How Pregnancy Changes a Woman’s Brain

We know a lot about the links between a pregnant mother’s health, behavior, and moods and her baby’s cognitive and psychological development once it is born. 

But how does pregnancy change a mother’s brain? “Pregnancy is a critical period for central nervous system development in mothers,” says psychologist Laura M. Glynn of Chapman University. “Yet we know virtually nothing about it.” Glynn and her colleague Curt A. Sandman, of University of the California Irvine, are doing something about that. Their review of the literature in Current Directions in Psychological Science, a journal published by the Association for Psychological Science, discusses the theories and findings that are starting to fill what Glynn calls “a significant gap in our understanding of this critical stage of most women’s lives.”
At no other time in a woman’s life does she experience such massive hormonal fluctuations as during pregnancy. Research suggests that the reproductive hormones may ready a woman’s brain for the demands of motherhood—helping her becomes less rattled by stress and more attuned to her baby’s needs. Although the hypothesis remains untested, Glynn surmises this might be why moms wake up when the baby stirs while dads snore on. Other studies confirm the truth in a common complaint of pregnant women: “Mommy Brain,” or impaired memory before and after birth. “There may be a cost” of these reproduction-related cognitive and emotional changes, says Glynn, “but the benefit is a more sensitive, effective mother.”
The article reviews research that refines earlier findings on the effects of the prenatal environment on the baby. For instance, evidence is accumulating to show that it’s not prenatal adversity on its own—say, maternal malnourishment or depression—that presents risks for a baby. Congruity between life in utero and life on the outside may matter more. A fetus whose mother is malnourished adapts to scarcity and will cope better with a dearth of food once it’s born—but could become obese if it eats normally. Timing is critical too: maternal anxiety early in gestation takes a toll on the baby’s cognitive development; the same high levels of stress hormones late in pregnancy enhance it.
Just as Mom permanently affects her fetus, new science suggests that the fetus does the same for Mom. Fetal movement, even when the mother is unaware of it, raises her heart rate and her skin conductivity, signals of emotion—and perhaps of pre-natal preparation for mother-child bonding. Fetal cells pass through the placenta into the mother’s bloodstream. “It’s exciting to think about whether those cells are attracted to certain regions in the brain” that may be involved in optimizing maternal behavior, says Glynn.
Glynn cautions that most research on the maternal brain has been conducted with rodents, whose pregnancies differ enormously from women’s; more research on human mothers is needed. But she is optimistic that a more comprehensive picture of the persisting brain changes wrought by pregnancy will yield interventions to help at-risk mothers do better by their babies and themselves.

Why bigger is better when it comes to our brain and memory

The hippocampus is an important brain structure for recollection memory, the type of memory we use for detailed reliving of past events. Now, new research published by Cell Press in the December 22 issue of the journal Neuron reveals characteristics of the human hippocampus that allow scientists to use anatomical brain scans to form predictions about an individual's recollection ability. The new research helps to explain why this relationship has been hard to find in the past and provides evidence for a possible underlying mechanism.
The hippocampus, a deep brain structure named for its curving seahorse shape, can be divided into anterior and posterior portions. Although research has generally linked smaller hippocampi with worse recollection in neuropsychological patients and during aging, this relationship has not held up among healthy young adults. "There is some evidence that extensive spatial memory acquisition leads to enlargement of the posterior hippocampus and a decrease in the anterior hippocampus," explains lead study author, Dr. Jordan Poppenk who conducted the study at Baycrest's Rotman Research Institute. "This suggested to us that the crucial predictor of individual differences in recollection ability might not be the overall size of the hippocampus but the separate contributions of the posterior and anterior segments of the hippocampus."
Dr. Poppenk and coauthor Dr. Morris Moscovitch analyzed high-resolution magnetic resonance imaging brain scans of healthy adults who had participated in recollection memory tests. Better recollection was associated with a larger posterior hippocampus and a smaller anterior hippocampus. The overall size of the hippocampus did not predict recollection, as larger posterior hippocampi were offset by smaller anterior hippocampi. The researchers went on to show that the link between the posterior hippocampus and recollection depended on interactions with other parts of the brain between the times that memories were learned and retrieved, particularly regions involved in perception which form the basis of recollected experience.
"Our results show for the first time that the size of the posterior hippocampus, especially when expressed as a ratio to the size of the anterior hippocampus, reliably predicts recollection in healthy adults. This finding explains the longstanding failure to correlate the overall size of the hippocampus with memory," concludes Dr. Poppenk. "We also provide evidence that it is the functional connections, possibly related to memory consolidation, between the posterior hippocampus and other parts of the brain that may underlie enhanced memory recollection."

Every cloud has a silver lining: Weather forecasting models could predict brain tumor growth

Every cloud has a silver lining: weather forecasting models could predict brain tumor growth
Ever wondered how meteorologists can accurately predict the weather? They use complex spatiotemporal weather models, i.e. mathematical equations that track the motions of the atmosphere through time and space, and combine them with incoming data streams from weather stations and satellites. Now, an innovative new study published in BioMed Central's open access journal Biology Direct has determined that the mathematical methodology used to assimilate data for weather forecasting could be used to predict the spread of brain tumors.
The authors from the Arizona State University and the Barrow Neurological Institute, Arizona, USA, wanted to prove that mathematical methods used in weather prediction could be useful in clinical situations – not just in brain cancer, but also in other cancers and diseases. They chose to study glioblastoma multiforme (GBM), a malignant brain cancer.
GBM is the most common and most aggressive type of brain cancer. Despite treatment, average patient survival is less than 15 months from initial diagnosis, and it is largely resistant to chemo- and radiotherapy. GBM can quickly invade large, sensitive regions of the brain, which makes it almost impossible to remove via surgery and almost certain to recur afterwards. Because little progress has been made in this area, GBM is an important area to study, and is a particularly good cancer against which to test a mathematical model, as its dynamics involve complex geometry.
In addition to setting out to prove that good quantitative predictions of GBM growth and spread are possible, the authors wanted to provide uncertainty estimates. An algorithm previously developed for numerical weather prediction – a modern state estimation algorithm known as a Local Ensemble Transform Kalman Filter (LETKF) – was applied to two different mathematical models of the growth and spread of glioblastoma. Synthetic magnetic resonance images of a hypothetical tumor were used for this purpose.
Data assimilation techniques were then used to update the state vector, i.e. the initial condition of the glioblastoma growth model, by combining new observations with one or more prior forecasts. They then measured the feasibility of the model in individual patient cases for making short-term (60-day) forecasts of GBM spread and growth.
Despite this being a preliminary study, the authors were successful in demonstrating the feasibility of LETKF for short-term, clinically relevant predictions of the growth and spread of malignant brain tumors. LETKF forecasting and data assimilation provides an accurate and computationally efficient way of updating the initial condition (state vector) of a complex spatiotemporal model with new quantitative measurements. The intelligent model can also take into account likely errors in model parameters and measurement uncertainties in magnetic resonance imaging.
Mark Preul, one of the leaders of the study, believes that LETKF should be considered for future efforts that use mathematical models for clinical purposes in individual patient cases. He said, "Though work remains before our approach can be seriously considered in clinical settings, an accurate forecast system for glioblastoma may prove useful for treatment planning and patient counseling."

Treatment for brain aneurysms without surgery

LOS ANGELES (KABC) -- Faith Mitchell enjoys what life has to offer. But it wasn't long ago her life took a scary turn.

After a nasty fall, painful headaches set in. A CT scan revealed an aneurism lodged behind her eye in a very deep part of the brain, a dangerous and almost inoperable spot.
Brain aneurysms are abnormal bulging of arteries. When they rupture, stroke, brain damage or death can follow. They're often discovered when it's too late and one in 15 people could develop them in their lifetime.
"I was really scared because I didn't know what to expect," Mitchell said.
When neurologist Dr. Scott Standard saw Mitchell's scans, he decided to use the newly Food and Drug Administration-approved Pipeline Embolization Device to remove her aneurysm.
"It's a revolutionary advance in terms of actually being able to reconstruct the blood vessels within the brain," Standard said.
Surgeons have traditionally removed a small section of the skull to go underneath the brain and clip the aneurysm. But with the Pipeline stent, everything is done through an artery in the leg.
"It allows blood flow to occur through the inside of the stent but also into the very small blood vessels around the aneurysm," Standard said.
Once inserted, the stent expands against the walls of the artery and across the aneurysm, cutting off blood flow. The blood remaining in the blocked-off aneurysm forms a clot which reduces the chance for it to grow or rupture.
Standard said the aneurysm will completely heal around the stent and completely go away.
Today, Mitchell has put her scare behind her.
"I'm getting stronger every day, feeling better every day," she said.
For now, the Pipeline stent is only FDA approved for certain types of complicated aneurysms.
The stent also cuts recovery time from six months to only 10 days.
Web extra:
Background: A brain aneurysm is a bulge or ballooning in a blood vessel in the brain. It often looks like a berry hanging on a stem. It can leak or rupture, causing bleeding into the brain. Brain aneurysms develop as a result of thinning and degenerating artery walls. Aneurysms often form at forks or branches in arteries where the vessel is weaker. Aneurysms can appear anywhere in the brain, but are most common at the base.
A ruptured brain aneurysm most often occurs in the space between the brain and the thin tissues covering the brain. A ruptured aneurysm quickly becomes life-threatening and requires prompt medical treatment. In about 30 percent of cases, ruptured brain aneurysms are fatal. Most, however, don't rupture, create health problems or cause symptoms. Such aneurysms are often detected during tests for other conditions.
Symptoms: A sudden, severe headache is the key symptom of a ruptured aneurysm. Additional signs include: nausea and vomiting, stiff neck, blurred or double vision, sensitivity to light, seizure, drooping eyelid, loss of consciousness and confusion. In some cases, an aneurysm may leak a small amount of blood, causing a sudden, severe headache. A more severe rupture almost always follows leaking.
An unruptured brain aneurysm may produce no symptoms. However, a large unruptured aneurysm may press on brain tissues and nerves, possibly causing pain above and behind an eye, a dilated pupil, vision changes, numbness, weakness or paralysis in one side of the face or a drooping eyelid.
Pipeline stent: The Pipeline Embolization Device received FDA premarket approval in April 2011. Stents in general led to good outcomes. They prop up the vessel wall and when the vessel lining grows over the stent, it strengthens. Older stents, because of their mesh construction, have not been successful at redirecting blood flow; blood can flow through the mesh.
The Pipeline stent provides a mesh so tightly woven that it redirects blood flow past the aneurysm so that the aneurysm can clot off and heal. The international success rate with this flow-diverting stent has been high: 90 to 95 percent of the aneurysms treated never came back.
The stent is 75 percent cobalt chromium and 25 percent platinum tungsten. It comprises 48 densely braided strands. It is customizable in that multiple devices can be telescoped together, one inside the next, for longer constructs.

Brain-Enhancing Drug Shown to Greatly Improve Mouse's Memory

A new drug that blocks a stress-provoked immune molecule in the brain can dramatically improve memory and learning abilities in mice, a new study says. A future pill that can suppress this molecule could show promise as a therapy for Alzheimer’s disease in humans, researchers say.
The treatment involves the enzyme PKR, which protects against viral infections. It serves two functions in the brain, acting as a stress responder that can cause cell death (such as in the case of a viral invasion) and regulating synaptic activity as it relates to the formation of memories. The brains of patients with Alzheimer’s, Huntington’s and other neurological diseases have been found to experience PKR activation. Researchers at the Baylor College of Medicine in Houston and McGill University in Montreal wanted to study the effects of PKR deficiency.
They genetically modified some mice to lack a gene that codes for PKR formation, and subjected the mice to some memory tests. A spatial memory test required mice to use visual cues to find a hidden platform inside a circular pool, for instance. Regular mice had to repeat the task a few times over a few days to remember where the platform was located, but the PKR-deficient mice figured it out after just one training session, according to a Baylor news release. Dr. Mauro Costa-Mattioli, assistant professor of neuroscience at BCM and lead author on the paper, said the researchers found that another immune enzyme, gamma interferon, took over some of PKR’s memory functions. It increased synaptic communication among neurons and gave the mice a sort of “super-memory,” Costa-Mattioli said.
The next step is the most interesting part, and could hold the most promise for research on Alzheimer’s and other neurological disorders. Costa-Mattioli and colleagues figured out a PKR inhibitor and injected it into the stomachs of normal, non-genetically-modified mice. It worked to suppress the PKR, the researchers said. The success of a gut-injected form suggests a pill form could also work well.
That’s several years and several human trials away, of course, but Costa-Mattioli said it could eventually help people who suffer from memory loss.

Why having high blood pressure can quadruple the risk of developing a brain tumour

People with highest blood pressure twice as likely to develop brain tumour

Risk increases fourfold for those with meningioma and high blood pressure 

People with high blood pressure may be at increased risk of developing brain tumours, according to a new study.
The overall risk doubles for people with the highest blood pressure levels, compared to those with the lowest.
But it increases up to fourfold for some people diagnosed with meningioma who had high blood pressure, claim researchers from Austria, Norway and Sweden.

At risk: People with the highest blood pressure levels are twice as likely to develop a brain tumour, according to researchers

The scientists took the blood pressure measurements of 580,000 people and then waited to see if they went on to develop a benign or malignant brain tumour over the next ten years.
Around one-third of those taking part were diagnosed with hypertension, the medical name for high blood pressure.
A total of 1,312 people were diagnosed with a brain tumour during the follow-up period, including one-third with high-grade tumours which are more likely to spread.
The findings show that the 20 per cent of participants with the highest blood pressure readings were twice as likely to be diagnosed with meningioma or malignant glioma, types of brain tumour accounting for most cases.

How to keep your brain young

Eating less activates a molecule for Brain Longevity and thus helps the brain stay young, a new study has revealed. Many studies suggest that obesity is bad for our brain, slows it down, causes early brain aging, making it susceptible to diseases typical of older people as the Alzheimer’s and Parkinson’s. In contrast, caloric restriction keeps the brain young.
A team of Italian researchers at the Catholic University of Sacred Heart in Rome have discovered that this molecule, called CREB1, is triggered by Caloric Restriction (low caloric diet) in the brain of mice. They found that CREB1 activates many genes linked to longevity and to the proper functioning of the brain.
CREB1 mediates the beneficial effects of the diet on the brain by turning on another group of molecules linked to longevity, the Sirtuins.
This finding is consistent with the fact that CREB1 is known to regulate important brain functions as memory, learning and anxiety control, and its activity is reduced or physiologically compromised by aging.
Moreover, Italian researchers have discovered that the action of CREB1 can be dramatically increased by simply reducing caloric intake, and have shown that CREB is absolutely essential to make caloric restriction work on the brain. In fact, if mice lack CREB1 the benefits of caloric restriction on the brain (improving memory, etc.) disappear.
So the animals without CREB1 show the same brain disabilities typical of overfed and/or old animals.
“Thus, our findings identify for the first time an important mediator of the effects of diet on the brain,” Dr Giovambattista Pani, lead researcher.
“This discovery has important implications to develop future therapies to keep our brain young and prevent brain degeneration and the aging process. In addition, our study shed light on the correlation among metabolic diseases as diabetes and obesity and the decline in cognitive activities.”
“Our hope is to find a way to activate CREB1, for example through new drugs, so to keep the brain young without the need of a strict diet,” Dr Pani added.
Caloric restriction means the animals can only eat up to 70 percent of the food they consume normally, and is a known experimental way to extend life, as seen in many experimental models.

Brain Imaging Shows Exercise Benefit in Fibromyalgia

Research presented at the Society of Neuroscience's annual meeting goes beyond the norm when looking at the benefits of exercise for people with fibromyalgia. By using fMRI (functional magnetic resonance imaging) to monitor changes in the brain, researchers demonstrated that aerobic exercise for 6 weeks increased activity in areas of the brain related to performing tasks, including the working (short-term) memory.
It was a small study, including only 9 women. They were all on medications for fibromyalgia symptoms, then weaned off the drugs and, about a month and a half later, started a 6-week aerobic exercise routine.
As you'd expect, self-reported pain increased when the women were off the meds, then decreased during the course of the exercise program. Working-memory tasks performed at each stage followed the reverse pattern, initially dipping and then rising significantly, researchers say.
The fMRI results mirrored the working memory results and showed a significant increase in activity in 8 areas of the brain that deal with performing tasks.
Cognitive dysfunction, often called "fibro fog," is a common symptom of fibromyalgia that is hard to measure. Working memory impairment generally goes along with fibro fog, making you forget why you walked into a certain room, or causing you to check the next step on a recipe over and over. Multi-tasking can go by the wayside as well.
For years, study after study has showed improvement with consistent, moderate exercise, but the reasons behinds the results were unclear. This study could help shed light on them by demonstrating the effect of exercise on specific areas of the brain.
However, in practice, many people with fibromyalgia find it difficult or impossible to exercise because even mild exertion can cause symptoms to flare for days or weeks afterward. Knowledgeable doctors generally recommend starting with extremely gentle exercise for a very short amount of time, such as 1 minute, and increasing the length of time and intensity of the work in tiny increments once you know what you've been doing is manageable.
While this study's results are interesting, it's important to note that it was small and results will need to be verified by larger trials.
Does exercise seem to make you think better? Do you struggle with exercising consistently? Have you given up on exercise? Leave your comments below!

UCLA neuroscientists demonstrate crucial advances in 'brain reading'

Innovative machine learning method anticipates neurocognitive changes, similar to predictive text-entry for cell phones, Internet search engines

By Jennifer Marcus

At UCLA's Laboratory of Integrative Neuroimaging Technology, researchers use functional MRI brain scans to observe brain signal changes that take place during mental activity. They then employ computerized machine learning (ML) methods to study these patterns and identify the cognitive state — or sometimes the thought process — of human subjects. The technique is called "brain reading" or "brain decoding."  

 

In a new study, the UCLA research team describes several crucial advances in this field, using fMRI and machine learning methods to perform "brain reading" on smokers experiencing nicotine cravings.

 

The research, presented last week at the Neural Information Processing Systems' Machine Learning and Interpretation in Neuroimaging workshop in Spain, was funded by the National Institute on Drug Abuse, which is interested in using these method to help people control drug cravings.

 

In this study on addiction and cravings, the team classified data taken from cigarette smokers who were scanned while watching videos meant to induce nicotine cravings. The aim was to understand in detail which regions of the brain and which neural networks are responsible for resisting nicotine addiction specifically, and cravings in general, said Dr. Ariana Anderson, a postdoctoral fellow in the Integrative Neuroimaging Technology lab and the study's lead author.

 

"We are interested in exploring the relationships between structure and function in the human brain, particularly as related to higher-level cognition, such as mental imagery," Anderson said. "The lab is engaged in the active exploration of modern data-analysis approaches, such as machine learning, with special attention to methods that reveal systems-level neural organization."

 

For the study, smokers sometimes watched videos meant to induce cravings, sometimes watched "neutral" videos and at sometimes watched no video at all. They were instructed to attempt to fight nicotine cravings when they arose.

 

The data from fMRI scans taken of the study participants was then analyzed. Traditional machine learning methods were augmented by Markov processes, which use past history to predict future states. By measuring the brain networks active over time during the scans, the resulting machine learning algorithms were able to anticipate changes in subjects' underlying neurocognitive structure, predicting with a high degree of accuracy (90 percent for some of the models tested) what they were watching and, as far as cravings were concerned, how they were reacting to what they viewed.

 

"We detected whether people were watching and resisting cravings, indulging in them, or watching videos that were unrelated to smoking or cravings," said Anderson, who completed her Ph.D. in statistics at UCLA. "Essentially, we were predicting and detecting what kind of videos people were watching and whether they were resisting their cravings."  

 

In essence, the algorithm was able to complete or "predict" the subjects' mental states and thought processes in much the same way that Internet search engines or texting programs on cell phones anticipate and complete a sentence or request before the user is finished typing. And this machine learning method based on Markov processes demonstrated a large improvement in accuracy over traditional approaches, the researchers said.

 

Machine learning methods, in general, create a "decision layer" — essentially a boundary separating the different classes one needs to distinguish. For example, values on one side of the boundary might indicate that a subject believes various test statements and, on the other, that a subject disbelieves these statements. Researchers have found they can detect these believe–disbelieve differences with high accuracy, in effect creating a lie detector. An innovation described in the new study is a means of making these boundaries interpretable by neuroscientists, rather than an often obscure boundary created by more traditional methods, like support vector machine learning.

 

"In our study, these boundaries are designed to reflect the contributed activity of a variety of brain sub-systems or networks whose functions are identifiable — for example, a visual network, an emotional-regulation network or a conflict-monitoring network," said study co-author Mark S. Cohen, a professor of neurology, psychiatry and biobehavioral sciences at UCLA's Staglin Center for Cognitive Neuroscience and a researcher at the California NanoSystems Institute at UCLA.   

 

"By projecting our problem of isolating specific networks associated with cravings into the domain of neurology, the technique does more than classify brain states — it actually helps us to better understand the way the brain resists cravings," added Cohen, who also directs UCLA's Neuroengineering Training Program.

 

Remarkably, by placing this problem into neurological terms, the decoding process becomes significantly more reliable and accurate, the researchers said. This is especially significant, they said, because it is unusual to use prior outcomes and states in order to inform the machine learning algorithms, and it is particularly challenging in the brain because so much is unknown about how the brain works.

 

Machine learning typically involves two steps: a "training phase" in which the computer evaluates a set of known outcomes — say, a bunch of trials in which a subject indicated belief or disbelief — and a second, "prediction" phase in which the computer builds a boundary based on that knowledge.

 

In future research, the neuroscientists said, they will be using these machine learning methods in a biofeedback context, showing subjects real-time brain readouts to let them know when they are experiencing cravings and how intense those cravings are, in the hopes of training them to control and suppress those cravings.

 

But since this clearly changes the process and cognitive state for the subject, the researchers said, they may face special challenges in trying to decode a "moving target" and in separating the "training" phase from the "prediction" phase.

 

The California NanoSystems Institute is an integrated research facility located at UCLA and UC Santa Barbara. Its mission is to foster interdisciplinary collaborations in nanoscience and nanotechnology; to train a new generation of scientists, educators and technology leaders; to generate partnerships with industry; and to contribute to the economic development and the social well-being of California, the United States and the world. The CNSI was established in 2000 with $100 million from the state of California. The total amount of research funding in nanoscience and nanotechnology awarded to CNSI members has risen to over $900 million. UCLA CNSI members are drawn from UCLA's College of Letters and Science, the David Geffen School of Medicine, the School of Dentistry, the School of Public Health and the Henry Samueli School of Engineering and Applied Science. They are engaged in measuring, modifying and manipulating atoms and molecules — the building blocks of our world. Their work is carried out in an integrated laboratory environment. This dynamic research setting has enhanced understanding of phenomena at the nanoscale and promises to produce important discoveries in health, energy, the environment and information technology.

Handheld Device Rapidly Detects Brain Injury

When accidents that involve traumatic brain injuries occur, a speedy diagnosis followed by the proper treatment can mean the difference between life and death. A research team, led by Jason Riley in the Section on Analytical and Functional Biophotonics at the U.S. National Institutes of Health, has created a handheld device capable of quickly detecting brain injuries such as hematomas, which occur when blood vessels become damaged and blood seeps out into surrounding tissues where it can cause significant and dangerous swelling.

A paper describing the team’s proof-of-concept prototype for the hematoma detection device appears in the Optical Society’s (OSA) open-access journal Biomedical Optics Express. The device is based on the concept of using instrumental motion as a signal in near-infrared imaging, according to the researchers, rather than treating it as noise. It relies on a simplified single-source configuration with a dual separation detector array and uses motion as a signal for detecting changes in blood volume in the tough, outermost membrane enveloping the brain and spinal cord.

One of the primary applications for the finished device will be the rapid screening of traumatic brain injury patients before using more expensive and busy CT and MRI imaging techniques. In cases where CT and MRI imaging facilities aren’t available, such as battlefields or on the scene of accidents, the team believes near-infrared imaging will help to determine the urgency of patient transport and treatment, as well as provide a means of monitoring known hematomas at the bedside or outpatient clinic.

Ensuring Respect for the Donated Brains of Children

Nature has reported on the tissue-bank shortage involving donations of brains from children¹. An accompanying editorial highlights that the key to treatments for autism and schizophrenia could lie in the brains of recently deceased children and that in order to make advances researchers require access to an international bank of donated material².
I would like to applaud the editors for their courage to direct attention to this sensitive subject. However, I would like to point out that there is an equal if not greater need for human brain tissue from the living, which is also difficult to obtain. Only leftover tissue from approved surgical procedures can be used, and the fact that tissue is saved from disposal must not compromise the quality of its diagnostic evaluation nor have an influence on the planning of the operation³.
The largest obstacle to a sustainable⁴ tissue resource does not appear to be the difficulty in obtaining consent to retain and use brain tissue for research² but the striking absence of an international legal framework to protect those who are entrusted with the handling of the tissues. These custodians (human tissue cannot be owned) are responsible for the collection, secure storage and diagnostic work-up before tissue is handed out to researchers⁴. Specific requirements for the handling of brain tissue need to be met⁴.
In order to avoid conflicts of interest, access to human tissue should not be controlled by enterprises whose purpose is to generate a profit⁴. If commercial entities are granted access by the relevant supervisory body, because and only if there is a clear benefit for the diseased, all interactions between the tissue bank and the company should be closely monitored and regularly audited by an international and truly independent committee⁴. Following the banking crisis, the real money is now in healthcare and drugs⁵ but human tissue and tissue banks must never be traded or sold³, and companies cannot serve as custodians of human tissue to avoid even the perception of a deal (someone cashing in on an altruistic gift). In this context, the observation that former drug company employees have joined charitable organizations that promote tissue donations or have been appointed to run hospitals is disquieting.
Human tissue banking is primarily a matter of public trust. This trust is based on an assumption of effective governance, which requires institutional policies and practices that encourage reporting of malpractice. Examples of human tissue abuse exist⁶ illustrating how responses to fraud are driven by scandals⁷. But it cannot be prudent to risk a scandal in an area as sensitive as human tissue banking. Therefore, meticulous professional conduct is the only viable way forward and a code of conduct for human brain banks has been proposed⁴.
In conclusion, medical institutions that house brain banks should be aware of any internal wrongdoing through robust processes and policies that oversee tissue collection and usage. However, at present there is insufficient protection of those who are expected to guarantee proper handling of the tissues. Specifically, “whistleblowing” legislation, if it exists at all, merely works retrospectively, i.e. through delayed and often inadequate compensation that is tied to successful legal proceedings which are difficult to finance. In addition, victimization of a public interest advocate in retaliation for her/his reporting of criminal activity by people in authority is not recognized as a legal offence and as a result there is no effective deterrent. Therefore, in order to facilitate sustainable human tissue banking the recent judgment of the European Court of Human Rights⁸, which provides the first serious legal guidance on “whistleblowing”, should be used to create legislation that is safe for human tissue banking and banks for brains from children in particular.
Professor Manuel B. Graeber MD PhD FRCPath, Neuropathologist, The Brain and Mind Research Institute, University of Sydney, Sydney, NSW 2050, Australia; email: manuel@graeber.net

Competing interests: MG is the founding Chairman of the former University Department of Neuropathology at Imperial College London which he decided to close down in 2007 for ethical reasons related to brain banking to distance himself and his professional discipline (neuropathology) from the then Imperial College executive in response to their attempt to suppress his public interest disclosures. In 2008, MG won a legal case against that same executive in order to bring his documentation into the public domain. Ruling by the London Employment Tribunals, case of Professor M Graeber v. Imperial College of Science, Technology and Medicine (Case Number 2202785/2007), 7 May 2008. Funding provided by the British Medical Association is gratefully acknowledged.
Reference List

1. Abbott A. Brain child. Nature 2011;478:442-443.
2. Editorial. A priceless resource. Nature 2011;478:427.
3. Graeber MB, Al Yamany M. Sustainable human tissue banking. Inaugural Biomarker Discovery Conference, Shoal Bay, NSW, Australia, 6-10 December 2010 (Abstract)
4. Graeber MB. Twenty-first century brain banking: at the crossroads. Acta Neuropathol 2008;115:493-496.
5. Rushe D. Meet the new 1%: healthcare CEOs replace bankers as America’s best paid. http://www.guardian.co.uk/business/2011/dec/14/healthcare-ceos-americas-best-paid
6. Feuer A. Dentist Pleads Guilty to Stealing and Selling Body Parts. http://www.nytimes.com/2008/03/19/nyregion/thecity/19bones.html
7. Smith R. Research misconduct: the poisoning of the well. Journal of the Royal Society of Medicine 2006;99: 232-237.
8. Ruling by the European Court of Human Rights, case of Heinisch v. Germany (Application no. 28274/08), 21 July 2011

Violent Video Games Alter Men’s Brains

One week of this can alter a young male brain. Gentlemen, hang on to your gray matter.

After playing violent video games for one week, young adult men showed signs of sustained changes in a region of the brain associated with emotional control, according to a new study from Indiana University.

“For the first time, we have found that a sample of randomly assigned young adults showed less activation in certain frontal brain regions following a week of playing violent video games at home,” says Yang Wang, assistant research professor of radiology and imaging sciences at Indiana University. “The affected brain regions are important for controlling emotion and aggressive behavior.”

Looking inside the brain

For the study, 28 healthy adult males, age 18 to 29, with low past exposure to violent video games were randomly assigned to two groups of 14. Members of the first group were instructed to play a shooting video game for 10 hours at home for one week and refrain from playing the following week. The second group did not play a video game at all during the two-week period.

Each of the men underwent MRI analysis while they completed an emotional interference task, and after just one week, the video game group members showed less activation in the left inferior frontal lobe during the emotional Stroop task and less activation in the anterior cingulate cortex during the counting Stroop task, compared to their baseline results and the results of the control group after one week.

“These findings indicate that violent video game play has a long-term effect on brain functioning,” says Wang. “These effects may translate into behavioral changes over longer periods of game play.”

Lifespan expert on the outcomes

GoLocalProv spoke with Peter J. Snyder, PhD, Vice President for Research and Institutional Official & Scientific Integrity Officer at Lifespan Affiliated Hospitals, about the study and his own research on the issue.
The study in question points to some alarming neurological outcomes with regards to violent gaming. Do you feel the study is worthwhile science? In other words, are these implications we should be paying attention to?

I do think that this is an important study, and it is “worthwhile science”, although there are clearly limitations: 1) it is a single study that deserves to be replicated; 2) it was conducted in a somewhat small sample (28 young men), although that is not such a small sample for expensive imaging studies; and 3) it is essentially a short-duration study that does not study the long-term effects of chronic exposure to video game violence.  In addition, the effects on the developing brain – in younger children – may be different from what was observed in a young adult sample, in ways that have not yet been studied with modern neuroimaging techniques.
One interesting thing about the current study is that the focus is on video gaming, and the entire history of truly violent video gaming on computers is just not that old yet.  Neither is the history of high-resolution fMRI as a way to image function dynamically in the human brain.  So, this study is using modern imaging techniques to study a very modern problem; there is not a whole lot of prior literature to compare this too.
The best and most relevant literature to compare this to is the study of exposure to violence on television, and this actually has been well-studied.  In comparing these new data (with video games) to the studies completed that look at the effects of repeated exposure to television violence on children’s behavior (both immediately and when followed over years) and hormonal responses, these new results fit PERFECTLY.  So, yes, we should be paying attention to this.

From your experience, have you seen research that supports this or the opposite?

As noted above, I am aware of numerous studies that support these results (in looking at exposure to television violence), but I am not aware of much credible results that support the opposite.  There are lots of studies that lead to the same conclusion that repeated and frequent exposure to television violence leads to diminished emotional reactivity amongst viewers (this fits precisely with the new fMRI data).  Moreover, there is good evidence that repeated exposure to violence in early life can lead to an increase in aggressiveness later on  – and this is a position that is supported by the National Institute of Mental Health.  Interestingly, a study shows that television violence exposure leads to increased tendencies to argue, disobey and to hit others (in children), and this holds also for exposure to cartoon violence on TV….which may be more directly analogous to the video gaming experience.

Should we be concerned about this data? How big a deal is this?

To put this into some real-world perspective, I do not allow my children to play video games at all during the school week, and we do not allow any sort of violent video games at all.  We also limit television time and monitor what is viewed.  As a parent and as a clinical neuropsychologist, I am convinced by the data.

Traumatic Brain Injury as a Result of Medical Malpractice

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Traumatic Brain Injury as a Result of Medical Malpractice

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When you or someone you love is the victim of medical malpractice and sustains a medical error injury, the ramifications can be disastrous and overwhelming. If the medical injury you sustained was the result of medical malpractice in Ohio, you should contact a malpractice lawyer in Cleveland who has handled cases similar to yours and may pursue the case to its terminal extent. The Possibility of Medical Error Injury during Brain Surgery One of the most complex types of medical error injuries you or a loved one can sustain after a botched procedure is a traumatic brain injury (TBI). The consequences of a TBI are rarely known until sometime after the initial injury takes place, largely due to the delicate nature of brain tissue and the brain’s concealment behind the hardy human skull.

Every injury’s treatment houses some potential for negligence, malpractice, or error, but few procedures are as high-stakes as those that involve the human brain, the complicated network of electrical synapses that enable, monitor, and maintain our core functions.

Even the slightest miscalculation during brain surgery can have dramatic consequences for the patient. Doctors and the medical community have long been aware of this potential for harm, and for this reason, brain surgery is often regarded as a last resort.

However, there are some circumstances that absolutely require surgical intervention on, in, or near the brain, and the professionals who we trust our health and wellness to during these procedures should be held to the highest standards of professionalism and exactitude.

Traumatic Brain Injury from Medical Malpractice 

The costs associated with a traumatic brain injury caused by a medical error are astronomical, and it is estimated that of those who seek medical treatment in a given year, approximately 2 percent will be injured as a result of malpractice. Of that 2 percent of injured patients, only 2 percent of that figure will ever seek legal remedy from the responsible party or parties.

If you have been injured, don’t let yourself be among the 98 percent of injured patients who don’t seek help. You are lawfully entitled to compensation for the negligence perpetrated against you, and you will need that compensation in order to pay for the cost of the treatment necessary to rectify the injuries you have suffered.

How a Medical Error Injury Attorney Can Help

You may be eligible for malpractice damages for your medical error injury, including (but not limited to) compensation for:

• the cost of medical expenses you incur;
• prescription medication; • medical devices;
• hospital and surgeon fees;
• lost wages from time you are forced to take off of work; and
• non-economic damages for your pain, suffering, and the loss of your quality and enjoyment of life.

If you’ve been injured as a result of a medical error injury or some other kind of medical malpractice in Ohio, prevailing laws include provisions that exist to protect you and your family in the aftermath.

Contact a lawyer in Cleveland who will investigate the circumstances of the malpractice that caused your injury and build a compelling case that demonstrates the extent of the damages you and your family have suffered in order to recoup the maximum amount of recovery available under the law.

The medical error injury team at The Becker Law Firm serves residents of the Cleveland and Elyria areas when they have been the victims of birth injury, catastrophic injury and wrongful death as the result of medical malpractice in Ohio. To arrange for a no-cost consultation,