Tuesday, January 27, 2009

Cocaine - Prenatal Exposure

A New York Times story, "'Crack Babies': An Epidemic That Didn't Happen" (January 27, 2009) gives good news on this topic. Children ages 4 - 13 who had prenatal exposure to cocaine have recovered from initial slow growth (both body and brain) and show no statistically significant difference in IQ. As a group, they are more likely to have decreased visual attention and executive function. They also have an increased frequency of defiant behavior and poor conduct. However, their symptoms are so subtle as to make it impossible to pick them out of a group of typical children. It appears that prenatal exposure to cocaine is similar in effect to that of tobacco, and thankfully, not at all similar to the effect of alcohol.

Eating Dirt

There is one less worry for parents - especially parents of children who lick or eat everything in sight (pica).

Jane Brody's New York Times' column today reviews the case for ingesting dirt. Children who run barefoot in the dirt, and eat with dirt on their hands are less likely to develop allergies and asthma. Children who are exposed to farm animals (or to household pets) with worms are less likely to get inflammatory bowel, Crohn's diseases and other autoimmune diseases. This is not to say that we should not wash our hand after using the toilet. We should. But just plain soap and water, please.

Dr. Brody asked immunologist, Dr. David Elliott, about intestinal worms. "There are very few diseases that people get from worms", he said. In fact, in Argentina, persons with Multiple Sclerosis who were infected with human whipworm had fewer recursions and with decreased severity. And pig whipworms, which stay for just a short time in the human intestinal tract, are beneficial for treating IBS, Crohn's and ulcerative colitis.

More reading: "Why Dirt is Good", Mary Ruebush, (Kaplan).

Sunday, January 25, 2009

Winter Depression and Low Dose Melatonin

Over the Counter Treatment for Seasonal Affective Disorder

I published this on my Brain-TuneUps blog, and am duplicating it here.

The short story: Low daily doses of liquid melatonin taken every day for 4 weeks once SAD has set in, can lift the mood. A low dose of melatonin - .3 mg - can be obtained by using small amounts of liquid melatonin. The time of day it is taken is important. For most people it is in the afternoon. For some (30%) it should be taken in the morning. (Per research (2) cited below)

Melatonin is available over the counter, but one should consult a doctor regarding usage.

Long Story: I live in a gray winter climate. Last week, I felt SAD creep into my brain. I used Natrol melatonin 1 mg liquid purchased from my local health food store. The dropper that came with my bottle holds .25 mg. of melatonin. I put the drops into a glass of water and drank it slowly during two hours in the afternoon. I noticed a positive effect in 24 hours and continued to see improvements over the next few days. I feel 85% back to normal. Light therapy in the morning would probably take care of the remnants of grogginess. I plan to continue until the end of February when daylight returns here and I am more active outside.

A running theory of the cause of seasonal affective disorder (SAD) or winter depression, is that a person's circadian rhythms are out of sync. NIHM defines this: "A person's rhythms are synchronized when the interval between the time the pineal gland begins secreting melatonin and the middle of sleep is about 6 hours. (1)" There are a number of therapies aimed at correcting the problem including lights, exercise, anti-depressants and melatonin. (See the Wikipedia entry.)

The synchronization can be off in two ways: - a longer-than or a shorter-than 6 hour interval. A study by Lewy, et al (2), showed that subjects who took low dosages of melatonin every day for 4 weeks found an improvement in mood. The dosage was as follows: for those who's interval is less than 6 hours, .3 mg in the afternoon. For those with a longer than 6 hour interval, .3 mg in the morning. If you have to guess which you are, the odds from the study favor the short interval (71% to 29%). The study gave 2 small doses adding up to .3 mg in 2 hours.

Melatonin is available over the counter, but generally in high dose formulations. The study used capsule formulation. There are liquid forms of melatonin available in some health food stores. (Again, I found Natrol 1 mg, and adjusted the amount.)

Both articles cited are available on line.

1. April 2006 article from the National Institute of Mental Health, "Properly Timed Light, Melatonin Lift Winter Depression by Syncing Rhythms".

2. Lewy AJ, Lefler BJ, Emens JS, Bauer VK. The circadian basis of winter depression. Proc Natl Acad Sci U S A. 2006 Apr 28.

Monday, January 19, 2009

Imitation as therapy

Last week, a colleague passed along the book, "Mirror Neurons and the Evolution of Brain and Language", by editors Stamenov and Gallese. Mirror neurons exist in specific regions in the brain and have a unique mission: learn how to copy someone else's movements as a way of learning to do something new. For a child this might be: take a lid off of a jar, play hopscotch, or hopefully, for one of my clients, brush your teeth.

Alicia, a 5 year old girl with autism, refuses to let mom brush her teeth (without a big fight). Mom and I want to desensitize her mouth a bit, so that she more readily accepts brushing. I put a glove on my hand and played games with Alicia while she was swinging. I managed to touch her mouth, and even get a finger onto her gum without too much of a struggle. But she was done with the game long before I managed to massage her gums.

During the next session, after playing our game for a few minutes, I guided her fingers to her teeth. I touched my teeth with my fingers and asked her to touch hers. To make this easier for her to understand, we moved to chairs in front of the mirror and kept practicing touching teeth, then gums. Alicia "got it" and her mom, who had been watching, felt comfortable with following through with the game. It's too early to say, but we have hopes that Alicia will learn to desensitize her own mouth, and then learn to brush her own teeth. Whew.