FOR IMMEDIATE RELEASE

CONTACT: Doug Carlson, College of Medicine
(850) 645-1255; doug.carlson@med.fsu.edu

By Doug Carlson
February 2014

PRENATAL NICOTINE EXPOSURE MAY LEAD
TO ADHD IN FUTURE GENERATIONS

TALLAHASSEE, Fla. — Prenatal exposure to nicotine could manifest as attention deficit hyperactivity disorder in children born a generation later, according to a new study by Florida State University College of Medicine researchers.

Professors Pradeep G. Bhide and Jinmin Zhu have found evidence that ADHD associated with nicotine can be passed across generations. In other words, your child’s ADHD might be an environmentally induced health condition inherited from your grandmother, who may have smoked cigarettes during pregnancy a long time ago. And the fact that you never smoked may be irrelevant for your child’s ADHD.

The researchers’ findings are published in the current issue of The Journal of Neuroscience.

“What our research and other people’s research is showing is that some of the changes in your genome — whether induced by drugs or by experience — may be permanent and you will transmit that to your offspring,” said Bhide, chair of developmental neuroscience and director of the Center for Brain Repair at the College of Medicine.

Bhide and Zhu, assistant professor of biomedical sciences, used a mouse model to test the hypothesis that hyperactivity induced by prenatal nicotine exposure is transmitted from one generation to the next. Their data demonstrated that there is a transgenerational transmission via the maternal, but not the paternal, line of descent.

“Genes are constantly changing. Some are silenced and others are expressed, and that happens not only by hereditary mechanisms, but because of something in the environment or because of what we eat or what we see or what we hear,” Bhide said. “So the genetic information that is transmitted to your offspring is qualitatively different than the information you got from your parents. This is how things change over time in the population.”

Building on recent discoveries about how things like stress, fear or hormonal imbalance in one individual can be passed along to the next generation, Bhide and Zhu were curious about a proven link between prenatal nicotine exposure and hyperactivity in mice.

Their work at the Center for Brain Repair has included extensive research around ADHD, a neurobehavioral disorder affecting about 10 percent of children and 5 percent of adults in the United States. Researchers have struggled to produce a definitive scientific explanation for a spike in ADHD diagnoses in the last few decades.

“Some reports show up to a 40 percent increase in cases of ADHD — in one generation, basically,” Bhide said. “It cannot be because a mutation occurred; it takes several generations for that to happen.”

One possible contributing factor, though unproven, is that the current spike in ADHD cases correlates in some manner to an increase in the number of women who smoked during pregnancy as cigarettes became fashionable in the United States around the time of World War II and in the decades that followed.

“Other research has shown a very high correlation between heavy smoking during pregnancy and the incidence of kids with ADHD,” Bhide said.

“What’s important about our study is that we are seeing that changes occurring in my grandparents’ genome because of smoking during pregnancy are being passed to my child. So if my child had ADHD it might not matter that I did not have a disposition or that I never smoked.”

Bhide cautions that the work, though conclusive, is based on a study in mice, which have served as a proxy for human phenotypes.

“It’s not that every child born to a mother who smokes has ADHD, and it also isn’t true that every person with ADHD will transmit the genetic material responsible,” he said.

“But our work has opened up new possibilities. The next question is how does transmission to future generations happen? What is the mechanism? And the second question is, if the individual is treated successfully would that stop the transmission to future generations?”

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In addition to Zhu and Bhide, the paper’s co-authors are Kevin P. Lee, a research assistant in the FSU College of Medicine, and Thomas J. Spencer and Joseph Biederman, both of the pediatric psychopharmacology unit of Massachusetts General Hospital and Harvard Medical School.
 

MEDIA ADVISORY

Feb. 28, 2014

FSU MEDICAL STUDENTS TO SPEND SPRING BREAK
ON OUTREACH TRIPS

If it’s spring break, don’t look for the students of FSUCares on a beach or at a bar. Members of the Florida State University College of Medicine student group will be giving out medical supplies and treatment — and getting a cultural education in return.

On Sunday, March 2, they will be available for interviews and photos as they pack medical supplies donated by the Tallahassee community. First- and second-year College of Medicine students will make the annual trip, along with six faculty members. They will split into two groups: one will go to Immokalee in southwest Florida and one will travel to a small village in Panama. Spring break is March 10-14.

FSUCares’ mission is to increase outreach to underserved communities, said Kimberly Driscoll, a faculty adviser for FSUCares.

Students will be available for interviews and photos on:

SUNDAY, MARCH 2

1 - 4 P.M.

FSU COLLEGE OF MEDICINE

STUDENT LEARNING COMMUNITY

1115 W. CALL ST.

TALLAHASSEE, FLA.

Directions: From downtown, travel west on Tennessee Street and turn left on Stadium Drive. The College of Medicine is at Stadium and Call Street. Limited parking is available in a parking lot located off Call between the College of Medicine and the Psychology Building. Additional parking is available in the parking garage at Stadium Drive and Spirit Way.

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March 3, 2014

The Tallahassee Memorial HealthCare board of directors and the Florida State University College of Medicine today announced plans to create a general surgery residency program in Tallahassee.

The program, expected to produce two new general surgeons a year when at full capacity, will be the only surgery residency program in Northwest Florida. Currently, the nearest general surgery residency programs are in Jacksonville and Gainesville.

Wade Douglas, M.D., a 1991 graduate of Florida A&M University and 1992 graduate of the Florida State University Program in Medical Sciences (PIMS), has been named the program’s inaugural director after a national search. Douglas, who earned his M.D. at the University of Florida College of Medicine in 1995, currently is director of the general surgery residency program at the Edwards School of Medicine at Marshall University. He is expected to assume his new duties July 1.

“As a surgeon, I have the opportunity to improve the health of a few thousand people during my career, but establishing and developing a quality residency program will provide the opportunity to directly and indirectly improve the health of a few hundred thousand people,” Douglas said. “That’s something I’m very excited about.”

The program will be based at Tallahassee Memorial Hospital with the FSU College of Medicine as its institutional sponsor. TMH and the medical school previously opened an internal medicine residency program in 2011, and TMH also sponsors a family medicine residency program, where more than half of the graduates since 1973 have elected to practice in Florida. Of those, 137 are practicing in the hospital’s service area, significantly increasing access to primary health care services for residents of the Big Bend region.

"With the addition of a new general surgery residency program, Tallahassee Memorial takes another step in its commitment to expand access to care in the Big Bend region through graduate medical education," said Mark O'Bryant, president and CEO, Tallahassee Memorial HealthCare. "Through our partnership with the FSU College of Medicine, this program will enhance the academic and clinical expertise available to our patients, and strengthen the TMH mission to transform care, advance health and improve lives."

More than 10 percent of medical students graduating from the FSU College of Medicine have matched in general surgery residency programs, making it one of the school’s most popular specialty choices. Nearly 60 percent of graduates have selected one of the primary care specialties of family medicine, internal medicine, pediatrics or obstetrics-gynecology.

“This residency program addresses an important area of need in Florida, particularly in the Panhandle region,” said John P. Fogarty, College of Medicine dean. “Because many physicians end up practicing in the vicinity of where they completed residency training, we see this as an outstanding opportunity to keep more of Florida’s talented medical school graduates caring for patients where they are needed – in our home state.”

Since 2000, only 30 percent of graduating Florida medical students matching with general surgery residency programs have received their training in-state. Due in part to a lack of available slots in Florida, these graduating students leave the state and many do not return to practice. Florida State’s community-based medical education program has shown better success at bringing physicians home to practice after completing an out-of-state residency or fellowship. Sixty percent of FSU medical alumni in practice are in Florida.

The new residency program also helps to address Florida’s aging physician workforce. According to the American Medical Association physician master file, nearly 30 percent of licensed physicians in the state are age 60 or older.

After his arrival in July, Douglas will begin working on developing the program and preparing to apply for accreditation through the Accreditation Council for Graduate Medical Education (ACGME). “He will play a critical role in the application process, and he brings invaluable experience through his work as director of the general surgery program at Marshall University,” Fogarty said. “That’s one of many reasons he stood out among a highly accomplished group of candidates that we interviewed.”

The ACGME is a private, nonprofit organization that accredits approximately 9,300 residency programs in 133 specialties and subspecialties that educate over 117,000 residents. Its mission is to improve the quality of health care in the United States by assessing and advancing the quality of resident physicians’ education.

The accreditation process could take up to one year to complete, making it likely that the first new general surgery residents at TMH won’t be in place before 2016.

Florida is on the verge of overtaking New York as the third-most-populous state in the country, but ranks 42nd nationally in the number of graduate medical education slots for residency programs. The deficit was partially addressed by legislation allowing vacant residency slots to be transferred to new regions and hospitals.

While the number of residency training slots remains capped at 100,000 through 1997’s Balanced Budget Act, according to the Association of American Medical Colleges, about 1,000 slots shifted toward states with a shortage of slots compared with overall population. Florida received approximately 300 of those slots, including those that are being used to create the new general surgery residency program at TMH.

The bill making those slots available gave preference to teaching hospitals that focus on primary care and general surgery residencies, emphasize community-based training, and are located in areas with growing populations, criteria that Tallahassee Memorial Hospital satisfies on all counts.

Graduates of the new residency program would be equipped with five years of training in the field of general surgery. A general surgeon has specialized knowledge and experience related to the diagnosis, preoperative, operative, and postoperative management, including the management of complications, in nine primary components of surgery, all of which are essential to the education of a broadly based surgeon.

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Contact:
Warren Jones, Tallahassee Memorial HealthCare, (850) 431-5875
Doug Carlson, Florida State University College of Medicine, (850) 645-1255