Category: AMBM

  • Mindfulness-Based Therapy for Opioid Misuse Offers Massive Return on Investment

    Mindfulness-Based Therapy for Opioid Misuse Offers Massive Return on Investment

    A new economic evaluation from the University of California San Diego School of Medicine has revealed that Mindfulness-Oriented Recovery Enhancement (MORE) — an innovative, evidence-based, neuroscience-informed therapy for opioid misuse and chronic pain — provides $12 in cost savings for every dollar spent, between two and six times more cost effective than other addiction treatments such as residential or intensive outpatient treatment. Over the course of a patient’s life, the analysis found that these savings came out to more than $324,000 per patient.

    Each dollar spent on a mindfulness-based opioid misuse treatment could yield $12 in economic benefit

    The results suggest that, if widely implemented, MORE could provide a potent, cost-effective solution for the opioid crisis, which currently costs the U.S. as much as $4 trillion per year in health care, criminal justice and lost productivity costs. The findings are published online in the journal Value in Health.

    “Opioid misuse is a major driver of overdose deaths, hospitalizations, homelessness and economic loss, so substantially reducing opioid misuse could have huge positive consequences for society,” said lead author Eric Garland, PhD, professor of psychiatry at UC San Diego School of Medicine and endowed professor at the Sanford Institute for Empathy and Compassion. “Our study suggests that MORE could be part of a scalable solution that improves outcomes for patients while also reducing burdens on the health care system and society at large.”

    MORE, developed by Garland, combines a unique sequence of mind-body techniques designed to address addiction, emotional distress and chronic pain at the same time. The intervention teaches mindfulness skills to regulate craving and pain, cognitive reappraisal skills to manage stress and negative emotions, and savoring techniques to help patients reconnect with naturally rewarding experiences.

    “Opioid addiction decreases the brain’s ability to experience natural healthy pleasure, driving increased cravings for the drug,” said Garland. “Our research shows that MORE helps restore this capacity in the brain, reducing cravings and preventing opioid misuse.”

    Previous publications from the MORE research team, based on a randomized clinical trial of 250 adults with chronic pain who were misusing prescribed opioids, found that the treatment reduced opioid misuse by 45% (tripling the effect of standard therapy), led to improvements in pain symptoms and opioid dosing, and strengthened the brain’s responses to positive experiences to reduce cravings. The new study, based on the trial data, sought to put this clinical success into an economic context, asking whether the treatment is cost-effective in addition to being clinically effective.

    The economic analysis found:

    • MORE had a benefit-to-cost ratio of 12-to-1, meaning the intervention was estimated to generate $12 in economic benefit for every $1 spent.
    • This is significantly greater than prior estimates for several other addiction treatment approaches, including comprehensive case management (1.8 to 1), residential treatment (between 2.0 to 1 and 4.8-to-1) and intensive outpatient treatment (5.1-to-1).
    • The lifetime cost savings per patient were $324,489.

    The researchers say the economic benefits of MORE likely stem from reductions across several major categories of harm associated with opioid misuse, including healthcare utilization, criminal justice involvement, lost productivity and overdose mortality.

    “At a relatively low cost, MORE has strong potential to reduce opioid misuse and generate substantial economic benefits for patients, health systems and society,” said Fernando Wilson, PhD, co-author on the study, professor of economics and population health sciences at the University of Utah, and director and endowed chair of the Matheson Center for Health Care Studies. “The cost of implementing MORE is small, and its potential payoff in averting misuse and risk of opioid use disorder is very large.”

    The new study builds on a broader body of evidence supporting the therapy. MORE has now been tested successfully in more than 16 randomized clinical trials involving over 2,500 participants, and has been taught to more than 1,200 clinicians in the United States and internationally. However, the researchers suggest that MORE could have an even larger impact if embedded more widely into health systems, which will require support and investment from healthcare organizations, insurers and policymakers.

    “My hope is that MORE can become a central part of the standard of care,” said Garland, “not only in addiction treatment settings, but also upstream in primary care, where we have a chance to intervene before opioid misuse progresses to more severe addiction.”

    Read the full paper: Economic Evaluation of Mindfulness-Oriented Recovery Enhancement for the Treatment of Opioid Misuse

    Watch the video: Promising Tool Against Opioid Use Disorder

    The study was funded, in part, by grants from the National Institutes of Health (R01DA058621, R01DA056537 and R01DA057631).

    Dr. Garland is Founder of the MORE Science Institute. The authors declare no other competing interests.

  • Different inflammatory processes tied to the same Alzheimer’s disease-related brain shrinkage and memory loss

    Different inflammatory processes tied to the same Alzheimer’s disease-related brain shrinkage and memory loss

    Alzheimer’s disease may look similar from one person to another even when different biological processes are driving the damage, according to a new study led by researchers at the University of California, Irvine.

    The researchers identified two distinct patterns involving inflammation in the brain. One was associated with damage to the brain’s small blood vessels, a marker known as white matter hyperintensities. The other was associated with the buildup of amyloid beta, considered a hallmark protein of Alzheimer’s disease.

    Although the two patterns differed by their connection to inflammatory markers, both were connected to higher levels of a blood marker associated with abnormal tau. They were also connected to shrinkage in brain regions that support memory and, ultimately, to poorer memory performance.

    The findings were published in Alzheimer’s & Dementia: Diagnosis, Assessment & Disease Monitoring. They support the idea that Alzheimer’s is not driven by exactly the same process in every person. Different combinations of inflammation, blood vessel damage, amyloid buildup and other biological problems may produce similar patterns of brain damage and memory loss.

    The findings have potentially profound clinical impacts. They may lead to the design of more targeted therapies and provide one explanation for the failure of clinical trials in Alzheimer’s disease thus far.

    “We keep talking about Alzheimer’s as though it is one disease with one cause, but the biology is much messier than that,” said senior author Michael A. Yassa, PhD, professor and James L. McGaugh Endowed Chair in Neurobiology and Behavior and director of UC Irvine’s Center for the Neurobiology of Learning & Memory. “Different biological problems may push the brain toward the same damaged state. For treatment, the key may be figuring out which processes are doing the most harm in each person and how they interact.”

    Different markers point to different kinds of damage

    The researchers studied 126 adults aged 60 and older who did not have mild cognitive impairment or dementia. The participants were enrolled in Yassa’s NIH-funded Biomarker Exploration in Aging, Cognition, and Neurodegeneration, or BEACoN, study.

    The research team combined blood tests, magnetic resonance imaging, amyloid PET brain scans and memory assessments. The scientists then used a statistical model to understand the pathways that connected these markers to downstream memory loss.

    They focused on two proteins found in blood, YKL-40 and glial fibrillary acidic protein, or GFAP. Both are associated with the activity of support cells in the brain that respond to injury and disease, but the study found that the two markers were linked to different biological patterns. Higher YKL-40 levels were associated with more white matter hyperintensities. These appear as bright spots on MRI scans and often reflect damage caused by disease in the brain’s small blood vessels. Higher GFAP levels, by contrast, were associated with greater amyloid buildup measured with PET imaging.

    “The two markers were signaling different processes or pathways that ultimately connect to the visible signs of Alzheimer’s,” said first author Batool Rizvi, PhD, who conducted the work while a graduate student with Yassa and is now a postdoctoral fellow at UC Davis. “Our results suggest that inflammation in Alzheimer’s is not one single process and that different inflammation mechanisms may act in parallel and converge on the same downstream outcome of cell loss.”

    Different routes, similar outcomes

    Both the small blood vessel damage and amyloid buildup were independently associated with higher levels of phosphorylated tau 217, or p-tau217. This blood marker is commonly used to detect abnormal changes involving tau, another protein central to Alzheimer’s disease.

    Higher p-tau217 levels were associated with thinning of tissue in the medial temporal lobe and with a smaller hippocampus. These brain regions play major roles in learning and memory. Participants with smaller hippocampal volume also performed worse on a memory test that measured how well they retained previously learned information after being presented with new material.

    The results suggest that inflammation connected to blood vessel damage and inflammation connected to amyloid may represent separate biological routes that become associated with a common pattern of tau-related changes and damage in memory systems.

    “This may help explain why a treatment aimed at one target works for some people but has little effect on others,” Yassa said. “A person whose disease is driven largely by vascular injury may need a different treatment from someone whose dominant problem is amyloid-related inflammation. Many people will probably have a mixture of both, along with other processes that we did not measure here.”

    The researchers said that future blood tests could combine several markers to provide a clearer picture of the processes affecting an individual patient. That information could help researchers design better clinical trials and eventually match patients with treatments aimed at the biological drivers most important in their disease.

    “Amyloid and vascular injury should not necessarily be treated as competing explanations,” Rizvi said. “They may be different parts of the disease in different people, or they may occur together. Following these markers over time could help us understand which process becomes active first and which one is most closely tied to cognitive decline.”

    Alzheimer’s may be many biological problems with a common endpoint

    The study reflects a broader view of Alzheimer’s that Yassa described in a 2025 essay in The Transmitter, titled “Everything, everywhere, all at once: Inside the chaos of Alzheimer’s disease.”

    In the essay, Yassa argued that Alzheimer’s may appear to be one disease because several biological problems can eventually produce similar symptoms. Amyloid may be an important driver in some people, while inflammation, blood vessel injury, problems with glucose use or excessive brain activity may play larger roles in others. These processes can also interact with one another. Over time, they may push the brain into a damaged and unstable condition that persists even after the original trigger is reduced.

    The current study provides evidence for one part of that framework by showing that two distinguishable patterns involving inflammation were associated with a common set of downstream brain changes.

    “Alzheimer’s may be less like a single chain of events and more like several roads leading to the same place,” Yassa said. “That makes the disease harder to understand, but it also opens more opportunities for treatment. We need to identify the main biological drivers in each person instead of assuming that everyone should receive the same therapy.”

    Study limitations and next steps

    The researchers cautioned that the study provides a snapshot in time. It cannot determine which changes occurred first or prove that one biological factor caused another. The participants were cognitively unimpaired, and some blood measurements were available in only a subset of the study group. The sample was also predominantly White, which limits how broadly the results can be applied. Larger studies will need to follow more diverse groups of people over time. Future research should examine whether these patterns predict memory decline, whether they change as Alzheimer’s progresses and whether they can be used to select and inform treatments.

    The study was supported by the National Institute on Aging grant R01AG053555.

    About the Center for the Neurobiology of Learning & Memory: Established in 1983 by the UC Regents, with James L. McGaugh as its Founding Director, the CNLM is the first research institute in the world dedicated to the interdisciplinary study of the fundamental brain mechanisms of learning and memory. It is credited with numerous seminal discoveries about how memory works and is recognized as a global leader in the area. Led by Director Michael Yassa, the CNLM is home to more than 120 faculty scientists at UC Irvine and beyond. For more information, visit cnlm.uci.edu.

    About the University of California, Irvine: Founded in 1965, UC Irvine is a member of the prestigious Association of American Universities and is ranked among the nation’s top 10 public universities by U.S. News & World Report. The campus has produced five Nobel laureates and is known for its academic achievement, premier research, innovation and anteater mascot. Led by Chancellor Howard Gillman, UC Irvine has more than 36,000 students and offers 224 degree programs. It’s located in one of the world’s safest and most economically vibrant communities and is Orange County’s second-largest employer, contributing $7 billion annually to the local economy and $8 billion statewide. For more on UC Irvine, visit www.uci.edu.

  • For mind and body: Community gathering places may counteract cognitive disability

    For mind and body: Community gathering places may counteract cognitive disability

    Community gathering places, where residents lead group activities, have been promoted across Japan as part of long-term care prevention efforts to extend healthy life expectancy. These often involve exercise and social interaction and are meant to help prevent cognitive decline. However, previous studies have reported inconsistent findings regarding their association with cognitive disability.

    Therefore, a research group, led by Associate Professor Kazuki Uemura at Osaka Metropolitan University’s Graduate School of Rehabilitation Science, investigated whether exercise habits influence the relationship between participation in community gathering places and cognitive disability. The researchers analyzed data from self-administered questionnaires and long-term care insurance records from 3,511 older adults in Habikino City, Osaka Prefecture, who had not been certified as requiring long-term care. After excluding invalid answers, 2,578 were included in the primary analysis. Participants and non-participants in city-supported weekly exercise groups were tracked for four years, and the risk of cognitive disability was examined using survival analysis.

    The study found that among older adults without regular exercise habits, those who participated in community gathering places had approximately half the risk of developing cognitive disability compared with non-participants. In contrast, no significant association was observed among older adults who already exercised regularly.

    “These findings support a growing direction in long-term care prevention policy, which creates opportunities for participation that are accessible to older adults who may find regular exercise difficult,” said Associate Professor Uemura.

    Furthermore, additional analyses focused on physical functional decline revealed similar benefits from community activities. As they are designed to accommodate frail older adults, the physical components provide additional health benefits for those without exercise habits.

    “We hope this evidence will help inform community-based initiatives that support a wide range of older adults and contribute to policies aimed at reducing health inequalities.”

    The findings were published in the Journal of the American Geriatrics Society.

    ###

    About OMU 

    Established in Osaka as one of the largest public universities in Japan, Osaka Metropolitan University is committed to shaping the future of society through the “Convergence of Knowledge” and the promotion of world-class research. For more research news, visit https://www.omu.ac.jp/en/ and follow us on social media: X, Instagram, LinkedIn.

  • Dreams aren’t random. The brain is rewriting reality.

    Dreams aren’t random. The brain is rewriting reality.

    Why do some dreams feel so vivid that they seem almost real, while others unfold as confusing fragments that are difficult to remember or understand? New research suggests the answer may depend on a combination of personality, sleep quality, mental habits, and major events unfolding in the outside world.

    A study led by researchers at the IMT School for Advanced Studies Lucca found that dreams are not simply random collections of images and thoughts. Instead, they appear to be shaped by both individual differences and shared experiences, including major social disruptions such as the COVID-19 pandemic.

    Thousands of Dream Reports Reveal Hidden Patterns

    The research, published in Communications Psychology, examined more than 3,700 descriptions of dreams and waking experiences from 287 people between the ages of 18 and 70.

    For two weeks, participants recorded their dreams and daily experiences. The researchers also collected information about each person’s sleeping habits, personality, cognitive abilities, and psychological characteristics.

    This broad set of information allowed the team to compare what people experienced while awake with the stories, settings, and emotions that appeared in their dreams.

    How AI Helped Scientists Study Dreams

    To analyze such a large number of written reports, the researchers used natural language processing (NLP), a form of artificial intelligence that examines patterns, relationships, and meaning in language.

    Rather than relying only on researchers to read and interpret every dream individually, the technology allowed the team to measure the semantic structure of the reports. Semantic structure refers to how ideas, words, and concepts are connected within a piece of language.

    The results showed that dream content was neither completely random nor inherently chaotic. Instead, dreams reflected a complex mixture of personal characteristics, including a tendency to mind-wander, an interest in dreams, and the quality of a person’s sleep. Events occurring in the broader world also influenced what people dreamed about.

    Dreams Do Not Simply Replay the Day

    When the researchers compared participants’ descriptions of waking life with their dream reports, they found that the brain did not appear to reproduce daily experiences exactly as they happened.

    Instead, familiar details were transformed.

    A workplace, hospital, classroom, or other everyday setting might appear in a dream, but it would often be combined with unrelated places, shifting viewpoints, or unfamiliar surroundings. Different parts of a person’s life could merge into a single vivid scene.

    These findings suggest that dreaming is not a simple replay system. The sleeping mind appears to reorganize pieces of reality, combining memories with imagination, expectations, and possible future experiences.

    The result can be a completely new scenario that feels immersive, emotionally intense, or surreal.

    Personality May Influence Dream Vividness

    The way dreams were transformed also differed from person to person.

    People who were more likely to experience mind-wandering while awake tended to report dreams that changed quickly and felt more fragmented. Their dreams often moved rapidly between scenes, ideas, or perspectives.

    By contrast, participants who placed greater value on dreams and believed that dreaming had personal meaning tended to describe richer and more immersive experiences. Their dream reports contained stronger perceptual detail, making the scenes feel more vivid and lifelike.

    The findings do not necessarily show that believing in dreams directly causes more vivid dreaming. However, they reveal a strong relationship between how people think about dreams and how they experience or remember them.

    The Pandemic Left a Mark on Dreams

    The researchers also examined dream reports collected during the COVID-19 lockdown by scientists at Sapienza University of Rome. They compared those reports with data gathered in later months and years by the IMT School team.

    During the lockdown, dreams contained stronger emotions and more references to restrictions, barriers, confinement, and other limitations. These themes reflected the conditions people were experiencing in daily life.

    As the months passed, those patterns became less pronounced. This gradual change suggests that dreams may evolve alongside psychological adjustment, particularly as people adapt to stressful or disruptive events.

    In other words, dreams may provide clues about how the mind responds to major changes over time.