The stressed-​​out brain

Clin­ical studies of ado­les­cents suf­fering from depres­sion have shown an inter­esting con­nec­tion between early life stress and the immune system.

“Those who have expe­ri­enced child­hood trauma and adver­sity tend to have higher levels of inflam­ma­tion bio­markers in their blood,” explained Heather Bren­house, an assis­tant pro­fessor of psy­chology at North­eastern University.

Many of the emo­tional and behav­ioral prob­lems asso­ci­ated with early life stress don’t appear until ado­les­cence, she said, “so you’ve got this group of kids who will go on to be sick, but you can’t iden­tify them early.” If, how­ever, those inflam­ma­tion bio­markers are present before clin­ical prob­lems arise, then doc­tors could use them to pre­dict future mental illness.

Backed by a new grant from the National Insti­tutes of Health, Bren­house is inves­ti­gating whether such bio­markers are present in rat models that expe­ri­ence early life stress as well as how inflam­ma­tion may be linked to neural cir­cuitry prob­lems that give rise to mental ill­ness. Under­standing that con­nec­tion, she said, could reveal new treat­ment options in addi­tion to early detec­tion oppor­tu­ni­ties pro­vided by biomarkers.

In pre­vious research, Bren­house found evi­dence of inflam­ma­tion in the brains of ado­les­cent ani­mals that were sep­a­rated from their mothers during their youth. When she looked for sim­ilar evi­dence in juve­nile ani­mals, how­ever, she came up empty handed.

For her new study, Bren­house will be taking small blood sam­ples to test for cytokines—molecules released during an immune response—at var­ious points before ado­les­cence. Over time, she will closely mon­itor for signs of cog­ni­tive dis­or­ders during adolescence.

At the same time, she will inves­ti­gate how early life stress changes the brain’s neural cir­cuitry in these ado­les­cents, par­tic­u­larly focusing on iden­ti­fying how sig­nif­i­cant the role of the NR2A—of a par­tic­ular type of neu­ro­trans­mitter receptor in the pre­frontal cortex—plays in mental ill­ness caused by early life stress. These recep­tors, she said, bind a mol­e­cule called glu­ta­mate, which is impli­cated in dis­eases such as schiz­o­phrenia. In ani­mals with early life stress, the con­cen­tra­tion of NR2As is higher.

“We know that NR2A is upreg­u­lated,” she said, we just don’t know if it’s impor­tant yet.”

Brenhouse’s work will also involve ana­lyzing whether blocking inflam­ma­tion changes how these NR2A recep­tors functions.

“Our ner­vous system and our immune system are con­stantly in com­mu­ni­ca­tion, for good reason,” Bren­house said. “Think about it: when you’re sick, you need to behave dif­fer­ently.” So-​​called “sick­ness behavior,” she said, is one of the eas­iest ways to think about the con­nec­tion between the two systems.

When it comes to stress, how­ever, the story is a little more com­pli­cated. In some cases, stress acti­vates the immune system, while in others it deac­ti­vates it. “We’re trying to figure out how early life stress, in par­tic­ular, changes the devel­op­ment of the immune system and how that winds up leading to neu­roin­flam­ma­tion later on.”

Study Shows Benefit of Working Until Age 70

For generations, it’s been the accepted norm, and hope, of Americans: Stop working at 65, collect Social Security, and enjoy retirement. But a new study from the Center for Retirement Research at Boston College says following that plan will cost you financially.

“If you retire at 65, you get 70 percent of what you’d get at age 70,” says Drucker Professor of Management Sciences Alicia Munnell, director of the center. “It’s the best-kept secret in town that the way you get the highest monthly benefit from Social Security is to wait until 70, and it’s so much higher. Nobody knows that, and if we really think it’s important for people to work longer, it’d be really nice to tell them that it makes a huge difference on how much they get from Social Security.”

The report, “Social Security’s Real Retirement Age Is 70,” cites the Delayed Retirement Credit, which has gotten more generous though the years. Initially rewarding potential retirees with a 1 percent increase in monthly payments for those who retired at 66 years old instead of 65, says Munnell, the DRC was boosted in 1983 to give those who retired at 66 years old an additional 3 percent in monthly benefits, and an additional 6 percent for those who retired at 67.

“But that didn’t really compensate for the fact that you were going to get your benefit for one or two years less, and so they gradually increased that delayed retirement benefit over time to 8 percent,” says Munnell. “At 8 percent, it’s an amount such that it compensates fully for the delayed claiming.”

Munnell illustrates the point with an example, using $1,000 as the top end monthly payment at age 70: Because benefits paid before age 70 are actuarially reduced, a retiree would receive $818 at age 67, $707 at 65, and just $568 for someone who claims at age 62.  Lifetime benefits are roughly equal for any claiming age between 62 — the earliest claiming age — and 70.

“So at 62 they’re lower but you get them for eight years longer,” says Munnell. “At 70, they’re a lot higher – they’re actually 76 percent higher – but you get them for eight years less and the two offset one another perfectly. Everything in between seems irrelevant.”

Although an advocate of working later in life, Munnell is well aware it’s not possible for everyone to work until 70.

“Some people have much tougher jobs that are sometimes physically demanding. Or they have health problems. Or they face discrimination. And there are weak labor markets. So it’s hard for everybody to stay and I understand that. But for the bulk of the population, working longer is an option — they need to be told that there’s this payoff to working longer and most people don’t know it.”

Munnell says if you can’t work until 70, do whatever you can to delay tapping into your retirement benefits.

“If you can’t work until that age and you have some money in your 401(k), you should use that to support yourself until you can get to 70 because then you get the most of this monthly income,” says Munnell. “In your 60s, you can take a little extra work and do stuff on the side, and you won’t realize these benefits are so low. But when you get into your 70s, you tend to have this being your only source of income, and it’s too little if you claim that early.”

The latest CRR report comes on the heels of a study the center released last year that refuted the idea older workers were crowding out younger workers, even during the 2008 recession. Examining gender, state information, and education data and other factors, Munnell and co-author April Yanyuan Wu found nothing to support the belief that there is a fixed number of jobs – a theory known as the “lump of labor.”

“This is a forced assumption,” says Wu, a CRR research economist. “The whole ‘lump of labor’ operates on the fallacy that economies are a fixed box, that if we are adding one job in, then we are taking one job out. But the whole economy is a dynamic process, so this fixed box theory is false.”

Young workers (under 25 years old) historically have a higher unemployment rate than those in other age groups, the researchers note. Industries in which young workers are typically employed, such as manufacturing, were hit hard by the recession and its aftermath, which helped fuel the “lump of labor” explanation.

“We were worried in the shorter time period when the whole economy was in a stagnant stage if there might be some crowding out, but we found none,” Wu says. “When the economy is good, there are more opportunities for both the older and the young. When the economy is good, wages increase as well — that happens to both age groups. But there’s no crowding out.”

Mind over matter – or mind over body – can give you an edge

“Move it. Feel it. Don’t give up!” You can coach yourself through the burn with your own pep talk.

Exercising is hard, but tell yourself it feels good, and you might just start to believe it, new research shows.

The research revealed that mentally and verbally encouraging yourself while exercising can keep you going longer and make you think a difficult workout is easier.

Study authors in England and the Netherlands asked 24 people to bike for as long as they could and then rate their level of effort from one to 10. Two weeks later, the group did the same thing but with one change – positively encouraging themselves while cycling, whether aloud or in their heads.

The American College of Sports Science published the study recently online in the journal Medicine and Science in Sports and Exercise.

Using self-motivation, they biked longer and rated their effort level as lower, even though their heart rates revved up the same as before, meaning the exercise felt easier even though it was more arduous. But this doesn’t mean pushing through the pain, a practice that takes a toll on even professional athletes.

In today’s “push yourself” workout culture, it’s easy to blur the line between working hard and going too far. And trainers, instructors and fitness enthusiasts are questioning the benefits of exercising to exhaustion.

CrossFit, a popular endurance training program, is a favorite target of critics, who point to the number of CrossFitters giving themselves Rhabdomyolysis, a serious condition when muscle fiber is released into the blood stream, causing kidney damage, as evidence.

“CrossFit is a very great methodology. There are a lot of really great things going on in the CrossFit community,” says former CrossFit instructor Lina Belkin, now a personal trainer at Chicago-based Barre Bee Fit. “The danger – not just with CrossFit but with anything that’s taking you to the extreme – is that you really have to listen to your body,” Belkin says.

Belkin’s fellow Barre Bee Fit instructor Madeline Franke says that part of listening to your body means knowing pain from burn.

“You can tell the difference between a good hurt and a bad hurt,” Franke says. “A good hurt is a deep, intense burning feeling in your muscle. A bad hurt is a sharp pain, which could be a muscle being pulled or a joint out of place.

“A lot of times the muscle will start to shake, start to quiver, and that’s a good thing,” Franke says. “That’s something we want because your muscle is changing shape.”

But recognizing pain from hard work isn’t easy because “most of us are really disconnected from our bodies,” Belkin says. Stop when you feel yourself pushing through the pain, she advises.

“I’m a victim of it myself,” Belkin says. “It’s really easy to throw form to the side, throw technique to the side, just because I wanted to win. Just because I wanted to be the best.”

When athletes are tired, they’re more likely throw form out the window and open themselves up to a higher chance for injury, Belkin says. She uses the example of blowing out a knee from poor form, lifting too heavy or rushing through squat repetitions.

“When you start doing things weird with your form because your body’s getting tired, that’s our opportunity as an instructor to say, ‘Listen, this isn’t about how many you can do, this is about making sure your repetitions are quality repetitions,’” Belkin says.

But it’s up to athletes to hold themselves accountable, both by pushing and also limiting themselves.

“There’s a difference between your mind being lazy like, ‘Oh this is hard, I don’t want to do it,” versus, ‘This is really hurting me,’” Belkin says.

So next time you want to give up, just ask yourself, are you tired or are you in pain? If it’s the former, being your own cheerleader may just keep you going.

Age changes how young children read social cues

From infancy, children learn by watching and imitating adults. Even when adults show them how to open a latch or solve a puzzle, for example, children use social cues to figure out what actions are important. But children read these cues differently depending on their age: Older children, interestingly, are more likely, not less likely, to faithfully imitate actions unnecessary to the task at hand, reports Cornell research.

The findings imply that children of different ages have different expectations when they watch and learn from adults, based on their growing social understanding, say authors Yue Yu, graduate student in the field of human development, and Tamar Kushnir, the Evalyn Edwards Milman Assistant Professor of Child Development in the College of Human Ecology, in a study published online in Developmental Psychology (Aug. 26) ahead of print.

“Understanding what causes children to imitate in any given situation, and especially to imitate actions that seem to have no obvious purpose, sheds light on how children’s minds work and what influences their learning,” Kushnir said.

To explore how age and social context influence children’s imitation behavior, the researchers conducted two experiments with 2- and 4-year-olds. In one, children played one of three games with the experimenter (copying the experimenter’s hand gestures, taking turns to find and fit a puzzle piece, or a non-interactive drawing game). Then, they played a puzzle-box game after watching the experimenter show two actions on the toy and retrieve a puzzle piece. In half the trials, only the second action was necessary to recover the puzzle piece.

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The researchers found that the 4-year-olds faithfully imitated both necessary and unnecessary actions to get the puzzle piece, regardless of the game they played beforehand; 2-year-olds, however, were heavily influenced by the context set up by the prior game. They were more likely to faithfully imitate unnecessary actions after playing the copying game and more likely to selectively emulate just the necessary action after playing the puzzle-solving game.

A second experiment ruled out the possibility that the 2-year-olds were merely primed to copy anyone – their strategies were not influenced by the copy game when they played it with a different experimenter. This suggests that toddlers in the first experiment were actively engaged in a social interaction with a particular individual from which they inferred goals for the following game, Yu and Kushnir concluded. Their findings underscore the important role that children’s developing social knowledge plays in what and how they learn, they said.

When toddlers watch adults, what they pay attention to and imitate appears highly dependent on the context and expectations set up by the adult, and this points to the importance of establishing rapport before trying to teach them something, said Yu.

Preschoolers, on the other hand, are more likely to view all adult’s purposeful actions as part of the social interaction, perhaps even as social norms, and thus imitate them as faithfully as possible. This enables imitation to be a source, not just for learning about objects (e.g., how a latch works), but for rich and accurate cultural transmission, Yu added.

Or for embarrassment, depending on what you just demonstrated in front of your preschooler.

The study, “Social Context Effects in 2- and 4-year-olds’ Selective Versus Faithful Imitation,” was supported in part by the National Science Foundation.

Menstrual Cycle Influences Concussion Outcomes

Researchers found that women injured during the two weeks leading up to their period (the premenstrual phase) had a slower recovery and poorer health one month after injury compared to women injured during the two weeks directly after their period or women taking birth control pills.

The University of Rochester study was published today in the Journal of Head Trauma Rehabilitation. If confirmed in subsequent research, the findings could alter the treatment and prognosis of women who suffer head injuries from sports, falls, car accidents or combat.

Several recent studies have confirmed what women and their physicians anecdotally have known for years: Women experience greater cognitive decline, poorer reaction times, more headaches, extended periods of depression, longer hospital stays and delayed return-to-work compared to men following head injury. Such results are particularly pronounced in women of childbearing age; girls who have not started their period and post-menopausal women have outcomes similar to men.

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Few studies have explored why such differences occur, but senior author Jeffrey J. Bazarian, M.D., M.P.H.says it stands to reason that sex hormones such as estrogen and progesterone, which are highest in women of childbearing age, may play a role.

“I don’t think doctors consider menstrual history when evaluating a patient after a concussion, but maybe we should,” noted Bazarian, associate professor of Emergency Medicine at the University of Rochester School of Medicine and Dentistry who treats patients and conducts research on traumatic brain injury and long-term outcomes among athletes. “By taking into account the stage of their cycle at the time of injury we could better identify patients who might need more aggressive monitoring or treatment. It would also allow us to counsel women that they’re more – or less – likely to feel poorly because of their menstrual phase.”

Although media coverage tends to focus on concussions in male professional athletes, studies suggest that women have a higher incidence of head injuries than men playing sports with similar rules, such as ice hockey, soccer and basketball. Bazarian estimates that 70 percent of the patients he treats in the URMC Sport Concussion Clinic are young women. He believes the number is so high because they often need more follow-up care. In his experience, soccer is the most common sport leading to head injuries in women, but lacrosse, field hockey, cheerleading, volleyball and basketball can lead to injuries as well.

Sex hormone levels often change after a head injury, as women who have suffered a concussion and subsequently missed one or more periods can attest. According to Kathleen M. Hoeger, M.D., M.P.H., study co-author and professor of Obstetrics and Gynecology at the University of Rochester School of Medicine and Dentistry, any stressful event, like a hit to the head, can shut down the pituitary gland in the brain, which is the body’s hormone generator. If the pituitary doesn’t work, the level of estrogen and progesterone would drop quickly.

According to Bazarian, progesterone is known to have a calming effect on the brain and on mood. Knowing this, his team came up with the “withdrawal hypothesis”: If a woman suffers a concussion in the premenstrual phase when progesterone levels are naturally high, an abrupt drop in progesterone after injury produces a kind of withdrawal which either contributes to or worsens post concussive symptoms like headache, nausea, dizziness and trouble concentrating. This may be why women recover differently than men, who have low pre-injury levels of the hormone.

Hoeger and Bazarian tested their theory by recruiting144 women ages 18 to 60 who arrived within four hours of a head hit at five emergency departments in upstate New York and one in Pennsylvania. Participants gave blood within six hours of injury and progesterone level determined the menstrual cycle phase at the time of injury. Based on the results, participants fell into three groups: 37 in the premenstrual/high progesterone group; 72 in the low progesterone group (progesterone is low in the two weeks directly after a period); and 35 in the birth control group based on self-reported use.

One month later, women in the premenstrual/high progesterone group were twice as likely to score in a worse percentile on standardized tests that measure concussion recovery and quality of life – as defined by mobility, self-care, usual activity, pain and emotional health – compared to women in the low progesterone group. Women in the premenstrual/high progesterone group also scored the lowest (average 65) on a health rating scale that went from 0, being the worst health imaginable, to 100, being the best. Women in the birth control group had the highest scores (average 77).

“If you get hit when progesterone is high and you experience a steep drop in the hormone, this is what makes you feel lousy and causes symptoms to linger,” said Bazarian. “But, if you are injured when progesterone is already low, a hit to the head can’t lower it any further, so there is less change in the way you feel.”

The team suspected that women taking birth control pills, which contain synthetic hormones that mimic the action of progesterone, would have similar outcomes to women injured in the low progesterone phase of their cycle. As expected, there was no clear difference between these groups, as women taking birth control pills have a constant stream of sex hormones and don’t experience a drop following a head hit, so long as they continue to take the pill.

“Women who are very athletic get several benefits from the pill; it protects their bones and keeps their periods predictable,” noted Hoeger. “If larger studies confirm our data, this could be one more way in which the pill is helpful in athletic women, especially women who participate in sports like soccer that present lots of opportunities for head injuries.”

In addition to determining menstrual cycle phase at the time of injury, Bazarian plans to scrutinize a woman’s cycles after injury to make sure they are not disrupted. If they are, the woman should make an appointment with her gynecologist to discuss the change.

The study was funded by the New York State Department of Health, the Academic Health Center Consortium and the Emergency Research Network of the Empire State (ERNIES). ERNIES is supported by the Pilot Research Collaborative Program of the Foundation for Healthy Living, the University of Rochester’s Clinical and Translational Science Award, the Upstate New York Translational Research Network (UNYTRN) and the Upstate New York Consortium for Healthcare Research and Quality (UNYCHRQ). University of Rochester medical student and lead author Kathryn Wunderle and doctoral candidate Erin Wasserman contributed to the research.....