November 1, 2021 - Podcast

Episode 197—Hydrocephalus, and treating smoking and mental health together

Every 15 minutes, someone in the United States has brain surgery related to hydrocephalus, more commonly known as “water on the brain.” People with hydrocephalus have excess cerebrospinal fluid, which is what surrounds and cushions the brain, providing vital nutrients to brain tissue and the spinal cord and helping to remove toxins. Currently, the only effective treatment involves brain surgery and the placement of a shunt, which often requires an additional brain surgery to revise. IUPUI’s Bonnie Blazer-Yost and colleagues are working to develop a safer, non-invasive option using a drug treatment, and she is seeing promising results. She says a drug could be used for as long as a patient requires, providing a stark difference from the uphill battle that children, particularly, face with shunts. Hydrocephalus is so common that one in every 1,000 infants is born with it, the elderly population is often affected, and it can also be a side effect of traumatic brain injury or stroke. The excess fluid affects the entire brain, which can affect overall mental function, and patients with hydrocephalus may experience pain, vision changes, walking disturbances and, in some cases, brain damage or death if not treated. The treatment being developed in Blazer-Yost’s lab is working to decrease the excess cerebrospinal fluid in animal models, without adverse side effects, she says, but it is a very long process to move the research from animals to humans during the development of a drug. She hopes to develop a potential treatment that a company would consider for drug development, as clinical trials can move much faster with a partner.

In other news, a new IU study found that mental health problems are common among adults who smoke cigarettes and have a substance use disorder, illustrating a need for treating smoking and mental health problems together. Led by IU Bloomington’s Maria Parker with other university partners, the study found mental health problems were more than twice as common among adults with a substance use disorder who smoke cigarettes compared to those without a substance use disorder and who do not smoke. Parker says smoking cessation does not undermine progress made in mental health or substance use treatment programs. As mental health problems continue to increase in the United States, Parker says it is critical to identify groups with higher prevalence of mental health problems that could be targeted for interventions. The researchers found serious psychological distress (a marker of mental health problems) varied significantly by substance use disorder status and cigarette smoking status. In fact, serous psychological distress was between three and five times higher for those with substance use disorder compared to those without across all smoking statuses, and these patterns were found for nearly every sex, age, race/ethnicity, income and martial status subgroup. The prevalence of serious psychological distress was highest for those with substance use disorder and daily cigarette smoking, with a quarter or more of those adults reporting distress. The study also found that serious psychological distress increased over time for all smoking statuses. Parker says to address cigarette smoking and substance use disorder for those with mental health problems, a broad psychiatric symptom assessment incorporated into cigarette smoking cessation or substance use disorder treatment programs may be beneficial. When assessing and treating individuals for cigarette smoking and substance use disorder, she says providers may want to screen for psychiatric symptoms.