Monday, May 31, 2010

Empathy is What Really Sets Vegetarians Apart (at least Neurologically Speaking)

Empathy Really Sets Vegetarians Apart (at least Neurologically Speaking) 
An article appeared in PLoS one this last month which describes brain differences between Vegetarians, Vegans and Omnivores in the way they process pictures of animal suffering.
I was originally planning to write about this only later this week (so that you'd have time to read my Harry Potter and Superstition Post), but since the always well-read Scientific Fundamentalist has a related post out at the moment, I figured I'd "jump on the bandwagon" with this right away. So here we go:
The study in question is a neuroimaging study intent on investigating whether
Cute Baby Rabbit Animal
"the neural representation of conditions of abuse and suffering might be different among subjects who made different feeding choice due to ethical reasons, and thus result in the engagement of different components of the brain networks associated with empathy and social cognition"

Please don't eat me...?!
The hypothesis behind this study is based on the observation that Vegetarians and Vegans tend to base their decision of avoiding animal products on ethical grounds. Assuming that Vegetarians and Vegans - because of their underlying moral philosophies - show greater empathy towards animal suffering, it is very well possible that these differences in empathy extend beyond the animal domain and show up - neurologically - as general differences in the degree of empathy felt towards others.The study - in basic terms - investigates this hypothesis by placing subjects into a functional Magnetic Resonance Imaging (fMRI) machine and looking at the "activation" of different brain areas as subjects viewed a randomized series of pictures. Pictures included neutral scenes and an even share of scenes depicting animal or human suffering.
The first main finding from this study was that Vegans and Vegetarians showed higher activation of empathy related brain areas (e.g. Anterior Cingular Cortex and left Inferior Frontal Gyrus) while observing scenes of suffering than did Ominvores.
Further, pictures of animal suffering (in contrast to human suffering) recruited brain regions in Vegans and Vegetarians that were not differentially recruited by Omnivores. These were areas which are thought to be associated with higher-order representations of the self and self values (e.g. medial Prefrontal Cortex).
baby cute kitten cat duck animal
don't worry, i won't let them eat you
In addition to these generally higher activations in certain areas, a second main finding of this study was to show that there are certain brain areas which only Vegetarians and Vegans seem to activate when processing pictures of suffering. In particular, when viewing human suffering pictures, Vegetarians recruited additional brain areas thought to be associated with bodily representations that distinguish self from others, and these areas were particularly active when mutilations were shown.The study has its own shortcomings, and I am somewhat breaking one of my own rules here by presenting fMRI related research without a thorough discussion of the statistics involved, however I feel vindicated by the fact that the authors themselves remain moderate in their conclusions by stating that
"Our results converge with theories that consider empathy as accommodating a shared representation of emotions and sensations between individuals, allowing us to understand others. They also led us to speculate that the neuronal bases of empathy involve several distinct components including mirroring mechanisms, as well as emotion contagion and representations of connectedness with the self. In addition, brain areas similar to those showing different emotional responses between groups in our study have also been found to be modulated by religiosity, further supporting a key role of affect and empathy in moral reasoning and social values." [italics added].
cute baby cow animal
and what about muh?
Whatever the case, showing that Vegetarians are possibly more empathetic to the suffering of others is much less interesting to me than simply exploiting another opportunity of pointing out the shear ridiculousness of current meat eating (and production) practices. Besides the well-documented health benefits of a Vegetarian diet, current rates of meat consumption are clearly incompatible with for our own long-term survival as a species. Hence, vegetarianism might be much more of an act of compassion to yourself than it is towards others.

Our brainless obsession with categorisation

Andy HadenTwo high profile news stories caught my eye last week. First, radio station The Edge's "Hug a Ginga Day" and then World Cup ambassador Andy Haden's "darkies" comment. Both have fuelled debates in the media, as well as the lounges and lunch rooms of the nation. The arguments ranged from accusations of racism and even terrorist intent, to justifications of harmless fun and political correctness. Mitigations have come thick and fast: the use of similar terms like "honky" for Europeans and the commonplace acceptance of blonde jokes make ginga-hugging and darkie-calling okay. 

I'm not going to wade into the dialectic exercise of deciding whether either were right or wrong — to be frank, I think both debates are trivial in the scheme of things. What interests me is that both issues exemplified our obsession with characterising ourselves and each other visually and, specifically, by reference to colour.
"Ginga" – red hair. "Darkie" – brown skin. Why the fuss?
Let's blame the reptilian brain — the least sophisticated part of what American physician and neuroscientist Paul D. MacLean calls our triune (three-part) brain. This most ancient part connects us to dinosaurs, reptiles and birds, is responsible for instinctual behaviours such as aggression, dominance and territoriality. According to British author, researcher and speaker David Icke, it responds to "partial representations" like colour and strangeness. Racism, among other forms of discrimination, is reptilian.
The two more evolved parts of the brain are the limbic system and neocortex. The limbic system governs motivation and emotion responsible for feeding, reproductive and parental behaviour. The neocortex, found only in mammals and most evolved in humans, produces language, abstraction, planning, and perception. People choose not to – or simply are unable to – engage these cerebral systems.
So when a radio host, sports ambassador or any other half-intelligent person decides to design promotional days around hair colour or makes throwaway comments about sportspeople based on the colour of their skin, I don't think they are necessarily being discriminatory or meaning to be offensive. They are just being lazy. 
They could think more complexly, but they are choosing not to because it's easier not to. They are using the most basic part of their brain to appeal to the lowest common denominator. The result is aggressive, dominant and territorial – and they risk hurting people in the process.
At best it's irritating and boring – at worst it's bad behaviour – and I think it should stop. But it won't until we grow up – or more to the point, grow into our brains.

Future of Computing may Lie in Organic Molecules

Researchers model a processor on how the brain works, taking their blueprints from observations of nature
Some of us may swear our computers have a personality, but we know they're not really alive. But a future generation of computing devices may, in fact, have organic components.

Some efforts to develop the future of computing range from photonics to spintronics-based computing, or even utilizing Cell microprocessors which can reportedly clock from 4 to 4.6 GHz with no problem. Now, a group of researchers from the U.S. and Japan have built a parallel computer made from organic molecules. In the years to come, your processors might be more organism than machine!
Seven Key Challenges You Can't Ignore: Download now

The researchers' goal is to build a computer processor that can solve problems with a heavier use of hardware than complex software, because excessive software can add time to the processing. To get closer to their goal they have been trying to mimic the way the human brain acts.

A brain is full of billions of neurons all connected together and working in complex networks to solve problems, often in parallel (more than one task at a time). The brain also has the ability to learn from its memory -- something all computer processors lack. By developing a biological processor, the computer may be able to solve complex problems faster from previously learned knowledge(in memory) and may be able to solve problems faster due to the added benefit of parallel computing like a brain.

To build their "processor" the researchers deposited two layers of 2, 3-dichloro-5, 6-dicyano-p-benzoquinone, also known as DDQ, onto a gold surface. The team then used a scanning tunneling microscope to encode information into the layers of organic material by transmitting electric pulses through it. This creates electric circuits between the molecules that can compute. The team then tested their prototype by successfully simulating phenomenons in nature.

The team hopes to create a truly brain-like computer that will be able to solve a variety of problems just like the human brain, using algae nonetheless. Since silicon-based processors can only get so small(11nm may be the limit), companies like Intel, AMD and IBM will have to take up other horizons-biological computing may be closer than you think!

Changing employee behavior: What managers need to know

When executives and managers are faced with the challenge of trying to change or modify employee behavior and performance, management strategies often encompass new approaches to coaching and motivation. Yet, many of those strategies and approaches may not be grounded in the latest knowledge about human behavior.
Advances in neuroscience now can provide guidance for the development of a new view of mental health/illness that can be translated into practical applications for personal, executive and life coaches as well as managers wishing to engage in coaching activities with their employees.
In a ground breaking article entitled “A New Intellectual Framework for Psychiatry,” Nobel Prize winner Eric Kandel proposed several principles based on neuroscience research. Of these principles, perhaps the most important is that “all mental processes, even the most complex psychological processes, derive from the operation of the brain,” Kandel also suggested that genes do not explain differences in mental illness and that experience and environment have significant influences. Researchers Nydia Cappes, Raquel Andres-Hynan and Larry Davidson of the Yale School of Medicine have proposed 7 principles of brain based psychotherapy that all coaches should become familiar with:
  • Principle 1: Both genetics and the environment interact in the brain to shape the individual. Both nature and nurture are equally capable of modifying brain structures; 
  • Principle 2: Experience transforms the brain. New experiences, creating new neural pathways, can physically change the brain. 
  • Principle 3: Memory systems in the brain are interactive. Memories are not a perfect account of what happened; they can be constructed at the time of retrieval in accordance with the method used to retrieve it. The sense of well-being and the development of personality and emotions are clearly tied to the capacity to store and retrieve information; 
  • Principle 4: Cognitive and emotional processes work in partnership. There can be no knowledge without emotion. Emotional feelings and memories are interactive; 
  • Principle 5: Bonding and attachment provide the foundation of change. The therapeutic relationship between coach and client can have the capacity to help clients modify neural systems and enhance emotional regulation;
  • Principle 6: Imagining activates and stimulates the same brain systems as does real perception; 
  • Principle 7: The brain can process nonverbal and unconscious information. Unconscious processes exert great influence on thought, feelings and actions. It is possible to react to unconscious perceptions without consciously understanding the reaction.
 In the past decade, coaching as a profession has grown significantly to the point of being the second fastest growing profession next to IT. Organizations such as the International Coaching Federation have attempted to establish uniform principles and standards to underpin coaching practices, but coaching remains an unregulated profession with a wide range of training programs and coaching practices. As a trainer of coaches entering the profession or sharpening their skills, or in assisting executives in augmenting their coaching skills, I have been struck by the prevalence of the basic lack of a fundamental understanding of the principles of human behavior and human performance by many. Anyone who is serious about becoming a coach or practicing their coaching skills would be wise to become knowledgeable about the most recent developments in neuroscience, such as the seven principles described above.
Ray B. Williams is Co-Founder of Success IQ University and President of Ray Williams Associates, companies located in Phoenix and Vancouver, providing leadership training, personal growth and executive coaching services.

The Bilingual Brain

At the GCRI Science Dinner and discussion on June 3, 2010, Professors Michael Ullman and Jürgen M. Meisel will share their insights on the physiological differences between learning a second language in youth and adulthood.

People who become bilingual early in life often show better concentration and are less prone to distractions. They also may be better protected against dementia and other age-related cognitive decline. The GCRI Science Dinner will focus on second language acquisition and the role of memory systems in the brain as they relate to first and second language acquirement.

Professor Ullman’s research examines brain bases of first (native) and second (foreign) language, how language and memory are affected in various disorders (e.g., autism, Tourette syndrome, Parkinson’s disease, Alzheimer’s disease), and how factors such as sex (male vs. female), handedness (left vs. right), and genetic variability affect the brain bases of language and memory. The title of his talk is “The Role of Memory Brain Systems in First and Second Language; or, What Rats Can Tell Us About Language.” Ullman teaches in the Department of Neuroscience, with secondary appointments in the Departments of Neurology, Linguistics and Psychology, at Georgetown University.

The title of Professor Meisel’s talk is “Simultaneous and Successive Acquisition of Bilingualism: Age of Onset of Acquisition in Early Childhood.” He is Professor emeritus of Romance Linguistics at the University of Hamburg and Adjunct Professor in the Department of Linguistics at the University of Calgary. One of the founding editors and current co-editor of the journal Bilingualism: Language and Cognition, Meisel’s latest book, “First and Second Language Acquisition: Parallels and Differences,” will be published by Cambridge University Press.

The German Center for Research and Innovation, which opened in February 2010, provides information and support for the realization of cooperative and collaborative projects between North America and Germany with the goal of enhancing communication on the critical challenges of the 21st century. Launched as a cornerstone of the German government’s initiative to internationalize science and research, it is one of five centers worldwide.

Exercise has unexpected beauty benefits

When Professor Harryono Judodihardjo signed up for a charity white collar boxing match he expected to get fit. But he didn’t expect to look and feel younger
Boxing GlovesWHEN Professor Harryono Judodihardjo signed up for a white collar boxing event his main aim was to raise money for children’s cancer charity Latch.
But the nine-week training programme is reaping unexpected benefits – the medical director of the Cellite Clinic, in Cardiff, said he is not only feeling fitter, leaner and more toned, he also looks and feels younger.
“Before I started training, I had hit 40 and was experiencing a drop in energy levels – getting through a hectic work schedule was hard. I’d put the lack of stamina down to the ageing process,” he said.
“Due to work commitments, I had pretty much given up on regular fitness training, and while I wasn’t exactly overweight, I had lost muscle definition and strength.
“When the Latch boxing event was offered to me, it seemed like a fun way of raising money for a worthwhile cause. I certainly wasn’t prepared for the life-enhancing benefits that regular boxing training has brought me.
“It’s no exaggeration to say that I feel 10 years younger and have regained a huge amount of vitality.”
Research has demonstrated that exercise plays an important role in our health and those who exercise live longer on average than those who have a sedentary lifestyle.
But boxing training itself has been shown to have multiple health benefits, including improved cardiovascular function; greater core strength; better balance and co-ordination and weight loss and improved wellbeing.
Simon Harling, of Elite Fitness, organised the white collar charity boxing event and is overseeing Prof Judodihardjo’s training programme.
“Boxing training provides an excellent cardiovascular workout that benefits the entire body, while on a psychological level, mastering a new skill enhances confidence,” he said.
“Boxing training is not just about using the arms, it involves squats, star jumps, press ups and abdominal work. Participants are on their toes the whole time, which helps balance, speed and co-ordination, plus there is the need to remain focused which in turn helps improve concentration.
“Picking up the technique is relatively straightforward as we have a high instructor to pupil ratio, and, as the sessions are carefully monitored, participants will not risk injuring themselves.
“The great thing about having the boxing evening to work towards is that it provides a challenge and a goal.
“However, we firmly believe that fitness needs to become an integral part of life if the benefits are to be maintained.
“Therefore, in order to keep people motivated, we run regular events that help people to keep up their skills levels and fitness.”
While the link between exercise and good health is widely recognised and understood, what is less well known is that exercise has a crucial part to play in the anti-ageing process.
Prof Judodihardjo, who is also the vice president of the British Association of Cosmetic Doctors, said: “As we age our hormone levels decrease – this applies to men and women equally – however exercise has been shown to boost hormone levels helping maintain youthfulness in mind and body.
“Boosting hormone levels can help increase energy levels, improve skin tone and texture, improve immune system function, increase bone density and muscle mass and decrease body fat.”
Exercise has also been shown to build brain health. The Irvine Institute for Brain Aging and Dementia, at the University of California, states: “Human and other animal studies demonstrate that exercise targets many aspects of brain function and has broad effects on overall brain health.
“The benefits of exercise have been best defined for learning and memory, protection from neuro-degeneration and alleviation of depression, particularly in elderly populations.”
Exercise reduces risk factors for a number of potentially lethal diseases, such as diabetes, hypertension and cardiovascular disease.
Prof Judodihardjo added: “It’s never too late to change your habits, and by establishing a healthy lifestyle now, you’ll continue to reap the rewards in the future.
“Furthermore, taking part in some form of exercise gets you out and about and meeting people, and social contact is also a crucial component in our health and happiness.”
The Elite Fitness Fight Club evening in aid of Latch takes place on June 11 at the Marriott Hotel, Cardiff. Call 029 2055 5272 for more information or to sponsor an event

Traumatic Brain Injury: No Longer a Death Sentence?

Two innovative treatments, one involving hormone therapy and the other a popular video game, are offering hope to those suffering from what would have, at one time, been a life-ending or life-altering traumatic brain injury (TBI).

TBIs cause a range of severe physical and mental disorders that can permanently and severely change the lives of both patients and their loved ones. They can cause permanent neurological, muscular and emotional trauma. According to the American Medical Association, recent studies have even proven a conclusive link between TBIs and clinical depression; concussion survivors may become up to eight times more likely to experience severe depression in the future.

Statistics provided by the Centers for Disease Control and Prevention (CDC) state that roughly two million Americans sustain traumatic brain injuries every year -- one every 15 seconds. Fifty thousand of these patients die, and 80,000 of them face long-term disability.

A Natural Cure?
In spite of strides in medical research in the past decades, scientists had not developed any consistently successful treatments for over 30 years. Thankfully, that may change in the near future. The National Institutes of Health is currently undergoing a large-scale, multi-million dollar study of the use of progesterone (a predominantly female hormone that is needed by the female body to stay healthy during pregnancy) to treat and lessen the impact of traumatic brain injuries.

Progesterone, like other neurosteroids, is produced and used in the brain, and is linked to the processes governing cognitive function and memory. The exact science of progesterone in the brain is not entirely understood, but animal studies show that progesterone can aid brain cell development and reduce trauma-related swelling.

The initial NIH study involved 100 patients with TBIs who were all given an IV infusion of progesterone within hours of the injury - there was a direct correlation between this treatment and a dramatic reduction in mortality and disability levels. The expanded follow-up study will involve about 1,100 patients over three years, and the medical community is anxiously awaiting the results.

A High-Tech Approach

Another promising approach to helping TBI patients takes advantage of readily available technology. In a case study of an injured soldier, Kansas State University researchers proved that regular use of Nintendo's Wii Fit video game system can markedly improve balance and aid in long-term neurological rehabilitation. The easy access, relatively low cost and interactivity of the Wii make it a more approachable option than other virtual reality rehabilitation systems.

Veterans of the wars in Iraq and Afghanistan often return from combat with TBIs, some of them undiagnosed in the field. The unique aspect of using the Wii system is that it can not only treat diagnosed conditions these servicemen and women are facing, but, by providing baseline readings that are stored over time, it may help to uncover previously unknown issues and treat them as well.

Many serious accidents and other TBI incidents cannot be prevented, but there is new hope that the most serious impacts can be more effectively treated in the coming years. If you or a loved one is suffering the lasting effects of a TBI, it is a good idea to consult an attorney in your area who has in-depth knowledge of the medical and legal aspects of these injuries.

The Shallows

The subtitle of Nicholas Carr’s The Shallows: What the Internet is Doing to Our Brains leads one to expect a polemic in the tradition of those published in the 1950s about how rock ’n’ roll was corrupting the nation’s youth; or in the 1970s about how television was turning kids into idiots; or in the 1990s about the sociopathology of rap music. But this is no such book. It is a patient and rewarding popularisation of some of the research being done at the frontiers of brain science. Carr has lately found it harder to concentrate on the serious reading he used to love. He is taken aback by the number of smart people who no longer read books. He puts the blame on the mental habits we have all learnt on the internet.
As Carr reminds us, thinkers from Plato to Marshall McLuhan understood that our tools affect our thoughts. The invention of clocks changed our conception of time. Space has looked different since we invented the map. When failing vision forced Friedrich Nietzsche to take up typing instead of writing longhand, his prose style changed radically. Our tools and our skills change us because using them forms new connections in the brain. We have come to understand just how adaptable the brain is. Literate people’s brains look different from those of the illiterate. Scans taken in the 1990s showed that the typical London cab driver – who must acquire and retain “the knowledge” of all the streets in his enormous city – has a dramatically enlarged posterior hippocampus (the part of the brain where such information is stored and used).
This “plasticity”, as neurologists call it, sounds like good news. Discovering the right stimulus or tool might open up some new “circuit” that will allow us to read foreign languages more easily or learn calculus. But changes in our brains can just as easily shunt neurological traffic towards worthless things: an addiction, for instance, or an idiotic video game.
That is more or less what is happening, according to Carr. Books, he says , “are in their cultural twilight”. People spend 30 per cent of their leisure time online. In the early days of the internet, it was natural to think – or hope – that the hours required for this new pursuit would come out of television viewing. That did not happen. TV is holding steady. It is reading that is being pushed out. What is the neurological consequence?
The web strengthens what Carr calls “primitive” mental functions (quick decision-making and problem-solving) over intellectual ones that were associated with reading (language, memory and visual processing). The shift can be measured on brain scans. The internet encourages distraction, interruption, dipping into one thing and sampling another. Through positive reinforcement and interactivity, the net, Carr says, “turns us into lab rats constantly pressing levers to get tiny pellets of social or intellectual nourishment”. Perhaps his most disturbing insight is that this distractibility is closer to the basic animal instincts of humans than to the focused, meditative, lost-to-the-world concentration that the reader practices. Our half-millennium of book-based culture is a historical anomaly, he seems to believe. The internet will sweep it away because the internet is more “natural” than the book.
Carr sees some interactions of computer and book as beneficial. The scanning of old works by Google is a boon to the extent that it makes hard-to-find texts more available. He doubts, though, that reading can be “enhanced” by hyperlinks, interactivity, embedded videos and other innovations. The resulting activity may be entertaining, but it will be something different from reading. A person’s working memory cannot hold too many pieces of information at the same time. On experiment after experiment, in context after context, psychologists have found that people who read old-fashioned text understand it better, and more profoundly, than people who read the same material “enhanced” with links. The same goes for understanding a newscast “crawl”.
Born in 1959, Carr straddles the book-dominated and web-dominated worlds and is at home in both. Members of his generation, he believes, have lived their lives as a “two-act play,” consisting of an analogue youth and a digital adulthood. You could conclude that when the people educated after, say, 1990 die, there will be, in the strictest sense, no literary culture left to speak of. Mild-mannered, never polemical, with nothing of the Luddite about him, Carr makes his points with a lot of apt citations and wide-ranging erudition. Either he is very well read or he is a hell of a Googler.

Deep-brain stimulation makes difference in the lives of people with Parkinson disease

A surgical treatment that stimulates distressed neural networks through electrodes threaded directly into a person's brain has quietly made a difference in the lives of tens of thousands of people with Parkinson disease, essential tremor, and dystonia over the course of the past decade. But while it steadies patients' shaking limbs with surprising effect, its benefits on some patients' minds and personal lives have been more mixed. Some caregivers, in particular, find the newfound mobility of their long-disabled spouses difficult to adjust to. And what about the mind, anyway? Could DBS eventually help other brain diseases such as Alzheimer's?
Initial efforts on that disease and others are getting underway, and depression has already shown some signs of responding to neurostimulation. Meanwhile, the device industry is duking it out, competing for a growing market with technological improvements. Alzforum reporter Amber Dance investigates in a new four-part series. Story links are below:

Deep-Brain Stimulation: Decade of Surgical Relief, Not Just for PD
21 May 2010. Twelve years on, Jeff Ryan still recalls the collective gasp in the operating room the day he got the electrodes implanted. He himself was in somewhat of a state of shock as he held the cup. “All of the sudden your hands that have been shaking like crazy all your life, are just rock steady,” he recalled. The Iowan had had essential tremor since his teens, and was starting to have trouble managing his farm because of the trembling. Surgeons ran wires into his brain and hooked them up to a pacemaker-like neurostimulator implanted in his chest, which sends electrical signals to his brain that quiet the tremors. “It just changes your life dramatically,” Ryan told ARF.
It’s not just Ryan, and it’s not just tremor. On April 28 in the Lancet Neurology online, researchers from Queen Elizabeth Hospital in Birmingham, UK, report on behalf of the PD SURG Collaborative Group that deep-brain stimulation plus medication led to greater improvement in Parkinson disease symptoms than meds alone. This was a six-year, 13-center trial, the largest to date (Williams et al., 2010).
In this series, ARF takes stock of deep-brain stimulation after more than a decade of life-altering procedures. Now is an interesting time to learn more about this surgical treatment, because even as scientists are gathering long-term, broad-based data on its initial indications—movement disorders—they are beginning to explore whether DBS might also work for a range of other conditions, including Alzheimer’s.
Deep-brain stimulation (DBS for short) has been used to treat essential tremor and Parkinson disease tremors since 1997, when the FDA approved the therapy. More than 55,000 DBS devices have been implanted worldwide, many targeting the tremors and dyskinesias of Parkinson disease. Doctors say even more people could benefit from DBS. “It is underutilized, in my opinion,” said Jerrold Vitek, a movement disorder neurologist and leading DBS researcher, who co-chaired the Center for Neurological Restoration at the Cleveland Clinic until his present move to the University of Minnesota in Minneapolis-St. Paul.
Scientists are starting to gather data on the long-term effects of the treatment, on symptoms as well as quality of life. In the case of Parkinson’s, the effects of DBS can seem miraculous—but it is not a solution for all life’s ills, recipients and researchers find. Sometimes, once the tremors and dyskinesias have stopped, problems can arise in other aspects of a person’s life such as work or relationships..
Beyond PD, clinical trials are running for myriad targets. The specific site for DBS is based on imaging studies showing where, in a given condition, the brain is struggling. Therefore, any condition linked to altered brain activity in a particular spot is a potential candidate for DBS . Neurosurgeons implant tiny wires, usually carrying four electrodes each, into the appropriate brain area. In a second procedure, surgeons place a neurostimulator just beneath the skin, frequently below the collarbone. Wires under the skin connect the two implements. The neurostimulator can provide electrical signals that are strong or weak, fast or slow, depending on the person’s needs. Researchers hope to improve both the surgical process of DBS—making it safer—as well as the post-operative process of programming the neurostimulator to provide the ideal signals
In deep-brain stimulation, a neurostimulator under the skin drives current to electrodes implanted into the brain. Image credit: St. Jude Medical
Optimizing Outcomes
In the most recent study of DBS outcomes, the Birmingham researchers and colleagues throughout the UK followed 366 people with advanced Parkinson disease (Williams et al., 2010). Half received DBS plus the best medical therapy available; the other half received only medical treatment. One year on, people who had surgery reported better mobility, ease in daily activities, and a drop in discomfort. People on the best medical therapy, in comparison, reported little change in their condition.
However, the scientists noted, DBS also led to more serious side effects, including 16 people who contracted infections at the surgery site, and one who died during the procedure. Because of the risks, the authors recommend that surgeons carefully select the people who are most likely to benefit from DBS.
Not everyone with Parkinson’s is a good candidate for DBS. Recipients must have had a PD diagnosis for at least five years to ensure they really have Parkinson’s. (Diagnostic accuracy for PD is low.) Surgeons generally restrict the treatment to people younger than 70, who they reason are best able to handle the risks of brain surgery and most likely to benefit from the chance to lead a more physically active life, said Elena Moro of Toronto Western Hospital in Ontario.
The people who respond best to surgery are those who already respond well to medication. Those people turn to DBS because the medication, after some years, often begins to cause uncomfortable side effects, such as the involuntary movements of dyskinesia, or because the medication wears off too quickly. For people who have taken PD meds such as levodopa for several years, life is a continuous cycle of “on” time, in which the drugs control symptoms well, and “off” time, when the medication wears off and they find themselves slow, trembling, even frozen in mid-movement. Peter and Barbara Higgs, both retired teachers in Workworth, Ontario, recall planning their outings and travels around the “on/off” cycle of Peter, who has Parkinson’s. Now “on” much of the time with his stimulator, Peter walked the 5K Parkinson SuperWalk in Peterborough, Ontario, last year. On average, people with DBS gain more than four hours of “on” time each day (see ARF related news story on Weaver et al., 2009).
However, people who do not find levodopa helpful may actually have a condition different from the “standard” Parkinson’s, such as dementia with Lewy bodies (DLB) or progressive supranuclear palsy, and the surgery is unlikely to help them. Some 15 percent of people with Parkinson’s meet the eligibility requirements for DBS, according to Moro.
Long follow-up studies show that even after five years—the maximum time yet published—DBS continues to support mobility. Among five people in a recent study of DBS recipients, subjects had nearly 60 percent less motor trouble while “off” medication than they did before the operation five years earlier. And the average dose of levodopa these people were taking dropped by half (Zabek et al., 2010). In another study of 49 people, researchers found similar improvements, although they also recorded some worsening of symptoms between the first and fifth year post-surgery (Krack et al., 2003). However, the authors noted that is to be expected from a progressive disease such as Parkinson’s.
Mysterious Ways
These outcomes are fairly impressive for a treatment that neither doctors nor scientists truly understand. DBS has its roots in chronic pain and tremor treatments of the 1970s, in which surgeons would simply destroy the area they thought was causing the problem. During the 1980s and 1990s, doctors found they could get similar effects by stimulating the area, a reversible treatment (Benabid et al., 1987; Benabid et al., 1991). “Maybe we excite cells with the high frequency, or maybe we change the pattern of discharge of these neurons, making them more normal,” Moro said. “Nobody really knows.”
Researchers also remain uncertain which brain region is the ideal target for Parkinson disease. In the majority of DBS operations, surgeons implant electrodes into the subthalamic nucleus (STN). This area is part of a circuit that connects dopamine production in the substantia nigra, commonly reduced in PD, to movement. Another part of this circuit is the globus pallidus internal segment (GPi), which also occasionally finds itself targeted by DBS. Each has its merits. The STN is easier to find in the brain and smaller, making it easier to place the electrode exactly where it belongs. But some scientists think that GPi stimulation minimizes side effects (Okun et al., 2009). Researchers are currently comparing the two regions directly in clinical studies.
The motor circuit that contains both the STN and GPi also feeds into non-motor functions. Therefore, DBS can have unintended consequences. Most side effects are mild; they include tingling in the limbs, slight paralysis, slurred speech, and loss of balance. They are often transient, occurring just after the stimulation turns on, or can be controlled by reducing the voltage delivered to the brain electrodes. Speech problems are of special concern, since some people with Parkinson’s already struggle to speak at a steady volume and enunciate words clearly. In a survey of 249 people with Parkinson’s, 99 of whom had had DBS, the nonprofit Parkinson Alliance found that speech dysfunction was a problem in both groups, but more so in the DBS subjects (Parkinson Alliance, 2009
Cognitive function and sleep are also areas of current interest, Moro said. In another Parkinson Alliance survey of 87 people with DBS and 76 without, the group found that people with DBS reported longer and less disturbed sleep (Parkinson Alliance, 2007 . As far as cognition is concerned, some DBS recipients show slightly reduced verbal fluency and vocabulary, working memory, and processing speed (Williams et al., 2010; Weaver et al., 2009). However, Moro said, these are decrements that come up on specific neuropsychological tests, and are unlikely to cause problems in a person’s day-to-day life.
“For a lot of people, it is just the simple everyday things that make the most difference,” Ryan said. Successful DBS could mean regaining the ability to shave, hold a glass full up to the brim, or toss a baseball to a child. Or even simply to express emotion, Peter Higgs said: “I can smile again.”—Amber Dance.

Deep-Brain Stimulation: Steadies the Body, But What About the Mind?

24 May 2010. With a few electrodes deftly threaded into a troubled brain, surgeons can often still the embarrassing tremors and alleviate the painful muscle cramps that come with Parkinson disease. But this deep-brain stimulation does not treat all that Parkinson’s does to a person. People may still have to cope with declining cognitive abilities, speech difficulties, or poor impulse control. And although DBS can quell some symptoms, it does not halt the inexorable progression of neurodegenerative disease. Sometimes, aspects of a person’s life—success at work, or in personal relationships—suffer following the huge upheaval that successful DBS surgery tends to bring with it. DBS can even break up a marriage.
Despite doctors’ best efforts, some people have unrealistic expectations for their outcomes, said Elena Moro of Toronto Western Hospital in Ontario. Unfortunately, the surgery’s results are not a sure thing, and people’s hopes are sometimes dashed. “It’s not working for me,” wrote J.R. Jay, a retired woman in Mobile, Alabama, in an e-mail to ARF. “I can’t tell you how I feel.” Jay had DBS for essential tremor. She has now been told the malfunctioning equipment necessitates a second surgery, but is seeking a second opinion. “I’m not happy,” she wrote.
Less Than a Miracle
People go through many changes following DBS, some positive, and some negative. In a survey conducted by the nonprofit Parkinson Alliance, people who had DBS reported less anxiety than those whose Parkinson’s was managed by medication alone. However, reports of depression were no different between the groups.
Some aspects of disease may remain the same, or even worsen, with deep-brain stimulation. For example, DBS can adversely affect speech, already a problem in people with PD—although in at least one case, DBS relieved stuttering in a person with PD (Walker et al., 2009). Impulsive behavior, such as hypersexuality or addiction to gambling, may remain after DBS or even worsen. In one instance, scientists in Amsterdam, The Netherlands, reported on a man who got hooked on slot machines after his DBS surgery. He had no history of compulsive gambling; indeed, family members described him as “stingy.” Dopamine agonists can also influence impulsive behavior, so his doctors were eventually able to control the compulsion by altering his medication (Smeding et al., 2007).
Emotional responses, too, may be altered by DBS. In a recent Danish study comprising in-depth interviews with people before and after DBS, one person told the researchers, “I have become much more sensitive; I cry over nothing” (Voon et al., 2008). Another research group found that following DBS, many people with Parkinson’s are less able to recognize the emotion in other people’s faces—particularly fear and sadness (Péron et al., 2010).
The potential side effects worried Greg Rice, a retired banker in Dover, Massachusetts, who had DBS for Parkinson’s five years ago. Rice has had Parkinson’s since 1993. Before his surgery, he had developed a late-blooming musical streak, composing symphonies. He suspected that his disease, plus a divorce in the late 1990s, unleashed his creativity, and with Parkinson’s keeping him from sleeping, he spent many night hours composing. He initially feared DBS would give him back mobility but take away this creativity. However, when he reached a point where he fell down 30 times a day, Rice decided the risk was worth taking.
Post-op, Rice is happy to still be composing, with the added benefit that he no longer falls down so often. Most importantly, he told ARF, the involuntary dyskinesia has stopped. “I would do it again even if I did lose the creativity, because the dyskinesia was driving me crazy,” Rice said. However, the surgery did not solve everything; he still struggles to speak intelligibly and sometimes gets “frozen,” crashing into things when he unfreezes. He copes with his disease by focusing on what he can do for others, working with his church, and coaching his daughter’s softball team. He was careful to note that DBS is not for everyone.
New Body, New Life
Symptomatic improvement in one arena does not always translate to the rest of a person’s life. For example, in a study of 23 people, researchers in Houston, Texas, found that people generally experienced greater energy levels and needed less help from a carer following DBS. But at the same time, the researchers found, some DBS recipients were unable or unwilling to apply their newfound abilities to succeed in the workplace, maintain interpersonal relationships, or to do more fun activities (Ferrara et al., 2010).
Researchers in France, who conducted pre- and post-op interviews with 29 DBS recipients, found similar results. In fact, they wrote, “Marital life and professional activity…worsened more often than they improved.” Of 16 participants who were working before surgery, only nine returned to work afterward. Social lives generally improved, but some participants reported that although they now had the physical ability to go out, they had no friends to see (Schüpbach et al., 2006).
The French study included 12 couples that had no notable marital problems before the surgery. In five of those couples, conflict arose post-operatively. It turned out that surgery changed a caregiver-patient dynamic that many couples were used to. In the study, the researchers noted one woman who spoke of her husband’s surgery: “When he was sick, we were a perfect couple. Now he wants to live the life of a young man, go out, meet new people; all of that is intolerable! I would rather he be like he was before, nice and docile!”
Families tend to stick together when someone is sick, said Helen Mayberg of Emory University in Atlanta, who was not involved in the study. But once a partner is physically independent, some caregivers may no longer feel obligated to stay in the relationship. Alternatively, people who previously needed care may want out of a relationship, and DBS gives them the opportunity to leave. Anthony Lang, a leading Parkinson’s physician-researcher at the Toronto Western Research Institute, noted in a plenary lecture at the 2009 AD/PD conference in Prague, Czech Republic, that response to DBS has become one of the more common reasons for divorce among PD patients. This has prompted some discussion among experts on whether the surgery should be offered at earlier stages of disease to people who are still more active and better able to make the most of their motor improvement without upending their pre-op life.
Any major surgery can cause upheaval, and for some people, the change is too much to bear. Researchers in a 55-center, global survey of more than 5,000 people who had DBS for Parkinson’s found the overall rate of successful suicide was 0.45 percent, and the attempt rate was 0.90 percent. When they compared post-DBS rates to the general population suicide rates in each country in the study, they found that DBS increased the suicide risk. The increased suicide rates continued for at least four years following the operation (Voon et al., 2008). Both researchers and patients suggest that a DBS team should include not only physicians and neurologists, but also psychologists or psychiatrists to guide people through the transition.
And in most cases, it is a transition worth making. For example, retired teachers Barbara and Peter Higgs, of Workworth, Ontario, were thrilled with the results of Peter’s DBS for Parkinson’s. “I am not that keen on being a caretaker, to tell you the truth,” Barbara Higgs said. “I was delighted to see him regain control of his life.” And the French study authors noted that despite mixed results from their surgery, none of the 29 people in their study wanted to turn the device off.—Amber Dance.

Deep-Brain Stimulation: An Electrode for All Occasions?
25 May, 2010. Deep-brain stimulation (DBS) is not just for shakes and trembles any more. With the advent of improved brain imaging, researchers are linking certain parts of brain anatomy to conditions ranging from addiction to Alzheimer disease. And for every MRI or CT scan showing a hot spot, it seems, there increasingly is a surgeon waiting to stick an electrode in it. “I do not think there is any disease that is ‘safe’ right now,” quipped Jerrold Vitek, a dementia with Lewy bodies (DLB) pioneer who is set to take over the Department of Neurology at the University of Minnesota in Minneapolis-St. Paul this July. “If you have a hammer, everything looks like a nail.”
DBS is creeping into the realm of psychiatric disorders such as obsessive-compulsive disorder (OCD), Tourette syndrome, and depression. Small studies show that the treatment is often effective and causes minimal side effects (reviewed in Kuhn et al., 2010). In part, the use of DBS in psychiatric conditions was inspired by unexpected results when doctors attempted stimulation to treat Parkinson’s. A couple of people with both PD and OCD, who received DBS for the Parkinson’s symptoms, also experienced a reduction in obsessive and compulsive behaviors (Mallet et al., 2002). In another case, a woman who received DBS to relieve Parkinson’s experienced profound sadness when certain parts of her brain were stimulated. The effect quickly disappeared when the electrodes were turned off (Bejjani et al., 1999). These side effects led researchers to suspect that thoughts and feelings, as well as movement, could be subject to alteration by DBS. Conditions such as Tourette’s (reviewed in Temel and Visser-Vandewalle, 2004) and OCD (Jung et al., 2006) have also responded to deep brain lesions, a precursor to DBS used in the past.
Diminishing Depression
Given the small but real risks inherent in brain surgery, DBS tends to become an option when a disease is serious and other therapies have failed. There are many conditions that, at least in some people, resist the best medicine currently on offer. For example, Helen Mayberg of Emory University in Atlanta, Georgia, works on treatment-resistant depression (TRD). The patients she works with have had major depression for years, and tried medication, psychological therapy, and electroconvulsive therapy, to no avail. Many are unable to work. “They are dangerously and intractably ill,” she said.
Mayberg was able to turn the images she saw on brain scans of sad or depressed people into a novel therapy for the condition. This is the first time, Mayberg said, that a targeted treatment came directly from images, with no other basis for potential efficacy. She and others observed that the subgenual cingulate cortex is overactive in people with TRD. Activity in the region also turns up with negative mood in healthy people (Mayberg et al., 1999). “We are interested in turning the activity down,” Mayberg said.
Mayberg, then at the University of Toronto in Ontario, initially tried DBS of the subgenual cingulate in six people (Mayberg et al., 2005). Later, she and others expanded the trial to include 14 more patients (Lozano et al., 2008). They saw effects even in the operating room, when surgeons stimulated the target area to make sure electrodes were properly placed. Spontaneously, some subjects reported that the room suddenly looked brighter, or that they experienced a “disappearance of the void” (Mayberg et al., 2005). By six months after the surgery, 60 percent of recipients had some response, and 35 percent were considered in remission (Lozano et al., 2008). DBS for depression is currently under trial in a study run by St. Jude Medical, Inc., of St. Paul, Minnesota, a maker of DBS devices, Mayberg said.
Mayberg cautioned that DBS marks only the beginning of a person’s recovery from TRD. “This does not make you happy,” she said. “This turns negative off.” The recipient must take the next step to regain a positive outlook. And just as a person who has, say, hip replacement surgery needs rehab, people who have DBS for depression need “psychological rehab,” Mayberg said, to help them adjust.
If I Had a Hammer….
Currently, DBS is FDA-approved for essential tremor, Parkinson disease, and dystonia. The FDA also allows some people with OCD to receive the device. Efficacy for this condition is under study but remains unproven. Beyond that, researchers are trying DBS for a whole laundry list of conditions (reviewed in Awan et al., 2009). Clinical trials are underway for Huntington disease, cluster headache, pain, epilepsy, and Tourette syndrome.
Some scientists hope that even conditions that cause their primary pathology outside of the brain may respond to DBS. For example, amyotrophic lateral sclerosis manifests primarily in the spinal cord—but researchers using single-photon emission computed tomography discovered lesions in the cortex of four people with ALS. They attempted DBS with these four in a preliminary study. Two years later, two of the people had only mild progression of the illness, which is normally fatal within three to five years, and their lesions had disappeared. The third recipient’s disease continued to progress after the first few months; the fourth, however, committed suicide (Sidoti and Agrillo, 2006).
Most DBS targets are based on what researchers know about how the brain works, but at least one, for Alzheimer disease, was discovered by more roundabout means. In 2008, researchers from Toronto Western Hospital in Ontario reported on a surprising finding (Hamani et al., 2008). They were hoping to help an obese man stem his desire for food. The 50-year-old, 420-pound man had tried dieting, psychological therapy, and medication without success. He feared that even if he received bariatric surgery, he would continue to overeat.
The researchers targeted the hypothalamus, an area known to influence feeding in animals (Takaki et al., 1992). In the past, doctors had targeted this region with lesions to treat obesity (Quaade, 1974).
During the surgery, the doctors turned on the signal to the electrodes to ensure they were hitting the target area. They asked the man, who was awake during the procedure, if he felt any change in hunger. He did not—but he did notice a strange sense of déjà vu. Suddenly, he flashed back 30 years to a scene in a park, surrounded by friends. He recognized his girlfriend from that time. When the doctors turned off the stimulation, the memory vanished; they turned it back on and the memory resurfaced.
“We were caught completely by surprise,” said study author Andres Lozano. “We knew immediately that this was something very significant.”
The hypothalamus is involved in memory as well as appetite (Soriano-Mas et al., 2005). In tests following the surgery, the researchers also found the obese man was more likely to remember word pairings when the stimulator was on; using electromagnetic tomography, they saw that the stimulation activated the brain’s memory circuit. (They used this method because the man was too large for a standard PET or MRI scan.) As to the effect on obesity, the man reported reduced cravings and did lose more than 25 pounds, but gained them back when he started turning off the neurostimulator to snack at night.
Based on this serendipitous, if anecdotal, finding, the researchers launched a small trial with six subjects to see if DBS can improve memory in six people with mild Alzheimer disease. Although DBS cannot repair the degenerated tissue lost in Alzheimer’s, Lozano hopes that it can improve input to “innocent bystander” parts of the brain that, while healthy themselves, are missing input from damaged neurons. Lozano expects to publish the results within the next few months. Researchers in the French city of Nice in 2009 listed a similar trial, though it is not recruiting yet.
In a related study, researchers in Germany this year began testing DBS for Alzheimer’s. Unlike the Toronto and the Nice groups, who are targeting the fornix region, this group is tickling the nucleus basalis of Meynert, an area known to degenerate in AD (see ARF related news story on Freund et al., 2009).
“These are exciting times,” Mayberg said of the rapidly expanding DBS field. “As we learn more about the brain, we are going to be able to help people in ways we had not thought about before.”—Amber Dance.

Deep-Brain Stimulation: There's Still Room for Improvement
26 May 2010. Though some 55,000 people have received deep-brain stimulation for conditions ranging from Parkinson disease to obsessive-compulsive disorder, there is still plenty of room to improve the process. Companies are working on smaller devices with longer battery life. Surgeons are seeking ways to more safely and precisely implant the electrodes that reset faulty brain signals. And people who receive DBS are hoping that researchers can improve the sometimes lengthy and cumbersome process of fine-tuning the settings on the pacemaker-like neurostimulator that controls the pulses to the electrodes.
Ever-improving imaging technology has been key to the spread of DBS, as doctors identify more brain regions that might benefit from the stimulation. For example, researchers have gone as high as seven-Tesla MR imaging, in comparison to the standard two Tesla scanners more routinely available (Cho et al., 2010). These high-resolution images help surgeons target the right spot. “Getting the electrodes in the right place is probably the most important thing to dictate clinical outcomes,” said Cameron McIntyre of the Cleveland Clinic. A millimeter to the left or right, and results will be less impressive than they could be. And this placement happens some six centimeters below the skull, where surgeons cannot navigate by sight.
In the OR
To help surgeons turn the images from an MRI or CT scan into a plan of operation, McIntyre and others have developed a software package called Cicerone (Miocinovic et al., 2007). The software lines up a person’s brain scans with standard neurophysiology maps and 3D brain atlases, so surgeons can identify the most promising site for stimulation and plan a route to get there. During the operation itself, the surgeon can also use the images to visualize the electrode’s location, and Cicerone will predict what regions it will stimulate.
In addition to placing the electrode, better images help doctors plan a safe surgery. The location of blood vessels varies from person to person, and surgeons may nick one, causing a hemorrhage. The risk of serious bleeding, leading to brain damage or death, is between 1 and 2 percent. Neurologist Jerrold Vitek, soon to move from Ohio’s Cleveland Clinic to the University of Minnesota in Minneapolis-St. Paul, said he wants to see that risk drop to 0.5 percent, so more people who might benefit from DBS will feel confident signing up for the procedure.
A person who receives DBS will likely need brain surgery once, but will also have a second surgery to implant the neurostimulator in the chest. It connects to the brain via wires under the neck’s skin. That surgery is necessary every time the neurostimulator’s batteries run out and require replacement—once every two to five years, depending on the voltage settings.
But Richard McEnery, a software developer and photographer in Sammamish, Washington, was burning through batteries in a year, he told ARF. DBS silenced much of his dystonia—a condition that includes involuntary muscle contraction—including the neck tremors that made him “look like a bobblehead doll,” he said. Now, McEnery benefits from a relatively new improvement in DBS technology, a rechargeable battery. It doesn’t last as long—perhaps a month—but he can top it off at home while watching TV. The recharger is a large plastic device connected to a battery. Once a week, McEnery dons a harness that aligns the recharger with the neurostimulator under his skin. Over an hour or two, the device wirelessly transmits power through his skin to the neurostimulator, and he is powered up and good to go.
DBS is not plug-and-play; the equipment requires setting and maintenance. Neurostimulator settings include many parameters; voltage, signal length, and frequency of stimulation are just a few. A doctor or nurse works with the DBS recipient to program the neurostimulator’s activity. Altogether, thousands of possible setting combinations exist, and every recipient needs a personalized one. Finding those magic numbers requires multiple office visits that can last hours. The time involved—and lack of many healthcare practitioners skilled in setting the device—is one of the biggest complaints among people who have DBS. McEnery recalls it took a year to perfect his settings.
The programming task frequently falls to nurses, neurophysiologists, and doctors still in training, who may or may not be expert in the process and in medical treatments for the condition at hand. In a 2006 study, researchers at Toronto Western Hospital examined the potential for an experienced neurologist to improve programming (Moro et al., 2006). They initiated the study when Elena Moro, an expert in DBS as well as management of Parkinson’s and movement disorders, joined the clinic. She reset neurostimulators for 44 people with Parkinson’s who had had DBS for an average of 3.5 years already. The result: more than half of the participants saw improvement in mobility and daily activities, and were able to reduce their anti-Parkinson’s medications. Others saw no benefit; in four people, symptoms worsened. The data suggest, the authors write, that the expertise of the programmer makes a difference.
“A great deal of clinical intuition goes into the process,” said McIntyre, who was not involved with the Toronto study. Yet again, he offers a computational solution. He and colleagues are developing StimExplorer, a program that integrates a patient’s MR images with the position of the electrode (Butson et al., 2007). It offers users a set of theoretically optimal parameter settings. They may not be just right, but they should, hopefully, put the user in the right ballpark from which fine-tuning is easier. McIntyre has licensed much of his technology for commercial development, and hopes his software will receive FDA approval in a year or two. Something like StimExplorer could help inexperienced programmers, Moro said.
As DBS becomes more popular, more companies are developing stimulators. Medtronic, Inc., headquartered in Minneapolis, Minnesota, currently holds much of the U.S. market. St. Jude Medical, Inc., based in St. Paul in the same state, already has a DBS device approved for Parkinson’s in Europe and is currently conducting a U.S. study. Competition should lead to improvements in the technology. For example, doctors hope to soon have a neurostimulator small enough to fit in the head, against the skull. This would eliminate the wires traveling through the neck, which might break. “I think you will see a lot of one-upmanship between the two players,” McIntyre said.—Amber Dance.

Brain tumor vaccine shows promise, study shows

Pfizer Inc. and Celldex Therapeutics Inc. said 70 percent of patients getting their experimental brain tumor vaccine were alive without their cancer worsening about eight months after diagnosis, a study found.
Cancer typically progresses in about 50 percent of patients during that time period, said Tom Davis, Celldex's chief medical officer. The finding, involving 40 patients, is from an interim analysis of a study by the American Society for Clinical Oncology. The full results will be presented this week at the group's annual meeting in Chicago.
The treatment is designed to ramp up the body's immune response to fight off the tumor. The vaccine targets the molecule called epidermal growth factor receptor variant III, which plays a role in cell growth. The strategy could be applied to breast, ovarian and prostate cancer as well, though none of those indications are in human testing, Celldex said.
In the research, newly diagnosed patients received injections of CDX-110 along with radiation therapy and Merck & Co.'s Temodar until their tumor progressed. All patients received the experimental treatment, rather than giving the medicine to half of the participants while the other half received placebos. Final results from 65 patients enrolled in the trial should be available by year's end, Davis said.

Bellingham student's recital a brain tumor benefit, in honor of his ailing aunt

Ben Read knew he wanted to play music for his culminating project at Bellingham High School, but wasn't sure if his performance would amount to much more than a pleasing interlude in his straight-A march toward college.
That changed Feb. 18, when Liz Albertson, his aunt in Bellevue, suffered a seizure in the middle of the night, waking her husband. Within a month, the families' worst fears were confirmed.
Liz was diagnosed with a glioblastoma multiforme brain tumor, an aggressive cancer that crushes hope as well as life in its tentacles.

Brain's cardiovascular, hormonal and asymmetric activation response when we get angry: UV scientists

When we get angry, the heart rate, arterial tension and testosterone production increases, cortisol (the stress hormone) decreases, and the left hemisphere of the brain becomes more stimulated. This is indicated by a new investigation lead by scientists from the University of Valencia (UV) that analyses the changes in the brain's cardiovascular, hormonal and asymmetric activation response when we get angry.

"Inducing emotions generates profound changes in the autonomous nervous system, which controls the cardiovascular response, and also in the endocrine system. In addition, changes in cerebral activity also occur, especially in the frontal and temporal lobes", Neus Herrero, main author of the study and researcher at UV, explains to SINC.

The researchers induced anger in 30 men using the version that has been adapted to Spanish of the procedure "Anger Induction" (AI), consisting of 50 phrases in first person that reflect daily situations that provoke anger. Before and immediately after the inducement of anger they measured the heart rate and arterial tension, the levels of testosterone and cortisol, and the asymmetric activation of the brain (using the dichotic listening technique), the general state of mind and the subjective experience of the anger emotion.

The results, published in the journal Hormones and Behavior, reveal that anger provokes profound changes in the state of mind of the subjects ("they felt angered and had a more negative state of mind") and in different psychobiological parameters. There is an increase in heart rate, arterial tension and testosterone, but the cortisol level decreases.

Asymmetries of brain activity
Nonetheless, "by focusing on the asymmetric brain activity of the frontal lobe that occurs when we experience emotions, there are two models that contradict the case of anger", the researcher highlights.

The first model, 'of emotional valence', suggests that the left frontal region of the brain is involved in experiencing positive emotions, whilst the right is more related to negative emotions.

The second model, 'of motivational direction', shows that the left frontal region is involved in experiencing emotions related to closeness, whilst the right is associated with the emotions that provoke withdrawal.

The positive emotions, like happiness, are usually associated to a motivation of closeness, and the negative ones, like fear and sadness, are characterised by a motivation of withdrawal.

However, not all emotions behave in accordance with this connection. "The case of anger is unique because it is experienced as negative but, often, it evokes a motivation of closeness", the expert explains.

"When experiencing anger, we have observed in our study an increase in right ear advantage, that indicates a greater activation of the left hemisphere, which supports the model of motivational direction", Herrero points out.. In other words, when we get angry, our asymmetric cerebral response is measured by the motivation of closeness to the stimulus that causes us to be angry and not so much by the fact we consider this stimulus as negative: "Normally when we get angry we show a natural tendency to get closer to what made us angry to try to eliminate it", he concludes.

Every emotion is unique
This is the first general study on emotions and more specifically on anger that examines all these different psychobiological parameters (cardiovascular, hormonal response and asymmetric activation response of the brain) in a single investigation to study the changes caused by the inducement of anger. In addition the results of the study are along the same lines as previous investigations and defend what has been noted by Darwin: that the emotions, in this case anger, are accompanied by unique and specific (psychobiological) patterns for each emotion.

Breakthrough in 'shakes' treatment could counteract disabling tremors

Patients whose lives are made a misery by constant shakes and tremors, could soon be relieved of their symptoms.
A team of scientists from Newcastle University have discovered a mechanism in the spine which  works to counteract the trembling effect of nervous diseases such as  Parkinson's and multiple sclerosis.
As a result they are closer to treating the shakes and transforming the lives  of up to one million sufferers in the UK alone.
Tremors can stop sufferers from doing simple every day tasks like making a cup of tea
Tremors can stop sufferers from doing simple every day tasks like making a cup of tea
Instead of looking at why people suffer from tremors, scientists have taken a  different approach in looking at why most don't have them.
Their aim has been to uncover something in the body which counters the tremor,  cancelling it out.
Research leader Prof Stuart Baker, professor of movement neuroscience at  Newcastle University said: 'We don't fully understand the brain systems causing  these tremors but they can have a massive impact on someone's quality of life.
'They lose the independence and the ability to do something simple like make a  cup of tea.
'Our approach was that instead of looking at why people suffer tremors, we  started to look at why most people don't suffer from them.
'The brain waves from the part of the brain controlling movement work at 10 cycles per second, so really, everyone should have a tremor at that frequency. In fact we do, but for most of us the tremor is so small as to be hardly  noticeable.
'We reasoned that there is something in the body which counters the tremor,  cancelling it out, and we wanted to find out what it was.
'Our research is a breakthrough in the respect we have taken a completely  different approach in looking at tremors.'
Mild tremor is a feature of daily life in healthy individuals, especially when  someone is nervous, tired or hungry.
But more severe tremors are a symptom of serious diseases, such as Essential  Tremor.
Essential Tremor is common in old age, but younger people can also be affected,  and in severe cases it can leave patients unable to walk unaided.
Newcastle University's research, which is published in the American Journal  Proceedings of the National Academy of Sciences and is funded by the Wellcome Trust, involved teaching macaque monkeys to move their index finger slowly  backwards and forwards.
This exacerbated the natural minor tremors that both primates and humans  experience.
Sensors were used to record the activity of nerve cells from the brain and the  spinal cord as the animals moved.
The brain and spinal cord both showed rhythmic activity at the same frequency  of the tremor.
But crucially the spinal cord was active alternately with the brain,  counteracting the oscillations and reducing the size of the tremor.
Prof Baker said: 'Therearer many different sorts of disease which produce  tremor.
In some, maybe the controller in the spine malfunctions, and that is what  actually causes the tremor.
'Understanding more about how the spinal controller works could open the way to  adjusting it to work better, reducing the levels of tremors patients suffer and  improving their lives.'
It is hoped the research - which has cost more than £1m - will help patients  within the next five to 10 years.
It will be used to understand medications and operations that can be used to  stop tremors.
'Our research is a very exciting developments,' said Prof Baker.
'It is humbling to think we are able to help change and improve the lives of  people with tremors.'
Norma Riley, 71, from Lanchester, Co. Durham, has suffered from tremors for the  last three years.
She has recently been diagnosed with orthostatic tremor - a neurological  movement disorder, characterised by high frequency tremors of the legs when in  a standing position, and an immediate sense of stability.
The grandmother said: 'I wobble a bit and I find it hard to walk. I need to use a wheelchair all the time to get to the shops and every time I  go out of the house.
'When I try to walk my legs give way. It is also hard for me to make something as simple as a hot drink as my arms  are always shaking.
'I used to like going out for long walks in the countryside but I can't do that  any more.
'The most important thing is to give those with tremors their quality of life back. Since mine started three years ago it has totally changed my life.'

Cold Sores May Contribute to Schizophrenia Symptoms

While schizophrenia is a complex psychiatric disorder that has its roots in genetic changes, researchers at Johns Hopkins University have uncovered a potentially new culprit for some of the condition's most common symptoms.
Reporting in the journal Schizophrenia Research, the psychiatrists describe a connection between the herpes simplex virus, responsible for cold sores, and the drop in concentration, memory and coordination that are often the earliest signs of schizophrenia. Previous studies have linked the presence of antibodies to the virus with both smaller brain volumes and cognitive problems in patients with the mental disorder.
So the Hopkins researchers, led by David Schretten, studied blood samples from 40 schizophrenic patients and asked these volunteers to perform a series of cognitive tests. Their findings confirmed that indeed, those who had herpes simplex antibodies, indicating that they had fought off an infection with the virus, scored lower on the tests of coordination, memory and motor skills than patients not possessing the same antibodies. In addition, brain scans  confirmed that the patients who performed poorly on the cognitive tests also had smaller brain volumes than those who hadn't been exposed to the virus. In particular the cerebellum, which controls motor function, was considerably smaller in these subjects.
These results lead the authors to believe that the herpes virus may be directly attacking brain tissue and triggering the cognitive deficits, and that somehow, the schizophrenic brain is more vulnerable to the viral assault. That suggests that there may be new ways to control the symptoms of schizophrenia by helping patients to prevent or control exposure to herpes simplex by reducing the number of cold sores they get.
In addition, since the cognitive problems are a prelude to the more severe symptoms of hallucinations and delusions that occur later on in schizophrenia, Schretten suggests that testing patients suspected of having the disorder for the presence of herpes simplex virus, and controlling the infection, may help to reduce the range and severity of cognitive symptoms.

Brain Injury May Exist Despite Normal Post-surgery Scans

Although both neuroimaging and clinical manifestations can indicate an organic brain injury after major surgery, new research suggests the two indicators may not always be consistent.

“Neurological injury can manifest whether or not you find signs of it on a CT [computed tomography] scan or MRI [magnetic resonance imaging],” said Chiranjeev Saha, MD, a fellow in cardiac anesthesia at Toronto General Hospital, in Ontario, Canada, and lead author of a study presented at the 2010 annual meeting of the Society of Cardiovascular Anesthesiologists, in New Orleans (abstract 32).
Dr. Saha and his team had noted a high rate of neurologic complications following heart surgeries at their hospital. These likely resulted from embolic insults and episodes of hypoperfusion, he said, and presumably were compounded by multiple perioperative factors including a patient’s physiologic condition.
In search of a correlation between resulting neurologic problems and visible evidence of injury using current technologies, the investigators reviewed clinical and neuroimaging data from 106 patients who underwent cardiac surgery with cardiopulmonary bypass (CPB) at the hospital, between June 2008 and May 2009.
All patients (aged 65 to 77 years) included in the analysis had either diffusion-weighted MRI or CT scans of the brain after indications of neurologic deficit, delirium, clinical seizures or a decreased level of consciousness. Because cardiac patients commonly have pacing wires in the chest—a contraindication for an MRI—and due to the longer time that an MRI requires, the CT scanner was used for 89 assessments, and the MRI for 17.
Delirium was diagnosed in 77 patients (72%), seizures in 36 (34%) and clinically manifested perioperative stroke in 18 (17%). Imaging identified 63 patients (59%) with brain infarcts: 25 new and 38 old lesions. These patients were not always the same individuals who presented with symptoms.
The team was surprised to discover that the 43 patients with normal scans were no less likely to have delirium or seizures than were those with detectable brain injuries, either new or old. In fact, seizures were significantly more likely to occur in patients without brain infarcts (P=0.002).
Old brain infarcts were also more closely associated with seizures (24% vs. 16%) and delirium (76.3% vs. 76%) than were new infarcts. That link did not surprise Charles Hogue, MD, associate professor of cardiac anesthesia at The Johns Hopkins University School of Medicine, in Baltimore, who was not involved in the study. “The patient’s inherent cerebral disease state plays a dominant role in the manifestations of brain injury after cardiac surgery,” he told Anesthesiology News.
Given the high resolution of both MRI and CT images, how is an insult missed? One explanation could be that the imaging technologies are not sensitive enough, said David Stump, MD, professor of anesthesiology and cardiothoracic surgery at Wake Forest University School of Medicine in Winston-Salem, N.C. A lesion’s size, for example, would have to be at least three millimeters to be obvious on an MRI scan. “Most microemboli cause smaller lesions and are therefore invisible to MRI,” Dr. Stump said.
Timing, too, is imperative. “From a clinical standpoint, it may take a significant amount of time to identify injured and nonviable brain tissue,” Dr. Saha explained. For this reason, CT scans are repeated every three or four days after a patient presents with a clinical manifestation of a stroke.
To complicate matters, despite a patient having neurologic symptoms, an organic injury may not have occurred. An electrolyte imbalance, inflammatory response and hemodilution can also cause seizures, delirium and loss of consciousness.
At the same time, an organic brain injury can exist without any accompanying clinical manifestations. “Many lesions occur in brain areas not examined with a clinical neurologic exam or with psychometric testing,” said Dr. Hogue, adding that these could still have long-term functional and cognitive significance.
Alternatively, it may be the case that any clinical manifestations of the injury were too subtle. Slight changes in balance, hormone management or neurotransmitter production, as well as blood pressure, temperature or sugar regulation, are all potential symptoms of small brain infarctions, Dr. Stump said.
Unfortunately, the generalized data, combined with the study’s retrospective design, limited the researchers’ ability to tease apart these factors. Dr. Saha noted that his group is working on a paper that will discuss in more detail the relationships between specific manifestations of neurologic insult and their clinical and imaging findings.
Recommendations regarding avoiding or ameliorating neurologic complications, he added, must be individualized based on specific risk factors—prompting further preoperative investigations, modification of intraoperative management and possible changes in the surgical approach—for example, off-pump percutaneous aortic valve replacement in severe aortic atherosclerosis.
If going through with bypass, Dr. Stump said, anesthesiologists should ready the patient’s “internal environment” for the effects of rapid changes in blood sugar, insulin, temperature, blood pressure and hematocrit. “We cannot prevent all emboli, but we can better prepare the patient to deal with the onslaught,” he said. Careful management of all of these variables is vital during surgery and while a patient is waking up, he added.

Why teenagers can't concentrate: too much grey matter

UK research into teenagers' brains shows their mental processes are like those of younger children
Many students are unable to concentrate long enough to finish their studies. Photograph: Alamy.
Parents who despair over their teenagers' lack of concentration in class, inability to sit still long enough to finish homework or plan ahead, should take solace. Their children are not being lazy or careless – they are hapless victims of neurobiology.
New research has found that teenagers' brains continue developing far longer into adulthood than previously thought. Adolescents may look like young adults but their brain structure resembles that of much younger children, according to the study to be published in the Journal of Neuroscience on Wednesday.
"It is not always easy for adolescents to pay attention in class without letting their minds wander, or to ignore distractions from their younger sibling when trying to solve a maths problem," said Dr Iroise Dumontheil of University College London's Institute of Cognitive Neuroscience, one of the authors of the research. "But it's not the fault of teenagers that they can't concentrate and are easily distracted. It's to do with the structure of their brains. Adolescents simply don't have the same mental capacities as an adult."
Using MRI scans, the brain activity of adolescents were monitored as they tried to solve a problem in their heads while ignoring environmental distractions.
The scans revealed an unexpected level of activity in the prefrontal cortex, a large region at the front of the brain involved in decision-making and multitasking. This indicated that the brain was working less effectively than that of an adult.
"We knew that the prefrontal cortex of young children functioned in this chaotic way but we didn't realise it continued until the late 20s or early 30s," said Dr Sarah-Jayne Blakemore, who led the study. "What we discovered was that the part of the brain needed to complete this sort of process is still very much developing throughout adolescence. This means it continues to do a lot of needless work when making these sorts of decisions."
Chaotic thought patterns are a result, she said, of teenagers' brains containing too much grey matter – the cell bodies and connections which carry messages within the brain. As we age, the amount of grey matter in our brains decreases.
"What our research has shown is that there is simply too much going on in the brains of adolescents," said Blakemore. "The result is that their brain energy and resources are wasted and their decision-making process negatively affected."
Adults, on the other hand, have less grey matter, said Blakemore. "This means that neural transmissions travel more efficiently from the cells to the brain, so the brain works far more effectively."

The Hidden Brain

What scientists can learn from ‘nothing.’

It took Sherlock Holmes to deduce the significance of the dog that didn’t bark.* So maybe it’s understandable that neuroscientists have traditionally ignored the brain activity that just hums away quietly in the background when the brain isn’t doing much of anything. Assuming this “default” or “resting” activity was meaningless random noise, they went so far as to subtract it out—and thus ignore it—on brain images such as PET scans and fMRIs.
Oops. Neuroscience is having its dark-energy moment, feeling as chagrined as astronomers who belatedly realized that the cosmos is awash in more invisible matter and mysterious (“dark”) energy than make up the atoms in all the stars, planets, nebulae, and galaxies. For it turns out that when someone is just lying still and the mind is blank, neurons are chattering away like Twitter addicts. The very idea of default activity was so contrary to the herd wisdom that when Marcus Raichle of Washington University in St. Louis, one of its discoverers, submitted a paper about it, a journal rejected it. That the brain might be so active in regions “doing nothing,” he says, had “escaped the neuroimaging establishment.” Now the establishment is catching up, with more and more labs investigating the brain’s default activity and a June meeting in Barcelona on brain mapping devoted to it.
The brain is in default mode when we stare into space, sleep, succumb to anesthesia, make our mind a blank while sitting motionless—in short, when the brain’s only task seems to be keeping us alive and breathing. This default activity, to everyone’s surprise, is no mere murmur in the background of a loud symphony. It is the symphony, consuming 20 times as much energy as the conscious life of the mind, including thinking, feeling, and using our senses—the mental acts captured by the brain imaging that so entrances the public. “The brain at rest is not at rest,” says neuroscientist Alvaro Pascual-Leone of Harvard. “Even more important, this resting activity is not random, but is well organized and constitutes the bulk of the brain’s activity.”
That’s a lot of energy to expend on “nothing,” which makes neuroscientists pretty sure the default mode serves important functions. One seems to be preparing the brain for future contingencies. “The resting activity seems to create images about what to expect from the outside world” so the brain can react more nimbly when actual sensory information arrives, says Pascual-Leone. Resting or default activity in the motor cortex, for instance, allows us to duck in time when an errant ball speeds toward our head. In the visual cortex, nine times as many synapses carry the background chatter that goes on when there is nothing to see, such as in total darkness or when the eyes are closed, as handle signals arriving from the eyes. That suggests the default activity is constantly creating mental images that can help us make sense of real ones. Raichle compares the default activity to a conductor’s baton, keeping distinct brain circuits (instruments) always checking in with each other and, in particular, with stored memories—of other times when thrown balls have hit someone’s head, perhaps. Thanks to the constant default activity, even when we lose synapses (which are constantly being formed and broken), we do not lose memories. As long as the background music keeps playing, if the oboe drops out its replacement can easily pick up the melody.
The scenario-creating, hypothesis-forming function of the default network has led Randy Buckner of Harvard to speculate that it gives us a “prospective brain.” The default mode is “active when you are not taking in and processing information from the outside world but are just thinking to yourself, remembering, imagining the future, and taking other people’s perspectives,” he says. The default network “may be a way to play out possible scenarios to help us plan and navigate social interactions.”
On that score, it’s striking that the brains of people with autism and schizophrenia show aberrant default activity and messed-up connections in regions that seem to be its ground zero. This abnormal default activity may be the basis for the trouble schizophrenics have distinguishing reality from fantasy, and the difficulty autistics have with social interaction. More than anything, though, the default activity offers a cautionary tale about the hubris of scientists who dismiss anything the brain does as unimportant.
*The canine guarding the estate where a murder occurred must have known the killer, he realized.

With Drinking, Parent Rules Do Affect Teens' Choices

New research challenges the "European Drinking Model."
New research finds that socializing kids to drink at the family table -- often referred to as the "European drinking model" -- doesn't necessarily translate to more responsible drinking patterns. 

As teenagers mature into their senior year of high school, many parents begin to feel more comfortable about letting them drink alcohol. But new research from brain scientists and parenting experts suggests loosening the reins on drinking may not be a good idea in the long run. And, researchers say, parents' approach to addressing teen drinking does influence a teen's behavior.
Brain researchers are finding that alcohol has a particularly toxic effect on the brain cells of adolescents. That's because their brain cells are still growing, says Susan Tapert, a professor of psychiatry at the University of California, San Diego.
The regions of the brain important for judgment, critical thinking and memory do not fully mature until a person is in his or her mid-20s. Tapert found that alcohol can damage the normal growth and development of a teenager's brain cells in these regions.
"Adolescents who engage in binge drinking (that is, having five or more drinks on occasion for boys, or four or more drinks on occasion for females) tend to show some brain abnormalities in their brain's white matter. That's the fibers that connect different parts of our brains," she wrote in a recent study.
And if binge drinking continues, within two to three years, Tapert says, it can result in subtle declines in a teen's thinking and memory. She reports declines in attention and memory among the teens who had engaged in binge drinking.
"Teenagers who initiate heavy drinking actually go downhill relative to kids who do not initiate heavy drinking during adolescence on several measures of cognitive function," she says
There is a lot of variability among individuals, but Tapert concludes that for some teens there may be no safe level of alcohol use. She saw negative effects in thinking and memory in teens after just 12 drinks in a month, or two or three binge drinking episodes a month.
The Role Of Parents
So if parents want to give a "no alcohol" message to their teens, what can they do? Alcohol researcher Caitlin Abar from Pennsylvania State University found that parents' efforts do play a role in shaping their teens' behavior. She studied how parents deal with their high school teenagers regarding alcohol use while still at home, and she then checked after the teens' first semester of college. Her study of 300 teenagers and their parents was published recently in the journal Addictive Behaviors.
"Parents who disapproved completely of underage alcohol use tended to have students who engaged in less drinking, less binge drinking, once in college," Abar says.
And conversely, a parent's permissiveness about teenage drinking is a significant risk factor for later binge drinking.
"The parents who are more accepting of teen drinking in high school were more likely to have children who engaged in risky drinking behaviors in college, compared to those children who had parents that were less accepting," Abar says. The researchers also asked the teens about their parents' drinking patterns and found that parents' own drinking behavior influenced a teen's later alcohol use.
Rules Matter
But, it was parents' rules that had the strongest effect, says Abar. Complete disapproval of teen drinking by parents was the most protective, even more than when parents allowed a limited amount of alcohol consumption.
Other studies support Abar's findings. Psychology professor Mark Wood from the University of Rhode Island says that parental monitoring — knowing where your teenagers are, who they're with, what they're doing — also pays off in terms of less drinking when they go off to college.
"The protective effects that parents exert in high school continue to be influential into college," Wood says. "Even after a time when the kids have left the home. So it's the internalization of those values, attitudes and expectations that seem to continue to exert an effect."
Research studies by Wood, Abar and others challenge the common parenting practice in much of Europe where kids are socialized to drink at the family table, with the expectation that they'll learn to drink responsibly. Dutch researcher Haske van der Vorst has studied this "European drinking model."
"A lot of parents have the idea," says van der Vorst, "that if I let my child drink at home with friends, then at least I can control it somehow. I can buy the alcohol myself. Then I am in control."
Unfortunately, she says, based on her research, the European drinking model isn't working. "Not at all actually," she says. "The more teenagers drink at home, the more they will drink at other places, and the higher the risk for problematic alcohol use three years later."
To underscore these findings, a recent survey of 15- and 16-year-olds throughout Europe finds that the majority of European countries have a higher rate of teen drunkenness than in this country.
This does not surprise researcher Abar.
"It really calls into question the strategy that parents are adopting of the European drinking model," she says. "The most protective strategy for parents is to make it really clear to their teens that they completely disapprove of underage alcohol use."
Abar says that families that institute a zero tolerance policy will not prevent college students and other teens from drinking. But, she says, teenagers from those households do tend to drink less.