UTSW Research: Alcohol-associated liver disease, depression treatment, and more

How alcohol-associated liver disease differs among races

Researchers have long known that outcomes for alcohol-associated liver disease (ALD) aren’t equal among all races and ethnicities in the U.S., but differences among these groups have been less clear. To investigate, researchers from the U.S., Spain, and Chile, including Thomas Cotter, M.D., Assistant Professor of Internal Medicine in the Division of Digestive and Liver Diseases at UT Southwestern Medical Center, searched three nationally representative databases covering 2011 to 2018 for racial and ethnic disparities in the natural history of ALD.

Their findings, published in Liver International, showed that Hispanic and Asian people had a higher rate of ALD at younger ages compared with non-Hispanic white individuals, despite lower overall alcohol consumption. Black people had comparatively lower rates of ALD and a reduced risk of death during hospitalization due to ALD. Hispanic and female Asian individuals had the lowest probability of liver transplantation if wait-listed. Future research should focus on determining the reasons for these differences, Dr. Cotter and his colleagues reported.

Esketamine shows promise for treatment-resistant depression

An estimated one-third of patients with major depressive disorder have treatment-resistant depression (TRD), characterized by an inadequate response to two or more oral antidepressants (OADs). Three international clinical trials have shown that esketamine (an intranasally delivered, specialized form of the anesthetic and antidepressant ketamine) can improve depression symptoms in patients with TRD when taken with a newly initiated OAD. However, whether these effects persisted in patient-reported measures was unknown. 

To answer this question, researchers led by Madhukar Trivedi, M.D., Professor of Psychiatry and Director of the Center for Depression Research and Clinical Care in the Peter O’Donnell Jr. Brain Institute at UT Southwestern, analyzed data from the clinical trials. Results, published in CNS Spectrums, showed a significant improvement in symptoms for those taking a new OAD with esketamine compared with a placebo nasal spray based on responses to the nine-item Patient Health Questionnaire, a validated measure of depression severity. Participants were also significantly more likely to achieve remission from TRD with esketamine than with the placebo. These results show a strong correlation between patient- and physician-reported measures and the promise of esketamine treatment for TRD.

COVID-19’s effects on individual employment

COVID-19’s unprecedented impact on the U.S. labor market has been well established, but its effects on individual employment and the ability to work have not. Ahamed Idris, M.D., Professor of Emergency Medicine and Internal Medicine at UT Southwestern, and researchers from several institutions studied data from 2,939 adults enrolled in the Innovative Support for Patients with SARS-CoV-2 Infections Registry (INSPIRE). There were eight INSPIRE study sites, including UTSW.

The researchers’ national study, published in PLOS ONE, compared long-term symptoms and outcomes among patients with COVID-like symptoms between December 2020 and August 2022. Each was employed before the pandemic and tested positive for COVID-19. Three months after infection, 7.2% reported missing 10 or more workdays and 13.9% reported not returning to work after infection. The chances of these events were significantly higher for the nearly 10% of participants who had five or more COVID-19 symptoms.

The research findings suggest that despite the end of the federal Public Health Emergency for COVID-19, the clinical and economic long-term implications of the pandemic on employment status and work absenteeism are important factors for policymakers to consider.

EEG testing shows possible biomarker for suicidal ideation

Understanding the neurobiological underpinnings of suicidal ideation and identifying biomarkers could help doctors identify those at risk and researchers develop effective interventions. Although studies using functional MRI (fMRI) have connected suicidal ideation with dysfunction in neuronal networks in the brain, the high cost of fMRI prevents it from being used as a clinical tool for assessing suicide risk.

Searching for alternatives, researchers led by Madhukar Trivedi, M.D., Professor of Psychiatry and Director of the Center for Depression Research and Clinical Care in the Peter O’Donnell Jr. Brain Institute at UT Southwestern, tested electroencephalography (EEG), a much less expensive brain-scanning tool, on 111 volunteers ages 10-26 who had a history or current diagnosis of depressive or bipolar disorder. Their results, published in the Journal of Psychiatric Research, showed dysfunction in the brain’s default mode network in those who tested positive for suicidal ideation on the Concise Health Risk Tracking survey. The researchers suggest EEG could offer an accurate, accessible method to test patients for suicidal ideation.

Other UTSW researchers who contributed to this study are Cherise R. Chin Fatt, Ph.D., Assistant Professor of Psychiatry; Abu Minhajuddin, Ph.D., Professor in the Peter O’Donnell Jr. School of Public Health and the Department of Psychiatry; Russell Toll, Ph.D., Assistant Professor of Psychiatry; and Jane A. Foster, Ph.D., Professor of Psychiatry.

About UT Southwestern Medical Center 

UT Southwestern, one of the nation’s premier academic medical centers, integrates pioneering biomedical research with exceptional clinical care and education. The institution’s faculty members have received six Nobel Prizes and include 25 members of the National Academy of Sciences, 22 members of the National Academy of Medicine, and 14 Howard Hughes Medical Institute Investigators. The full-time faculty of more than 3,200 is responsible for groundbreaking medical advances and is committed to translating science-driven research quickly to new clinical treatments. UT Southwestern physicians provide care in more than 80 specialties to more than 120,000 hospitalized patients, more than 360,000 emergency room cases, and oversee nearly 5 million outpatient visits a year.