'A lot of people think they're invincible,' surgeon saysIt was just a regular day that changed A.J. Avilla's life forever.
The 19-year-old off-road motorcycle racer zoomed up an 80-foot wooden ramp he had just built.
He went flying -- not to the end of the ramp but 50 feet in the air, then slammed hard into the ground.
He broke his neck and femurs.
"I woke up four days later really confused," said Avilla, of Cambridge. "At first I thought I was paralyzed. It was the saddest moment of my life. I felt like I lost everything."
Avilla's crash is similar to the dozens hospitals see every Victoria Day weekend -- a peak time for brain and spine injuries.
Avilla's crash took its toll on his body, and on his family.
Though the accident happened in March, he's now just starting to walk again with a cane.
"(My family's) still recovering emotionally. Seeing me walk again is a big step for them, too," he said.
"It just feels like I got a second chance."
Not everyone gets that chance.
After leg and arm breaks, the most common injury at this time of year is brain or spine injury, said Dr. Niv Sne, trauma expert and surgeon at Hamilton General Hospital.
In 2008-09, about 20,000 people in Ontario suffered bicycle-related injuries, he said.
About 500 people in the Hamilton region have serious ATV accidents each year.
Across Ontario, 20 die from these annually, he added.
Most often injured in ATV crashes are males aged 15 to 19, according to the Ontario Injury Prevention Resource Centre.
"A lot of people think they're invincible," Sne said.
"This is the start of the summer peak (in trauma injuries). This is the time when kids get out their motorcycles, ATVs, do their partying."
Though boating accidents aren't as common now, Sne said, people often get hypothermia because the water's still too cold.
Near drownings, fractures, heat stroke and food illnesses from more outdoor eating also increase at this time of year, said paramedic Mario Posteraro, president of OPSEU Local 256.
Sne said brain injury death rates haven't changed for the last 20 years, and that people should change their behaviour in simple ways to avoid any injuries:
* Know your equipment
* Make sure there's a supervisor
* Don't drink and drive
* Wear helmets and protective gear
* Be aware of your surroundings
"Even though you might think it's OK to ride around in your neighbourhood without the proper equipment, it takes one small millisecond for it to change the rest of your life," he said.
Overall, about 30 per cent of all traumatic injuries can be avoided, he added.
And it's never just the victim who suffers from a severe accident, Sne said.
"It's not just dealing with the patients. It's going to the parents and saying, 'Your kid will never walk again,' or 'Your kid will never regain consciousness again,'" he said.
"Potentially these things could have been avoidable."
Tuesday, May 25, 2010
New drug improves symptoms in autism disorder
Researchers from Mount Sinai School of Medicine have identified a drug that improves communication between nerve cells in a mouse model of Phelan McDermid Syndrome (PMS). Behavioral symptoms of PMS fall under the autism spectrum disorder category.
The research will be presented Friday at the International Meeting for Autism Research (IMFAR) in Philadelphia.
Previous research has shown that a gene mutation in the brain called SHANK3 can cause absent or severely delayed language abilities, intellectual disability, and autism. Mount Sinai researchers developed mice with a mutant SHANK3 gene and observed a lapse in communication between nerve cells in the brain, which can lead to learning problems. This communication breakdown indicated that the nerve cells were not maturing properly.
The researchers then injected the mice with a derivative of a compound called insulin-like growth factor-1 (IGF1), which is FDA-approved to treat growth failure in children. After two weeks of treatment, nerve cell communication was normal and adaptation of nerve cells to stimulation, a key part of learning and memory, was restored.
"The result of IGF1 treatment of these mice is an exciting development on the road to ultimate therapies for individuals with PMS," said Joseph Buxbaum, PhD, Director of the Seaver Autism Center for Research and Treatment at Mount Sinai School of Medicine. "If these data are further verified in additional preclinical studies, individuals with a SHANK3 mutation may benefit from treatments with compounds like this one."
Dr. Buxbaum and his team at the Seaver Autism Center will continue to evaluate the efficacy of IGF1 in mice. Patrick Hof, MD, Professor of Neuroscience at Mount Sinai School of Medicine, will specifically evaluate the effects of the compound on neuroanatomical changes. Additionally, Jacqueline Crawley, PhD, Senior Investigator at the National Institutes of Health, will study the effects on behavioral changes in the mice.
Doctor will fight GMC striking-off
Twelve years after his initial report was published, Dr Andrew Wakefield was found guilty of serious professional misconduct at a hearing in central London.
The doctor, who grew up in Bath but spends much of his time in America, confirmed he would appeal against a decision by the General Medical Council (GMC) to strike him off the medical register.
A GMC panel ruled he acted in a way that was "dishonest", "misleading" and "irresponsible" while carrying out research into a possible link between the measles, mumps and rubella (MMR) vaccine, bowel disease and autism.
But parents have pledged to give him their continued support.
Allison Edwards, chairwoman of campaign group Cry Shame, said: "I knew they would do this, they've had the intention of doing this for the past three years.
"This is to issue a warning to doctors not to dissent. No children were harmed in the clinical tests, they were trying to look at the problems and treat them, and the children improved. How do you get charged with doing your job?"
Isabella Thomas, 53, from Somerset, insisted her sons Michael, 18, and Terry, 16, received "fantastic" treatment under Dr Wakefield.
Another of her sons, Nigel, 30, handed a petition with more than 11,000 signatures to the GMC in support of Dr Wakefield and his colleagues, Professors John Walker-Smith and Simon Murch.
Mr Thomas said: "I've seen my parents struggle to find out what was wrong with their children and how upset they were when doctors dismissed their concerns or could not do anything for them.
"Dr Wakefield was accused of a callous disregard for the children but that's exactly what the GMC are doing. He tried to help them. It's ridiculous to say that any of the tests they had were in any way inappropriate."
Dr Wakefield was educated at King Edward's School in Bath and his parents – both retired doctors – still live in the city.
He said: "I will be appealing and I hope Professor Walker-Smith will be appealing.
"I think it's a very sad day when government pressure and grossly distorted journalism can have such a profound effect on healthcare for very sick children in the UK."
He insisted there had been fully-informed consent for the children in the Lancet study.
He said there was parental consent for extracting blood from a group of children at his son's birthday party.
He added: "In reporting their findings, the GMC panel sought to deny that the case against me and my colleagues is related to issues of MMR vaccine safety and, specifically, the role of this vaccine in causing autism. This is not in fact the case.
"Efforts to discredit and silence me through the GMC process have provided a screen to shield the Government from exposure on the (Pluserix) MMR vaccine scandal."
Prof Walker-Smith, 73, was also found guilty of serious professional misconduct and struck off. Prof Murch was found not guilty.
Dr Wakefield caused controversy when he published a study suggesting a link between the MMR vaccine, bowel disease and autism.
The research, which appeared in The Lancet medical journal in 1998, sparked a massive decline in children having the triple jab.
The GMC said Dr Wakefield took blood from his son's friends at a birthday party, paying the youngsters £5 each, before joking about it during a presentation.
He also ordered some youngsters to undergo unnecessary colonoscopies, lumbar punctures (spinal taps), barium meals, blood and urine tests and brain scans, the panel said.
Dr Wakefield was an honorary consultant in experimental gastroenterology at London's Royal Free Hospital at the time of his research.
A spokeswoman for the Department of Health said: "Thankfully, more parents are having their children vaccinated with MMR and they see it as being as safe as other childhood vaccines."
The doctor, who grew up in Bath but spends much of his time in America, confirmed he would appeal against a decision by the General Medical Council (GMC) to strike him off the medical register.
A GMC panel ruled he acted in a way that was "dishonest", "misleading" and "irresponsible" while carrying out research into a possible link between the measles, mumps and rubella (MMR) vaccine, bowel disease and autism.
Allison Edwards, chairwoman of campaign group Cry Shame, said: "I knew they would do this, they've had the intention of doing this for the past three years.
"This is to issue a warning to doctors not to dissent. No children were harmed in the clinical tests, they were trying to look at the problems and treat them, and the children improved. How do you get charged with doing your job?"
Isabella Thomas, 53, from Somerset, insisted her sons Michael, 18, and Terry, 16, received "fantastic" treatment under Dr Wakefield.
Another of her sons, Nigel, 30, handed a petition with more than 11,000 signatures to the GMC in support of Dr Wakefield and his colleagues, Professors John Walker-Smith and Simon Murch.
Mr Thomas said: "I've seen my parents struggle to find out what was wrong with their children and how upset they were when doctors dismissed their concerns or could not do anything for them.
"Dr Wakefield was accused of a callous disregard for the children but that's exactly what the GMC are doing. He tried to help them. It's ridiculous to say that any of the tests they had were in any way inappropriate."
Dr Wakefield was educated at King Edward's School in Bath and his parents – both retired doctors – still live in the city.
He said: "I will be appealing and I hope Professor Walker-Smith will be appealing.
"I think it's a very sad day when government pressure and grossly distorted journalism can have such a profound effect on healthcare for very sick children in the UK."
He insisted there had been fully-informed consent for the children in the Lancet study.
He said there was parental consent for extracting blood from a group of children at his son's birthday party.
He added: "In reporting their findings, the GMC panel sought to deny that the case against me and my colleagues is related to issues of MMR vaccine safety and, specifically, the role of this vaccine in causing autism. This is not in fact the case.
"Efforts to discredit and silence me through the GMC process have provided a screen to shield the Government from exposure on the (Pluserix) MMR vaccine scandal."
Prof Walker-Smith, 73, was also found guilty of serious professional misconduct and struck off. Prof Murch was found not guilty.
Dr Wakefield caused controversy when he published a study suggesting a link between the MMR vaccine, bowel disease and autism.
The research, which appeared in The Lancet medical journal in 1998, sparked a massive decline in children having the triple jab.
The GMC said Dr Wakefield took blood from his son's friends at a birthday party, paying the youngsters £5 each, before joking about it during a presentation.
He also ordered some youngsters to undergo unnecessary colonoscopies, lumbar punctures (spinal taps), barium meals, blood and urine tests and brain scans, the panel said.
Dr Wakefield was an honorary consultant in experimental gastroenterology at London's Royal Free Hospital at the time of his research.
A spokeswoman for the Department of Health said: "Thankfully, more parents are having their children vaccinated with MMR and they see it as being as safe as other childhood vaccines."
Discovery of stem cell illuminates human brain evolution, points to therapies
UCSF scientists have discovered a new stem cell in the developing human brain. The cell produces nerve cells that help form the neocortex – the site of higher cognitive function—and likely accounts for the dramatic expansion of the region in the lineages that lead to man, the researchers say.
Arnold Kriegstein, MD, PhD
Future studies of these cells are expected to shed light on developmental diseases such as autism and schizophrenia and malformations ofbrain development, including microcephaly, lissencephaly and neuronal migration disorders, they say, as well as age-related illnesses, such as Alzheimer’s disease.Studies also will allow scientists to track the molecular steps that the cell goes through as it evolves into the nerve cell, or neuron, it produces. This information could then be used to prompt embryonic stem cells to differentiate in the culture dish into neurons for potential use in cell-replacement therapy.
The study is reported in a recent issue of the journal Nature, (vol. no. 464, 554-561; issue 7288).
“This discovery has the potential to transform our understanding of the development and evolution of the human neocortex, the most uniquely human part of the central nervous system,” says the senior author of the study, neurologist Arnold Kriegstein, MD, PhD, director of the Eli and Edythe Broad Center of Regeneration Medicine and Stem Cell Research at UCSF.
“It also should inform our understanding of developmental diseases and advance the creation of cell-based therapies. Many neurological diseases develop in neurons or the neural circuits between them. If we’re going to understand how these disorders develop, we have to better understand how the human and primate cerebral cortex develops.”
In rodents and humans, the developing cortex contains a layer of neural stem cells called radial glial cells that resides near the fluid-filled ventricles and produces cells that are precursors to neurons. These precursor neurons further proliferate in a region known as the subventricular zone (SVZ), to increase their numbers, and then differentiate into newborn neurons. The neurons then migrate along radial glial fibers up to the neocortex, where they help form the tissue that is the site of sensory perception, motor commands, spatial reasoning, conscious thought and language.
In human and nonhuman primates, however, the SVZ has a massively expanded outer region, known as the outer subventricular zone (OSVZ). About 20 years ago, scientists presumed that the OSVZ also contained stem cells, but until now they have lacked evidence.
In the current study, lead authors David V. Hansen, PhD, a postdoctoral fellow, and Jan H. Lui, a graduate student in the Kriegstein lab, examined the OSVZ, using new labeling and tracking techniques to follow individual cells and their progeny over time in cultured tissue slices from fetal cortex tissue that had been donated for research.
They characterized two kinds of cells within the region—both the novel neural stem cell and its daughter cell, known as the transit amplifying cell. The stem cell closely resembles the radial glial cell in structure and behavior and, like the radial glia, has radial fibers which newborn neurons migrate along up to the neocortex.
The region is a busy hub of cell proliferation. The stem cell undergoes asymmetrical cell division, giving rise to two distinct daughter cells—one a copy of the original stem cell, the other a transit amplifying cell. The transit amplifying cell undergoes multiple rounds of symmetrical divisions before all of its daughter cells begin the process of differentiating into neurons.
“We are very interested in understanding how these modes of division are regulated,” says Kriegstein. “We suspect that faults in cell-cycle regulation account for a variety of developmentalbrain diseases.”
More broadly, he says the team wants to understand how the new stem cells compare to radial glial cells and how the two sets of neurons they produce integrate in the neocortex. “Neurons are probably being generated in both the SVZ and OSVZ at once,” he says. “They likely end up in the same layer of the neocortex as they migrate into position and start forming circuits.
“This suggests to us that there may be a mosaic of cell types in the human neocortex, in which there are cells that originate in the traditional zone and cells produced in the newer zone that intermix in the cortex. The complexity of primate neocortex may be significantly increased by the interaction of the evolutionarily-speaking ‘younger’ neurons with those originating in the more primitive zone.”
The massive number of cells within the OSVZ of humans “tells us we have to be careful when modeling human brain diseases in mice,” says Kriegstein. “Especially in the neocortex—the most highly developed part of the brain in primates and humans – there are going to be important differences between rodents and humans.”
The other co-author of the study was Philip R. L. Parker, a graduate student in the Kriegstein lab.
The study was funded by grants from the California Institute for Regenerative Medicine and the Bernard Osher Foundation.
UCSF is a leading university dedicated to promoting health worldwide through advanced biomedical research, graduate-level education in the life sciences and health professions, and excellence in patient care.
diggsdigg Bacteria For Your Brain?
A type of bacteria found in the environment may help students while cramming for their next test. New research shows it could help you learn.
"Myobacterium vaccae is a natural soil bacterium which people likely ingest or breathe in when they spend time in nature," Dorothy Matthews of the Sage Colleges in Troy, New York, who conducted the research with Colleague Susan Jenks, was quoted as saying.
Previous studies of M. vaccae shows when the bacteria is injected in mice, they grew some neurons in their brain that increased serotonin levels, which plays a key role in the learning process, and decreased anxiety.
Researchers fed live bacteria to mice and assessed their ability to navigate through a maze. The mice who were fed the bacteria navigated two-times faster and with less demonstrated anxiety than the controlled mice.
Matthews and Jenks conducted two follow-up experiments in where the bacteria were removed from the diet and the mice were retested. On average, the mice who had taken the bacteria ran faster, but by the final experiment there was no significant difference, suggesting the effect of M. vaccae is temporary.
"This research suggests the M. vaccae may play a role in anxiety and learning in mammals," Matthews explained. "It is interesting to speculate that creating learning environments in schools that include time in the outdoors where M. vaccae is present may decrease anxiety and improve the ability to learn new tasks."
Brain-injured face stigma
EDMONTON - Barb Baer Pillay, who's 50, remembers when anybody who wasn't the brightest person in the world was told, "Oh, you're brain-damaged."
"It was definitely not a good thing to be," says the program development manager for NABIS, a local brain injury society.
There's still such a stigma attached to brain injuries that admitting you have one is like coming out of the closet, Baer Pillay says, even though 10,000 Albertans a year suffer a brain injury.
So it's a testament to people such as Garnet Cummings and his family that he is talking publicly about the brain injury he received in a near-fatal collision 12 years ago, she says. The former high-profile chief of emergency at the Royal Alexandra Hospital and former medical director of the northern division of STARS Air Ambulance loved practising medicine, but had to stop after the brain injury affected his short-term memory.
Cummings hopes to raise public awareness of brain injuries when he speaks at NABIS's annual fund-raising breakfast June 4.
About 2,000 Albertans suffer a brain injury annually from such traumatic events as motor-vehicle collisions, falls or assaults. Another 3,000 brain injuries have a connection to such medically-related events as surgeries gone wrong, infections, meningitis, encephalitis, insulin shock, tumours, aneurysms, overdoses and substance abuse, says Baer Pillay. The other 50 per cent are the result of strokes.
"Thirty years ago, you wouldn't survive many of the brain injuries that occurred," Baer Pillay says. "Now, we have such amazing medical advances we're saving a lot more people, which is changing the whole scenario."
Communication disorders are common with brain injuries, so once all of a person's physical problems have abated and they're back running, walking, speaking, etc., he or she is still likely to have memory problems and aphasia (the partial or total loss of the ability to understand words and use language), Baer Pillay says.
"In conversation, the person has to slow down because they can't process words as fast as you," prompting people who don't understand brain injuries to think they're stupid, she explains.
"That's something people with cancer or people who have had a heart attack don't have to deal with, but people with brain injuries do, unless you walk around with a label on your forehead that says, 'I have a brain injury; it doesn't mean I'm stupid,' " Baer Pillay says.
Brain injuries range from those whose only problem is not being able to read as fast as they could before, to no longer being able to live independently.
Garnet Cummings counts himself among the lucky ones who is not able to do a lot of the things he loved, such as practising medicine or running marathons, but can still do "a lot of stuff," including communicating well.
His life after the collision was recorded in a series of black-and-white photographs taken by his stepdaughter, Kristin Olinyk, for a documentary photography course she recently completed at Grant Mac-Ewan University. You'll find those images in an audio slideshow she produced.
"It was definitely not a good thing to be," says the program development manager for NABIS, a local brain injury society.
There's still such a stigma attached to brain injuries that admitting you have one is like coming out of the closet, Baer Pillay says, even though 10,000 Albertans a year suffer a brain injury.
So it's a testament to people such as Garnet Cummings and his family that he is talking publicly about the brain injury he received in a near-fatal collision 12 years ago, she says. The former high-profile chief of emergency at the Royal Alexandra Hospital and former medical director of the northern division of STARS Air Ambulance loved practising medicine, but had to stop after the brain injury affected his short-term memory.
Cummings hopes to raise public awareness of brain injuries when he speaks at NABIS's annual fund-raising breakfast June 4.
About 2,000 Albertans suffer a brain injury annually from such traumatic events as motor-vehicle collisions, falls or assaults. Another 3,000 brain injuries have a connection to such medically-related events as surgeries gone wrong, infections, meningitis, encephalitis, insulin shock, tumours, aneurysms, overdoses and substance abuse, says Baer Pillay. The other 50 per cent are the result of strokes.
"Thirty years ago, you wouldn't survive many of the brain injuries that occurred," Baer Pillay says. "Now, we have such amazing medical advances we're saving a lot more people, which is changing the whole scenario."
Communication disorders are common with brain injuries, so once all of a person's physical problems have abated and they're back running, walking, speaking, etc., he or she is still likely to have memory problems and aphasia (the partial or total loss of the ability to understand words and use language), Baer Pillay says.
"In conversation, the person has to slow down because they can't process words as fast as you," prompting people who don't understand brain injuries to think they're stupid, she explains.
"That's something people with cancer or people who have had a heart attack don't have to deal with, but people with brain injuries do, unless you walk around with a label on your forehead that says, 'I have a brain injury; it doesn't mean I'm stupid,' " Baer Pillay says.
Brain injuries range from those whose only problem is not being able to read as fast as they could before, to no longer being able to live independently.
Garnet Cummings counts himself among the lucky ones who is not able to do a lot of the things he loved, such as practising medicine or running marathons, but can still do "a lot of stuff," including communicating well.
His life after the collision was recorded in a series of black-and-white photographs taken by his stepdaughter, Kristin Olinyk, for a documentary photography course she recently completed at Grant Mac-Ewan University. You'll find those images in an audio slideshow she produced.
UW institute will study ABC's of child learning, brain development
Gov. Chris Gregoire cut a purple ribbon held by a team of excited pre-schoolers Monday morning, and officially opened a $7 million facility that researchers believe could revolutionize how we understand the development of a child's brain.
The Magnetoencephalography (or MEG) machine monitors minute changes in the magnetic field in the brain. The study subject reclines in a chair (or in the case of an infant, a car seat), and the machine fits over the head, like an old beauty-salon hair dryer would, if the hair dryer were the size of a fridge.
The MEG facility at the Institute for Learning and Brain Sciences at the University of Washington is the first in the world to be designed for use with young children.
Patricia Kuhl, co-director of the institute, said the improvement in technology was like "going from still photographs to video in living color."
Four million dollars came from the state's Life Sciences Discovery Fund, which dispenses money from a court settlement with tobacco companies.
Gregoire said that the state is already drawing on the institute's work on early learning as it works on building early childhood education programs and that the information the new facility can provide should help better kids' lives.
"Children are literally born learning, and every day we fail them is a lost opportunity for that child," she said.
The MEG makes it possible to observe, in detail, how the brain responds to different kinds of stimuli. Unlike MRI machines, which have study subjects staying still in a noisy, clanking tube, MEGs work while their study subjects are seated in a quiet room.
In a video of an experiment in Finland, a round-faced baby sits in a car seat, under the MEG, gazing at a research assistant playing with a Slinky and a plastic pompom.
"We have the best toy-wavers," said Erica Stevens, assistant director of the institute.
Meanwhile, the baby listens to language sounds, from its native tongue and others, and 306 sensors in the machine record the electromagnetic responses in the child's brain.
The scans look like black and white brain sections, with activity highlighted as sparks of color. The MEG can localize activity to the millimeter and time it to the millisecond.
And this gives scientist a tool that can answer some fundamental questions. In an interview before the ribbon-cutting, Andrew Meltzoff, the other co-director of the institute, said a good example is in this action: hearing a phrase and repeating it back.
Scientists know that task involves several parts of the brain -- associated with hearing, language and motor control -- but they don't know how those parts cooperate, said Meltzoff.
"People haven't been able to look at how the pieces get connected."
The MEG might also help scientists to understand more about problems such as autism and epilepsy, and possibly find what Kuhl calls "biomarkers," signs that can be detected with standard medical equipment, and found and treated early, before brain patterns are set.
It might also give some insight into the causes and the impact of stereotypes, such as the idea that girls aren't good at math.
(In a new study of 240 Seattle elementary school students, researchers at the institute found that the conviction that boys were better at math showed up as early as second grade).
The MEG will be the centerpiece of what backers are calling the "Developing Mind Project." The institute is getting three new faculty members this year to help carry out the research.
William H. Gates Sr. , co-chair of the Bill & Melinda Gates Foundation, one of several private backers of the project, spoke by webcast from London.
"It would produce ground-breaking data, new data for the improvement of all ages," he said.
The Magnetoencephalography (or MEG) machine monitors minute changes in the magnetic field in the brain. The study subject reclines in a chair (or in the case of an infant, a car seat), and the machine fits over the head, like an old beauty-salon hair dryer would, if the hair dryer were the size of a fridge.
The MEG facility at the Institute for Learning and Brain Sciences at the University of Washington is the first in the world to be designed for use with young children.
Patricia Kuhl, co-director of the institute, said the improvement in technology was like "going from still photographs to video in living color."
Four million dollars came from the state's Life Sciences Discovery Fund, which dispenses money from a court settlement with tobacco companies.
Gregoire said that the state is already drawing on the institute's work on early learning as it works on building early childhood education programs and that the information the new facility can provide should help better kids' lives.
"Children are literally born learning, and every day we fail them is a lost opportunity for that child," she said.
The MEG makes it possible to observe, in detail, how the brain responds to different kinds of stimuli. Unlike MRI machines, which have study subjects staying still in a noisy, clanking tube, MEGs work while their study subjects are seated in a quiet room.
In a video of an experiment in Finland, a round-faced baby sits in a car seat, under the MEG, gazing at a research assistant playing with a Slinky and a plastic pompom.
"We have the best toy-wavers," said Erica Stevens, assistant director of the institute.
Meanwhile, the baby listens to language sounds, from its native tongue and others, and 306 sensors in the machine record the electromagnetic responses in the child's brain.
The scans look like black and white brain sections, with activity highlighted as sparks of color. The MEG can localize activity to the millimeter and time it to the millisecond.
And this gives scientist a tool that can answer some fundamental questions. In an interview before the ribbon-cutting, Andrew Meltzoff, the other co-director of the institute, said a good example is in this action: hearing a phrase and repeating it back.
Scientists know that task involves several parts of the brain -- associated with hearing, language and motor control -- but they don't know how those parts cooperate, said Meltzoff.
"People haven't been able to look at how the pieces get connected."
The MEG might also help scientists to understand more about problems such as autism and epilepsy, and possibly find what Kuhl calls "biomarkers," signs that can be detected with standard medical equipment, and found and treated early, before brain patterns are set.
It might also give some insight into the causes and the impact of stereotypes, such as the idea that girls aren't good at math.
(In a new study of 240 Seattle elementary school students, researchers at the institute found that the conviction that boys were better at math showed up as early as second grade).
The MEG will be the centerpiece of what backers are calling the "Developing Mind Project." The institute is getting three new faculty members this year to help carry out the research.
William H. Gates Sr. , co-chair of the Bill & Melinda Gates Foundation, one of several private backers of the project, spoke by webcast from London.
"It would produce ground-breaking data, new data for the improvement of all ages," he said.
A new look into the brain
Mriganka Sur is the Paul E. Newton Professor of Neuroscience, Head, Department of Brain and Cognitive Sciences, and Director of the Simons Initiative on Autism and the Brain at MIT. He studies the organisation, development and plasticity of the cerebral cortex of the brain using experimental and theoretical approaches. He has discovered fundamental principles by which networks of the cerebral cortex are wired during development and change dynamically during learning. Recently, his group demonstrated novel mechanisms underlying disorders of brain development, and proposed innovative strategies for treating such disorders.
I have been fascinated by the human brain from my student days, even though all my training has been in electrical engineering — first during my undergraduate degree from IIT Kanpur in 1974 and then during graduate studies in the US. Everything starts withthe brain: Our ways of thinking, our understanding of the world, and for that matter, our ways of changing the world. So understanding the brain will not only help us treat brain disorders and build intelligent machines but also enable us to grasp and change the human condition.
Here, I will try to distill what I have learnt as a brain scientist into one key idea that I believe is truly important for change that can be transformative and impactful.
This idea is disruption.
What do I mean by this? Disruption, or a radical change that breaks from the past, is critically important for a society and for science and technology to leap forward. I believe that change is overwhelmingly incremental or gradual because that is the kind of change encouraged by systems. Systems of people, of science and of organisations are about gradualness.
Yet the problems that confront us are not going to be solved fundamentally that way. And this is all the more true in the developing world. The West has advanced to where it has by exponential change, if you will, including many disruptive changes in its centuries ofdevelopment . In the developing world, we seek to emulate the same goals and trajectory but we know that sequence cannot be repeated. For instance, we cannot have the same kind of consumptivedevelopment and hope to build a sustainable future.
There has to be a disruption in the way we think about development, or science and technology, or even progress. There are many challenges of our time such as social inequality, economic inequality and inequality in terms of access to resources like energy or water. These problems cannot be solved without massive disruptive change in the way we approach them.
I am a tremendous believer in the possibilities of the human mind to solve problems. But this creative potential requires formal as well as informal ways to be unleashed, and in a manner that will reward disruption.
In my own field of neuroscience, there is a complicated history of how we understand diseases and disorders of the mind. It used to be thought that mental disorders are due to mystical causes or are caused by reasons outside of the body.
The single most disruptive transformation in our way of understanding human health and disease is that we now know that there can be no pathology or disease without an underlying biology. And while many diseases do start with external causes such as parasites and infections, it is their interaction with the body that leads to diseases.
Many brain disorders and diseases are sources of shame for patients today. This is so in the West, and particularly so in India. We need to demystify these disorders of the mind just as we have done with tuberculosis or malaria or any of the more common diseases of the body. The mind is a product ofthe brain, and its disorders reflect disorders in how the brain works.
Yet we often do not think of mental diseases as having biological causes. The many different kinds of mental disorders — including autism and learning disorders on one end of the life span through schizophrenia, bipolar disorder, Parkinson’s and Alzheimer’s disease on the other end — are all specific diseases that have specific roots inthe brain . And the truth that there are physical, brain-specific causes of these mental disorders and diseases is a deeply disruptive way of thinking about them.
Going even deeper, the way we treat brain disorders has to do with a profound disruption in the way we understand the brain itself. For instance some of our own work begins with the idea that how the brain develops is linked to specific disorders of the mind.
In Western Europe and America, there are tens of millions of people who suffer from brain disorders. There is no reason to think that the numbers are radically different in India; it is just that the numbers are hidden. After heart disease and cancer,brain disorders are some of the most devastating disorders that afflict individuals, families and society. Because brain disorders are often life-long, and because they extract an enormous emotional as well as financial toll, the burden of brain disorders is extremely high.
No society — particularly one that has ambitions to be at the forefront on the global stage — can progress without dealing with these diseases. Allbrain disorders will be understood as disorders of biology, and their treatment will involve many kinds of disruptive thinking. Take autism, of which there are many forms and biological causes, though with common clinical signs. In these ways autism resembles cancer, which also has various forms and causes. Yet there are no drugs based on mechanisms of disease for treating autism or the vast majority of mental disorders and diseases.
An important step for neuroscience is to understand and treat subsets of autism in the same way that we are beginning to understand and treat subsets of cancer. I am not suggesting autism is cancer because cancer is normal biology gone awry. But one kind of autism is due to delayeddevelopment of synapses in the brain that leads to underdevelopment of certain cognitive processes. Based on this discovery, my laboratory has proposed innovative therapeutics that are entering clinical trials.
Disruptive ideas often start at the interface of fields, such as the confluence of science and engineering. I am starting collaborations with neuroscientists and neurologists in India to study the biology ofthe brain and its disorders. I hope to spark similar ideas among my fellow researchers, and help Indian scientists disrupt their fields in the process!
I have been fascinated by the human brain from my student days, even though all my training has been in electrical engineering — first during my undergraduate degree from IIT Kanpur in 1974 and then during graduate studies in the US. Everything starts withthe brain: Our ways of thinking, our understanding of the world, and for that matter, our ways of changing the world. So understanding the brain will not only help us treat brain disorders and build intelligent machines but also enable us to grasp and change the human condition.
Here, I will try to distill what I have learnt as a brain scientist into one key idea that I believe is truly important for change that can be transformative and impactful.
This idea is disruption.
What do I mean by this? Disruption, or a radical change that breaks from the past, is critically important for a society and for science and technology to leap forward. I believe that change is overwhelmingly incremental or gradual because that is the kind of change encouraged by systems. Systems of people, of science and of organisations are about gradualness.
Yet the problems that confront us are not going to be solved fundamentally that way. And this is all the more true in the developing world. The West has advanced to where it has by exponential change, if you will, including many disruptive changes in its centuries ofdevelopment . In the developing world, we seek to emulate the same goals and trajectory but we know that sequence cannot be repeated. For instance, we cannot have the same kind of consumptivedevelopment and hope to build a sustainable future.
There has to be a disruption in the way we think about development, or science and technology, or even progress. There are many challenges of our time such as social inequality, economic inequality and inequality in terms of access to resources like energy or water. These problems cannot be solved without massive disruptive change in the way we approach them.
I am a tremendous believer in the possibilities of the human mind to solve problems. But this creative potential requires formal as well as informal ways to be unleashed, and in a manner that will reward disruption.
In my own field of neuroscience, there is a complicated history of how we understand diseases and disorders of the mind. It used to be thought that mental disorders are due to mystical causes or are caused by reasons outside of the body.
The single most disruptive transformation in our way of understanding human health and disease is that we now know that there can be no pathology or disease without an underlying biology. And while many diseases do start with external causes such as parasites and infections, it is their interaction with the body that leads to diseases.
Many brain disorders and diseases are sources of shame for patients today. This is so in the West, and particularly so in India. We need to demystify these disorders of the mind just as we have done with tuberculosis or malaria or any of the more common diseases of the body. The mind is a product ofthe brain, and its disorders reflect disorders in how the brain works.
Yet we often do not think of mental diseases as having biological causes. The many different kinds of mental disorders — including autism and learning disorders on one end of the life span through schizophrenia, bipolar disorder, Parkinson’s and Alzheimer’s disease on the other end — are all specific diseases that have specific roots inthe brain . And the truth that there are physical, brain-specific causes of these mental disorders and diseases is a deeply disruptive way of thinking about them.
Going even deeper, the way we treat brain disorders has to do with a profound disruption in the way we understand the brain itself. For instance some of our own work begins with the idea that how the brain develops is linked to specific disorders of the mind.
In Western Europe and America, there are tens of millions of people who suffer from brain disorders. There is no reason to think that the numbers are radically different in India; it is just that the numbers are hidden. After heart disease and cancer,brain disorders are some of the most devastating disorders that afflict individuals, families and society. Because brain disorders are often life-long, and because they extract an enormous emotional as well as financial toll, the burden of brain disorders is extremely high.
No society — particularly one that has ambitions to be at the forefront on the global stage — can progress without dealing with these diseases. Allbrain disorders will be understood as disorders of biology, and their treatment will involve many kinds of disruptive thinking. Take autism, of which there are many forms and biological causes, though with common clinical signs. In these ways autism resembles cancer, which also has various forms and causes. Yet there are no drugs based on mechanisms of disease for treating autism or the vast majority of mental disorders and diseases.
An important step for neuroscience is to understand and treat subsets of autism in the same way that we are beginning to understand and treat subsets of cancer. I am not suggesting autism is cancer because cancer is normal biology gone awry. But one kind of autism is due to delayeddevelopment of synapses in the brain that leads to underdevelopment of certain cognitive processes. Based on this discovery, my laboratory has proposed innovative therapeutics that are entering clinical trials.
Disruptive ideas often start at the interface of fields, such as the confluence of science and engineering. I am starting collaborations with neuroscientists and neurologists in India to study the biology ofthe brain and its disorders. I hope to spark similar ideas among my fellow researchers, and help Indian scientists disrupt their fields in the process!
How poverty shapes the brain
Scientists hope bold new research will help poor children succeed
Using sophisticated imaging, Canadian James Swain will soon begin to peer inside the brains of people who grew up in poverty.
Over the past four decades, researchers have established how poverty shapes lives, that low socioeconomic status is associated with poor academic performance, poor mental and physical health and other negative outcomes. Dr. Swain is part of a new generation of neuroscientists investigating how poverty shapes the brain.
The University ofMichigan
researcher will use a number of imaging technologies to compare the structure and function of brains of young adults from families with low socioeconomic status to those who are middle-class.
He knows the work has the potential to be controversial, but he hopes it will eventually lead to new teaching methods or early childhood interventions that would help children from low socioeconomic status (SES) families succeed at school and in life.
“That would be the dream, to inform social policy,” said Dr. Swain, who is from Toronto.
He and other neuroscientists are building on preliminary evidence that suggests the chronic stress of living in an impoverished household, among other factors, can have an impact on the developing brain.
Studies suggest a number of areas of the brain may be affected by low socioeconomic status, including the circuitry involved in language, memory and in executive functions, a set of skills that help us focus on a problem and solve it.
But Amedeo D’Angiulli at Carleton University in Ottawa wants to steer his fellow researchers away from the idea that they should be looking for poverty-related deficits. At an Association for Psychological Science conference in Boston this week, he will urge them to think about any differences they find as potential strengths, not weaknesses.
“I would see this work informing the school system, to exploit some of the strengths that are in these children and introduce curriculum that instead of penalizing them would allow them to function,” he said.
Unlike most of his colleagues, Dr. D’Angiulli grew up in relative poverty, in one the poorest cities in Italy. He was raised by a single mother. She was often too ill to care for him, so various relatives would temporarily take him in. He was the first member of his extended family to attend university, completing his doctorate at Northeastern University in Boston.
His early life has shaped the direction of his research. His idea is that brain changes associated with poverty may somehow be adaptive, and help children cope with chaotic or unpredictable environments.
In one study, he looked at how children filter out irrelevant information and pick up on what is important. To do this, he monitored the electrical activity of their brains when they were asked to listen to a random series of four tones and press a button every time they heard two of those tones.
He found that children from low SES families tend to use far more parts of their brain during the test than kids from middle-income families. It was as if the low SES children paid equal attention to every sound they heard, he says. Children from high-income homes only paid close attention to the two tones they had been asked to identify.
He stresses that the differences were in how they did the task, not how well they performed. All the children had similar reaction times and accuracy rates.
He interprets the results as meaning that low SES children are able to easily divide their attention, and says they might do well in schools that use the Montessori method. It was developed by Maria Montessori in the Lorenzo slum district of Rome in the early 1900s and involves a lot of self-directed learning rather than a teacher getting everyone in the class to focus on the same task at the same time.
At the University of Michigan, Dr. Swain will be looking at many different parts of the brain and the connections between regions.
His volunteers are 52 young adults that one of his colleagues, Gary Evans at Cornell University, has been tracking since they were in their mothers’ wombs. Half of them grew up in poverty, the other half in working or middle-class homes.
Starting as early as next month, Dr. Swain will begin two days of brain imaging and tests for each volunteer. He will assess their language skills and memory and study how their brains react to pictures of scary faces, and whether that reaction changes when they are stressed. (He’ll stress them by asking them to do mental arithmetic in front of strangers.)
He already has a detailed life history of each volunteer, which will make it possible to look for brain features associated with resilience. Some people, after all, emerge relatively unscathed from difficult childhoods. Dr. Swain wants to see if there is something different about their brains.
Dr. D’Angiulli is also planning studies that will look at the neuropsychology of resilience. He knows that many factors come into play, including the quality and nature of children’s relationship with their parents or guardian.
There won’t be a quick or easy resiliency training regime for poor kids, he says. But he hopes the work will lead to a greater understanding of how to help them succeed.
Over the past four decades, researchers have established how poverty shapes lives, that low socioeconomic status is associated with poor academic performance, poor mental and physical health and other negative outcomes. Dr. Swain is part of a new generation of neuroscientists investigating how poverty shapes the brain.
The University of
He knows the work has the potential to be controversial, but he hopes it will eventually lead to new teaching methods or early childhood interventions that would help children from low socioeconomic status (SES) families succeed at school and in life.
“That would be the dream, to inform social policy,” said Dr. Swain, who is from Toronto.
He and other neuroscientists are building on preliminary evidence that suggests the chronic stress of living in an impoverished household, among other factors, can have an impact on the developing brain.
But Amedeo D’Angiulli at Carleton University in Ottawa wants to steer his fellow researchers away from the idea that they should be looking for poverty-related deficits. At an Association for Psychological Science conference in Boston this week, he will urge them to think about any differences they find as potential strengths, not weaknesses.
“I would see this work informing the school system, to exploit some of the strengths that are in these children and introduce curriculum that instead of penalizing them would allow them to function,” he said.
Unlike most of his colleagues, Dr. D’Angiulli grew up in relative poverty, in one the poorest cities in Italy. He was raised by a single mother. She was often too ill to care for him, so various relatives would temporarily take him in. He was the first member of his extended family to attend university, completing his doctorate at Northeastern University in Boston.
His early life has shaped the direction of his research. His idea is that brain changes associated with poverty may somehow be adaptive, and help children cope with chaotic or unpredictable environments.
In one study, he looked at how children filter out irrelevant information and pick up on what is important. To do this, he monitored the electrical activity of their brains when they were asked to listen to a random series of four tones and press a button every time they heard two of those tones.
He found that children from low SES families tend to use far more parts of their brain during the test than kids from middle-income families. It was as if the low SES children paid equal attention to every sound they heard, he says. Children from high-income homes only paid close attention to the two tones they had been asked to identify.
He stresses that the differences were in how they did the task, not how well they performed. All the children had similar reaction times and accuracy rates.
He interprets the results as meaning that low SES children are able to easily divide their attention, and says they might do well in schools that use the Montessori method. It was developed by Maria Montessori in the Lorenzo slum district of Rome in the early 1900s and involves a lot of self-directed learning rather than a teacher getting everyone in the class to focus on the same task at the same time.
At the University of Michigan, Dr. Swain will be looking at many different parts of the brain and the connections between regions.
His volunteers are 52 young adults that one of his colleagues, Gary Evans at Cornell University, has been tracking since they were in their mothers’ wombs. Half of them grew up in poverty, the other half in working or middle-class homes.
Starting as early as next month, Dr. Swain will begin two days of brain imaging and tests for each volunteer. He will assess their language skills and memory and study how their brains react to pictures of scary faces, and whether that reaction changes when they are stressed. (He’ll stress them by asking them to do mental arithmetic in front of strangers.)
He already has a detailed life history of each volunteer, which will make it possible to look for brain features associated with resilience. Some people, after all, emerge relatively unscathed from difficult childhoods. Dr. Swain wants to see if there is something different about their brains.
Dr. D’Angiulli is also planning studies that will look at the neuropsychology of resilience. He knows that many factors come into play, including the quality and nature of children’s relationship with their parents or guardian.
There won’t be a quick or easy resiliency training regime for poor kids, he says. But he hopes the work will lead to a greater understanding of how to help them succeed.
Targeting brain circuits for addiction, relapse
WASHINGTON — Could a once-a-month alcoholism shot keep some of the highest-risk heroin addicts from relapse? A drug that wakes up narcoleptics treat cocaine addiction? An old antidepressant fight methamphetamine?
This is the next frontier in substance abuse: Better understanding of how addiction overlaps with other brain diseases is sparking a hunt to see if a treatment for one might also help another.
We're not talking about attempts just to temporarily block an addict's high. Today's goal is to change the underlying brain circuitry that leaves substance abusers prone to relapse.
It's "a different way of looking at mental illnesses, including substance abuse disorders," says National Institute on Drug Abuse Director Dr. Nora Volkow, who on Monday urged researchers at the American Psychiatric Association's annual meeting to get more creative in the quest for brain-changing therapies for addiction.
Rather than a problem in a single brain region, scientists increasingly believe that psychiatric diseases are a result of dysfunctioning circuits spread over multiple regions, leaving them unable to properly communicate and work together. That disrupts, for example, the balance between impulsivity and self-control that plays a crucial role in addiction.
These networks of circuits overlap, explaining why so many mental disorders share common symptoms, such as mood problems. It's also a reason that addictions — to nicotine, alcohol or various types of legal or illegal drugs — often go hand-in-hand with post-traumatic stress disorder, depression, schizophrenia and other mental illnesses.
Think of it as if the brain were an orchestra, its circuits the violins and the piano and the brass section, all smoothly starting and stopping their parts on cue, Volkow told The Associated Press.
"That orchestration is disrupted in psychiatric illness," she explains. "There's not a psychiatric disease that owns one particular circuit."
So NIDA, part of the National Institutes of Health, is calling for more research into treatments that could target circuits involved with cognitive control, better decision-making and resistance to impulses. Under way:
_Manufacturer Alkermes Inc. recently asked the Food and Drug Administration to approve its once-a-month naltrexone shot — already sold to treat alcoholism — to help people kick addiction to heroin and related drugs known as opioids. Scientists have long known that naltrexone pills can block heroin's effects, but the pills last only a day so skipping a dose lets addicts get high again. Alkermes' studies show the monthly version, named Vivitrol, can help reduce heroin use long-term.
But Volkow points to a study in Russia that found naltrexone shots also reduced cravings for the illegal drug. That's important, she says, because the treatment may be extinguishing too-active reward circuitry in the brain that conditioned people to keep using, and thus may prevent relapse.
With NIDA funding, Dr. Charles O'Brien of the University of Pennsylvania is studying that question in a tough-to-treat population, prison parolees. They quickly relapse as they return home and so-called "cue-induced cravings" reawaken, strong desires triggered by seeing friends they once did drugs with or simply passing by their old seller's street corner. At five sites around the Northeast, O'Brien's study will test if six months of Vivitrol can stop that cycle.
_Studies at several hospitals around the country suggest modafinil, used to fend off the sudden sleep attacks of narcolepsy, also can help cocaine users abstain. It may act as a mild stimulant that reduces their desire for the drug. But back to those brain circuits, cocaine causes damage in networks involved in reasoning, weighing decisions and overcoming impulses. Some research suggests modafinil counters that problem by improving what scientists call executive function, higher-order decision-making that involves those capabilities.
_An old antidepressant, bupropion, that's already used for smoking cessation now is being tested for methamphetamine addiction, based on early-stage research suggesting it somehow blunts the high. But Volkow says addiction makes the brain more sensitive to stressors that in turn trigger negative mood circuitry, so she wants antidepressants also to be tested in combination with other addiction medications.
Medication isn't the only option. Biofeedback teaches people with high blood pressure to control their heart rate. O'Brien's colleagues at Penn are preparing to test if putting addicts into MRI machines for real-time brain scans could do something similar, teaching them how to control their impulses to take drugs.
"It's controlling your own brain," O'Brien says. While the idea is extremely early-stage, "we think that it's very promising."
This is the next frontier in substance abuse: Better understanding of how addiction overlaps with other brain diseases is sparking a hunt to see if a treatment for one might also help another.
We're not talking about attempts just to temporarily block an addict's high. Today's goal is to change the underlying brain circuitry that leaves substance abusers prone to relapse.
It's "a different way of looking at mental illnesses, including substance abuse disorders," says National Institute on Drug Abuse Director Dr. Nora Volkow, who on Monday urged researchers at the American Psychiatric Association's annual meeting to get more creative in the quest for brain-changing therapies for addiction.
Rather than a problem in a single brain region, scientists increasingly believe that psychiatric diseases are a result of dysfunctioning circuits spread over multiple regions, leaving them unable to properly communicate and work together. That disrupts, for example, the balance between impulsivity and self-control that plays a crucial role in addiction.
These networks of circuits overlap, explaining why so many mental disorders share common symptoms, such as mood problems. It's also a reason that addictions — to nicotine, alcohol or various types of legal or illegal drugs — often go hand-in-hand with post-traumatic stress disorder, depression, schizophrenia and other mental illnesses.
Think of it as if the brain were an orchestra, its circuits the violins and the piano and the brass section, all smoothly starting and stopping their parts on cue, Volkow told The Associated Press.
"That orchestration is disrupted in psychiatric illness," she explains. "There's not a psychiatric disease that owns one particular circuit."
So NIDA, part of the National Institutes of Health, is calling for more research into treatments that could target circuits involved with cognitive control, better decision-making and resistance to impulses. Under way:
_Manufacturer Alkermes Inc. recently asked the Food and Drug Administration to approve its once-a-month naltrexone shot — already sold to treat alcoholism — to help people kick addiction to heroin and related drugs known as opioids. Scientists have long known that naltrexone pills can block heroin's effects, but the pills last only a day so skipping a dose lets addicts get high again. Alkermes' studies show the monthly version, named Vivitrol, can help reduce heroin use long-term.
But Volkow points to a study in Russia that found naltrexone shots also reduced cravings for the illegal drug. That's important, she says, because the treatment may be extinguishing too-active reward circuitry in the brain that conditioned people to keep using, and thus may prevent relapse.
With NIDA funding, Dr. Charles O'Brien of the University of Pennsylvania is studying that question in a tough-to-treat population, prison parolees. They quickly relapse as they return home and so-called "cue-induced cravings" reawaken, strong desires triggered by seeing friends they once did drugs with or simply passing by their old seller's street corner. At five sites around the Northeast, O'Brien's study will test if six months of Vivitrol can stop that cycle.
_Studies at several hospitals around the country suggest modafinil, used to fend off the sudden sleep attacks of narcolepsy, also can help cocaine users abstain. It may act as a mild stimulant that reduces their desire for the drug. But back to those brain circuits, cocaine causes damage in networks involved in reasoning, weighing decisions and overcoming impulses. Some research suggests modafinil counters that problem by improving what scientists call executive function, higher-order decision-making that involves those capabilities.
_An old antidepressant, bupropion, that's already used for smoking cessation now is being tested for methamphetamine addiction, based on early-stage research suggesting it somehow blunts the high. But Volkow says addiction makes the brain more sensitive to stressors that in turn trigger negative mood circuitry, so she wants antidepressants also to be tested in combination with other addiction medications.
Medication isn't the only option. Biofeedback teaches people with high blood pressure to control their heart rate. O'Brien's colleagues at Penn are preparing to test if putting addicts into MRI machines for real-time brain scans could do something similar, teaching them how to control their impulses to take drugs.
"It's controlling your own brain," O'Brien says. While the idea is extremely early-stage, "we think that it's very promising."
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