Geschwind D.H.,Semel Institute |
State M.W.,University of California at San Francisco
The Lancet Neurology | Year: 2015
Autism spectrum disorder is typical of the majority of neuropsychiatric syndromes in that it is defined by signs and symptoms, rather than by aetiology. Not surprisingly, the causes of this complex human condition are manifold and include a substantial genetic component. Recent developments in gene-hunting technologies and methods, and the resulting plethora of genetic findings, promise to open new avenues to understanding of disease pathophysiology and to contribute to improved clinical management. Despite remarkable genetic heterogeneity, evidence is emerging for converging pathophysiology in autism spectrum disorder, but how this notion of convergent pathways will translate into therapeutics remains to be established. Leveraging genetic findings through advances in model systems and integrative genomic approaches could lead to the development of new classes of therapies and a personalised approach to treatment. © 2015 Elsevier Ltd. Source
Walwyn W.M.,Semel Institute |
Miotto K.A.,University of California at Los Angeles |
Evans C.J.,Semel Institute and Brain Research Institute
Drug and Alcohol Dependence | Year: 2010
There are few pharmaceuticals superior to opiates for the treatment of pain. However, with concerns of addiction, withdrawal and questionable efficacy for all types of pain, these compounds are far from a magical panacea for pain-relief. As it is unlikely that other classes of compounds will supersede the opioids in the very near future, it is important to both optimize current opioid therapies and curb the astounding diversion of opioids from their intended analgesic use to non-medical abuse. In optimizing opioid therapeutics it is necessary to enhance the clinical awareness of the benefits of treating pain and combine this with aggressive strategies to reduce diversion for non-medical use. At the heart of the issue of opioid misuse is the role of opioid systems in the reward circuitry, and the adaptive processes associated with repetitive opioid use that manifest during withdrawal. Emerging pharmacological insights of opioid receptors will be reviewed that provide future hope for developing opioid-based analgesics with reduced addictive properties and perhaps, reduced opponent processes. In addition, with the increased understanding of nociceptive circuitry and the molecules involved in transmitting pain, new therapeutic targets have become evident that may result in effective analgesics either alone or in combination with current opioid therapies. © 2010. Source
Ford C.L.,University of California at Los Angeles |
Wallace S.P.,University of California at Los Angeles |
Newman P.A.,University of Toronto |
Lee S.-J.,University of California at Los Angeles |
And 2 more authors.
Gerontologist | Year: 2013
Purpose: One in 4 persons living with HIV/AIDS is an older adult (age 50 or older); unfortunately, older adults are disproportionately diagnosed in late stages of HIV disease. Psychological barriers, including belief in AIDS-related conspiracy theories (e.g., HIV was created to eliminate certain groups) and mistrust in the government, may influence whether adults undergo HIV testing. We examined relationships between these factors and recent HIV testing among at-risk, older adults. Design and Methods: This was a cross-sectional study among older adults enrolled in a large venue-based study. None had a previous diagnosis of HIV/AIDS; all were seeking care at venues with high HIV prevalence. We used multiple logistic regression to estimate the associations between self-reported belief in AIDS-related conspiracy theories, mistrust in the government, and HIV testing performed within the past 12 months. Results: Among the 226 participants, 30% reported belief in AIDS conspiracy theories, 72% reported government mistrust, and 45% reported not undergoing HIV testing within the past 12 months. Belief in conspiracy theories was positively associated with recent HIV testing (adjusted odds ratio [OR] = 1.94, 95% confidence interval [CI] = 1.05- 3.60), whereas mistrust in the government was negatively associated with testing (OR = 0.43, 95% CI = 0.26-0.73). Implications: Psychological barriers are prevalent among at-risk older adults seeking services at venues with high HIV prevalences and may influence HIV testing. Identifying particular sources of misinformation and mistrust would appear useful for appropriate targeting of HIV testing strategies. © The Author 2013. All rights reserved. Source
Chung B.,RAND Corporation |
Chung B.,University of California at Los Angeles |
Jones L.,Healthy African American Families II |
Dixon E.L.,Queenscare Health and Faith Partnership |
And 3 more authors.
Journal of Health Care for the Poor and Underserved | Year: 2010
Quality improvement (QI) for depression in primary care can reduce disparities in outcomes. We describe how community-partnered participatory research was used to design Community Partners in Care, a randomized trial of community engagement to activate a multiple-agency network versus support for individual agencies to implement depression QI in underserved communities. Source
It’s an age-old quandary: Are we born “noble savages” whose best intentions are corrupted by civilization, as the 18th century Swiss philosopher Jean-Jacques Rousseau contended? Or are we fundamentally selfish brutes who need civilization to rein in our base impulses, as the 17th century English philosopher Thomas Hobbes argued? After exploring the areas of the brain that fuel our empathetic impulses — and temporarily disabling other regions that oppose those impulses — two UCLA neuroscientists are coming down on the optimistic side of human nature. “Our altruism may be more hard-wired than previously thought,” said Leonardo Christov-Moore, a postdoctoral fellow at UCLA’s Semel Institute of Neuroscience and Human Behavior. The findings, reported in two recent studies, also point to a possible way to make people behave in less selfish and more altruistic ways, said senior author Marco Iacoboni, a UCLA psychiatry professor. “This is potentially groundbreaking,” he said. For the first study, which was published in February in Human Brain Mapping, 20 people were shown a video of a hand being poked with a pin and then asked to imitate photographs of faces displaying a range of emotions — happy, sad, angry and excited. Meanwhile, the researchers scanned participants’ brains with functional magnetic resonance imaging, paying close attention to activity in several areas of the brain. One cluster they analyzed — the amygdala, somatosensory cortex and anterior insula — is associated with experiencing pain and emotion and with imitating others. Two other areas are in the prefrontal cortex, which is responsible for regulating behavior and controlling impulses. In a separate activity, participants played the dictator game, which economists and other social scientists often use to study decision-making. Participants are given a certain amount of money to either keep for themselves or share with a stranger. In the UCLA study, participants were given $10 per round for 24 rounds, and the recipients were actual Los Angeles residents whose names were changed for the game, but whose actual ages and income levels were used. After each participant had completed the game, researchers compared their payouts with brain scans. Participants with the most activity in the prefrontal cortex proved to be the stingiest, giving away an average of only $1 to $3 per round. But the one-third of the participants who had the strongest responses in the areas of the brain associated with perceiving pain and emotion and imitating others were the most generous: On average, subjects in that group gave away approximately 75 percent of their bounty. Researchers referred to this tendency as “prosocial resonance” or mirroring impulse, and they believe the impulse to be a primary driving force behind altruism. “It’s almost like these areas of the brain behave according to a neural Golden Rule,” Christov-Moore said. “The more we tend to vicariously experience the states of others, the more we appear to be inclined to treat them as we would ourselves.” In the second study, published earlier this month in Social Neuroscience, the researchers set out to determine whether the same portions of the prefrontal cortex might be blocking the altruistic mirroring impulse. In this study, 58 study participants were subjected to 40 seconds of a noninvasive procedure called theta-burst Transcranial Magnetic Stimulation, which temporarily dampens activity in specific regions of the brain. In the 20 participants assigned to the control group, a portion of the brain that had to do with sight was weakened on the theory it would have no effect on generosity. But in the others, the researchers dampened either the dorsolateral prefrontal cortex or the dorsomedial prefrontal cortex, which combine to block impulses of all varieties. Christov-Moore said that if people really were inherently selfish, weakening those areas of the brain would free people to act more selfishly. In fact, though, study participants with disrupted activity in the brain’s impulse control center were 50 percent more generous than members of the control group. “Knocking out these areas appears to free your ability to feel for others,” Christov-Moore said. The researchers also found that who people chose to give their money to changed depending on which part of the prefrontal cortex was dampened. Participants whose dorsomedial prefrontal cortex was dampened, meanwhile, tended to be more generous overall. But those whose dorsolateral prefrontal cortex was dampened tended to be more generous to recipients with higher incomes — people who appeared to be less in need of a handout. “Normally, participants would have been expected to give according to need, but with that area of the brain dampened, they temporarily lost the ability for social judgments to affect their behavior,” Christov-Moore said. “By dampening this area, we believe we laid bare how altruistic each study participant naturally was.” The findings of both studies suggest potential avenues for increasing empathy, which is especially critical in treating people who have experienced desensitizing situations like prison or war. “The study is important proof of principle that with a noninvasive procedure you can make people behave in a more prosocial way,” Iacoboni said.