Sunday, June 20, 2010

This Is Your Brain. Aging

Science is reshaping what we know about getting older. (The news is better than you think.)

Illustration by Sarah Cline for Newsweek
Over the years, Timothy Salthouse has tested more than 8,000 people in his lab at the University of Virginia, assessing their memories, problem-solving skills, and other mental functions to see how the brain fares with age. The results have been predictably dismal: after age 25 or so, it’s pretty much all downhill. (No news there: Plato wrote that when a man grows old, he "can no more learn much than he can run much.") But something bothered Salthouse about the results, and on a late spring day in his office at the Russell Sage Foundation on New York’s Upper East Side, where he has been a visiting scholar this year, he whips out a graph that captures the paradox.
Guinness World Records
Photos: A look at the oldest achievers, from flying in space to climbing Mt. Everest.

The graph shows two roller-coastering lines. One represents the proportion of people of each age who are in the top 25 percent on a standard lab test of reasoning ability—thinking. The other shows the proportion of CEOs of Fortune 500 companies of each age. Reasoning ability peaks at about age 28 and then plummets, tracing that well-known plunge that makes those older than 30 (OK, fine, 40) cringe: only 6 percent of top scorers are in their 50s, and only 4 percent are in their 60s. But the age distribution of CEOs is an almost perfect mirror image: it peaks just before age 60. About half are older than 55. And the number under 40 is about zero.
One can make a cheap joke out of this (so that’s why AIG, GM, Lehman, et al. tanked: the smartest people weren’t running them), but Salt-house deduces more counterintuitive, and hopeful, lessons. The first is that in real life, rather than in psych labs, people rely on mental abilities that stand up very well to age and discover work-arounds for the mental skills that do fade. The second is that some mental abilities actually improve with age, and one of them may be the inchoate thing called wisdom, which is not a bad thing to have when running a company. Little of the gloom-and-doom conventional wisdom about what happens to the brain as we age, says Salt-house, "is based on well-established empirical evidence." Instead, he says, much of it seems to be "influenced as much by the authors' preconceptions and attitudes as by systematic evaluation" of solid data.
Insights like that are producing a dramatic, and hopeful, rethinking of what happens to the mind and brain as we age. Some of the earlier bad-news findings are being questioned as scientists discover that the differences between today’s 20-year-old brains and 80-year-old brains reflect something other than simple age, and instead have to do with how people live their lives. And a deeper understanding of normal cognitive aging is producing interventions that, because they target the cell-level brain changes that accompany aging, promise to be more effective than memory exercises and crossword puzzles.
Take the claim that brain volume shrinks beginning in our 30s. Earlier studies suggested that the prefrontal cortex (just behind the forehead) takes the greatest hit; this is the region responsible for executive function such as forethought, reasoning, and "fluid" intelligence—the ability to figure out, for instance, which letter best continues the sequence G-B-F-C-E. But those data, it turns out, may be skewed by the inclusion of people who have very early dementia—so early that they have no symptoms, explains neuroscientist John Morrison of Mount Sinai School of Medicine in New York, but still have neuronal loss and thus volume loss in their prefrontal cortex. If only truly healthy people were studied, there might be no such volume loss, he says.
Earlier studies also found that myelination, the fatty insulation around neurons, peaks in our late 20s and then declines. Because myelin allows electrical signals to travel through the brain more quickly and efficiently, its loss means it takes longer to connect a face with a name, a book with an author, or any other facts. Its loss also makes the brain "noisier," explains neuroscientist Henry Mahncke of Posit Science: "It’s like a radio that is no longer precisely tuned to a station. It takes the brain more effort to find that signal, and that takes resources away from memory and thinking." But myelination loss, according to new research, should come with an asterisk. Most of it seems to occur on one specific part of neurons—the part responsible for learning new things. The part responsible for long-term memory shows no such loss.
In fact, a study of rhesus monkeys published this month shows how well the aging brain holds up. The animals’ prefrontal cortex indeed loses "dendritic spines," tiny protrusions that, acting as the brain’s wide receivers, catch the neurotransmitters that carry signals from other neurons. But there are two kinds of spines in monkeys as well as people. Small, thin ones are responsible for learning and remembering new things (where did I park my car?), and short, stubby ones are responsible for recalling things we’ve known for years. The brain loses some 45 percent of the first kind—and zero of the second kind, Morrison and colleagues reported in June in the Journal of Neuroscience.
That would account for why we have trouble with new memories as we age but not with our core knowledge. "We hypothesize that expertise and knowledge are coded in the synapses and spines that are not lost with age," says Morrison. "This may be how the brain retains what it learned decades ago, and why a professor of cell biology can teach well into his 80s." It may also be why, although most people’s ability to reason and solve novel problems declines with age, knowledge holds up just fine, with vocabulary increasing through at least age 60. Emotional intelligence, social skills, and self-control generally improve with age, too.
And as always, individuals differ. In general, cognitive processes such as processing speed—how quickly the brain takes in and makes sense of information from the outside world, as well as how quickly signals propagate along a thinking circuit—decline beginning in our 20s, just as our respiratory and immune systems decline. Memory and problem-solving improve into our 20s and then plateau, beginning to decline in our 50s or 60s. But averages hide big individual differences. The scores of some adults in their 60s on memory, problem--solving, and other cognitive tests are above the average of adults in their 20s. As anecdotal evidence, Salt-house gestures down the hall to the office of economist Robert Solow, 86, a Nobel laureate who is as intellectually active as ever and producing research papers that—and I’m going to have to just quote here—"rejected the representative-agent models that more or less impose optimal properties on ob-served trajectories" in macroeconomics.
We can’t all be Solows, even in our 30s—let alone our 80s. But clearly, some brains hold up better than others. Some of the difference may be genetic, but since we can’t go back and ask Mom and Dad to bequeath us different genes, the possibilities for intervention on this front are limited. That leaves how we live our lives. Salt-house points out that only about 20 percent of the variation among people in standard measures of memory, problem-solving, and other executive functions is the result of age. The rest—64 to 96 percent on different cognitive test scores, he estimates in his new book, Major Issues in Cognitive Aging—reflects factors other than age.
One such factor may be generational. Many of the dismal conclusions about aging come from what are called cross-sectional comparisons: haul 20-somethings and 60- to 80-somethings into the lab, test, compare, repeat. The differences are supposed to indicate what will happen to the first group when they reach the age of the second. But that may not be right. Consider a visitor to Miami. She notices that most of the older people are New York Jews, while many of the younger ones are Latino. She concludes that as people age, they change from Latino to Jewish.
We may be making a similar mistake when we compare young and old brains. The differences may not mean that mental function falls off a cliff as we age. Instead, warns Salt-house, many "age-related differences [in brain function] could reflect generational differences." The fact that more recent generations outperform older ones belies the idea that we are getting dumber, and is so well established, it has its own name—the Flynn effect. As a result, cross-sectional studies finding that today’s 80-year-olds don’t think and remember as well as today’s 30-year-olds may be capturing this generational difference, and thus painting a more pessimistic picture of the aging brain than it warranted. When the same people are measured over and over, says Salthouse, "at least before about age 60" there is "either stability or an increase" in brain function with age.
The recognition that so much of the difference in brain function is due to something other than age has ignited a market in interventions that might postpone, mitigate, or even prevent some of the decline. The largest study of interventions is ACTIVE (Advanced Cognitive Training for Independent and Vital Elderly), which began in 1998. It gave 2,832 adults, ages 65 to 94, either no training (the control group) or training in reasoning, memory, and processing speed in 10 sessions of 60 to 75 minutes each. The reasoning training, for instance, gave people strategies for breaking a problem into easier steps and identifying patterns of relations. The memory training involved strategies to form images or associations: to remember a list of words that includes penguin, scissors, and cupcake, for instance, visualize the bird wielding the tool while pecking the chocolate frosting.
As expected, people got better at what they trained on. In general, the gains were equal to turning back the clock seven to 15 years for reasoning and remembering, and even longer for processing speed. But there was essentially no transfer: getting better at memory did not sharpen reasoning, and faster processing speeds did not improve memory. Somewhat alarming was that after training, most people’s performance fell even more precipitously than it did without training. That probably reflects the fact that for brain training to "take," it has to be like aerobics, says Mahncke: "We think that for each core mental ability you want to train, you’ll need a booster every nine to 12 months."
Doing crossword puzzles would seem to be ideal brain exercise since avid puzzlers do them daily and say it keeps them mentally sharp, especially with vocabulary and memory. But this may be confusing cause and effect. It is mostly people who are good at figuring out "Dole’s running mate" who do crosswords regularly; those who aren’t, don’t. In a recent study, Salt-house and colleagues found "no evidence" that people who do crosswords have "a slower rate of age-related decline in reasoning." As he put it in a 2006 analysis, there is "little scientific evidence that engagement in mentally stimulating activities alters the rate of mental aging," an idea that is "more of an optimistic hope than an empirical reality." (P.S.: Bob Dole’s 1996 VP choice was Jack Kemp.)
What does support mental acuity as we age is the same thing that’s good for your heart, lungs, immune system, and muscles: aerobic exercise such as brisk walking. A seminal study by scientists at the University of Illinois found that three vigorous, 40-minute walks a week over six months improves memory and reasoning. It also spurs the birth of new brain neurons, scientists led by the University of Illinois’s Art Kramer reported in 2006, and increases the volume of white matter, which connects neurons, in areas responsible for such executive functions as planning.
Walking is free, but Americans spent $13 million on brain-fitness software and games last year, Ambient Insight, a market-research company, reported in April. Nintendo’s Brain Age ($19.99), the Web-based MyBrainTrainer ($29.95 for one year), HappyNeuron’s Brain Fitness ($69.95), and the like improve the skills they train, say independent scientists: drilling yourself to hit the right-arrow key when you see a green light improves reaction time, doing exercises in which you decide whether one face matches another will speed up visual processing, and determining whether words in a new list match any of those in an old one boosts short-term memory. But as in the ACTIVE study, it’s not clear these improvements translate into a fitter brain overall.
An approach that targets the underlying brain processes might. A computer-game-like program from Posit called InSight ($395), for instance, includes an exercise in which you discern which direction a pattern on a screen is moving as a second pattern appears before the brain is finished processing the first. The idea is to turn up the signal and dial down the noise in the brain. "We think it’s important to fix the underlying information-processing machine rather than target higher-level functions like memory directly," says Mahncke. "By training the brain to improve its signal-to-noise ratio, information goes through more accurately and faster." A 2009 study found that healthy older adults (65 and over) who used a Posit program based on the same principle, Brain Fitness ($395), an hour per day for eight weeks improved their processing speed to that of 40-year-olds and their memory to that of brains 10 years younger. And a study scheduled for publication finds that such "perceptual training" improves memory in older adults. It’s enough to give you hopethat, for the brain, aging may become almost optional.

Brain can repair addiction's damage

“Addiction” is a term used often in our society. It seems as if every week there is some news story or discussion about a newly recognized addiction that is plaguing our society.

Within the past few years, a whole variety of new addictions have been identified: video games, internet/computer usage, exercise, pornography, sex, food and gambling are just some examples. Despite how often it is discussed, most people do not have a true understanding of what addiction actually is.

One of the main reasons for that is that addiction is not a diagnostic term. When someone seeks professional assistance for what they think is an addiction, the professional will do a thorough evaluation. After examining the behavior and its consequences, the diagnosis is made using the criteria outlined in the Diagnostic and Statistical Manual IV TR, published by the American Psychological Association. That diagnosis is for “abuse” or “dependence,” not addiction.

Essentially, addiction can be any behavior that one engages in compulsively, that an individual is unable to control despite a desire to do so, and that has caused negative consequences within one's life. In the purest form of addiction, drug or alcohol use, it is easy to see the multiple aspects of the problem. Within the dependence category, one can have psychological dependence, physical dependence or, quite commonly, both.

Research has now shown that addiction changes the brain. The brain's production and usage of a variety of neurotransmitters is affected. The good news is that with most addiction, after enough time has passed without usage, the brain will begin to recover. (This is not true if the individual is abusing inhalants).

This is a huge advance in science, as for many years it was believed that the brain could not repair the damage done to it. Of course the longer and the more severe the usage, the longer it will take the brain to begin its recovery.

The best recognized and most common treatment for addiction is the Alcoholics Anonymous model. AA was originally formed in 1937. While it has been widely successful, the understanding and treatment of addiction have come a long way. In examining the 12 Steps of AA, it is clear that a good base knowledge of addiction existed even back when the organization was founded.

It is important to remember that addiction isn't about weakness, moral failings or being a “bad” person. No one sets out with the intention of becoming addicted. It is also not a matter of the individual having will power and “just saying ‘no.'”

Addiction develops when people sees to change their normal way of being — the way they feel or think about things. As a result, treatment involves directly addressing these underlying issues and helping the individual to develop skills for coping with the situations in their life, rather than turning to something to numb it away.

If you or someone you know is struggling with an addiction or you are concerned that you might be, please seek help. Addiction can be treated.

April Wilson is a counselor at The Samaritan Counseling Center

Low, high manganese levels may affect the infant brain


NEW YORK (Reuters) -– Babies with either relatively high or relatively low levels of manganese in their blood may be slower to hit certain developmental milestones in their first year than other infants, a new study suggests.

The findings do not prove that manganese -- which is present in food, water, air and soil -- is the reason for the slower development. But they are in line with the general understanding of manganese -- that small amounts in the diet are necessary for normal nervous system function, while high amounts can be harmful.

What's new in this study is that it focused on manganese levels in the first few years of life, and whether there might be any effects of relatively low-level environmental exposure on the still-developing brain.

Most of what's been known about the health effects of elevated manganese levels has come from studies of workers heavily exposed to the element on the job, explained lead researcher Dr. Birgit Claus Henn, of the Harvard School of Public Health in Boston.

In their study, Henn and her colleagues found that at the age of 12 months, children in either the bottom 20 percent or the top 20 percent for blood manganese levels had lower scores on a standard test of mental development than those whose manganese levels fell in between.

On the other hand, blood manganese at age 2 was not related to mental development scores. And while there was still a relationship between manganese levels at age 12 months and mental-development scores at older ages, the connection was weaker, the researchers report in the journal Epidemiology.

Because the study is the first to look at blood manganese levels and brain development in children this age, the findings should be “interpreted cautiously,” Henn told Reuters Health in an email.

However, she said, “if our findings are confirmed in other studies, the results suggest that both low and high manganese levels may have adverse effects on neurodevelopment among young children, especially at 1 year of age, which may be a sensitive time point.”

Manganese is a natural component of rock and soil, and people are routinely exposed to it through air, water and food, including grains, fruits and vegetables. It is also used in industry, mainly in steel production, and heavy occupational exposure to manganese can be toxic to nerve cells -- leading to symptoms such as difficulty concentrating and Parkinson-like problems like slowed movement and coordination problems.

For the current study, Henn and her colleagues followed 448 Mexican children from birth to age 3. Every six months, the children were given standard tests of mental development, including measures of vocalization and communication, memory and problem-solving -- such as tackling simple goals like reaching a toy.

In general, children in the bottom and top 20 percent for blood manganese at the age of 12 months scored about three points lower than their peers on the mental development.

According to Henn, that difference is akin to what has been seen when young children's blood levels of lead -- which is known to harm early brain development -- rise from 10 micrograms per deciliter of blood (mcg/dL) to 30 mcg/dL. (Lead levels of 10 mcg/dL or higher are considered to be potentially dangerous in young children.)

According to U.S. health officials, the “normal” range of manganese levels in the blood is between 4 and 14 micrograms per liter (mcg/L) of blood. However, that range is not age-specific, Henn and her colleagues point out, and there is currently no clear “normal” for young children.

In this study, children in the bottom 20 percent for manganese at the age of 12 months had levels below roughly 20 mcg/L. In the top 20 percent, levels were higher than 28 mcg/L.

It is not certain that the manganese levels themselves were responsible for the relatively lower mental-development scores. The researchers did account for a number of other factors -- including blood lead levels and mothers' IQ and education levels -- and the connection remained.

However, Henn said that it is still possible that other factors, such as exposures to other environmental toxins, could explain the findings.

For now, she said, there are some steps parents can take to limit young children's exposure to manganese while ensuring that they also get enough of it. Manganese is present in some fertilizers and fungicides, for instance, so parents can try to limit their children's exposure to those products.

Henn also noted that while manganese levels in public drinking water are regulated, there can be high levels in well water. So avoiding that water source may be helpful.

On the other hand, Henn said, it is rare for people to be overexposed to manganese through food. So parents should make sure that their children get the healthful foods -- including whole grains and green, leafy vegetables -- that contain manganese.

Is God only in our brain?

Let’s imagine that, with a simple push of a button we could control our brain, turning off, for example, drug addiction, or turning on our thought capacity or velocity or, even, improving our memorizing ability.
Now let’s imagine a machine is capable of inducing mystic states of mind and of making “virtual encounters” with the Divine possible. Such a technique, that is capable of improving specific parts of our brain with minimal side-effects is something that motivates a large number of investigations in an area that is becoming the Holy Grail of Neurophysiology.
Well, that technique already exists and is called TMS – Transcranial Magnetic Stimulation. It’s a non-invasive method of stimulating, inhibitting and moulding specific brain circuits: a magnet similar to the one used for NMRs (Nuclear magnetic resonances), is focused on specific parts of the cerebral cortex and impulses of variable intensity, frequency and duration can, with low frequencies, ihibit the cortex and, with high frequencies, stimulate it, and its effects last longer than the stimulation.
Developed in 1985 at Sheffield University, and improved from 1995 on, it has been used, successfully, among patients suffering from major depression, resistent to conventional treatment, to speed up the effect of anti-depressants; and among schizophrenic patients with auditory hallucinations. It is thought that the FDA might soon qualify this technique as being secure for the treatment of patients with drug-resistant depression, as an alternative to Electroconvulsive therapy (ECT). It’s also being tested for Epilepsy, chronic pain, brain haemorrhages, appetite regulation, Attention-Deficit Hyperactivity Disorder (ADHD), etc. It’s in the field of brain performance improvement that this method shows more possibilities.
Studies conducted at the Gottingen University, in Germany and at the Centre for the Mind in Sydney, Australia have shown a 10% improvement in the learning of motor skills and significant improvements in the creative capacity of volunteers that were subject of specific stimulation with TMS. In addition, research sponsored by the USA military have already put it in the helmet of pilots, hoping to raise their performance, and inside a portable device the size of an mp3 player, able to stimulate the brain with the touch of a button.
The work of neurophysiologist and TMS pioneer Michael Persinger from Laurentian University in Sudbury, Ont├írio, has focused on the stimulation of the right hemisphere of the brain, able to induce mystical states of mind with “sensorial presence” in volunteers that experience intense pleasure and intense panic, which leads them to believe the test chamber is haunted, as well as sensations of “direct contact” with the Divine.
Persinger believes that normal alterations, those which are not artificially induced, of the magnetic fields may be responsible for paranormal experiences, such as ghost phenomenons, OVNIs and mystic apparitions. Based on Persinger’s work in the emerging area of Neurotheology there already are scientists exploring the biological basis of spirituality and venturing that the religious phenomenon can have an electromagnetic explanation and that mystical experiences, such as those felt by Saints and Mystics can be recreated in laboratory, by electromagnetic impulses.
Sources, that have not yet been confirmed, say that there is work and anxiety from Vatican to Jerusalem with the far-reac of Persinger’s experiments

An Oxymoron? – Intelligent People Use Less of Their Brain.

No, wait, bigger is better, right? I mean, the larger the brain to body ratio, the smarter the species... Therefore bigger brains = more potential activations = higher intelligence.
Turns out it is more complicated than that. Bigger brains are indeed associated with higher intelligence (across, rather than within, species though), but intelligent people, in fact, may use less of their brains than their less intelligent counterparts! Rex E. Jung of the University of New Mexico and the Mind Research Network and Richard J. Haier of the UC Irvine were among the first to study intelligence using some of the most modern brain-imaging technology available to date. In one experiment, participants performed an intelligence test while their brain activity was recorded via PET technology. The surprising finding was that people who scored higher on the intelligence test had less brain activity, or, in other words, they used less brain energy while performing the test than their less intelligent counterparts!
In a follow-up study, Jung and Haier used PET scanning again to study people while they
played the game of Tetris for the first time, and then after a 50-day practice period. Not only brain activity in all participants decreased after practicing for 50 days, but more intelligent people showed the greatest brain activity decrease!From the first glance, these findings seem like an oxymoron - shouldn't smart people's brains make more connections, thus exhibiting more activity when thinking, especially on a difficult task such as an intelligence test? What Jung and Haier suggest, though, is that intelligent brains are just more efficient, making appropriate neural connections, and making them faster, thus providing more correct answers on an intelligence test.
What about Creativity and the Brain?
Although researchers disagree on the type of relationship between creativity and intelligence, most of them concur that such relationship exists. Jung and Haier, as well as several other researchers, report that similar to intelligent people, creative individuals show low levels of mental activity. Upon closer investigation, however, at least in one of such studies (Jausovec, 2000), the creativity task required participants to find solutions to creative problems. Such tasks seem similar to "convergent thinking" tasks, where usually only one correct, albeit creative, answer exists to any given problem. It appears then that such tests are akin to intelligence tests, thus, not surprisingly, the brain activity during such convergent thinking tasks is similar to brain activity during intelligence tasks. Perhaps this is also the reason convergent thinking is negatively associated with cranial dopamine levels (Akbari Chermahini & Hommel, 2010). Neurotransmitter dopamine has been linked to motivation and behavior activation. Hence the lower the dopamine levels, the lower the brain activity, the higher the convergent thinking.
I would suggest, however, that brain activity during divergent thinking would show a differentiated pattern. A person is required to come up with as many possible (creative) answers to a given problem while performing a divergent thinking test. It appears that in this case, the more is better, as more neural connections would lead to potentially more responses. In fact, several studies conducted by Colin Martindale and colleagues have shown that creative people have greater activity in some parts of the brain, and higher alpha activity during the inspiration stage of the creative process.
More studies will be needed to disentangle and confirm the above findings. At this time, however, we can say with a certain amount of confidence, that smarter brains require less energy to perform various tasks. We can also say that practice can lead to increased brain efficiency, again eventually requiring fewer resources. So keep practicing that guitar - with time you will literally need less brainpower to play like a pro!
References
Akbari Chermahini, S., & Hommel, B. (2010). The (b)link between creativity and dopamine: Spontaneous eye blink rates predict and dissociate divergent and convergent thinking. Cognition, 115, 458-465.
Jausovec, N. (2000). Differences in cognitive processes between gifted, intelligent, creative, and average individuals while solving complex problems: An EEG study. Intelligence, 28, 213-237.

Brain distorts body image: Study

A new study suggests that the brain often distorts body image, explaining the reason why certain individuals suffer from eating disorders like anorexia.

According to the study published in the Proceedings of the National Academy of Sciences, distorted perception, which is associated with body image problems in some people, is the result of the confusion reported in the way brain stores information of different parts of the body.

These distortions affect position sense, the ability through which the brain determines where different parts of the body are even when the eyes are closed.

While the visual image of the body is generated consciously, the distortions are believed to be the result of subconscious signals, the study found.

"These findings may well be relevant to psychiatric conditions involving body image such as anorexia nervosa, as there may be a general bias towards perceiving the body to be wider than it is," said lead researcher Matthew Longo.

"They [anorexic patients] are able to judge other people's bodies quite accurately and would describe someone else the same size as themselves correctly, but still not be able to do that about their own weight and shape," Longo added.

CPAP therapy restores brain tissue in adults with obstructive sleep apnoea

Obstructive sleep apnoea patients had reductions of grey-matter volume at baseline but showed significant grey-matter volume increase after three months of CPAP therapy, according to a research abstract presented in San Antonio, Texas, at SLEEP 2010, the 24th annual meeting of the Associated Professional Sleep Societies LLC.
Results indicate that obstructive sleep apnoea patients showed focal reductions of grey-matter volume at baseline in the left hippocampus, posterior parietal cortex and right superior frontal gyrus. Significant grey-matter volume increases were observed after three months of continuous positive airway pressure therapy in hippocampal and frontal structures. No further improvement in gray-matter volume was observed after one year of CPAP therapy.  
"OSA patients showed cognitive impairment associated with neurostructural damage affecting specific cerebral regions," said principal investigator Vincenza Castronovo, PhD, clinical psychologist and psychotherapist and sleep laboratory coordinator at the University Vita-Salute San Raffaele and San Raffaele Scientific Institute in Milan, Italy. "In addition, we show that most of the neuropsychological deficits are reversed after three months of treatment with CPAP and, for the first time, that such cognitive improvements parallel an increase of grey-matter volume in specific hippocampal and frontal brain regions. The increase of grey-matter volume in these regions is significantly correlated with the improvement at neuropsychological tests of executive functioning and short-term memory."  
The study involved 17 patients with an apnoea-hypopnea index (AHI) greater than 30 (i.e. more than 30 breathing pauses per hour of sleep), indicating severe obstructive sleep apnoea. They were compared with 15 healthy controls. Brain scans were conducted by 3 Tesla magnetic resonance imaging (MRI), and a processing technique called "voxel-based morphometry" (VBM) was used to characterise regional cerebral volume and tissue concentration differences in gray matter by examining the entire brain. VBM increasingly is being used as a tool to examine patterns of brain change in healthy ageing or neurodegenerative disease, as well as neuroanatomical correlates of behavioural or cognitive deficits and skills.  
Castronovo added that measuring neuropsychological performance may help physicians assess OSA patients for treatment effectiveness. "Our results also suggest that specific neuropsychological measures are valuable tools for the assessment of therapy success and can offer to patients and physicians the evidence that adherence to treatment can lead not only to clinical but also to brain-structural recovery," she said. The study was supported by the Respironics Foundation.  
The National Institute of Neurological Disorders and Stroke reports that "gray matter" refers to the cerebral cortex, where the brain does most of its information processing. The cortex is a layer of tissue that has a gray-coloured appearance because it lacks the myelin insulation that gives most other parts of the brain a white appearance.  
According to the American Academy of Sleep Medicine, OSA is a sleep-related breathing disorder that involves a decrease or complete halt in airflow despite an ongoing effort to breathe. It occurs when the muscles relax during sleep, causing soft tissue in the back of the throat to collapse and block the upper airway. This leads to partial reductions (hypopneas) and complete pauses (apnoeas) in breathing that can produce abrupt reductions in blood oxygen saturation and reduce blood flow to the brain. Most people with OSA snore loudly and frequently, and they often experience excessive daytime sleepiness.   
The treatment of choice for OSA is CPAP therapy, which provides a steady stream of air through a mask that is worn during sleep. This airflow keeps the airway open to prevent pauses in breathing and restore normal oxygen levels. Help for OSA is available at more than 2,000 AASM-accredited sleep disorders centers across the US.  
Last year Castronovo reported that there was a large overlap in the pattern of brain activity in men with OSA and healthy controls during a working-memory task. But some regions were less active in men with untreated OSA, while additional brain regions such as the hippocampus showed increased activation. Then after three months of CPAP therapy, men with OSA showed decreases in the activation of the left inferior frontal gyrus and anterior cingulate cortex, and bilaterally in the hippocampus. The study, published in the September issue of the journal SLEEP, supports the "compensation hypothesis", suggesting that the brain "recruits help" to maintain performance and compensate for the neural dysfunction caused by OSA.  

Conscious sedation for brain surgery may shorten hospital stay

Washington, DC: A new study has suggested that the recovery time and cost of brain-tumour surgery might both be reduced if surgery is performed while patients are awake during part of the procedure.
The study, conducted at The Ohio State University Comprehensive Cancer Center-Arthur G James Cancer Hospital and Richard J. Solove Research Institute, examined the outcomes of 39 patients treated for glioma, a type of brain tumor that affects about 20,000 Americans annually.
The doctors wanted to learn if surgeries that used conscious sedation - in which patients are initially anesthetised but restored to consciousness during surgery on the brain itself - had outcomes different from those using more traditional general anesthesia.

"Our data suggest that patients who received conscious sedation had shorter hospital stays than those receiving general anesthesia, and that this reduced the cost of treatment," said study leader Dr E Antonio Chiocca, professor and chair of neurological surgery and Dardinger Family Endowed Chair in Oncological Neurosurgery.
"This finding needs to be validated with a randomized prospective clinical trial, but if it holds true, it would mean that changing our current way of delivering anesthesia for these patients could allow them to leave the hospital sooner and save resources," Chiocca added.
Neurosurgeons usually reserve conscious sedation for patients with tumors located near the brain's speech and sensorimotor centers, Chiocca says.
The method was originally conceived as early as the 1950s to avoid or minimize the accidental damaging of these centers. Since then, additional studies have indicated that conscious sedation can result in more complications than procedures using general anesthesia, while others appear to show the opposite
To investigate the question, Chiocca and his colleagues studied the outcomes of 20 cases that used conscious sedation during surgery for stage II, III or IV gliomas and compared them with 19 cases that used general anesthesia.
The investigators evaluated each patient for the number of days they remained in the hospital and for the cost of four items that directly related to the surgery: the cost of the operating room, of anesthesia, of neurosurgical intensive care and of the hospital room. Each patient was also evaluated for neurological complications.
No significant differences were found in the percentage of complications. Regarding the four costs examined by the investigators, the expense associated with the operating room and anesthesia were the same in both groups, and both groups spent a similar period in neurosurgical intensive care.
Patients receiving conscious sedation, however, had shorter hospital stays after leaving intensive care than did patients receiving general anesthesia, for a total of 3.5 days and 4.6 days respectively.
The shorter hospital stay led to an average 36% decrease in post-intensive-care direct cost for cases receiving conscious sedation compared with those receiving general anesthesia.
"Overall. our findings suggest that glioma resection under conscious sedation is associated with shorter hospital stays and reduced inpatient expenses compared with the same surgery under general anesthesia," Chiocca said.

Right Brain: Handling a Crisis With Both the Left and Right Brain

I am not one to go for the fire and brimstone thing, but this past week in American history has been something. 100 million gallons of oil in the ocean and counting, Obama goes to the Gulf while lightning strikes the ship with the containment cap, shutting it down for another week. Hayward squirms on the hot seat of a congressional hearing, while our politicians blow a lot of steam that goes nowhere. Its hard to wrap our mind's around the magnitude of it all. However, a most interesting moment came during the hearings when a shrimp fisherwoman barged in with oil stained hands and demanded criminal action.
Seeing her made me feel so much better in a strange sort of way. She had an oil streaked face, disheveled hair, and dripping hands. She was mad -- outraged, and she was not afraid to show it, even if it got her arrested. It was almost iconic, and reminded me of old tribe's women who would rub themselves with ashes to manage their grief, or Native women who would trill their anguish to the world. It fulfilled a more primal side of how we instinctively want to react in a crisis.
Many of us everyday folk sometimes feel like life is hemorrhaging out of control, and are struggling to manage all the emotions with logic and reason -- with less than satisfactory results. Maybe you are out of a job, hate your job, battling a divorce, an illness, or struggling with your kids. Often life hits us with something we did not expect, and we have absolutely no idea how to solve the problem, or what to do next. Maybe it is time to call in the right brain.
In a crisis, the left brain only knows how to come up with strategies and options. Sort of like the role President Obama is playing -- he is a left-brained master of keeping his cool and plodding a path of resolution. Yet his poll numbers have dropped -- why? Because we all need to acknowledge the emotional side of the crisis in order to move on. We also need the raging woman with wild hair and blackened fingers to satisfy the right brain of imagery, emotion and ritual.
I have several friends in their late 30's and 40's that are battling breast cancer. It is like an oil leak within the body -- going out of control, destroying everything in sight, and the methods to treat are still crude and scary. In a similar way, the first line of attack is left-brained: get the medical team lined up, assemble the tests, go before the tumor board and come up with a treatment plan. Yet, this also does not ultimately cut it, and we long for some sort of sublime experience to take us out of our bodies and into a more luminous place.
What to do in a crisis of the inner or outer world? Cry a lot, get your mind wrapped around it -- and fight. The boundaries of the inner and the outer world are more transparent than we know. I have found that teaching retreats and workshops which manage overwhelming challenges in life often requires accessing the right brain now and then. The left brain is in charge of being mad, blaming, getting facts, creating lists and making plans. This is a normal reaction, and the TV has been filled with endless examples of our left brain attempts to handle what is unimaginable.
However, the right brain operates on a different level. It wants to pray, meditate, draw, create something or experience a ritual to help gain perspective. A crisis is an assault to all of our senses -- whether it is an external environmental crisis like the Gulf, or an inner crisis like cancer. When the world does not make sense, sometimes we have to access other resources.
In my last post, I interviewed leadership consultant and author Margaret Wheatley, about the power and importance of Perseverance- and recommended a tonglen style meditation of breathing in the horrifying black tar of the gulf into our bodies, and breathing out light, clean and fresh water instead. Many struggled with this right brain approach to a crisis -- this is a waste of time! The left brain demands more concrete actions, like writing letters and yelling at the TV.
I think both strategies are necessary. When a friend of mine was diagnosed with breast cancer, she put her executive trained brain into action and knew every detail of what her treatment would involve. However, what made the greatest impact on her was a special ritual her friends created for her; making a plaster cast of her chest before her double mastectomy that was painted with special words, prayers and images. She was sung to, held, and encircled in a way that harkened back another time.
It made a difference. She was filled with love and hope in a way no chemo treatment could even begin to touch. Rituals can be any sort of experience that is more symbolic than logical. It engages the heart over the head -- the right brain over the left. Rituals and interactive experiences with other people are often so powerful; it moves the head into a different mindset, fills us with grounded clarity and lifts our hearts.
Many have created special ceremonies and rituals for the Gulf spill. Altars have been cropping up in the sand, special healing circles and vigils. Check out Hands Across the Sands- an international ritual set up for June 26th for any group on any beach, to join at 11am and at noon to simply gather together, join hands and pray for an end to offshore drilling and resolution in the Gulf.
Is it going to put a cap on the oil? Not anymore than the time wasted clicking pictures on Capitol Hill of politicians battling for sound byte air time. American's need time to digest the magnitude of this tragedy, to be able to take it in, understand the impact and have a clear mind to make fundamental changes in the future. And, taking time to acknowledge the unseen world, to keen, to create, to come together -- remains fundamental to our very nature.

Detect epilepsy early, avoid brain damage

BANGALORE: Twelve-year-old Megha (name changed) used to blink her eyes at intervals and suddenly go blank for a couple of minutes. It is only when her parents and teachers saw that it was repetitive, she was diagnosed with a form of epilepsy.

This complex neurological disorder has several manifestations. At the free epilepsy screening camp organized by The Times of India in collaboration with BGS Global Hospitals on Saturday, around 75 complex cases were consulted. 


The same campaign will be carried forward for one more week from Monday to Saturday next week at the BGS Hospital campus. Patients will be screened for free. Since there are many myths associated with epilepsy, its treatment has been grossly mismanaged in rural areas. In some places, if women have symptoms of epilepsy, they are considered social outcast.

WHY DOES IT HAPPEN?
The causes of epilepsy go back to poor pre-natal care and incidence of brain fever during childhood that leave a part of the brain damaged. Infections of the brain like neurocysticercosis (parasitic infection of the central nervous system), often caused due to the vegetables that are laced with sewage water or toxic chemicals and pesticides, can also be a reason. A head injury that was not treated properly may also show symptoms of epilepsy at a later stage.

MYTHS
People often associate epilepsy with retardation or psychological disorder. They are given iron rods during seizures or people throw water on them. It can turn dangerous with the patient hurting himself with the object. Women try to hide the condition as they are severely discriminated by the family. Early treatment only can control further brain damage.

SYMPTOMS
“Each type of epilepsy is different. Some people have a vague feeling one or two days prior to the seizure that something is going to happen. It is called prodrome, while some others might see flashes of light or have an abnormal sensation of smell or a sinking feeling. This is called ‘aura’. The patient usually knows that something is wrong,” explains Dr N K Venkataramana, vice-chairman and chief neurosurgeon, BGS Global Hospitals.

Sometimes the symptom is as mild as going blank for a couple of minutes which is called absence seizure. One could also suddenly drop on the floor, which is the drop seizure. If you happen to see someone with symptoms like severe jerking, froth coming out of mouth and sudden paralysis, the best thing to do is to remove sharp objects from the vicinity. Observe the sequence of events, help him lie down in a lateral position, according to Venkataramana.

Children at huge risk of brain tumours from mobile phones, says expert

Expert calls for ban over brain cancer dangers
Girl with mobile phone (Pic:Lilly Dong/SM)
Children should be banned from using mobile phones immediately to stop them suffering brain tumours, an expert has warned.
US scientist Lloyd Morgan said cases of brain cancer could rise 25 fold in the future and predicted there would not be enough trained surgeons to help victims.
"I predict a tsunami of brain tumours," he said. "I do not think we will see the beginning of it for 10 or maybe 15 years but, once it explodes, it could be devastating.
"We could see anything between an increase of four times and 25 times. And unless we train more neurosurgeons now, a great many people will not be able to have surgery."
Mr Morgan, of America's Environmental Health Trust pressure group, said safety measures needed to be put in place immediately.
He said: "Mobiles are like cars - they are not safe, although they can be made safe enough. If you hold a mobile just six inches from your head, the radiation is 10,000 times smaller. Manufacturers should make them hands-free only so you cannot hold one to your ear.
"Children should not be allowed to use them at all. There is a lot of evidence they are more affected by radiation."
Mr Morgan made his controversial comments after presenting a paper warning that a landmark study into mobile phone use released last month had got its results wrong.
The Interphone study, which brought together scientists from 13 countries under the World Health Organisation, found no significant link between shortterm mobile use and cancer, and a slight link in the long term. And confusingly it found in some cases mobiles DECREASED the risk of tumours.
But Mr Morgan said the way the results were analysed meant the true risks were ignored and claimed they were actually 25 per cent higher than the report said.
Under his analysis, presented to a conference last week in Seoul, South Korea, the risk of the most common brain tumour, a glioma, doubles if you use a mobile just once a week for 10 years.
Cancer Research UK has described Mr Morgan's analysis as "overblown" and said there was no evidence brain tumour rates had risen since the use of mobiles had become widespread.
However, his comments come as Britain starts a 30-year project to monitor the health of 100,000 mobile users.
Scientists from London's Imperial College will try to find links between mobile use and a huge range of health problems, including tumours.
At Christmas, the Sunday Mirror revealed the radiation levels of Britain's most popular phones and dsicovered that some pump out as much as three times more radiation than other models TEXT, DON'T CALL..
Mobiles have been linked to an increase in brain tumours, although there is no conclusive evidence.
They contain transmitters which send out waves in all directions , including some into the user's heads.
Britain's official advice is for under-16s to limit mobile use to essential calls. But hardly anyone knows about the guidelines and children as young as eight have handsets.
Children are at greater risk than adults because they have thinner skulls and their brains are still growing. Watchdogs say parents should tell children not to hold phones to their ear and to encourage them to text rather than call.
Print Info In Shop Britain should follow the example of America and display radiation levels next to handsets in stores, an expert said last night.
Last week San Francisco became the first to introduce the new law, which forces stores to show emission levels so the pubic can compare them. And California has ruled mobile radiation levels will have to be displayed on posters in shops.
In Britain manufacturers must reveal the figures - but they are buried in manuals. Graham Philips of mobile campaign group Powerwatch said: "Anyone buying a mobile should know about these figures."

Brain circuits behind hearing develop without sensory experience

Applying a new technique, researchers have found that brain circuits that enable hearing develop without sensory experience.
Researchers at the Keck School of Medicine of the University of Southern California (USC) reached surprising findings about the role of nature versus nurture in the development of the neural circuits in the auditory cortex- the area of the brain that is responsible for processing information about sound.
Two research teams at the Zilkha Neurogenetic Institute (ZNI) found that before an animal model had any hearing experience, the brain's elementary thalamocortical circuits with balanced excitation and inhibition functions - a feature of brain activity essential for normal functions-had already formed.
"The scientific view had been that sensory experience should play an instructive role in the initial formation of appropriate brain circuits, so this is a big surprise. Because the circuits had already formed, no sensory experience was required," said Li Zhang, principal investigator on the study.
The study is considered as a step in addressing a major debate in neuroscience over the last century-it could explain the roles of genetics and environment in the development of the human nervous system.
"In general we know that both factors play essential roles in the establishment of neural circuits. The question is which factor plays a dominant role in the different stages of development, and how. It's a difficult question to resolve because of the dauntingly complex structure of the brain," said Zhang.
They also found that after the onset of hearing an elegant refinement of the neuron's excitation function takes place.
"Previously, it was thought that a pruning of profuse connectivity was responsible for the sharpening of sensory receptive fields of neurons, which leads to improved sensory processing during development," said Zhang.
"We now see that the sharpening depends more on fine adjustments in the strength of excitatory neural connections, and that modulations of the excitatory and inhibitory connections lead to a slight breakdown of the priorly formed excitation-inhibition balance," he added.
Zhang said that the key to these findings was a new method of studying the functional neural circuitry of the brain.
In the experimental setting, the researchers surgically exposed the cortex of the brain of a young anesthetized rat.
They used glass microelectrodes to reach and patch onto neurons buried in the cortical tissue, and then break into their membranes in order to monitor their electrical activity.
This allowed the researchers to separately record the inhibition and excitation functions of the neurons.
"This is the first time anyone has applied this cutting-edge electrophysiological technique - in vivo whole-cell voltage-clamp recording - to the developing cortex of the brain. Previous hypotheses were limited by techniques that couldn't reveal detailed structure and subtle changes," said Zhang.
Currently, Zhang's research team is examining how the neural circuitry is affected when animals are exposed to noise.