Researchers at the University of Colorado Anschutz Medical Campus along with colleagues at Johns Hopkins University and other institutions have conducted the largest ever genome sequencing of populations with African ancestry in the Americas.
The scientists, for the first time, have created a massive genetic catalog of the African diaspora in this hemisphere. It offers a unique window into the striking genetic variety of the population while opening the door to new ways of understanding and treating diseases specific to this group.
The study was published today in the journal Nature Communications.
“The African Diaspora in the Western Hemisphere represents one of the largest forced migrations in history and had a profound impact on genetic diversity in modern populations,” said the study’s principal investigator Kathleen Barnes, PhD, director of the Colorado Center for Personalized Medicine at CU Anschutz. “Yet this group has been largely understudied.”
Barnes said those of African ancestry in the Americas suffer a disproportionate burden of disability, disease and death from common chronic illnesses like asthma, diabetes and other ailments. The reasons why, remain largely unknown.
With that question in mind Barnes and her colleagues, with support from the NIH’s National Heart, Lung and Blood Institute, created the `Consortium on Asthma among African-ancestry Populations in the Americas’ or CAAPA. They sequenced the genome of 642 people of African ancestry from 15 North, Central and South American and Caribbean populations plus Yoruba-speaking individuals from Ibadan, Nigeria. The ultimate goal of the study is to better understand why they are more susceptible to asthma in the Americas. But the result was a wide-ranging genetic catalogue unlike any other.
The African genome is the oldest and most varied on earth. Africa is where modern humans evolved before migrating to Europe, Asia and beyond.
Barnes and her team are finding changes in the DNA of Africans in the Americas that put them at higher risk for certain diseases. Perhaps one reason for this is the amount of genetic material they carry from other populations including those of European ancestry and American Indians.
“Patterns of genetic distance and sharing of single nucleotide variations among these populations reflect the unique population histories in each of the North, Central and South American and Caribbean island destinations of West African slaves, with their particular Western European colonial and Native American populations,” the study said.
For example, the researchers showed that the mean African ancestry varied widely among populations depending on where they were settled, from 27% of Puerto Ricans to 89% of Jamaicans. In places like the Dominican Republic, Brazil, Honduras and Colombia there was also significant Native American ancestry as well.
Untangling this genetic history will take years, but Barnes said the catalogue is a good start. The data will serve as an important resource for disease mapping studies in those with African ancestry.
“This will contribute to the public database and give clinicians more information to better predict and track human disease,” Barnes said. “It will allow us to tailor clinical to specific individuals based on their ethnic and racial backgrounds.”
A companion paper demonstrating the clinical utility of the African diaspora genome catalog appears in the same issue of Nature Communications.
Considering that CSI offered 263 training sessions to surgeons from around the world in fiscal 2016 – up 65 percent from 2015 – it’s safe to say that the facility’s innovations and education programs are rapidly improving health care across the globe.
CSI typically offers four to five trainings a week. It’s not unusual for surgical courses on skull base tumors to take place one day, aortic aneurysms the next and hernia repair the next. Partitions are often set up so different trainings – a spinal surgery here, a heart procedure there – can take place simultaneously. Surgical techniques on every quadrant of the body are taught in the facility by world-class experts from the CU School of Medicine (SOM) using state-of-the-art equipment.
‘Our mission is to educate’
“We try to be a one-stop shop for everyone who trains here. We handle logistics on everything from lodging and transportation to the specimen and equipment needs of each training,” said Sarah Massena, CSI executive director. “We just try to make it streamlined and easy for the trainees who come here, so they can go back home and enhance patient safety.
“Our main mission is to educate,” she said, “We want to enhance patient safety in the operating room.”
CSI, which operates 24/7 and is the only surgical training center at an academic institution in this region, moved to a new space inside Bioscience 1 in the Fitzsimons Redevelopment Authority (FRA) in early 2015 and has seen a dramatic increase in trainings since. Last year, 3,400 surgeons attended trainings in the 5,000-square-foot facility.
The high-volume facility, which launched in 2005, was previously located in a 1,700-square-foot space in the anatomy lab on the fifth floor of the Education 1 building.
“One of the major advantages of this facility is that it’s a custom build-out,” said Peter Mouser, CSI lab manager. “These suites were an empty shell, and we worked with our architects and building-design people to have the surgical training suite be built out the way it should be.”
Attractive to medical device industry
A challenge, however, is that the CSI loses the rent discount that came with being physically located on an academic medical campus. Being across the street – the FRA is located on the north side of Montview Boulevard – means that CSI’s rent increased. “We had to move here because, for our needs, it was the only space available,” Massena said. “We’re still right next door to an academic medical campus, so our trainees can drive in, park for free and come straight into our lab.” For physicians already on campus, including residents at the University of Colorado Hospital (UCH), CSI is an easy walk to and from the hospital.
The facility is multidisciplinary, so it has five founding surgical departments in the SOM that help fund its operations. The departments, representing 15 surgical divisions, are Surgery, Orthopedics, Obstetrics and Gynecology, Otolaryngology and Neurology. The many “outside” trainings offered by CSI – 70 percent of the courses are for surgeons from outside the CU Anschutz Medical Campus, compared to 30 percent for residents at the campus – help subsidize the departmental-member trainings.
CSI is attractive to industry representatives seeking to test medical technology. Medtronic, an international medical device company, collaborates with Omid Jazaeri, MD, an associate professor in the Department of Surgery, on its latest stent technology. Da Vinci Surgery regularly brings in its magnified, 3D high-definition vision technology for trainings. The state-of-the-art robotics system allows surgeons to operate with enhanced vision and precision. The system also allows a surgeon at another location, such as on the East Coast, to operate a remote console and perform procedures in CSI’s surgical suite.
Each spring, Samy Youssef, MD, PhD, professor of neurosurgery in the CU SOM, has trained over 60 surgeons from around the globe at a three-day cadaveric dissection-training course in skull base/endoscopic surgical techniques. The invitational course is in high demand and currently filled through the 2020 session.
“The surgeons we have coming from Germany, Japan and elsewhere are impressed when they see this facility,” Youssef said. “For example, it’s very convenient to have the lecture room next door to the surgical room where the senior residents get hands-on practice.”
In addition, CU’s Department of Neurosurgery offers a Skull Base Surgery year-long fellowship/resident program that uses the CSI Microsurgery Laboratory to give young neurosurgeons exposure to complex cranial cases and minimally invasive skull base approaches.
Besides the cadavers on the operating tables and the surgeons in scrubs surrounding them, the striking elements of CSI are the innovative pieces of equipment, flat-screen monitors all around, and the booms that house the equipment. Less obvious are ceiling cameras that can zoom in on proctor stations and livestream procedures across the globe. Procedures are also regularly recorded.
Robust AV technology
Trainees can watch a live feed of a surgery taking place at UCH and simultaneously practice the techniques on specimens at CSI. “The audio-visual (AV) technology is very robust in this facility,” Mouser said. “It really provides for an enhanced educational experience for our surgical trainees.”
The facility is so busy that it is already bursting at the seams to store its surgical equipment. Staffing is another area that had to be increased to deal with demand. CSI recently hired two lab support technicians to help stagger the hours of the small staff – the facility now has five employees, including Medical Director Thomas Robinson, MD – around the late-day, early-morning and weekend training sessions that best suit surgeons’ busy schedules.
The staff at CSI constantly has dialogues with surgeons about the latest techniques and equipment on which they’d like to have training. “Also,” Massena said, “we engage in a lot of continuing medical education for surgeons to learn the latest surgical techniques.
“What I always say is, ‘Wouldn’t you rather that your surgeon practices techniques in a lab than on your mother, father, brother or sister in the OR?’” she said.
If successful, this could have major implications for those suffering brain injury, stroke, Parkinson’s disease and other neurological problems.
The team of neuroscientists and engineers will use a special lightweight microscope, which they designed, to peer into and control the living brain of a mouse as they try to reconnect parts of the brain that no longer communicate with each other.
The miniature microscope, using a unique electrowetting lens, is mounted on the head of a mouse and with its high-powered, fiber-optic light can actually view and control neural activity as it happens.
“Adaptive optical devices that are included in a miniature microscope are a game changer,” said grant co-investigators Juliet Gopinath, assistant professor in electrical, computer and energy engineering and Victor Bright, professor of mechanical engineering, both at CU Boulder. “They enable truly miniature 3D imaging devices without mechanically moving parts.”
According to Gopinath and Bright, the electrowetting lens is compact, low power and has good optical quality making it ideal for this kind of research. The liquid lens can change shape when voltage is applied.
The team will use an optic fiber to disrupt the signals between the olfactory bulb of a mouse, which receives information on odors, and the olfactory cortex, the part of the brain that allows it to smell. In essence, they will shut down its ability to smell and then try to restore it by activating the olfactory cortex using the miniature microscope.
The mouse will be awake and behaving normally throughout this while the team views and controls what is happening in the brain with the electrowetting fiber-coupled microscope. They can stimulate the animal’s brain activity using powerful laser light that flows through the microscope’s fiber-optic bundle.
“One major problem with the brain is that with certain diseases or injuries, one part of the brain stops talking to another,” said co-investigator Diego Restrepo, professor of cell and developmental biology and director of the Center for NeuroScience at the University of Colorado School of Medicine. “If someone has a stroke they may no longer be able to speak.”
Once connections between brain areas are lost, it is difficult to get them communicating again.
Restrepo said if researchers are successful reestablishing brain connections in a mouse, they may be able do the same in humans with brain injury or disease.
“For example, if there is loss of connection between the retina that detects the image in the eyes and the visual cortex, in the back of the brain the patient has a problem detecting images that in the worst case leads to blindness,” Restrepo said. “That loss of connection between the retina and visual cortex can be due to neural problems such as stroke, neuro-immune disease or traumatic brain injury.”
If this experiment is successful, he said, this microscope could eventually be modified to activate neurons in the visual cortex based on the visual input. In other words, creating a bridge between two parts of the brain where communication has stopped.
“This is an interdisciplinary grant which combines bioengineering with neurological applications,” said Emily Gibson, assistant professor of bioengineering at CU Anschutz. “The idea is to use this device which can image individual neurons and stimulate those individual neurons in that 3D volume.”
She also noted that two of the principal investigators on the grant are women, a rarity in the field of engineering.
“This particular grant is for high risk, high payoff approaches,” she said. “And this is a very high risk project. We are pushing the technology farther and seeing if we can use these optical tools to ultimately make an impact on humans.”
The grant is funded under a program from the National Science Foundation known as the “Integrative Strategies for Understanding Neural and Cognitive Systems (NSF-NCS).”
It is one element of NSF’s broader effort directed at Understanding the Brain, (http://www.nsf.gov/brain/) a multi-year activity that includes NSF’s participation in the Brain Research through Advancing Innovative Neurotechnologies (BRAIN) Initiative.
The team also won a second NSF grant of $200,000 to be used in the dissemination and commercialization of its microscope.
In perhaps the first national survey of its kind, two-thirds of people sampled said it is at least sometimes appropriate for health care providers to talk to patients about firearms. The remainder said it is never appropriate.
The study was published this week in the journal `Annals of Internal Medicine.’
Dr. Marian `Emmy’ Betz, associate professor of emergency medicine at the CU School of Medicine.
The 3,914 adults who completed the survey were asked: “In general, would you think it is never, sometimes, usually or always appropriate for physicians and other health professionals to talk to their patients about firearms?”
The survey posed the same question about alcohol, seat belts and cigarettes in the household.
Overall, 66 percent said it is at least sometimes appropriate for doctors to talk about firearms with patients. About 81 percent said it is at least sometimes appropriate to talk about seatbelts.
The respondents were almost equally divided between men and women with a mean age of 49. Thirty percent had one child under 18 living at home. And 35 percent of respondents said they had one or more guns in the household.
More women (71 percent) than men (61 percent) said it is at least sometimes appropriate for providers to talk to patients about guns. Gun owners with a child at home or who viewed the firearm as a risk factor for suicide were more likely to support the idea of having the topic brought up.
“This suggests that discussions may be best received when they are clearly relevant to the clinical context,” the study said.
Dr. Marian Betz, MD, MPH, an associate professor at the University of Colorado School of Medicine and co-author of the study, said the survey results may encourage more healthcare providers to talk to patients about guns in the home.
“A doctor working with a patient with depression or risk factors for suicide should suggest that the patient considering making firearms less accessible until they recover, for example by storing the guns away from home,” Betz said. “And doctors are wise to recommend to parents of children or teenagers that they keep any household guns locked.”
Betz said it was important to recognize that 66 percent, not 100 percent, of respondents said it was sometimes acceptable to ask about guns.
“Patients can always decline to answer those questions,” she said. “But that shouldn’t deter a physician from bringing up the topic – in a respectful, nonjudgmental way – when relevant.”
Betz also noted that more work needs to be done to understand how to make these conversations more acceptable and impactful. Collaborations between public health professionals and firearm organizations could help in developing educational materials and messages.
The co-authors of the study include Deborah Azrael, PhD and Catherine Barber, MPA from the Harvard School of Public Health and Matthew Miller, MD, ScD from Northeastern University’s Bouvé College of Health Sciences.
While the lure of academic medicine careers often lies in the promise of finding life-saving cures and new medical treatments, many young faculty leave the field in frustration after failing to win grants to fund their research. As a result, the best and brightest recruits are often lost to academic medicine.
The study, published recently in the journal Academic Medicine, shows participants in the Clinical Faculty Scholars Program (CFSP) at CU Anschutz won about four times as many grants as those who didn’t take the course.
Dr. Anne Libby, PhD, professor and vice-chair of academic affairs at CU Anschutz.
The innovative, faculty-led program began in 2004 but its impact is just now being studied.
“We are in perhaps the most challenging and competitive period of academic funding in history,” said Anne Libby, PhD, lead author of the study and professor and vice-chair for academic affairs of the Department of Emergency Medicine. “National Institutes of Health budgets have shrunk and there is a critical lack of state funding.”
That means researchers seeking funding must know how to write focused, understandable grant applications and remain persistent in the face of rejection.
“Thousands of junior faculty begin their appointments at academic health centers planning careers that will include externally funded research,” the study said. “Attrition in the early-career faculty ranks indicates that many talented and well-trained clinicians and scientists who seek these careers are not retained by academic health centers in part because of their inability to achieve external funding.”
The two-year CFSP program offers a research mentoring team to five junior faculty selected annually with the goal of teaching them how to win funding. Each scholar gets a primary senior mentor who they meet with regularly to develop targeted research plans. There are also group meetings and sessions with program directors to keep scholars on track.
Study co-author Adit Ginde, MD, MPH, a program alumnus and now co-director of CFSP, said this all happens during an intense time in a researcher’s career.
“There is only a two or three year period to become really successful in this field,” he said. “Without a robust environment and concentrated career mentorship, often very talented people who could or should have successful research careers will not succeed. We provide them the structure to make it through this critical period.”
Ginde, an associate professor of emergency medicine at CU Anschutz, said CFSP shows early professionals how to write grants, find mentors and collaborators and locate the right sponsors.
According to Libby, it’s a level of complexity few researchers have ever been taught.
Dr. Adit Ginde, MD, MPH, associate professor of emergency medicine at CU Anschutz.
“What you don’t want to happen is see good people working in isolated silos wither on the vine,” she said. “In the world of academic medicine, it’s sink or swim.”
The study shows the program is working.
Researchers looked at the number of grants won by the junior faculty before and after the training and also compared them to those who did not participate in the program.
They found that the mean annual dollars increased significantly for the CFSP participants compared to those who didn’t take the course. Those in the program won an average of $83,427 a year in grants vs. $27,343 for those who didn’t take part. They also wrote more grants as well.
“They are in there applying. They learn to understand rejection. In fact, we normalize rejection,” Libby said. “I tell them rejection is a rite of passage and if they aren’t getting rejected they aren’t submitting enough grants.”
She said the program is a proven and financially sustainable way to enhance the grant productivity of young faculty, especially important now as more and more senior faculty are set to retire.
“We have shown that with the right resources junior faculty from a wide range of disciplines can be trained for extramural grant success and that the resulting productivity is observable on average after one year of this training and grows over time,” the study said.
Ginde noted that the program taught him the value of persistence and collaboration in his own career as a clinical researcher.
“And it is now seen as the flagship research career development program on our campus,” he said.
The study co-authors include Patrick Hosokawa, MS, Diane Fairclough, DrPH, Allan Prochazka, MD and Pamela Jones, PhD, all of the University of Colorado Anschutz Medical Campus.
Researchers at the University of Colorado Anschutz Medical Campus have discovered how the most severe forms of West Nile virus cause memory loss and mood disorders, opening the door to potential new treatments for the mosquito-borne illness.
The study, published in the journal Nature, says 50 percent of patients who survive the most damaging kind of West Nile infection often go on to develop memory loss, learning difficulties, a lack of concentration and irritability.
Exactly why this happens has been a mystery until now.
Dr. Kenneth Tyler, MD, professor and chair of the department of neurology at the CU School of Medicine.
Researchers discovered that the virus doesn’t kill off neurons but sparks inflammation that prunes synapses, the connections that carry messages between nerve cells.
“What we found in mice, and later confirmed in humans, is that it’s not the death of cells that causes memory loss, it’s the loss of nerve cell connections,” said study co-author Kenneth Tyler, MD, chairman of the department of neurology at the University of Colorado School of Medicine. “The viral infection activates microglial cells and complement pathways which are helping to fight the infection but in turn end up destroying synapses.”
Bette K. DeMasters, MD, professor and head of neuropathology at CU Anschutz, also co-authored the study.
The researchers found that mice infected with West Nile had a difficult time negotiating their way out of a maze that healthy mice figured out much faster. They later discovered that the infected mice suffered significant damage to their synapses. The scientists examined brain tissue from humans who had died from West Nile and found the same phenomenon.
Tyler said West Nile is the leading cause of acute viral encephalitis in the U.S. though still relatively rare. Only about one in 100 people infected with the disease develop the most severe form, he said.
West Nile appeared in the U.S. during the late 1990s and has remained a persistent threat. Last year, California had 730 cases, Texas 252 cases and Colorado 101 cases.
In Colorado, that number included 57 neuro-invasive cases, the most serious kind, and two deaths.
“This discovery opens up the opportunity to test therapies and medications on mice as a precursor to humans,” Tyler said. “We already have some drugs that might be good candidates for treating this condition.”
The best way to avoid West Nile is to wear long sleeves, use mosquito repellant and steer clear of standing water. The mosquito that carries the virus is most active at dusk and dawn.
Researchers at the University of Colorado Anschutz Medical Campus are seeking participants for a research study designed to understand the health and nutritional factors that influence infant brain development in order to provide better care to newborns in the developing world. Scientists in the CHILD Imaging Lab are inviting expectant mothers and families with infants in the Denver area to participate in the study.
Worldwide, approximately one out of every four children under the age of two suffers from stunted growth caused by insufficient nutrition in utero and during the first two years of life. Children who experience stunting are, on average, 4-6 inches shorter than their healthy peers, more likely to contract disease and have a reduced ability to learn. Children in developing countries often suffer because of a lack of access to the right variety of foods and the right amount of foods.
Under the direction of Sean Deoni, PhD, Associate Professor of Radiology at the CU School of Medicine, researchers in the CHILD Imaging Lab based in Children’s Hospital Colorado hope to understand how factors like prenatal maternal nutrition and health affect infant brain growth and development. Over the course of this study researchers will assess nutritional health, cognitive performance, and infant brain structure and function.
Expectant mothers less than 22 weeks pregnant, or families with healthy infants between three and 15 months of age may be eligible to participate. Participants will be asked to come to the Anschutz Medical Campus in Aurora for two to six visits and will be reimbursed for their time.
This study is funded by the Bill & Melinda Gates Foundation, which supports nongovernmental organizations in the developing world to implement interventions that educate parents about nutritional needs of their children and to provide greater access to the right variety of foods and vitamins.
For more information, please call the CHILD Imaging Lab at (720)777-8756 e-mail, firstname.lastname@example.org, or visit <a href="http://www la viagra.childimaginglab.org”>www.childimaginglab.org. Questions about research participant rights and responsibilities can be directed to the Colorado Multiple Institutional Review Board at 303-724-1055, please reference COMIRB #15-0707.
Despite the dangers, more and more physicians are drawn to working in impoverished or strife-torn areas where medical care is rudimentary yet the needs are overwhelming. But few possess the skills to operate under such harsh conditions.
The Center for Surgical Innovation is a multi-disciplinary training center dedicated to promoting education courses for surgeons around the world. From 2015-2016, it trained over 4,000 surgeons.
Dr. David Kuwayama, a vascular surgeon, has worked with Doctors Without Borders and other humanitarian groups worldwide.
This unique program will teach senior surgical and obstetrics residents how to perform surgery in low-resource environments without high-tech surgical tools. They will learn how to do a craniotomy with a handsaw, hernia repair without mesh and skin grafts using hand blades rather than electrical ones.
“This is the only humanitarian training course for surgical residents in the country,” said David Kuwayama, MD, MPA, a vascular surgeon at CU Anschutz and director of global health in the department of surgery. He has also worked with Doctors Without Borders and other humanitarian groups in developing countries, disaster zones and areas of conflict.
The work is often dangerous. Last October, 30 people were killed at a Doctors Without Borders/ Médecins Sans Frontières hospital in Kunduz, Afghanistan when an American AC-130 gunship opened fire at what they thought were Taliban fighters. Other hospitals supported by the group have been attacked in Idlib, Aleppo, and Hama governorates in Syria, forcing at least three to close down.
But it’s done nothing to quell enthusiasm for humanitarian medical work.
“There is a wellspring of interest now in global health despite the often difficult situations,” Kuwayama said. “More and more people want to make it part of their careers but there are few training opportunities.”
Kuwayama held a pilot program last year with just four senior surgical residents to gauge outside interest. This year, they have increased that to 12 residents. The workshop will be taught by attending physicians from CU Anschutz and will cover general surgery, vascular surgery, orthopedic surgery, neurosurgery and OBGYN.
“While working abroad, I found that American doctors often lack the skills to work in these often tough environments,” Kuwayama said. “Our goal is to provide those skills so they are prepared for whatever the situation calls for.”
What: The Colorado Humanitarian Surgical Skills Workshop
Where: The Center for Surgical Innovation, University of Colorado Anschutz Medical Campus, Aurora, Colo.
When: June 4 & 5 from 7:30 a.m. – 5 p.m.
More information: Interested media are invited to attend the lectures. For more information please contact David Kelly, 303-503-7990, email@example.com
A coalition of doctors and ethicists, including two from the University of Colorado Anschutz Medical Campus and another from Regis University, are behind a new law signed Wednesday allowing doctors to take better care of the most vulnerable patients in hospitals and emergency rooms.
The `Medical Decision Making for Unrepresented Patients’ law was signed by Gov. John Hickenlooper at a ceremony at the Northern Colorado Medical Center in Greeley. The measure will allow physicians to act as proxies for patients unable to provide consent or with no other proxy available.
Jackie Glover, PhD, professor of pediatrics at CU School of Medicine and Center for Bioethics and Humanities.
“This is a national problem that has been discussed for decades,” said Jackie Glover, PhD, professor of pediatrics who teaches ethics at the Center for Bioethics and Humanities at CU Anschutz. “If you are a patient without family or friends you are appointed a guardian but that’s an awful long process in Colorado.”
Glover along with CU Anschutz Professor of Medicine Jean Abbott, MD, MH and Debra Bennett-Woods, EdU, FACHE, and professor of health services education at Regis University, collaborated with a coalition of ethics committees under the umbrella of the Colorado Health Care Ethics Forum or CHEF to draft the legislation.
“This bill is a matter of social justice,” said Bennet-Woods, “HB16-11101 will enable the care team to provide the right treatment, at the right time and in the right setting.”
Glover said unrepresented patients in hospitals and long-term care facilities can’t speak for themselves and have no family or close friends to speak for them. By one estimate more than 16 percent of patients admitted to ICUs today are unrepresented and the number is growing. By 2020, more than 2 million Americans will have outlived friends and family.
Jean Abbott, MD, MH, professor emerita CU School of Medicine and Center for Bioethics and Humanities.
The group found willing partners in Rep. David Young and Sen. Kevin Lundberg who introduced the measure in the state Legislature.
The law will allow a second doctor, who is not the patient’s attending physician, to serve as a proxy of last resort when a patient is unable to provide consent and no proxy can be found. The hospital ethics committee must oversee this process, ensuring that all reasonable efforts to find a proxy have been made.
But the law will not require physicians to act as proxies. It also won’t replace volunteer guardianship programs, nor will it provide funding for a public guardianship program.
Glover said her group got together, examined what other states do and drafted the legislation. They were surprised at how quickly it advanced through the political process.
“The process brought together a novel set of stakeholders and has the potential to keep them at the table as best practices are developed and rolled out,” she said.
But the law is only the beginning.
“The hard work is yet to come,” Glover said. “We now have to develop best practices going forward.”
Researchers at theUniversity of Colorado Anschutz Medical Campushave discovered that women suffering from anorexia nervosa and those who are obese responddifferently totaste, a finding that could lead to new treatments for the eating disorders.
“Taste is an important driver of food intake and invariably associated with distinct neuronal patters in the insula, the brain’s primary taste cortex,” saidthe study’slead authorGuido Frank, MD, a psychiatrist and associate professor at the CU School of Medicine.
The study was recently published online in theInternational Journal of Eating Disorders.
Guido Frank, MD, associate professor of medicine and psychiatrist at the CU School of Medicine.
Frank and his team set out to find if abnormal eating patterns were associated with changes in the insula’s ability to classify taste stimuli.
Some 106 womenof similar ageunderwent brain imagingwhiletastingsugar wateror a tasteless water solution. Researchers studied how well the insula could differentiate betweentheflavors.
Individuals with anorexia nervosa orthosewho were obese, haddifficulty distinguishing between ordinary water and sugar water, compared to controlsubjectsandthosewho had recovered from anorexia nervosa.
“If you can’t differentiate between tastes,that could impact how much you eat,” Frank said. “That could also activate or not activate brain reward circuits.”
Thesechanges, he said, could occur on a variety of levels. For example, leptin and other hormones are altered inobesity andeatingdisorders, affectinghow thebrainresponds to food. At the same time, the reduced ability of the insula to classify taste could be due to structural changes withinthis brain regionor alternatively could resultinaltered taste signal processing in different pathways to the insula.
Researchindicates thatthese problems diminish once a person reaches a healthy weight.
While more research is needed, Frank saidone possible treatmentcould be toalter the taste of food.
“Perhaps adjusting flavor intensity by reducing it for those with anorexia and enhancing it for those who are obese,” he said.“It’s something we need to examine more closely.”