ww.care

Real Care for Wounded Warriors Foundation Inc.

Archives for April 2016

Ketamine for treatment-resistant depression: recent developments and clinical applications.

Ketamine for treatment-resistant depression: recent developments and clinical applications.

Related Articles

Ketamine for treatment-resistant depression: recent developments and clinical applications.

Evid Based Ment Health. 2016 Apr 6;

Authors: Schwartz J, Murrough JW, Iosifescu DV

Abstract

Approximately one-third of patients with major depressive disorder (MDD) do not respond to existing antidepressants, and those who do generally take weeks to months to achieve a significant effect. There is a clear unmet need for rapidly acting and more efficacious treatments. We will review recent developments in the study of ketamine, an old anaesthetic agent which has shown significant promise as a rapidly acting antidepressant in treatment-resistant patients with unipolar MDD, focusing on clinically important aspects such as dose, route of administration and duration of effect. Additional evidence suggests ketamine may be efficacious in patients with bipolar depression, post-traumatic stress disorder and acute suicidal ideation. We then discuss the safety of ketamine, in which most neuropsychiatric, neurocognitive and cardiovascular disturbances are short lasting; however, the long-term effects of ketamine are still unclear. We finally conclude with important information about ketamine for primary and secondary physicians as evidence continues to emerge for its potential use in clinical settings, underscoring the need for further investigation of its effects.

PMID: 27053196 [PubMed – as supplied by publisher]

State Policies on Service Dogs for Military Veterans.

State Policies on Service Dogs for Military Veterans.

Related Articles

State Policies on Service Dogs for Military Veterans.

NCSL Legisbrief. 2015 Dec;23(47):1-2

Authors: Reed JB

Abstract

U.S. service members returning home from combat often face physical, mental and emotional challenges. Providing service dogs to these veterans is one method being used successfully to help address the difficulties they face. Under the federal Americans with Disabilities Act (ADA), a service animal is defined as “any dog that is individually trained to do work or perform tasks for the benefit of an individual with a disability, including a physical, sensory, psychiatric, intellectual or other mental disability.” The work the dog undertakes must be directly related to the person’s disability. Examples include guiding people who are blind, pulling a wheelchair, alerting a person with hearing loss, protecting a person having a seizure, and calming someone with post-traumatic stress disorder (PTSD) during an anxiety attack or psychiatric episode.

PMID: 27032124 [PubMed – indexed for MEDLINE]

Neuroanatomical features in soldiers with post-traumatic stress disorder.

Neuroanatomical features in soldiers with post-traumatic stress disorder.

http:--http://bit.ly/26u0QXT http:--http://bit.ly/1rgTF5iRelated Articles

Neuroanatomical features in soldiers with post-traumatic stress disorder.

BMC Neurosci. 2016;17(1):13

Authors: Sussman D, Pang EW, Jetly R, Dunkley BT, Taylor MJ

Abstract

BACKGROUND: Posttraumatic stress disorder (PTSD), an anxiety disorder that can develop after exposure to psychological trauma, impacts up to 20 % of soldiers returning from combat-related deployment. Advanced neuroimaging holds diagnostic and prognostic potential for furthering our understanding of its etiology. Previous imaging studies on combat-related PTSD have focused on selected structures, such as the hippocampi and cortex, but none conducted a comprehensive examination of both the cerebrum and cerebellum. The present study provides a complete analysis of cortical, subcortical, and cerebellar anatomy in a single cohort. Forty-seven magnetic resonance images (MRIs) were collected from 24 soldiers with PTSD and 23 Control soldiers. Each image was segmented into 78 cortical brain regions and 81,924 vertices using the corticometric iterative vertex based estimation of thickness algorithm, allowing for both a region-based and a vertex-based cortical analysis, respectively. Subcortical volumetric analyses of the hippocampi, cerebellum, thalamus, globus pallidus, caudate, putamen, and many sub-regions were conducted following their segmentation using Multiple Automatically Generated Templates Brain algorithm.

RESULTS: Participants with PTSD were found to have reduced cortical thickness, primarily in the frontal and temporal lobes, with no preference for laterality. The region-based analyses further revealed localized thinning as well as thickening in several sub-regions. These results were accompanied by decreased volumes of the caudate and right hippocampus, as computed relative to total cerebral volume. Enlargement in several cerebellar lobules (relative to total cerebellar volume) was also observed in the PTSD group.

CONCLUSIONS: These data highlight the distributed structural differences between soldiers with and without PTSD, and emphasize the diagnostic potential of high-resolution MRI.

PMID: 27029195 [PubMed – in process]

Neuropsychiatric Predictors of Post-Injury Headache After Mild-Moderate Traumatic Brain Injury in Veterans.

Neuropsychiatric Predictors of Post-Injury Headache After Mild-Moderate Traumatic Brain Injury in Veterans.

http:--media.wiley.com-assets-7315-19-WiRelated Articles

Neuropsychiatric Predictors of Post-Injury Headache After Mild-Moderate Traumatic Brain Injury in Veterans.

Headache. 2016 Apr;56(4):699-710

Authors: Bomyea J, Lang AJ, Delano-Wood L, Jak A, Hanson KL, Sorg S, Clark AL, Schiehser DM

Abstract

OBJECTIVES: To determine differences in neuropsychiatric complaints between Veterans with mild to moderate traumatic brain injury (TBI), with and without headache, compared with Veteran controls, and to identify neuropsychiatric predictors of headache severity.

BACKGROUND: Mild to moderate TBI is a common occurrence in Veterans, and is frequently associated with complaints of headache. Neuropsychiatric complaints are also common among individuals who have sustained head injury, although the relationship between these factors and headache after injury is unclear. Research is needed to comprehensively determine differences between individuals with mild to moderate traumatic brain injury who differ with respect to headache, and which injury, psychological, or sleep and fatigue factors predict headache severity.

METHODS: A cross-sectional study compared 85 Veterans in three groups (positive for TBI and headache, positive for TBI without significant headache, and a control group) on a set of injury characteristics and neuropsychiatric variables. Correlates of headache severity were examined, and a regression model was used to identify significant independent predictors of headache severity.

RESULTS: Individuals with mild to moderate TBI and headache endorsed significantly greater neuropsychiatric symptoms than participants in the other groups (ηp (2)  = .23-.36) Neuropsychiatric complaints, as well as presence of posttraumatic amnesia, were correlated with headache in the subsample with TBI (rs = .44-.57). When entering all predictors into a regression model, only fatigue represented a significant independent predictor of headache severity (β = .59, R(2) = .35).

CONCLUSIONS: Rather than being a global risk factor, mild to moderate TBI was associated with poorer mental health outcomes, particularly for those who endorse headache. Findings underscore the possibility that Veterans with history of TBI who present with complaints of headache may represent a particularly vulnerable subgroup. Additionally, our findings suggest that clinical outcomes may be improved in those with neurotrauma by incorporating a focus on fatigue in treatment.

PMID: 27028095 [PubMed – in process]

Gut feeling: Research examines link between stomach bacteria, PTSD

Gut feeling: Research examines link between stomach bacteria, PTSD Could bacteria in your gut be used to cure or prevent neurological conditions such as post-traumatic stress disorder (PTSD), anxiety or even depression? Two researchers think that’s a strong possibility. (Source: ScienceDaily Headlines)