Archive for month: December, 2023

A new study from Mass Eye and Ear investigators shows that individuals who report tinnitus, which present as a ringing in the ears in more than one out of ten adults worldwide, are experiencing auditory nerve loss that is not picked up by conventional hearing tests. This work is part of a P50 grant awarded by the National Institutes of Health (NIH) to Mass Eye and Ear researchers within the Eaton-Peabody Laboratories (EPL) for their work on cochlear synaptopathy, which is commonly referred to as “hidden hearing loss.” The results from this study provide a better understanding on the origins of tinnitus and are published November 30th in Scientific Reports.

“Beyond the nuisance of having persistent ringing or other sounds in the ears, tinnitus symptoms are debilitating in many patients, causing sleep deprivation, social isolation, anxiety and depression, adversely affecting work performance, and reducing significantly their quality of life,” said senior author Stéphane F. Maison, PhD, CCC-A, a principal investigator at Mass Eye and Ear, a member of Mass General Brigham, and clinical director of the Mass Eye and Ear Tinnitus Clinic.

“We won’t be able to cure tinnitus until we fully understand the mechanisms underlying its genesis. This work is a first step toward our ultimate goal of silencing tinnitus.”

Many individuals with hearing loss report a buzzing, humming, ringing or even roaring sound in their ears.

It’s been a longstanding idea that these symptoms, known as tinnitus, arise as a result of a maladaptive plasticity of the brain.

In other words, the brain tries to compensate for the loss of hearing by increasing its activity, resulting in the perception of a phantom sound, tinnitus.

Until recently though, this idea was disputed as some tinnitus sufferers have normal hearing tests.

However, the discovery of cochlear synaptopathy back in 2009 by Mass Eye and Ear investigators brought back to life this hypothesis as it was evidenced that patients with a normal hearing test can have a significant loss to the auditory nerve.

In view of this paradigm shift in the way researchers and clinicians think about hearing loss, Maison and his team sought to determine if such hidden damage could be associated with the tinnitus symptoms experienced by a cohort of normal hearing participants.

By measuring the response of their auditory nerve and brainstem, the researchers found that chronic tinnitus was not only associated with a loss of auditory nerve but that participants showed hyperactivity in the brainstem.

“Our work reconciles the idea that tinnitus may be triggered by a loss of auditory nerve, including in people with normal hearing,” said Maison.

In terms of future directions, the investigators aim to capitalize on recent work geared toward the regeneration of auditory nerve via the use of drugs called neurotrophins.

“The idea that, one day, researchers might be able to bring back the missing sound to the brain and, perhaps, reduce its hyperactivity in conjunction with retraining, definitely brings the hope of a cure closer to reality,” Maison added.

Reference:

Viacheslav Vasilkov, Benjamin Caswell-Midwinter, Yan Zhao, Victor de Gruttola, David H. Jung, M. Charles Liberman, Stéphane F. Maison. Evidence of cochlear neural degeneration in normal-hearing subjects with tinnitus. Scientific Reports, 2023; 13 (1) DOI: 10.1038/s41598-023-46741-5.

Treating a pregnant patient with chronic spontaneous urticaria (CSU) can be quite challenging. According to recent findings, most CSU treatments for pregnant patients involved the use of second-generation H1-antihistamines (sgAHs), while information on the safety of Omalizumab is limited.

A recent multiethnic study highlighted the potential connection between exposure to certain environmental chemicals and the prevalence of metabolic syndrome (MetS) in women. The findings of the study were published in the Journal of the Endocrine Society.

Metabolic syndrome is a group of conditions associated with an elevated risk of cardiovascular disease, includes factors like high blood pressure, elevated fasting glucose, increased triglycerides, expanded waist circumference, and low levels of high-density lipoprotein cholesterol.

This analysis focused on four classes of urinary endocrine-disrupting chemicals (EDCs), the bisphenol A (BPA), triclosan, parabens, and phthalates. The study involved 1728 women after adjusting for variables such as age, body mass index (BMI), racial and ethnic background, and breast cancer status.

The results showed that metabolic syndrome was identified in 30.0% of the women. There were no statistically significant associations between MetS and BPA, triclosan, or phthalate metabolite excretion. Also, an intriguing inverse relationship emerged with total parabens (Ptrend = .002) was noticed which indicated a potential protective effect against metabolic syndrome.

The study explored potential variations in these associations based on race, ethnicity, and BMI. While these were suggestive of inverse associations between EDCs and MetS among Latino and African American women, no statistically significant heterogeneity was detected in those with a BMI under 30 kg/m2.

The findings of this study suggest a complex interplay between environmental exposures and metabolic health, particularly among women. This inverse association observed here with parabens prompts further investigation into the potential protective role of these chemicals in the context of MetS.

Reference:

Ihenacho, U., Guillermo, C., Wilkens, L. R., Franke, A. A., Tseng, C., Li, Y., Sangaramoorthy, M., Derouen, M. C., Haiman, C. A., Stram, D. O., Le Marchand, L., Cheng, I., & Wu, A. H. (2023). Association of endocrine disrupting chemicals with the Metabolic syndrome among women in the Multiethnic Cohort Study. Journal of the Endocrine Society, 7(12). https://doi.org/10.1210/jendso/bvad136

Results from a phase II clinical trial indicate that psilocybin, a hallucinogenic chemical found in certain mushrooms of the genus Psiloybe, may benefit individuals with cancer and major depression. Trial participants treated with psilocybin not only experienced a lessening of depressive symptoms but also spoke highly of the therapy when interviewed at the end of the trial. The findings are published by Wiley in two articles appearing online in CANCER, a peer-reviewed journal of the American Cancer Society.

By binding to a specific subtype of serotonin receptor in the brain, psilocybin can cause alterations to mood, cognition, and perception. Psilocybin is currently classified as a Schedule I drug-defined as having no accepted medical use and a high potential for abuse-and is not approved by the US Food and Drug Administration for clinical use. However, multiple randomized controlled trials have demonstrated the safety and potential efficacy of psilocybin-assisted therapy-which combines psilocybin with psychological support from trained therapists-to treat major depressive disorder. Additionally, ongoing research is looking into the use of psilocybin-assisted therapy for various other mental health conditions, such as anxiety, addiction, and post-traumatic stress disorder.

In this latest phase II open-label trial involving adults with cancer and major depression, 30 participants at Sunstone Therapies in Rockville, Maryland received a single 25 mg dose of synthesized psilocybin plus a 1:1 session with a therapist and group therapy support.

“This study was differentiated by its group approach. Cohorts of 3-4 patients were simultaneously treated with 25 mg of psilocybin in adjacent rooms open at the same time, in a 1:1 therapist:patient ratio. The cohorts had preparation for the therapy as well as integration sessions following the psilocybin session as a group,” explained lead author Manish Agrawal, MD, of Sunstone Therapies.

Participants enrolled had moderate to severe depression scores at baseline. After eight weeks of treatment, Dr. Agrawal and his colleagues observed that patients’ depression severity scores dropped by an average of 19.1 points, a magnitude that would indicate the majority no longer experienced depression. Furthermore, 80% of participants experienced a sustained response to treatment, and 50% showed full remission of depressive symptoms after one week, which was sustained for eight weeks. Treatment-related side effects such as nausea and headache were generally mild.

“As an oncologist for many years, I experienced the frustration of not being able to provide cancer care that treats the whole person, not just the tumor,” said Dr. Agrawal. “This was a small, open-label study and more research needs to be done, but the potential is significant and could have implications for helping millions of patients with cancer who are also struggling with the severe psychological impact of the disease.”

Dr. Agrawal is also the senior author of a second study led by Yvan Beaussant, MD, MSc, of Dana-Farber Cancer Institute that gathered input from patients in the trial during exit interviews. Participants described generally positive experiences. In terms of safety, they noted that being a part of the group calmed their fears and increased their sense of preparedness to engage in therapy. Regarding therapeutic efficacy, they felt that being connected to the group deepened and enriched their experience, ultimately contributing to their experience of self-transcendence and compassion for one another. Also, the use of both individual and group sessions was found to support the therapy in different ways. For example, the implementation of individual and group sessions allowed the therapy to remain an intimate introspective process while adding a sense of “togetherness” to it.

“As a hematologist and palliative care physician and researcher, it was profoundly moving and encouraging to witness the magnitude of participants’ improvement and the depth of their healing journey following their participation in the trial. Participants overwhelmingly expressed positive sentiments about their experience of psilocybin-assisted therapy while emphasizing the importance of the supportive, structured setting in which it took place,” said Dr. Beaussant. “Many described an ongoing transformative impact on their lives and well-being more than two months after having received psilocybin, feeling better equipped to cope with cancer and, for some, end of life.”

Before this intervention is implemented into clinical practice, additional studies should include larger numbers of patients, along with a control arm to compare its effects with other treatments or placebo.

Reference:

Manish Agrawal, William Richards, Yvan Beaussant, Sarah Shnayder, Rezvan Ameli, Kimberly Roddy, Norma Stevens, Brian Richards, Nick Schor, Betsy Jenkins, Mark Bates, Psilocybin-assisted group therapy in patients with cancer diagnosed with a major depressive disorder, Cancer, https://doi.org/10.1002/cncr.35010.

UK: A recent study published in Neurology, the medical journal of the American Academy of Neurology, has revealed that the regularity of a person’s sleep is an important factor when considering a person’s risk of dementia. 

The researchers showed that people who have very irregular sleep patterns may have a higher risk of dementia than those who have more regular sleep patterns. The study does not prove that sleep irregularity causes dementia. It only shows an association.

Sleep regularity is how consistent you are at going to sleep and waking up at the same time each day.

“Sleep health recommendations often focus on getting the recommended amount of sleep, which is seven to nine hours a night, but there is less emphasis on maintaining regular sleep schedules,” said study author Matthew Paul Pase, PhD of Monash University in Melbourne, Australia. “Our findings suggest the regularity of a person’s sleep is an important factor when considering a person’s risk of dementia.”

The study involved 88,094 people with an average age of 62 in the United Kingdom. They were followed for an average of seven years.

Participants wore a wrist device for seven days that measured their sleep cycle. Researchers then calculated the regularity of participants’ sleep. They determined the probability of being in the same sleep state, asleep or awake, at any two time points 24 hours apart, averaged over seven days. A person who sleeps and wakes at the exact same times each day would have a sleep regularity index of 100, while a person who sleeps and wakes at different times every day would have a score of zero.

Researchers then looked at medical data to identify which participants developed dementia and found 480 people developed the disease.

Researchers found links between sleep regularity scores and risk of dementia. Compared to those with an average sleep regularity index, the risk of dementia was highest for people who had the most irregular sleep.

People in the lowest fifth percentile had the most irregular sleep with an average score of 41. Those in the highest 95th percentile had the most regular sleep with an average score of 71. People between these two groups had an average sleep regularity score of 60.

After adjusting for age, sex and genetic risk of Alzheimer’s disease, researchers found that those with the most irregular sleep were 53% more likely to develop dementia than people in the middle group. For people with the most regular sleep, researchers found they did not have a lower risk of developing dementia than people in the middle group.

“Effective sleep health education combined with behavioral therapies can improve irregular sleep patterns,” Pase said. “Based on our findings, people with irregular sleep may only need to improve their sleep regularity to average levels, compared to very high levels, to prevent dementia. Future research is needed to confirm our findings.”

Pase said that although they adjusted for several factors that can affect the risk of dementia, they cannot rule out that another unknown factor may play a role in the association between sleep regularity and dementia.