Sunday, January 31, 2010

Deep brain stimulation treats depression

US medical researchers say they are studying the use of deep brain stimulation to offer hope to people suffering from a variety of disorders.

The technique can ease symptoms of depression, epilepsy, obsessive-compulsive disorder, headaches, chronic pain and stroke that have not responded well to other treatments, according to new and increasing research.

"Deep brain stimulation" - a surgical process that uses implanted electrodes to stimulate specific parts of the brain affected by a disorder - has already improved the lives of tens of thousands of people with motor disorders, including Parkinson's disease and tremors. The FDA approved the treatment for these conditions several years ago.

“The brain controls the body, so if you can control the brain then you can control the body,” said Dr. Roy Bakay, professor of neurosurgery at the Rush University Medical Center in Chicago. Bakay was one of about 60 researchers involved in the first large, randomized Deep Brain Stimulation (DBS) study on epilepsy. "The very promising results are being published in a medical journal later this year," Bakay added.

“Participants in the study who received deep brain stimulation showed a significant reduction in seizures,” Bakay said. All of the participants suffered from refractory epilepsy, a form of the condition that does not respond well to anti-seizure medications. The treatment targeted the brain's anterior thalamus, part of a limbic circuit that incorporates a lot of epileptic processes.

The two medical device companies behind the deep brain stimulation technology - Medtronic, Inc., and St. Jude Medical, Inc. - fund a large percentage of multiple ongoing DBS studies.

Further research is necessary before DBS could be considered a clinically useful treatment for treatment-resistant depression. There are also important ethical considerations, since DBS treatment first requires potentially risky brain surgery.

Mind aerobics: 'You have to keep your brain in tune with your body'

Every Thursday at 3 p.m., 10 to 15 of The Oaks residents get together in their recreation room to practice “Mind Aerobics.” What is that?

It’s exercising your brain for things you can’t remember, a quote you heard on TV, the time you’re due at a meeting and so forth.

“It stretches your creative thinking,” Linda Biswell, director of The Oaks Campus Life, says. She learned about the course through her work, then studied more available material and set up the class.

Last week, as soon as the 12 women and three men had gathered around two big tables pulled together, Linda got things started: “Alright, exercise one. Let’s do our breathing. Keep in mind that of every breath we take, 20 percent of the oxygen goes to our brains and warms them up. We’ll breathe in for four counts, hold it for seven, then breathe out for eight counts and repeat four times.”

The men and women silently followed her lead. After the last exhale, they mumbled reactions among themselves.

Your name; fruit or veggie

Linda moved immediately into the first exercise, a true brain activator requiring quick-fire answers.

“As your turn comes, each of you will call out your first name, then the name of a food that starts with the same letter. For instance, I’ll call ‘Linda Lettuce.’ Then, Eileen Milberg, here on my right, will give her first name and a food, also both names every person before her has spoken. It helps if you repeat them silently as we move along.”

“I’ll never remember a single one,” several people said. Linda started with her name, then Eileen added “Eileen Egg.” Then came “Sarah Salad” (last name, Symmes). The next lady hesitated a moment before adding, “Doris Dark Chocolate” (Bonnette).

Giggles started all around the table. Next, when a man hesitated trying to recall the first three, then blurted out, “Sam Squash” (Wood), laughter broke out. They laughed harder upon hearing “Barbara Baloney” (Mitchum), followed by “Judy Jello” (Shroads) and “Doreeta Doughnuts” (Pigott).

“Wouldn’t kids love this game?” someone commented, then laughed out again at the call of “Yolanda Yam.”

The group next moved into a crossword puzzle in which every square already had one letter.

”Study it and find the name of a famous person,” Linda explained.

The contestants worked silently except for mumbles.

“I’ve already got a Bruce and a Helen. Could that be Helen of Troy?” someone asked.

“I can’t find any last names, either,” another complained.

“It has to be the first and the last name,” the leader said firmly.

Five more minutes of trials and errors passed before three came up with Mary Pickford at the same time.

“Wrong,” they were told. “It isn’t spelled ‘Mary Pickboard.’”

Two minutes later, someone called out, “Merryl Streep,” and the contest ended.

Doodle Contest
Linda, who didn’t let any one of these exercises last more than 10 minutes, moved immediately to one of the favorites, the “Doodle Contest.” Passing out sheets of paper and pens, she instructed them to make a “doodle,” anything round, square – but no more than half finished. They did, then passed their sheets to the person next to them, who was told to draw the doodle into “something recognizable, anything at all.”

When finished, they held up their art to interpret.

“I got a girl with hands, so I drew on big thumbs,” said one lady artist.

The man next to her said, “I got a dog, so I added a dog house.”

Another noted, “I had an outline of what looked like a sick man, so I put him in a cowboy suit and drew a horse under his legs.”

For the last puzzle, Linda handed out a crossword and gave them only five minutes. Only one player solved it all. Then Linda distributed their homework for next week.

“There won’t be any excuse for not finishing and bringing this back,” she announced. “Study the three slots, two syllables each, and try to write one in the little center circle and link the other syllables to the front and back to form words.”

A full room of lively conversation accompanied the departure. Marian Youorski, director of wellness who had sat in on the class, said, “These mental exercises are a perfect companion to our physical strength training, which includes walking and swimming. To attain the best of health, you have to keep your brain in tune with your body.”

Obviously, the puzzle participants agre

New brain scan better at detecting early Alzheimers

WASHINGTON (AFP) -– A new kind of brain scan seems to be better at detecting early signs of change related to the onset of Alzheimer's disease.

The scan, called diffusion tensor imaging (DTI), could prove important to earlier detection and in turn better treatment.

“As better medicines for Alzheimer's disease become available, it will be important to identify people at high risk for the disease as early and accurately as possible so treatment can be most effective,” said Norbert Schuff of the University of California San Francisco, who wrote an editorial about the study.

The DTI-MRI, more sensitive than traditional MRI for detecting changes in brain chemistry, allows for mapping fiber tracts that connect brain regions.

Researchers looked at 67 healthy people in Rome aged 20-80.

“Our findings show this type of brain scan appears to be a better way to measure how healthy the brain is in people who are experiencing memory loss. This might help doctors when trying to differentiate between normal aging and diseases like Alzheimer's,” said author Giovanni Carlesimo, PhD, with Tor Vergata University in Rome.

“DTI, along with MRI, could serve as an important tool in understanding how and why a person experiences memory decline,” he added

An estimated 37 million people worldwide, including 5.3 million in the United States, live with dementia, with Alzheimer's disease causing the majority of cases, according to the World Health Organization (WHO).

With the aging of populations, this figure is projected to increase rapidly over the next 20 years.

Can Certain Foods 'Arouse' Your Brain?

Wendy Wessler, who is divorced and lives on New York's Long Island, lost 150 pounds after gastric bypass surgery, but the weight is creeping back. She says she just can't understand why she can't say no to food.

The ingredients in some fast food could trick the brain into overeating."If I am upset or I am really stressed out, I just think I am going to get home to get a bag of chips," Wessler told "Good Morning America." "I just keep telling myself I should know better. I should be stronger, just as a person [says], 'You are intelligent, you shouldn't be doing this. This is not grown up behavior. This is child behavior."

Contrary to her opinion, Wessler's behavior is fairly common among adults, affecting an estimated 70 million Americans, according to former FDA commissioner Dr. David Kessler. Kessler too has struggled throughout his life with food compulsion.

In Kessler's new book, "The End of Overeating," he describes how the part of the brain the amygdale, which is the area of the brain that controls our desires, can affect overeating.

Let's unlock secrets of the brain

Bangalore: By the end of 2010, over 100 million people in India will be over 60 years of age. They would be vulnerable to a host of ailments including brain disorders.

There is an urgent need for research to understand causes, prevention and cure. Padma Shri awardee Vijayalakshmi Ravindranath, head of the Centre for Neurosciences, Indian Institute of Science talks about initiatives that are imperative to improving mental health care.

Women scientists and awards
It’s very rare for women scientists to be honoured. There are a lot of doubts about whether women have the energy and ability to head important institutions and departments of science. But it is possible if you are a hard worker and persevere. The problems before women scientists are the same all over the world as science is very demanding. There are bound to be differences between problems men and women face. The two are different nature and the way they think is also not alike.

Brain research needs attention
One third of the diseases in this world are caused by brain disorders. Most disorders don’t have any cure. We only give symptomatic relief without curing the disorder. This is true in the case of depression, schizophrenia, Alzheimer’s, Parkinson’s and similar disorders that carry social stigma. The burden of brain disorders is enormous. But what’s worse is that our health policies don’t give them enough importance. That’s the reason I’m deeply concerned about brain disorders. In India, a large number of children have autism and other developmental disabilities; adults suffer from epilepsy. There are also a host of disorders that affect us as we grow older. So, from birth to death, brain disorders contribute a lot to our uneasiness. There is such a great need to understand why these diseases are caused and what can we do to prevent and cure them. However, there’s not much public awareness on brain disorders. We need people to show more interest in brain research; funding should facilitate the same.

Sowing seeds of interest
As part of our efforts to get students interested in science, we conduct summer training programmes that are attended by thousands of students. We also do a brain awareness week for students and lay-people. Students are amazed when we talk about the brain and its abilities. Many of them come up to us at the end of the session and say that they genuinely have an interest to pursue science as their career. Scientists like us are always inspired by young people.

Training teachers is important
Today, science is progressing rapidly. Even we at the IISc have a tough time keeping abreast with it despite having cutting edge technology at our disposal. And if it’s hard for us, one can imagine how difficult it must be for a college teacher to upgrade lessons. Hence, giving them continuing-education courses helps a great deal. Even though science academies in the country are doing their best, much more has to be done. The country would require at least 7,000 university science teachers in the coming future; the biggest question we ask ourselves everyday is where are those people are going to come from? One solution would be to get back Indian scientists and professionals from abroad and another would be rapidly building capacity. That is difficult because it takes a good decade to build capacity.

More old-age homes
In India, by the end of 2010, there are going to be 100 million people over the age of 60. Lifespan has considerably increased and quite understandably, there will be a definite percentage of them who will develop neuro-degenerative disorders like Parkinson’s and Alzheimers. It’s a pretty disturbing scenario because on the one hand, people are living longer and on the other, the joint-family system has disintegrated. Soon, it’ll be old couples living alone. And there’s not going to be any kind of private or public healthcare for these people. Their disorders are incurable and there’s lack of numbers in terms of physicians, home-stays and day-care centres. Families will not be able to keep their parents at home, how much ever they love them because they will be too sick to be treated at home. Today, we have hospitals and homes, but no nursing homes to take ‘long-term care’ of these people.

Parental pressure should ease up
Parents look at only one thing — how quickly the child can earn a lot of money and how they can become financially secure. Even Homi Baba’s dad wanted him to become an engineer but he had to fight it and do what he wanted. Parents put undue pressure on their children and carry unlimited expectations from them. Parental love is unconditional: you have to love your child for what he is and not what you want him to become. As economic situations improve, I think that more parents will be open to the idea of letting their kids nurture their interests. They will perhaps realise that it’s important for children to be happy rather than successful.

Let’s course-correct
Initiatives in the field of science have taken off successfully. Funding for many projects has tripled in the last seven years. Even funding for educational institutions has gone up great deal. And so far, the path has been smooth. One has to understand that it is hard to implement things. As long as we have the good sense to course-correct and move ahead with lesser mistakes, it’s going to be successful.