Illinois Medicine

KIDS ON THE BRINK L THE M.O. OF MS Researchers link multiple sclerosis to reduced levels of neurotransmitter D AMAGE TO A PARTICULAR AREA OF THE BRAIN and a resulting reduction in a neurotransmitter called noradrenaline are associated with multiple sclerosis, researchers in the College of Medicine found in a study published online in the journal Brain. The infiltration of white blood cells involved in immune defense through the blood-brain barrier is an important contributor to the progres- sion of MS. For the last 15 years, Douglas Feinstein, PhD, research pro- fessor in anesthesiology, and his colleagues have been studying the importance of noradrenaline to inflammatory processes in the brain. Because the major source of noradrenaline is neurons in an area of the brain called the locus coeruleus, the researchers hy- pothesized that damage to that area was responsible for lowered levels of noradrenaline in the brains of MS patients. "There's a lot of evidence of damage to the LC in Alzheimer's and Parkinson's disease, but this is the first time that it has been demonstrated that there is stress involved to the neurons in the LC of MS patients and that there is a reduction in brain noradren- aline levels," says Paul Polak, research specialist in the health sciences in anesthesiology and first author on the paper. The researchers, who also included Sergey Kalinin, MD, postdoctoral research associate in anesthesiology, found that LC damage and reduced levels of noradrenaline occur in a mouse model of MS and that similar changes could be found in the brains of MS patients. According to Polak, the findings suggest that LC damage, accompanied by reduction in noradrenaline levels in the brain, may be a common feature among a host of neurologic diseases. "There are a number of FDA-approved drugs that have been shown to raise levels of noradrenaline in the brain, and we believe that this type of therapeutic intervention could benefit patients with MS and other neurodegenerative diseases, and should be investigated," Polak says. New study looks at mental health in LGBT youth ESBIAN, GAY, BISEXUAL AND TRANSGENDER youth enjoy greater levels of mental health than past surveys showed, but one-third of LGBT youth meet the criteria for some form of mental illness and have attempted suicide, ac- cording to College of Medicine researchers. "One of the most important findings from our work is that most of these youth are doing very well and are not experiencing mental health problems," says Brian Mustanski, PhD, assistant professor of psychiatry at the college and lead author of the study, published online and in the December issue of the American Journal of Public Health. The study was supported by a grant from the American Foundation for Suicide Prevention. The study is the first to report the frequency of mental disorders in LGBT youth using the criteria of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, the standard diagnostic tool in psychiatry. Previous studies have relied on questionnaire-type surveys, which may overestimate mental disorders in certain groups according to the authors, who include Erin Emerson, research data analyst in psychiatry at the college, and Robert Garafalo, MD, MPH, associate professor of pediatrics and preventive medicine, Northwestern University Feinberg School of Medicine. The researchers recruited 246 ethnically diverse 16- to 20-year-old LGBT youth in Chicago and conducted structured psychiatric interviews with them to assess major de- pression, post-traumatic stress disorder, suicide attempts and conduct disorder. About 70 percent of LGBT youth did not meet criteria for any mental disorders. However, one-third of participants met the criteria for at least one of the mental disorders, with 10 percent meeting the criteria for post-traumatic stress disorder and about 15 percent meeting criteria for major depression. The LGBT youths in the study had a higher prevalence of mental disorders than youths in national samples but were similar to other samples of urban, racial and ethnic minority youths. One-third had made a suicide attempt at some point in their life, and about 6 percent had made a suicide attempt in the last year—a prevalence also comparable to urban, minority youth. "The big question is, are these youth more likely to have mental disorders relative to other kids?" says Mustanski, director of the University of Illinois at Chicago's IMPACT Program, which conducts research to improve the health of LGBT individuals. "The answer to that is, that it really depends on who you're comparing them to." I L L INOI S MEDICINE | 9

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