Scott L. Sole, MD
Location and Office HoursParkersburg Neurological Associates Inc
Parkersburg, WV 26104
Are sensory integration issues a real problem?
Heather Wittenberg, PhD, Psychology, answeredThere is some controversy over whether sensory integration issues are “legitimate”, from a medical standpoint. Many pediatricians will dismiss the topic as unfounded or irrelevant. Studies are ongoing as to the efficacy of treatment approaches. But while these studies continue, many parents are finding these approaches extremely helpful. In my practice, I have seen exceptional progress made in cases with sensory issues, and I work closely with occupational therapists (OTs) who provide invaluable assistance to families. I do often recommend that an OT conduct an evaluation of a child with behavioral difficulties.
What is the neuropeptide Substance P?
Neuropeptidesoriginate in the nervous system and brain (hence, the neuropart), including the peripheral nerve endings in skin. One neuropeptide that gets a lot of attention in research circles is called Substance P. It’s a well-known chemical that promotes pain in the body, and can also increase sebum production (not a good thing if you’re prone to acne).
Substance P may further be a player in depression and anxiety, which are often affiliated with acne. When the body senses stress, nerves, especially nerve endings in the skin, send out Substance P in response. When neuropeptide receptors in skin receive messages, they react by sharing the message out to other cells, which tells them how to function. This is how the feeling of embarrassment can move from your brain to your skin, causing it to blush. Similarly, when you are happy, your skin glows; you are white as a ghost when frightened. It’s as if we were chameleons and can change pretty quickly, what we are thinking and how we are feeling has an outward appearance.
From The Mind-Beauty Connection: 9 Days to Less Stress, Gorgeous Skin, and a Whole New You by Amy Wechsler.
What conditions are associated with low serotonin levels?
Bradley Bongiovanni, Integrative Medicine, answeredDr. Murray covered the conditions associated with low serotonin quite well. What many patients (and physicians who treat patients with low serotonin) are not aware of is the importance of measuring serotonin levels clinically. Likely less than 1% of clinicians who treat these patients with low serotonin actually measure it.
The question arises, how do you measure it. There are several ways: brain tissue biopsy, spinal tap of CNS fluid, serum or urine. The first two are not recommended in an outpatient setting obviously, and serum measurements tend to be less stable (unless you're collecting in a research setting). Thus, urine is the ideal specimen for most clinicians in an outpatient setting.
Is it accurate? Valid question, but not the right question. Yes, urine is extremely reliable and accurate as a specimen choice. The best question, however, is does the urine accurately reflect what's happening in the brain? Animal research and clinical experience suggest it does.
Where this rubber meets the road is for the average patient with a mood disorder presents to the clinic. Without testing, how would the clinician know how to treat the disorder? Answer: they don't, they guess. The problem is that the clinician ends up treating a diagnosis, not the biochemical imbalance underlying it. Does the patient have a predominantly serotonergic depression? Or is it dopaminergic? The treatment would be quite different. And this is the benefit of measuring multiple neurotransmitter levels in the clinical, outpatient setting.Helpful? 1 person found this helpful.
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