UPMC Physician Resources

Under Our Nose: Supplemental Oxygen Can Make Tumors Shrink, Says New Study

PITTSBURGH, March 4, 2015 – A method of profoundly enhancing some cancer treatments could be right under our noses. A study co-authored by a University of Pittsburgh researcher has shown in an animal model that breathing air with a higher than usual concentration of oxygen can alter certain metabolic pathways to allow chemotherapy and immunotherapy to shrink tumors more effectively.

The blood supply of a tumor often does not match the pace of the cancer’s growth, which leads to areas that are ischemic, or oxygen deprived, explained Edwin Jackson, Ph.D., professor of pharmacology and chemical biology, Pitt School of Medicine, and a co-author of a paper published online today in Science Translational Medicine. That causes the tumor cells to make adenosine, a molecule that not only promotes blood flow, but also binds to a receptor on killer T-cells and essentially puts them to sleep. In effect, adenosine acts as a shield against immune system cells that would otherwise attack the cancer.

“We realized if we could find a way to block the increase in adenosine, we might be able to help the immune system respond to the tumor to make anti-cancer therapies more effective,” Dr. Jackson said. “This study shows that simply breathing more oxygen can accomplish that aim, which could lead to an amazing breakthrough in cancer treatment.”

The study team, led by Michail Sitkovsky, Ph.D., director of the New England Inflammation and Tissue Protection Institute at Northeastern University, exposed mice with lung tumors to respiratory hyperoxia at levels of 40 to 60 percent oxygen, comparable to what patients might receive in the hospital. Another group of mice breathed air, which is approximately 21 percent oxygen. Tumors in mice that received supplemental oxygen shrank – some regressed completely – and the animals were more likely to survive than those on room air.

“Supplemental oxygen prevented the tumor from making extra adenosine, so the immune cells could do their job and attack the cancer cells,” Dr. Sitkovsky explained. “But if anti-tumor immune cells aren’t present, oxygen has no effect. We hope we will soon see clinical trials of respiratory hyperoxia in combination with immunotherapies to see whether it can help cancer patients.”

He noted also the effects might be stronger in combination with an agent that he calls “super-caffeine,” which blocks the receptor where adenosine binds to inhibit the immune cells.

For Dr. Jackson, whose lab is thought to be the world’s best in the measurement of adenosine and its metabolites, the breakthrough research is personally deeply rewarding. Fourteen years ago, his older brother, James F. Jackson, died at 57 of renal cell carcinoma. In 1986, Mr. Jackson received the National Science Foundation Presidential Award for Excellence in Science Teaching from Vice President George H.W. Bush.

“Jim was my childhood mentor and the reason I am a scientist today. His three years of treatment was an emotional and frustrating time for me because we didn’t have the right tools to help him,” Dr. Jackson said. “I started doing cancer research because of that experience, and I hope these results will one day prevent suffering and loss by countless other families.”

Other study investigators included researchers from the Dana Farber Cancer Institute, Harvard Medical School and the University of Miami. The project was funded by National Institutes of Health grants CA 112561, CA 111985, AT 002788, and AI 091693; National Cancer Institute grant 5PO1CA109094-03; and Northeastern University.

Medicare and Patients with Schizophrenia Could Save $150 Million on Part D Plans

PITTSBURGH, March 2, 2015 – Using an “intelligent,” rather than random, method for assigning people with schizophrenia to Medicare Part D prescription drug coverage plans could save Medicare and patients a combined $150 million annually, a new University of Pittsburgh Graduate School of Public Health analysis discovered.

The results are reported in the March issue of the journal Health Affairs and build upon an earlier study finding that Medicare could have saved more than $5 billion in its Part D low-income subsidy program in 2009 if it had used intelligent assignment among all beneficiaries who received a subsidy.

Medicare Part D provides prescription drug coverage assistance to people enrolled in Medicare who have incomes below 150 percent of the federal poverty level. Since 2006, the government has randomly assigned low-income enrollees to stand-alone Part D plans, based upon the region in which they live.

“If the government pilots intelligent assignment of Medicare Part D beneficiaries, people with schizophrenia would be an ideal group to start with,” said lead author Yuting Zhang, Ph.D., associate professor of health economics at Pitt Public Health’s Department of Health Policy and Management. “The majority of these patients are already randomly assigned to Part D plans. They spend considerably more on medication than the general Medicare population, but most of their drug spending is subsidized by the government, and these patients often have a difficult time selecting ideal plans themselves.”

Dr. Zhang and her team obtained data on nearly 120,000 beneficiaries with schizophrenia and developed a computer algorithm to intelligently assign them to plans available in their regions based on their medication needs.

Intelligent assignment translated into an annual savings of $466 per beneficiary with schizophrenia.

Schizophrenia – a chronic, disabling brain disorder often treated with medications – affects 2.6 percent of Medicare beneficiaries enrolled in stand-alone Part D plans. More than 9 out of 10 people with the disorder are eligible for a low-income subsidy for their Part D prescription drug benefit, meaning they pay little or no premium for their Part D plan and have only nominal copayments. Although Medicare beneficiaries are allowed to select a plan other than the one to which they were randomly assigned, there is little financial reason for people with schizophrenia to do so.

“This situation highlights why it would be beneficial for the government to use intelligent assignment,” said Dr. Zhang. “We recommend that Medicare use intelligent assignment as the default approach for all beneficiaries with schizophrenia who receive a low-income subsidy, and consider it as an option for all Part D beneficiaries, regardless of their income.”

Additional authors on this research are Seo Hyon Baik, Ph.D., of Pitt Public Health; and Joseph P. Newhouse, Ph.D., of Harvard University.

This research was supported by National Institute of Mental Health grants RC1 MH088510 and R21 MH100721; and the Agency for Healthcare Research and Quality grant R01 HS018657.

Dr. Newhouse is director of, and holds equity in, Aetna, which sells Part D plans.

UPMC CancerCenter First in World to Treat Patient with New Cyberknife MLC that Shapes Radiation to Tumor, Decreases Treatment Time

PITTSBURGH, March 2, 2015UPMC CancerCenter last week became the first center in the world to treat a patient with the CyberKnife® M6™ System’s new multileaf collimator, which enables precise shaping of radiation beams to any irregularly shaped tumor, sparing healthy surrounding tissues and reducing the time patients must undergo treatments.

The CyberKnife® M6™ System with the InCise™ Multileaf Collimator (MLC) was used for the first time on Feb. 26 on a 56-year-old western Pennsylvania woman being treated for a benign brain tumor. UPMC CancerCenter was one of the InCise MLC evaluation sites working in collaboration with Accuray, the device’s manufacturer. The patient’s treatment lasted 22 minutes, about half of the time treatment would have taken without the use of advanced software and novel technologies, said Dwight E. Heron, M.D., FACRO, FACR, director of Radiation Services at UPMC CancerCenter, a partner with the University of Pittsburgh Cancer Institute.

This new technology will be especially useful for tumors in the body that are hard to reach or tend to move, he said. The treatment was administered as a multidisciplinary effort between Steven Burton, M.D., from the department of Radiation Oncology and Johnathan Engh, M.D., from the department of Neurosurgery.

“Our patient was diagnosed with a brain meningioma and was a good candidate for the highly-focused treatment that can be delivered by the CyberKnife,” said Dr. Heron, who oversees the largest system in the U.S. accredited by the American College of Radiation Oncology. “With the addition of the MLC, we were able to precisely target the tumor and spare healthy tissue, and it took us significantly less time to do it. This real-world case is consistent with our InCise MLC technical evaluation experience and exceeded our expectations in its efficiency.”

The M6 Series delivers radiosurgery and stereotactic body radiation therapy, enabling precise, high-quality dose distributions to be administered to patients with extreme accuracy over a minimum number of treatments, reducing side effects and preserving patients’ quality of life. The system is able to adjust and automatically stay on target in real-time, accounting for patient and tumor motion. CyberKnife is the only robotic radiosurgery system available today that delivers such high-precision treatments throughout the body.

“We congratulate Dr. Heron, Dr. Saiful Huq and their team on treating the first patient using the CyberKnife M6 System and InCise MLC,” said Joshua H. Levine, president and chief executive officer of Accuray. “With the addition of the MLC, clinicians can deliver the same precise radiosurgery treatments they have come to expect with the CyberKnife System for a wider range of tumor types, including larger and different kinds of tumors than were previously treated.”

Pitt to Lead $14M National Trial Comparing Approaches to Treat Back Pain, Avoid Surgery

PITTSBURGH, Feb. 25, 2015 – The University of Pittsburgh will lead a $14 million clinical trial to determine how well an intervention that helps people better understand their back pain early on works toward promoting recovery and keeping the pain from becoming chronic down the road. UPMC will be the first in the trial to offer the intervention, followed by four other academic medical centers nationwide.

The five-year award from the Patient-Centered Outcomes Research Institute (PCORI) is the 13th and largest to come in to Pitt and UPMC through the Comparative Effectiveness Research Center housed in the university’s Health Policy Institute. This Center bridges Pitt’s Schools of the Health Sciences and UPMC, providing a multidisciplinary platform and research infrastructure for patient-centered comparative effectiveness research across all of the health sciences.

The Pitt-led study will examine the transition from acute lower back pain to chronic lower back pain, and compare two approaches that can be delivered in a primary care office. The first approach allows physicians to do what they think is best, which is termed “usual care.” The second approach teams up physicians with physical therapists to deliver cognitive behavioral therapy, a specialized therapy designed to help patients put their lower back pain in perspective, allowing them to identify and overcome barriers to recovery.

“Certain patients are more inclined to worry that when their back hurts they are further harming it, causing them to become inactive,” said lead investigator Anthony Delitto, Ph.D., chair of the Department of Physical Therapy in Pitt’s School of Health and Rehabilitation Sciences. “That can seriously impede recovery, cause further damage and lead to chronic back pain. Once the problem becomes chronic, the effects are magnified, even causing some people to lose their jobs and have prolonged difficulty with most daily activities. Chronic lower back pain is clearly something we would like to avoid.”

Lower back pain accounts for about $86 billion in health care expenditures every year, according to a study in the Journal of the American Medical Association. A major focus of the Affordable Care Act is mandating studies to examine pain as a public health problem and look for solutions.

“Our Comparative Effectiveness Research Center was created to provide the infrastructure to support these larger, pragmatic studies,” said Sally C. Morton, Ph.D., director of Pitt’s Comparative Effectiveness Research Center and chair of the Department of Biostatistics at Pitt’s Graduate School of Public Health. “We built the necessary methodological expertise and data environment to allow researchers to answer the questions facing our health system that are important to patients. Ultimately, these taxpayer investments through PCORI will improve outcomes and inform national policy and practice. ”

Dr. Delitto’s study, called TARGET, will recruit 60 primary-care clinics affiliated with UPMC, Intermountain Healthcare, Johns Hopkins Hospital and Health System, Boston Medical Center and The Medical University of South Carolina. At each site, 12 primary-care clinics will be randomly assigned to one of two study arms: the usual care their physician would prescribe for lower back pain or primary care coupled with physical and cognitive behavioral therapy.

Across the five regional sites, the team expects to recruit 2,640 patients with acute lower back pain, which is defined as pain they feel less than half the time and have had for less than 6 months. These patients will be evaluated with a standardized test that characterizes their response to pain and their predisposition to psychosocial characteristics that cause them to avoid pain out of fear.

The study will compare a patient-centered outcome that asks how well the patients perform activities that typically bother people with lower back pain, such as sitting, standing, walking, lifting, traveling and sleeping. Finally, the research team will measure the number of X-rays, MRIs, surgery and other lower back-related medical procedures for all patients enrolled in the study.

“This is the heart of patient-centered comparative effectiveness research,” said Everette James, J.D., M.B.A., director of Pitt’s Health Policy Institute. “Our mission is to use real-life research to find the right treatment for each patient at the right time.”

The PCORI award has been approved pending completion of a business and programmatic review by PCORI staff and issuance of a formal award contract.

Stem Cells from Wisdom Teeth Can Be Transformed into Corneal Cells

PITTSBURGH, Feb. 23, 2015 – Stem cells from the dental pulp of wisdom teeth can be coaxed to turn into cells of the eye’s cornea and could one day be used to repair corneal scarring due to infection or injury, according to researchers at the University of Pittsburgh School of Medicine. The findings, published online today in STEM CELLS Translational Medicine, indicate they also could become a new source of corneal transplant tissue made from the patient’s own cells.

Corneal blindness, which affects millions of people worldwide, is typically treated with transplants of donor corneas, said senior investigator James Funderburgh, Ph.D., professor of ophthalmology at Pitt and associate director of the Louis J. Fox Center for Vision Restoration of UPMC and the University of Pittsburgh, a joint program of UPMC Eye Center and the McGowan Institute for Regenerative Medicine.

“Shortages of donor corneas and rejection of donor tissue do occur, which can result in permanent vision loss,” Dr. Funderburgh said. “Our work is promising because using the patient’s own cells for treatment could help us avoid these problems.”

Experiments conducted by lead author Fatima Syed-Picard, Ph.D., also of Pitt’s Department of Ophthalmology, and the team showed that stem cells of the dental pulp, obtained from routine human third molar, or wisdom tooth, extractions performed at Pitt’s School of Dental Medicine, could be turned into corneal stromal cells called keratocytes, which have the same embryonic origin.

The team injected the engineered keratocytes into the corneas of healthy mice, where they integrated without signs of rejection. They also used the cells to develop constructs of corneal stroma akin to natural tissue.

“Other research has shown that dental pulp stem cells can be used to make neural, bone and other cells,” Dr. Syed-Picard noted. “They have great potential for use in regenerative therapies.”

In future work, the researchers will assess whether the technique can correct corneal scarring in an animal model.

Co-authors include Yiqin Du, M.D., Ph.D., Kira L. Lathrop, M.A.M.S., Mary M. Mann, M.S., and Martha L. Funderburgh, M.S.P.H., all of the University of Pittsburgh. The project was funded National Institutes of Health grants EY016415, EY009368 and EY008098; Research to Prevent Blindness; and the Eye and Ear Foundation of Pittsburgh.

Pitt Study Finds Popular YouTube Videos Drown Viewers with Positive Portrayals of Drunkenness

PITTSBURGH, Feb. 20, 2015 – The 70 most popular videos depicting drunkenness on YouTube account for more than 330 million views, with little portrayal of the negative outcomes of excessive alcohol consumption, according to an analysis led by the University of Pittsburgh Center for Research on Media, Technology, and Health (CRMTH).

The popularity of such videos on YouTube could be an opportunity for public health interventions aimed at educating teenagers and young adults of the negative consequences of intoxication, the researchers suggest in an article published in today’s issue of the journal Alcoholism: Clinical and Experimental Research.

“There has been little research examining Internet-based, alcohol-related messaging,” said lead author Brian A. Primack, M.D., Ph.D., director of CRMTH and assistant vice chancellor for health and society in Pitt’s Schools of the Health Sciences. “While we know that some viewers may be savvy enough to skeptically view music videos or advertisements portraying intoxication as fun, those same viewers may be less cynical when viewing user-generated YouTube videos portraying humorous and socially rewarding escapades of a group of intoxicated peers.”

Dr. Primack’s team mined YouTube for five terms synonymous with alcohol intoxication – drunk, buzzed, hammered, tipsy and trashed – winnowing their findings down to the most relevant.

There were a total of 333,246,875 views for all 70 videos combined.

  • Humor was juxtaposed with alcohol use in 79 percent of the videos.
  • Motor vehicle use was present in 24 percent.
  • Although 86 percent of the videos showed active intoxication, only 7 percent contained references to alcohol dependence.
  • An average of 23.2 “likes” were registered for every “dislike.”
  • While 89 percent of the videos involved males, only 49 percent involved females.
  • A specific brand of alcohol was referenced in 44 percent of the videos.

“This is the first comprehensive attempt to analyze YouTube data on intoxication, and these statistics should be valuable in guiding interventions,” said Dr. Primack, also a practicing physician. “For example, we know that men tend to report more frequent binge drinking than women and that alcohol use is perceived as more socially acceptable for men. Because they are portrayed more frequently in YouTube videos, it may be useful to target men with future interventions debunking alcohol-related myths propagated on social media.”

Dr. Primack found it concerning that nearly half the videos contained specific brand references. While this could indicate industry influence, the researchers did not note any clear indication of intentional advertising. Past research has linked exposure to brand references in popular media to encouraging alcohol consumption.

Additional authors on this research are Jason B. Colditz, M.Ed., and Kevin C. Pang, both of Pitt; and Kristina M. Jackson, Ph.D., of Brown University.

This research was funded by ABMRF/The Foundation for Alcohol Research.

UPMC Whitfield Cancer Centre Receives Joint Commission International Accreditation for 3rd Time; Meets Highest Standards of Safety and Quality

PITTSBURGH, Feb. 19, 2015 – For the third time since 2008, the UPMC Whitfield Cancer Centre, operated by UPMC in Waterford, Ireland, has successfully achieved accreditation from the Joint Commission International (JCI). This recognition is based on an extensive review of the center’s patient safety and quality standards and processes.

The JCI is the recognized leader in international health care accreditation and is considered the gold standard in global health care. Its accreditation process focuses on determining whether a health care facility has the right systems and processes in place to support high-quality and safe patient care, and has the culture and capacity to continuously improve care. JCI’s surveyors examine crucial issues such as patient and family education, access to care and medication management. The process requires hospitals to demonstrate a track record of standards compliance and relies on candid interviews with patients, nurses and physicians about care practices.

“The success of this, our third, accreditation survey reflects the ongoing efforts of the whole Cancer Centre team and their dedication to continuing to provide a quality service to all cancer patients in the southeast region,” said Catriona McDonald, director of operations and radiotherapy services manager.

“Demonstrating compliance with JCI standards serves as validation of an organization’s commitment to an internationally recognized, time-tested and comprehensive level of quality,” explained Cheryl Brill, UPMC’s vice president of international clinical operations and quality. “This outstanding result is a testament to the UPMC Whitfield Cancer Centre staff and to their commitment to excellence in the treatment of patients.”

UPMC Whitfield Cancer Centre offers the most advanced radiation therapy, including intensity-modulated radiation therapy and image-guided radiation therapy, to residents of the southeast region of Ireland. One of only four ambulatory care centers to be JCI-accredited in Ireland, the center is committed to delivering the highest standard of radiation therapy and supportive care for patients with all types of cancer.

Established to respond to a growing demand around the world for standards-based evaluation of quality in health care, JCI today accredits or certifies more than 700 health care organizations and clinical care programs in over 100 countries. JCI is the international arm of the Joint Commission, which has worked for more than 50 years to improve the quality and safety of health care services. As the largest accreditor of health care organizations in the United States, the Joint Commission accredits and certifies more than 20,500 health care organizations through a voluntary process and is recognized as a leader in all aspects of safe, high-quality care.

UPMC’s Dr. Marshall Webster Named to Congressional Panel Reshaping VA’s Health Care

PITTSBURGH, Feb. 19, 2015 Marshall W. Webster, M.D., a long-time physician leader at UPMC, has been selected to serve on the Commission on Care established by Congress to examine how to best deliver health care to the nation’s veterans.

Appointed to the commission by Harry Reid, minority leader of the U.S. Senate, and nominated by Sen. Robert P. Casey Jr., Dr. Webster will be one of only 15 voting members on the panel, which was established by the Veterans Access, Choice and Accountability Act of 2014. The goal of the commission is to examine how best to strategically organize the Veterans’ Health Administration, locate health care resources and deliver care to veterans.

“I am confident Dr. Webster’s talents and qualifications will make him an excellent choice to serve on the commission and examine how to best provide our veterans with timely access to the quality care they deserve,” said Sen. Casey.

As a physician, academic and senior vice president at UPMC, Dr. Webster has a long track record of establishing and maintaining relationships with physicians and community hospitals, a critical skill for his work on the commission. Given UPMC’s “exemplary service” and long history with the Department of Veterans Affairs Medical Center of Pittsburgh, Dr. Webster’s ties to UPMC “will be particularly beneficial to the Commission on Care,” Sen. Casey noted.  Since the passage of the Veterans Access, Choice and Accountability Act, UPMC has received hundreds of referrals from the VA to better provide veterans with quality and timely care.

Since 2012, Dr. Webster has served as senior vice president of UPMC, working on strategic development. He also oversees graduate medical education for UPMC and serves as interim chair of the Department of Anesthesiology. From 2002 to 2012, he was president of the University of Pittsburgh Physicians, president of the UPMC Physician Services Division and executive vice president of UPMC.

Dr. Webster is a Distinguished Service Professor of Surgery at the University of Pittsburgh School of Medicine and held the Mark M. Ravitch Endowed Chair in Surgery for nearly 10 years. He graduated from Johns Hopkins University School of Medicine, completed his surgical residency at Pitt and is board-certified in general, thoracic and vascular surgery.

A veteran himself, Dr. Webster was commissioned as a lieutenant (junior grade) in the U.S. Naval Reserves and was promoted to lieutenant in 1965. Following the completion of his surgical training, he served on active duty as a lieutenant commander stationed at the Philadelphia Naval Hospital from 1970 to 1972.

Simulation Brings Facts to Measles Outbreak and Vaccination Debate

PITTSBURGH, Feb. 17, 2015 – To bring facts and clarity to the public debate about immunization in light of the recent measles outbreak, the University of Pittsburgh Graduate School of Public Health today unveiled a computer simulation that explores the impact of measles outbreaks in cities across the U.S. Users can see how an outbreak would play out if their city had high or low vaccination rates.

The simulation – which is easily accessible from mobile devices – is an adaptation of the popular Framework for Reconstructing Epidemiological Dynamics (FRED), a free resource created at Pitt. By visiting fred.publichealth.pitt.edu/measles, people can select cities they’re interested in and watch short animations that play out an outbreak with either high or low vaccination coverage.

“FRED users can see on a map of any major metropolitan area in the U.S. how one case of measles can turn into a major outbreak or be quickly quashed, all depending on the vaccination rates of a community,” said Donald S. Burke, M.D., Pitt Public Health dean and UPMC-Jonas Salk Chair of Global Health. “Our hope is that people will use this to have informed discussions about the value of vaccination and its role in preventing epidemics.”

Examining the impact of high and low vaccination rates allows people to grasp the concept of herd immunity, explained Dr. Burke. The Centers for Disease Control and Prevention (CDC) estimates that when 95 percent of a community – or the “herd” – is vaccinated against measles, the 5 percent who can’t be vaccinated because they are too young or have compromised immune systems, as well as those whose immunity wore off or never took hold, should be protected because the virus can’t gain a foothold and spread. When vaccination rates dip too low, the herd isn’t protected and measles can sweep through a community.

Measles is a highly contagious virus. If someone with measles is in a room, nine out of 10 unvaccinated people in that room will contract the virus. For two hours after the infected person leaves, the room’s air will harbor the virus.

The measles, mumps, rubella (MMR) vaccine is recommended for children between 12 and 15 months of age, with a booster usually given between 4 and 6 years of age. Older children and adults who missed the vaccine or aren’t sure if they received it can get immunized by their doctor or at a vaccination clinic.

Future iterations of FRED Measles will allow users to adjust vaccination rates and experiment with how closing schools could affect an outbreak.

“Teachers could use FRED to help their students get a hands-on look at how public health interventions impact an infectious disease outbreak,” said FRED creator John Grefenstette, Ph.D., professor of health policy and management at Pitt Public Health. “It’s also something that pediatricians could use to open a dialogue with parents who may not want to vaccinate their children. Public health officials and policy makers could use it to explain vaccination campaigns. There really are a lot of possibilities.”

FRED was created at Pitt’s Models of Infectious Disease Agent Study (MIDAS) Center of Excellence, which is supported by the NIH’s National Institute of General Medical Sciences. MIDAS investigates novel computational and mathematical models of existing and emerging infectious diseases to guide intervention strategies.

Pitt Expert Talks Teenage Brain Development at American Association for the Advancement of Science Annual Meeting

PITTSBURGH, Feb. 14, 2015 – Teenage exploration and risk taking could be explained by dramatic changes in the brain that allow elaborate planning and are driven by the need for immediate reward, according to a University of Pittsburgh neuroscientist who will be talking about her research in a panel discussion and press briefing at the American Association for the Advancement of Science annual meeting, Feb. 13 to 16, in San Jose, Calif.

Using an elegant model in which eye movements, or saccades, reveal insight into executive brain function, Beatriz Luna, Ph.D., Staunton Professor of Psychiatry and Pediatrics, Pitt School of Medicine, has studied hundreds of young volunteers to examine brain development during the transition between childhood and adulthood.

“Our studies are beginning to challenge the traditional concept that the teenage brain can’t plan because of an immature prefrontal cortex,” Dr. Luna said. “Our findings indicate that the teen prefrontal cortex is not much different than in the adult, but it can be easily overruled by heightened motivation centers in the brain. You have this mixture of newly gained executive control plus extra reward that is pulling the teenager toward immediate gratification.”

In the experiments, volunteers are instructed to immediately look away from a small light that randomly appears on a screen in front of them. This “anti-saccade” test shows if the brain is able to engage the planning centers of the prefrontal cortex to overcome the impulse to look toward the light rather than away from it. Dr. Luna’s team has found in previous studies that children succeed in about half their tries, teens in about 70 percent of tries and adults in about 90 percent of tries. People with mental illnesses typically struggle with the task.

The study team had volunteers do the same tasks while scanning their brains with functional MRI. They found that much of the architecture of mature brain is in place by adolescence, but the ability of the networks to talk to one another and integrate information is still a work in progress.

“Further enhancement of this network integration is likely why adults can switch and very quickly adapt their behavior to changing circumstances, which is more difficult for adolescents,” Dr. Luna explained.

She added that while parents and teachers sometimes find bewildering the choices teens might make, their brains are perfectly adapted to explore and take some chances as they become independent adults.

“Across societies and species, we know that adolescence is a period of increased sensation seeking that can lead to risk taking, which increases mortality rate,” Dr. Luna said. “Also, we often see during this period the first signs of mental illnesses such as schizophrenia, depression and eating disorders. All of these have a neurobiological basis, so if we know how the brain is changing, we might be able to figure out a way to intervene earlier in life.”

Dr. Luna and researchers from the Children’s National Medical Center, Washington, D.C.; Columbia University Medical Center; and University of California, Berkeley, will present their work from 1:30 to 4:30 p.m., Saturday, Feb. 14, during a AAAS session called “From Womb to Tomb.”

They also will participate in a news briefing that day which will be webcast at 10 a.m. PT, 1 p.m. ET, at http://www.eurekalert.org/aaasnewsroom/2015/.

Watch a video of Dr. Luna describing her work.

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