pavlova Yuliia / Shutterstock.com

    What is giggle incontinence?

    Giggle incontinence is a type of daytime urinary incontinence characterized by uncontrollable episodes of urinary incontinence due to loud, powerful, or bursting laughter. Unlike enuresis, stress urinary incontinence, non-neurogenic voiding dysfunction, bladder and bowel dysfunction, or anatomical disorders causing incontinence, giggle incontinence lacks additional functional symptoms.

    Historically, giggle incontinence has been mistaken for stress urinary incontinence and an overactive bladder. Moreover, giggle incontinence has been considered a particular type of laughter-induced daytime urinary incontinence that can be distinguished from laughter-induced stress urinary incontinence by its specific feature of complete emptying of the bladder.

    The exact etiology of giggle incontinence is not fully understood. However, two main hypotheses indicate the involvement of the central nervous system and dysfunction of the detrusor and pelvic floor muscles.

    The authors of the current review systematically searched various scientific databases and identified 26 studies on giggle incontinence published between 1959 and 2023. These studies were assessed to describe the historical background, current understanding, and challenges associated with giggle incontinence.   

    Different types of urinary incontinence in children

    Various terminologies have been used to describe giggle incontinence, including micturition induced by giggling, ambivalent laughter micturition, and enuresis risoria. To better understand giggle incontinence and develop appropriate treatments, it is important to distinguish the clinical consequences of giggle incontinence from those associated with stress urinary incontinence and an overactive bladder.

    According to the International Children’s Continence Society (ICCS), stress urinary incontinence is characterized by the involuntary loss of urine due to activities that increase intra-abdominal pressure, such as sneezing, coughing, or laughter. Current estimates indicate that stress urinary incontinence affects 8-19% of children.

    An overactive bladder is characterized by minor and frequent micturition, as well as other symptoms, including urgency, pollakiuria, and incontinence. This condition affects 5-12% of children.   

    ICCS describes giggle incontinence as a rare disorder marked by significant voiding during or after laughter, while bladder function remains normal in its absence. The condition is characterized by laughter-induced uncontrollable urine loss that cannot be stopped until the bladder is completely emptied. However, the condition is not associated with any concurrent urological disorders.    

    By analyzing 26 studies that reported a total of 351 giggle incontinence cases since 1959, giggle incontinence primarily affects females, with some cases reporting a family history of this condition. Giggle incontinence primarily affects children over five years of age and often improves or disappears with age.

    Pathophysiology

    A widely accepted hypothesis on the pathogenesis of giggle incontinence indicates the involvement of the central nervous system, similar to cataplexy, which is the loss of voluntary muscle control. Laughter acts as a stimulus to induce hypotonia and relaxation of pelvic floor muscles, thereby leading to uncontrolled micturition.

    Mechanistic evidence links cataplexy with type 1 narcolepsy-associated laughter-induced muscle weakness. Most patients with type 1 narcolepsy are positive for the human leukocyte antigen HLA-DQB1*06:02, which may contribute to the familial tendency observed in some giggle incontinence patients.

    Attention-deficit hyperactivity disorder (ADHD) is a common condition observed in about 23% of giggle incontinence patients. Existing evidence also links giggle incontinence pathogenesis with pelvic floor muscle dysfunction, as the proper functioning of these muscles is required for the closing of vaginal, urethral, and anal sphincters in response to increased intra-abdominal pressure. It has also been hypothesized that laughter-induced instability of the detrusor muscle can lead to giggle incontinence.

    Diagnosis

    A detailed voiding history is crucial for diagnosing diverse forms of daytime urinary incontinence. This will typically include a detailed patient history, maintenance of a voiding diary, analysis of urinary tract infection history, evaluation of toileting positions, and thorough physical examination of the abdominal, genital, and lumbosacral regions.

    These procedures should be combined with lower urinary tract ultrasound, voiding residual analysis, and electromyographic flowmetry for an accurate diagnosis of lower urinary tract dysfunction. However, these examinations often provide normal results in patients with giggle incontinence.  

    Existing evidence highlights a connection between giggle incontinence and overactive bladder waves. However, urodynamic studies have defined overactive bladder waves as sensitive hyperactive waves, whereas giggle incontinence waves are considered asymptomatic hyperactive waves. Laughter-induced asymptomatic hyperactive waves may justify the urgent and spontaneous urination in giggle incontinence patients and distinguish it from the sensitive hyperactivity waves observed in overactive bladder.

    Treatment

    Medications that are commonly used to treat neurodynamic lower urinary tract disorders include anticonvulsants, antidepressants, anticholinergics, α-adrenergic blockers, and electric shocks. Three therapies are currently being used to control incontinence, including standard urotherapy, biofeedback, and methylphenidate.

    Previous studies have shown that six-month standard urotherapy can partially improve giggle incontinence in 33% of patients; however, this therapy failed to cure the condition. Patients who are unresponsive to standard urotherapy are typically advised to undergo specific urotherapy.

    Studies using biofeedback for giggle incontinence patients have reported an efficacy rate of 73% after ten weeks of weekly sessions. Patients are often advised to continue biofeedback training alone or in combination with methylphenidate once continence is achieved.

    Methylphenidate is a central nervous system stimulant that acts by influencing urethral smooth muscles and increasing dopamine activity in the brain. Methylphenidate has been found to completely resolve giggle incontinence symptoms in patients; however, the treatment may cause adverse side effects in some patients, including insomnia, tachycardia, hypertension, anorexia, weight loss, abdominal pain, headache, irritability, agitation, or anxiety.  

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  • Parenting strategies may mitigate ADHD development in exuberant kids

    Parenting strategies may mitigate ADHD development in exuberant kids

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    Parents of young children with an excitable or exuberant temperament could adapt their parenting style to help moderate their child’s potential development of Attention Deficit/Hyperactivity Disorder (ADHD), according to a new study co-authored by a University of Waterloo researcher. 

    Developmental psychologists know that temperament, parenting, and the brain’s executive functions are interconnected factors in developing ADHD symptoms throughout childhood. But, the study found specific factors that predict a higher chance of ADHD symptoms, pointing to the importance of early targeted intervention.

    A collection of early traits we call exuberance in child temperament, such as high excitement, curiosity and positive responses to unfamiliar people and contexts, combined with family factors might predispose some kids to develop ADHD symptoms.”


    Dr. Heather Henderson, professor in developmental psychology at Waterloo and co-author of the study

    “This work demonstrates that parents can really help break down the pathways that lead to ADHD through more directive and engaged parenting behaviours, such as guiding the child with verbal and physical cues as they encounter new situations.” 

    While exuberance in pre-schoolers can be very positive, research shows exuberant children can also have difficulty with self-regulation and executive functions, such as working memory and flexible thinking.

    Following 291 children from just four months of age to 15 years, the researchers observed child temperament and parent-child interactions at three years, assessed the child’s executive functioning at four years, and analyzed parent-reported ADHD symptoms six times between ages five and 15. The study determined that temperament and parenting work together to impact a child’s developing executive functions.

    The findings suggest that ADHD symptoms increase throughout childhood when a child shows early exuberant temperament, low to normal executive functions, and receives less directive and engaged parenting as the young child navigates new situations.

    “Symptoms of ADHD typically stabilize from ages five to nine and decrease from ages nine to 15. But for predictable cases of very young children with exuberant temperament and less directive parenting, that stabilization may not occur,” Henderson said. 

    “More directive parenting, which is not controlling but guides the child with verbal and physical cues, can help develop the child’s self-regulatory skills and prevent their ADHD symptoms from increasing.”

    Source:

    Journal reference:

    Lorenzo, N. E., et al. (2023). The Developmental Unfolding of ADHD Symptoms from Early Childhood Through Adolescence: Early Effects of Exuberant Temperament, Parenting and Executive Functioning. Research on Child and Adolescent Psychopathology. doi.org/10.1007/s10802-023-01140-2.

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  • Interpersonal distrust from childhood bullying linked to mental health problems in teens

    Interpersonal distrust from childhood bullying linked to mental health problems in teens

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    A new study, co-led by UCLA Health and the University of Glasgow, found that young teenagers who develop a strong distrust of other people as a result of childhood bullying are substantially more likely to have significant mental health problems as they enter adulthood compared to those who do not develop interpersonal trust issues.

    The study, published in the journal Nature Mental Health on Feb. 13, is believed to be the first to examine the link between peer bullying, interpersonal distrust, and the subsequent development of mental health problems, such as anxiety, depression, hyperactivity and anger.

    Researchers used data from 10,000 children in the United Kingdom who were studied for nearly two decades as part of the Millennium Cohort Study. From these data, the researchers found that adolescents who were bullied at age 11 and in turn developed greater interpersonal distrust by age 14 were around 3.5 times more likely to experience clinically significant mental health problems at age 17 compared to those who developed less distrust.

    The findings could help schools and other institutions to develop new evidence-based interventions to counter the negative mental health impacts of bullying, according to the study’s senior author Dr. George Slavich, who directs UCLA Health’s Laboratory for Stress Assessment and Research.

    There are few public health topics more important than youth mental health right now. In order to help teens reach their fullest potential, we need to invest in research that identifies risk factors for poor health and that translates this knowledge into prevention programs that can improve lifelong health and resilience.”


    Dr. George Slavich,  study’s senior author

    The findings come amid growing public health concerns about the mental health of youth. Recent studies by the U.S. Centers for Disease Control and Prevention found that 44.2% of sampled high school students in the U.S. reported being depressed for at least two weeks in 2021, with one in 10 students who were surveyed having reported attempted suicide that year.

    In this new study, the researchers viewed these alarming trends from the perspective of Social Safety Theory, which hypothesizes that social threats, such as bullying, impact mental health partly by instilling the belief that other people cannot be trusted, or that the world is an unfriendly, dangerous or unpredictable place.

    Prior research has identified associations between bullying and mental and behavioral health issues among youth, including its impact on substance abuse, depression, anxiety, self-harm and suicidal thoughts. However, following youth over time, this study is the first to confirm the suspected pathway of how bullying leads to distrust and, in turn, mental health problems in late adolescence.

    Slavich said when people develop clinically significant mental health problems during the teenage years, it can increase their risk of experiencing both mental and physical health issues across the entire lifespan if left unaddressed.

    In addition to interpersonal distrust, the authors examined if diet, sleep or physical activity also linked peer bullying with subsequent mental health problems. However, only interpersonal distrust was found to relate bullying to greater risk of experiencing mental health problems at age 17.

    “What these data suggest is that we really need school-based programs that help foster a sense of interpersonal trust at the level of the classroom and school,” Slavich said. “One way to do that would be to develop evidence-based programs that are especially focused on the transition to high school and college, and that frame school as an opportunity to develop close, long-lasting relationships.”

    The study was co-authored by Dr. George Slavich, Professor of Psychiatry and Biobehavioral Sciences at UCLA, and Dr. Dimitris Tsomokos, a researcher at the University of Glasgow.

    Source:

    University of California – Los Angeles Health Sciences

    Journal reference:

    Tsomokos, D. I., & Slavich, G. M. (2024). Bullying fosters interpersonal distrust and degrades adolescent mental health as predicted by Social Safety Theory. Nature Mental Health. doi.org/10.1038/s44220-024-00203-7.

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  • Nutritional epigenetics education reduces ultra-processed food intake in parents of children with autism and ADHD

    Nutritional epigenetics education reduces ultra-processed food intake in parents of children with autism and ADHD

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    In a recent publication released by PubMed, American scientists led by Dr. Dufault at the Food Ingredient and Health Research Institute, reported the results of a clinical trial in which parents who received nutritional epigenetics education significantly reduced their consumption of ultra-processed foods while increasing their intake of whole and/or organic foods. The education intervention used curriculum focused on the constructs of the nutritional epigenetics model that explains how autism and attention deficit/hyperactivity disorder (ADHD) may develop from the excess consumption of ultra-processed foods.

    Consumption of ultra-processed foods leads to heavy metal exposures and dietary deficits that create mineral imbalances such as zinc and calcium losses. Inadequate zinc stores can disrupt the function of the metal transporter metallothionein (MT) gene preventing the elimination of heavy metals found in ultra-processed foods. The bioaccumulation of mercury and/or lead is common in children with autism and ADHD who are often zinc deficient. Mercury, lead, and other heavy metals are known to suppress the paraoxonase (PON1) gene. Paraoxonase is required by the body to detoxify the neurotoxic organophosphate pesticide residues found routinely in the food supply by the United States Department of Agriculture. Children with autism and ADHD are more susceptible to the harmful effects of organophosphate pesticide exposures.

    Parents who received nutritional epigenetics education learned how to reduce their children’s dietary exposures to heavy metal and organophosphate pesticide residues. The parents learned how to read food ingredient labels and changed their diet as they avoided buying foods with allowable heavy metal and pesticide residues. In learning how specific food ingredients contribute to heavy metal exposures, impact nutrient status and/or gene behavior, parents gained the knowledge they needed to feed themselves and their children a healthier diet. By the end of the education intervention, parents had changed their minds about their ability to control their child’s behavior through diet.

    Children behave better when they feel better. Because the severity of symptoms in autism and ADHD correlate directly to the heavy metal levels in blood, children with less heavy metal exposure show improvements in behavior and cognition. In addition, because heavy metals, in single or multi-metallic combination, create conditions for gut dysbiosis, improvements in diet can reduce inflammation and improve gut health. Reducing ultra-processed food consumption can alleviate symptoms associated with gut dysbiosis which is often a co-morbid condition found in children with autism and ADHD.

    Autism and ADHD are preventable, but the prevalence of these neurodevelopmental disorders will continue to increase in the United States until changes are made to reduce the allowable heavy metal residues in the ultra-processed food supply. The US Congress released two reports in 2021 on the problem of heavy metals in baby foods. The first report issued on February 4, 2021, revealed baby foods are tainted with dangerous levels of arsenic, lead, cadmium, and mercury. The second report, issued on September 29, 2021, confirmed new disclosures from manufacturers show dangerous levels of heavy metals in even more baby foods.

    Source:

    Food Ingredient and Health Research Institute

    Journal reference:

    Dufault, R. J., et al. (2024) Nutritional epigenetics education improves diet and attitude of parents of children with autism or attention deficit/hyperactivity disorder. World Journal of Psychiatry. doi.org/10.5498/wjp.v14.i1.159.

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