Study identifies brain networks that play crucial role in suicide risk
An international team of researchers has identified key networks within the brain which they say interact to increase the risk that an individual will think about — or attempt — suicide.
Writing today in Molecular Psychiatry, the researchers say that their review of existing literature highlights how little research has been done into one of the world’s major killers, particularly among the most vulnerable groups, medicalxpress.com reported.
The facts in relation to suicide are stark: 800,000 people die globally by suicide every year, the equivalent of one every 40 seconds.
Suicide is the second leading cause of death globally among 15-29 year olds. More adolescents die by suicide than from cancer, heart disease, AIDS, birth defects, stroke, pneumonia, influenza, and chronic lung disease combined. As many as one in three adolescents think about ending their lives and one in three of these will attempt suicide.
“Imagine having a disease that we knew killed almost a million people a year, a quarter of them before the age of thirty, and yet we knew nothing about why some individuals are more vulnerable to this disease,” said Dr. Anne-Laura van Harmelen, co-first author from the University of Cambridge. “This is where we are with suicide. We know very little about what’s happening in the brain, why there are sex differences, and what makes young people especially vulnerable to suicide.”
A team of researchers, including Hilary Blumberg, MD, John and Hope Furth Professor of Psychiatric Neuroscience at Yale, carried out a review of two decades’ worth of scientific literature relating to brain imaging studies of suicidal thoughts and behavior.
In total, they looked at 131 studies, which covered more than 12,000 individuals, looking at alterations in brain structure and function that might increase an individual’s suicide risk.
Combining the results from all of the brain imaging studies available, the researchers looked for evidence of structural, functional, and molecular alterations in the brain that could increase risk of suicide. They identified two brain networks — and the connections between them — that appear to play an important role.
The first of these networks involves areas towards the front of the brain known as the medial and lateral ventral prefrontal cortex and their connections to other brain regions involved in emotion. Alterations in this network may lead to excessive negative thoughts and difficulties regulating emotions, stimulating thoughts of suicide.
The second network involves regions known as the dorsal prefrontal cortex and inferior frontal gyrus system. Alterations in this network may influence suicide attempt, in part, due to its role in decision making, generating alternative solutions to problems, and controlling behavior.
The researchers suggest that if both networks are altered in terms of their structure, function or biochemistry, this might lead to situations where an individual thinks negatively about the future and is unable to control their thoughts, which might lead to situations where an individual is at higher risk for suicide.
“The review provides evidence to support a very hopeful future in which we will find new and improved ways to reduce risk of suicide,” said Professor Hilary Blumberg. “The brain circuitry differences found to converge across the many studies provide important targets for the generation of more effective suicide prevention strategies.
“It is especially hopeful that scientists, such as my co-authors on this paper, are coming together in larger collaborative efforts that hold terrific promise.”
The majority of studies so far have been cross-sectional, meaning that they take a ‘snapshot’ of the brain, rather than looking over a period of time, and so can only relate to suicidal thoughts or behaviors in the past.
The researchers say there is an urgent need for more research that looks at whether their proposed model relates to future suicide attempts and at whether any therapies are able to change the structure or function of these brain networks and thereby perhaps reduce suicide risk.
The review highlighted the paucity of research into suicide, particularly into sex differences and among vulnerable groups. Despite suicidal thoughts often first occurring as early as during adolescence, the majority of studies focused on adults.
“The biggest predictor of death by suicide is previous suicide attempt, so it’s essential that we can intervene as early as possible to reduce an individual’s risk,” said co-first author Dr. Lianne Schmaal from the University of Melbourne. “For many individuals, this will be during adolescence. If we can work out a way to identify those young people at greatest risk, then we will have a chance to step in and help them at this important stage in their lives.”
Even more striking, despite the fact that transgender individuals are at increased risk for suicide, just one individual in the 131 samples included for the review was identified to be transgender.
“There are very vulnerable groups who are clearly not being served by research for a number of reasons, including the need to prioritize treatment, and reduce stigma,” said van Harmelen. “We urgently need to study these groups and find ways to help and support them.”
In 2018, the researchers launched the HOPES (Help Overcome and Prevent the Emergence of Suicide) study, supported by the mental health research charity MQ. HOPES brings together data from around 4,000 young people across 15 different countries in order to develop a model to predict who is at risk of suicide. Over the course of the project, the team will analyze brain scans, information on young people’s environment, psychological states and traits in relation to suicidal behavior from young people from across the world, to identify specific, universal risk-factors.
Brush your teeth to protect the heart
Brushing teeth frequently is linked with lower risks of atrial fibrillation and heart failure, according to a study published in the European Journal of Preventive Cardiology, a journal of the European Society of Cardiology (ESC).
Previous research suggests that poor oral hygiene leads to bacteria in the blood, causing inflammation in the body. Inflammation increases the risks of atrial fibrillation (irregular heartbeat) and heart failure (the heart’s ability to pump blood or relax and fill with blood is impaired), medicalxpress.com reported.
This study examined the connection between oral hygiene and occurrence of these two conditions.
The retrospective cohort study enrolled 161,286 participants of the Korean National Health Insurance System aged 40 to 79 with no history of atrial fibrillation or heart failure. Participants underwent a routine medical examination between 2003 and 2004. Information was collected on height, weight, laboratory tests, illnesses, lifestyle, oral health, and oral hygiene behaviors.
During a median follow-up of 10.5 years, 4,911 (3.0 percent) participants developed atrial fibrillation and 7,971 (4.9 percent) developed heart failure.
Tooth brushing three or more times a day was associated with a 10 percent lower risk of atrial fibrillation and a 12 percent lower risk of heart failure during 10.5-year follow up. The findings were independent of a number of factors including age, sex, socioeconomic status, regular exercise, body mass index, and comorbidities such as hypertension.
While the study did not investigate mechanisms, one possibility is that frequent tooth brushing reduces bacteria in the subgingival biofilm (bacteria living in the pocket between the teeth and gums), thereby preventing translocation to the bloodstream.
Senior author Dr. Tae-Jin Song of Ewha Womans University, Seoul, South Korea, noted that the analysis was limited to one country and as an observational study does not prove causation. But he added: “We studied a large group over a long period, which adds strength to our
An accompanying editorial stated: “It is certainly too early to recommend tooth brushing for the prevention of atrial fibrillation and congestive heart failure”. It added: “While the role of inflammation in the occurrence of cardiovascular disease is becoming more and more evident, intervention studies are needed to define strategies of public health
Seven bitter herbs to improve digestion
Proper digestion, absorption, and utilization of nutrients is very important to nourish cells, tissues, and organs. Some herbs that help improve digestion are digestive bitters.
The bitter herbs have an intensely bitter taste. This bitterness promotes appetite and aids digestion. This action can be achieved via the taste buds and a reflex action in the brain. If these herbs are given in capsules and cannot be tasted, their digestive properties do not come into play, manukafeed.com wrote.
Some other herbs that aid digestion are sialogogue which stimulate the flow of saliva. As digestion starts in the mouth, the importance of saliva in the digestion cannot be overstressed. The saliva breaks down large carbohydrates into smaller units, which can then be processed in other parts of the system. Eating in a rush can hinder proper digestion, as there will be no time for saliva to mix thoroughly with the food.
Cayenne pepper (red hot chili pepper) is a sialogogue, which stimulates the flow of saliva. It also increases secretion of digestive fluids by the stomach. Ginger is also great for circulation, the heart, respiratory system, lungs, and the colon. It can be a great substitute for black pepper. But remember it is very hot, so use sparingly and be careful with a shaker — if the powder is in the air, it can cause sneezing. If some gets in your eyes, flush them with cool water immediately.
Ginger, like cayenne, is a good sialogogue. It promotes gastric secretion. Ginger can also act as a bitter and can stimulate sluggish digestion. It is a classic digestive tonic that has multiple benefits for the digestive tract, including toning of the intestinal muscles, improving bile flow, helping with the digestion of fats, and lessening the risk of intestinal inflammation. Besides easing indigestion, ginger also reduces inflammation, stimulates blood circulation, helps with nausea and relieves feverish conditions. Ginger root tea eases sore throat pain and kills cold viruses. For an infusion or tea, pour a cup of boiling water over one teaspoonful of the fresh root and let it infuse for five minutes. To prevent motion sickness, drink tea or juice mixed with half a teaspoon of ground ginger 30 minutes before traveling.
Centaury is a strong bitter, aromatic, mild nervine and gastric stimulant. It will definitely improve digestion and it is a useful herb in dyspepsia or any condition where a sluggish digestion is involved. In dyspepsia, it works best in combination with Meadowsweet, Marshmallow Root, and Chamomile. It is indicated also in appetite loss like anorexia nervosa, especially in combination with Burdock root and Chamomile.
But it may be used whenever a digestive and gastric stimulant is required. For an infusion/tea, pour a cup of boiling water over one teaspoon of dried herbs and let it stand for 5-10 minutes. It should be taken 30 minutes before meals.
Though Barberry is one of the best remedies for correcting liver function and promoting the flow of bile, it is also a bitter tonic with mild laxative effects. It is used to strengthen and cleanse the system, especially in weak or debilitated people. It is often indicated when there is an inflammation of the gallbladder or in the presence of gallstones. But it should be avoided in pregnancy. To enjoy it, put one teaspoonful of the bark into a cup of cold water and bring to the boil. Leave for 10-15 minutes and drink three times a day.
Gentian is among the strongest digestive bitters. It stimulates the appetite and digestion through a general stimulation of the digestive juices. Gentian promotes the production of saliva, gastric juices, and bile. It is also accelerates the emptying of the stomach. It is indicated in cases with a lack of appetite and sluggishness of the digestive system. Thus, it may be helpful with many symptoms of the improper digestion such as dyspepsia and flatulence. Put 1/2 a teaspoonful of the shredded root in a cup of water and boil for five minutes. This should be drunk warm about 15-30 minutes before meals.
Dandelion root is a mild bitter, especially the one collected in spring. It is also a powerful diuretic with the best natural sources of potassium. This makes dandelion root is ideally balanced and safe diuretic. To prepare a drink, put two or three teaspoonfuls of the root into a cup of water and bring it to the boil and gently simmer for 10-15 minutes. This should be drunk three times a day.
Elecampane’s excellent bitter principle makes it useful to stimulate appetite and improve digestion. But it is also a good expectorant (relieves cough) and diaphoretic (helps with fever). Elecampane is very useful for irritating bronchial coughs, especially in children.
It may even be used in asthma and bronchitic asthma as well as in the treatment of tuberculosis. To make an infusion, pour a cup of cold water over one teaspoon of the shredded root. Let it stand for 8-10 hours.
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