Wednesday, April 24, 2019

Voice analysis software may help diagnose PTSD in veterans

Voice analysis software can help detect post-traumatic stress disorder (PTSD) in veterans based on their speech, a study suggests.

Doctors have long understood that people with psychiatric disorders may speak differently than individuals who do not have mental health problems, researchers note in Depression and Anxiety. While some previous research points to the potential for distinct speech patterns among people with PTSD, it’s been unclear whether depression that often accompanies PTSD might explain the unique voice characteristics.

In the current study, voice analysis software detected which veterans had PTSD and which ones did not with 89 percent accuracy.

“Those with the PTSD talked more slowly (slower tongue movement), were more monotonous with fewer bursts of vocalization, were less animated and energetic (lifeless) in their speech, and had longer hesitations and a flatter tone,” said the lead study author.

“Our findings suggest that speech-based characteristics can be used to diagnose this disease, and with further refinement and validation, may be employed in the clinic in the near future,” the author said.

The team used an artificial intelligence program that “learns” how to classify individuals based on examples of speech.

First, researchers recorded hours-long interviews based on questions often asked by clinicians to diagnose PTSD. Altogether, they interviewed 53 Iraq and Afghanistan veterans with PTSD related to their service as well as 78 veterans without the disease.

Then, they fed the recordings into voice analysis software developed by Stanford Research Institute (SRI) International, designers of the “Siri” App, to yield a total of 40,526 speech-based features captured in short spurts of talk.

The software linked patterns of specific voice features with PTSD, including less clear speech and a lifeless, metallic tone, both of which had long been reported anecdotally as helpful in diagnosis.

While the study did not explore the disease mechanisms behind PTSD, the theory is that traumatic events change brain circuits that process emotion and muscle tone that affect a person’s voice, the study team writes.

The study was small, and it wasn’t designed to prove whether or how PTSD might directly cause changes in vocal patterns. It’s also possible that results might be different for people who experienced trauma unrelated to military service such as sexual assault or a natural disaster.

Other warning signs of PTSD may also be easier for family members to spot, said the Dr.

“I think more general, observable indicators of trauma are more relevant in such cases,” a researcher who wasn’t involved in the study said. “Noticing that a family member exposed to a recent trauma appears to be unusually irritable, aggressive, hyper-vigilant, or reports nightmares, flashbacks of the trauma, or appears socially withdrawn or depressed ... would warrant a clinical assessment.”

But it may not be too far in the future that a tool like the one tested in the study could be one way to identify people who need to be evaluated for PTSD, said U.S. Army Capt.

“In a perfect world, I see this technology used as an early warning tool for PTSD,” the Captain who wasn’t involved in the study, said by email. 

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Thursday, December 13, 2018

Study sheds light on genetic overlap between major psychiatric disorders

Most medical disorders have well-defined physical characteristics seen in tissues, organs and bodily fluids. Psychiatric disorders, in contrast, are not defined by such pathology, but rather by behavior.
A  study, has found that autism, schizophrenia and bipolar disorder share some physical characteristics at the molecular level, specifically, patterns of gene expression in the brain. Researchers also pinpointed important differences in these disorders' gene expression.

"These findings provide a molecular, pathological signature of these disorders, which is a large step forward," said a distinguished professor of neurology, psychiatry and human genetics. "The major challenge now is to understand how these changes arose."

Researchers know that certain variations in genetic material put people at risk for psychiatric disorders, but DNA alone doesn't tell the whole story. Every cell in the body contains the same DNA; RNA molecules, on the other hand, play a role in gene expression in different parts of the body, by "reading" the instructions contained within DNA.

The study's lead author,  reasoned that taking a close look at the RNA in human brain tissue would provide a molecular profile of these psychiatric disorders.

Researchers analyzed the RNA in 700 tissue samples from the brains of deceased subjects who had autism, schizophrenia, bipolar disorder, major depressive disorder or alcohol abuse disorder, comparing them to samples from brains without psychiatric disorders.

The molecular pathology showed significant overlap between distinct disorders, such as autism and schizophrenia, but also specificity, with major depression showing molecular changes not seen in the other disorders.

"We show that these molecular changes in the brain are connected to underlying genetic causes, but we don't yet understand the mechanisms by which these genetic factors would lead to these changes," the Prof. said. "So, although now we have some understanding of causes, and this new work shows the consequences, we now have to understand the mechanisms by which this comes about, so as to develop the ability to change these outcomes." 

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Researchers uncover molecular mechanisms linked to autism and schizophrenia

Since the completion of the groundbreaking Human Genome Project in 2003, researchers have discovered changes to hundreds of places in the DNA, called genetic variants, associated with psychiatric diseases such as autism spectrum disorder and schizophrenia. Now, new findings from a major study has linked many of these changes in DNA to their molecular effect in the brain, revealing new mechanisms of diseases. 

In the new papers, researchers and collaborators from more than a dozen institutions from around the world provide the largest-ever datasets on the molecular workings of the brain. The findings provide a roadmap for development of a new generation of therapies for psychiatric conditions.

"This work provides several missing links necessary for understanding the mechanisms of psychiatric diseases," said  a senior author.

During the last decade, scientists have conducted genetic studies of people with psychiatric diseases, comparing the results to healthy individuals to find genes that have different sequences in those with disease. Often, however, their findings led to more questions than answers. Scientists not only discovered genes linked to the diseases, they also uncovered hundreds of areas of DNA found in between genes, called regulatory DNA, that also seemed to have an association.

Scientists know these sections of DNA can control when, where and how genes are turned on and off in many ways. However, figuring out which "regulatory regions" affect which genes— and therefore the RNA and proteins encoded by the genes— is not straightforward.

In 2015, researchers at 15 institutions around the country, came together in the Consortium to study in more detail the brain's regulatory DNA. An earlier project, known as ENCODE, already had uncovered the roles sections of regulatory DNA, but it was clear that these might be different in the brain than other organs. The PsychENCODE has analyzed not just genetic variants linked to psychiatric diseases, but also patterns of RNA and proteins in 2,188 brain bank samples from both healthy individuals and those with a psychiatric disorder.

In one new paper, the researchers describe this new data, which helps explain the roles of tens of thousands of sections of regulatory DNA in affecting RNA and proteins in the brain. The data also reveals which genes are most often expressed at the same time as each other, suggesting new biological processes and pathways. The dataset—essentially a detailed model of the inner molecular workings of the human brain— is now publicly available as a starting point for other researchers to mine mechanisms of disease and potential drug targets.

"This resource is so vast that you can start by choosing one interesting disease associated genetic variant and begin digging into that and discovering how it impacts molecular networks in the brain," he said. "Having robust data of this scope provides a foundation for countless new studies."

In a second paper, assistant professor of psychiatry and biobehavioral Sciences  and other collaborators, used that new data to look specifically at how RNA molecules are dysregulated—either present at higher levels, lower levels, or in altered conformations— in autism spectrum disorder, schizophrenia and bipolar disorder.

Using nearly 1,700 brain bank samples, the researchers revealed thousands of RNA molecules that are either spliced differently— with different sections of genetic material—or present at higher or lower levels in the brains of people with one of the psychiatric diseases.

"You can't look at the brain under a microscope and see substantial differences in these  disorders" the Prof. said. "But we've now shown that if you look finely at patterns of how genes are expressed, you see pathways that are clearly dysregulated."

Among the surprises in the data— altered levels of RNA linked to neuroinflammation and the brain's immune cells showed very different trajectories in people with schizophrenia, autism spectrum disorder and bipolar disorder.

Additionally, the study showed the importance of looking at individual cell types within the when parsing the new RNA data— in some cases, alternately spliced RNA was linked to disease but only when the RNA was found in certain cell types and not others.

Finally, new genes were implicated in the diseases based on the RNA results; five were linked to autism spectrum disorder, 11 to bipolar disorder, and 56 to schizophrenia.

Once again, the data is mostly important as a jumping off point for future studies, the researchers said.

"This is the tip of the iceberg," a Prof. said. "The ability to compile together 2,000 brains has been revolutionary in terms of revealing new genetic mechanisms, but it also points to how much we don't know." 

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Friday, March 09, 2018

Childhood exposure to violence may lead to psychiatric disorders

Exposure to violence during childhood may lead to psychiatric disorders, a study has found.
Results showed that having experienced any traumatic event and low socioeconomic status were associated with an internalising disorder such as depression and anxiety and an externalising disorder including attention-deficit hyperactivity.

The study, was conducted in two different neighbourhoods in the city of Sao Paulo, Brazil, one urban and one rural.

Around 180 students from public schools and their caregivers were interviewed to determine the influence of previous violent events and of socio-economic status on the prevalence of psychiatric disorders.

Researchers evaluated psychiatric disorders including: internalising disorders (depression, anxiety and post-traumatic stress disorder) and externalising disorders (attention-deficit hyperactivity disorder, conduct disorder and oppositional-defiant disorder).

Nearly 22 per cent of the youths had a psychiatric disorder. Depression and attention-deficit hyperactivity disorder were the most common diagnoses, at 9.5 per cent, and 9 per cent, respectively, followed by anxiety disorder at 6 per cent

A total of 14 per cent of the sample had an internalising disorder, nearly half of whom were males (45 per cent).

Another 15.5 per cent had an externalising disorder.

Almost 60 per cent of the adolescents with any diagnosis had experienced at least one violent event during their lifetime.

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Saturday, February 10, 2018

Scientists Have Mapped Out How Our Genes Might Lead To Mental Illness

It's often said mental illness runs in the family. But while that's true, scientists have had very little luck actually understanding how our genes influence our risk of developing major depression or schizophrenia. New research published yesterday seems to provide something big needed for that greater insight: A road-map of how genes are expressed differently in the brains of people with one of five major psychiatric disorders. 

An international coalition of researchers sifted through data from earlier studies that analysed the genetic makeup of people's brains - donated after death - who were diagnosed with either clinical depression, schizophrenia, autism spectrum disorder, alcoholism or bipolar disorder. The studies involved 700 people in total.

The researchers specifically looked at the RNA molecules found within these people's brain cells in the cerebral cortex, which "read" and translate the DNA packed into every cell. That allowed them to broadly see and map out how the cells actually carried out the genetic instructions they were coded with. Lastly, they used the brains of people with a non-psychiatric condition, irritable bowel disorder, as a control group.

They ultimately found a lot of distinct overlaps of molecular activity between the brains of people with psychiatric disorders that weren't found in "healthy" brains, indicating that many of the same sort of biological dysfunctions underpin them.

"These findings provide a molecular, pathological signature of these disorders, which is a large step forward," senior author said in a statement.

The findings might even change how we conceptualise certain mental illnesses. For instance, the molecular signature seen in people's brains with bipolar disorder was the most similar to those with schizophrenia. That came as a surprise to the researchers since the symptoms of each tend to be very different from one another.

There were also surprising key differences. The brains of people with alcoholism shared almost nothing in common with anyone else's. That flies in the face of earlier research suggesting that depression and alcoholism are often genetically connected. And depression, too, had many patterns of molecular activity not found with the other disorders. These distinctions are important, since they might someday help scientists develop better diagnostic tests, the researchers said.

Genes are far from the only thing that influence how a cell performs (or fails at) its assigned job; the environment we spend our lives soaked in also plays a dramatic role. And there's no single genetic mutation that will ever explain why someone is prone to depression. In fact, scientists now understand a person's genetic risk of mental illness comes from a lot of almost-insignificant genetic variations - some incredibly common, some rare - that interact with each other in ways we simply don't have a grasp of right now.

But the findings, and the team believe, will provide a lot of new breadcrumbs for scientists to follow. And these breadcrumbs might not just lead to diagnostic tests, but actual treatments. Already,  some of the researchers are pursuing a clinical trial that will test a potential treatment for autism, based on findings in the current study and others that suggest certain brain cells called microglia seem to be overactive in the brains of people living with autism.

For the most part, though, the real work is still to come.

"We show that these molecular changes in the brain are connected to underlying genetic causes, but we don't yet understand the mechanisms by which these genetic factors would lead to these changes," the researcher said. "So, although now we have some understanding of causes, and this new work shows the consequences, we now have to understand the mechanisms by which this comes about, so as to develop the ability to change these outcomes."

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Tuesday, September 26, 2017

Child Abuse May Alter Neurons in Brain

Adults who were victims of child abuse tend to have thinner layers of myelin coating in the brain, according to a new study.

Myelin is the protective fatty coating that covers the long thread-like parts of nerve cells called axons and helps them conduct electrical signals more efficiently. Myelin builds up progressively (in a process known as myelination) primarily during childhood, and then continues to mature until early adulthood.
Earlier research has shown significant white matter abnormalities in the brains of people who had experienced child abuse. (White matter is mostly made up of billions of myelinated nerve fibers stacked together.)

However, because these observations were made in the brains of living people through MRI (magnetic resonance imaging), it was impossible to gain a clear picture of the affected white matter cells and molecules.

To better study the microscopic changes which occur in the brains of adults who have experienced child abuse, the researchers compared post-mortem brain samples from three different groups of adults: people who had committed suicide who suffered from depression and had a history of severe childhood abuse (27 individuals); people with depression who had committed suicide but who had no history of being abused as children (25 individuals); and brain tissue from a third group of people who had neither psychiatric illnesses nor a history of child abuse (26 people).

The findings reveal that the thickness of the myelin coating in a significant proportion of the nerve fibers was reduced only in the brains of those who had suffered abuse as children. The researchers also found underlying molecular changes that selectively affect the cells responsible for myelin generation and maintenance. In addition, increases were found in the diameters of some of the largest axons among only this group.

The researchers speculate that together, these changes may alter functional coupling between the cingulate cortex and subcortical structures such as the amygdala and nucleus accumbens (areas of the brain linked respectively to emotional regulation and to reward and satisfaction). These changes may also contribute to altered emotional processing in adult victims of child abuse.

The researchers conclude that early life abuse may result in long-term disruption of a range of neural functions in the anterior cingulate cortex. They are planning to conduct more research that will help determine exactly how these effects impact the regulation of emotions and attachment.

Severe childhood abuse is tied to an increased risk of psychiatric disorders such as depression, as well as high levels of impulsivity, aggressiveness, anxiety, more frequent substance abuse, and suicide.

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