ScienceDaily (Dec. 22, 2008) — All spiritual experiences are based in the brain. That statement is truer than ever before, according to a University of Missouri neuropsychologist.
An MU study has data to support a neuropsychological model that proposes spiritual experiences associated with selflessness are related to decreased activity in the right parietal lobe of the brain.
The study is one of the first to use individuals with traumatic brain injury to determine this connection. Researchers say the implication of this connection means people in many disciplines, including peace studies, health care or religion can learn different ways to attain selflessness, to experience transcendence, and to help themselves and others.
This study, along with other recent neuroradiological studies of Buddhist meditators and Francescan nuns, suggests that all individuals, regardless of cultural background or religion, experience the same neuropsychological functions during spiritual experiences, such as transcendence. Transcendence, feelings of universal unity and decreased sense of self, is a core tenet of all major religions. Meditation and prayer are the primary vehicles by which such spiritual transcendence is achieved.
“The brain functions in a certain way during spiritual experiences,” said Brick Johnstone, professor of health psychology in the MU School of Health Professions. “We studied people with brain injury and found that people with injuries to the right parietal lobe of the brain reported higher levels of spiritual experiences, such as transcendence.”
This link is important, Johnstone said, because it means selflessness can be learned by decreasing activity in that part of the brain. He suggests this can be done through conscious effort, such as meditation or prayer. People with these selfless spiritual experiences also are more psychologically healthy, especially if they have positive beliefs that there is a God or higher power who loves them, Johnstone said.
“This research also addresses questions regarding the impact of neurologic versus cultural factors on spiritual experience,” Johnstone said. “The ability to connect with things beyond the self, such as transcendent experiences, seems to occur for people who minimize right parietal functioning. This can be attained through cultural practices, such as intense meditation or prayer or because of a brain injury that impairs the functioning of the right parietal lobe. Either way, our study suggests that ‘selflessness’ is a neuropsychological foundation of spiritual experiences.”
The research was funded by the MU Center on Religion and the Professions. The study – “Support for a neuropsychological model of spirituality in persons with traumatic brain injury” – was published in the peer-reviewed journal Zygon.
“Our research focused on the personal experience of spiritual transcendence and does not in any way minimize the importance of religion or personal beliefs, nor does it suggest that spiritual experience are related only to neuropsychological activity in the brain,” Johnstone said. “It is important to note that individuals experience their God or higher power in many different ways, but that all people from all religions and beliefs appear to experience these connections in a similar way".
Tuesday, December 23, 2008
Robotic Technology Improves Stroke Rehabilitation
ScienceDaily (Dec. 23, 2008) — Research scientists using a novel, hand-operated robotic device and functional MRI (fMRI) have found that chronic stroke patients can be rehabilitated, according to a study presented today at the annual meeting of the Radiological Society of North America (RSNA).
This is the first study using fMRI to map the brain in order to track stroke rehabilitation.
"We have shown that the brain has the ability to regain function through rehabilitative exercises following a stroke," said A. Aria Tzika, Ph.D., director of the NMR Surgical Laboratory at Massachusetts General Hospital (MGH) and Shriners Burn Institute and assistant professor in the Department of Surgery at Harvard Medical School in Boston. "We have learned that the brain is malleable, even six months or more after a stroke, which is a longer period of time than previously thought."
According to the Centers for Disease Control and Prevention, stroke is the third leading cause of death in the U.S. and a principal cause of severe long-term disability. Approximately 700,000 strokes occur annually in the U.S., and 80 percent to 90 percent of stroke survivors have motor weakness.
Previously, it was believed that there was only a short window of three to six months following a stroke when rehabilitation could make an improvement.
"Our research is important because 65 percent of people who have a stroke affecting hand use are still unable to incorporate the affected hand into their daily activities after six months," Dr. Tzika said.
Dr. Tzika is an affiliated member of the Athinoula A. Martinos Center for Biomedical Imaging in the Department of Radiology at MGH, where the research is ongoing.
To determine if stroke rehabilitation after six months was possible, the researchers studied five right-hand dominant patients who had strokes at least six months prior that affected the left side of the brain and, consequently, use of the right hand.
For the study, the patients squeezed a special MR-compatible robotic device for an hour a day, three days per week for four weeks. fMRI exams were performed before, during, upon completion of training and after a non-training period to assess permanence of rehabilitation. fMRI measures the tiny changes in blood oxygenation level that occur when a part of the brain is active.
The results showed that rehabilitation using hand training significantly increased activation in the cortex, which is the area in the brain that corresponds with hand use. Furthermore, the increased cortical activation persisted in the stroke patients who had exercised during the training period but then stopped for several months.
"These findings should give hope to people who have had strokes, their families and the rehabilitative specialists who treat them," Dr. Tzika said.
Co-authors are Dionyssios Mintzopoulos, Ph.D., Azadeh Khanicheh, Ph.D., Bruce Rosen, M.D., Ph.D., Loukas Astrakas, Ph.D., and Michael Moskowitz, M.D.
This is the first study using fMRI to map the brain in order to track stroke rehabilitation.
"We have shown that the brain has the ability to regain function through rehabilitative exercises following a stroke," said A. Aria Tzika, Ph.D., director of the NMR Surgical Laboratory at Massachusetts General Hospital (MGH) and Shriners Burn Institute and assistant professor in the Department of Surgery at Harvard Medical School in Boston. "We have learned that the brain is malleable, even six months or more after a stroke, which is a longer period of time than previously thought."
According to the Centers for Disease Control and Prevention, stroke is the third leading cause of death in the U.S. and a principal cause of severe long-term disability. Approximately 700,000 strokes occur annually in the U.S., and 80 percent to 90 percent of stroke survivors have motor weakness.
Previously, it was believed that there was only a short window of three to six months following a stroke when rehabilitation could make an improvement.
"Our research is important because 65 percent of people who have a stroke affecting hand use are still unable to incorporate the affected hand into their daily activities after six months," Dr. Tzika said.
Dr. Tzika is an affiliated member of the Athinoula A. Martinos Center for Biomedical Imaging in the Department of Radiology at MGH, where the research is ongoing.
To determine if stroke rehabilitation after six months was possible, the researchers studied five right-hand dominant patients who had strokes at least six months prior that affected the left side of the brain and, consequently, use of the right hand.
For the study, the patients squeezed a special MR-compatible robotic device for an hour a day, three days per week for four weeks. fMRI exams were performed before, during, upon completion of training and after a non-training period to assess permanence of rehabilitation. fMRI measures the tiny changes in blood oxygenation level that occur when a part of the brain is active.
The results showed that rehabilitation using hand training significantly increased activation in the cortex, which is the area in the brain that corresponds with hand use. Furthermore, the increased cortical activation persisted in the stroke patients who had exercised during the training period but then stopped for several months.
"These findings should give hope to people who have had strokes, their families and the rehabilitative specialists who treat them," Dr. Tzika said.
Co-authors are Dionyssios Mintzopoulos, Ph.D., Azadeh Khanicheh, Ph.D., Bruce Rosen, M.D., Ph.D., Loukas Astrakas, Ph.D., and Michael Moskowitz, M.D.
Friday, December 19, 2008
Alzheimer's Disease: Women Affected More Often Than Men
The Society for Women's Health Research (SWHR) issued the following newsrelease:Alzheimer's Disease: Women Affected More Often than Men
Nearly 4.5 million people suffer from Alzheimer's disease (AD) in ourcountry, and more than half of them are women, according to the NationalInstitute on Aging in Bethesda, Md. As the general population continuesto age, this number is expected to increase significantly over the nextfew decades.
Alzheimer's disease is the most common form of dementia, a group ofbrain disorders that interferes with a person's ability to carry outdaily activities. In AD, areas of the brain change and deteriorate,which causes a decline in cognition and memory functioning. In somepatients, the deficits are large enough to get in the way of performingnormal, everyday tasks.
There is evidence that AD affects women differently than men. "Manystudies of gender differences in cognition have pointed to greaterlanguage deficits in women with Alzheimer's disease as compared to men,"explains Michael S. Rafii, M.D., Ph.D., director of the Memory DisordersClinic and an attending neurologist at the Shiley-Marcos AlzheimerDisease Research Center at the University of California, San Diego."Naming and word-recognition skills have been reported to be moreadversely affected in female patients with AD than in male patients, andthe differences have been shown to be sustained over time."Notable sex and gender differences in behavior among Alzheimer patientshave been observed as well. "
Male patients exhibit greater problems thanfemale patients in wandering, abusiveness and social impropriety,particularly in the more advanced stages of the disorder," Rafii pointsout. In fact, major tranquilizers and behavior management programs areused more frequently on male patients.While there is currently no cure for AD, researchers continue to makeprogress. More drugs are being studied, and researchers have identifiedseveral genes associated with the disease. "Recent work has been focusedon identifying the molecule that may be causing AD symptoms," saysRafii. Researchers from the University of Minnesota and Johns HopkinsUniversity "discovered a protein complex in the brain that appears toimpair memory."Combined with sophisticated imaging techniques, this discovery isenabling scientists to take a clear picture of the protein deposits inthe brain. According to Rafii, "This could lead to accurate diagnosis ofAD at very early stages.Previously, a definitive diagnosis of the disease could only be madethrough an autopsy after the patient's death, typically at a very latestage of the illness."
Diagnosing AD can be tricky, especially because many people are underthe assumption that forgetfulness is a normal part of the aging process.But patients with AD suffer from much more than simple memory lapses.
Here are a few common signs and symptoms of the disease:- Persistent forgetfulness or memory loss-
Disorientation-
Problems performing routine tasks-
Inability to express thoughts coherently or finish sentences- Loss of judgment-
Changes in personality
As in other diseases, early diagnosis is very important for patientswith AD. Certain medications have been found to be useful in the earlierstages of the disease, so the sooner the diagnosis is made, the better.
Nearly 4.5 million people suffer from Alzheimer's disease (AD) in ourcountry, and more than half of them are women, according to the NationalInstitute on Aging in Bethesda, Md. As the general population continuesto age, this number is expected to increase significantly over the nextfew decades.
Alzheimer's disease is the most common form of dementia, a group ofbrain disorders that interferes with a person's ability to carry outdaily activities. In AD, areas of the brain change and deteriorate,which causes a decline in cognition and memory functioning. In somepatients, the deficits are large enough to get in the way of performingnormal, everyday tasks.
There is evidence that AD affects women differently than men. "Manystudies of gender differences in cognition have pointed to greaterlanguage deficits in women with Alzheimer's disease as compared to men,"explains Michael S. Rafii, M.D., Ph.D., director of the Memory DisordersClinic and an attending neurologist at the Shiley-Marcos AlzheimerDisease Research Center at the University of California, San Diego."Naming and word-recognition skills have been reported to be moreadversely affected in female patients with AD than in male patients, andthe differences have been shown to be sustained over time."Notable sex and gender differences in behavior among Alzheimer patientshave been observed as well. "
Male patients exhibit greater problems thanfemale patients in wandering, abusiveness and social impropriety,particularly in the more advanced stages of the disorder," Rafii pointsout. In fact, major tranquilizers and behavior management programs areused more frequently on male patients.While there is currently no cure for AD, researchers continue to makeprogress. More drugs are being studied, and researchers have identifiedseveral genes associated with the disease. "Recent work has been focusedon identifying the molecule that may be causing AD symptoms," saysRafii. Researchers from the University of Minnesota and Johns HopkinsUniversity "discovered a protein complex in the brain that appears toimpair memory."Combined with sophisticated imaging techniques, this discovery isenabling scientists to take a clear picture of the protein deposits inthe brain. According to Rafii, "This could lead to accurate diagnosis ofAD at very early stages.Previously, a definitive diagnosis of the disease could only be madethrough an autopsy after the patient's death, typically at a very latestage of the illness."
Diagnosing AD can be tricky, especially because many people are underthe assumption that forgetfulness is a normal part of the aging process.But patients with AD suffer from much more than simple memory lapses.
Here are a few common signs and symptoms of the disease:- Persistent forgetfulness or memory loss-
Disorientation-
Problems performing routine tasks-
Inability to express thoughts coherently or finish sentences- Loss of judgment-
Changes in personality
As in other diseases, early diagnosis is very important for patientswith AD. Certain medications have been found to be useful in the earlierstages of the disease, so the sooner the diagnosis is made, the better.
Saturday, December 6, 2008
Veterans w/ TBI at Risk for dementia, aggression, memory loss, depression, & symptoms similar to those of Parkinson's disease
Today the U.S. Institute of Medicine released the following announcement:Contacts: Christine Stencel, Media Relations OfficerAlison Burnette, Media Relations AssistantOffice of News and Public Information202-334-2138; e-mail <news@nas.edu>Date: Dec. 4, 2008
FOR IMMEDIATE RELEASEMilitary Personnel With Traumatic Brain Injury at Risk for Serious Long-Term Health ProblemsMilitary personnel who suffer severe or moderate traumatic brain injury(TBI) face an increased risk for developing several long-term healthproblems, says a new report from the Institute of Medicine thatevaluates the evidence on long-term consequences of TBI.These conditions include Alzheimer's-like dementia, aggression, memoryloss, depression, and symptoms similar to those of Parkinson's disease.Even mild TBI is associated with some of these adverse consequences,noted the committee that wrote the report.In addition, the report notes that brain injuries sustained as a resultof exposure to the force of an explosion without a direct strike to thehead -- one of the most common perils for soldiers in Iraq andAfghanistan -- may be underdiagnosed due to the lack of research onblast injury. It calls for the U.S. Department of Defense and the U.S.Department of Veterans Affairs to step up clinical and animal studies ofblast-induced neurotrauma (BINT)."Explosive devices and other weaponry have become more powerful anddevastating throughout the wars in Iraq and Afghanistan, and we areseeing much higher rates of nonpenetrating traumatic brain injury andblast-induced injury among military personnel who have served in thesecountries than in earlier wars," said George W. Rutherford, professor ofepidemiology and preventive medicine and vice chair, department ofepidemiology and biostatistics, School of Medicine, University ofCalifornia, San Francisco, and chair of the committee that wrote thereport. "It is important to identify and understand any long-termhealth effects of these injuries so that wounded service members do notlose valuable time for therapy and rehabilitation."As of January, more than 5,500 military personnel have suffered TBIsduring the conflicts in Iraq and Afghanistan, according to DOD. Theprolific use of explosive weaponry in Iraq has made blast-relatedinjuries the signature wound of the war, with many service membershaving been exposed to multiple explosions.Although recent clinical findings and military experience have shownthat short-term and long-term neurologic deficits may result fromexposure to the energy of a blast without a direct blow to the head, theprevailing opinion among neurological professionals had been that blast-related impairments were rare because the skull adequately shields thebrain. The report recommends that VA and DOD support research on BINTand the development of a good animal model of BINT, which is currentlylacking. Without good research data, neurological and behavioralchanges in blast victims may be underestimated and undiagnosed, andthese individuals may not get timely needed treatment, the report notes.TBI can be mild, moderate, or severe. The committee's review of theresearch on TBI at all levels of severity determined that there issufficient evidence that brain injuries resulting from severe, skull-piercing wounds can cause unprovoked seizures and premature death.Seizures can also be caused by severe, nonpenetrating TBI as well asmore moderate brain injury.Studies link both moderate and severe TBI with other long-termconsequences, including increased risk for Alzheimer's-like dementia,symptoms similar to those of Parkinson's disease, and diminishedabilities to maintain social relationships. Other data links mild TBIto increased risk for PTSD among Gulf War veterans. The evidence inthese cases shows an association, but it is not sufficient to concludethat TBI causes these problems. Likewise, TBI at any level of severity-- even mild -- appears to be associated with increased risk foraggressive behavior, depression, and memory and concentration problems.TBI may be associated with certain other potential consequences, but theevidence is only suggestive of a link. For example, moderate and severeTBI may put individuals at greater risk for developing diabetesinsipidus and psychosis, but the evidence is limited. Some data suggestthat mild TBI accompanied by loss of consciousness is linked to thedevelopment of symptoms similar to Alzheimer's and Parkinson's diseaseas well as vision problems and seizures, but the data have significantshortcomings. Likewise, TBI at all levels of severity may be linked toreduced alcohol and drug use within the first few years following theinjury, but there is inadequate evidence to be certain.Due to insufficient evidence, it is not possible to say whether mild TBIcan result in neurocognitive deficits or loss of ability to functionsocially. Also, the evidence does not indicate whether mild TBI thatwas not accompanied by loss of consciousness could lead to thedevelopment of Alzheimer's-like dementia, or whether any TBI is linkedto mania, bipolar disorder, multiple sclerosis, or amyotrophic lateralsclerosis.To develop a fuller picture of the effects of TBI and blast injuries,the committee recommended that DOD conduct pre-deployment neurocognitivetests of all military personnel to establish a baseline for identifyingpost-injury consequences and that the VA include uninjured servicemembers and other comparison groups in the Traumatic Brain InjuryVeterans Health Registry which it is building.The study was sponsored by the U.S. Department of Veterans Affairs.Established in 1970 under the charter of the National Academy ofSciences, the Institute of Medicine provides independent, objective,evidence-based advice to policymakers, health professionals, the privatesector, and the public. The National Academy of Sciences, NationalAcademy of Engineering, Institute of Medicine, and National ResearchCouncil make up the National Academies. A committee roster follows.Copies of Gulf War and Health: Long-Term Consequences of TBI areavailable from the National Academies Press; tel. 202-334-3313 or1-800-624-6242 or on the Internet at http://www.nap.edu. Reporters mayobtain a copy from the Office of News and Public Information (contactslisted above).
FOR IMMEDIATE RELEASEMilitary Personnel With Traumatic Brain Injury at Risk for Serious Long-Term Health ProblemsMilitary personnel who suffer severe or moderate traumatic brain injury(TBI) face an increased risk for developing several long-term healthproblems, says a new report from the Institute of Medicine thatevaluates the evidence on long-term consequences of TBI.These conditions include Alzheimer's-like dementia, aggression, memoryloss, depression, and symptoms similar to those of Parkinson's disease.Even mild TBI is associated with some of these adverse consequences,noted the committee that wrote the report.In addition, the report notes that brain injuries sustained as a resultof exposure to the force of an explosion without a direct strike to thehead -- one of the most common perils for soldiers in Iraq andAfghanistan -- may be underdiagnosed due to the lack of research onblast injury. It calls for the U.S. Department of Defense and the U.S.Department of Veterans Affairs to step up clinical and animal studies ofblast-induced neurotrauma (BINT)."Explosive devices and other weaponry have become more powerful anddevastating throughout the wars in Iraq and Afghanistan, and we areseeing much higher rates of nonpenetrating traumatic brain injury andblast-induced injury among military personnel who have served in thesecountries than in earlier wars," said George W. Rutherford, professor ofepidemiology and preventive medicine and vice chair, department ofepidemiology and biostatistics, School of Medicine, University ofCalifornia, San Francisco, and chair of the committee that wrote thereport. "It is important to identify and understand any long-termhealth effects of these injuries so that wounded service members do notlose valuable time for therapy and rehabilitation."As of January, more than 5,500 military personnel have suffered TBIsduring the conflicts in Iraq and Afghanistan, according to DOD. Theprolific use of explosive weaponry in Iraq has made blast-relatedinjuries the signature wound of the war, with many service membershaving been exposed to multiple explosions.Although recent clinical findings and military experience have shownthat short-term and long-term neurologic deficits may result fromexposure to the energy of a blast without a direct blow to the head, theprevailing opinion among neurological professionals had been that blast-related impairments were rare because the skull adequately shields thebrain. The report recommends that VA and DOD support research on BINTand the development of a good animal model of BINT, which is currentlylacking. Without good research data, neurological and behavioralchanges in blast victims may be underestimated and undiagnosed, andthese individuals may not get timely needed treatment, the report notes.TBI can be mild, moderate, or severe. The committee's review of theresearch on TBI at all levels of severity determined that there issufficient evidence that brain injuries resulting from severe, skull-piercing wounds can cause unprovoked seizures and premature death.Seizures can also be caused by severe, nonpenetrating TBI as well asmore moderate brain injury.Studies link both moderate and severe TBI with other long-termconsequences, including increased risk for Alzheimer's-like dementia,symptoms similar to those of Parkinson's disease, and diminishedabilities to maintain social relationships. Other data links mild TBIto increased risk for PTSD among Gulf War veterans. The evidence inthese cases shows an association, but it is not sufficient to concludethat TBI causes these problems. Likewise, TBI at any level of severity-- even mild -- appears to be associated with increased risk foraggressive behavior, depression, and memory and concentration problems.TBI may be associated with certain other potential consequences, but theevidence is only suggestive of a link. For example, moderate and severeTBI may put individuals at greater risk for developing diabetesinsipidus and psychosis, but the evidence is limited. Some data suggestthat mild TBI accompanied by loss of consciousness is linked to thedevelopment of symptoms similar to Alzheimer's and Parkinson's diseaseas well as vision problems and seizures, but the data have significantshortcomings. Likewise, TBI at all levels of severity may be linked toreduced alcohol and drug use within the first few years following theinjury, but there is inadequate evidence to be certain.Due to insufficient evidence, it is not possible to say whether mild TBIcan result in neurocognitive deficits or loss of ability to functionsocially. Also, the evidence does not indicate whether mild TBI thatwas not accompanied by loss of consciousness could lead to thedevelopment of Alzheimer's-like dementia, or whether any TBI is linkedto mania, bipolar disorder, multiple sclerosis, or amyotrophic lateralsclerosis.To develop a fuller picture of the effects of TBI and blast injuries,the committee recommended that DOD conduct pre-deployment neurocognitivetests of all military personnel to establish a baseline for identifyingpost-injury consequences and that the VA include uninjured servicemembers and other comparison groups in the Traumatic Brain InjuryVeterans Health Registry which it is building.The study was sponsored by the U.S. Department of Veterans Affairs.Established in 1970 under the charter of the National Academy ofSciences, the Institute of Medicine provides independent, objective,evidence-based advice to policymakers, health professionals, the privatesector, and the public. The National Academy of Sciences, NationalAcademy of Engineering, Institute of Medicine, and National ResearchCouncil make up the National Academies. A committee roster follows.Copies of Gulf War and Health: Long-Term Consequences of TBI areavailable from the National Academies Press; tel. 202-334-3313 or1-800-624-6242 or on the Internet at http://www.nap.edu. Reporters mayobtain a copy from the Office of News and Public Information (contactslisted above).
Alzheimer's Disease Biomarkers in Healthy Adults
New Study Identifies Link Between Alzheimer's Disease Biomarkers In Healthy Adults
ScienceDaily (Dec. 5, 2008) — A new study provides an insight into normal, physiological levels and association between proteins involved in development of Alzheimer's disease.
A group of scientists and physicians from the University of Washington and Puget Sound Veterans' Affairs Health Care System in Seattle, in collaboration with groups from the University of Pennsylvania and the University of California San Diego, performed a study in cognitively normal and generally healthy adults, from young to old (age range 21-88 years), of both genders, measuring levels of different brain-derived molecules associated with Alzheimer's disease.
Investigators determined that cerebrospinal fluid (CSF) levels of apolipoprotein E (apoE), one of the most important proteins involved in transfer of fatty substances between different brain cells, are highly correlated with the levels of proteins known to be involved in development of Alzheimer's disease, amyloid precursor protein (APP) and tau.
While many studies have previously shown that apoE gene is very important for Alzheimer's disease development, the connection between apoE protein and other relevant CSF markers in healthy adults was not known. Although this type of study cannot establish causal associations, the results strongly suggest that the CSF levels of apoE may explain a significant proportion of the levels of APP- and tau-related biological markers in the healthy human brain, indicating a strong physiological link between apoE, APP and tau. In other words, the study points to a possibility that modulation of the levels of apoE may affect the levels of APP and tau in the brain.
Furthermore, the study has shown that people who have a "beneficial" genetic form of apoE (so-called APOE2), which is associated with lower risk of Alzheimer's disease, have lower CSF levels of beta-amyloid peptide 42, a molecule implicated in development of Alzheimer's disease plaques. This finding may explain some of the basis for the known protective effects of the APOE2 observed in large population studies.
Dr. Simona Vuletic, Northwest Lipid Metabolism and Diabetes Research Laboratories, University of Washington School of Medicine, Seattle, commented, "Understanding the associations between these important molecules in the brain of cognitively normal, healthy people will help us develop better strategies not only for diagnosis, but possibly also better prevention and treatment for Alzheimer's disease. This study also provides baseline data and an opportunity to understand how these normal relationships change, leading to the disease."
Journal reference:
Simona Vuletic, Ge Li, Elaine R. Peskind, Hal Kennedy, Santica M. Marcovina, James B. Leverenz, Eric C. Petrie, Virginia M-Y. Lee, Douglas Galasko, Gerard D. Schellenberg, John J. Albers. Apolipoprotein E Highly Correlates with AßPP- and Tau-Related Markers in Human Cerebrospinal Fluid. Journal of Alzheimer's Disease, 15:3; November 2008
ScienceDaily (Dec. 5, 2008) — A new study provides an insight into normal, physiological levels and association between proteins involved in development of Alzheimer's disease.
A group of scientists and physicians from the University of Washington and Puget Sound Veterans' Affairs Health Care System in Seattle, in collaboration with groups from the University of Pennsylvania and the University of California San Diego, performed a study in cognitively normal and generally healthy adults, from young to old (age range 21-88 years), of both genders, measuring levels of different brain-derived molecules associated with Alzheimer's disease.
Investigators determined that cerebrospinal fluid (CSF) levels of apolipoprotein E (apoE), one of the most important proteins involved in transfer of fatty substances between different brain cells, are highly correlated with the levels of proteins known to be involved in development of Alzheimer's disease, amyloid precursor protein (APP) and tau.
While many studies have previously shown that apoE gene is very important for Alzheimer's disease development, the connection between apoE protein and other relevant CSF markers in healthy adults was not known. Although this type of study cannot establish causal associations, the results strongly suggest that the CSF levels of apoE may explain a significant proportion of the levels of APP- and tau-related biological markers in the healthy human brain, indicating a strong physiological link between apoE, APP and tau. In other words, the study points to a possibility that modulation of the levels of apoE may affect the levels of APP and tau in the brain.
Furthermore, the study has shown that people who have a "beneficial" genetic form of apoE (so-called APOE2), which is associated with lower risk of Alzheimer's disease, have lower CSF levels of beta-amyloid peptide 42, a molecule implicated in development of Alzheimer's disease plaques. This finding may explain some of the basis for the known protective effects of the APOE2 observed in large population studies.
Dr. Simona Vuletic, Northwest Lipid Metabolism and Diabetes Research Laboratories, University of Washington School of Medicine, Seattle, commented, "Understanding the associations between these important molecules in the brain of cognitively normal, healthy people will help us develop better strategies not only for diagnosis, but possibly also better prevention and treatment for Alzheimer's disease. This study also provides baseline data and an opportunity to understand how these normal relationships change, leading to the disease."
Journal reference:
Simona Vuletic, Ge Li, Elaine R. Peskind, Hal Kennedy, Santica M. Marcovina, James B. Leverenz, Eric C. Petrie, Virginia M-Y. Lee, Douglas Galasko, Gerard D. Schellenberg, John J. Albers. Apolipoprotein E Highly Correlates with AßPP- and Tau-Related Markers in Human Cerebrospinal Fluid. Journal of Alzheimer's Disease, 15:3; November 2008
Friday, November 28, 2008
Baffling Chronic Pain Linked to Weird Rewiring of Brain
Baffling Chronic Pain Linked To Weird Rewiring Of Brain
ScienceDaily (Nov. 27, 2008) — Scientists peered at the brains of people with a baffling chronic pain condition and discovered something surprising. Their brains looked like an inept cable guy had changed the hookups, rewiring the areas related to emotion, pain perception and the temperature of their skin.
The new finding by scientists at Northwestern University's Feinberg School of Medicine, begins to explain a mysterious condition that the medical community had doubted was real.
The people whose brains were examined have a chronic pain condition called complex region pain syndrome (CRPS.) It's a pernicious and nasty condition that usually begins with an injury causing significant damage to the hand or the foot. For the majority of people, the pain from the injury disappears once the limb is healed. But for 5 percent of the patients, the pain rages on long past the healing, sometimes for the rest of people's lives.
About 200,00 people in the U.S. have this condition.
In a hand injury, for example, the pain may radiate from the initial injury site and spread to the whole arm or even the entire body. People also experience changes in skin color to blue or red as well as skin temperature (hotter at first, then becoming colder as the condition turns chronic.) Their immune system also shifts into overdrive, indicated by a hike in blood immune markers.
The changes in the brain take place in the network of tiny, white "cables" that dispatch messages between the neurons. This is called the brain's white matter. Several years ago, Northwestern researchers discovered chronic pain caused the regions in the brain that contain the neurons -- called gray matter because of it looks gray -- to atrophy.
This is the first study to link pain with changes in the brain's white matter. It will be published November 26 in the journal Neuron.
"This is the first evidence of brain abnormality in these patients," said A. Vania Apkarian, professor of physiology at the Feinberg School and principal investigator of the study. " People didn't believe these patients. This is the first proof that there is a biological underpinning for the condition. Scientists have been trying to understand this baffling condition for a long time."
Apkarian said people with CRPS suffer intensely and have a high rate of suicide. "Physicians don't know what to do," he said. "We don't have the tools to take care of them."
The new findings provide anatomical targets for scientists, who can now look for potential pharmaceutical treatments to help these patients, Apkarian said. He doesn't know yet if chronic pain causes these changes in the brain or if CRPS patients' brains have pre-existing abnormalities that predispose them to this condition.
In the new study, the brains of 22 subjects with CRPS and 22 normal subjects were examined with an anatomical MRI and a diffusion tensor MRI, which enabled scientists to view the white matter. In addition to changes in white matter, the CRPS patients' brains showed an atrophy of neurons or gray matter similar to what has been previously shown in other types of chronic pain patients.
Apkarian said the white matter changes in patients' brains is related to the duration and intensity of their pain and their anxiety. It is likely that white matter reorganizes in other chronic pain conditions as well, but that has not yet been studied, he noted.
ScienceDaily (Nov. 27, 2008) — Scientists peered at the brains of people with a baffling chronic pain condition and discovered something surprising. Their brains looked like an inept cable guy had changed the hookups, rewiring the areas related to emotion, pain perception and the temperature of their skin.
The new finding by scientists at Northwestern University's Feinberg School of Medicine, begins to explain a mysterious condition that the medical community had doubted was real.
The people whose brains were examined have a chronic pain condition called complex region pain syndrome (CRPS.) It's a pernicious and nasty condition that usually begins with an injury causing significant damage to the hand or the foot. For the majority of people, the pain from the injury disappears once the limb is healed. But for 5 percent of the patients, the pain rages on long past the healing, sometimes for the rest of people's lives.
About 200,00 people in the U.S. have this condition.
In a hand injury, for example, the pain may radiate from the initial injury site and spread to the whole arm or even the entire body. People also experience changes in skin color to blue or red as well as skin temperature (hotter at first, then becoming colder as the condition turns chronic.) Their immune system also shifts into overdrive, indicated by a hike in blood immune markers.
The changes in the brain take place in the network of tiny, white "cables" that dispatch messages between the neurons. This is called the brain's white matter. Several years ago, Northwestern researchers discovered chronic pain caused the regions in the brain that contain the neurons -- called gray matter because of it looks gray -- to atrophy.
This is the first study to link pain with changes in the brain's white matter. It will be published November 26 in the journal Neuron.
"This is the first evidence of brain abnormality in these patients," said A. Vania Apkarian, professor of physiology at the Feinberg School and principal investigator of the study. " People didn't believe these patients. This is the first proof that there is a biological underpinning for the condition. Scientists have been trying to understand this baffling condition for a long time."
Apkarian said people with CRPS suffer intensely and have a high rate of suicide. "Physicians don't know what to do," he said. "We don't have the tools to take care of them."
The new findings provide anatomical targets for scientists, who can now look for potential pharmaceutical treatments to help these patients, Apkarian said. He doesn't know yet if chronic pain causes these changes in the brain or if CRPS patients' brains have pre-existing abnormalities that predispose them to this condition.
In the new study, the brains of 22 subjects with CRPS and 22 normal subjects were examined with an anatomical MRI and a diffusion tensor MRI, which enabled scientists to view the white matter. In addition to changes in white matter, the CRPS patients' brains showed an atrophy of neurons or gray matter similar to what has been previously shown in other types of chronic pain patients.
Apkarian said the white matter changes in patients' brains is related to the duration and intensity of their pain and their anxiety. It is likely that white matter reorganizes in other chronic pain conditions as well, but that has not yet been studied, he noted.
Wednesday, November 26, 2008
How Is Our Left Brain Different From Our Right?
ScienceDaily (Nov. 25, 2008) — Since the historical discovery of the speech center in the left cortex in 150 years ago, functional differences between left and right hemisphere have been well known; language is mainly handled by left hemisphere, while spatial recognition is more specialized to the right hemisphere. However, the structural differences of synapses underlying left-right difference of the brain remained unknown.
Japanese research team, led by Prof Ryuichi Shigemoto in National Institute for Physiological Sciences, Dr Yoshiaki Shinohara and his colleagues found that synaptic size and shape in the center of the spatial memory (i.e. hippocampus) were asymmetrical between synapses receiving input from the left and right hemisphere. Hajime Hirase in Brain Science Institute in RIKEN helped this study, and it was done under Japan Science Technorogy Agency support.
They investigated the electron microscopic structure of synapses in left and right hippocampus, and found synapses made by terminals from the right hippocampus are large, complex in shape, and rich in the GluR1 subunit of AMPA-type glutamate receptors. In contrast, synapses receiving input from the left hippocampus are small and rich in the NR2B subunit of NMDA receptors. That means, both synaptic structure and synaptic molecules differ between synapses with left and right inputs.
"Long-term potentiaon (LTP), that is known as the cellular mechanism of learning and memory, depends on the allocation of glutamate receptors in hippocampus.
According to our present finding, synapses receiving right input may be more suitable to initiate LTP. This finding may help understand how our left and right brains work differently", said Prof Shigemoto.
This report is published in Proceedings of National Academy of Sciences in the week of Nov 17, 2008.
Japanese research team, led by Prof Ryuichi Shigemoto in National Institute for Physiological Sciences, Dr Yoshiaki Shinohara and his colleagues found that synaptic size and shape in the center of the spatial memory (i.e. hippocampus) were asymmetrical between synapses receiving input from the left and right hemisphere. Hajime Hirase in Brain Science Institute in RIKEN helped this study, and it was done under Japan Science Technorogy Agency support.
They investigated the electron microscopic structure of synapses in left and right hippocampus, and found synapses made by terminals from the right hippocampus are large, complex in shape, and rich in the GluR1 subunit of AMPA-type glutamate receptors. In contrast, synapses receiving input from the left hippocampus are small and rich in the NR2B subunit of NMDA receptors. That means, both synaptic structure and synaptic molecules differ between synapses with left and right inputs.
"Long-term potentiaon (LTP), that is known as the cellular mechanism of learning and memory, depends on the allocation of glutamate receptors in hippocampus.
According to our present finding, synapses receiving right input may be more suitable to initiate LTP. This finding may help understand how our left and right brains work differently", said Prof Shigemoto.
This report is published in Proceedings of National Academy of Sciences in the week of Nov 17, 2008.
How To Know You're Having a Stroke; Most Stroke Pts Don't Think They're Having a Stroke; Time is Crucial
The Mayo Clinic released the following announcement:Do you know you're having a stroke?Symptom awareness can improve recoveryA Mayo Clinic study shows a majority of stroke patients don't thinkthey're having a stroke -- and as a result -- delay seeking treatmentuntil their condition worsens. The findings appear in the current issueof Emergency Medicine Journal at http://emj.bmj.com/.
Researchers studied 400 patients who were diagnosed at Mayo Clinic'semergency department with either acute ischemic stroke or a transientischemic attack (TIA), a temporary interruption of blood flow to part ofthe brain.Less than half of the patients -- 42 percent -- thought they were havinga stroke. In fact, most in the study did not go to the emergency roomwhen symptoms appeared. The median time from onset of symptoms toarrival at the hospital was over three and a half hours. Most said theythought the symptoms would simply go away. The delay in seeking medicalhelp was the same among men and women.When asked how they knew about stroke symptoms, nearly one-fifth saidthey thought a stroke always came on gradually. Just over half (51.9percent) said they thought that seeking medical care immediately wasimportant.Significance of the findings"Time is crucial in treating stroke," says Latha Stead, M.D., emergencymedicine specialist and lead author of the study. "Each individual'smedical background differs and affects recovery, but in general thesooner a patient experiencing a stroke reaches emergency care, the morelikely the stroke can be limited and the condition managed to preventfurther damage and improve recovery." The researchers say their findingsclearly indicate that better public
understanding of stroke symptomswill lead to a faster response and better outcomes.What you should knowStrokes can happen quickly or can occur over several hours, with thecondition continually worsening. The thrombus or clot that is causingthe stroke can frequently be dissolved or disintegrated so blood canagain flow to the brain. In such cases, immediate treatment can mean thedifference between a slight injury and a major disability. Interestinglyonly 20.8 percent of the participants knew about such treatment. By useof stents, medications and other technology, physicians can stop astroke from spreading and greatly limit damage. Stroke symptoms include:
* Sudden numbness, weakness, or paralysis of your face, arm or leg-- usually on one side of the body
* Sudden difficulty speaking or understanding speech (aphasia)
* Sudden blurred, double or decreased vision
* Sudden dizziness, loss of balance or loss of coordination
* A sudden, severe "bolt out of the blue" headache or an unusualheadache, which may be accompanied by a stiff neck, facial pain, painbetween your eyes, vomiting or altered consciousness
* Confusion or problems with memory, spatial orientation or perceptionIn such cases, a stroke gives no warning. But one possible sign of animpending stroke is a TIA.
The signs and symptoms of TIA are the same asfor a stroke, but they last for a shorter period -- several minutes to afew hours -- and then disappear, without leaving apparent permanenteffects. You may have more than one TIA, and the signs and symptoms maybe similar or different. A TIA indicates a serious risk that a full-blown stroke may follow
Researchers studied 400 patients who were diagnosed at Mayo Clinic'semergency department with either acute ischemic stroke or a transientischemic attack (TIA), a temporary interruption of blood flow to part ofthe brain.Less than half of the patients -- 42 percent -- thought they were havinga stroke. In fact, most in the study did not go to the emergency roomwhen symptoms appeared. The median time from onset of symptoms toarrival at the hospital was over three and a half hours. Most said theythought the symptoms would simply go away. The delay in seeking medicalhelp was the same among men and women.When asked how they knew about stroke symptoms, nearly one-fifth saidthey thought a stroke always came on gradually. Just over half (51.9percent) said they thought that seeking medical care immediately wasimportant.Significance of the findings"Time is crucial in treating stroke," says Latha Stead, M.D., emergencymedicine specialist and lead author of the study. "Each individual'smedical background differs and affects recovery, but in general thesooner a patient experiencing a stroke reaches emergency care, the morelikely the stroke can be limited and the condition managed to preventfurther damage and improve recovery." The researchers say their findingsclearly indicate that better public
understanding of stroke symptomswill lead to a faster response and better outcomes.What you should knowStrokes can happen quickly or can occur over several hours, with thecondition continually worsening. The thrombus or clot that is causingthe stroke can frequently be dissolved or disintegrated so blood canagain flow to the brain. In such cases, immediate treatment can mean thedifference between a slight injury and a major disability. Interestinglyonly 20.8 percent of the participants knew about such treatment. By useof stents, medications and other technology, physicians can stop astroke from spreading and greatly limit damage. Stroke symptoms include:
* Sudden numbness, weakness, or paralysis of your face, arm or leg-- usually on one side of the body
* Sudden difficulty speaking or understanding speech (aphasia)
* Sudden blurred, double or decreased vision
* Sudden dizziness, loss of balance or loss of coordination
* A sudden, severe "bolt out of the blue" headache or an unusualheadache, which may be accompanied by a stiff neck, facial pain, painbetween your eyes, vomiting or altered consciousness
* Confusion or problems with memory, spatial orientation or perceptionIn such cases, a stroke gives no warning. But one possible sign of animpending stroke is a TIA.
The signs and symptoms of TIA are the same asfor a stroke, but they last for a shorter period -- several minutes to afew hours -- and then disappear, without leaving apparent permanenteffects. You may have more than one TIA, and the signs and symptoms maybe similar or different. A TIA indicates a serious risk that a full-blown stroke may follow
Tuesday, November 25, 2008
Brain AbnormalitiesThat May Play Key Role in ADHD
ScienceDaily (Nov. 24, 2008) — A study published in the online advance edition of The American Journal of Psychiatry for the first time reveals shape differences in the brains of children with ADHD, which could help pinpoint the specific neural circuits involved in the disorder. Researchers from the Kennedy Krieger Institute in Baltimore, Md. and the Johns Hopkins Center for Imaging Science used a new analysis tool, large deformation diffeomorphic mapping (LDDMM), which allowed them to examine the precise shape of the basal ganglia.
The study found boys with ADHD had significant shape differences and decreases in overall volume of the basal ganglia compared to their typically developing peers. Girls with ADHD did not have volume or shape differences, suggesting sex strongly influences the disorder's expression.
Previous studies examining the basal ganglia in children with ADHD were limited to volume analysis and had conflicting results, with some reporting a smaller volume and some reporting no difference in volume. LDDMM provides detailed analysis of the shape of specific brain regions, allowing for precise examination of brain structures well beyond what has been examined in previous MRI studies of ADHD. In this study, LDDMM was used to map the brains of typically developing children in order to generate a basal ganglia template. This is the first reported template of the basal ganglia. After creating LDDMM mappings of the basal ganglia of each child with ADHD, statistical analysis was conducted to compare them to the template.
In this study, the initial volume analysis revealed boys with ADHD had significantly smaller basal ganglia volumes compared with typically-developing boys. Moving beyond the standard volume analysis, the LDDMM revealed shape abnormalities in several regions of the basal ganglia. Comparison of the standard volume and LDDMM analysis of girls with ADHD and their typically developing peers failed to reveal any significant volume or shape differences.
The multiple shape differences found in boys with ADHD suggests that the disorder may not be associated with abnormalities in one specific neural circuit. Rather, it appears the disorder involves abnormalities in parallel circuits, including circuits important for the control of complex behavior and more basic motor responses, such as hitting the brake pedal when a traffic light turns yellow. Findings revealing abnormalities in circuits important for basic motor response control may be crucial to understanding why children with ADHD have difficulty suppressing impulsive actions.
"This study represents a major advancement in our ability to examine the neuroanatomic features of ADHD and other developmental disorders," said Dr. Stewart H. Mostofsky, senior study author and a pediatric neurologist in the Department of Developmental Cognitive Neurology at the Kennedy Krieger Institute. "Using LDDMM, we can more accurately measure the impact of ADHD on brain development, which will not only bring us closer to unlocking the biological basis of the disorder, but help us better diagnose and treat patients."
Researchers used MRI scans to examine children ages 8-13 years, including: 47 children with ADHD and a control group of 66 typically developing children. Researchers compared the LDDMM mappings of children with ADHD to their typically developing peers, and then went a step further by repeating the analysis separately for boys and girls. Children with ADHD who had a history of other neuropsychiatric diagnoses including conduct disorder, mood disorder, generalized anxiety disorder, separation anxiety disorder and/or obsessive-compulsive disorder were excluded from the study. Additionally, none of the children with ADHD had a learning disability or a history of speech/language disorders.
Potential next steps include research that carefully examines whether the brain abnormalities found in this study can predict certain behavioral features of ADHD. Future studies will also examine structural features associated with the ability to compensate and respond to therapy. The researchers also plan to use LDDMM analysis on children in a wider age range to see if changes in the basal ganglia occur over time.
The Center for Imaging Science at Johns Hopkins University, under the direction of Director Dr. Michael I. Miller, was a key collaborator in this study.
The study found boys with ADHD had significant shape differences and decreases in overall volume of the basal ganglia compared to their typically developing peers. Girls with ADHD did not have volume or shape differences, suggesting sex strongly influences the disorder's expression.
Previous studies examining the basal ganglia in children with ADHD were limited to volume analysis and had conflicting results, with some reporting a smaller volume and some reporting no difference in volume. LDDMM provides detailed analysis of the shape of specific brain regions, allowing for precise examination of brain structures well beyond what has been examined in previous MRI studies of ADHD. In this study, LDDMM was used to map the brains of typically developing children in order to generate a basal ganglia template. This is the first reported template of the basal ganglia. After creating LDDMM mappings of the basal ganglia of each child with ADHD, statistical analysis was conducted to compare them to the template.
In this study, the initial volume analysis revealed boys with ADHD had significantly smaller basal ganglia volumes compared with typically-developing boys. Moving beyond the standard volume analysis, the LDDMM revealed shape abnormalities in several regions of the basal ganglia. Comparison of the standard volume and LDDMM analysis of girls with ADHD and their typically developing peers failed to reveal any significant volume or shape differences.
The multiple shape differences found in boys with ADHD suggests that the disorder may not be associated with abnormalities in one specific neural circuit. Rather, it appears the disorder involves abnormalities in parallel circuits, including circuits important for the control of complex behavior and more basic motor responses, such as hitting the brake pedal when a traffic light turns yellow. Findings revealing abnormalities in circuits important for basic motor response control may be crucial to understanding why children with ADHD have difficulty suppressing impulsive actions.
"This study represents a major advancement in our ability to examine the neuroanatomic features of ADHD and other developmental disorders," said Dr. Stewart H. Mostofsky, senior study author and a pediatric neurologist in the Department of Developmental Cognitive Neurology at the Kennedy Krieger Institute. "Using LDDMM, we can more accurately measure the impact of ADHD on brain development, which will not only bring us closer to unlocking the biological basis of the disorder, but help us better diagnose and treat patients."
Researchers used MRI scans to examine children ages 8-13 years, including: 47 children with ADHD and a control group of 66 typically developing children. Researchers compared the LDDMM mappings of children with ADHD to their typically developing peers, and then went a step further by repeating the analysis separately for boys and girls. Children with ADHD who had a history of other neuropsychiatric diagnoses including conduct disorder, mood disorder, generalized anxiety disorder, separation anxiety disorder and/or obsessive-compulsive disorder were excluded from the study. Additionally, none of the children with ADHD had a learning disability or a history of speech/language disorders.
Potential next steps include research that carefully examines whether the brain abnormalities found in this study can predict certain behavioral features of ADHD. Future studies will also examine structural features associated with the ability to compensate and respond to therapy. The researchers also plan to use LDDMM analysis on children in a wider age range to see if changes in the basal ganglia occur over time.
The Center for Imaging Science at Johns Hopkins University, under the direction of Director Dr. Michael I. Miller, was a key collaborator in this study.
Tinnitus: Psychological Treatment and Neurostimulation Offer Hope
ScienceDaily (Nov. 24, 2008) — A remarkable number of patients with tinnitus demonstrate withdrawal behaviour and have a negative view of life. Feelings of anxiety and depression result in patients experiencing the complaint as a major burden on their quality of life. In addition to psychological treatment, neurostimulation now also appears to be a very promising therapy.
This is the result of research conducted by Hilke Bartels of the University Medical Center Groningen. She will be awarded a PhD by the University of Groningen on 26 November 2008.
Patients with tinnitus hear noises that do not originate outside but within the body itself. They can be squeaks, whistles or whooshing noises, or even rumbles, knocking or rustling sounds. It is estimated that 10-30 percent of the Dutch suffer from tinnitus. Four to five percent of these people feel seriously limited as a result; for example, they can’t concentrate properly anymore, or have trouble sleeping. The complaint usually starts when people are between the ages of 40 and 60 and their hearing is not what it used to be.
Overactive brains
For a long time it was assumed that the cause of tinnitus lay in the auditory organ itself. However, it is now clear that the brain is responsible: overactive parts of the brain in the auditory region emit continuous signals that are the cause of the ‘phantom noise’. This over-activity is usually the result of hearing loss. However, noise (buzzing in the ears after visiting a concert or discotheque), an infection or an operation on the ear, or a jaw or neck problem can also cause the symptoms.
With the help of the image-forming technologies PET and fMRI, Bartels mapped the over-activity of the relevant parts of the brain. She was thus able to confirm existing theories about the complaint.
Negative attitude
Bartels’s research has revealed that a remarkable number of tinnitus patients are depressed and have a negative attitude towards life. They do not dare to share these feelings with others, which means they experience little social support, which in turn leads to withdrawal behaviour. This is also described as the so-called ‘type D personality’. No fewer than 94 of the 265 tinnitus patients investigated had such a personality type. These patients experienced significantly more psychological discomfort, the research revealed. Anxiety and depression appear to strengthen the effect of tinnitus. People with a type D personality in particular should undergo treatment that concentrates on the reduction of anxiety and depression, according to Bartels.
Effective neurostimulation
A psychological approach is not the only light on the horizon, however. Between 2001 and 2003, the UMCG started an experimental treatment regime whereby the relevant brain areas were continuously stimulated with the help of a pulse generator, a sort of pacemaker. An evaluation revealed that four of the six patients treated in this way had significantly positive long-term results. The patients indicated that the ‘noise’ was reduced to manageable levels and awarded the treatment a mark of 7 out of 10. Neurostimulation with a magnet outside the skull also looks like an interesting treatment option. The tinnitus of 5 of the 24 patients who underwent this experimental treatment was temporarily suppressed.
Recommendations
Thus far no treatment has been shown to be effective for the majority of tinnitus patients. Current treatment options have either a medical, an audiological or a psychological basis. According to Bartels, a multidisciplinary approach is essential. She also calls for the use of validated questionnaires to chart the nature and the impact of tinnitus.
This is the result of research conducted by Hilke Bartels of the University Medical Center Groningen. She will be awarded a PhD by the University of Groningen on 26 November 2008.
Patients with tinnitus hear noises that do not originate outside but within the body itself. They can be squeaks, whistles or whooshing noises, or even rumbles, knocking or rustling sounds. It is estimated that 10-30 percent of the Dutch suffer from tinnitus. Four to five percent of these people feel seriously limited as a result; for example, they can’t concentrate properly anymore, or have trouble sleeping. The complaint usually starts when people are between the ages of 40 and 60 and their hearing is not what it used to be.
Overactive brains
For a long time it was assumed that the cause of tinnitus lay in the auditory organ itself. However, it is now clear that the brain is responsible: overactive parts of the brain in the auditory region emit continuous signals that are the cause of the ‘phantom noise’. This over-activity is usually the result of hearing loss. However, noise (buzzing in the ears after visiting a concert or discotheque), an infection or an operation on the ear, or a jaw or neck problem can also cause the symptoms.
With the help of the image-forming technologies PET and fMRI, Bartels mapped the over-activity of the relevant parts of the brain. She was thus able to confirm existing theories about the complaint.
Negative attitude
Bartels’s research has revealed that a remarkable number of tinnitus patients are depressed and have a negative attitude towards life. They do not dare to share these feelings with others, which means they experience little social support, which in turn leads to withdrawal behaviour. This is also described as the so-called ‘type D personality’. No fewer than 94 of the 265 tinnitus patients investigated had such a personality type. These patients experienced significantly more psychological discomfort, the research revealed. Anxiety and depression appear to strengthen the effect of tinnitus. People with a type D personality in particular should undergo treatment that concentrates on the reduction of anxiety and depression, according to Bartels.
Effective neurostimulation
A psychological approach is not the only light on the horizon, however. Between 2001 and 2003, the UMCG started an experimental treatment regime whereby the relevant brain areas were continuously stimulated with the help of a pulse generator, a sort of pacemaker. An evaluation revealed that four of the six patients treated in this way had significantly positive long-term results. The patients indicated that the ‘noise’ was reduced to manageable levels and awarded the treatment a mark of 7 out of 10. Neurostimulation with a magnet outside the skull also looks like an interesting treatment option. The tinnitus of 5 of the 24 patients who underwent this experimental treatment was temporarily suppressed.
Recommendations
Thus far no treatment has been shown to be effective for the majority of tinnitus patients. Current treatment options have either a medical, an audiological or a psychological basis. According to Bartels, a multidisciplinary approach is essential. She also calls for the use of validated questionnaires to chart the nature and the impact of tinnitus.
Tuesday, November 18, 2008
Unraveling Mystery of Brain Aneurysms
ScienceDaily (Nov. 15, 2008) — Yale researchers have taken the first critical steps in unraveling the mysteries of brain aneurysms, the often fatal rupturing of blood vessels that afflicts 500,000 people worldwide each year and nearly killed Vice President-elect Joseph Biden two decades ago.
An international team — led by Murat Gunel, professor of neurosurgery and neurobiology, and Richard Lifton, Sterling Professor and chair of genetics, and a Howard Hughes Medical Institute investigator — scanned the genomes of more than 2,000 individuals suffering from intracranial aneurysms along with 8,000 healthy subjects. They discovered three chromosome segments, or loci, where common genetic variations can create significant risk for ruptured aneurysms, which in turn cause strokes.
The subjects came from hospitals in Finland, the Netherlands and Japan, and the results were similar in all groups, indicating that these variations increase risk among diverse human populations.
The findings, reported online in the journal Nature Genetics, could lead to new screening tests to identify hundreds of thousands of people at risk for strokes caused by bleeding and point to new therapies that might be able to strengthen blood vessels in the brain before they burst.
"Even though we have made significant strides in treating unruptured aneurysms, until now we have not had an effective means of identifying the majority of individuals at risk of developing this deadly problem. These genetic findings provide a starting point for changing that equation," Gunel said.
The median age when hemorrhagic stroke occurs is 50 years old, and usually there are no warning signs. In the majority of cases, the resulting strokes cause death or severe brain damage. Without an understanding of the cause of these events, physicians have been left to respond after the fact, once the damage has largely been done. Biden was one of the lucky individuals who survived a ruptured aneurysm with minimal damage — although at the time he was stricken, his condition was thought to be grave enough that a priest was summoned to confer last rites.
The Yale study showed that the risk of harboring an aneurysm increased with the number of risk variants, or alleles. Individuals with the highest number of risk alleles tripled their risk of an aneurysm, researchers found.
Based on this large collaborative study, a screening test may one day be able to identify those who are at higher risk of forming brain aneurysms or suffering a bleeding stroke as a result.
"These findings provide fundamental insights into the genetic and biochemical changes that cause this devastating brain disease, providing hope that we may also be able to provide preventive therapy before rupture occurs," Lifton said.
For instance, the new findings implicate variations in the gene SOX17, which is known to play a crucial role in the early development and repair of endothelial cells that make up the arterial walls of blood vessels. "These variations may interfere with the ability to produce cells that repair damage to the blood vessels, suggesting a path forward for developing new approaches to prevention," Gunel said.
Kaya Bilguvar of Yale was first author of the paper. Other Yale researchers included Shrikant Mane, Christopher E. Mason, Murim Choi, Emilia Gaal, Yasa Bayri, Luis Kobl, Zulfikar Arlier, Sudhakar Ravuri, and Matthew W. State.
The work was funded by the National Institutes of Health, the Yale Center for Human Genetics and Genomics, the Yale Program on Neurogenetics and the Howard Hughes Medical Institute.
Citation: Nature Genetics, Nov. 9, 2008
An international team — led by Murat Gunel, professor of neurosurgery and neurobiology, and Richard Lifton, Sterling Professor and chair of genetics, and a Howard Hughes Medical Institute investigator — scanned the genomes of more than 2,000 individuals suffering from intracranial aneurysms along with 8,000 healthy subjects. They discovered three chromosome segments, or loci, where common genetic variations can create significant risk for ruptured aneurysms, which in turn cause strokes.
The subjects came from hospitals in Finland, the Netherlands and Japan, and the results were similar in all groups, indicating that these variations increase risk among diverse human populations.
The findings, reported online in the journal Nature Genetics, could lead to new screening tests to identify hundreds of thousands of people at risk for strokes caused by bleeding and point to new therapies that might be able to strengthen blood vessels in the brain before they burst.
"Even though we have made significant strides in treating unruptured aneurysms, until now we have not had an effective means of identifying the majority of individuals at risk of developing this deadly problem. These genetic findings provide a starting point for changing that equation," Gunel said.
The median age when hemorrhagic stroke occurs is 50 years old, and usually there are no warning signs. In the majority of cases, the resulting strokes cause death or severe brain damage. Without an understanding of the cause of these events, physicians have been left to respond after the fact, once the damage has largely been done. Biden was one of the lucky individuals who survived a ruptured aneurysm with minimal damage — although at the time he was stricken, his condition was thought to be grave enough that a priest was summoned to confer last rites.
The Yale study showed that the risk of harboring an aneurysm increased with the number of risk variants, or alleles. Individuals with the highest number of risk alleles tripled their risk of an aneurysm, researchers found.
Based on this large collaborative study, a screening test may one day be able to identify those who are at higher risk of forming brain aneurysms or suffering a bleeding stroke as a result.
"These findings provide fundamental insights into the genetic and biochemical changes that cause this devastating brain disease, providing hope that we may also be able to provide preventive therapy before rupture occurs," Lifton said.
For instance, the new findings implicate variations in the gene SOX17, which is known to play a crucial role in the early development and repair of endothelial cells that make up the arterial walls of blood vessels. "These variations may interfere with the ability to produce cells that repair damage to the blood vessels, suggesting a path forward for developing new approaches to prevention," Gunel said.
Kaya Bilguvar of Yale was first author of the paper. Other Yale researchers included Shrikant Mane, Christopher E. Mason, Murim Choi, Emilia Gaal, Yasa Bayri, Luis Kobl, Zulfikar Arlier, Sudhakar Ravuri, and Matthew W. State.
The work was funded by the National Institutes of Health, the Yale Center for Human Genetics and Genomics, the Yale Program on Neurogenetics and the Howard Hughes Medical Institute.
Citation: Nature Genetics, Nov. 9, 2008
Exercise Increases Brain Growth Factor and Receptors, Prevents Stem Cell Drop in Middle Age
The American Physiological Society released the following announcement:
Exercise increases brain growth factor and receptors, prevents stem celldrop in middle age
BETHESDA, Md. (Nov. 18, 2008)
A new study confirms that exercise canreverse the age-related decline in the production of neural stem cellsin the hippocampus of the mouse brain, and suggests that this happensbecause exercise restores a brain chemical which promotes the productionand maturation of new stem cells.Neural stem cells and progenitor cells differentiate into a variety ofmature nerve cells which have different functions, a process calledneurogenesis. There is evidence that when fewer new stem or progenitorcells are produced in the hippocampus, it can result in impairment ofthe learning and memory functions. The hippocampus plays an importantrole in memory and learning.The study, "Exercise enhances the proliferation of neural stem cells andneurite growth and survival of neuronal progenitor cells in dentategyrus of middle-aged mice," was carried out by Chih-Wei Wu, Ya-TingChang, Lung Yu, Hsiun-ing Chen, Chauying J. Jen, Shih-Ying Wu, Chen-PengLo, Yu-Min Kuo, all of the National Cheng Kung University MedicalCollege in Taiwan. The study appears in the November issue of theJournal of Applied Physiology, published by The American PhysiologicalSociety.
Rise in corticosterone or fall in nerve growth factor?The researchers built on earlier studies that found that the productionof stem cells in the area of the hippocampus known as the dentate gyrusdrops off dramatically by the time mice are middle age and that exercisecan slow that trend. In the current study, the researchers wanted totrack these changes in mice over time, and find out why they happen.
One hypothesis the researchers investigated is that the age-relateddecline in neurogenesis is tied to a rise in corticosterone in middleage. Elevation of corticosterone has been associated with a drop in theproduction of new stem cells in the hippocampus.The second hypothesis is that nerve growth factors -- which encouragenew neural cell growth but which decrease with age -- account for thedrop in neurogenesis. Specifically, the study looked at whether adecrease in brain-derived neurotrophic growth factor leads to a declinein new neural stem cells.Variables studied.
The researchers trained young (3 months), adult (7 months), early middle-aged (9 months), middle-aged (13 months) and old (24 months) mice to runa treadmill for up to one hour a day.The study tracked neurogenesis, age, exercise, serum corticosteronelevels and brain-derived neurotrophic factor (BDNF) and its receptorTrkB levels in the hippocampus. The researchers focused on middle age asa critical stage for the decline of neurogenesis in the mice. As expected, the study found that neurogenesis drops off sharply inmiddle-aged mice. For example, the number of neural progenitor andmitotic (dividing) cells in the hippocampus of middle-aged mice was only5% of that observed in the young mice.The researchers also found that exercise significantly slows down the loss of new nerve cells in the middle-aged mice. They found thatproduction of neural stem cells improved by approximately 200% comparedto the middle-aged mice that did not exercise. In addition, the survivalof new nerve cells increased by 170% and growth by 190% compared to thesedentary middle-aged mice.
Exercise also significantly enhanced stemcell production and maturation in the young mice. In fact, exerciseproduced a stronger effect in younger mice compared to the older mice.How does this happen?Based on these results, it appears that nerve growth factor has more todo with these findings than the corticosterone:
* The middle-aged exercisers had more brain-derived neurotrophicfactor and its receptor, TrkB, compared to the middle-aged mice that didnot exercise. This suggests that exercise promotes the production ofbrain-derived neurotrophic factor which, in turn, promotesdifferentiation and survival of new brain cells in the hippocampus.
* Exercise did not change the basal level of serum corticosterone inmiddle-aged mice. This suggests that the reduction of neurogenesisduring aging is not due to the drop in corticosterone levels.
Exercise increases brain growth factor and receptors, prevents stem celldrop in middle age
BETHESDA, Md. (Nov. 18, 2008)
A new study confirms that exercise canreverse the age-related decline in the production of neural stem cellsin the hippocampus of the mouse brain, and suggests that this happensbecause exercise restores a brain chemical which promotes the productionand maturation of new stem cells.Neural stem cells and progenitor cells differentiate into a variety ofmature nerve cells which have different functions, a process calledneurogenesis. There is evidence that when fewer new stem or progenitorcells are produced in the hippocampus, it can result in impairment ofthe learning and memory functions. The hippocampus plays an importantrole in memory and learning.The study, "Exercise enhances the proliferation of neural stem cells andneurite growth and survival of neuronal progenitor cells in dentategyrus of middle-aged mice," was carried out by Chih-Wei Wu, Ya-TingChang, Lung Yu, Hsiun-ing Chen, Chauying J. Jen, Shih-Ying Wu, Chen-PengLo, Yu-Min Kuo, all of the National Cheng Kung University MedicalCollege in Taiwan. The study appears in the November issue of theJournal of Applied Physiology, published by The American PhysiologicalSociety.
Rise in corticosterone or fall in nerve growth factor?The researchers built on earlier studies that found that the productionof stem cells in the area of the hippocampus known as the dentate gyrusdrops off dramatically by the time mice are middle age and that exercisecan slow that trend. In the current study, the researchers wanted totrack these changes in mice over time, and find out why they happen.
One hypothesis the researchers investigated is that the age-relateddecline in neurogenesis is tied to a rise in corticosterone in middleage. Elevation of corticosterone has been associated with a drop in theproduction of new stem cells in the hippocampus.The second hypothesis is that nerve growth factors -- which encouragenew neural cell growth but which decrease with age -- account for thedrop in neurogenesis. Specifically, the study looked at whether adecrease in brain-derived neurotrophic growth factor leads to a declinein new neural stem cells.Variables studied.
The researchers trained young (3 months), adult (7 months), early middle-aged (9 months), middle-aged (13 months) and old (24 months) mice to runa treadmill for up to one hour a day.The study tracked neurogenesis, age, exercise, serum corticosteronelevels and brain-derived neurotrophic factor (BDNF) and its receptorTrkB levels in the hippocampus. The researchers focused on middle age asa critical stage for the decline of neurogenesis in the mice. As expected, the study found that neurogenesis drops off sharply inmiddle-aged mice. For example, the number of neural progenitor andmitotic (dividing) cells in the hippocampus of middle-aged mice was only5% of that observed in the young mice.The researchers also found that exercise significantly slows down the loss of new nerve cells in the middle-aged mice. They found thatproduction of neural stem cells improved by approximately 200% comparedto the middle-aged mice that did not exercise. In addition, the survivalof new nerve cells increased by 170% and growth by 190% compared to thesedentary middle-aged mice.
Exercise also significantly enhanced stemcell production and maturation in the young mice. In fact, exerciseproduced a stronger effect in younger mice compared to the older mice.How does this happen?Based on these results, it appears that nerve growth factor has more todo with these findings than the corticosterone:
* The middle-aged exercisers had more brain-derived neurotrophicfactor and its receptor, TrkB, compared to the middle-aged mice that didnot exercise. This suggests that exercise promotes the production ofbrain-derived neurotrophic factor which, in turn, promotesdifferentiation and survival of new brain cells in the hippocampus.
* Exercise did not change the basal level of serum corticosterone inmiddle-aged mice. This suggests that the reduction of neurogenesisduring aging is not due to the drop in corticosterone levels.
Saturday, November 15, 2008
Bad Health Habits and Lifestyle Choices Are Among Alzheimer's Causes
Stress, inactivity and even certain medications can weaken memory.
By Melissa Healy November 17, 2008
When it comes to preserving memories, we are sometimes our own worst enemies. The lives we lead often undermine the complex process of creating and retrieving memories. And they can boost the odds of our developing diseases -- including Alzheimer's -- that further ravage the brain's mechanisms of memory. Here are things that science tells us pose the greatest threat to our memories: Knowing them, says UCLA neurologist Dr. Gary Small, may allow us "to act early to prevent."Medications
Want a healthier brain for clearer thinking and better memory?Researcher says this nutrient may reverse "up to 12 years of decline"
www.hsibaltimore.com
Brain Food
Attend 4 Stimulating Lectures by Ivy League Profs - Stay Sharp
www.onedayu.com
Many medications prescribed widely in the U.S. can cause memory problems. Among the most likely to disrupt memory are benzodiazepines (including Ativan, Valium and Xanax). Any drug that can cause drowsiness can disturb concentration and absorption of new facts -- there are legions of those, including over-the-counter antihistamines.Some drugs have been discovered by accident to have memory-disrupting qualities and have been hailed as possible treatments for those at risk of post-traumatic stress disorder. Beta blockers, prescribed widely, have been shown to reduce the emotional power of certain memories and are being investigated by the U.S. military. Propofol, a sedative colloquially known as "milk of amnesia," can also erase a few minutes of memory.Untreated heart disease
High blood pressure, high cholesterol, Type 2 diabetes and obesity all raise the risk of stroke, which can affect memory profoundly. Studies have also found those with Type 2 diabetes at three times greater risk for Alzheimer's as the general population. Those with high cholesterol and blood pressure in midlife are also at greater risk. And obesity (particularly excess fat around the middle) has been linked to higher dementia rates 30 years later.
StressResearchers know that high emotion surrounding an event assures that it will be committed to memory. As the brain floods with adrenaline and norepinephrine, the mechanisms of memory are excited. Episodes of high stress, intense happiness, love and sadness can preserve a sharp memory. But when stress is constant and the brain is bathed chronically in stress hormones such as cortisol, attention grows weak and events are stored fitfully in short-term memory and fitfully committed to long-term memory. Established memories are poorly retrieved.Cortisol overload will cause many of the brain cells with memory functions to power down. And over time, chronic stress will degrade communications between cells in brain regions important to learning and memory. Even several hours of steady stress can flood the brain with hormones that disrupt memory, according to a March report by UC Irvine researchers in the Journal of Neuroscience.
Alcoholism causes progressive brain shrinkage and disrupts communications between regions involved in storing and retrieving memories. In the extreme, an alcoholic can exhibit total loss of long-term memories. But memory "blackouts" and fragmented recollection are common even among social drinkers, researchers have found. Heavy alcohol use can also cause vitamin B1 deficiencies, which along with vitamin B12 deficiencies can negatively affect memory.
epression sabotages concentration and with it, memory. Brain-imaging reveals that depression decreases activity in the brain's frontal lobes, a linchpin of memory-making.A study reported in 2006 by University of Rochester researcher Mark Mapstone found that among middle-aged women, those with depressive symptoms had more complaints of memory lapses and poorer performance registering new information than those without mood disturbance.Mapstone found that the women did not show cognitive problems on neuropsychological tests. With their attention spread thin by competing demands and mood disturbances affecting concentration, many fear they have Alzheimer's when in fact they may have problems getting information into the memory stream, rather than storing or retrieving it. Attention-deficit disorder and sleep deprivation are thought to have similar effects.
Couch potato lifestylePhysical and mental exercises are essential to keeping memory functioning: Lack of either is associated with memory problems, especially as we age.The brain, like any organ, benefits from improved blood flow that comes with aerobic activity. And its tissues are strengthened with increased use. Plus, studies show that those with higher education levels and a habit of mental stimulation build up a "cognitive reserve" that reduces the symptom severity even when their brains are under attack by Alzheimer's. "It's a common sense expression, but it seems to be true: A huge amount of data says use it or lose it," says UC Irvine neuroscientist James McGaugh
By Melissa Healy November 17, 2008
When it comes to preserving memories, we are sometimes our own worst enemies. The lives we lead often undermine the complex process of creating and retrieving memories. And they can boost the odds of our developing diseases -- including Alzheimer's -- that further ravage the brain's mechanisms of memory. Here are things that science tells us pose the greatest threat to our memories: Knowing them, says UCLA neurologist Dr. Gary Small, may allow us "to act early to prevent."Medications
Want a healthier brain for clearer thinking and better memory?Researcher says this nutrient may reverse "up to 12 years of decline"
www.hsibaltimore.com
Brain Food
Attend 4 Stimulating Lectures by Ivy League Profs - Stay Sharp
www.onedayu.com
Many medications prescribed widely in the U.S. can cause memory problems. Among the most likely to disrupt memory are benzodiazepines (including Ativan, Valium and Xanax). Any drug that can cause drowsiness can disturb concentration and absorption of new facts -- there are legions of those, including over-the-counter antihistamines.Some drugs have been discovered by accident to have memory-disrupting qualities and have been hailed as possible treatments for those at risk of post-traumatic stress disorder. Beta blockers, prescribed widely, have been shown to reduce the emotional power of certain memories and are being investigated by the U.S. military. Propofol, a sedative colloquially known as "milk of amnesia," can also erase a few minutes of memory.Untreated heart disease
High blood pressure, high cholesterol, Type 2 diabetes and obesity all raise the risk of stroke, which can affect memory profoundly. Studies have also found those with Type 2 diabetes at three times greater risk for Alzheimer's as the general population. Those with high cholesterol and blood pressure in midlife are also at greater risk. And obesity (particularly excess fat around the middle) has been linked to higher dementia rates 30 years later.
StressResearchers know that high emotion surrounding an event assures that it will be committed to memory. As the brain floods with adrenaline and norepinephrine, the mechanisms of memory are excited. Episodes of high stress, intense happiness, love and sadness can preserve a sharp memory. But when stress is constant and the brain is bathed chronically in stress hormones such as cortisol, attention grows weak and events are stored fitfully in short-term memory and fitfully committed to long-term memory. Established memories are poorly retrieved.Cortisol overload will cause many of the brain cells with memory functions to power down. And over time, chronic stress will degrade communications between cells in brain regions important to learning and memory. Even several hours of steady stress can flood the brain with hormones that disrupt memory, according to a March report by UC Irvine researchers in the Journal of Neuroscience.
Alcoholism causes progressive brain shrinkage and disrupts communications between regions involved in storing and retrieving memories. In the extreme, an alcoholic can exhibit total loss of long-term memories. But memory "blackouts" and fragmented recollection are common even among social drinkers, researchers have found. Heavy alcohol use can also cause vitamin B1 deficiencies, which along with vitamin B12 deficiencies can negatively affect memory.
epression sabotages concentration and with it, memory. Brain-imaging reveals that depression decreases activity in the brain's frontal lobes, a linchpin of memory-making.A study reported in 2006 by University of Rochester researcher Mark Mapstone found that among middle-aged women, those with depressive symptoms had more complaints of memory lapses and poorer performance registering new information than those without mood disturbance.Mapstone found that the women did not show cognitive problems on neuropsychological tests. With their attention spread thin by competing demands and mood disturbances affecting concentration, many fear they have Alzheimer's when in fact they may have problems getting information into the memory stream, rather than storing or retrieving it. Attention-deficit disorder and sleep deprivation are thought to have similar effects.
Couch potato lifestylePhysical and mental exercises are essential to keeping memory functioning: Lack of either is associated with memory problems, especially as we age.The brain, like any organ, benefits from improved blood flow that comes with aerobic activity. And its tissues are strengthened with increased use. Plus, studies show that those with higher education levels and a habit of mental stimulation build up a "cognitive reserve" that reduces the symptom severity even when their brains are under attack by Alzheimer's. "It's a common sense expression, but it seems to be true: A huge amount of data says use it or lose it," says UC Irvine neuroscientist James McGaugh
Thursday, November 13, 2008
It's Never Too Late To Grow Your Brain
It's never too late to grow your brain TheStar.com - Atkinson 2008 - It's never too late to grow your brain
There's much people can do to preserve and even enhance brain function — at any age.
Related stories. With medical breakthroughs, the quest for eternal youth and longevity has never been more in reach. But we may be searching for the wrong things, according to two University of Chicago scientists. Good news: there are many easy ways to mitigate the effects aging has on your brain. It's just a matter of firming up that grey matter. From Harvard-educated medical doctor Andrew Weil to naturopath Alan Logan, the advice about nourishing the brain is consistent.
The maximum human lifespan is 122, achieved by Jeanne Calment, who lived in the south of France all her life and ate a healthy Mediterranean diet.
Related Graphics
Brain fitnessSome simple techniques for improving brain function.
THE SERIES Toronto journalist Judy Steed has been writing about social issues for 30 years. Last fall, she embarked on a one-year project to document the most pressing policy implications of our aging society as part of the 2008 Atkinson Fellowship in Public Policy.She has visited dozens of nursing homes and interviewed hundreds of health-care workers, policy-makers and seniors to present this weeklong portrait.
MEMORY: Scientific research into neurological function has an uplifting message these days: It's never too late, and there's a lot you can do to preserve, and even improve, how your brain works
November 13, 2008 Judy SteedSpecial to the Star
"You can teach an old dog new tricks," says Dr. Donald Stuss, a leading neuroscientist. "The brain can potentially grow new cells and make new connections."
Until quite recently, medical science held that the brain, when fully developed, was "a finished deal," Stuss says. Now we know – thanks in part to the groundbreaking insights generated by Baycrest's Rotman Research Institute, where Stuss is director of research and senior scientist – that there is still much to learn.
Case in point: the brain's plasticity. The newly discovered extent of the flexibility and adaptability of our grey matter means "the brain can reorganize, brain networks can change, the brain is not a fixed, limited system," Stuss says. "The brain can generate new neurons and more brain regions can be recruited, brought into play, to help us as we get older."
This knowledge – gained through imaging technologies that show us the brain in action, letting us watch different regions of the brain light up, enabling the measurement of magnetic changes in neurons – has revolutionized scientists' approach to the brain, transformed medical education, and given us hope of delaying, if not preventing, brain dysfunction.
"Different areas of the brain can take over when others are damaged," Stuss says. "The brain can recruit capacity from other parts of the brain."
To take advantage of these incredible new findings, we have to change how we age.
We have to learn how to stimulate our brain in order to keep it healthy into advanced old age.
These are the odds: over the age of 85, between a third and a half of the population will develop dementia, in the present circumstances.
This is what longevity can mean: long years of not knowing what's going on, not knowing who you are.
Aging boomers may boast about their prospects for unprecedented longevity, but the harsh truth is that you can't enjoy old age if you haven't got the healthy brain to go with it.
At Extendicare Lakefield – a typical Ontario nursing home, just outside Peterborough – 86 is the average age of admission, and 85 per cent of residents have dementia.
But it doesn't have to be that way.
That's where the astounding new brain research comes in. The future of neuroscience lies in the exploration of brain regeneration.
Given the demographics – all the aging baby boomers living in fear of dementia, eager to be the first generation to benefit from the new research – and all the money flowing into brain research at advanced scientific facilities around the world, it's no wonder brain researchers can barely contain their excitement.
Thanks to the revolution in brain imaging, modern neuroscience is poised to penetrate the ultimate mysteries of the brain: how memory functions, what causes dementia, how brain deterioration can be prevented.
"There's a whole host of new therapies coming down the pipe," says Dr. Max Cynader, director of the Brain Research Centre at University of British Columbia. "We're the lucky ones."
We're in the right place at the right time, if we live long enough.
Certainly Cynader's Brain Research Centre is benefiting from the unprecedented passion for figuring out the brain. His centre has received upwards of $37 million since 2007 from government and private sources, enough to recruit some of the finest minds in the world.
"Health is more than the absence of disease," Cynader says. "What mechanisms in the brain enable us to age well? How can we avoid neuro-degenerative dysfunction?"
These questions signal a profound shift: from studying advanced brain failure – people with Alzheimer's disease – scientists are turning their attention to preventing dysfunction, supporting brain health, lowering the risks of brain disease – just as we've learned how to prevent heart disease.
After 25 years studying Alzheimer's disease, Dr. Gary Small of UCLA's world renowned Brain Research Institute, is embracing the shift. "It's easier to protect the healthy brain and treat it earlier, rather than trying to treat the brain already damaged (by dementia)."
Small is at the forefront of another development in brain research: "the digital divide," in which "digital natives" – kids who've grown up with technology – are worlds apart from "digital immigrants" — older folks.
Small's results, recorded in a new book entitled iBrain: Surviving the Technological Alteration of the Modern Mind, are startling.
For instance, he found that young men who play violent video games have "an impaired ability to recognize human facial expressions."
Our use of technology, and the way it "distracts from our human experience of face-to-face contact," he asserts, is having a profound impact on the actual wiring of the brain.
More proof of the brain's plasticity – and more uncharted territory for brain researchers to explore
There's much people can do to preserve and even enhance brain function — at any age.
Related stories. With medical breakthroughs, the quest for eternal youth and longevity has never been more in reach. But we may be searching for the wrong things, according to two University of Chicago scientists. Good news: there are many easy ways to mitigate the effects aging has on your brain. It's just a matter of firming up that grey matter. From Harvard-educated medical doctor Andrew Weil to naturopath Alan Logan, the advice about nourishing the brain is consistent.
The maximum human lifespan is 122, achieved by Jeanne Calment, who lived in the south of France all her life and ate a healthy Mediterranean diet.
Related Graphics
Brain fitnessSome simple techniques for improving brain function.
THE SERIES Toronto journalist Judy Steed has been writing about social issues for 30 years. Last fall, she embarked on a one-year project to document the most pressing policy implications of our aging society as part of the 2008 Atkinson Fellowship in Public Policy.She has visited dozens of nursing homes and interviewed hundreds of health-care workers, policy-makers and seniors to present this weeklong portrait.
MEMORY: Scientific research into neurological function has an uplifting message these days: It's never too late, and there's a lot you can do to preserve, and even improve, how your brain works
November 13, 2008 Judy SteedSpecial to the Star
"You can teach an old dog new tricks," says Dr. Donald Stuss, a leading neuroscientist. "The brain can potentially grow new cells and make new connections."
Until quite recently, medical science held that the brain, when fully developed, was "a finished deal," Stuss says. Now we know – thanks in part to the groundbreaking insights generated by Baycrest's Rotman Research Institute, where Stuss is director of research and senior scientist – that there is still much to learn.
Case in point: the brain's plasticity. The newly discovered extent of the flexibility and adaptability of our grey matter means "the brain can reorganize, brain networks can change, the brain is not a fixed, limited system," Stuss says. "The brain can generate new neurons and more brain regions can be recruited, brought into play, to help us as we get older."
This knowledge – gained through imaging technologies that show us the brain in action, letting us watch different regions of the brain light up, enabling the measurement of magnetic changes in neurons – has revolutionized scientists' approach to the brain, transformed medical education, and given us hope of delaying, if not preventing, brain dysfunction.
"Different areas of the brain can take over when others are damaged," Stuss says. "The brain can recruit capacity from other parts of the brain."
To take advantage of these incredible new findings, we have to change how we age.
We have to learn how to stimulate our brain in order to keep it healthy into advanced old age.
These are the odds: over the age of 85, between a third and a half of the population will develop dementia, in the present circumstances.
This is what longevity can mean: long years of not knowing what's going on, not knowing who you are.
Aging boomers may boast about their prospects for unprecedented longevity, but the harsh truth is that you can't enjoy old age if you haven't got the healthy brain to go with it.
At Extendicare Lakefield – a typical Ontario nursing home, just outside Peterborough – 86 is the average age of admission, and 85 per cent of residents have dementia.
But it doesn't have to be that way.
That's where the astounding new brain research comes in. The future of neuroscience lies in the exploration of brain regeneration.
Given the demographics – all the aging baby boomers living in fear of dementia, eager to be the first generation to benefit from the new research – and all the money flowing into brain research at advanced scientific facilities around the world, it's no wonder brain researchers can barely contain their excitement.
Thanks to the revolution in brain imaging, modern neuroscience is poised to penetrate the ultimate mysteries of the brain: how memory functions, what causes dementia, how brain deterioration can be prevented.
"There's a whole host of new therapies coming down the pipe," says Dr. Max Cynader, director of the Brain Research Centre at University of British Columbia. "We're the lucky ones."
We're in the right place at the right time, if we live long enough.
Certainly Cynader's Brain Research Centre is benefiting from the unprecedented passion for figuring out the brain. His centre has received upwards of $37 million since 2007 from government and private sources, enough to recruit some of the finest minds in the world.
"Health is more than the absence of disease," Cynader says. "What mechanisms in the brain enable us to age well? How can we avoid neuro-degenerative dysfunction?"
These questions signal a profound shift: from studying advanced brain failure – people with Alzheimer's disease – scientists are turning their attention to preventing dysfunction, supporting brain health, lowering the risks of brain disease – just as we've learned how to prevent heart disease.
After 25 years studying Alzheimer's disease, Dr. Gary Small of UCLA's world renowned Brain Research Institute, is embracing the shift. "It's easier to protect the healthy brain and treat it earlier, rather than trying to treat the brain already damaged (by dementia)."
Small is at the forefront of another development in brain research: "the digital divide," in which "digital natives" – kids who've grown up with technology – are worlds apart from "digital immigrants" — older folks.
Small's results, recorded in a new book entitled iBrain: Surviving the Technological Alteration of the Modern Mind, are startling.
For instance, he found that young men who play violent video games have "an impaired ability to recognize human facial expressions."
Our use of technology, and the way it "distracts from our human experience of face-to-face contact," he asserts, is having a profound impact on the actual wiring of the brain.
More proof of the brain's plasticity – and more uncharted territory for brain researchers to explore
Wednesday, November 12, 2008
Steps to a nimble mind: Physical and mental exercise help keep the brain fit
Neuroscience is uncovering techniques to prevent cognitive decline.
By Kathleen Phalen Tomaselli, AMNews correspondent. Nov. 17, 2008.
The brain -- containing 100 billion neurons, 900 billion glial cells, 100 trillion branches and 1,000 trillion receptors -- reacts to stimuli in a series of electrical bursts, spanning a complex map of connections. Whether calculating an algorithmic equation or learning the tango, our brain continuously changes in response to our ideas, actions and activities.
Each time a dance step is learned, for instance, new pathways are formed. "Dancing is excellent for the brain and body," says Vincent Fortanasce, MD, clinical professor of neurology at the University of Southern California in Los Angeles. He wrote the Anti-Alzheimer's Prescription. "Not only are you moving around more, your brain is in constant motion as it recalls steps and movements. It's an example that highlights a wave of new thinking about the importance of brain fitness.
Until recently, conventional wisdom held that our brains were intractable, hard-wired computers. What we were born with was all we got. Age wore down memory and the ability to understand, and few interventions could reverse this process. But increasingly, evidence suggests that physical and mental exercise can alter specific brain regions, making radical improvements in cognitive function. "When you challenge the brain with new skills and new ways of doing things, it increases connections in the brain," says Ericka P. Simpson, MD, a neurologist who co-directs the MDA Neuromuscular Clinics and directs the ALS clinical research division at the Methodist Hospital System Neurological Institute in Houston. "It increases synaptic density."
With nearly 72 million Americans turning 65 over the next two decades, physicians need the tools to handle growing patient concerns about how to best maintain brain health. Armed with this new brand of science, frontline physicians will be better equipped to address the needs of aging baby boomers, already in the throes of the brain fitness revolution. "They are the gatekeepers of information, and people listen," says Eduardo Locatelli, MD, MPH, a neurologist and medical director of the Florida Neuroscience Center in Fort Lauderdale. Dr. Locatelli implements brain fitness techniques for his postsurgery epilepsy patients as well as patients who present with mild- to moderate-stage Alzheimer's and dementia. "Encourage new experiences. ... Use it or lose it. Challenge it and gain."
The plastic brain
Within the brain, the pathways and regions that are most utilized generally grow and become stronger while other parts shrink. "The brain is very Darwinian, it's survival of the fittest," says Edward Taub, PhD, a behavioral neuroscientist at the University of Alabama at Birmingham, who has researched neuroplasticity since the 1970s. "At one time it was believed we did not use 90% of our brain. That is false. The brain is a zero sum game. Every part of the brain is used. It has enormous plasticity."
Thus, by challenging the brain and forcing the use of different pathways, brain maps can be altered. And such changes offer young and old -- even brain-injured individuals -- an opportunity to learn or re-learn things. "Vocabulary can increase into age 90," says Gary J. Kennedy, MD, a professor in the Dept. of Psychiatry and Behavioral Sciences at Albert Einstein College of Medicine. He also directs the geriatric psychiatry division at Montefiore Medical Center in the Bronx, N.Y. "As people age they may be slower, but they are capable of more and more complex projects."
Brain volume shrinks up to 1% every year after age 65.
To best illustrate neuroplasticity, consider stroke patients with damaged limbs. Contrary to traditional therapy, which works to strengthen the good limb, Taub restrains the uncompromised limb, forcing patients to use the damaged arm or leg. The therapy, constraint-induced movement therapy, also known as CI therapy, helps to rewire the brain.
"The more you use it, more neurons are available ... the more demand for cortical space and the more the patient is able to use the [damaged] arm," Taub said. Over time, small steps lead to improvements in activities of daily living. Ultimately, the damaged limb, at least in part, recovers because, although the brain does not regrow damaged areas, it re-routes around them.
When the brains of CI patients were examined, a tremendous increase in grey matter was detected, and interestingly, Taub says, the healthy part of the brain was recruited for the task. Some of Taub's research was published in the Nov. 1, 2006, Journal of the American Medical Association.
CI applications are now being explored for other forms of brain injury.
Young brains, old brains?
Mental agility begins declining around age 24, says Dr. Fortanasce. But there is a big difference between agility and capacity. "I may be slower, but what I know now far outweighs what I knew at 24," he says. "Some individuals perform their greatest creative work in late life. Verdi, for example, composed Othello at 73 and Falstaff at 79."
Greg Jicha, MD, PhD, assistant professor of neurology at the University of Kentucky College of Medicine, shares related stories, such as that of an 82-year-old who learned to play the trumpet. "I've heard people say, 'You can't teach an old dog new tricks.' That can't be further from the truth," says Dr. Jicha, who also heads the healthy brain aging research group at the university's Sanders-Brown Center on Aging. "When you look at the plasticity of the adult brain, it is amazing."
Mental agility, but not capacity, begins declining around age 24.
But age also brings anatomic changes. Brain weight and blood flow to the brain decrease by 20%. The number of fibers and nerves decrease by 37%. And brain volume shrinks up to 1% every year after age 65. Dr. Fortanasce also points to hormonal shifts, with the presence of dopamine and serotonin diminishing as cortisol, an aging hormone, increases. "Between age 20 and 70, we lose nearly 90% of youth hormones."
So what keeps some brains younger than their chronology? Experts point to a prescription of neurobics. This concept includes life-long learning, trying new things, a healthy diet, social interactions, sleep and physical activity. "Exercise can actually increase neurogenesis and increase the size of the hippocampus," says Dr. Fortanasce, who promotes isometrics and weight-bearing exercise. "Exercise also increases youth hormones. And novelty, doing new things, builds branches."
In a 2006 study in the Journal of Aging and Physical Activity, Brandeis University researchers found that strength training increased the participants' working memory span. The higher the level of resistance, the more memory improved, suggesting that strength training benefits not only the muscles but also the mind.
Dr. Locatelli suggests reversing daily patterns. People who take the same route to work every day need to push themselves beyond their comfort zones. A person can try to eat using his or her weaker hand, for instance. Or someone could listen to another type of music than the type usually favored. Activate unfamiliar areas of the brain, Dr. Locatelli says. The key is new places, socializing with different people, and reading new things.
And primary care physicians can help communicate this message.
"When a patient expresses concern about memory loss, never cast it off as associated with age," says Tom Perls, MD, MPH, associate professor of medicine at Boston University Medical Center. Dr. Perls also heads the New England Centenarian Study. "This is an incredibly serious issue. Losing brain function is devastating." Ask about memory. And rule out other conditions like depression or low thyroid first. "Encourage them to exercise the brain in novel and complex ways," he says.
Exercising new connections
So what about dance steps? At McGill University in Montreal, researchers found that the tango may be better than walking for improving execution of complex tasks because it incorporates elements found in standard neurological rehabilitation programs. It's also fun and social.
Participants, ages 62 to 90, were randomly assigned to a walking group or a tango dancing group, meeting two hours twice a week for 10 weeks. The tango group improved in balance, posture and motor coordination, as well as cognition.
Physical and mental exercise improve cognitive function.
According to new research published in the October issue of the journal Nature Neuroscience, University College London scientists say complex brain processes that enable the memorization and replication of activities such as playing the piano or riding a bicycle require the execution of complicated sequences of movements involving dozens of muscles. According to their research, pianists who learned and practiced their art from an early age had elevated amounts of myelin. This finding suggests that when people learn new skills, myelination might occur. Earlier studies indicated that brains of patients diagnosed with senile dementia had lowered amounts of myelin.
The emphasis, though, is the importance of embracing the complex and novel. And Joe Hardy, PhD, a cognition neuroscientist who develops brain plasticity training programs, says some common-sense advice from physicians is not based on good evidence. "They often recommend doing crossword puzzles," he says. "But evidence suggests that crossword puzzles are not helpful."
Hardy has been developing brain games for the San Francisco-based company Posit Science. The games -- the Brain Fitness Program and Insight -- have been tested in several randomized clinical trials funded by the National Institutes of Health. The results indicate that the brain age clock can roll back 10 years. "The key thing in terms of exercise for the brain: You need to do new things, thus forming new paths," he says.
Some have even compared this new era in brain health to the 1950s, when heart health came to the fore. "New things are coming out all the time, and we are going to see a revolution in brain health," Hardy says. "I think this is going to change the way people age."
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ADDITIONAL INFORMATION:
Increasing cognitive reserve
Who will live to be 100?
In a bit of fortune-telling fun, a series of lifestyle-related questions might offer a calculated prediction. The Life Expectancy Calculator can help patients find out how they rate right now and how changes in diet, exercise or sleep patterns might add years to the forecast. The calculator is available online (www.livingto100.com). This tool was created by Tom Perls, MD, MPH, associate professor of medicine at Boston University Medical Center, who heads the New England Centenarian Study.
A related and very important question is whether your patients' brains -- or maybe your own -- will stay young as bodies age.
According to Dr. Perls, building cognitive reserve delays the onset of memory loss, and research suggests that novel and complex brain activities can delay cognitive decline and extend lifespan. "There's a natural tendency to lose muscle as we age," he says, and by building cognitive reserve, people are exercising their temporal lobes as they would their quads.
Dr. Perls has categorized a series of games based on cognitive function, available online (fun.eons.com/brain_games). For instance, stimulating areas in the temporal and frontal lobes with games that focus on recall and retention of past and present information targets memory. For language, focus on the parietal lobe with word-building games that prompt production and understanding of spoken and written communication. Exercising the frontal lobe can be done with problem-solving puzzles and strategy games in which players control and apply mental skills.
For motor function, engage the parietal lobe edge with navigation-type games that encourage body movement through the interaction of the brain, nerves and muscles. For visual-spatial skills, stimulate the occipital and temporal lobes. Games involving discrimination, perception, attention and tracking objects visually can achieve this goal.
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London cabbies have bigger hippocampi
London cabbies' brains grow on the job. According to studies by scientists at the University College London Institute of Neurology -- the first published in the April 11, 2000, issue of Proceedings of the National Academy of Sciences with follow-up research presented in 2006 and 2007 -- these professional drivers have a larger posterior hippocampus, the brain region tied to learning and navigation.
Researchers credit complex daily tasks, such as navigating a labyrinth of 320 standard routes in a six-mile area, with increasing brain size. And functional MRI demonstrated that the longer on the job, the bigger the brain.
Still, there may be a price. As brain regions continually competed for space, the posterior hippocampus grew while the anterior hippocampus, which is associated with memory, decreased. "The brain has enormous plasticity," says Edward Taub, PhD, a behavioral neuroscientist at the University of Alabama at Birmingham. He has studied neuroplasticity since the 1970s. "Every part of the brain is used. The more you use a function, it may be at the expense of another."
As an outgrowth of the early taxi driver studies, U.S. scientists began exploring the effects of employing complicated navigational skills. At Brandeis University in Waltham, Mass., scientists created the virtual taxicab video game to study the way brains work. As subjects play, they become increasingly proficient in navigating complex routes, which researchers believe is tied to building cognitive maps of the environment.
Additionally, German scientists reported in the June 2006 issue of The Journal of Neuroscience that the brains of German medical students, while studying for final exams, showed increases in the posterior hippocampus, similar to the London cabbie study. Three months later, according to MRI imaging, the hippocampus had returned to its former size.
Weblink
Life Expectancy Calculator (www.livingto100.com)
Dr. Perls' brain games (fun.eons.com/brain_games
By Kathleen Phalen Tomaselli, AMNews correspondent. Nov. 17, 2008.
The brain -- containing 100 billion neurons, 900 billion glial cells, 100 trillion branches and 1,000 trillion receptors -- reacts to stimuli in a series of electrical bursts, spanning a complex map of connections. Whether calculating an algorithmic equation or learning the tango, our brain continuously changes in response to our ideas, actions and activities.
Each time a dance step is learned, for instance, new pathways are formed. "Dancing is excellent for the brain and body," says Vincent Fortanasce, MD, clinical professor of neurology at the University of Southern California in Los Angeles. He wrote the Anti-Alzheimer's Prescription. "Not only are you moving around more, your brain is in constant motion as it recalls steps and movements. It's an example that highlights a wave of new thinking about the importance of brain fitness.
Until recently, conventional wisdom held that our brains were intractable, hard-wired computers. What we were born with was all we got. Age wore down memory and the ability to understand, and few interventions could reverse this process. But increasingly, evidence suggests that physical and mental exercise can alter specific brain regions, making radical improvements in cognitive function. "When you challenge the brain with new skills and new ways of doing things, it increases connections in the brain," says Ericka P. Simpson, MD, a neurologist who co-directs the MDA Neuromuscular Clinics and directs the ALS clinical research division at the Methodist Hospital System Neurological Institute in Houston. "It increases synaptic density."
With nearly 72 million Americans turning 65 over the next two decades, physicians need the tools to handle growing patient concerns about how to best maintain brain health. Armed with this new brand of science, frontline physicians will be better equipped to address the needs of aging baby boomers, already in the throes of the brain fitness revolution. "They are the gatekeepers of information, and people listen," says Eduardo Locatelli, MD, MPH, a neurologist and medical director of the Florida Neuroscience Center in Fort Lauderdale. Dr. Locatelli implements brain fitness techniques for his postsurgery epilepsy patients as well as patients who present with mild- to moderate-stage Alzheimer's and dementia. "Encourage new experiences. ... Use it or lose it. Challenge it and gain."
The plastic brain
Within the brain, the pathways and regions that are most utilized generally grow and become stronger while other parts shrink. "The brain is very Darwinian, it's survival of the fittest," says Edward Taub, PhD, a behavioral neuroscientist at the University of Alabama at Birmingham, who has researched neuroplasticity since the 1970s. "At one time it was believed we did not use 90% of our brain. That is false. The brain is a zero sum game. Every part of the brain is used. It has enormous plasticity."
Thus, by challenging the brain and forcing the use of different pathways, brain maps can be altered. And such changes offer young and old -- even brain-injured individuals -- an opportunity to learn or re-learn things. "Vocabulary can increase into age 90," says Gary J. Kennedy, MD, a professor in the Dept. of Psychiatry and Behavioral Sciences at Albert Einstein College of Medicine. He also directs the geriatric psychiatry division at Montefiore Medical Center in the Bronx, N.Y. "As people age they may be slower, but they are capable of more and more complex projects."
Brain volume shrinks up to 1% every year after age 65.
To best illustrate neuroplasticity, consider stroke patients with damaged limbs. Contrary to traditional therapy, which works to strengthen the good limb, Taub restrains the uncompromised limb, forcing patients to use the damaged arm or leg. The therapy, constraint-induced movement therapy, also known as CI therapy, helps to rewire the brain.
"The more you use it, more neurons are available ... the more demand for cortical space and the more the patient is able to use the [damaged] arm," Taub said. Over time, small steps lead to improvements in activities of daily living. Ultimately, the damaged limb, at least in part, recovers because, although the brain does not regrow damaged areas, it re-routes around them.
When the brains of CI patients were examined, a tremendous increase in grey matter was detected, and interestingly, Taub says, the healthy part of the brain was recruited for the task. Some of Taub's research was published in the Nov. 1, 2006, Journal of the American Medical Association.
CI applications are now being explored for other forms of brain injury.
Young brains, old brains?
Mental agility begins declining around age 24, says Dr. Fortanasce. But there is a big difference between agility and capacity. "I may be slower, but what I know now far outweighs what I knew at 24," he says. "Some individuals perform their greatest creative work in late life. Verdi, for example, composed Othello at 73 and Falstaff at 79."
Greg Jicha, MD, PhD, assistant professor of neurology at the University of Kentucky College of Medicine, shares related stories, such as that of an 82-year-old who learned to play the trumpet. "I've heard people say, 'You can't teach an old dog new tricks.' That can't be further from the truth," says Dr. Jicha, who also heads the healthy brain aging research group at the university's Sanders-Brown Center on Aging. "When you look at the plasticity of the adult brain, it is amazing."
Mental agility, but not capacity, begins declining around age 24.
But age also brings anatomic changes. Brain weight and blood flow to the brain decrease by 20%. The number of fibers and nerves decrease by 37%. And brain volume shrinks up to 1% every year after age 65. Dr. Fortanasce also points to hormonal shifts, with the presence of dopamine and serotonin diminishing as cortisol, an aging hormone, increases. "Between age 20 and 70, we lose nearly 90% of youth hormones."
So what keeps some brains younger than their chronology? Experts point to a prescription of neurobics. This concept includes life-long learning, trying new things, a healthy diet, social interactions, sleep and physical activity. "Exercise can actually increase neurogenesis and increase the size of the hippocampus," says Dr. Fortanasce, who promotes isometrics and weight-bearing exercise. "Exercise also increases youth hormones. And novelty, doing new things, builds branches."
In a 2006 study in the Journal of Aging and Physical Activity, Brandeis University researchers found that strength training increased the participants' working memory span. The higher the level of resistance, the more memory improved, suggesting that strength training benefits not only the muscles but also the mind.
Dr. Locatelli suggests reversing daily patterns. People who take the same route to work every day need to push themselves beyond their comfort zones. A person can try to eat using his or her weaker hand, for instance. Or someone could listen to another type of music than the type usually favored. Activate unfamiliar areas of the brain, Dr. Locatelli says. The key is new places, socializing with different people, and reading new things.
And primary care physicians can help communicate this message.
"When a patient expresses concern about memory loss, never cast it off as associated with age," says Tom Perls, MD, MPH, associate professor of medicine at Boston University Medical Center. Dr. Perls also heads the New England Centenarian Study. "This is an incredibly serious issue. Losing brain function is devastating." Ask about memory. And rule out other conditions like depression or low thyroid first. "Encourage them to exercise the brain in novel and complex ways," he says.
Exercising new connections
So what about dance steps? At McGill University in Montreal, researchers found that the tango may be better than walking for improving execution of complex tasks because it incorporates elements found in standard neurological rehabilitation programs. It's also fun and social.
Participants, ages 62 to 90, were randomly assigned to a walking group or a tango dancing group, meeting two hours twice a week for 10 weeks. The tango group improved in balance, posture and motor coordination, as well as cognition.
Physical and mental exercise improve cognitive function.
According to new research published in the October issue of the journal Nature Neuroscience, University College London scientists say complex brain processes that enable the memorization and replication of activities such as playing the piano or riding a bicycle require the execution of complicated sequences of movements involving dozens of muscles. According to their research, pianists who learned and practiced their art from an early age had elevated amounts of myelin. This finding suggests that when people learn new skills, myelination might occur. Earlier studies indicated that brains of patients diagnosed with senile dementia had lowered amounts of myelin.
The emphasis, though, is the importance of embracing the complex and novel. And Joe Hardy, PhD, a cognition neuroscientist who develops brain plasticity training programs, says some common-sense advice from physicians is not based on good evidence. "They often recommend doing crossword puzzles," he says. "But evidence suggests that crossword puzzles are not helpful."
Hardy has been developing brain games for the San Francisco-based company Posit Science. The games -- the Brain Fitness Program and Insight -- have been tested in several randomized clinical trials funded by the National Institutes of Health. The results indicate that the brain age clock can roll back 10 years. "The key thing in terms of exercise for the brain: You need to do new things, thus forming new paths," he says.
Some have even compared this new era in brain health to the 1950s, when heart health came to the fore. "New things are coming out all the time, and we are going to see a revolution in brain health," Hardy says. "I think this is going to change the way people age."
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ADDITIONAL INFORMATION:
Increasing cognitive reserve
Who will live to be 100?
In a bit of fortune-telling fun, a series of lifestyle-related questions might offer a calculated prediction. The Life Expectancy Calculator can help patients find out how they rate right now and how changes in diet, exercise or sleep patterns might add years to the forecast. The calculator is available online (www.livingto100.com). This tool was created by Tom Perls, MD, MPH, associate professor of medicine at Boston University Medical Center, who heads the New England Centenarian Study.
A related and very important question is whether your patients' brains -- or maybe your own -- will stay young as bodies age.
According to Dr. Perls, building cognitive reserve delays the onset of memory loss, and research suggests that novel and complex brain activities can delay cognitive decline and extend lifespan. "There's a natural tendency to lose muscle as we age," he says, and by building cognitive reserve, people are exercising their temporal lobes as they would their quads.
Dr. Perls has categorized a series of games based on cognitive function, available online (fun.eons.com/brain_games). For instance, stimulating areas in the temporal and frontal lobes with games that focus on recall and retention of past and present information targets memory. For language, focus on the parietal lobe with word-building games that prompt production and understanding of spoken and written communication. Exercising the frontal lobe can be done with problem-solving puzzles and strategy games in which players control and apply mental skills.
For motor function, engage the parietal lobe edge with navigation-type games that encourage body movement through the interaction of the brain, nerves and muscles. For visual-spatial skills, stimulate the occipital and temporal lobes. Games involving discrimination, perception, attention and tracking objects visually can achieve this goal.
Back to top.
London cabbies have bigger hippocampi
London cabbies' brains grow on the job. According to studies by scientists at the University College London Institute of Neurology -- the first published in the April 11, 2000, issue of Proceedings of the National Academy of Sciences with follow-up research presented in 2006 and 2007 -- these professional drivers have a larger posterior hippocampus, the brain region tied to learning and navigation.
Researchers credit complex daily tasks, such as navigating a labyrinth of 320 standard routes in a six-mile area, with increasing brain size. And functional MRI demonstrated that the longer on the job, the bigger the brain.
Still, there may be a price. As brain regions continually competed for space, the posterior hippocampus grew while the anterior hippocampus, which is associated with memory, decreased. "The brain has enormous plasticity," says Edward Taub, PhD, a behavioral neuroscientist at the University of Alabama at Birmingham. He has studied neuroplasticity since the 1970s. "Every part of the brain is used. The more you use a function, it may be at the expense of another."
As an outgrowth of the early taxi driver studies, U.S. scientists began exploring the effects of employing complicated navigational skills. At Brandeis University in Waltham, Mass., scientists created the virtual taxicab video game to study the way brains work. As subjects play, they become increasingly proficient in navigating complex routes, which researchers believe is tied to building cognitive maps of the environment.
Additionally, German scientists reported in the June 2006 issue of The Journal of Neuroscience that the brains of German medical students, while studying for final exams, showed increases in the posterior hippocampus, similar to the London cabbie study. Three months later, according to MRI imaging, the hippocampus had returned to its former size.
Weblink
Life Expectancy Calculator (www.livingto100.com)
Dr. Perls' brain games (fun.eons.com/brain_games
Any new symptom in an older person should be considered a drug side effect until proven otherwise
They are the drugged-out generation, and they're not who you think they are.
They're 80. And 85 and 90 and 95 – overmedicated seniors clogging emergency departments, blocking hospital beds and sicker than they have any reason to be.
The Number 1 drug users in North America, outside of patients in long-term care facilities, are women over the age of 65. Twelve per cent are on 10 or more meds, sometimes up to 20 or more drugs; 23 per cent take at least five drugs. In long-term care, seniors are on six to eight medications, on average. Fifteen per cent of seniors admitted to hospital are suffering drug side effects. It's not uncommon to find seniors dizzy and dotty from being prescribed so many drugs. "You'd fall down, too, if you were on so many drugs," says Dr. William Dalziel, a prominent Ottawa geriatrician.
Typically, overmedicated seniors have been seen by numerous specialists who have prescribed various medications to treat a host of chronic ailments – high blood pressure, hypertension, diabetes, osteoporosis, arthritis, heart disease, cancer – but there hasn't been any oversight by a geriatrician skilled in looking at the big picture and assessing contra-indications and side effects.
Ask any doctor with expertise in seniors what their top health concerns are and they all cite overmedication.
Dr. Mark Nowacynski, an exceedingly rare family doctor who does home visits on a full-time basis, shakes his head. "So many old people are prescribed so many drugs, they don't know what they're for and they often don't take them properly," he says.
Nowacynski recalls taking care of an old man who was seeing six specialists.
"He was very anxious and confused; the specialists' advice often conflicted. I was astounded at how many meds he was on, more than 20. He wasn't taking them as prescribed and he was suffering from various side effects and interactions that weren't being monitored."
Over time, Nowacynski – or Dr. Mark, as his patients call him – was able to wean his patient down to fewer than 10 drugs.
One of the reasons overmedication is such a serious issue, apart from the biological aspects, is that seniors become vulnerable to serious falls when they're excessively drugged, and serious falls can lead to a downward spiral of hospitalization, extreme fear of going out, isolation and death. As well, many seniors have trouble sleeping; instead of being encouraged to tire themselves out with exercise and activities, they may become habituated to sleeping pills that leave them groggy during the day.
Another problem, says Dr. Paula Rochon, a Baycrest geriatrician, is that doses for older people should often be much lower than for younger people. She notes that Valium is long acting and very sedating and shouldn't be prescribed at all to seniors.
Not only does overmedication cost the health-care system millions of dollars annually in unnecessary, expensive prescriptions but also the entire system slows down – and wait times for other patients lengthen – as emergency departments and hospitals struggle to diagnose drug-related problems.
Doctors and nurses trained in the ailments of old age and alert to the problem of overmedication can resolve many of these issues quite quickly, but most doctors haven't had any significant geriatric training. Stories are legion about elders blocking emergency rooms and being admitted to hospital, with doctors thinking the old people are having heart attacks and ordering expensive tests when the problem is simply overmedication.
In 1995, the Canadian Medical Association Journal found that doctors who wrote the most prescriptions also had the highest death rates among their patients.
"This study found that some doctors, in trying to maximize the number of patients they could process per day, did not take the time necessary to find out what was wrong with these patients," writes David Foot in his bestseller Boom, Bust, Echo. "That kind of medical practice results in overmedicated and inappropriately medicated patients."
According to Dr. Jerry Gurwitz, chief of geriatric medicine at the University of Massachusetts Medical School: "Any new symptom in an older person should be considered a drug side effect until proven otherwise."
At Baycrest, Toronto's health sciences centre focused on geriatric care, Rochon has spent years working with the facility's doctors, researchers and residents in long-term care to find solutions to overmedication.
"When you're dealing with complex conditions (in seniors) and all these drugs, how do doctors make the right choices?" she asks. "It gets complicated for everybody."
Thanks to her efforts, Baycrest has developed software for a computerized physician order entry system. Instead of scrawling, often illegibly, on a prescription pad, doctors sign in to a database and get full access to residents' medical histories and comprehensive pharmacological information, before they order prescriptions.
Baycrest's wireless networks were upgraded and the centre became the first long-term care facility in Canada, and one of the first in North America, to do its drug prescribing electronically.
"At a glance, you can look at the patients' history, get their age, weight, see what other meds they're on, see their medication history, allergies, blood work, other consults," Rochon says. "Everything you need is at your finger tips."
The U.S. Department of Health and Human Services was so impressed that it funded a landmark study to determine Baycrest's effectiveness in reducing adverse drug events in long-term care. The U of M's Gurwitz, who was a principal investigator, stated that Baycrest was "ahead of the curve in adopting health information technology" and "there are few places like Baycrest in all of North America in which to carry out such a study."
Prescribing is now much improved at Baycrest, Rochon says, and "doctors are making better decisions because they've got better information."
Most Toronto hospitals have followed Baycrest's lead and use computerized physician order systems.
The Ontario government has responded to the issue with the MedsCheck program (MedsCheck.ca), in which pharmacists are paid to assess seniors' medications and detect problems. People who have an OHIP card and are taking three or more prescription drugs for a chronic condition are eligible. On presenting their card, they receive a one-on-one, private consultation for up to 30 minutes with a pharmacist, who will make sure they are taking their drugs properly and educate them about possible adverse drug reactions.
"Some over-the-counter medications can interfere with certain health conditions and adversely affect some prescription medications," the MedsCheck website states. Decongestants, for instance, may be taken to relieve cold symptoms, but they can have the effect of raising blood pressure. Vitamin C can reduce the efficacy of chemotherapy.
Still missing, however, is a Canada-wide policy. In 2002, Roy Romanow recommended a National Drug Agency that would include a national program for managing medications to, among other things, monitor prescriptions and adverse drug reactions among seniors.
"The evidence is that new drugs come on the market every few days and in Canada there is no comprehensive process to address their safety, quality and cost-effectiveness," Romanow says. "Health Canada says it does this, but it doesn't, not like the Food and Drug Administration in the United States."
Romanow says a national program would make a huge difference in the daily lives of seniors, the major consumers of drugs in Canada.
Six years since Romanow's prescription, it has yet to be filled.
They're 80. And 85 and 90 and 95 – overmedicated seniors clogging emergency departments, blocking hospital beds and sicker than they have any reason to be.
The Number 1 drug users in North America, outside of patients in long-term care facilities, are women over the age of 65. Twelve per cent are on 10 or more meds, sometimes up to 20 or more drugs; 23 per cent take at least five drugs. In long-term care, seniors are on six to eight medications, on average. Fifteen per cent of seniors admitted to hospital are suffering drug side effects. It's not uncommon to find seniors dizzy and dotty from being prescribed so many drugs. "You'd fall down, too, if you were on so many drugs," says Dr. William Dalziel, a prominent Ottawa geriatrician.
Typically, overmedicated seniors have been seen by numerous specialists who have prescribed various medications to treat a host of chronic ailments – high blood pressure, hypertension, diabetes, osteoporosis, arthritis, heart disease, cancer – but there hasn't been any oversight by a geriatrician skilled in looking at the big picture and assessing contra-indications and side effects.
Ask any doctor with expertise in seniors what their top health concerns are and they all cite overmedication.
Dr. Mark Nowacynski, an exceedingly rare family doctor who does home visits on a full-time basis, shakes his head. "So many old people are prescribed so many drugs, they don't know what they're for and they often don't take them properly," he says.
Nowacynski recalls taking care of an old man who was seeing six specialists.
"He was very anxious and confused; the specialists' advice often conflicted. I was astounded at how many meds he was on, more than 20. He wasn't taking them as prescribed and he was suffering from various side effects and interactions that weren't being monitored."
Over time, Nowacynski – or Dr. Mark, as his patients call him – was able to wean his patient down to fewer than 10 drugs.
One of the reasons overmedication is such a serious issue, apart from the biological aspects, is that seniors become vulnerable to serious falls when they're excessively drugged, and serious falls can lead to a downward spiral of hospitalization, extreme fear of going out, isolation and death. As well, many seniors have trouble sleeping; instead of being encouraged to tire themselves out with exercise and activities, they may become habituated to sleeping pills that leave them groggy during the day.
Another problem, says Dr. Paula Rochon, a Baycrest geriatrician, is that doses for older people should often be much lower than for younger people. She notes that Valium is long acting and very sedating and shouldn't be prescribed at all to seniors.
Not only does overmedication cost the health-care system millions of dollars annually in unnecessary, expensive prescriptions but also the entire system slows down – and wait times for other patients lengthen – as emergency departments and hospitals struggle to diagnose drug-related problems.
Doctors and nurses trained in the ailments of old age and alert to the problem of overmedication can resolve many of these issues quite quickly, but most doctors haven't had any significant geriatric training. Stories are legion about elders blocking emergency rooms and being admitted to hospital, with doctors thinking the old people are having heart attacks and ordering expensive tests when the problem is simply overmedication.
In 1995, the Canadian Medical Association Journal found that doctors who wrote the most prescriptions also had the highest death rates among their patients.
"This study found that some doctors, in trying to maximize the number of patients they could process per day, did not take the time necessary to find out what was wrong with these patients," writes David Foot in his bestseller Boom, Bust, Echo. "That kind of medical practice results in overmedicated and inappropriately medicated patients."
According to Dr. Jerry Gurwitz, chief of geriatric medicine at the University of Massachusetts Medical School: "Any new symptom in an older person should be considered a drug side effect until proven otherwise."
At Baycrest, Toronto's health sciences centre focused on geriatric care, Rochon has spent years working with the facility's doctors, researchers and residents in long-term care to find solutions to overmedication.
"When you're dealing with complex conditions (in seniors) and all these drugs, how do doctors make the right choices?" she asks. "It gets complicated for everybody."
Thanks to her efforts, Baycrest has developed software for a computerized physician order entry system. Instead of scrawling, often illegibly, on a prescription pad, doctors sign in to a database and get full access to residents' medical histories and comprehensive pharmacological information, before they order prescriptions.
Baycrest's wireless networks were upgraded and the centre became the first long-term care facility in Canada, and one of the first in North America, to do its drug prescribing electronically.
"At a glance, you can look at the patients' history, get their age, weight, see what other meds they're on, see their medication history, allergies, blood work, other consults," Rochon says. "Everything you need is at your finger tips."
The U.S. Department of Health and Human Services was so impressed that it funded a landmark study to determine Baycrest's effectiveness in reducing adverse drug events in long-term care. The U of M's Gurwitz, who was a principal investigator, stated that Baycrest was "ahead of the curve in adopting health information technology" and "there are few places like Baycrest in all of North America in which to carry out such a study."
Prescribing is now much improved at Baycrest, Rochon says, and "doctors are making better decisions because they've got better information."
Most Toronto hospitals have followed Baycrest's lead and use computerized physician order systems.
The Ontario government has responded to the issue with the MedsCheck program (MedsCheck.ca), in which pharmacists are paid to assess seniors' medications and detect problems. People who have an OHIP card and are taking three or more prescription drugs for a chronic condition are eligible. On presenting their card, they receive a one-on-one, private consultation for up to 30 minutes with a pharmacist, who will make sure they are taking their drugs properly and educate them about possible adverse drug reactions.
"Some over-the-counter medications can interfere with certain health conditions and adversely affect some prescription medications," the MedsCheck website states. Decongestants, for instance, may be taken to relieve cold symptoms, but they can have the effect of raising blood pressure. Vitamin C can reduce the efficacy of chemotherapy.
Still missing, however, is a Canada-wide policy. In 2002, Roy Romanow recommended a National Drug Agency that would include a national program for managing medications to, among other things, monitor prescriptions and adverse drug reactions among seniors.
"The evidence is that new drugs come on the market every few days and in Canada there is no comprehensive process to address their safety, quality and cost-effectiveness," Romanow says. "Health Canada says it does this, but it doesn't, not like the Food and Drug Administration in the United States."
Romanow says a national program would make a huge difference in the daily lives of seniors, the major consumers of drugs in Canada.
Six years since Romanow's prescription, it has yet to be filled.
Monday, October 13, 2008
Brain Boost Drugs "Growing Trend"
Brain boost drugs 'growing trend'
Increasing numbers of people are using prescription drugs like Ritalin to boost alertness and brain power, say experts.
Up to a fifth of adults, including college students and shift workers, may be using cognitive enhancers, a poll of 1,400 by Nature journal suggests.
Neuropsychologist Professor Barbara Sahakian of Cambridge University said safety evidence is urgently needed.
Experts gather to debate this topic at a meeting in London on Monday evening.
The use of these cognitive enhancing drugs is spreading to younger and younger people. That's a concern Neuropsychologist Professor Barbara Sahakian
Professor Sahakian's own work shows 17% of students in some US universities admit to using the stimulant Ritalin (methylphenidate) - a drug designed to treat hyperactive children - to maximise their learning power.
One in five of the 1,400 people who responded to the Nature survey said they had taken Ritalin, Provigil (modafinil) or beta-blockers for non-medical reasons. They used them to stimulate focus, concentration or memory.
Of that one in five, 62% had taken Ritalin and 44% Provigil - a drug normally prescribed to alleviating daytime tiredness in people suffering from the rare sleep disorder narcolepsy.
Unchecked
Most users had somehow obtained their drugs on prescription or else bought them over the internet.
Although these are only snapshots of use, Professor Sahakian says it does suggest these drugs are becoming more popular.
Professor Sahakian said given the increasing use of these drugs outside of their intended clinical setting, safety trials were urgently needed.
"We do not really have long-term efficacy and safety data in healthy people. These are studies that really need to be done.
"The use of these cognitive enhancing drugs is spreading to younger and younger people. That's a concern.
"Methylphenidate does have substantial abusive potential so we have to be worried about substance abuse problems and the use of these drugs in the developing brain in children."
John Harris, professor of bioethics at the University of Manchester said people should be allowed to make their own minds up about these drugs.
He said: "If these cognitive enhancing drugs make our lives better and make us better able to concentrate and better able to perform, this would surely be a good thing."
The debate will be heard at Kings Place, London
Increasing numbers of people are using prescription drugs like Ritalin to boost alertness and brain power, say experts.
Up to a fifth of adults, including college students and shift workers, may be using cognitive enhancers, a poll of 1,400 by Nature journal suggests.
Neuropsychologist Professor Barbara Sahakian of Cambridge University said safety evidence is urgently needed.
Experts gather to debate this topic at a meeting in London on Monday evening.
The use of these cognitive enhancing drugs is spreading to younger and younger people. That's a concern Neuropsychologist Professor Barbara Sahakian
Professor Sahakian's own work shows 17% of students in some US universities admit to using the stimulant Ritalin (methylphenidate) - a drug designed to treat hyperactive children - to maximise their learning power.
One in five of the 1,400 people who responded to the Nature survey said they had taken Ritalin, Provigil (modafinil) or beta-blockers for non-medical reasons. They used them to stimulate focus, concentration or memory.
Of that one in five, 62% had taken Ritalin and 44% Provigil - a drug normally prescribed to alleviating daytime tiredness in people suffering from the rare sleep disorder narcolepsy.
Unchecked
Most users had somehow obtained their drugs on prescription or else bought them over the internet.
Although these are only snapshots of use, Professor Sahakian says it does suggest these drugs are becoming more popular.
Professor Sahakian said given the increasing use of these drugs outside of their intended clinical setting, safety trials were urgently needed.
"We do not really have long-term efficacy and safety data in healthy people. These are studies that really need to be done.
"The use of these cognitive enhancing drugs is spreading to younger and younger people. That's a concern.
"Methylphenidate does have substantial abusive potential so we have to be worried about substance abuse problems and the use of these drugs in the developing brain in children."
John Harris, professor of bioethics at the University of Manchester said people should be allowed to make their own minds up about these drugs.
He said: "If these cognitive enhancing drugs make our lives better and make us better able to concentrate and better able to perform, this would surely be a good thing."
The debate will be heard at Kings Place, London
Thursday, October 9, 2008
Musicians Use Both Sides of the Brain Than Nonmusicians: Divergent Thinking
Supporting what many of us who are not musically talented have oftenfelt, new research reveals that trained musicians really do thinkdifferently than the rest of us. Vanderbilt University psychologistshave found that professionally trained musicians more effectively use acreative technique called divergent thinking, and also use both the leftand the right sides of their frontal cortex more heavily than theaverage person.The research by Crystal Gibson, Bradley Folley and Sohee Park iscurrently in press at the journal Brain and Cognition."We were interested in how individuals who are naturally creative lookat problems that are best solved by thinking 'out of the box'," Folleysaid. "We studied musicians because creative thinking is part of theirdaily experience, and we found that there were qualitative differencesin the types of answers they gave to problems and in their associatedbrain activity."
One possible explanation the researchers offer for the musicians'elevated use of both brain hemispheres is that many musicians must beable to use both hands independently to play their instruments."Musicians may be particularly good at efficiently accessing andintegrating competing information from both hemispheres," Folley said."Instrumental musicians often integrate different melodic lines withboth hands into a single musical piece, and they have to be very good atsimultaneously reading the musical symbols, which are like left-hemisphere-based language, and integrating the written music with theirown interpretation, which has been linked to the right hemisphere."
Previous studies of creativity have focused on divergent thinking, whichis the ability to come up with new solutions to open-ended,multifacetedproblems. Highly creative individuals often display more divergentthinking than their less creative counterparts.
To conduct the study, the researchers recruited 20 classical musicstudents from the Vanderbilt Blair School of Music and 20 non-musiciansfrom a Vanderbilt introductory psychology course. The musicians each hadat least eight years of training. The instruments they played includedthe piano, woodwind, string and percussion instruments. The groups werematched based on age, gender, education, sex, high school grades and SATscores.The researchers conducted two experiments to compare the creativethinking processes of the musicians and the control subjects. In thefirst experiment, the researchers showed the research subjects a varietyof household objects and asked them to make up new functions for them,and also gave them a written word association test. The musicians gavemore correct responses than non-musicians on the word association test,which the researchers believe may be attributed to enhanced verbalability among musicians. The musicians also suggested more novel usesfor the household objects than their non-musical counterparts.In the second experiment, the two groups again were asked to identifynew uses for everyday objects as well as to perform a basic control taskwhile the activity in their prefrontal lobes was monitored using a brainscanning technique called near-infrared spectroscopy, or NIRS. NIRSmeasures changes in blood oxygenation in the cortex while an individualis performing a cognitive task."When we measured subjects' prefrontal cortical activity whilecompleting the alternate uses task, we found that trained musicians hadgreater activity in both sides of their frontal lobes. Because weequated musicians and non-musicians in terms of their performance, thisfinding was not simply due to the musicians inventing more uses; thereseems to be a qualitative difference in how they think about thisinformation," Folley said.The researchers also found that, overall, the musicians had higher IQscores than the non-musicians, supporting recent studies that intensivemusical training is associated with an elevated IQ score.
One possible explanation the researchers offer for the musicians'elevated use of both brain hemispheres is that many musicians must beable to use both hands independently to play their instruments."Musicians may be particularly good at efficiently accessing andintegrating competing information from both hemispheres," Folley said."Instrumental musicians often integrate different melodic lines withboth hands into a single musical piece, and they have to be very good atsimultaneously reading the musical symbols, which are like left-hemisphere-based language, and integrating the written music with theirown interpretation, which has been linked to the right hemisphere."
Previous studies of creativity have focused on divergent thinking, whichis the ability to come up with new solutions to open-ended,multifacetedproblems. Highly creative individuals often display more divergentthinking than their less creative counterparts.
To conduct the study, the researchers recruited 20 classical musicstudents from the Vanderbilt Blair School of Music and 20 non-musiciansfrom a Vanderbilt introductory psychology course. The musicians each hadat least eight years of training. The instruments they played includedthe piano, woodwind, string and percussion instruments. The groups werematched based on age, gender, education, sex, high school grades and SATscores.The researchers conducted two experiments to compare the creativethinking processes of the musicians and the control subjects. In thefirst experiment, the researchers showed the research subjects a varietyof household objects and asked them to make up new functions for them,and also gave them a written word association test. The musicians gavemore correct responses than non-musicians on the word association test,which the researchers believe may be attributed to enhanced verbalability among musicians. The musicians also suggested more novel usesfor the household objects than their non-musical counterparts.In the second experiment, the two groups again were asked to identifynew uses for everyday objects as well as to perform a basic control taskwhile the activity in their prefrontal lobes was monitored using a brainscanning technique called near-infrared spectroscopy, or NIRS. NIRSmeasures changes in blood oxygenation in the cortex while an individualis performing a cognitive task."When we measured subjects' prefrontal cortical activity whilecompleting the alternate uses task, we found that trained musicians hadgreater activity in both sides of their frontal lobes. Because weequated musicians and non-musicians in terms of their performance, thisfinding was not simply due to the musicians inventing more uses; thereseems to be a qualitative difference in how they think about thisinformation," Folley said.The researchers also found that, overall, the musicians had higher IQscores than the non-musicians, supporting recent studies that intensivemusical training is associated with an elevated IQ score.
Tuesday, September 23, 2008
vVeterans with Mild Traumatic Brain Injury Receive Increase in Disability Benefits
WASHINGTON — The government plans to substantially increase disability benefits for veterans with mild traumatic brain injuries, acknowledging for the first time that veterans suffering from this less severe version of the Iraq war's signature wound will struggle to make a living.
"We're saying it's real," said Tom Pamperin, a deputy director for the Department of Veteran Affairs, about the significance of the change to benefits in the regulation the VA plans to publish today. Up to 320,000 troops who served in Iraq and Afghanistan suffered traumatic brain injury, a RAND Corp. study estimated this year. The vast majority of the cases are mild and came from exposure to an explosion, often from a roadside bomb. Most veterans with mild cases recover, Pamperin said, but some are left with permanent problems.
Compensation could reach $600 a month, the VA said. Currently, veterans with symptoms such as headaches, dizziness, sensitivity to light, ringing in the ears and irritability and insomnia collect $117. After it takes effect in 30 days, the new regulation will benefit between 3,500 and 5,000 veterans a year, the department said. It estimated the changes would cost an extra $120 million through 2017.
More than 1.6 million U.S. troops have served in Iraq and Afghanistan. About half of those are now veterans, and slightly less than half of those veterans have sought health care from the VA, records show. In the past year, the department has screened 190,000 of these veterans for brain injury. About 20% showed signs of a brain injury, but only about 5% were confirmed as suffering the wound.
The regulation modifies a 1961 rating schedule for mild brain trauma and brings compensation for this ailment into the 21st Century, said Lonnie Bristow, chairman of an Institute of Medicine committee that studied veterans' benefits.
The old regulation failed to recognize that wounds such as brain injuries from blasts — which do not show up on scans — are only understood by what patients say they are suffering, Bristow said.
"VA has been assessing their injuries based on outdated science," said Sen. Daniel Akaka, D-Hawaii, chairman of the Veterans Affairs Committee.
Veterans groups, such as the Disabled American Veterans, applauded the change. However, they said the estimated numbers of traumatic brain injury cases may prove low, because the science around blast damage to the brain is still new.
Veterans who have suffered the most severe brain injuries will not receive much, if any, extra money because existing regulations provided adequate compensation in serious cases, Pamperin said. Consolidating all brain injury standards into one regulation, he said, will make it easier for veterans to get extra benefits to pay for special circumstances such as being housebound by the injury. USA Today Gregg Zoroya
"We're saying it's real," said Tom Pamperin, a deputy director for the Department of Veteran Affairs, about the significance of the change to benefits in the regulation the VA plans to publish today. Up to 320,000 troops who served in Iraq and Afghanistan suffered traumatic brain injury, a RAND Corp. study estimated this year. The vast majority of the cases are mild and came from exposure to an explosion, often from a roadside bomb. Most veterans with mild cases recover, Pamperin said, but some are left with permanent problems.
Compensation could reach $600 a month, the VA said. Currently, veterans with symptoms such as headaches, dizziness, sensitivity to light, ringing in the ears and irritability and insomnia collect $117. After it takes effect in 30 days, the new regulation will benefit between 3,500 and 5,000 veterans a year, the department said. It estimated the changes would cost an extra $120 million through 2017.
More than 1.6 million U.S. troops have served in Iraq and Afghanistan. About half of those are now veterans, and slightly less than half of those veterans have sought health care from the VA, records show. In the past year, the department has screened 190,000 of these veterans for brain injury. About 20% showed signs of a brain injury, but only about 5% were confirmed as suffering the wound.
The regulation modifies a 1961 rating schedule for mild brain trauma and brings compensation for this ailment into the 21st Century, said Lonnie Bristow, chairman of an Institute of Medicine committee that studied veterans' benefits.
The old regulation failed to recognize that wounds such as brain injuries from blasts — which do not show up on scans — are only understood by what patients say they are suffering, Bristow said.
"VA has been assessing their injuries based on outdated science," said Sen. Daniel Akaka, D-Hawaii, chairman of the Veterans Affairs Committee.
Veterans groups, such as the Disabled American Veterans, applauded the change. However, they said the estimated numbers of traumatic brain injury cases may prove low, because the science around blast damage to the brain is still new.
Veterans who have suffered the most severe brain injuries will not receive much, if any, extra money because existing regulations provided adequate compensation in serious cases, Pamperin said. Consolidating all brain injury standards into one regulation, he said, will make it easier for veterans to get extra benefits to pay for special circumstances such as being housebound by the injury. USA Today Gregg Zoroya
Sunday, August 31, 2008
Even W/Out Dementia Mental Skills Decline Years Before Death
The American Academy of Neurology issued the following announcement:Even without dementia, mental skills decline years before death
A new study shows that older people's mental skills start decliningyears before death, even if they don't have dementia. The study ispublished in the August 27, 2008, online issue of Neurology, the medicaljournal of the American Academy of Neurology."These changes are different and separate from the changes in thinkingskills that occur as people get older," said study author ValgeirThorvaldsson, MSc, of Göteberg University in Sweden. "We foundaccelerated changes in people's mental skills that indicated a terminaldecline phase years before death."The start of the decline is different for various cognitive abilities.Perceptual speed, which measures how quickly people can compare figures,begins declining nearly 15 years before death. Spatial ability startsdeclining nearly eight years before death. And verbal ability startsdeclining about six-and-a-half years before death.
The study involved 288 people with no dementia who were followed fromage 70 to death, with an average age at death of 84. The participants'mental skills were measured up to 12 times over a period of 30 years,and they were evaluated to make sure they had not developed dementia.A number of factors may explain this terminal decline in mental skills,Thorvaldsson said. "Cardiovascular conditions such as heart disease ordementia that is too early to be detected could be factors," he said."Increased health problems and frailty in old age often lead toinactivity, and this lack of exercise and mental stimulation couldaccelerate mental decline."Thorvaldsson noted that verbal abilities declined sharply in theterminal phase and did not decline significantly due to age only. "Thisindicates that people remain stable in their verbal abilities unlessthey are experiencing disease processes that also increase theirmortality risk," he said. "A change in verbal ability might therefore beconsidered a critical marker for degeneration in health in older people."
A new study shows that older people's mental skills start decliningyears before death, even if they don't have dementia. The study ispublished in the August 27, 2008, online issue of Neurology, the medicaljournal of the American Academy of Neurology."These changes are different and separate from the changes in thinkingskills that occur as people get older," said study author ValgeirThorvaldsson, MSc, of Göteberg University in Sweden. "We foundaccelerated changes in people's mental skills that indicated a terminaldecline phase years before death."The start of the decline is different for various cognitive abilities.Perceptual speed, which measures how quickly people can compare figures,begins declining nearly 15 years before death. Spatial ability startsdeclining nearly eight years before death. And verbal ability startsdeclining about six-and-a-half years before death.
The study involved 288 people with no dementia who were followed fromage 70 to death, with an average age at death of 84. The participants'mental skills were measured up to 12 times over a period of 30 years,and they were evaluated to make sure they had not developed dementia.A number of factors may explain this terminal decline in mental skills,Thorvaldsson said. "Cardiovascular conditions such as heart disease ordementia that is too early to be detected could be factors," he said."Increased health problems and frailty in old age often lead toinactivity, and this lack of exercise and mental stimulation couldaccelerate mental decline."Thorvaldsson noted that verbal abilities declined sharply in theterminal phase and did not decline significantly due to age only. "Thisindicates that people remain stable in their verbal abilities unlessthey are experiencing disease processes that also increase theirmortality risk," he said. "A change in verbal ability might therefore beconsidered a critical marker for degeneration in health in older people."
Friday, August 29, 2008
Brains of Stroke Survivors Show Improvement From Exercise
Depending on where in the brain it occurs, a stroke can result in paralysis, difficulties with breathing, swallowing, walking and balance, or problems understanding language.
People who have suffered a stroke may benefit from walking on a treadmill years after the brain injury, according to researchers who saw signs of the brain healing itself.
The results, published in Monday's issue of the journal Stroke: Journal of the American Heart Association, suggest the brain retains the capacity to rewire itself when exercised months or years after conventional physical therapy ends.
"This is great news for stroke survivors because results clearly demonstrate that long-term stroke damage is not immutable and that with exercise it's never too late for the brain and body to recover," said Dr. Daniel Hanley, a neurology professor at the Johns Hopkins University School of Medicine in Baltimore, who helped lead the study.
A stroke is a brain injury caused by a lack of blood. It happens to 50,000 Canadians each year.
Depending on where in the brain it occurs, a stroke can result in paralysis, difficulty breathing, swallowing, walking and keeping one's balance, or problems understanding language, among other symptoms.
'Many stroke survivors believe there's nothing to be gained from further rehabilitation, but our results suggest that health and functional benefits from walking on a treadmill can occur even decades out from stroke.'— Dr. Richard Macko
The study involved 71 people with an average of 63. They all had had a stroke at least six months
before the study began, and on average, it happened four years earlier. When the study started, half of the subjects could walk without assistance, while the others used a cane, walker or a wheelchair.
Regardless of disability, half of the participants walked on a treadmill for 40 minutes three times a week for six months, while the rest did stretching exercises for the same time. Those who were physically impaired because of the stroke used supporting slings or tethers to help them complete the exercises.
Changes in brain activity
Physical therapists increased the intensity of the workouts over time by increasing the speed and incline on the treadmill, although their aerobic capacity was never taxed beyond recommended levels.
The researchers used functional magnetic resonance imaging on 32 subjects chosen equally from both groups to look for possible changes in brain activity during the study.
The scans showed increased activity in the brainstem areas associated with walking in the treadmill group, while no changes were seen in the stretching group.
"This suggests that the brain is responsible for the improvement we saw in patients' walking ability," said study author Dr. Andreas Luft, a professor of neurorehabilitation at the University of Zurich in Switzerland.
"It seems to be recruiting other regions to take on the job of areas damaged by stroke."
Among the treadmill walkers, walking speed improved by 51 per cent compared with 11 per cent among the stretchers. The treadmill walkers also improved their mobility and aerobic fitness by about 18 per cent, while no change was seen in the stretching group, the researchers said.
Most stroke rehabilitation programs focus on short-term improvements and end a few months after someone has had a stroke.
"Many stroke survivors believe there's nothing to be gained from further rehabilitation, but our results suggest that health and functional benefits from walking on a treadmill can occur even decades out from stroke," said Dr. Richard Macko, a professor of neurology at the University of Maryland School of Medicine who also helped lead the study.
People who have suffered a stroke may benefit from walking on a treadmill years after the brain injury, according to researchers who saw signs of the brain healing itself.
The results, published in Monday's issue of the journal Stroke: Journal of the American Heart Association, suggest the brain retains the capacity to rewire itself when exercised months or years after conventional physical therapy ends.
"This is great news for stroke survivors because results clearly demonstrate that long-term stroke damage is not immutable and that with exercise it's never too late for the brain and body to recover," said Dr. Daniel Hanley, a neurology professor at the Johns Hopkins University School of Medicine in Baltimore, who helped lead the study.
A stroke is a brain injury caused by a lack of blood. It happens to 50,000 Canadians each year.
Depending on where in the brain it occurs, a stroke can result in paralysis, difficulty breathing, swallowing, walking and keeping one's balance, or problems understanding language, among other symptoms.
'Many stroke survivors believe there's nothing to be gained from further rehabilitation, but our results suggest that health and functional benefits from walking on a treadmill can occur even decades out from stroke.'— Dr. Richard Macko
The study involved 71 people with an average of 63. They all had had a stroke at least six months
before the study began, and on average, it happened four years earlier. When the study started, half of the subjects could walk without assistance, while the others used a cane, walker or a wheelchair.
Regardless of disability, half of the participants walked on a treadmill for 40 minutes three times a week for six months, while the rest did stretching exercises for the same time. Those who were physically impaired because of the stroke used supporting slings or tethers to help them complete the exercises.
Changes in brain activity
Physical therapists increased the intensity of the workouts over time by increasing the speed and incline on the treadmill, although their aerobic capacity was never taxed beyond recommended levels.
The researchers used functional magnetic resonance imaging on 32 subjects chosen equally from both groups to look for possible changes in brain activity during the study.
The scans showed increased activity in the brainstem areas associated with walking in the treadmill group, while no changes were seen in the stretching group.
"This suggests that the brain is responsible for the improvement we saw in patients' walking ability," said study author Dr. Andreas Luft, a professor of neurorehabilitation at the University of Zurich in Switzerland.
"It seems to be recruiting other regions to take on the job of areas damaged by stroke."
Among the treadmill walkers, walking speed improved by 51 per cent compared with 11 per cent among the stretchers. The treadmill walkers also improved their mobility and aerobic fitness by about 18 per cent, while no change was seen in the stretching group, the researchers said.
Most stroke rehabilitation programs focus on short-term improvements and end a few months after someone has had a stroke.
"Many stroke survivors believe there's nothing to be gained from further rehabilitation, but our results suggest that health and functional benefits from walking on a treadmill can occur even decades out from stroke," said Dr. Richard Macko, a professor of neurology at the University of Maryland School of Medicine who also helped lead the study.
Thursday, July 10, 2008
How Foods Affect Brain Health, Cognitive Functions; Omega-3, Folic acid, Curcumin
The University of California, Los Angeles, issued the following news release: Scientists learn how food affects the brain. In addition to helping protect us from heart disease and cancer, a balanced diet and regular exercise can also protect the brain and ward off mental disorders.” Food is like a pharmaceutical compound that affects the brain," said Fernando Gomez-Pinilla, a UCLA professor of neurosurgery and physiological science who has spent years studying the effects of food, exercise and sleep on the brain. "Diet, exercise and sleep have the potential to alter our brain health and mental function. This raises the exciting possibility that changes in diet are a viable strategy for enhancing cognitive abilities, protecting the brain from damage and counteracting the effects of aging."Gomez-Pinilla analyzed more than 160 studies about food's affect on the brain; the results of his analysis appear in the July issue of the journal Nature Reviews Neuroscience and are available online atwww.nature.com/nrn/journal/v9/n7/abs/nrn2421.html.Omega-3 fatty acids -- found in salmon, walnuts and kiwi fruit -- provide many benefits, including improving learning and memory and helping tonight against such mental disorders as depression and mood disorders, schizophrenia, and dementia, said Gomez-Pinilla, a member of UCLA'sBrain Research Institute and Brain Injury Research Center. Synapses in the brain connect neurons and provide critical functions; much learning and memory occurs at the synapses, Gomez-Pinilla said."Omega-3 fatty acids support synaptic plasticity and seem to positively affect the expression of several molecules related to learning and memory that are found on synapses," Gomez-Pinilla said. "Omega-3 fatty acids are essential for normal brain function.” Dietary deficiency of omega-3 fatty acids in humans has been associated with increased risk of several mental disorders, including attention-deficit disorder, dyslexia, dementia, depression, bipolar disorder and schizophrenia," he said. "A deficiency of omega-3 fatty acids in rodents results in impaired learning and memory.” Children who had increased amounts of omega-3 fatty acids performed better in school, in reading and in spelling and had fewer behavioral problems, he said. Preliminary results from a study in England show that school performance improved among a group of students receiving omega-3 fatty acids. In an Australian study, 396 children between the ages 6 and 12 who were given drink with omega-3 fatty acids and other nutrients (iron, zinc, folic acid and vitamins A, B6, B12 and C) showed higher scores on tests measuring verbal intelligence and learning and memory after six months and one year than a control group of students who did not receive the nutritional drink. This study was also conducted with 394 children in Indonesia. The results showed higher test scores for boys and girls in Australia, but only for girls in Indonesia. Getting omega-3 fatty acids from food rather than from capsule supplements can be more beneficial, providing additional nutrients,Gomez-Pinilla said. Scientists are learning which omega-3 fatty acids seem to be especially important. One is docosahexaenoic acid, or DHA, which is abundant in salmon. DHA, which reduces oxidative stress and enhances synaptic plasticity and learning and memory, is the most abundant omega-3 fatty acid in cell membranes in the brain.” The brain and the body are deficient in the machinery to make DHA; ithas to come through our diet," said Gomez-Pinilla, who was born and raised in salmon-rich Chile and eats salmon three times a week, along with a balanced diet. "Omega-3 fatty acids are essential.” A healthy diet and exercise can also reduce the effect of brain injury and lead to a better recovery, he said. Recent research also supports the hypothesis that health can be passed down through generations, and a number of innovative studies point to the possibility that the effects of diet on mental health can be transmitted across generations, Gomez-Pinilla said. A long-term study that included more than 100 years of birth, death, health and genealogical records for 300 Swedish families in an isolated village showed that an individual's risk for diabetes and early death increased if his or her paternal grandparents grew up in times of food abundance rather than food shortage.” Evidence indicates that what you eat can affect your grandchildren’s brain molecules and synapses," Gomez-Pinilla said. "We are trying to find the molecular basis to explain this.” Controlled meal-skipping or intermittent caloric restriction might provide health benefits, he said. Excess calories can reduce the flexibility of synapses and increase the vulnerability of cells to damage by causing the formation of free radicals. Moderate caloric restriction could protect the brain by reducing oxidative damage to cellular proteins, lipids and nucleic acids, Gomez-Pinilla said. The brain is highly susceptible to oxidative damage. Blueberries have been shown to have a strong antioxidant capacity, he noted. In contrast to the healthy effects of diets that are rich in omega-3fatty acids, diets high in trans fats and saturated fats adversely affect cognition, studies indicate. Junk food and fast food negatively affect the brain's synapses, saidGomez-Pinilla, which eats fast food less often since conducting this research. Brain synapses and several molecules related to learning and memory is adversely affected by unhealthy diets, he said. Emerging research indicates that the effects of diet on the brain, combined with the effects of exercise and a good night's sleep, can strengthen synapses and provide other cognitive benefits, he added. In Okinawa, an island in Japan where people frequently eat fish and exercise, the lifespan is one of the world's longest, and the population has a very low rate of mental disorders, Gomez-Pinilla noted. Folic acid is found in various foods, including spinach, orange juice and yeast. Adequate levels of folic acid are essential for brain function, and foliate deficiency can lead to neurological disorders such as depression and cognitive impairment. Foliate supplementation, either by itself or in conjunction with other B vitamins, has been shown to be effective in preventing cognitive decline and dementia during aging and enhancing the effects of antidepressants. The results of a recent randomized clinical trial indicate that a three-year folic acid supplementation can help reduce the age-related decline in cognitive function. In patients with major depression and schizophrenia, levels of signaling molecule known as brain-derived neurotrophic factor, or BDNF, are reduced. Antidepressants elevate BDNF levels, and most treatments for depression and schizophrenia stimulate BDNF. Here, too, omega-3fatty acids are beneficial, as is the curry spice curcumin, which has-been shown to reduce memory deficits in animal models of Alzheimer’s disease and brain trauma. BDNF is most abundant in the hippocampus and the hypothalamus -- brain areas associated with cognitive and metabolic regulation. The high consumption of curcumin in India may contribute to the low prevalence of Alzheimer's disease on the subcontinent. In humans, a mutation in a BDNF receptor has been linked to obesity and impairments in learning and memory."BDNF is reduced in the hippocampus, in various cortical areas and in the serum of patients with schizophrenia," Gomez-Pinilla said. "BDNFlevels are reduced in the plasma of patients with major depression.” Smaller food portions with the appropriate nutrients seem to be beneficial for the brain's molecules, such as BDNF, he said. Gomez-Pinilla showed in 1995 that exercise could have an effect on the brain by elevating levels of BDNF. He noted that while some people have extremely good genes, most of us are not so lucky and need a balanced diet, regular exercise and a goodnight's sleep. The National Institutes of Health’s National Institute of Neurological Disorders and Stroke funded the research
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