Brain Awareness Week 2013 runs from March 11 until St. Patrick’s Day (a particularly good day to be thinking about protecting your noggin).  In honor of this worldwide celebration, IRETA offers a brief update on adolescent brain research with a dash of SBIRT.

On Thursday, March 7, the Interagency Coordinating Committee on the Prevention of Underage Drinking (ICCPUD)  presented a webinar about brain research and underage screening–two topics of great interest to IRETA staff and certainly great relevance to medical practitioners, parents, and anyone who works with youth.  The whole slideshow presentation is available to download here.

Below is a summary of key points.

1. Dr. Vivian Faden of the National Institute on Alcohol Abuse and Alcoholism (NIAAA) introduced the concept of “scaffolding,” protective stuff in a young person’s life that may help steer away from harmful substance use.  Most of the scaffolding she mentioned was intuitive and familiar, such as “positive peer groups.”  But she also emphasized screening as scaffolding.

Nationally, the highest prevalence of alcohol dependence diagnoses is among 18-20 year olds.  Implementing universal screening programs, she said, will help catch these cases earlier, before they progress to dependence.  And, she said, we’ve got to change the landscape so that children and adults expect to talk about drinking with their doctors.

2. Dr. Faden explained the need for a new tool to screen adolescents and showed the group NIAAA’s screening tool for youth.  It’s the shortest one available, only two questions long.   The tool itself, NIAAA’s Practitioner’s Guide, and other resources are all available online.   Other resources include information about confidentiality for minors and brief motivational interviewing methods.

Although the tool was designed for use in primary care offices, it’s currently being evaluated in five sites, including school and juvenile justice settings.

3.  NIAAA’s Dr. Aaron White broke down some of the ways that–in just the last couple years– researchers have begun to understand substance use and the adolescent brain.  It’s fascinating stuff.  During childhood, the brain’s gray matter increases.  We’ve known that for awhile.  This has led to the conclusion that the brain is pretty well developed by adolescence.  However, during the adolescent years, although gray matter production declines, white matter production increases.  Scientists are beginning to understand why this matters.

Gray matter is what we usually think of as “brain cells.”  It’s where memories are stored and computations take place.  White matter, however, has been called the “bedrock” of the brain.  It supports gray matter.  It facilitates communication throughout the brain.  During adolescence, when white matter increases, it sort of “locks in” gray matter.  It helps solidify who we are.   The brain is very much developing during adolescence: it’s going from a mushier, moldable state to a more concrete one.

4.  Dr. White talked about three areas of the adolescent brain affected by substance use:  the prefrontal cortex, the hippocampus, and the reward system.  This is really interesting.  He explained how substance use during adolescence has immediate and long term effects on these parts of the brain.  Below, dramatically simplified, is what we know.

PREFRONTAL CORTEX: The prefrontal cortex is responsible for advanced, human-type behavior like planning, personality, decision-making, socializing.

• In the short term: Alcohol and drugs prevent it from working fully.  Therefore, impulsive behavior increases.  Risks are taken.
• In the long term: Alcohol and drugs affect its development.  This can lead to cognitive deficits, like difficulty with long-term planning.

HIPPOCAMPUS: The hippocampus makes autobiographical memories.  We use it to tell ourselves the story of who we are and what’s happened to us.

• In the short-term: Alcohol and drugs, in large quantities, can cause the hippocampus to shut down.  This is known as a blackout.  Obviously, a blackout poses all sorts of dangers, including the possibility of continued substance use resulting in poisoning/overdose.
• In the long-term: The neurogeneration of the hippocampus peaks during adolescence.  As with the prefrontal cortex, there’s evidence that the hippocampus doesn’t develop as well for people who use substances during their adolescence.

REWARD SYSTEM: The reward system extends into many parts of our brains.  It’s very old and is designed to keep us alive.  The primary neurotransmitter associated with the reward system is dopamine, the chemical rush that makes us feel good, that “rewards” us.  The reward system is activated when we eat good food, during orgasm, and when we feel a sense of pride in our accomplishments.  All intoxicants that humans use activate this system.  That’s what NIDA’s Dr. Volkow is referring to when she says that drugs “hijack our brains.”

An adolescent’s reward system is especially acute.  This is because her brain is working hard to learn how to survive “outside the nest.”  The clock is ticking.  So the adolescent brain’s reward system is particularly intense to emphasize life lessons learned.

• In the short term: The good feelings associated with alcohol and drugs are more intense and can lead more easily to repeated use
• In the long term: Seeking the reward associated with substances can become a habitual behavior into adulthood

5. Dr. White shared his perception that heavy binge drinking seemed to be intensifying among young people.  He cited a substantial increase in hospitalizations related to alcohol overdose in the past decade.  He also pointed to the issue of alcohol combined with other drugs, which increased at a higher rate during that time period.   Widespread adolescent polydrug use is on the rise.

6. Much of the brain research that Dr. White presented, he told the group, is very new.  It’s only in the last few years that scientists recognized that white matter matters at all.  And the investigation of the long-term effects of substance use on the three areas of the brain outlined above–that’s still in its earliest stages.

Rather exciting, isn’t it?  By Brain Awareness Week 2014 (March 10-16; mark your calendars), we will surely know more than we do today.

Recommended Resource

In 2011, National Geographic published “Teenage Brains,” a lovely feature-length article looking at what we’re learning about how adolescent brain development works

An aerial view of the University of Hawai’i at Manoa, Honolulu, and Diamond Head.

On Friday, I finished my first of six weeks of lab work at the University of Hawai’i (UH) at Manoa’s Biogeochemical Stable Isotope Facility.  My work here will contribute to one chapter of my PhD dissertation, and is supported by the Inter-university Training for Continental-scale Ecology program at the University of Utah and my SciFund supporters (thank you!).  UH is the best place for me to complete this lab work because their facility is well equipped, and the lab personnel (especially my direct supervisor Dr. Brian Popp) have lots of experience using the analysis of compound-specific amino acids (I’ll explain in a bit…) research techniques to answer ecological questions that are similar to those of my study, and specifically for species that inhabit open ocean ecosystems (like sea turtles!).  Over the next few weeks, I’ll be chronicling my research-in-residence experience.  And after just one week, I can already report that Hawaii is not a bad place to work!

The Big Picture:  Previously, I collected epidermis (“skin”) samples from 350 individual olive ridley sea turtles from across an area of the eastern Pacific Ocean that spans the latitudes of Mexico and several countries in Central America, and extends offshore hundreds of miles — quite a large study region!  These oceanic samples are rare due to the resource and logistical restraints of at-sea data collection, and therefore this is one of the first studies able to address large-scale marine turtle ecology and conservation questions in such breadth and depth.

The Skinny on Stable Isotopes:  “You are what you eat!”  That is the idea behind stable isotope analysis.  When an animal consumes food, elements like carbon and nitrogen are assimilated into it’s tissues.  Isotopes are atoms of the same element (e.g., Carbon) that have different masses (e.g., 12C and 13C).  During biological processes, such as respiration, the lighter stable isotope (12C) reacts more readily than the heavier stable isotope (13C), and thus at any given time, a fraction of the heavier isotope (13C) is left behind, which is called “fractionation.”  Studies like mine use isotope-ratio mass spectrometry to measure the ratio of stable isotopes stored in animal tissue, relative to a known standard — a biochemical thumbprint of sorts:

δ13C ‰ = [(13C/12Csample - 13C/12Cstandard) / (13C/12Cstandard)] * 1000

What I’m Doing:   I am measuring the stable isotope values of my olive ridley skin samples in order to piece together a comprehensive snapshot of what individual turtles were eating during a certain time frame (in this case, a matter of weeks to months), and in which foodwebs.  Here at UH, I am focusing on Nitrogen, and I’m trying to discern if olive ridleys have distinct foraging areas by latitude, or relative to distance-to-shore, or both.

While at UH, I will be analyzing 24 samples for specific amino acids, which are the building blocks for proteins.  (24 might not seem like a lot, but remember how hard it is to obtain these samples at-sea, and keep in mind that each sample costs about $225 to run!)  To do this, I first need to isolate the amino acids stored in each sea turtle skin sample –> chemistry!

I ground each skin sample with a mortar and pestle and placed the tiny bits into a glass vial, where all the chemistry takes place:

The very first steps of the process are freeze drying the skin sample and removing the lipids (resultant skin sample in top pane). Then, an appropriate amount (5-10mg) of sample must be ground with a mortar and pestle (lower left) and transferred to a glass vial (lower right), in which all the chemistry is performed.

Then, I instigated a number of chemical reactions with fancy names like “acid hydrolysis,” “esterification of the carboxyl terminus,” and “trifluoroacetylation of the amine group,” which took 3.5 days to complete.  This photo collage provides a snapshot of the various steps involved:

The 45-step sample preparation for my first batch of 9 turtle skin samples took about 4 days. One down, at least two more batches to go!

The third-to-last step in a 45-step sample prep process.

One of the last and most satisfying steps is collecting the distinct layer of chloroform-bound purified amino acids — the fruits of my labor!

At the end of the week, I had nine of 24 samples prepped and ready for mass spectrometry… but we’ll save that chemistry lesson for another day!

For each ‘Batch 1′ turtle skin sample, these are the isolated amino acids in chloroform, ready for analysis of stable nitrogen of individual amino acids!

http://www.clinicaltrials.gov as #NCT01065038

Based on the research, Anagrelide as the selective platelet lowering agent is not inferior compared to hydroxyurea in preventing thrombotic complications in patients. More details on the article can be found from the following source below.

Source:

bloodjournal: http://bloodjournal.hematologylibrary.org/content/early/2013/01/11/blood-2012-07-443770.abstract
Anagrelide: http://en.wikipedia.org/wiki/Anagrelide
Hydroxyurea: http://en.wikipedia.org/wiki/Hydroxycarbamide

The problems with women and Hollywood include massive underrepresentation (TV, however is ahead of the curve, and certainly the better for the likes of Fey and Rhimes), a body-image obsession that pigeonholes actresses and largely limits positive roles to “sexy” roles, the assumption that movies need to be drafted for and marketed to each sex, and poorer odds for women to move into executive positions, financially or creatively.

Some films count on a female vote and aren’t ashamed to show it. Consider the fuzzy yellow trailer for “The Help” featuring witticisms by the black leads and a plucky score (a far cry from the actual tone of the film), or the sexy, glittery trailers for “Magic Mike” and “Sex and the City 2”; others are projected to attract men but include images of shirtless men in their trailers, presumably to encourage the wives and girlfriends to come along. Obviously, the equation of female moviegoers’ interest with their desires for friendship  with women and sex with men is as problematic as the equation of female actors’ and filmmakers’ success according to their perpetuation of female stereotypes of personality and social worth. Either way, there are significant economic and psychological impacts on those women who love film. They are neither as uniform in their approach nor singular in their interests nor small in number as andocentric Hollywood would suggest.

See also my essay on institutional sexism and feminism over at Confluey, and my prezi on violent female characters.