Brain Histamine Map Links Genetic Factors to Mental Health and Psychiatric Disorders

A study headed by researchers at King’s College London and the University of Porto has mapped the histamine system in the brain. Histamine, a molecule more commonly associated with allergies, plays a separate but poorly understood role in brain function. The new study addresses this gap, building the first multiscale map of the histamine system which spans from genetics to behavior and related mental health conditions.

The findings provide a new framework for understanding how this often-overlooked chemical system contributes to brain function and could point towards new treatment strategies for histamine-related conditions such as depression, ADHD, and schizophrenia. The study was funded by the National institute for Health and Care Research (NIHR) Maudsley Biomedical Research Centre.

Daniel Martins, MD, PhD, visiting senior research fellow at the Institute of Psychiatry, Psychology & Neuroscience (IoPPN) King’s College London, said, “This work provides a crucial foundation for future research. By integrating molecular biology, brain imaging, and computational analysis, it offers a new perspective on how neurotransmitter systems are organized across the human brain. As neuroscience moves toward more integrated and personalized models of mental health, understanding systems like histamine may prove essential for unlocking new approaches to diagnosis and treatment.”

Martins is first and corresponding author of the team’s published paper in Nature Mental Health, which is titled “Mapping histamine pathway networks in the human brain across cognition and psychiatric disorders.” In their paper the team concluded, “This study provides an integrated characterization of the histaminergic system in the human brain, leveraging transcriptomic, neuroimaging, and functional datasets to delineate its molecular organization and relevance to brain function underlying cognition and psychiatric disorders.”

Histamine is a neurotransmitter, a molecule crucial for neurons to communicate with one another, the authors explained. “Neuronal histamine plays a crucial role in the regulation of brain function, serving as a neuromodulator with widespread influence across multiple neurotransmitter systems.” However, neuroscience research has classically focused on understanding other neurotransmitter systems such as dopamine and serotonin.

As the investigators noted, the organization of histamine in the human brain remains incompletely characterized. However, they explained, dysregulation of the histaminergic system has been implicated in a number of neuropsychiatric conditions, including anxiety, depression, schizophrenia, and autism spectrum disorder (ASD), as well as neurodegenerative diseases including Alzheimer’s, Parkinson’s, and Huntington’s diseases. “Therefore, targeting the brain histamine system has garnered significant attention as a potential new therapeutic strategy for treating these disorders, with pharmacological interventions aimed at modulating histamine receptor activity showing promise in preclinical models.”

Histamine acts through four known histamine receptors, which are responsible for how the signal will influence receiver neurons. Each of these histamine receptors, (histamine receptor H1 (encoded by HRH1), H2 (HRH2), H3  (HRH3) and H4 (HRH4)), mediates distinct functions. For their newly reported study, Martins and colleagues carried out what they described as multimodal analysis, integrating transcriptomic, neuroimaging, developmental and functional datasets to map the architecture of the histaminergic system.

To build a comprehensive map of how histamine acts in the brain, researchers first combined genetic and molecular data with physical maps of the brain.

This revealed which brain regions receive more input from the brain’s histamine system, and which parts show greater capacity to respond to histamine. These molecular data were then linked with positron emission tomography imaging of histamine receptors in living individuals, as well as functional neuroimaging databases that map brain regions to specific cognitive processes and mental health conditions. This type of scan shows how different parts of the brain are working by tracking a tiny amount of radioactive tracer in real time.

Their results found that different histamine receptors were found on brain cells that either turn activity up (excitation) or turn it down (inhibition). “The findings reveal that histaminergic genes exhibit distinct cellular and regional expression profiles, closely aligning with known histaminergic neuroanatomy and function,” they wrote. “At the single-cell level, histamine receptor H1 and histamine receptor H2 were enriched in excitatory neurons, whereas histamine receptor H3 showed preferential expression in inhibitory populations.” This suggests histamine may be important in maintaining the balance between excitation and inhibition, a fundamental property of healthy brain function.

Brain regions with higher histamine-related gene expression were consistently associated with processes such as emotional regulation, stress and fear responses, decision-making, impulsivity, reward, sleep, and memory.

The parts of the brain where histamine-related genes were most active also overlapped significantly with brain regions known to be affected in several psychiatric conditions, including attention-deficit/hyperactivity disorder, major depressive disorder, schizophrenia, and anorexia nervosa. This is in keeping with previous hypotheses linking histamine to these disorders. “By linking histaminergic gene expression to brain-cell types, neurotransmitter systems, cognitive domains and psychiatric disorders, these correlational findings generate several hypotheses concerning histamine’s critical role in brain organization, neurodevelopment and mental health, which further experimental mechanistic work should prioritize and build onto investigate causal relationships,” the investigators concluded.

Martins said, “Current psychiatric treatments largely target neurotransmitters such as serotonin and dopamine, yet histamine interacts closely with these systems and influences their activity. By providing a detailed map of histamine-related pathways, this work suggests new opportunities for developing treatments that target this system more directly, particularly for symptoms such as cognitive dysfunction, fatigue, and impaired motivation.

While these findings do not establish a direct causal role, they suggest that histamine signalling may contribute to regional vulnerability in these disorders. This aligns with a growing view in psychiatry that mental health conditions arise from disruptions across interacting brain systems rather than a single chemical imbalance.”

This new map paints a neural picture of a previously lesser-studied molecule. It opens up future avenues of research into exactly what histamine is doing in various cell types and parts of the brain.

“We want to emphasise that these findings are hypothesis-generating and based on large-scale datasets that capture patterns rather than direct mechanisms,” commented senior author Steve Williams, PhD, professor of neuroimaging at IoPPN King’s College London. Future studies will focus on testing how histamine signaling changes in living individuals, for example through pharmacological interventions or longitudinal imaging approaches.

Co-author Daniel Van Wamelen, PhD, clinical senior lecturer in neuroscience at IoPPN, King’s College London and one of the authors on the paper said: “This kind of work is already taking place at King’s College London, for example in the iMarkHD project. In this project we use Positron Emission Tomography scans to study a specific histamine receptor (called H3) in people with Huntington’s disease, an inherited condition that affects the brain. The goal is to see how histamine activity changes in different parts of the brain over time, and how these changes relate to symptoms such as apathy, depression, and anxiety.”

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Adopting a user-centred design approach for the development of on-device technology to prevent the viewing of child sexual abuse material: app design insights and principles from the development of ‘Salus’

IntroductionThe volume of Child Sexual Abuse Material (CSAM) available online and the global demand for it has reached unprecedented levels. Increasing numbers of individuals concerned about their online behaviour are contacting therapeutic providers for help and support outside of the criminal justice system. Previous research asking individuals what would help them to stop viewing CSAM suggests that the availability of a technological solution to voluntarily self-manage access to CSAM could be an effective tool.AimTo explore the findings from the user-centered design (UCD) of the ‘Salus’ prototype – a technological prevention tool to support effective self-management of individuals at risk of committing a first or further CSAM offence(s).Materials and methodsIn this two-year, European Commission funded project we conducted research in four European countries: Belgium, Germany, the Netherlands, and the United Kingdom (UK). For the UCD phase of the project we conducted semi-structured interviews with 31 at-risk individuals in Belgium (n=10), Germany (n=10) and the UK (n=11), to explore the specific needs, design features, deployment methods, and concerns and barriers for the design, functionality and deployment of Salus. Additionally, four focus group discussions (FGDs) were held in Belgium, the Netherlands, and the UK with service providers (primarily therapists and managers) with extensive experience of supporting individuals at risk of committing CSAM offences to explore the same questions at the service level.ResultsIn terms of privacy and security, the potential discovery of apps such as Salus, data security and legal consequences of app usage are the main concerns of potential app users. There was consensus on the value of blocking CSAM, but opinions on the inclusion of an optional adult sexual content (pornography) filter in Salus design were not unanimous. Users should be able to switch a pornography filter on and off at their convenience. Blocking notifications should be quiet and subtle. Interactivity features are welcomed by potential users – these may include a diary function; a personal CSAM statistics page; a resources section; and a function to allow users to provide feedback to the app developers. Such features should be optional for users in order to prevent any unintended consequences of app usage. Finally, app deployment must be safe and secure.ConclusionBased on these findings, we propose seven evidence-based design principles for user-centered harm-reduction technology: privacy-by-default architecture; discretion through design ambiguity; adaptive notification systems; optional interactivity with user control; trusted-channel deployment; progressive trust building; and fail-safe harm prevention. These principles provide a framework for app developers and researchers working on similar technologies to develop interventions that reduce harmful behaviours.

Long-term neurodevelopment in preterm neonates with necrotizing enterocolitis: systematic review and meta-analysis

IntroductionNecrotizing enterocolitis (NEC) is a common complication in preterm infants and is associated with significant mortality and long-term morbidity, including gastrointestinal sequelae, brain injury, and developmental delays. This systematic review and meta-analysis examines long-term neurodevelopmental outcomes in infants born at less than 34 weeks’ gestation who survive NEC and identifies specific developmental domains most vulnerable to neurodevelopmental impairment.MethodsThe systematic review was performed according to the PRISMA guidelines. We systematically searched Pubmed (including MEDLINE), Embase and Web of Science for relevant articles. Studies were graded for quality using the GRADE system and bias was assessed using the ROBINS-E Risk of Bias tool. We performed gestational-age stratified subgroup analyses (22–28 weeks versus 29–34 weeks) and evaluated the risk of impairment in different neurodevelopmental domains.ResultsSurvivors of NEC are at increased risk of neurodevelopmental impairment (RR 1.42, 95% CI 1.32–1.53). Several neurodevelopmental domains are negatively impacted, such as motor skills (RR 2.08, 95% CI 1.86–2.32), cognition (RR 1.75, 95% CI 1.57–1.96), vision (RR 4.36, 95% CI 2.91–6.55), hearing (RR 4.09, 95% CI 2.91–5.77) and cerebral palsy (RR 2.48, 95% CI 2.15–2.86). The risk of epilepsy and behavioral problems does not differ between NEC survivors and age-matched controls. This increased risk of impairment after NEC persists after stratification for gestational age and extends into school-age.ConclusionNEC Survivors face an elevated risk of neurodevelopmental impairment, irrespective of gestational age, with deficits spanning multiple developmental domains. These findings highlight the need for targeted, long-term follow-up to enable timely detection and individualized interventions for developmental delays throughout childhood.Systematic review registrationhttp://www.crd.york.ac.uk/PROSPERO, identifier CRD42022322564.

Association between childhood ADHD problems and premature mortality: identifying modifiable cardiovascular mechanisms in a UK population cohort

BackgroundIndividuals with attention deficit hyperactivity disorder (ADHD) are at increased risk of premature mortality, but the mechanisms that underlie this association after young adulthood are unknown. As ADHD is associated with cardiovascular disease, modifiable cardiovascular risk factors could contribute to links between ADHD and premature mortality.AimsThis study aims to investigate whether specific cardiovascular risk factors explain the association between childhood ADHD problems and a higher risk of premature mortality.MethodsWe used the UK 1958 birth cohort, the National Child Development study (NCDS), and linked death register data to examine whether children with ADHD problems at age 7 years were at higher risk of premature mortality by age 58 and if specific modifiable cardiovascular risk factors, measured at midlife (age 44 years), mediated this association using path analysis.ResultsA total of 8,016 individuals completed both the age 7 ADHD assessment and the age 44/45 biomedical assessment. Of these individuals, 231 (3.1%) were grouped as likely having ADHD. The odds ratio (OR) for deaths (n = 251) in the ADHD group versus the non-ADHD group was 1.86 (95% CI 1.08–3.17). The risk was largely explained by cigarette smoking status at midlife and by a higher waist–hip ratio (a measure of obesity).ConclusionsChildhood ADHD problems are associated with a higher risk of premature mortality by age 58. This risk seems to be mainly explained by two potentially modifiable cardiovascular risk factors: obesity and smoking. These risks should be prioritized for preventative interventions to reduce the risk of premature mortality in those with a history of ADHD.

Surf Therapy: A Powerful Low-Intensity Approach in Global Youth Mental Health Care


By Mai El Shoush, Partnerships Campaign Manager, Stavros Niarchos Foundation (SNF) Global Center for Child and Adolescent Mental Health at the Child Mind Institute


In Conversation with Waves for Change

The world’s oceans have long been profound forces that shape coastlines, cultures, and scientific discovery. And today, through targeted programs, they also serve as therapeutic environments transforming youth mental health worldwide.

As global health systems continue to explore solutions that minimize resource constraints while addressing child and adolescent mental health demands, innovative approaches like surf therapy are demonstrating remarkable effectiveness as low-intensity initiatives. From the beaches of California to the coastal communities of South Africa, Australia, Hawai’i, the United Kingdom, and Senegal, these programs are creating accessible entry points for young people.

Wave for Change (W4C) — a South Africa-based organization and valued implementation partner of the Stavros Niarchos Foundation (SNF) Global Center at the Child Mind Institute — has developed an evidence-based Surf Therapy program for youth in underserved communities. We spoke with their chief development officer Paula Yarrow and senior grant manager Jill Sloan about the award-winning program. As a highly regarded Cape Town‑based NGO that uses surfing as a therapeutic tool to support youth mental health, W4C offers safe spaces, evidence‑based emotional regulation tools, community mentorship, and a pathway to resilience for young people growing up in challenging environments.

The partnership includes the identification of workforce gaps and training needs for frontline workers such as NGOs, to further expand evidence-based support and brief interventions through culturally appropriate, low-intensity psychological therapy approaches. The context-specific training materials are expected to be piloted later in the year in South Africa and are intended to improve access to quality mental health care for young people.

W4C launched Surf Therapy in 2009, which has since helped more than 10,000 adolescents experiencing high-stress environments gain valuable coping skills across its hubs in the Western and Eastern Cape as well as Cape Town. Participants learn how to build positive social networks and develop self-regulation skills to support healthy emotional and behavioral responses to stress, with coaches themselves aged between 18-25. The program creates a fun, culturally relevant environment through the Take 5 model — a framework W4C has designed to be adapted for a range of sports, arts, and cultural initiatives. The model has been utilized by several leading global organizations, including UNICEF.

Waves for Change also played a key role in the founding of the International Surf Therapy Organization (ISTO), connecting practitioners, clinicians, and researchers to advance science research, raise awareness, and support surf therapy.

Catching a wave at Surf Therapy – Image Nelson Rosier Coulhan

How does Waves for Change use evidence-based Surf Therapy and capacity building as a solution to fill the gap in youth mental health care?

Approximately 90 percent of the world’s adolescents live in low- and middle-income countries (LMICs). In the most underserved communities, adolescents may experience repeated exposure to violence, unmet basic needs, and limited access to safe spaces or trusted caregivers. Typically, there are very few mental health services that are accessible to such youth.

The more Adverse Childhood Experiences (ACEs) a child or adolescent has whilst growing up, the more likely they are to develop toxic stress — an ongoing stress state without respite. This can often lead to mental health conditions such as anxiety, depression, substance misuse, and cognitive impairment. This can also result in the development of physical health conditions such as heart disease as they grow into adulthood.

The main problem we’ve identified is that there aren’t enough trained workforces (e.g., sports coaches, youth facilitators) that are able to deliver simple, fun, structured play-based sessions with consistency at scale. Our work provides a response to this issue within the adolescent mental health promotion and illness prevention arena. Additionally, our initiatives significantly increase the number of individuals — coaches, teachers, mentors or others — who are already in contact with young adolescents and can provide them with mental health support to foster their immediate and longer-term mental health.

How has Waves for Change adapted the organization’s Surf Therapy program to develop the Take 5 model?

Waves for Change’s Take 5 training model has been incubated, tested, and rigorously evaluated within W4C’s award-winning Surf Therapy program. Take 5 distils the key components of our Surf Therapy program, providing coaches with the essential skills they need to build and sustain caring relationships with children. And it uses a simple teaching routine that creates consistently engaging, fun, structured programs for children and adolescents that suit their language, culture, and context.

Take 5 is low intensity and cost-effective — tailored for high-stress environments and the unique mental wellness needs of adolescents living in multidimensional poverty, conflict, or crisis.

How has partnering with young people to research and co-develop programs made the work more impactful?

In research studies we’ve conducted, adolescent participants (ages 10-16) reported experiencing between 6-8 adverse events every year, including violence and abuse. When asked what sorts of spaces they wanted to see at Waves for Change, the adolescents identified core components such as access to a safe space where they could have fun, be heard, and learn skills to cope. These components now form the bedrock of our Surf Therapy program. We initially worked with 9-12-year-olds and have since developed the follow-on programme for adolescents up to age 16 who have graduated the Surf Therapy programme. This is called Surf Club and is available to all Surf Therapy graduates.

Waves for Change also conducts pre- and post-intervention surveys with participants to monitor the impact of our work. Our coaches (ages 18-25) are at the frontline of delivering our services. A key role they play is to listen with care and respect to the adolescents’ concerns, and to share them with our Child Protection team for review and follow-up when needed.

Surf Therapy at Hout Bay – Photo credit Waves for Change

What makes your partnership with the SNF Global Center at the Child Mind Institute unique?

Working with the Child Mind Institute allows Waves for Change to collaborate with and learn from colleagues doing similar work in the adolescent mental health space across South Africa, the United Kingdom, and Brazil. The partnership offers an opportunity to learn about approaches that have been successful in other health systems. It has also allowed Waves for Change to share detailed information about the training and supervision protocol used to develop key competencies in the coach workforce that leads Surf Therapy in South Africa. This has helped the Child Mind Institute to develop a comprehensive guide for other similar workforces.

Can you expand on the importance of partnerships in strengthening youth mental health care and community empowerment?

Partnerships allow for the consolidation of skills and resources so that a greater impact can be achieved. For example, at Waves for Change, we work with over 70 referral partners every year to identify young adolescents who can benefit from our Surf Therapy program. We are also partnering with the Department of Cultural Affairs and Sport to use our Take 5 model to train MOD and YearBeyond coaches and mentors, who are already reaching large numbers of children and young adolescents through their work. And we’re contributing to building the broader ecosystem of mental health support for adolescents and children by training large national NGOs, government agencies, and humanitarian organizations with our Take 5 model.

How can non-profits further help foster strong peer networks and inclusive safe spaces?

Some of the key lessons we have learnt are the following:

  • In the field of youth mental health, make youth the leaders on program implementation
  • Provide youth with skills, opportunities, supervision, and support so that they can grow and develop further
  • Maintain a strong culture of protection, respect, and communication so that all participants feel safe, welcome, accepted, and heard

Read more about W4C’s Surf Therapy from Youth Liaison Officer, Azola Sibanda and Training Manager Jamie-Lee Davids

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