Saturday, October 20, 2012

How our brains work to erase bad memories

Got a bad memory? The brain has a unique way of helping you forget.
Say you’re on a date and you trip and fall so your dress rides up and he sees your underwear. Or your boss tells you that for the third year in the row there will be no raises. Both of these experiences feel uncomfortable, but what do you do to forget these awkward memories? Researchers found that we use two different ways -- suppression or substitution -- to avoid thinking of uncomfortable or unhappy memories.

“We assume that, in everyday life, healthy people will use a mixture of both mechanisms to prevent an unwanted memory from coming to mind,” says Roland Benoit, a scientist at the Medical Research Council, Cognition and Brain Sciences Unit at University of Cambridge, via email. “We did not know whether the processes of direct suppression and thought substitution can be isolated, and which, if any of them, would actually cause forgetting.” 

Roland and his co-author, Michael Anderson, asked 36 adults to participate in a memory exercise where half suppressed memories and the other half substituted new memories. The researchers hoped to understand how we voluntarily forget and how it affects general memory. The subjects were tested during magnetic resonance imaging procedures, or MRIs, allowing the researchers to observe how the brain works during suppression and substitution.

While both processes cause forgetting, a different region of the brain controls each one. When people suppress memories, the dorsal prefrontal cortex inhibits activation in the hippocampus, which plays an important role in retaining memories.

“It thus effectively breaks the remembering process. This, in turn, disrupts the memory representations that would be necessary for recalling the unwanted memory later on,” Benoit explains.

When it comes to substitution, the brain works a bit differently -- the caudal prefrontal cortex and midventrolateral prefrontal cortex form a network of sorts that works with the hippocampus to swap out new information with details people would soon forget.

“By just looking at how well people forgot memories, you couldn’t tell whether they had done direct suppression or thought substitution,” Benoit says. “These mechanisms are based on different brain systems that work in opposite fashion: One (direct suppression) by ‘slamming the mental break’ to stop the remembering process and the other (thought substitution) by steering the remembering process towards a substitute memory.”

Even though people exploit both to forget those nagging, unwanted memories, actively overlooking unpleasant events can negatively impact how we remember. But Benoit notes that learning how people deal with unwanted memories helps them understand how people with traumatic memories, such as PTSD sufferers, cope with remembering. 

“It is perfectly natural for people, upon encountering an unwelcome reminder, to try to put the unpleasant reminding out of mind. We all have experienced this.  Intuitively, it feels as though we solved this problem.” 

Fish oil helped save our son

Bobby Ghassemi was just 17 years old when he was in a horrific car accident. Bobby Ghassemi was just 17 years old when he was in a horrific car accident. 

After the accident in March 2010, doctors told Bobby's family that he could live out the rest of his life in a vegetative state. After the accident in March 2010, doctors told Bobby's family that he could live out the rest of his life in a vegetative state.

(CNN) -- Time seemed to slow as Marjan Ghassemi saw her 17-year-old son, Bobby, lying in a hospital bed after a car crash.

He had a thick band of gauze wrapped around his head and a tangle of tubes protruding from his body. A hole was cut into his windpipe, and the hollow-sounding hiss of machines helping him breathe filled the room.
At that point, there was no telling whether he would live or die, but Marjan was determined not to cry.

"From day one, when we got there, I didn't want him to know we were crying, that we were upset," she said. "I wanted all positive energy in the room.

Ten days after the accident, Bobby was still in a coma. Bobby's father, Peter, talked with Dr. Michael Lewis, who suggested that omega-3 fatty acids might be able to help. Peter insisted that his son be given high doses of fish oil through a feeding tube. Ten days after the accident, Bobby was still in a coma. Bobby's father, Peter, talked with Dr. Michael Lewis, who suggested that omega-3 fatty acids might be able to help. Peter insisted that his son be given high doses of fish oil through a feeding tube.  
"I went in his ear and said ... 'You fight your way and come back to us.' "

It was March 2010. Bobby Ghassemi had been driving fast along a winding road in Virginia when his car barreled off the road. By the time paramedics arrived, he was in a coma and barely alive.

"For all intents and purposes, he was dead on the scene," said Dr. Michael Lewis, a physician who later advised the family. "I'm looking at the reports, and they report a Glasgow Coma Score of 3. A brick or a piece of wood has a Glasgow Coma Score of 3. It's dead."

Ghassemi was airlifted to a hospital. For the first three days, it was touch and go.

Ghassemi's brain was so engorged, doctors needed to relieve the pressure by taking out a portion of his skull. He also had what is called diffuse axonal injury: bleeding that suffused nearly every part of his brain.
"His doctor said to me, 'Listen, he has survived. It is a miracle that he lived, that he made it,' " Marjan Ghassemi said. " 'If he comes out of the coma ... I don't know if he's going to be a vegetable for the rest of his life or whether he'll remember anybody.' "

Bobby says the omega-3 fatty acids have helped in recovering his motor skills. Bobby says the omega-3 fatty acids have helped in recovering his motor skills.  
Ten days later, as Bobby lay comatose but stable, his father, Peter Ghassemi, was sick of waiting and desperate for an intervention. After a series of phone calls to friends, he ended up speaking with Lewis, an Army colonel and doctor.

After some discussion, Lewis proposed something that Peter Ghassemi had never heard about for traumatic brain injuries: fish oil.

At that point, Peter Ghassemi was open to anything.

"Every minute passing was hurting my son ... because they weren't really doing anything to help him besides keeping him alive and stabilizing all of his vital signs," he said. "If there was a chance to improve, I wanted it to be done right then."

'He was really in dire straits'
Fish oil -- which is composed of omega-3 essential fatty acids, also found in the brain -- had been used only once before to treat a brain injury as devastating as Ghassemi's. That was in 2006, in the case of Randal McCloy, the sole survivor of a mine disaster in West Virginia.

McCloy, 26, was trapped in a mine for 41 hours while the air around him and 12 other miners filled with noxious methane and carbon monoxide. By the time he was pulled from underground, he had had a heart attack, was in liver and kidney failure and had a collapsed lung, according to his doctors.

His brain was also riddled with damage from the carbon monoxide and methane.

McCloy's prognosis was not very different from Ghassemi's. According to his neurosurgeon at the time, Dr. Julian Bailes, restoring McCloy's normal brain function was truly a long shot.

"Randy was really on death's doorstep," said Bailes, now co-director of NorthShore Neurological Institute in Evanston, Illinois. "He was really in dire straits."

Like with Ghassemi, once McCloy was stabilized, there was little doctors could do to stem the tide of inflammation and cell death occurring in his brain.

But Bailes and other doctors on McCloy's team resisted the "wait and see" course common in these types of cases and began an unorthodox treatment regimen, including hyperbaric oxygen treatments and high doses of fish oil.

"The concept was then trying to rebuild his brain with what it was made from when he was an embryo in his mother's womb," Bailes said.

The brick wall analogy
That's the theory behind using omega-3 fatty acids to heal brain injury. The human brain, which itself is a fatty mass, is about 30% composed of omega-3 fatty acids, according to Lewis.

In his words, high doses of omega-3 fatty acids, since they mirror what is already in the brain, could facilitate the brain's own natural healing process.

"It really gets down to what I would call my brick wall analogy," Lewis said. "If you have a brick wall and it gets damaged, wouldn't you want to use bricks to repair the wall? And omega-3 fatty acids are literally the bricks of the cell wall in the brain."

Most of the studies about omega-3 for traumatic brain injury are in animals, but they indicate potential for healing the human brain.

After a trauma, the brain tends to swell, and the connections between some nerve cells can become damaged, while other cells simply die.

National Institutes of Health research suggests that omega-3 fatty acids may inhibit cell death and could be instrumental for reconnecting damaged neurons.

Another recent study revealed genes that are activated to contain massive damage -- especially inflammation -- when the brain is injured. What activates those genes: omega-3.

"We have strong data that suggest omega-3 will activate good proteins to cope with brain damage and turn off proteins that cause neuroinflammation," said Dr. Nicolas Bazan, director of the Neuroscience Center of Excellence at LSU Health in New Orleans and author of the study.

And besides that, according to Bailes and Lewis, fish oil may be the only solution for brain damage that continues after a traumatic brain injury patient has been stabilized.

"There is no known solution; there's no known drug; there's nothing that we have really to offer these sorts of patients," said Bailes, who along with Lewis received money from companies that make fish oil after their treatment of Ghassemi and McCloy.

The damage to McCloy's brain was profound, according to Bailes. Not only did it experience massive cell death, the protective sheath around McCloy's nerve cells had been stripped during the hours of exposure to toxic gases. That sheath, called myelin, allows brain cells to communicate with one another.

Bailes consulted with a fish oil expert and eventually decided that administering 20 grams a day of omega-3 fish oil through a feeding tube might repair the myelin sheath. (For comparison: A typical supplemental dose for someone with an uninjured brain is about 2 grams a day.)

"We decided to throw the kitchen sink at him," Bailes said. "If we were going to fail, we were going to fail with all guns blazing, so we gave him a very high, unprecedented dose to make sure we saturated and got high levels in the brain."

Less than three weeks after the mine disaster, McCloy was emerging from his coma. Three months after that, he was walking and speaking.

Citing McCloy's dramatic recovery, Lewis spoke with Peter Ghassemi about introducing omega-3 for his son. After that conversation, Peter Ghassemi was convinced and began to pressure his son's doctors.

"It was a fight," Peter Ghassemi said. "They didn't believe, and they said, 'Fine, the West Virginia miner was one case. Bring me 999 more cases, a thousand more cases ... before I can give it to your son.' "

But eventually they conceded, and Bobby Ghassemi was started on high-dose fish oil therapy, at a dosage that mirrored what Bailes had given to McCloy in 2006.

'The whole place was cheering for me'
Two weeks after beginning the regimen, Ghassemi was emerging from his coma.

"We saw hand movements on the left side," Peter Ghassemi said. "Around the fifth or sixth week, there was some movement, and then his hands started moving more, the leg was moving more."

Soon after that, Bobby began to show signs of recognizing his family and his dog and of discerning things like colors and numbers. Slowly, his brain was recovering, and his family ardently believes that the high-dose fish oil is the reason why.

"His brain was still recovering, but with (omega-3), it recovered much faster and in a shorter amount of time," Peter Ghassemi said. "His brain was damaged, and this was food for the brain."

Three months after his accident, Bobby Ghassemi was well enough to attend his high school graduation.
"The whole place was cheering for me, and they all stood up and were screaming and cheering my name," Ghassemi, now 20, recalls with a smile. "I took my graduation cap off and waved it around."

He still has significant left-side weakness and is relearning how to walk, but his progress has been tremendous, according to Lewis.

"In my opinion, and this is pure speculation, he never would have come out of a coma if it hadn't been for the use of omega-3s to allow that natural healing process to occur," said Lewis, founder of the Brain Health Education and Research Institute. "In the end, the brain has to heal itself. There are no magic cures for brain injury."

Large-scale study needed
But what do these two dramatic stories really say about omega-3 as a potential treatment for traumatic brain injury? For now, they are merely stories with omega-3 as a common denominator.

The remaining questions are as poignant as the stories themselves: Could youth have been a factor for Ghassemi and McCloy? What about other treatments given to McCloy, like hyperbaric oxygen? Could they have played a role?

Those and other questions could and should be answered, according to experts, with a large-scale clinical study.
"These two clinical cases where we have a wildly unexpected recovery, was it just luck that they woke up?" asked Dr. Joseph Hibbeln, an omega-3 expert and chief of the Section on Nutritional Neurosciences at the National Institutes of Alcohol Abuse and Alcoholism. "Or is there some reasonable scientific explanation for it?
"Given that there aren't any other treatments, this is a good bet," Hibbeln said. "It's really only reasonable to go forward with doing the full press of careful intervention studies."

The implications of a successful study are huge: 1.7 million people suffer a traumatic brain injury each year in the United States.

And research into how omega-3 might function for stroke, Parkinson's disease and early Alzheimer's disease is ongoing.

"The message that I'm trying to get across is, there's more you can do," Lewis said. "If you add omega-3s, we can then begin to let the brain heal itself a little more efficiently."

"Up until the time the pharmaceutical industry gives us a drug that cures all brain injury, this is the best hope we have," Bailes said.

High-carb diet may impair brain function

Older people who load up their plates with carbohydrates have nearly four times the risk of developing mild cognitive impairment, a new study finds.

Sugars also played a role in the development of MCI, which is often a precursor to Alzheimer’s disease, says the report in the newest Journal of Alzheimer’s Disease. Eating more proteins and fats offers some protection from MCI.

Mayo Clinic researchers tracked 1,230 people ages 70 to 89 and asked them to provide information on what they ate the previous year. Among that group, only the 940 people who showed no signs of cognitive impairment were asked to return for follow-ups every 15 months.

By the study’s fourth year, 200 of the 940 were beginning to show mild cognitive impairment — problems with memory, language, thinking and judgment. Compared with people who rank in the bottom 20 percent for carbohydrate consumption, those in the highest 20 percent had a 3.68 times greater risk of MCI, the study found. Overall, about six in every 100 people develop MCI in their lifetime.

Not everyone with MCI develops Alzheimer’s disease, but many do, says lead author Rosebud Roberts, a professor in the department of epidemiology at the Mayo Clinic in Rochester, Minn. Alzheimer’s affects 5.2 million U.S. adults, numbers that are expected to triple by 2050.

“If we can stop people from developing MCI, we hope we can stop people from developing dementia. Once you hit the dementia stage, it’s irreversible,” says Roberts.

Among foods regarded as complex carbohydrates: rice, pasta, bread and cereals. The digestive system turns them into sugars. Fruits, vegetables and milk products are simple carbs.

“A high-carbohydrate intake could be bad for you because carbohydrates impact your glucose and insulin metabolism,” says Roberts. “Sugar fuels the brain, so moderate intake is good. However, high levels of sugar may actually prevent the brain from using the sugar — similar to what we see with type 2 diabetes.”

Roberts says high glucose levels might affect the brain’s blood vessels and play a role in the development of beta amyloid plaques, proteins toxic to brain health that are found in the brains of people with Alzheimer’s. Researchers don’t know what causes the disease, but they suspect the buildup of beta amyloid is a leading cause.

Also among the study’s findings:

Those whose diets were highest in fat (nuts, healthy oils) were 42 percent less likely to get cognitive impairment, while those who had the highest intake of protein (chicken, meat, fish) had a reduced risk of 21 percent.

Several popular diets, including the Mediterranean (fish, poultry-based protein; plenty of plant-based foods and healthy fats) and Atkins (low-carb, meat-lover’s diet), make pitches for the multiple health benefits from lowering carb intake, including reduced risk for heart disease and diabetes, and improved brain health.

Eric Westman of Duke University Health System, who is author of The New Atkins for a New You, called this “a provocative, preliminary study that suggests that we can add the loss of mental function in older age to the list of medical problems caused by excessive carbohydrate consumption. This is not proof that a low-carb diet will fix dementia, but it is a good argument for conducting studies to determine if it can.”

Roberts says the study offers hope because “it shows a modifiable way we can reduce risk for the disease. It is important to eat a balance of protein, carbohydrates and fat.”

Why brain tumors are so hard to destroy

The most common and aggressive brain tumor grows by turning normal brain cells into stem cells, which can continuously replicate and regrow a tumor with only a handful of cells left behind, new research finds.

The findings help explain why the tumors, called glioblastomas, are so difficult to treat, said study researcher Inder Verma, a molecular biologist at The Salk Institute in California. Even the surgical removal of a tumor may not be able to extract every single cancerous cell, Verma told LiveScience.

Glioblastomas "reoccur because every cell that is left behind has the ability to start all over again," Verma said.
Aggressive tumors
Glioblastoma multiforme tumors make up the majority of brain tumor cases and have a very poor prognosis. According to a 2010 study in CA: A Cancer Journal for Clinicians, the average survival rate after a glioblastoma diagnosis is 14 months (though improving surgical techniques had boosted that number from 10 months in only five years prior to the study).

Verma and his colleagues were interested in finding a more accurate way of studying tumor growth. Most mice studies of cancer introduce human tumor cells into mice with no immune systems or genetically engineer mice so that every cell is cancer-prone. But that's not how tumors arise in real life, Verma said. He and his co-researchers wanted to find a way to mimic cancer's growth from a single cell to out-of-control.

Using viruses, they introduced cancer-causing genes into mice, developing a technique in which as few as 20 cancerous cells can trigger tumor growth. They then found that a mere 10 cells from one of these mouse tumors, transplanted into a healthy mouse, could lead to a whole new tumor in that mouse. [Colorful But Deadly: Images of Brain Cancer]

"That suggested that every cell in these tumors or glioblastomas has the ability to make new glioblastomas," Verma said.

Stem cell switch
Researchers once believed that glioblastomas arose only from glial cells, the "support" cells in the brain that surround neurons. When it was discovered that the brain contains stem cells, which are capable of transforming into any sort of neural tissue, researchers figured cancer could arise from those cells, too, said study researcher Dinorah Friedmann-Morvinski, also a Salk Institute researcher.

But now, Friedmann-Morvinski, Verma and their colleagues have found they can coax even neurons into cancer cells by introducing cancer-causing genes. The neurons, which should not be able to divide and reproduce anymore, turn back into stem cells, which can continuously divide.

Researchers have successfully reprogrammed cells into stem cells in the lab, a feat that earned scientists John B. Gurdon and Shinya Yamanaka the 2012 Nobel Prize in Medicine. It was surprising, still, to find the cancer cells performing this trick, Friedmann-Morvinski told LiveScience, but there were "some hints it might be happening."

The next step, the researchers said, is to learn more about how the cells revert into stem cells and then find a way to block the out-of-control growth of these cancerous cells.

"You have to kill them in order to kill the tumor in the long run," Verma said.

How the brain perceives direction and location

London, October 20 (ANI): In a new study, researchers are investigating nerve cells in the brain that function in establishing one's location and direction.

Dartmouth neurobiologist Jeffrey Taube is using microelectrodes to record the activity of cells in a rat's brain that make possible spatial navigation -how the rat gets from one place to another - from "here" to "there."
But before embarking to go "there," you must first define "here."

"Knowing what direction you are facing, where you are, and how to navigate are really fundamental to your survival," Taube said. 

"For any animal that is preyed upon, you'd better know where your hole in the ground is and how you are going to get there quickly. And you also need to know direction and location to find food resources, water resources, and the like," he said,

Not only is this information fundamental to your survival, but knowing your spatial orientation at a given moment is important in other ways, as well. 

Taube points out that it is a sense or skill that you tend to take for granted, which you subconsciously keep track of. 

"It only comes to your attention when something goes wrong, like when you look for your car at the end of the day and you can't find it in the parking lot," Taube said.

Perhaps this is a momentary lapse, a minor navigational error, but it might also be the result of brain damage due to trauma or a stroke, or it might even be attributable to the onset of a disease such as Alzheimer's.
Understanding the process of spatial navigation and knowing its relevant areas in the brain may be crucial to dealing with such situations.

One critical component involved in this process is the set of neurons called "head direction cells."
These cells act like a compass based on the direction your head is facing. They are located in the thalamus, a structure that sits on top of the brainstem, near the centre of the brain.

He is also studying neurons he calls "place cells." These cells work to establish your location relative to some landmarks or cues in the environment. 

The place cells are found in the hippocampus, part of the brain's temporal lobe. They fire based not on the direction you are facing, but on where you are located.

Studies were conducted using implanted microelectrodes that enabled the monitoring of electrical activity as these different cell types fired.

Taube explains that the two populations - the head direction cells and the place cells - talk to one another.
"They put that information together to give you an overall sense of 'here,' location wise and direction wise," he said.

"That is the first ingredient for being able to ask the question, 'How am I going to get to point B if I am at point A?' It is the starting point on the cognitive map," Taube said.

Taube and Stephane Valerio, his postdoctoral associate for the last four years, have just published a paper in the journal Nature Neuroscience, highlighting the head direction cells. 

The studies described in Nature Neuroscience discuss the responses of the spatial navigation system when an animal makes an error and arrives at a destination other than the one targeted - its home refuge, in this case. 

The authors describe two error-correction processes that may be called into play - resetting and remapping - differentiating them based on the size of error the animal makes when performing the task.

When the animal makes a small error and misses the target by a little, the cells will reset to their original setting, fixing on landmarks it can identify in its landscape. 

"We concluded that this was an active behavioural correction process, an adjustment in performance," Taube said.

"However, if the animal becomes disoriented and makes a large error in its quest for home, it will construct an entirely new cognitive map with a permanent shift in the directional firing pattern of the head direction cells," he said.

This is the "remapping."

The study has been published in Nature Neuroscience.

Brain-eating amoeba

PHYSICIANS M. Fowler and R.F. Carter first described human disease caused by amoebo flagellates in Australia in 1965. Their work on amoebo flagellates has provided an example of how a protozoan can effectively live both freely in the environment and in a human host. 

Since 1965 more than 144 cases have been confirmed in a variety of countries. In 1966 Fowler termed the infection resulting from N. fowleri primary amoebic meningoencephalitis (Pam) to distinguish this central nervous system (CNS) invasion from other secondary invasions caused by other true amoebas such as entamoeba histolytica.

A retrospective study determined the first documented case of Pam possibly occurred in Britain in 1909. Onset symptoms of infection start about five days (range is from one to seven days) after exposure.

The initial symptoms include, but are not limited to, changes in taste and smell, headache, fever, nausea, vomiting and stiff neck. Secondary symptoms include confusion, hallucinations, lack of attention, ataxia, and seizures. After the start of symptoms, the disease progresses rapidly over three to seven days, with death occurring from seven to 14 days after exposure.

Countries where cases of amoebia are found are the US, Chezk Republic, New Zealand, Pakistan and the UK. It is a universal issue. International organisations must get together to find out its solution to save human lives.

When the brain refuses to take the hint

Many misconceptions about MS... Photo: K.R. Deepak
The Hindu Many misconceptions about MS...

Multiple Sclerosis (MS) is a disease of the brain and spinal cord marked by loss of balance, vision loss, weakness of limbs, and bladder dysfunction among other symptoms. However, it often goes 
undiagnosed, leading to delay in treatment. It affects women more than men. The disorder is commonly diagnosed between 20 and 40 years but can be seen at any age. 

MS is caused by damage to the myelin sheath, the protective covering that surrounds nerve cells. Due to damage in the nerve layer, transmission of signals from the brain and spinal cord is affected. 

Due to certain myths and misconceptions, many people do not come out in the open to get themselves diagnosed and treated. Multiple Sclerosis is stereotypically believed to be a disease that is fatal, contagious, genetic, that can’t be treated, and that every patient ends up in a wheelchair. 

According to research, most people with MS have a normal life expectancy and it is not contagious or infectious. As for the fear of ending up in a wheelchair, most MS patients do not require a wheelchair if diagnosed early. At the same time, the use of mobility devices is just a way of providing independence and relief from fatigue and other symptoms. The fear of MS being a genetic disease can easily be explained by the fact that, even though people with relatives who have MS have a slightly higher chance of getting it, there is no genetic certainty. 

The last decade has seen the development of disease-modifying therapies (DMTs) to treat MS. These therapies directly affect the underlying process in relapsing-remitting MS. The physician will determine the best DMT course depending upon various factors. An accurate diagnosis of multiple sclerosis is based on the combination of clinical features, cerebrospinal MR imaging, neurophysiological and laboratory tests.

Therapy matters

MS may be a chronic debilitating disease but it can be managed with proper care. Alternative therapies such as physical therapy, speech therapy and occupational therapy help manage the symptoms. 

While researchers are working to develop new treatments for different stages of MS, several other forms of treatments are being undertaken. The problem, though, is that these are untested and cannot be recommended safely. Take stem cell treatment, for example. It may be a reality in the future but is now used only for research. Even though technologically advanced, stem cell treatments pose the threat of uncontrollable growth in the stem cells leading to tumors. 

Need for awareness

As a result these treatments may be said to take undue advantage of the patient’s desperation. Also what is needed is much higher awareness among patients about these treatments.

MS is largely incurable; but there are several ways of improving the patients’ life. In case of MS, the patients must avoid stress at any cost. Other factors that can worsen symptoms include over exposure to sun and steam baths. Increased body temperature can temporarily make the symptoms worse by causing the nerves affected by MS to function even more poorly.

Many patients with MS understand these arguments but still insist on going ahead with banned or non-viable procedures like “liberation therapy” and “stem cell therapy”. They can hardly be blamed as they fear ongoing loss of function and premature death. 

Leading a healthy lifestyle and paying heed to the suggestions of experts is recommended. Health decisions should not be based on hope and desperation but should be rational and practical. 


Muscular: Unable to balance, numbness or tingling or pain in any part of the body, unable to move arms/legs properly or coordinate movement,  muscular spasms, tremor or weakness in limbs.

Bowel and bladder: Constipation, inability to control bowels, difficulty urinating or frequent need/strong urge to urinate.

Eye: Uncontrollable rapid eye movement, double vision, discomfort, and vision loss.

Sexual: Decreased sexual drive, problem with erections, ejaculation or vaginal lubrication.

Patients, families help direct groundbreaking brain research

WILLIAM SUAREZ/HOLLAND BLOORVIEW Holland Bloorview patient Corvin shows Dr. Tom Chau his favourite computer game in 2009. Dr. Chau and his team had developed a customized communication switch to allow Corvin to access a computer.

Two years ago, a 26-year-old man with severe spastic quadriplegic cerebral palsy communicated with the outside world for the first time.

Tom Chau, vice-president of research at Holland Bloorview, and his team had spent months training him how to use the heat from his mouth, one of the only parts of his body that he could control, by opening and closing it.

These signals, when linked to an infrared thermographic switch, allowed the man to type his first word.

“M-U-T-H—,” he wrote.

“Mouth,” a research assistant in the room said, according to Chau. “Are you typing, ‘Mouth?' ”
“ — E-R,” he finished.

“He typed ‘Mother,' ” Chau recalls. “He typed ‘Mother.' ”

Chau says it is stories like these that motivate him in his work. There are 18 scientists at Holland Bloorview’s Research Institute, with four focusing on three to four different groundbreaking, brain-related research initiatives at any given time. It sounds like a lot, but Chau says resources are limited and they have to be choosy about what projects to take on.

Since children and their families at the hospital act as research subjects, Chau says it's often their input that informs the direction research takes.

In addition to Chau's work in brain computer interfacing, scientist Darcy Fehlings studies neuro-reorganization, which focuses on the rehabilitation of children with congenital brain disorders; Michelle Keightley is investigating the neuro-rehabilitation of kids with acquired brain injuries; and clinician-scientist Evdokia Anagnostou is a child neurologist and the co-lead of the Autism Research Centre at Holland Bloorview, which opened in 2011.

“Here, we believe that understanding the biology will lead to treatment,” Anagnostou says. “If we don't understand what the biological problem is, then our attempts for therapeutics are very modest.”

The centre is tapped into global autism spectrum disorder (ASD) research, and scientists communicate with the scientific community and the Holland-Bloorview community to decide what initiatives to take on.

Recently, Anagnostou studied oxytocin hormone levels. In women, the hormone is important for producing breast milk and during labour and delivery. But when the oxytocin gene in male and female animals was removed, the animals lost aspects of their social function.

Anagnostou is applying these findings to kids with ASD in the hope that by manipulating their oxytocin levels she can improve their social interactions.

In another Holland Bloorview study, the ratio of chemicals in the brain associated with excitability and calmness are manipulated with Riluzole, a drug used to treat amyotrophic lateral sclerosis (ALS), more commonly known as Lou Gehrig's disease. Scientists believe that there may be an imbalance in this chemical ratio in the brains of kids with ASD, making it difficult for them to filter out what most people consider “noise” or insignificant information.

There are already therapeutics that patients benefit from at Holland Bloorview, and the new 18-month well-baby visit, a program being rolled out by the Ontario government, could help pediatricians recognize the signs of autism or other issues at an early age. But in order for kids to benefit from the early diagnosis, they must receive treatment.

“The earlier we pick them up, the better the chances for outcomes,” Anagnostou says. “But do you know what the Toronto system for autism services is doing with early diagnoses? They put them on a waiting list until they're three.”

Keightley, a neurologist, studies acquired brain injuries, such as meningitis, vasculitis, stroke and concussions, which have become particularly topical with respect to professional sports.

Scientists have developed new “return-to-play” guidelines for adults who have suffered a concussion, stipulating a period of rest before they can play again. But there are no such evidence-based guidelines for children and youth.

“In the province of Ontario alone, there are probably 240,000 kids playing registered hockey. And we know that a conservative estimate of a concussion is 10 per cent,” says Keightley. “So that's 24,000 concussions happening every year in the sport of hockey alone.”

In one study, Keightley had kids wear a special helmet while they played hockey that recorded information about what parts of the head were hit. Scans of their brains were taken before and after games, in an effort to see if hits affected brain function. Results are pending.

Despite the exciting prospects in brain research at Holland Bloorview, Chau says one of the more challenging aspects is that there's always a chance participants won't benefit directly from their participation, nor is there any certainty that the experiment will work. And since children and families can commit themselves to studies for long periods of time, it can really test the resilience of researchers and their subjects. And, yet, according to Anagnostou, they never have any shortage of willing participants for the work they're doing.

“I have to say it has been impressive how willing Ontarians are to participate,” she says. “We haven't had to place a single ad in the newspaper yet for our study. They come.”

Mobile phone 'caused brain tumour' says Italy's top court

Mobile phone Compensation case: an Italian court has concluded that mobile phone use gave a businessman a benign brain tumour. 

ITALY'S top court has ruled a businessman's brain tumour was caused by regular mobile phone use so he deserves worker's compensation.

Innocente Marcolini, whose face is partially paralysed, argued that using mobile phones six hours a day for 12 years while dealing with clients in China and elsewhere overseas caused the tumour on the trigeminal nerve in his head.

His lawyers presented doctors who testified that excessive mobile phone use increases risk of such tumours.
The impact of the ruling earlier this week is unclear. Numerous large scientific studies have failed to find a causal link between cellphones and brain tumours.

The World Health Organisation classifies mobile phones as "possible" carcinogens, in the same category as pesticides and coffee.