NSBRI, Sep. 26, 2008 — Self-guided treatment for depression could soon be only a mouse click away.

Scientists with the National Space Biomedical Research Institute (NSBRI) are developing an interactive, multi-media program that will assist astronauts in recognizing and effectively managing depression and other psychosocial problems, which can pose a substantial threat to crew safety and mission operations during long-duration spaceflights.

Even though the depression treatment is under development for NASA, project leader Dr. James Cartreine said it could be spun off for use on Earth.

“This project has great potential as a self-guided treatment for many people,” said Cartreine, a member of NSBRI’s Neurobehavioral and Psychosocial Factors Team. “Depression is the number one cause of disability days in the United States, but it’s not only about days lost. Depression also results in presenteeism – showing up for work but not really working.”

The depression treatment is part of the Virtual Space Station, a multi-media program that addresses multiple types of potential psychosocial problems and can be used for training before, and for assistance during, missions. Other problems being addressed via the Virtual Space Station include interpersonal conflict, and stress and anxiety.

Cartreine, a Harvard Medical School research psychologist based in the Division of Clinical Informatics at Beth Israel Deaconess Medical Center in Boston, said the Virtual Space Station will make effective therapeutic depression treatment more easily accessible to astronauts aboard the International Space Station and proposed missions to the moon and Mars. Currently, astronauts have audio and video access to psychologists only when communication links are available.

Project co-investigator and former astronaut Dr. Jay Buckey said long-duration spaceflight can be tough on astronauts. “While astronauts are not particularly prone to psychological problems, the environment is very demanding,” Buckey said. “On a mission, they face a lot of challenges that could lead to depression.”

Buckey, a professor and physician at Dartmouth Medical School, said the depression module and other aspects of the Virtual Space Station are based upon proven methods. “These are unique NSBRI products that did not exist before,” Buckey said. “The Virtual Space Station is based on proven treatment programs and is a very helpful way to work on problems in general.”

The system’s multi-media approach for depression includes graphics and video featuring a psychologist who leads the user through a straightforward process called Problem-Solving Treatment. The system provides feedback based upon the information provided when answering a series of questions.

The first step of the process is to make a problem list and select a problem on which to work. The second and third steps are setting goals and brainstorming ways to reach them. The final two steps are assessing the pros and cons of possible solutions and making an action plan to implement them. The program also helps users plan and schedule enjoyable activities, which people who have depression often stop doing. Additionally, the program provides preventative and educational information on depression.

Cartreine and Buckey, who received input from 29 current and former astronauts while designing the Virtual Space Station, said some of the system’s other benefits include its portability and privacy. “It can be delivered to the International Space Station on a flash drive and run directly from that drive, so that the astronaut has complete control over his or her data,” Cartreine said. “The system is private and secure. The user is the only one who can share the information with others.”

An early version of the depression treatment system was beta-tested on research stations in Antarctica, which is used as an analog to long-duration spaceflights due to its isolation from the rest of the world, length of stay and team composition. Cartreine said feedback from that early test run has been positive, and a clinical evaluation of the latest version on 68 Boston-area volunteers is about to begin.

“We plan to study the program’s ability to treat depression,” he said. “We are looking for people who are similar to astronauts, such as people in the technology industry.”

Eventually, the researchers want to adapt the system for use in many different settings, giving people access to treatment they may not have now. For instance, people with depression often seek treatment by going to their primary care physician, so the researchers hope to adapt it for use at the doctor’s office or in a person’s home.

The system could also be beneficial in rural areas where clinical help is in short supply or nonexistent. Other possible locations for use include schools, social service offices, places of worship, military bases, prisons, commercial ships, oil rigs and underwater research stations.

The self-guided treatment project is part of the NSBRI Neurobehavioral and Psychosocial Factors Team portfolio, which includes studies on and development of countermeasures for stress, anxiety, interpersonal conflict and fatigue.

Content on stress and anxiety management for the Virtual Space Station is being developed by Dr. Raphael Rose at UCLA. Harvard Medical School and Massachusetts General Hospital researcher Dr. Gary Strangman is studying the depression treatment program’s effects on brain activity using infrared imaging.

Adapted from materials provided by National Space Biomedical Research Institute.

Mayo Clinic Health Letter — Aristotle and Hippocrates believed in the power of images in the brain to enliven the heart and body. Today, research shows they were right. Guided imagery is helping patients use the full range of the body’s healing capacity.

Guided imagery is more than listening to relaxing sounds. It’s a learning process to listen to someone’s voice, relax the breathing and consciously direct the ability to imagine. The effect of guided vivid imagery sends a message to the emotional control center of the brain.

From there, the message is passed along to the body’s endocrine, immune and autonomic nervous systems. These systems influence a wide range of bodily functions, including heart and breathing rates and blood pressure.

Guided imagery has been shown to benefit patients by:

* Reducing side effects from cancer treatment
* Reducing fear and anxiety prior to surgery. Studies have shown that surgery patients who participated in two to four guided imagery sessions required less pain medication and left the hospital more quickly than those who hadn’t used imagery.
* Managing stress
* Managing headaches. Studies have shown that guided imagery may aid in reducing the frequency of migraine headaches as effectively as taking preventive medications.

Adapted from materials provided by Mayo Clinic

September 26, 2008 — Calorie restriction, a diet that is low in calories and high in nutrition, may not be as effective at extending life in people as it is in rodents, according to scientists at Washington University School of Medicine in St. Louis.

Previous research had shown that laboratory animals given 30 percent to 50 percent less food can live up to 50 percent longer. Because of those findings, some people have adopted calorie restriction in the hope that they can lengthen their lives. But the new research suggests the diet may not have the desired effect unless people on calorie restriction also pay attention to their protein intake.

In an article published online this month in the journal Aging Cell, investigators point to a discrepancy between humans and animals on calorie restriction. In the majority of the animal models of longevity, extended lifespan involves pathways related to a growth factor called IGF-1 (insulin-like growth factor-1), which is produced primarily in the liver. Production is stimulated by growth hormone and can be reduced by fasting or by insensitivity to growth hormone. In calorie-restricted animals, levels of circulating IGF-1 decline between 30 percent and 40 percent.

“We looked at IGF-1 in humans doing calorie restriction,” says first author Luigi Fontana, M.D., Ph.D., assistant professor of medicine at Washington University and an investigator at the Istituto Superiore di Sanità in Rome, Italy. “For years, we have been following a cohort of people from the CR Society who have been on long-term calorie restriction. We found no difference in IGF-1 levels between people on calorie restriction and those who are not.”

The CR Society members, who call themselves CRONies (Calorie Restriction with Optimal Nutrition), had been on a calorie-restriction diet for an average of seven years when Fontana did the measurements, but their IGF-1 levels were virtually identical to sedentary people who ate a standard, Western diet.

Because calorie restriction is linked to extraordinary increases in maximal lifespan in rats and mice, Fontana and colleagues at Washington University, including principal investigator John O. Holloszy, M.D., professor of medicine, have been involved in a scientific study that compares calorie restriction to exercise and measures many biological factors linked to longevity and health. Called the CALERIE study (Comprehensive Assessment of the Long term Effects of Reducing Intake of Energy), the project randomly divided 48 people into three groups: Eighteen cut their caloric intake by 25 percent for one year. Another 18 started exercising to increase their energy expenditure by 25 percent for a year. A third group of 10 people didn’t change anything.

At the end of that year, the investigators measured IGF-1 levels in all three groups. Again they found no reductions in the group on calorie restriction.

“That was puzzling because it was the first time we hadn’t seen agreement between mice and rats on calorie restriction and humans on calorie restriction,” Fontana explains. “But we know there are two major influences on IGF-1 levels: calorie intake and protein intake. So we decided to look at the influence of protein.”

Again, Fontana had a ready-made study group. His team has been following a population of strict vegans for several years. They tend to eat less protein than the CRONies from the CR Society, so he compared IGF-1 levels between the two groups.

“The vegans had significantly less circulating IGF-1, even if they were heavier and had more body fat than CRONies,” he says. “Protein in the diet seemed to correlate with the lower levels of IGF-1. The strict vegans took in about 10 percent of their total calories from protein, whereas those on calorie restriction tended to get about 23 or 24 percent of calories from protein.”

The investigators wanted to take one more look at the relationship between dietary protein and IGF-1, so Fontana asked a group of CRONies to eat less protein for a few weeks. He says it was not easy to cut protein because those on calorie restriction have to do a lot of calculating and juggling to ensure they take in very few calories and still get adequate nutrition. Increasing dietary protein is one way many CRONies guard against becoming malnourished.

“But six of them agreed to lower their protein intake,” Fontana explains, “and after three weeks their circulating IGF-1 declined dramatically.”

Previous research from Fontana’s group had found that a diet lower in protein might protect against some cancers. These more recent findings suggest lowering protein also might be important to longevity. Fontana admits his evidence is preliminary, but the findings suggest that when people adjust their diets to improve health and lengthen life, they should control not only calories and fat but also keep an eye on protein.

Fontana isn’t proposing radical low-protein diets. Instead, he is suggesting the current recommended daily allowance (RDA) for protein, which is 0.82 grams of protein per kilogram of body weight, or about 56 grams of protein for an average, adult man and 46 grams for an average, adult woman. Most people, including CRONies, consume much more protein than the RDA recommendation.

“It’s much easier to restrict protein than to restrict calories,” he says. “If our research is on the right track, maybe humans don’t need to be so calorie restricted. Limiting protein intake to .7 or .8 grams per kilogram per day might be more effective. That’s just a hypothesis. We have to confirm it in future studies.”

Until then, Fontana suggests people might want to look at protein consumption and tailor it to RDA recommendations. Traditionally, he says, nutritionists have not worried about people eating too much protein, but these findings suggest perhaps they should.

Journal references:

1. Fontana et al. Long-term effects of calorie or protein restriction on serum IGF-1 and IGFBP-3 concentration in humans. Aging Cell, 2008; 7 (5): 681 DOI: 10.1111/j.1474-9726.2008.00417.x
2. Fontana L, Klein S, Holloszy JO. Long-term low-protein, low-calorie diet and endurance exercise modulate metabolic factors associated with cancer risk. American Journal of Clinical Nutrition, vol. 84; pp. 1456-1462, Dec. 2006

Adapted from materials provided by Washington University School of Medicine

‘Mitochondrial Eve’ Research: Humanity Was Genetically Divided For 100,000 Years

Researchers believe that about 60,000 years ago, modern humans started their epic journeys to populate the world. This time period has been the primary focus of anthropological genetic research. However, relatively little is known about the demographic history of our species over the previous 140,000 years in Africa. The human race was divided into two separate groups within Africa for as much as half of its existence, says a Tel Aviv University mathematician. Climate change, reduction in populations and harsh conditions may have caused and maintained the separation. Dr. Saharon Rosset, from the School of Mathematical Sciences at Tel Aviv University, worked with team leader Doron Behar from the Rambam Medical Center to analyze African DNA. Their goal was to study obscure population patterns from hundreds of thousands of years ago. Rosset, who crunched numbers and did the essential statistical analysis for the National Geographic Society’s Genographic Project, said the team was trying to understand the timing and dynamics of the split into at least two separate groups. “We wanted to look into the ancient history of our species. How did we live throughout most of our existence as a species? Did we live as one — or were we fractured into small groups? Until now, it wasn’t really clear,” says Rosset. The current study returns the focus to Africa and thereby refines the understanding of early modern Homo sapiens history. Rosset, who is also affiliated with IBM’s T.J. Watson Research Center in New York, says the study provides insight into the early demographic history of human populations before they moved out of Africa. “These early human populations were small and isolated from each other for many tens of thousands of years,” says Rosset. The team’s research was based on a survey of African mitochondrial DNA (mtDNA) and is the most extensive survey of its kind. It included over 600 complete mtDNA genomes from indigenous populations across the continent. MtDNA, inherited down the maternal line, was used in 1987 to discover the age of the famous “Mitochondrial Eve,” the most recent common female ancestor of everyone alive today. This work has since been extended to show unequivocally that “Mitochondrial Eve” was an African woman who lived sometime during the past 200,000 years. Recent data suggests that Eastern Africa went through a series of massive droughts between 90,000 and 135,000 years ago. It is possible that this climate shift contributed to the population splits. What is surprising is the length of time the populations were separate — for as much as half of our entire history as a species. Dr. Spencer Wells, director of the Genographic Project and Explorer-in-Residence at the National Geographic Society, said, “This new study illustrates the extraordinary power of genetics to reveal insights into some of the key events in our species’ history. Tiny bands of early humans, forced apart by harsh environmental conditions, coming back from the brink to reunite and populate the world. Truly an epic drama, written in our DNA.