Random Bedtimes Breed Bad Behavior In Kids

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Parents learn the hard way that late bedtimes make for cranky kids the next day. But inconsistent bedtimes may have a greater effect on children's behavior, a study says.

Kids who didn't go to bed on a regular schedule had more behavior problems at home and at school. When those children were put to bed at the same time each night, their behavior improved.

That data came from an ongoing study of 10,230 British schoolchildren. Mothers were asked if their child had a regular bedtime during the school week. That information was collected when the children were ages 3, 5 and 7.

The mothers were also asked to complete a standardized test that measures behavior, including conduct problems, hyperactivity, emotional symptoms, problems with peers and positive behavior.

Children who went to bed after 9 p.m. were rated as having more behavior problems than children who went to bed earlier. That's no surprise; there's abundant evidence on the effects of lack of sleep on children's school performance and behavior.

But irregular bedtimes actually caused worse behavior than short sleep.

Teachers were asked to rate some of the children's behavior at age 7. They too reported more behavior problems in children with irregular bedtimes.

The good news is that the behavior problems improved when children were shifted to a more regular schedule. The scientists call that a "clear dose-response pattern." And behavior deteriorated in children who had regular bedtimes at age 5 and were on a more random plan by age 7, the parents said.

The sleep issues could affect behavior in two ways, according to the researchers at University College London. It could mess up children's circadian rhythms, which are slow to change. And it could affect maturing brain regions involved in regulation of behavior.

Pediatricians should ask about irregular bedtimes, the researchers say, not just how many hours a kid is logging.

This study has shortcomings. It doesn't report how much the children actually slept, but rather how much their mothers said they slept. And it could be that the families with random bedtimes had other problems that affected the child's behavior.

Lack of sleep causes health problems in children and adults, including weight gain and insulin resistance.

And regular bedtimes are recommended for adults too, because maintaining a regular circadian rhythmmakes it easier to fall asleep and wake up on time. No word if it makes grownups less cranky. But it probably couldn't hurt.

What are the NFL players being told about concussions by their own Players' Association?

I think its fascinating that the teams have physicians but that the Players' Association is advocating the use of IMPARTIAL specialists: neurologists. JR


What is a concussion?

A concussion is a type of brain injury. It occurs when the brain moves quickly enough to interrupt its function. Most concussions result in full recovery, but some can lead to more severe injuries if not recognized and treated properly.

The source of the injury is not always clear. It can come from a blow to the head or even from a blow to the body. It can come from one big hit  or from several smaller ones.

You may not always be aware that you are concussed. It is common that  concussed people do not know they are injured. Look out for the health of your teammates. Be aware of these signs and symptoms in yourself  and fellow players:
What is interesting is that the NFL plaers' association is teaming up with neurologists (the American Academy of Neurologists)


WHAT IS A CONCUSSION?

• Disorientation or confusion
• Memory loss
• Behavior or personality change
• Trouble concentrating
• Feeling sleepy or groggy
• Sensitive to light or sound
• Dizziness or nausea
• Headache

If you or a teammate have any of these symptoms, tell your medical staff immediately. Trying to play with a concussion puts  you at serious risk for further injury
.
WHAT SHOULD I EXPECT FROM MY TEAM?

IMMEDIATE EVALUATION OF A SUSPECTED CONCUSSION.
If a concussion is suspected (in either a game or practice), you should
be evaluated immediately. There is an NFL protocol for this evaluation
that can be done in under 10 minutes. If you think you may have a
concussion, report your symptoms and request this exam. DO NOT
TRY TO PLAY THROUGH THIS INJURY.


THOROUGH EVALUATION TO DETERMINE PRESENCE OF
CONCUSSION.

Not every hit that causes symptoms is a concussion and  only medical personnel can make the diagnosis. You should be evaluated  with a comprehensive neurological evaluation, ideally in a quiet, distractionfree place.

RETURN TO WORK. If you have a concussion, you should not participate  in a game or practice until you are (1) symptom free at rest and during physical exertion and (2) cleared by your team physician AND the team’s  independent neurological consultant.

 The return to work protocol should
involve several steps of increasing exertion – from a stationary bike, to
jogging, to agility work, to non-contact drills. With each step, a player must
be symptom free to move to the next step. You should never play football
after a concussion if you have not been evaluated appropriately or are still  experiencing symptoms.

WHAT ELSE CAN I DO?

You have the right to a second opinion.

It is your health and your brain. If  you are unsure about your medical condition and/or your medical care,
do not hesitate to seek additional care. There are many experts in sports  concussion that can provide the care you need.

Don’t let any question go unasked. You and your family deserve the best  information. If you would like help getting a second opinion, or have a question, call

Fireworks and Migraine - What is a scinitllating scotoma?

Its a type of aura...

Migraine Aura: Typical Features

•  Visual disturbances confined to one field
• – phosphenes, eg, sparks, flashes, geometric forms
• – scotoma, area of diminished vision moving across visual
• field
• – scintillating scotoma, flickering spectrum at margin of
• scotoma
•  Sensory: unilateral paresthesias and/or numbness
•  Weakness, or more commonly a sense of limb
• heaviness: unilateral
• Speech: dysphasia

These four depictions of a scintillating scotoma show one of the more
common manifestations of the visual aura, in which a central scotoma is
bordered by a crescent of scintillating zigzags or other simple geometric
patterns, which slowly advances to the edge of the visual field. The zigzag
pattern is sometimes termed a fortification spectrum for its resemblance to the
battlements of a castle or city wall.

Dr. Hubert Airy, a 19th century physician, described the elaborate scintillating
scotoma he experienced with his migraine aura: “When it was at its height it
seemed like a fortified town with bastions all around it, these bastions being
coloured most gorgeously… All the interior of the fortification, so to speak,
was boiling and rolling around in a most wonderful manner as if it was some
thick liquid all alive.”

While simpler black-and-white patterns are somewhat more common than Dr.
Airy’s elaborate fortification spectra, the migraine aura continues to fascinate
both physicians and patients.

From the AAO...

Typical visual aura

A translucent semicircle with a jagged edge starts to the left of center in the visual field as a barely noticeable obscuration with a shimmery, zigzag left margin.

Within 10 minutes, it has enlarged to occupy nearly half of the left hemifield.

By 20 minutes, the entire left hemifield is obscured.

This is the "scintillating scotoma" ("fortification scotoma"), the most common and most specific aura (or prodrome) that precedes the headache of migraine. Here is what the visual aura of migraine looks like to the patient.

More about this phenomenon

A visual cortical phenomenon, it is present in the hemifields of both eyes, although most patients believe it is only seen by the eye whose temporal field is affected (unless they went to medical school and learned about hemifield representation of vision!).

Current thinking is that aminergic pathways from the brain stem to the visual cortex set off a wave of excitation followed by depression that causes first the shimmering, then blindness. The jagged leading edge probably results from the way the wave travels across the visual cortex.

The jagged edge and buildup across the hemifield in 20 minutes are unique to migraine, usually a benign phenomenon. In a small minority, migraine is triggered by underlying metabolic or structural disease.

The buildup of a scintillating scotoma occurs in only 25% of migraineurs. Others report stationary shining spots or lines or just blurred vision. These latter hallucinations are not exclusive to migraine, however, and could reflect the visual hallucinations of many processes, including ischemia, intoxication, inflammation, dementia, psychosis, or tumor.

What to do?

The diagnosis of migraine depends entirely on history. Remember that migraine is a "reaction pattern" in the central nervous system. Most of the time it is benign, but serious diseases can imitate it.

In order not to overlook these serious diseases, be sure that the patient's description hits enough characteristic features to make migraine a solid bet. Otherwise, order brain imaging and evaluate for cerebrovascular and meningeal disorders.

More here
 and
More here

Back to school sleeping tips

This article gives tips for how to prepare your child to successfully go back to school, most importantly by making sure they are getting enough sleep.

Did you know the best preparation for back to school is a good night’s sleep? Lack of sleep can affect a child’s performance, attention, learning, behavior and biological functions, experts say. In fact, recent studies show that American students might be falling behind in school due to a lack of shut-eye.

With all the excitement and stress that accompanies the new school year, many children slip into a pattern all too familiar to tired parents. One more book, one more glass of water, one more TV show ... the child who continually resists going to bed experiences difficulty in falling asleep, resulting in what doctors identify as limit-setting sleep disorder.

Parents can help children through the transition by creating an enjoyable bedtime routine that’s fun and relaxing, says Dr. Laura Sergis, pediatrician for the Children’s Medical Group and advisory board member at Cloud b, creators of award-winning products designed to help children sleep. The all important routine can include family story time with favorite books, sing-alongs to favorite lullabies and cuddly companions that alleviate night time fears with soothing sounds and lights. Incorporating a trusted buddy like Cloud b’s newTwilight Carz in the bedtime routine helps children transition from playtime to bedtime with its fun push and play action by day and its soothing starlight projection by night.

Sleep expert Kim West, licensed certified social worker, also known as The Sleep Lady, recommends that all electronics be turned off an hour before bedtime. Homework and getting bags together should be done before the one-hour electronics off time – the one hour should be for relaxing activities including bathing, washing up, reading, talking about the day, etc. Read stories like the new Scholastic classic, “My Turtle and Me”, inspired by Cloud b’s Twilight Turtle, an adorable plush that projects a soothing view of the night sky to comfort children to a peaceful night’s sleep.

Parents can add another magical element to the routine with Cloud b’s new Twilight Turtle Tunes that plays personalized lullabies featuring favorite songs, soothing sounds and even the voices of loving parents or caregivers as it projects a starry sky above. Parents put it all together on the Twilight Turtle Tunes app that delivers the magic to the special edition toy via Bluetooth.

In planning the ideal bedtime, West suggests parents do “the math backwards.” For example, if your 2-year-old needs to be up at 7 a.m. to get dressed and out the door to daycare, then he should be asleep by 8 p.m. (This age needs, on average, 11 hours at night and two hours during the day.)

She notes that it also goes without saying that parents should eliminate caffeine from their children’s diets. If it can’t be done completely, then no caffeine after 3 p.m. Dinner should be at least two hours before bedtime so that your child gets a chance to digest.

Finally, exercise during the day does help a child sleep better, but try to avoid exercise an hour before bedtime. Definitely avoid rough-housing, which can really rile up a child just when you want him to be settling down.

As parents find the best routine and stick to it, they’ll discover that the whole family is functioning better. Bedtime may become the best time of the day – a calm, quiet moment before slumber to make great memories and strengthen the bond between parents and children.

Read more here

Helmet type does not lower concussion risk

A new study shows that the helmet type, whether new or old, or extremely pricey or not, does not significantly change the risk of concussion.

Newer, heavier and more expensive football helmets will not lower a player's risk of concussion, new research finds.

A study of more than 1,300 players on football teams at 36 Wisconsin high schools found that players wearing older helmets received just as much protection from concussion as players with flashy new models, said study author Timothy McGuine, senior scientist and research coordinator for the University of Wisconsin Health Sports Medicine Center in Madison.

"The helmet technology is advanced as it can be. They've done a wonderful job. We don't have skull fractures in football," he said. "But I don't know how much padding can be put in to prevent the brain from sloshing around inside the cranium."

This research, to be presented Saturday at the American Orthopaedic Society for Sports Medicine's annual meeting in Chicago, comes at a time when some sports equipment manufacturers are marketing expensive football helmets amid claims that they offer better protection against concussion than earlier models, McGuine said.

"They're all being touted as the next best thing to prevent sports injuries, and it really puts the squeeze on athletic directors and coaches," he said. "Some companies are going right to the parents and saying, 'We know it's too expensive for the school to pay for it, so you should pay for this helmet to protect your child.'"

About 40,000 U.S. high school football players receive a concussion, which is a form of mild traumatic brain injury, every year during play or practice, McGuine said.

As part of the study, licensed athletic trainers at each high school kept detailed records during the 2012 football season. This included recording the safety equipment used by each player, including mouth guards, the number of games and practices in which each player participated, and the number of sports-related concussions sustained.

The players wore helmets manufactured by Riddell, Schutt and Xenith.

Out of 1,332 players tracked, 115 sustained a concussion during the season, McGuine reported.

Researchers found no difference in the rate of concussion by either the type of helmet worn or the helmet's age.

"We found the actual incidence of concussion was not more for players wearing the newest helmets versus wearing helmets 3, 4 or 5 years old," McGuine said. "We also looked at [concussion] severity by helmet model. No difference there, either."

The study also found that players who wore a specialized or custom-fitted mouth guard actually had a higher risk of concussion than players who wore a generic mouth guard provided by their school.

"Should parents pay $30 for a mouth guard to protect their son against concussion, or just use the $1 mouth guard the school provides?" McGuine asked.

The American Medical Society of Sports Medicine released a position statement in January that said hard sports helmets can prevent impact injuries such as lacerations or fractures but have not been shown to reduce the incidence or severity of concussions, said Dr. Anne-Felicia Ambrose, medical director of the traumatic brain injury unit in the department of rehabilitation medicine at Mount Sinai Medical Center in New York City.

"In terms of equipment, there really isn't that much more we can do," Ambrose said. "Where we have a lot of potential for reducing concussion is the way the game is played."

Altering the rules of football games and the guidelines governing practice sessions can make the game safer and prevent concussions, she said.

For example, limiting contact between players outside of competition is one means of reducing concussions, she said. "A lot more concussions occur during practice, when coaches cannot have their eyes on everyone on the field," Ambrose said. "The chance of impact is increased."

McGuine agreed. "I don't see any reason for kids to have full tackle on practice days," he said.

Coaches and athletic trainers also can help reduce injuries by properly fitting each player's helmet at the start of the season and checking the fit every week, he added.

Read more here

Women's Sleep and Heart Health

This article discusses how the amount and quality of sleep women get is extremely important to their heart health.

Getting enough sleep on a regular basis is one important way to protect the health of your heart. Poor and insufficient sleep is associated with a range of cardiovascular problems, including high blood pressure,heart attack, and heart failure. Both men and women are at increased risk for these conditions. But we continue to learn that when it comes to health problems associated with sleep, the particular risks to men and women are not always the same. A new study suggests that for women who already have heart disease, poor sleep may be particularly dangerous to their heart health.

Statistics from the American Heart Association reveal that heart disease is a bigger problem for women than most of us think:

Heart disease is the No. 1 killer of women, and is more deadly than all forms of cancer combined.

• Heart disease causes 1 in 3 women’s deaths each year, killing approximately one woman every minute.
• An estimated 43 million women in the U.S. are affected by heart disease.
• Since 1984, more women than men have died each year from heart disease.
• Only 1 in 5 American women believe that heart disease is her greatest health threat.

Research indicates that poor-quality sleep—and waking too early in particular—is associated with increased inflammation among women with heart disease. There was no similar association found for men, suggesting that women with heart disease and sleep problems may be at particular risk for inflammation that can be damaging to the heart.

Researchers at the University of California San Francisco investigated the relationship between sleep quality and inflammation linked to coronary heart disease. They also sought information about how an association between sleep and inflammation might differ between men and women. Their investigation included 980 men and women at the outset, and 626 completed the 5-year study. All of those included were suffering from coronary heart disease. The average age of men in the study was 66. Women were slightly younger, with an average age of 64. Researchers measured sleep quality by asking participants to rate their sleep over the previous month. They also asked for reports of some of the most common sleep problems, including difficulty falling asleep, difficulty staying asleep, waking frequently throughout the night, and waking too early in the morning. Researchers assessed inflammation levels using 3 biomarkers: Interkeukin-6, C-reactive protein, and Fibrinogen.

After 5 years, researchers repeated tests for inflammation and once again sought reports on sleep quality and sleep problems. When they analyzed data for both men and women together, researchers found no links between inflammation and sleep quality. However, when they analyzed data taking gender into account, researchers found a relationship between inflammation and sleep existed for women, but not for men:

• Women who reported poor sleep quality experienced greater increases in levels of inflammation over the 5-year period than men.
• Women who reported their sleep quality as “very poor” or “fairly poor.” experienced increases to their inflammation markers that were 2.5 times greater than men who reported the same levels of poor sleep.
• The association between inflammation and sleep remained intact for women even after taking into account other factors that might influence inflammation, including age, cardiac function, body mass index, medication use, and lifestyle factors.
• The link between inflammation and sleep for women with coronary heart disease was particularly strong among those women who had a tendency to wake too early in the morning.
• Women were more likely than men to report waking too early. They were slightly more likely than men to report waking frequently during the night and having difficulty falling asleep.
• Because the majority of women in the study were post-menopausal,researchers hypothesized that low estrogen levels might explain the link between poor sleep and inflammation. This question was not examined in the study itself.

This is not the first study to suggest that lack of sleep may be particularly dangerous for women’s heart health. Researchers in the United Kingdom also found inflammation linked to lack of sleep in women. This large-scale study included 4,600 adult men and women. As in the current research, changes to women’s inflammation levels were linked to sleep problems, whereas no such association was found in men. In an Italian studythat included both men and women, women with resistant hypertension—a form of high blood pressure that is not responsive to medication—were 5 times as likely to have sleep problems. There was no similar link between resistant hypertension and poor sleep in men.

This latest study provides some important information about one way that sleep may affect heart health. It’s also another reminder that when it comes to health in general and sleep in particular, gender matters.  In recent years there has been an increased focus on learning more about the differences in sleep between men and women, and how these differences may contribute to specific health risks. Evidence suggests that circadian rhythms in men and women are markedly different. Our circadian clocks are remarkably sensitive and precise, and even a small difference in circadian timing can have a significant impact on sleep. We need to continue to pay attention to gender differences in sleep, as a way to better understand, diagnose, and treat both sleep problems and the broad array of health concerns now associated with poor sleep.

Read more here

Tips for sleeping during summer nights

Longer summer days and more hours of daylight can mean sleep problems for many people. This article gives tips for getting better sleep over the summer.

Those extra hours of daylight in the summer contribute to sleep problems experienced by many Americans, experts say.

The Loyola University Health System team offers tips on how to get a good night's sleep.

At least an hour before bedtime, start quieting down and relaxing. Don't exercise or do any other vigorous activities. Turn off handheld devices and remove them from the room. Darken the room and create a comfortable environment in terms of temperature, bedding, mattress and sleepwear.

Try to go to bed at the same time every night. Don't have any food and beverages for several hours before bedtime. This will reduce the chances that you'll have to get up in the night to go to the bathroom.

Make a list of worries, future errands and other things that are on your mind before you go to bed. This can help reduce anxiety, organize your thoughts and prepare you for sleep. Think twice about allowing pets to sleep with you. If they move in the night and make noise, they disturb sleep.

Some people who take medications before bed may do better to take them in the morning or the other way around, according to a Loyola news release. If you think this is an issue, talk to your doctor about changing your medication schedule.

Train your mind and body to associate the bedroom with relaxation and sleep, not exercising, playing games or watching TV. Discuss good sleep strategies with your partner. You need their cooperation for your efforts to succeed.

If your sleep problems persist, you may have a sleep disorder such as sleep apnea, the Loyola experts say. Talk to your doctor about undergoing a sleep study.

Read more here

First Sequencing for the Full Genome of Autism

The first full genome sequencing for autism has been completed which provides immense promise regarding autism prevention, diagnosis, and treatment.

A collaborative formed by Autism Speaks, the world's leading autism science and advocacy organization, has found full genome sequencing examining the entire DNA code of individuals with autism spectrum disorder (ASD) and their family members to provide the definitive look at the wide ranging genetic variations associated with ASD. The study published online today in American Journal of Human Genetics, reports on full genome sequencing on 32 unrelated Canadian individuals with autism and their families, participants in the Autism Speaks Autism Genetic Resource Exchange (AGRE). The results include both inherited as well as spontaneous or de novo, genetic alterations found in one half of the affected families sequenced.

This dramatic finding of genetic risk variants associated with clinical manifestation of ASD or accompanying symptoms in 50 percent of the participants tested is promising, as current diagnostic technology has only been able to determine a genetic basis in about 20 percent of individuals with ASD tested. The large proportion of families identified with genetic alterations of concern is in part due to the comprehensive and uniform ability to examine regions of the genome possible with whole genome sequencing missed in other lower resolution genome scanning approaches.

"From diagnosis to treatment to prevention, whole genome sequencing efforts like these hold the potential to fundamentally transform the future of medical care for people with autism," stated Autism Speaks Chief Science Officer and study co-author Robert Ring, Ph.D.

The study identified genetic variations associated with risk for ASD including de novo, X-linked and other inherited DNA lesions in four genes not previously recognized for ASD; nine genes previously determined to be associated with ASD risk; and eight candidate ASD risk genes. Some families had a combination of genes involved. In addition, risk alterations were found in genes associated with fragile X or related syndromes (CAPRIN1 and AFF2), social-cognitive deficits (VIP), epilepsy (SCN2A and KCNQ2) as well as NRXN1 and CHD7, which causes ASD-associated CHARGE syndrome.

"Whole genome sequencing offers the ultimate tool to advance the understanding of the genetic architecture of autism," added lead author Dr. Stephen Scherer, senior scientist and director of the Centre for Applied Genomics at The Hospital for Sick Children (SickKids) and director of the McLaughlin Centre at the University of Toronto. "In the future, results from whole genome sequencing could highlight potential molecular targets for pharmacological intervention, and pave the way for individualized therapy in autism. It will also allow for earlier diagnosis of some forms of autism, particularly among siblings of children with autism where recurrence is approximately 18 per cent."

This $1 million collaboration of Autism Speaks, SickKids, BGI and Duke University piloted Autism Speaks' initiative to generate the world's largest library of sequenced genomes of individuals with ASD announced in late 2011. "As we continue to test more individuals and their family members from the AGRE cohort, we expect to discover and study additional genetic variants associated with autism. This collaboration will accelerate basic and translational research in autism and related developmental disabilities," concluded Autism Speaks Vice President for Scientific Affairs Andy Shih, Ph.D. who oversees the collaboration, "and this collection of sequenced genomes will facilitate new collaborations engaging researchers around the world, and enable public and private entities to pursue pivotal research."

In this pilot effort, a total of 99 individuals were tested, including the 32 individuals with ASD (25 males and seven females) and their two parents, as well as three members of one control family not on the autism spectrum. Using families in the Autism Speaks AGRE collection, this Autism Speaks initiative will ultimately perform whole genome sequencing on more than 2,000 participating families who have two or more children on the autism spectrum. The data from the 10,000 AGRE participants will enable new research in the genomics of ASD, and significantly enhance the science and technology networks of Autism Speaks and its collaborators.

Read more here

Irregular bedtimes can limit a child's brain power

By looking at how children scored on tests, researchers show that children who go to sleep at irregular times score lower on exams than children with regular bedtimes.

Going to bed at different times every night appears to reduce children's brainpower, a new British study suggests.

The research included 11,000 children in the United Kingdom whose family routines, including bedtimes, were recorded when they were aged 3, 5 and 7. At age 7, the children were given tests to assess their math and reading skills and spatial awareness.

Irregular bedtimes were most common at age 3, when around one in five children went to bed at varying times. By the age of 7, more than half the children went to bed regularly between 7:30 p.m. and 8:30 p.m.

At age 7, girls who had irregular bedtimes had lower scores on all three tests than girls with regular bedtimes. This was not the case among 7-year-old boys, according to the study, which was published online in the Journal of Epidemiology and Community Health.

Irregular bedtimes at age 5 were not associated with poorer brainpower in girls or boys at age 7. But irregular bedtimes at age 3 were associated with lower scores in reading, math and spatial awareness in both genders, suggesting that around the age of 3 could be a sensitive period for the development of mental skills.

The impact of irregular bedtimes seemed to be cumulative. Girls who never had regular bedtimes at ages 3, 5 and 7 had significantly lower reading, math and spatial-awareness scores than girls who had consistent bedtimes. The impact was the same in boys, but at any two of the three ages.

Irregular bedtimes could disrupt natural body rhythms and cause sleep deprivation, harming children's ability to acquire and retain information, the researchers said.

"Early child development has profound influences on health and well-being across the life course," said study author Amanda Sacker, from the department of epidemiology and public health at University College London. "Therefore, reduced or disrupted sleep -- especially if it occurs at key times in development -- could have important impacts on health throughout life."

While the study found an apparent connection between irregular bedtimes and reduced mental acuity, it did not prove cause-and-effect.

Read more here

Combination of brain-attacking antibodies signals autism

Researchers at the University of California Davis found that mothers who have a certain combination of brain-attacking antibodies have a 99% chance of giving birth to a child with autism.

A significant portion of autism cases can be identified with nearly perfect accuracy before symptoms appear, possibly even before conception, according to research published Tuesday.

It found that 23 percent of children with autism spectrum disordershave mothers with a certain combination of antibodies in their blood. Mothers who have this combination are 99 percent likely to have autistic children, according to researchers at the University of California Davis.

A study led by Judy Van de Water of UC Davis finds that 23 percent of those with autism spectrum disorders have mothers with a specific combination of autoantibodies that attack seven proteins involved in fetal brain development.

Experts not involved with the work said it could represent a major advance if validated. The studies don’t deal with the great majority of other cases of the disorder; in which a variety of factors appear to be involved.Two studies based on the research were published in the open access journal Translational Psychiatry. One study, led by UC Davis researcher Judy Van de Water, is here. The second, led by her UC Davis colleague Melissa Bauman, is here. Open access means the complete studies are free to readers.

San Diego-based Pediatric Bioscience is developing a test for the autism-linked antibodies, said Jan D’Alvise, chief executive of the privately held company. The test is expected to be commercially available in late 2014.

The studies found that seven proteins active in fetal brains were targeted by the maternal antibodies, said Van de Water, an immunologist at UC Davis School of Medicine, who took part in both studies. Van de Water is also the chief scientific adviser to Pediatric Bioscience. Some maternal antibodies normally cross over through the placenta, guarding the developing baby against infection.

The main study, led by Van de Water, examined the maternal antibodies’ effects on the seven fetal brain proteins and correlated them with an autism or autism spectrum diagnosis in 246 children. Maternal antibodies were also examined in a control group of 149 normally developing children.

The study found certain combinations of antibodies that were found in 23 percent of mothers of autism spectrum disorder children, but in less than 1 percent of a control group of mothers who did not have ASD children.

The second study, led by colleague Melissa Bauman, examined the autism-linked antibodies’ effects in young rhesus monkeys. It found significant disruptions in the social behavior of these monkeys; monkeys not exposed to the antibodies did not experience the disruptions.

Pediatric Bioscience is developing the antibody test for two uses, D’Alvise said.

“One is a simple blood test that will tell women their risk of having an autistic child before they conceive,” D’Alvise said.

Prospective mothers who test positive could avoid the risk by using a surrogate mother who tests negative to carry the baby, she said.

Secondly, the test can also be taken by new mothers to assess autism risk in their infants, so those at risk can be treated promptly.

“It’s very hard to diagnose these kids early, and they benefit from interventional therapy, if you catch them early,” D’Alvise said.

About 1 in 88 children are diagnosed with autism spectrum disorder, according to the U.S. Centers for Disease Control and Prevention. At the mild end, those with Asperger’s syndrome experience significant difficulties in social interaction. At the severe end, classic autism includes delay in language development, repetitive behavior and intense fascination with certain objects or patterns.

While more work is needed before a test can be approved, Van de Water said the study results were solid, and she is confident in their accuracy. Further down the road, a preventive therapy might be possible, she said. Such a therapy would block the antibodies in the pregnant mothers, allowing normal development of the baby.

Maternal immune response dysfunction

The study represents “a great advance forward to explaining a substantial sub-set of cases of ASD,” said Cheryl Dissanayake, director of the Olga Tennison Autism Research Centre at La Trobe University, near Melbourne, Australia.

Dissanayake said by email that she had been aware of the research, and considers the rhesus monkey study to give more validity to Van de Water’s work.

“My own interest in dysregulated growth (both physical and brain growth) in a subset of cases is also modeled in the rhesus monkeys,” Dissanayake said. “These really are significant findings, although as always, more research is needed. I couldn’t recommend this work strongly enough.”

Eric Courchesne, a UCSD researcher studying the neurobiology of autism, was cautious in evaluating the results. He said the study covers an important area of research, identifying molecular markers in those with autism.

"The study suggests an important future study: Do mothers who already have an ASD child and these markers, have an increased risk of having another child with ASD?" Courchesne asked.

Elizabeth A. Thomas, a neuroscientist at The Scripps Research Institute, said the study results could be useful in assessing autism risk.

“These findings could have enormous potential to serve as a biomarker for disease risk in children, however, whether such a diagnostic test would have predictive value in assessing a woman’s risk of having a child with autism prior to conception, is less clear,” Thomas said. “This is because the samples were obtained from mothers of children at the time of the child’s diagnosis, not before pregnancy.”

The results make sense in light of what is already known about autism, Thomas said.

“Although autism spectrum disorders are highly heterogeneous, there is substantial evidence for maternal immune dysregulation during pregnancy and increased risk for autism, as well as other neuropsychiatric disorders, in offspring,” Thomas said. “However, exactly how maternal immune dysregulation is related to altered brain development and subsequent behavioral abnormalities is not clear.”

Identifying the seven target proteins represents “a critical advancement in the field,” Thomas said. “Because autism is known to have a strong genetic contribution, it would be important to see if any of these target proteins converge with the autism-associated genetic data that has been published in recent years.”

“Because several of the target proteins identified in this study are known to play important roles in neurodevelopment, it would be of interest to see if any of these maternal autoantibodies are associated with increased risk for other neuropsychiatric or neurodevelopmental disorders."

Monkey parallel

The studies builds on previous research by Van De Water and colleagues that found women with certain antibodies were at greater risk of having a child with autism than woman without the antibodies.

The study led by UC Davis researcher Bauman found a parallel in rhesus monkeys exposed to the autism-linked antibodies. These well-studied monkeys have their own complex social system, and the researchers looked for signs of disruption.

That study included three groups, one exposed to the maternal autism-linked antibodies, a second exposed to antibodies from human mothers whose children did not have autism, and a third group that did not receive any antibodies. Thus, the study had three groups, one test and two control.

Monkey offspring exposed to the autism-linked antibodies showed abnormal social behavior not displayed by the control offspring, the study said. This behavior included approaching unfamiliar monkeys, unusual for young rhesus monkeys.

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Preschoolers who sleep less have more behavior issues

A study shows that toddlers and preschoolers who do not get enough sleep have more behavior problems than those who get adequate sleep.

Four-year-olds with shorter than average sleep times have increased rates of "externalizing" behavior problems, reports a study in the July Journal of Developmental & Behavioral Pediatrics, the official journal of the Society for Developmental and Behavioral Pediatrics. The journal is published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health.

"Preschool children with shorter nighttime sleep duration had higher odds of parent-reported overactivity, anger, aggression, impulsivity, tantrums, and annoying behaviors," according to the new research by Dr. Rebecca J. Scharf of University of Virginia, Charlottesville, and colleagues. They recommend that parents and health care providers discuss steps to improve sleep habits for preschool-age children with behavior problems.

Shorter Sleep Times, More Behavior Problems

The researchers analyzed parent responses from a nationally representative study of approximately 9,000 children, followed from birth through kindergarten age. When the children were four years old, nighttime sleep duration was estimated by asking the parents what time their child typically went to bed and woke on weekdays.

On a standard child behavior questionnaire, parents rated their child on six different "externalizing" behavior problems such as anger and aggression. (Externalizing behavior problems are outward behaviors, distinguished from "internalizing" problems such as depression and anxiety.) The relationship between sleep duration and behavior scores was assessed, with adjustment for other factors that might affect sleep or behavior.

The average bedtime was 8:39 pm and wake time 7:13 am, giving a mean nighttime sleep duration of about 10½ hours. Eleven percent of children were considered to have "short sleep duration" of less than 9¾ hours (calculated as one standard deviation below the average).

On the child behavior questionnaire, 16 percent of children had a high score for externalizing behavior problems. Behavior problems were more common for boys, children who watched more than two hours of television daily, and those whose mothers reported feeling depressed.

After adjustment for other factors, "Children in the shortest sleep groups have significantly worse behavior than children with longer sleep duration," Dr Scharf and colleagues write. The effect was greatest for aggressive behavior problems, which were about 80 percent more likely for children with nighttime sleep duration of less than 9¾ hours.

Shorter sleep times were also associated with 30- to 46-percent increases in rates of the other externalizing behaviors studied, including overactivity, anger, impulsivity, tantrums, and annoying behaviors. In a linear analysis, as sleep duration increased, troubling behaviors decreased.

Previous studies in smaller groups of children have identified shorter nighttime sleep duration as a risk factor for behavior problems in preschool children. The average 10½-hour sleep time in this nationally representative sample is less than in studies performed in past decades, and less than currently recommended for four-year-olds.

The new results, along with other recent studies, add to the evidence that preschoolers who sleep less will have more behavior problems, including disruptive behaviors like aggression and overactivity. Although the study can't draw any conclusions about causality, "there is good reason to believe that short nighttime sleep duration leads to externalizing behaviors," the researchers write.

Dr Scharf and coauthors recommend that doctors and health care providers ask about bed and wake times when talking to parents about young children with behavior problems. They add, "Advocating for regular sleep habits, healthy sleep hygiene, and regular bedtime routines may be helpful for young children."

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Study: Gut Bacteria Levels Lower in Children with Autism

A study claims that children with autism have lower levels of bacteria in the gut which makes them more susceptible to harmful bacteria.

A link may exist between autism and bacteria in a child's digestive tract, a small new study suggests.

Researchers analyzed gut bacteria in fecal samples from 20 children with autism and 20 children without the disorder. The children with autism had significantly fewer types of gut bacteria, which potentially could make them more vulnerable to harmful bacteria.

The study also found that children with autism had significantly lower amounts of three types of important gut bacteria.

Autism, a neurodevelopmental disorder that can range from mild to severe, affects social and communication skills.

The new study appears July 3 in the journal PLoS One.

"One of the reasons we started addressing this topic is the fact that autistic children have a lot of [gastrointestinal] problems that can last into adulthood," study leader Rosa Krajmalnik-Brown, a researcher at Arizona State University's Biodesign Institute, said in a university news release. "Studies have shown that when we manage these problems, their behavior improves dramatically."

This type of research could lead to new ways to treat autism-associated gastrointestinal problems, and improve diagnosis, prevention and treatment of autism, the study authors said.

Previous research has shown that gut bacteria plays a role in a wide range of important functions, including digestion, controlling body weight, immune response regulation and the production of neurotransmitters that affect the brain and behavior.

Although this study showed a potential link between gut bacteria and autism, it did not prove a cause-and-effect relationship.

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Study: In-Vitro fertilization related to slight risk of mental deficit

A new study claims that children born through in-vitro fertilization have a slightly higher risk of having a mental deficit, possibly due to a lower birth weight.

Despite some concerns, children born by in vitro fertilization do not seem to have an increased risk of autism, a large new study finds. They may, however, have a slightly higher-than-normal chance of being intellectually impaired.

The study, reported in the July 3 issue of the Journal of the American Medical Association, looked at more than 2.5 million infants born in Sweden between 1982 and 2007. It found that the nearly 31,000 children conceived via in vitro fertilization (IVF) did not have an increased risk of the developmental disorder autism.

They were, however, 18 percent more likely to have an intellectual disability (which used to be called mental retardation), defined as an IQ lower than 70 and limited abilities in schoolwork .

Experts stressed that the risk is quite low: The rate of intellectual disability among IVF kids was about 46 per 100,000 each year, versus about 40 per 100,000 among kids conceived naturally.

"The vast majority of children born after the different types of IVF treatment will be perfectly healthy," said lead researcher Sven Sandin, of the Karolinska Institute, in Stockholm, and King's College London, in England.

What's more, the risk seemed largely related to the fact that babies born via IVF are often multiples (such as twins or triplets), and, therefore, frequently born preterm or at a low weight. That in itself carries a higher-than-normal risk of intellectual disability.

Experts said the findings suggest that whenever possible, IVF should involve implanting only one embryo in the woman's uterus, rather than the traditional route of implanting at least two.

"From the results of this study, we think that the use of single-embryo transfer should be extended," Sandin said.

An infertility specialist not involved in the study agreed. "I think we should be encouraging more single-embryo transfers," said Dr. Marcelle Cedars, director of reproductive endocrinology at the University of California, San Francisco.

That is happening more often these days, said Cedars, who wrote an editorial published with the study. At her center, she said, more than half of IVF patients have a single embryo implanted -- although that is higher than the national norm.

There is still a chance, however, that certain IVF procedures carry a risk.

Sandin's team found that a specific IVF technique used for male infertility -- called intracytoplasmic sperm injection, or ICSI -- was related to an increased risk of intellectual disability, even among single babies.

Again, the actual rates of intellectual impairment were quite low, Sandin said. But the results suggest there could be something about the intracytoplasmic sperm injection, or fathers' infertility, that contributes to the risk.

"People have for some time been concerned about the ICSI procedure," Cedars said.

That is partly because intracytoplasmic sperm injection is invasive: A single sperm is injected directly into an egg, whereas in standard IVF, sperm fertilize the eggs in a lab dish. "[ICSI] also bypasses the natural selection of sperm" that happens during fertilization, Cedars said, in which sperm compete to penetrate the egg and the fittest one wins.

But an alternative explanation is that male infertility -- which may involve genetically abnormal sperm -- is raising the risk of intellectual disability, rather than some effect of intracytoplasmic sperm injection, Cedars said.

Sandin agreed, but said it's impossible to say for sure based on these findings.

The study corroborates past research that has found no excess risk of autism after IVF. But this is by far the largest and best designed study to look at the question, Cedars said.

"This gives us powerful evidence that there is no association with autism," she said. She added that expectant parents can also be reassured that the risk of intellectual disability linked to intracytoplasmic sperm injection is still very low, even if it's higher than the norm.

Although the study found an association between certain IVF procedures and a higher risk of intellectual disabilities in children, it did not establish a cause-and-effect relationship.

Cedars and Sandin both said more studies are needed to see how children fare after IVF, and to dig for reasons for the current findings on ICSI.

Between 1978 and 2012, about 5 million children worldwide were born via IVF, and the numbers will only increase, Cedars said. And in some countries -- including the United States -- intracytoplasmic sperm injection is being increasingly used in cases in which there is no clear problem with the man's fertility, because there is a perception that it's more efficient.

But that belief, Sandin's team said, is unproven.

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Sleep and Emotional Health

Sleep can have a large impact on a person's emotional health and vice versa.

The relationship between disordered sleep and emotional health is an intricate one, as each can influence the other for better and worse. Stress and worry, as well as mental illnesses such as depression and anxiety can interfere with sleep. And an abundance of research indicates that people who experience disrupted sleep, including obstructive sleep apnea and insomnia, are at dramatically elevated risk for depression and other psychiatric disorders. Insomnia is an important risk factor for depression, and has also been linked to a sharply increased risk of suicide among people who suffer from depression. Despite all that we know about this complicated relationship, scientists are still working to understand the underlying mechanics and root causes of sleep disorders and mood disorders when both are present.

A new study provides some important new information about how disrupted, insufficient sleep may contribute to the onset of emotional difficulties as well as the development of depression and other psychiatric problems. Researchers at the University of Pittsburgh School of Medicine investigated emotional responses in the brains of people with insomnia and found dysfunctional activity in an area of the brain that regulates and processes emotions. Their findings may provide an explanation for the mechanism by which disrupted sleep influences depression and other psychiatric conditions.

Researchers included 44 adults in their study. Of these, 14 had chronic insomnia, and no other primary psychiatric disorders. The remaining 30 participants were people who had no insomnia and who slept well. All of the study subjects participated in the same exercise, a task involving voluntary emotional regulation. First, participants were shown a series of images containing both negative and neutral emotional content. They were asked to view the series of images passively, without trying to control or influence their emotional responses. When they were shown the images a second time, participants were asked to decrease their emotional response using a voluntary emotional regulation technique called cognitive reappraisal. Cognitive reappraisal involves the deliberate attempt to change your emotional response to a stimulus. In this case, participants were asked to intentionally decrease their negative emotional responses to the images shown to them. Researchers’ analysis showed:

• A distinct difference in the brain activity of those with insomnia compared to those with normal sleep patterns. Specifically, researchers found a dramatic difference in the activity of the amygdala, a cluster of neurons within the temporal lobe that plays a critical role in processing and regulating emotion.
• Amygdala activity was significantly greater for those with insomnia during the period when they were asked to decrease their negative responses to images using cognitive reappraisal, compared to those without the sleep disorder.
• There was no significant difference between insomnia and non-insomnia participants during their passive viewing of the images.

Previous research has shown that cognitive reappraisal decreases amygdala activity.These results, which show the opposite, suggest that insomnia may impair the brain’s ability to successfully process negative emotions, a finding that could help to explain the mechanics of how sleep contributes to depression and other psychiatric disorders.

Other recent research has demonstrated evidence of neural changes and emotional regulation difficulties among people with disordered, insufficient sleep:

• The ability to accurately judge emotion in human faces is compromised by sleep deprivation, according to research conducted at the University of California, Berkeley. Researchers measured the ability to read emotions in faces by people who were sleep deprived in a laboratory setting, and found significant impairment to their assessment of certain emotions, including anger and sadness. The impairment was particularly significant among women. The decrease in this ability was alleviated after a night of recovery sleep.
• Researchers in the United Kingdom examined how sleep deprivation affects inhibition and impulse control. They found a night of sleep deprivation lowered inhibition and increased impulsivity to negative stimuli.
• In responding to a series of images categorized as pleasant, neutral, or unpleasant, people who were sleep deprived perceived the neutral images more negatively than those who were not sleep deprived. Those who were sleep deprived also demonstrated more negative moods.
• Sleep deprived patients were more highly reactive to both negative and positive stimuli, showing greater levels of activity in the limbic regions of the brain, where much of the work of emotional regulation and processing occurs.

The latest research findings add to the growing body of scientific knowledge indicating that sleep problems cause dysfunction in the brain that may contribute to emotional difficulties and psychiatric conditions. This is an exciting and important area of research, as scientists continue to explore the biological roots of both sleep disorders and psychiatric disorders.

All of us who’ve experienced insufficient, disrupted sleep know first-hand how being sleep deprived can negatively affect our emotional equilibrium. When we’re tired, we’re more likely to be short-tempered, impatient, and moody. Research such as this brings us closer to understanding the mechanics that may underlie a broad range of emotional disturbance and dysfunction.

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