̽��ֱ�� of Cambridge - Camilla Nord

Boost your life in 2025: Top tips for a healthier body and mind from Cambridge experts

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Five Cambridge experts share their top tips on ways to boost your body and mind, backed up by their own research

Study shows brain differences in interpreting physical signals in mental health disorders

sc604 — Tue, 22 Jun 2021 01:16:31 +0000

̽��ֱ��researchers, from the ̽��ֱ�� of Cambridge, found that the part of the brain which interprets physical signals from the body behaves differently in people with a range of mental health disorders, suggesting that it could be a target for future treatments.

̽��ֱ��researchers studied ‘interoception’ – the ability to sense internal conditions in the body – and whether there were any common brain differences during this process in people with mental health disorders. They found that a region of the brain called the dorsal mid-insula showed different activity during interoception across a range of disorders, including depression, schizophrenia, eating disorders and anxiety disorders.

Many people with mental health disorders experience physical symptoms differently, whether that’s feeling uncomfortably full in anorexia, or feeling like you don’t have enough air in panic disorder.

̽��ֱ��results, reported in ̽��ֱ��American Journal of Psychiatry, show that activity in the dorsal mid-insula could drive these different interpretations of bodily sensations in mental health. Increased awareness of the differences in how people experience physical symptoms could also be useful to those treating mental health disorders.

We all use exteroception – sight, smell, hearing, taste and touch – to navigate daily life. But interoception – the ability to interpret signals from our body – is equally important for survival, even though it often happens subconsciously.

“Interoception is something we are all doing constantly, although we might not be aware of it,” said lead author Dr Camilla Nord from the MRC Cognition and Brain Sciences Unit. “For example, most of us are able to interpret the signals of low blood sugar, such as tiredness or irritability, and know to eat something. However, there are differences in how our brains interpret these signals.”

Differences in interoceptive processes have previously been identified in people with eating disorders, anxiety and depression, panic disorder, addiction and other mental health disorders. Theoretical models have suggested that disrupted cortical processing drives these changes in interoceptive processing, conferring vulnerability to a range of mental health symptoms.

Nord and her colleagues combined brain imaging data from previous studies and compared differences in brain activity during interoception between 626 patients with mental health disorders and 610 healthy controls. “We wanted to find out whether there is something similar happening in the brain in people with different mental disorders, irrespective of their diagnosis,” she said.

Their analysis showed that for patients with bipolar, anxiety, major depression, anorexia and schizophrenia, part of the cerebral cortex called the dorsal mid-insula showed different brain activation when processing pain, hunger and other interoceptive signals when compared to the control group.

̽��ֱ��researchers then ran a follow-up analysis and found that the dorsal mid-insula does not overlap with regions of the brain altered by antidepressant drugs or regions altered by psychological therapy, suggesting that it could be studied as a new target for future therapeutics to treat differences in interoception.

“It’s surprising that in spite of the diversity of psychological symptoms, there appears to be a common factor in how physical signals are processed differently by the brain in mental health disorders,” said Nord. “It shows how intertwined physical and mental health are, but also the limitations of our diagnostic system – some important factors in mental health might be ‘transdiagnostic’, that is, found across many diagnoses.”

In future, Dr Nord is planning studies to test whether this disrupted activation could be altered by new treatments for mental health disorders, such as brain stimulation.

̽��ֱ��research was supported by NIHR Cambridge Biomedical Research Centre.

Reference:
Camilla L. Nord, Rebecca P. Lawson and Tim Dalgleish. ‘Disrupted dorsal mid-insula activation during interoception across psychiatric disorders.’ ̽��ֱ��American Journal of Psychiatry (2021). DOI: 10.1176/appi.ajp.2020.20091340

Researchers have shown why people with mental health disorders, including anorexia and panic disorders, experience physical signals differently.

In spite of the diversity of psychological symptoms, there appears to be a common factor in how physical signals are processed differently by the brain in mental health disorders: it shows how intertwined physical and mental health are

Camilla Nord

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Rhythm and bleughs: how changes in our stomach’s rhythms steer us away from disgusting sights

cjb250 — Tue, 24 Nov 2020 16:00:00 +0000

Disgust is a natural response to unpleasant sights, such as rotting food, bodily waste and creepy crawlies, and has evolved to help us survive, encouraging us to avoid things that might spread disease. But for some people, disgust can become pathological, affecting their mental health and quality of life.

In a study published today in Current Biology, researchers at the MRC Cognition and Brain Sciences Unit show that domperidone, a commonly-prescribed anti-nausea medicine, can help significantly reduce how much volunteers look away from disgusting images.

Domperidone works by stabilising the rhythm of the electrical signals in our stomach muscles. Normally, these signals help the stomach expand and contract, helping move food through the digestive tract. These rhythms become abnormal when we are nauseous or when we are hungry or full, for example. When they are strongly disrupted – for example, when we feel strong revulsion towards something – they can cause us to throw up the contents of our stomach.

In the study, twenty-five volunteers aged 18-35 were randomly assigned to one of two groups: one group to receive domperidone, the second a placebo.

Before taking their pills, the volunteers were shown a series of unpleasant images along with neutral images, such as a scarf or buttons, while the researchers tracked their eye movements. Thirty minutes after taking their tablets, the volunteers were again shown the images while their eye movements were tracked.

Next, the researchers offered an incentive to the volunteers: for every four to eight seconds that they could look at a disgusting image, they would receive 25p – and hear a ‘kerching!’ sound. ̽��ֱ��volunteers then viewed the images again for a final round, but this time with no incentive.

̽��ֱ��volunteers were also asked to rate how disgusting they found the images at the start and end of the trial.

̽��ֱ��researchers found that initially, taking domperidone made little difference to the time the volunteers spent looking at a particular image. As could be expected among both groups, the dwell time increased dramatically when they were paid to look at the images.

In the final condition – when the volunteers were no longer being incentivised – the team found that volunteers who had received domperidone spent significantly longer than the placebo group looking at the disgusting images. By the end, people looked at the neutral image roughly 5.5 seconds more than the disgusting image, but under the influence of domperidone, the difference was only about 2.5 seconds.

Domperidone made no difference to how disgusting the volunteers rated the images to be.

“We’ve known for some time that when you see something disgusting, your stomach muscles’ electrical signals become dysregulated, which in some cases causes people to feel sick or their stomach to turn. You’re then likely to avoid that thing,” said Dr Camilla Nord from the MRC Cognition and Brain Sciences Unit at the ̽��ֱ�� of Cambridge.

“What we’ve shown here is that when we steady the stomach’s electrical signals, people become less avoidant of a disgusting image after engaging with it. Changes in the stomach’s rhythm led to reduced disgust avoidance in our study – and so the stomach’s rhythm must be one cause of disgust avoidance in general.”

“In another recent study, we showed that we do not become immune to looking at disgusting images – a fact supported by the placebo condition in this new study,” said Dr Edwin Dalmaijer, also from the MRC Unit. “This is one reason why treating pathological disgust by exposure is often unsuccessful. Our research suggests domperidone may help.”

“We’ve shown that by calming the rhythms of our stomach muscles using anti-nausea drugs, we can help reduce our instinct to look away from a disgusting image,” added Professor Tim Dalgleish, also from the MRC Unit, “but just using the drug itself isn’t enough: overcoming disgust avoidance requires us to be motivated or incentivised. This could provide us with clues on how we can help people overcome pathological disgust clinically, which occurs in a number of mental health conditions and can be disabling.”

Explaining why the stomach should play a role in our disgust response, Dr Nord added: “When the brain constructs its representation of the environment, it integrates signals from the outside world, such as ‘is it daylight?’ with signals from the inside world, such as ‘am I hungry?’. So your internal environment, and your perception of it, plays a large role in how you experience the world.

“Many studies have shown that the state of our body influences emotion, perception, and action. For example, the timing and your awareness of your heartbeats influences learning, anxiety, and other emotion perception. Our study shows that the state of your stomach also influences your behaviour.”

̽��ֱ��research was supported by the Medical Research Council, AXA Research Fund and the National Institute for Health Research Cambridge Biomedical Research Centre.

Reference
Nord, CL & Dalmaijer, E, et al. A causal role for gastric rhythm in human disgust avoidance. Current Biology; 24 Nov 2020; DOI: 10.1016/j.cub.2020.10.087

Does the sight of maggots squirming in rotten food make you look away in disgust? ̽��ֱ��phrase ‘makes my stomach turn’ takes on a new meaning today as researchers at the ̽��ֱ�� of Cambridge reveal that changes in the rhythm of our stomachs prompt us to look away from disgusting images.

What we’ve shown here is that when we steady the stomach’s electrical signals, people become less avoidant of a disgusting image after engaging with it

Camilla Nord

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An expression of disgust

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Young people at risk of addiction show differences in key brain region

cjb250 — Mon, 04 Mar 2019 08:03:30 +0000

̽��ֱ��study adds further evidence to support the idea that an individual’s biological makeup plays a significant role in whether or not they develop an addictive disorder.

Adolescence and young adulthood is an important time in a person’s development. It is during this time that individuals begin to demonstrate behaviours that are associated with addiction and which suggest that they may be at risk.

One of these behaviours is impulsivity. Sometimes, we need to make quick decisions, for example in response to a danger or a threat. At other times, it is better to hesitate and decide only after careful deliberation. Impulsivity refers to where we respond and act prematurely, without considering the consequences of our actions. While most people occasionally act impulsively, people affected by disorders including attention deficit hyperactivity disorder (ADHD), substance and behavioural addictions, and mental health problems such as depression and anxiety, show much greater levels of impulsivity.

In a study published today in the journal Neuropsychopharmacology, a team of researchers at Cambridge’s Department of Psychiatry, in collaboration with a group at Aarhus ̽��ֱ�� in Denmark, has shown a strong association between increased behavioural impulsivity in young adults and abnormalities in nerve cells in the putamen, a key brain region involved in addictive disorders.

As part of the study, 99 young adults aged 16 to 26 carried out a computer-based measure of impulsivity. ̽��ֱ��researchers also scanned the volunteers’ brains using a sequence that is sensitive to myelin content. Myelin is a protein-rich sheath that coats the axis of a nerve cell, analogous to the plastic coating that surrounds electrical wiring, and is essential to fast nerve conduction in the brain and body.

̽��ֱ��team found that those young adults who displayed higher measures of behavioural impulsivity also had lower levels of myelin in the putamen. This work builds on similar findings in rodent models of impulsivity from scientists at Cambridge and elsewhere.

“People who show heightened impulsivity are more likely to experience a number of mental health issues, including substance and behavioural addictions, eating disorders, and ADHD,” says Dr Camilla Nord of the MRC Cognition and Brain Sciences Unit, lead author on the study.

This suggests that impulsivity is an ‘endophenotype’, say the researchers; in other words, a set of behavioural and brain changes that increases people’s general risk for developing a group of psychiatric and neurological disorders.

“We know that most mental health symptoms are not specific to particular disorders,” says Dr Nord. “This work provides an important piece of the puzzle in establishing brain signatures that are general across a number of mental health disorders, rather than specific to any single one.”

̽��ֱ��putamen is a key brain hub in addiction, sending dopamine signals elsewhere in the brain, and helping mediate how impulsively we behave. “ ̽��ֱ��significance of decreased myelination implies there are tiny microstructural changes in this part of the brain affecting its function, and thereby affecting impulsivity,” says senior author Dr Valerie Voon, also from Cambridge.

“ ̽��ֱ��degree of myelination alters the speed and efficiency of neuronal communication, meaning that if a population has decreased myelination only in one particular region, as we show, there is something highly local about any changes in neural speed and efficiency,” add co-author Dr Seung-Goo Kim.

Although it is not possible to say definitely whether the decreased myelination causes individuals to behave impulsively, the fact that all participants were healthy and had not been diagnosed with addiction or any other psychiatric diagnosis suggests a more causal link than has been demonstrated in previous studies.

In future, the finding may help in predicting an individual’s risk of developing a problem with addiction, say the researchers, but they caution that this would require further research and testing.

̽��ֱ��research was funded by the Aarhus ̽��ֱ�� Research Foundation, the Danish Ministry for Social Affairs and the Interior and the UK Medical Research Council. ̽��ֱ��work was also supported by NIHR Cambridge Biomedical Research Centre.

Reference
Nord CL, Kim S, Rømer Thomsen,K, Callesen MB, Kvamme TL, Jensen M, Pedersen MU, Voon V. ̽��ֱ��myeloarchictecture of impulsivity: premature responding in youth is associated with decreased myelination of ventral putamen. Neuropsychopharmacology; 15 Feb 2019; DOI: 10.1038/s41386-019-0343-6

Young adults at risk of developing problems with addiction show key differences in an important region of the brain, according to an international team led by researchers at the ̽��ֱ�� of Cambridge.

karosieben

Smoking young people

Researcher profile: Dr Camilla Nord

Dr Camilla Nord is interested in mental health disorders, and in particular how we translate what we have learnt about the brain from neuroscience into better and more effective treatments.

“What most motivates me about my own research is working out how to test specific hypotheses about mental health—say, if a specific brain region is under-active in depression— in a way that could improve our ability to predict, diagnose, and treat mental health disorders,” she says.

A key aim of her work at the MRC Cognition and Brain Sciences Unit and at Addenbrooke’s Hospital is to develop more refined ways of predicting treatment outcome – “in other words, when someone shows a certain set of symptoms, we could run computer-based tests or brain imaging scans that would give us some indication of the best treatment for that individual person.

“These tests will never exist without a series of experiments developing and testing different possible predictors. I hope to run these sorts of early-stage studies in the next few years, before taking these studies forward into clinical trials in the future, in collaboration with the NHS and other large-scale organisations.”

Ultimately, she hopes this will lead to is a future where it is possible to tailor mental health treatments to each patient.

Camilla’s research involves working with volunteers on a daily basis for computer-based experiments at the MRC unit, or at Addenbrooke’s for brain stimulation experiments.

“When I am not running experiments, I am analysing data, including brain scans, using statistical models to test my hypotheses, or writing papers and giving talks to communicate my findings to the rest of the field and the public.”

It is the public engagement side of her work that can be particularly insightful. “I think some of the most interesting opportunities I’ve had were when I’ve been given the chance to discuss my work with patients, hear their feedback, and listen to their ideas about what might be most fruitful for our future directions of research. I think this sort of research-patient interaction will be vital to developing better ways of treating mental health difficulties in future.”

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