BrainBlog

BrainBlog

Wednesday, December 28, 2005

Abstract of the Day: Patient-Reported Outcomes (PROs)

Werz MA, Schoenberg MR, Meador KJ, Loring DW, Ray PG, Kaul-Gupta R, & Ogrocki P. Subjective preference for lamotrigine or topiramate in healthy volunteers: Relationship to cognitive and behavioral functioning. Epilepsy and Behavior. 2005 Dec 21; [Epub ahead of print].

Department of Neurology, University Hospitals of Cleveland and Case Western Reserve University School of Medicine, Cleveland, OH, USA.

OBJECTIVE: Outcomes research emphasizes patient self-assessment and preferences in optimizing treatment. We previously showed that lamotrigine produces significantly less cognitive and behavioral impairment compared with topiramate. In the current study we extend these observations to subject self-report of preference for lamotrigine or topiramate independent of potentially confounding effects of seizures or seizure control. Additionally, drug preference was related to effects of lamotrigine and topiramate on objective neuropsychological tests as well as self-perception on behavioral instruments. METHODS: Thirty-seven healthy volunteers completed a double-blind, randomized crossover design incorporating two 12-week treatment periods of lamotrigine and topiramate each titrated to a dose of 300mg/day. Evaluation of 23 objective neuropsychological and 15 subjective behavioral measures occurred at four times: pretreatment baseline, first treatment, second treatment, and posttreatment baseline. Preference for lamotrigine or topiramate was assessed, while blinding was maintained, at the final study visit when each subject was asked which drug he or she would prefer to take. RESULTS: A large majority (70%) preferred lamotrigine, 16% stated preference for topiramate, and 14% had no preference (drugs equivalent). Consistent with preference, those preferring lamotrigine performed better on 19 of 23 objective and 13 of 15 subjective behavioral measurements while on lamotrigine. Inconsistent with preference, subjects preferring topiramate performed better on 19 of 23 objective and 9 of 15 subjective behavioral measures while on lamotrigine. Topiramate preference also did not correlate with IQ, serum concentration, body mass index, age, or gender. Topiramate preference did relate to responses on the Profile of Mood States. CONCLUSION: Lamotrigine was preferred by the majority of subjects, congruent with objective neuropsychological and subjective behavioral measures. In contrast, for those stating a preference for topiramate the results on objective neuropsychological measures were impaired while fewer complaints were noted on the Profile of Mood States. This suggests that preference for topiramate may be determined by an effect on mood.

PMID: 16377253 [PubMed - as supplied by publisher]
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Anthony H. Risser | |

Sunday, December 25, 2005

Abstract of the Day: Smell Identification and Anosmia Screening

Jackman AH & Doty RL. Utility of a three-item smell identification test in detecting olfactory dysfunction. Laryngoscope. 2005 Dec; 115(12): 2209-2212.
 
From the Smell and Taste Center, Department of Otorhinolaryngology-Head and Neck Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, U.S.A.

OBJECTIVE:: Physicians rarely assess smell function, largely because of time considerations. Therefore, there is clinical need for very brief cranial nerve I screening tests. Although a few such tests exist, none have been adequately validated. The goal of this study was to empirically assess the utility of a three-item microencapsulated odor identification test in detecting olfactory dysfunction. SETTING:: Smell and taste center at a university medical center. METHODS:: The test was administered to 224 consecutive patients (98 men and 126 women ranging in age from 15-88 years). As part of their overall assessment, the well-validated 40-item University of Pennsylvania Smell Identification Test (UPSIT) was also administered. Sensitivity, specificity, and both negative and positive predictive values of the three-item test were established relative to UPSIT dysfunction categories. Test-retest reliability was determined in a subset of 39 patients. RESULTS:: The three-item test was abnormal in 99% (67/68) of patients with anosmia, 85% (35/41) of those with severe microsmia, 76% (31/41) of those with moderate microsmia, and 50% (17/34) of those with mild microsmia. Of the 40 normosmic patients, 62.5% (25/40) correctly identified all odors, 25% (10/40) two odors, and 12.5% (5/40) one odor. None of the normosmic patients missed all three items. Using a cut-off score of 2, the test's sensitivity and specificity were 99% and 40%, respectively, for detecting total anosmia. The corresponding negative and positive predictive values were 98% and 43%. For detecting anosmia and severe microsmia, these values were 93%, 45%, 88%, and 63%. For detecting any olfactory pathology, they were 82%, 63%, 42%, and 91%. The test-retest reliability was 0.87. CONCLUSION:: The brief three-item test used in this study was found to be highly sensitive in identifying olfactory loss in patients with chemosensory complaints, particularly those with severe dysfunction. Although only moderately specific, its high reliability and negative predictive value suggests it may be an appropriate screening test for olfactory loss.

PMID: 16369168 [PubMed - in process]
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Anthony H. Risser | |

Sunday, December 18, 2005

Upcoming Event: NEUROfest, NYC, January 2006

Untitled Theater Company #61 explores the nexus of science and art in NEUROfest, the first-ever theater festival dedicated to neurological conditions.

NEUROfest
5-29 January 2006
Theater 5
311 West 43rd Street, 5th floor

Additional info: NEUROfest homepage

A collection of theater artists from around the country will present work inspired by various neurological conditions, including: Amnesia (Korsakov's Syndrome), Aphasia, Autism, Capgras Syndrome, Creutzfeldt-Jakob Disease (CJD), Dementia, Meniere's Disease, Synesthesia, and Tourette's Syndrome.

Taken from an e-mailed release, here is the program:
CJD
Written and Directed by James Jordan
The Boondogglers
Condition dealt with: Creutzfeldt-Jakob Disease (a relative of Mad Cow)
A multimedia one man show written and performed by a neurologist about his experience with a patient with CJD, augmented with live music performance.

IMPOSTERS
by Justin Warner
Directed by Ari Laura Keith
Glass House Productions
Condition dealt with: Capgras syndrome
Inspired by the rare neurological condition Capgras' Syndrome, IMPOSTORS is a quirky, funny, heartfelt exploration of the contradictions and distortions that hold all families together. After a brain injury, a son believes his parents have been replaced with exact duplicates of themselves, triggering a series of events that threatens to unravel the entire family. IMPOSTORS won the Kennedy Center-ACTF playwriting contest for the Mid-Atlantic region, and was also a finalist for the Princess Grace Award. IMPOSTORS will run simultaneously with NEUROfest at the Union Theatre in London.

STRANGERS and LINGUISH
Written and directed by Edward Einhorn
Untitled Theater Co. #61
Conditions dealt with: Amnesia (Korsakov's Syndrome) and Aphasia
LINGUISH posits a disease which causes aphasia, the neurological disorder that takes away one's ability to use language. Four relative strangers are among the first to be affected, and are thrown together in quarantine. As the disease affects them, they are forced to try to find new ways to communicate. In STRANGERS, a man and a woman are in what seems to be a doctor's waiting room. Is it? If so, what's wrong?

SYNDROME
by Kirk Wood Bromley
Performed and directed by Timothy McCowen Reynolds
Inverse Theater Company
Condition dealt with: Tourette's
Syndrome is a play about a man sitting in his room attempting to muster the courage to meet his parents for dinner. We quickly discover that there are reasons for his anxiety, stemming from his submission to a "spectrum of psychological disorders" that have taken over his mind. Nothing, however, is really wrong with him.

TABULA RASA
Words by Robert Lawson, Music by Henry Akona
Directed by Henry Akona
Music Direction by Ekaterina Stanislavskaya
High Fidelity Theater
Condition dealt with: Autism
An opera featuring interlinked stories of two children, both lost in the woods. One, a 19th century tale inspired by stories of the Wild Boy of Aveyron and other children who grew up in the wild. The other, the 21st century tale of a young girl lost in the forest of mood altering medications. Tabula Rasa examines the effects of nature and nurture, and the fundamental meaning of language and human relationships.

WELCOME TO TOURETTAVILLE!
by Jonathan Ospa, June Rachelson-Ospa, and Daniel Neiden
Music by Jody Gray, Doug Katsaros and Daniel Neiden
Directed by Daniel Neiden
Condition dealt with: Tourette's Syndrome
A musical inspired by a young boy's dreamworld where 4 aliens, Tick, Blinky, Screamer, and the guru of all Tourettians, The Big Bleeper, befriend and inspire him toward self-acceptance. The musical was co-written by June Rachelson-Ospa and her 7 year old son Jonny Ospa.

NEUROshorts
(NEUROshorts is one entire evening)

THE BOY WHO WANTED TO BE A ROBOT
by Edward Einhorn
Directed by Barry Weil
Evolve Theater Company
Condition dealt with: Autism (Aspergers)
A fairy tale set on another planet, this is a Pinnochio story in reverse, about a child who grows up in a robot country and just wants to be a robot like everyone else.

VESTIBULAR
by: Kelly R. Haydon
Directed by: Jolie Tong
Monkey Business Productions
Length: 20 minutes
Condition dealt with: Meniere's disease
As vertigo routinely attacks a former dancer stricken with Meniere's Disease, an informal conversation with his nurse turns into a revelation that challenges the idea of dependency as a passive force

THE TASTE OF BLUE
by Alexandra Edwards
Directed by Julia Martin
The Transformative Theater Company
Conditions dealt with: Synesthesia, Eidetic memory
The sound of the saxophone is blue. The letter O is blue. And blue tastes good. A woman describes her world, in which every sense calls up another. When the world turns gray, she must turn to her own imaginary landscape, filled with memories, to find something delicious.

DOCTORS JANE AND ALEXANDER
by Edward Einhorn
Directed by Ian Hill
GeminiCollisionWorks
Condition dealt with: Dementia
A found text plays about a psychologist now suffering from dementia, and her father, the discoverer of the Rh factor.

Plus:
For One Night Only!
CINCINATTI
by Don Nigro
Directed by John Clancy
Theater Company: Clancy Productions
Condition dealt with: Brain tumors
A one woman show by Nancy Walsh, a portrait of madness�originally performed after the removal of a brain tumor from Nancy Walsh, allowing her to only say things she had already memorized. Done in conjunction with a seminar.
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Anthony H. Risser | |

Saturday, December 17, 2005

Epilepsy: Diagnosis and Treatment Patient Care

The December issue of Postgraduate Medicine includes a series of articles on the topic of current epilepsy management. These articles can be accessed from the issue's table-of-contents page.
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Anthony H. Risser | |

Wednesday, December 14, 2005

Abstract of the Day: fMRI and Auditory Attention

Nakai T, Kato C, & Matsuo K. An FMRI study to investigate auditory attention: A model of the cocktail party phenomenon. Magnetic Resonance Medical Science. 2005; 4(2): 75-82.

Functional Brain Imaging Laboratory, Department of Gerontechnology, National Center for Geriatrics and Gerontology.

In human life, discrimination of a target voice from other voices or sounds is indispensable, and inability for such discrimination results in sensory aphasia. To investigate the neuronal basis of the attentional system for human voices, we evaluated brain activity during listening comprehension tasks using functional magnetic resonance imaging (fMRI) at 3T. Diotic listening comprehension tasks, in which a narration was superimposed by another given by the same speaker (SV experiment) or by a different speaker (DV experiment), were presented to normal volunteers. The story indicated in the baseline task blocks, in which only one narration was presented, was intensively followed during the superimposed task blocks. In each experiment, 6 task blocks, 3 blocks for each condition, and 7 rest blocks were alternatively repeated, and the contrast of the superimposed condition to the baseline condition in each session was obtained. In the DV experiment, compared with the control condition, activation in Wernicke's area (BA22) was increased. In the SV experiment, activation in the frontal association cortex (BA6, BA9/ 46, BA32, BA13/47) was additionally increased. These results suggested that difficulty in phonological processing to discriminate human voices calls for further semantic, syntactic, and prosodic processing, as well as augmented selective attention.

PMID: 16340161 [PubMed - as supplied by publisher]
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Anthony H. Risser | |

Saturday, December 10, 2005

p25 and Memory Functioning

From the BBC, a report about a recent research study published in the journal Neuron:
'Jekyll and Hyde' dementia clue
BBC
10 December 2005

[snip]

In the study, the researchers "switched on" p25 at will in the brain's learning and memory centre, the hippocampus.

In these mice, they found that switching on p25 for only two weeks boosted learning and memory compared to normal mice.

But if the p25 was switched on for six weeks, mice displayed impaired learning and memory in tests.

Physiological studies showed that these mice showed significant brain damage and lost nerve cells in the hippocampus.

But those who had elevated p25 levels for just two weeks had no such effects.

The researchers concluded that short-term production of p25 boosts learning - but long term exposure affects the ability to form new memories.

The researchers, led by Dr Li-Huei Tsai, say the study suggested that the protein was normally beneficial, helping form memories and enable learning.

But if there was too much p25, perhaps because of other changes in the brain linked to dementias, nerve cells can die.

[snip]

[ ... Read the full article ... ]
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Anthony H. Risser | |

Tuesday, December 06, 2005

Abstract of the Day: Neuropsychology Assessment in Outcome from Extremely Low Birth Weight (ELBW)

Mikkola K, Ritari N, Tommiska V, Salokorpi T, Lehtonen L, Tammela O, Paakkonen L, Olsen P, Korkman M, & Fellman V. Neurodevelopmental outcome at 5 years of age of a national cohort of extremely low birth weight infants who were born in 1996-1997. Pediatrics. 2005 Dec; 116(6): 1391-1400.

Hospital for Children and Adolescents, Helsinki University Central Hospital, Helsinki, Finland.

OBJECTIVE: Increasing survival of extremely low birth weight (ELBW; birth weight < 1000 g) infants raises a concern regarding the risks of adverse long-term outcome such as cognitive dysfunction. Few studies have reported long-term follow-up of representative regional cohorts. The objective of this study was to assess the 5-year outcome of a prospectively followed national ELBW infant cohort. METHODS: Of all live-born ELBW infants (n = 351) who were delivered in the 2-year period 1996-1997 in Finland, 206 (59%) survived until the age of 5 years. Of these, 103 were born at < 27 gestational weeks (GW). A total of 172 children were assessed with neurocognitive tests (Wechsler Preschool and Primary Scale of Intelligence-Revised and a Developmental Neuropsychological Assessment [NEPSY]). Nine children with cognitive impairment and inability to cooperate in testing were not assessed. Motor development was assessed with a modified Touwen test. RESULTS: The rate of cognitive impairment in the ELBW survivors was 9%. The rate of cerebral palsy was 14% (19% of ELBW infants who were born at < 27 GW). The mean full-scale IQ of the assessed children was 96 +/- 19 and in children of GW < 27 was 94 +/- 19. Attention, language, sensorimotor, visuospatial, and verbal memory values of NEPSY assessment were significantly poorer compared with normal population means. Four percent needed a hearing aid, and 30% had ophthalmic findings. Of 21 children who had been treated with laser/cryo for retinopathy of prematurity, 17 (81%) had abnormal ophthalmic findings. Of the whole cohort, 41 (20%) exhibited major disabilities, 38 (19%) exhibited minor disabilities, and 124 (61%) showed development with no functional abnormalities but subtle departures from the norm. Only 53 (26%) of the total ELBW infant cohort were classified to have normal outcome excluding any abnormal ophthalmic, auditory, neurologic, or developmental findings. Being small for gestational age at birth was associated with suboptimal growth at least until age 5. CONCLUSIONS: Only one fourth of the ELBW infants were classified as normally developed at age 5. The high rate of cognitive dysfunction suggests an increased risk for learning difficulties that needs to be evaluated at a later age. Extended follow-up should be the rule in outcome studies of ELBW infant cohorts to elucidate the impact of immaturity on school achievement and social behavior later in life.

PMID: 16322163 [PubMed - in process]
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Anthony H. Risser | |

Monday, December 05, 2005

Taste

From an NIH press release earlier today:
NIDCD-funded Researchers Find Missing "Piece of the Pie" in Understanding Taste

Scientists funded by the National Institute on Deafness and Other Communication Disorders (NIDCD), one of the National Institutes of Health, are a step closer to unraveling the mystery of taste. In a study published in the December 2, 2005, issue of Science, researchers have pinpointed the chemical responsible for transmitting signals from the taste buds — small sensory bumps on the tongue, throat, and roof of the mouth — to the taste nerves leading to the brain. Today’s findings provide scientists with a more complete picture of this complicated process, helping advance the study of taste and taste disorders.

“People with taste disorders might not be able to enjoy the fun of eating and are at risk for other health problems, such as poorly balanced nutrition, so researchers are working to understand more fully how our sense of taste works,” says James F. Battey, Jr., M.D., Ph.D., director of the NIDCD. “Until now, there has always been a missing link between the detection of chemicals in the taste buds and the transmission of chemical signals from the taste nerves to the brain. Through an ingenious use of genetic engineering, these researchers have finally been able to solve the puzzle.”

Using “knockout mice,” mice that are genetically altered to be missing one or more key genes, the researchers were able to narrow the field of possible chemicals to one: adenosine 5’-triphosphate, or ATP, a high-energy molecule that is also important for helping cells in the body to function. The scientists produced mice that are missing the genes that encode two key receptors found in taste nerves — P2X2 and P2X3 — both of which bind to ATP. They found that the taste nerves of mice lacking the P2X2 and P2X3 genes showed no response to taste stimulation, although the nerves remained responsive to touch, temperature, and menthol. These results indicate that not only are P2X2 and P2X3important in transmitting taste signals, but the chemical that they bind to — ATP — is also important.
[ ... Read the full release ... ]
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Anthony H. Risser | |

Saturday, December 03, 2005

Abstract of the Day: Dementia and Caregiver Quality of Life

Thomas P, Lalloue F, Preux PM, Hazif-Thomas C, Pariel S, Inscale R, Belmin J, & Clement JP. Dementia patients caregivers quality of life: The PIXEL study. International Journal of Geriatric Psychiatry. 2005 Dec 2; [Epub ahead of print]

University Department of Psychogeriatrics & Memory Clinic CH Limoges, France.

BACKGROUND: Alzheimer's disease and related syndromes have heavy social and human consequences for the patient and his family. Beyond the neuropsychiatric effects of specific therapies for dementia, one of today's challenges is the quality of life for both patients and their informal caregivers. OBJECTIVES: This survey tends to determine parameters influencing caregivers' quality of life, and its possible link with patients' quality of life. METHODS: A scale measuring caregivers' quality of life, developed from data from previous PIXEL studies was used. It is a questionnaire composed of 20 items. The scale was related to the socio-demographic data of both patients and their main caregivers, to the ADRQL scale (Alzheimer Disease Related Quality Life) of Rabins for the QoL of dementia patients, to the patients medical and therapeutic data, specially a neuropsychological inventory: Folstein's cognition test, Cornell's depression scale, the fast battery of frontal assessment, Katz's dependence index, Cummings' neuropsychiatric inventory for behavioral and psychological symptoms of dementia and to a physician evaluation of caregiver's depression. RESULTS: One hundred patients diagnosed with dementia who live at home with their principal caregivers were recruited for this survey. Patients were 80.2 +/- 6.8 years old and caregivers were 65.7 +/- 12.8 years old. The caregivers' quality of life was correlated to the quality of life of the patients they cared for, the importance of behavioral disorders, and the duration of dementia evolution. Women caregivers had a worse quality of life and were more depressive than men. DISCUSSION: Caregivers' and patients' quality of life are related and both share a community of distress. Copyright (c) 2005 John Wiley & Sons, Ltd.

PMID: 16323256 [PubMed - as supplied by publisher]
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Anthony H. Risser | |

Methylphenidate Transdermal Patch (Daytrana), ADHD, & the FDA: FDA Briefing Information

Briefing Information for the FDA's psychopharmacologic drugs advisory committee meeting on Friday.
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Anthony H. Risser
| |

Methylphenidate Transdermal Patch (Daytrana), ADHD, & the FDA: Thursday and Friday

THURSDAY:

From The Washington Post website:
Problem Found With Potential ADHD Patch
The Associated Press
Thursday, December 1, 2005; 3:01 PM

WASHINGTON -- A patch developed to treat attention deficit hyperactivity disorder in children received a negative review from a Food and Drug Administration scientist, who concluded the drug cannot be safely marketed.

The patch uses methylphenidate, the same drug that is in Ritalin. But FDA reviewer Dr. Robert Levin found the patch produces troubling side effects too often to be considered safe. His findings were in briefing documents released by the agency on Thursday in advance of a public meeting on the drug.

The reviewer's findings are not the final word. An independent panel of experts convened by the FDA is expected to consider on Friday whether the patch is effective and safe. The FDA has the final call on whether the patch can be made available, but the agency often follows the advice of its panels.

The patch, developed by Noven Pharmaceuticals of Miami and Shire Pharmaceuticals Group in the United Kingdom, goes on a child's hip for nine hours, according to submissions by the company. It releases into the body methylphenidate, a stimulant that calms children with ADHD. It is for children between the ages of 6 and 12.

Noven pitched the patch as a way to treat ADHD in children for whom taking pills is difficult or unpleasant. It can also be removed if it causes any side effects.

But some children who received the patch during trials reported decreased appetites, headaches, insomnia, nausea and developing tics, the FDA said. Some also had skin irritation where the patch was applied. These occurred more often than in children taking Concerta, a pill that uses methylphenidate, and those taking a placebo, the FDA said.
[ ... Read the full article ... ]


FRIDAY:

From Reuters.com:
...FDA panel supports ADHD patch with limits
Fri Dec 2, 2005 4:02 PM ET
By Susan Heavey

GAITHERSBURG, Md., Dec 2 (Reuters) - An experimental patch to treat children with attention deficit hyperactivity disorder (ADHD) is safe and effective but should carry certain restrictions, a U.S. advisory panel unanimously said on Friday.

The Food and Drug Administration is considering whether to approve the patch, made by Britain's Shire Pharmaceuticals Group Plc (SHP.L...) and U.S.-based Noven Pharmaceuticals Inc (NOVN.O...). The FDA usually follows the advice of its advisers.

The panel's decision came after a key FDA staff reviewer earlier on Friday said the patch should be approved, reversing his opinion, released on Thursday, that it was too risky.

"I have reconsidered this (earlier) recommendation for a number of reasons. I think some of the safety concerns remain, but they seem to occur to a lesser degree," Robert Levin, a staff reviewer in the FDA's Division of Psychiatry Products, told panelists.
[ ... Read the full article ... ]
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Anthony H. Risser
| |

Friday, December 02, 2005

Malnutrition and the Brain

From the December issue of The APA Monitor:
Feed the birds
Songbird study offers new insights into how malnutrition impairs development and cognition
By Rachel Adelson
The APA Monitor
December 2005
Print version: page 16

Slim postpartum pickings for young birds may stunt their brain growth and impede their ability to later remember where they store food. In fact, early deprivation may send adult birds into a downward spiral and thwart their survival, according to new research by Vladimir Pravosudov, PhD, of the University of Nevada, Reno, and Pierre Lavenex, PhD, and Alicja Omanska, PhD, of the University of California, Davis.

They studied the impact of early malnutrition on the western scrub-jay, a long-tailed, blue-feathered songbird. They underfed scrub-jay chicks. Then a year later, when these scrawny chicks grew up, they were worse off as adults than birds who ate better when young–even though the experimental group had caught up by then in weight. The experimental birds had smaller hippocampi with fewer neurons than the control birds and performed worse on spatial-memory tasks that required them to recover seeds they had cached away.
[ ... Read the full article ... ]
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Anthony H. Risser | |

Monday, November 28, 2005

Primary Progressive Aphasia (PPA): Want to Learn More?

Northwestern University's Cognitive Neurology and Alzheimer's Disease Center has a helpful overview of PPA online here:
PPA Handbook.
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Anthony H. Risser | |

Primary Progressive Aphasia (PPA)

From an NIH press release from earlier today:
Study Links Progressive Aphasia Syndrome to Prion Gene

Most people with a rare type of dementia called primary progressive aphasia (PPA) have a specific combination of prion gene variants, a new study shows. The study is the first to link the prion protein gene to this disorder. It was funded in part by the National Institute of Neurological Disorders and Stroke (NINDS), part of the National Institutes of Health (NIH), and appears in the December 2005 issue of the Annals of Neurology.

The researchers, led by James A. Mastrianni, M.D., Ph.D., of the University of Chicago, also looked at the prion protein gene in people with Alzheimer's disease and amyotrophic lateral sclerosis (ALS or Lou Gehrig's disease) and did not find any association with specific gene variants in those disorders.

PPA is classified as a type of frontotemporal dementia because of the pattern of brain degeneration it causes. The primary symptoms of the disease are problems speaking or understanding speech, and these problems gradually get worse over time. People with PPA also may develop difficulty with math. Most other functions remain normal for at least two years after the language symptoms appear, but the disease may eventually cause other changes, such as problems with memory, reasoning, and spatial abilities. While PPA sometimes runs in families, it has never before been linked to variations in a specific gene.

Unlike the abnormal disease-causing prions linked to Creutzfeldt-Jakob disease (CJD) and other so-called "prion diseases", the normal prion protein is found in everyone. The gene that codes for the normal protein has several common variants. One variant of the gene codes for an amino acid called methionine at a point called codon 129, while another version codes for the amino acid valine at codon 129. These variants appear to influence disease susceptibility and symptoms in CJD and other prion diseases, probably because they determine how the prion protein folds. Proteins' folded shapes affect how well they can function. Some protein shapes also interfere with normal cellular processes.

People normally have two copies of every gene. In the new study, Dr. Mastrianni and his colleagues found that almost 85 percent of the people with PPA who took part in this study had one copy of the prion gene coding for the methionine variant and the other coding for valine. "The association between this gene combination and the disease is really dramatic," he says. However, not all people with the two gene variants develop PPA. Therefore the prion gene is probably not the primary cause of the disease, he adds.

The researchers think that the methionine/valine combination leaves people susceptible to PPA in ways that are not yet understood. Previous studies have suggested that normal prion proteins carry out a variety of functions, from cellular delivery of copper to cell signaling and even triggering or preventing cell death. The proteins may work either better or worse depending on which gene variants people inherit. Any of the proteins' normal activities could be important in the chain of events that leads to PPA.

“This is a new case where prion genes are linked to a neurological disorder, and it suggests that we need to learn more about the normal function of prions in the nervous system in order to better understand their role in disease,” says Michael Nunn, Ph.D., the NIH neurology institute’s program director for this study.
[ ... Read the full release ... ]
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Anthony H. Risser | |

Thursday, November 24, 2005

Human-Computer Interfaces and Facial Cognition

The N=1: Population of One blog discusses and points to an upcoming academic workshop about HCI and cognitive factors related to faces: Read the post.
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Anthony H. Risser | |

Tuesday, November 22, 2005

Abstract of the Day: Donepezil (Aricept) and Alzheimer Disease

Csernansky JG, Wang L, Miller JP, Galvin JE, & Morris JC. Neuroanatomical predictors of response to donepezil therapy in patients with dementia. Archives of Neurology. 2005 Nov; 62(11): 1718-1722.

Alzheimer's Disease Research Center, and Department of Psychiatry, Washington University School of Medicine, St Louis, MO 63110, USA.

BACKGROUND: Patients with dementia of the Alzheimer type (DAT) respond variably to treatment with acetylcholinesterase inhibitors. OBJECTIVE: To determine whether measures of hippocampal volume and shape predict the response to donepezil in patients with DAT. DESIGN: T1-weighted, magnetic resonance images were obtained from patients with DAT, who subsequently underwent treatment with donepezil. Brain-mapping algorithms were used to quantify hippocampal volume and shape, and growth curves were used to estimate clinical outcome. SETTING: A referral outpatient center specializing in treatment of dementia. PATIENTS: Thirty-seven patients with very mild or mild DAT received donepezil therapy for up to 4 weeks before magnetic resonance imaging and for 24 to 96 weeks after magnetic resonance imaging. INTERVENTION: Donepezil, 10 mg/d. MAIN OUTCOME MEASURE: Rate of change in the cognitive portion of the Alzheimer's Disease Assessment Scale total scores. RESULTS: Smaller hippocampal volume and inward variation of the lateral and inferomedial portions of the hippocampal surface were correlated with a poorer response to donepezil therapy. CONCLUSIONS: Measures of hippocampal volume and surface variation can be used to predict the response of patients with DAT to the acetylcholinesterase inhibitor donepezil.

PMID: 16286546 [PubMed - in process]
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Anthony H. Risser
| |

Abstract of the Day: Verbal Fluency Testing and Multiple Sclerosis (MS)

Henry JD, Beatty WW. Verbal fluency deficits in multiple sclerosis. Neuropsychologia. 2005 Nov 14; [Epub ahead of print]

School of Psychology, University of New South Wales, Sydney, NSW, Australia.

A quantitative review of 35 studies with 3673 participants was conducted to estimate and compare the magnitude of deficits upon tests of phonemic and semantic fluency for participants with multiple sclerosis (MS) relative to healthy controls. Participants with MS were substantially but similarly impaired on tests of phonemic and semantic fluency. These deficits were larger than deficits on measures of verbal intelligence, confrontation naming and another widely used measure of executive functioning, the Wisconsin Card Sorting Test, but were of a comparable or smaller magnitude relative to deficits on the oral version of the Symbol Digit Modalities Test (SDMT). This is consistent with other research suggesting that measures of verbal fluency and the SDMT may be amongst the most sensitive neuropsychological measures to cognitive impairment in MS. Increased neurological disability and a chronic progressive (as opposed to a relapsing remitting) disease course were associated with larger deficits on tests of phonemic and semantic fluency. However, it is suggested that this latter finding is attributable to the distinct clinical features of chronic progressive and relapsing remitting sub-types. Thus, patients who follow a chronic progressive course tend to be older, have an increased duration of illness and experience greater neurological disability. Once these variables were controlled for, differences between the two sub-types were substantially attenuated.

PMID: 16293271 [PubMed - as supplied by publisher]
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Anthony H. Risser | |

Friday, November 18, 2005

Business World: Biogen Idec, Elan, & Tysabri (Natalizumab)

From the AP:

Elan Shares Jump As Tysabri to Get Review
By THE ASSOCIATED PRESS
Published: November 18, 2005
Filed at 12:52 p.m. ET

DUBLIN, Ireland (AP) -- Shares in Irish drug maker Elan Corp. PLC jumped Friday after U.S. regulators announced they would accelerate their review of a key suspended drug, Tysabri.

On the Irish Stock Exchange in Dublin, Elan shares rose 4.4 percent to close at 9.24 euros ($10.81) amid renewed optimism about the multiple sclerosis-fighting drug. Elan is developing Tysabri in conjunction with Cambridge, Massachusetts-based Biogen Idec Inc.

The U.S. Food and Drug Administration said Thursday night it had granted Tysabri ''priority review'' status, which means that a decision on whether the drug can return to the U.S. market will be made within six months instead of the standard 10.

[ ... Read the full article ... ]
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Anthony H. Risser | |

In The Weeklies: Pharmacotherapy in Older Adults

In the current issue of the British Medical Journal:

Jennifer Glass, Krista L Lanctôt, Nathan Herrmann, Beth A Sproule, & Usoa E Busto. Sedative hypnotics in older people with insomnia: meta-analysis of risks and benefits. British Medical Journal;  2005; 331: 1169. [doi:10.1136/bmj.38623.768588.47]

[ ... Read the full article ... ]
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Anthony H. Risser | |

Thursday, November 17, 2005

Wednesday, November 16, 2005

Abstract of the Day: Neuropsychology Tracking in Epilepsy Care

Lutz MT & Helmstaedter C. EpiTrack: Tracking cognitive side effects of medication on attention and executive functions in patients with epilepsy. Epilepsy and Behavior, 2005 Oct 30; [Epub ahead of print].

Department of Epileptology, University of Bonn, Bonn, Germany.

RATIONALE: Achievement of maximum seizure control with preservation or even improvement of patient's cognitive capabilities is the major aim of epilepsy therapy. EpiTrack is a brief screening tool for the tracking of cognitive side effects of antiepileptic drugs. Test selection was based on recent studies on the effects of topiramate on cognition and retrospective inspection of results from patients with antiepileptic drug (AED) side effects. METHODS: The 15-minute screening tool comprises six subtests: the Trail-Making Test (parts A and B), a test of response inhibition, digit span backward, written word fluency, and a maze test. These tests were standardized in 220 healthy subjects, 100 of whom were reevaluated after 5.3 months to obtain information on reliability and practice effects. Criterion validity was determined by correlation to other neuropsychological measures. For a first clinical evaluation, the impact of epilepsy (seizures) and medication on EpiTrack scores was evaluated cross-sectionally in 184 consecutive inpatients with chronic epilepsy. RESULTS: According to the normative data, we developed an easy scoring scheme assigning test scores on a 7-point scale. The EpiTrack is suitable for patients between 18 and 60 years of age. Age corrections were included for patients between 40 and 60 years. EpiTrack scores on subtests for both controls and patients were submitted to principal component analysis. VARIMAX rotation yielded a two-factor solution (verbal/visuo-spatial) that accounted for 63.8% of the total variance in controls. In the patient group, only one factor emerged accounting for 54.7% of variance. EpiTrack correlates with global scores of attention (r=0.85) and language (r=0.67) (P's<0.001). At a cutoff score of 25, only 2.7% of the controls were classified as impaired, while impairment was indicated in 48.4% of the patients. The score is sensitive to monthly frequency of complex partial seizures and to number of AEDs. It shows negative cognitive effects of valproate and topiramate given in mono/polytherapy. CONCLUSION: EpiTrack is a promising 15-minute screening tool for the detection and tracking of cognitive side effects of AEDs and adverse effects of seizures in patients with epilepsy. Future application will show its value in prospective follow-up studies on AED side effects.

PMID: 16266826 [PubMed - as supplied by publisher]
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Anthony H. Risser | |

PubMed Goes RSS

Save a couple of steps and a little time in your lit searches by making use of the new RSS feed options on PubMed. Details are provided from the homepage.
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Anthony H. Risser | |

The Amateur Pharmacists

From The New York Times:
Young, Assured and Playing Pharmacist to Friends
By AMY HARMON
Published: November 16, 2005
The New York Times

[snip]

For a sizable group of people in their 20's and 30's, deciding on their own what drugs to take - in particular, stimulants, antidepressants and other psychiatric medications - is becoming the norm. Confident of their abilities and often skeptical of psychiatrists' expertise, they choose to rely on their own research and each other's experience in treating problems like depression, fatigue, anxiety or a lack of concentration. A medical degree, in their view, is useful, but not essential, and certainly not sufficient.

They trade unused prescription drugs, get medications without prescriptions from the Internet and, in some cases, lie to doctors to obtain medications that in their judgment they need.
[ ... Read the full article ... ]
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Anthony H. Risser | |

Tuesday, November 15, 2005

Fibril Structure and Alzheimer Disease

From a Salk Institute for Biological Studies press release:
Released: Fri 11-Nov-2005, 08:55 ET 
Embargo expired: Mon 14-Nov-2005, 17:00 ET 
 
3-D Structure of Alzheimer's Disease Filament Shows How It Zips Up Peptides

Newswise — Researchers have solved the three dimensional structure of the long thread-like fibers that fill the brains of Alzheimer's disease patients. The structure reveals the proteins that make up the fibrils lock onto each other much like a zipper on a jacket. This advance, reported in the Nov. 14th early online edition of Proceedings of the National Academy of Sciences (PNAS), helps illuminate the molecular roots of Alzheimer's and possibly other degenerative diseases of the brain.

“Now that we understand at an atomic level how these fibrils form, it might help researchers develop a biomarker test to diagnose Alzheimer's disease at an early stage, as well as drugs to treat it,” says the study's lead investigator, Salk Institute for Biological Studies scientist Roland Riek, Ph.D., who collaborated with researchers at the University of Lausanne and Roche pharmaceuticals, both in Switzerland

As a result of the study, Riek and his colleagues may now understand how a potential Alzheimer's disease medication now in clinical trials in Europe reacts to the fibril. The drug binds to the end of the fibril chain of beta amyloid proteins, halting their lethal accumulation, an early step in the formation of the amyloid plaque deposits that are a hallmark of Alzheimer's.

[snip]

The research team of the Salk Institute in collaboration with the University of Lausanne and Roche, developed new research techniques to determine the 3D structure that mimics the most common type of fibrils found in patients with the disease.

They discovered that beta amyloid proteins (peptides) that make up these fibrils attach to each other on one end with an ever-growing property.

“From this structure we can nicely see what happens physically, where the fibril forms a template on which to bind other amyloid peptides in an inter-collated way,” Riek says. “The way these peptides lock on to each other is like a zipper on a jacket.” Due to the ever-growing property the zipper binds more and more loose peptides together to produce dense “plaque” filaments that may be toxic to the functioning of brain nerve cells.
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Anthony H. Risser | |

Blogger/Blogspot Dysfunctional Once Again

Friday, November 04, 2005

Hippocampus and Early-Life Memories

The November issue of The APA Monitor includes a short piece about a recent talk by Dr. Lynn Nadel discussing advances in research related to the hippocampus and memory:

Why we can't remember when...
The hippocampus's role in memory may help explain why we cannot remember our early childhood, and why stress affects our memory later in life.
By LEA WINERMAN
APA Monitor
November 2005
Print version: page 36
[ ... Read the article ... ]
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Anthony H. Risser | |

Tuesday, November 01, 2005

Monday, October 31, 2005

Art Therapy in Dementia

From The New York Times:
The Pablo Picasso Alzheimer's Therapy
By RANDY KENNEDY
The New York Times
Published: October 30, 2005

SITTING the other day in front of Picasso's rapturous "Girl Before a Mirror" at the Museum of Modern Art, Rueben Rosen wore the dyspeptic look of a man with little love for modern art. But the reason he gave for disliking the painting was not one you might expect to hear from an 88-year-old former real estate broker.

Xanthe Alban-Davies discusses Picasso's "Girl Before a Mirror" with, from left, Rueben Rosen, Irene Brenton and Sheila Barnes at the Museum of Modern Art. "It's like he's trying to tell a story using words that don't exist," Mr. Rosen said.

"It's like he's trying to tell a story using words that don't exist," Mr. Rosen said finally of Picasso, fixing the painter's work with a critic's stare. "He knows what he means, but we don't."

This chasm of understanding is one that Mr. Rosen himself stares into every day. He has midstage Alzheimer's disease, as did the rest of the men and women who were sitting alongside him in a small semicircle at the museum, all of them staring up at the Picasso.
[ ... Read the full article ... ]
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Anthony H. Risser | |

Wednesday, October 26, 2005

Pandemic-Flu (H5N1, Avian Influenza, "Bird Flu") Educational References

Pandemic-Flu (H5N1, Avian Influenza, "Bird Flu") Educational References

Here is an updated version of the reference set that I will episodically post here:

Background and historical references:

Barry, John M. (2004). The great influenza. NY: Viking. [comment: A very readable account of what happened and why in the 1918 pandemic, with an emphasis on the political expediences and cronyism of the day and media complacency - along with accounts of the public-health leaders who needed to fight not only the virus, but politicians and newspaper editors in order to eke out ways of dealing with the virus. Also, a good description of how this type of influenza differs from the typical, yearly bouts of influenza that most all of us are aware of.]

Department of Health and Human Services (2004). Pandemic Influenza Preparedness and Response Plan [Executive Summary - Draft August 2004].

Garrett, L. (2005). The next pandemic? Foreign Affairs, July/August issue. Link

Gibbs, W.W. & Soares, C. (2005). Preparing for the pandemic. Scientific American, November issue. Link

National Intelligence Estimate (2000). The Global Infectious Disease Threat and Its Implications for the United States. (NIE 99-17D, January 2000). Link

Osterholm, M.T. (2005a). Preparing for the next pandemic. The New England Journal of Medicine, 352, 1839-1842. Link

Osterholm, M.T. (2005b). Preparing for the next pandemic. Foreign Affairs, July/August issue. Link

Public Broadcasting Service (PBS) Influenza 1918 (American Experience). Link [comment: Includes a transcript of the broadcast.]

Snacken, R., Kendal, A.P., Haaheim, L.R., & Wood, J.M. (1999). The next influenza pandemic: Lessons from Hong Kong, 1997. Emerging Infectious Diseases, 5(2). Link


Medical/clinical/public health references:

Australian Government Department of Health and Aging - Avian Influenza (also called Bird Flu): Link

CDC - Avian Influenza (Bird Flu): Link

CDC - Antiviral Agents for Influenza: Background Information for Clinicians (December 2003): Link

CIDRAP - Avian Influenza: Link

Department of Health and Human Services - Medical Surge Capacity and Capability Handbook (2004): Link

Department of Health and Human Services - Pandemic influenza: Link

Department of Health and Human Services - Pandemic Influenza Tabletop Exercise Package: Link

ECDC (European Centre for Disease Prevention and Control) Avian Influenza : Link

FAO (Food and Agricultural Organization of the UN) - Animal Health: Avian Influenza: Link

Gani R, Hughes H, Fleming D, Griffin T, Medlock J, Leach S. (2005). Potential impact of antiviral drug use during influenza pandemic. Emerging Infectious Diseases, 11, 1355-1361. Link

NIH NIAID DMID (National Institutes of Health - National Institute of Allergy and Infectious Diseases - Division of Microbiology and Infectious Diseases): Link

NIH NIAID DMID - Influenza page: Link

NIH NIAID DMID - Development of a Clinical Trial Plan for Pandemic Influenza Vaccines (22-23 September 2005): Link

OIE (Office International des Epizooties): Link

OIE: Preparation of the Joint WHO/OIE/FAO Conference to Mobilise Resources for Control of Avian Influenza in Animals and for Prevention of Pandemic Influenza in Humans Geneva (Switzerland), 7-9 November 2005 BASIC OIE DOCUMENTATION: Link

The Writing Committee of the World Health Organization (WHO) Consultation on Human Influenza A/H5.
Avian Influenza A (H5N1) infection in humans. The New England Journal of Medicine. 2005; 353: 1374-1385.
Link

WHO - Avian Influenza: Assessing the pandemic risk (January 2005): Link

WHO - Avian Influenza Fact Sheet: Link

WHO - Responding to the avian influenza pandemic threat: Recommended strategic actions (02 September 2005): Link

WHO Global Influenza Preparedness Plan (2005). Link


Surveillance and tracking websites:

Avian Influenza Outbreak Maps: Link

European Union Documented Human Case Map [jpg updated on a regular basis]: Link

Eurosurveillance: Link

OIE Update on avian influenza in animals (Type H5): Link

ProMED-mail: Link

World Health Organization (WHO): Link


Medications:

FDA: Relenza: Link

FDA: Tamiflu: Link


Individual websites:

FluWiki: Link

H5N1 Blog: News and resources about Avian Flu: Link

A webpage from my own website: Infectious Disease Link [comment: I have not updated the page in over a year, but contains some educational and backgrounder general resources.]

The Coming Influenza Pandemic, a .pdf document written by a Georgia physician that you can download from the webpage cited below. Some of the self-care, home-care comments might be useful. Some of the contents might seem alarmist, unless taken with a "worst case" grain of salt -
Link

Wikipedia: Avian Influenza: Link

BBC: Bird Flu in Depth: Link

Flu Pandemic Preparedness Snowball by Peter M. Sandman (10 October 2005): Link

Pandemic Influenza Risk Communication: The Teachable Moment by Peter M. Sandman and Jody Lanard (04 July 2005): Link

Wall Street Journal Avian Flu News Tracker: Link

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Anthony H. Risser | |
|

Tuesday, October 25, 2005

Upcoming Event: NYC, 05 November 2005

From The City University of New York (CUNY) website:

Visual Art & the Brain: At the Interface of Art and Science
DATE - November 5, 2005

TIME - 10am-6pm

COLLEGE NAME - Graduate Center

ADDRESS - 365 Fifth Ave @ 34th St

PHONE - 212/817-8215

DESCRIPTION
"This conference will explore the nature of the science-art interface, the inspiration this interface provides to scientists and artists alike, and the impact of such interactions on areas of research and other human endeavors. The morning session will explore scientific perspectives: What is vision? How do we perceive art and why do we respond to it emotionally? The afternoon session will focus on the interface of art and science, and will feature discussions with artists and scientists on communicating the beauty and power of science as well as its social and ethical implications. This event is suitable for scientists interested in art, and artists interested in science. Please visit our website for further event details. "

ADMISSION - $60
~

The morning session is entitled, How Does the Brain See Art? and is chaired by Dr. Torsten Wiesel: President Emeritus, Rockefeller University and Nobel Laureate. Speakers include Drs. Margaret Livingstone, David Freedberg, and V. S. Ramachandran. One of the two afternoon sessions is entitled Cognitive and Practical Approaches to Creating Visual Expressions of Scientific Information and is chaired by Dr. Felice Frankel, director, Envisioning Science Project at the Massachusetts Institute of Technology.

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Anthony H. Risser | |

Neuropsychology Executive-Function Card Game?

Boing Boing posts today about a "geeky card game" that seems to call for a good dose of healthy frontal lobe functioning. The game is called "Set." Read the posting here.

(Another Boing Boing post today is about an online atlas of the monkey brain.)
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Anthony H. Risser | |

Monday, October 24, 2005

Predicting Alzheimer Disease: More Wish Than Reality

A core contemporary issue in the clinical neurology and neuropsychology of aging and dementia is discussed in an article in tomorrow's New York Times:

Predicting Alzheimer's Is More Wish Than Reality
By LAURIE TARKAN
The New York Times
Published: October 25, 2005

Read the article
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Anthony H. Risser | |

Business World: Synthetic Blood International, Inc. and Traumatic Brain Injury

From a company press release:
Synthetic Blood Announces Positive Results from Traumatic Brain Injury Preclinical Study

COSTA MESA, Calif.--(BUSINESS WIRE)--Oct. 24, 2005--Synthetic Blood International, Inc. (OTCBB:SYBD) today announced that study data suggest that its proprietary perfluorocarbon (PFC) blood substitute and therapeutic oxygen carrier Oxycyte(TM) improves cognitive recovery following traumatic brain injury in a fluid percussion injury model, a widely accepted rat model that simulates moderate head injury with prolonged cognitive deficits sustained in humans. Cognitive recovery was determined by performance in a standard water maze test. As announced previously, Synthetic Blood plans to initiate a Phase II proof-of-concept study to evaluate the safety and biological effects of Oxycyte in patients with traumatic brain injury.

In the study "Perfluorocarbon Emulsion Improves Cognitive Recovery Following Lateral Fluid Percussion Brain Injury in Rats," rats administered Oxycyte at 4.5ml/kg and 9.0ml/kg dose levels showed significantly better performance in the water maze test and had fewer dying neurons in the brain than control animals treated with a saline solution. Additionally, the group receiving Oxycyte at the higher dose maintained mean arterial blood pressure at a relatively higher level, which could indicate a further improvement in the cerebral blood flow after traumatic brain injury.
[ ... Read the full press release ... ]
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Anthony H. Risser
| |

Self-Awareness

The November 2005 issue of Scientific American includes an article by Carl Zimmer, The Neurobiology of the Self.

Update 26 October 2005 - Carl Zimmer has placed a link to a .pdf version of this article on his blog.
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Anthony H. Risser | |

Sunday, October 23, 2005

Stem-Cell Research: Batten Disease

From sfgate.com:
Trials for stem-cell treatment of brain disease
Clinical testing set to begin on kids with fatal affliction
Cornelia Stolze, Carl T. Hall, Chronicle Staff Writers
San Francisco Chronicle
Friday, October 21, 2005

Researchers in California are about to start the first FDA-sanctioned clinical trial of a stem cell treatment for a brain disease.

The trial will offer regulators one of their first opportunities to reveal what standards should apply for novel "regenerative medicine" experiments in human subjects. Special safety concerns include the long-term cancer-causing potential of stem cells and the risk that they may wire into the brain's circuitry improperly.

"A great deal of attention will be paid to the outcome of this trial," said Dr. Arnold Kriegstein, a neurologist and head of a stem cell program at UCSF, who is not involved in the new study. "It really represents the first trial of its kind. Regardless of the outcome, all of us interested in cell-based therapies will be watching what happens."

The study is sponsored by a small Palo Alto biotech company, Stem Cells Inc., to test the safety of injecting fetal-derived neural stem cells into the brains of children suffering from a rare and always fatal disorder known as Batten disease.

The condition afflicts about 2 to 4 of every 100,000 children born in the United States. Babies may appear normal at first, only to begin losing coordination and suffering seizures several months after birth. Eventually, children become blind, bedridden and unable to communicate before they die at an early age. No therapy is available to stop or even slow down the symptoms.

The problems are caused by a gene mutation, which leads to a lack of an enzyme needed for proper recycling of certain substances that otherwise can build up in the brain. The stem cells are intended to serve as delivery vehicles to get the missing enzyme where it's needed.

Two Stanford physicians -- Dr. Gregory Enns, an assistant professor of pediatrics and director of the biochemical genetics program at Stanford, and Dr. Stephen Huhn, chief of pediatric neurosurgery at Packard Children's Hospital -- helped design the trial protocol. They intend to begin the first procedures sometime next year, if an internal review board at Stanford gives its consent.

Enns said families with Batten disease have little choice but to try a novel approach.

"This is an unremitting disease that is particularly tragic," he said. "Right now there is nothing we can do to stop the progression of this terrible disorder."
[ ... Read the full article ... ]
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Anthony H. Risser | |

Friday, October 21, 2005

Knowledge Management Software for Neuros

The Neurodudes have opened an interesting discussion on their blog about knowledge management software for neuroscientists: Neurodude post. Thanks for the good info!
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Anthony H. Risser | |

Parkinson Disease Update Live on C-SPAN Today

The Parkinson Disease event presented by the NIH, which I noted here earlier [BrainBlog post on 11 October 2005] was broadcast live today on C-SPAN: Advances in Parkinson's Disease.

Check the C-SPAN website for any reairing dates and times.
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Anthony H. Risser | |

In the Weeklies: Meeting of Minds

This week's issue of the British Medical Journal includes a news report about the Meeting of Minds project funded by the European Commission, "in which a group of 126 citizens from nine countries has been meeting over the last 18 months to consider the implications of developments in brain science."

Read the full article
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Anthony H. Risser | |

Wednesday, October 19, 2005

The Game Brain: Memory and Dr. Aaron Nelson

From The Arizona Republic:
Fading memory
Forgetfulness and compensating for it are part of life
Mary Beth Faller
The Arizona Republic
Oct. 18, 2005 12:00 AM

Aaron P. Nelson and his family were driving on their vacation and were about 50 miles from their home in Massachusetts. They realized they had forgotten their child's beloved blanket, and drove back home to retrieve it. When they got home, they found that they had left a set of keys in the ignition of their other car - with the engine running.

That's a doozy of a memory lapse, and Nelson should know. He's the chief of neuropsychology in the division of cognitive and behavioral neurology at Brigham and Women's Hospital in Boston, and also a professor at Harvard Medical School.

As a memory expert, he knows that even an embarrassing incident like that does not mean Alzheimer's disease is imminent. But many people worry about that when they start to forget things. Many of his patients, especially those in their 40s or 50s, were worried. So he wrote The Harvard Medical School Guide to Achieving Optimal Memory (McGraw-Hill, 2005, $14.95 paperback).

"This book is intended for those people in midlife and beyond who are looking for the answer to 'Is there something wrong?' " Nelson says. "So much of what people worry about turns out to be benign and quite manageable through different kinds of maneuvers."
[ ... Read the full article ... ]
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Anthony H. Risser | |

Monday, October 17, 2005

Imaging Technologies and Mental Disorders: Potential vs. Use?

From tomorrow's New York Times:
Can Brain Scans See Depression?
By BENEDICT CAREY
The New York Times
Published: October 18, 2005

They seem almost alive: snapshots of the living human brain.

Not long ago, scientists predicted that these images, produced by sophisticated brain-scanning techniques, would help cut through the mystery of mental illness , revealing clear brain abnormalities and allowing doctors to better diagnose and treat a wide variety of disorders. And nearly every week, it seems, imaging researchers announce another finding, a potential key to understanding depression , attention deficit disorder, anxiety.

Yet for a variety of reasons, the hopes and claims for brain imaging in psychiatry have far outpaced the science, experts say.

After almost 30 years, researchers have not developed any standardized tool for diagnosing or treating psychiatric disorders based on imaging studies.
[ ... Read the full article. ... ]
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Anthony H. Risser | |

"Map Shock"

Read an interview with Dr. Don Dansereau by Cliff Atkinson on the topic of what the cognitive psychologist terms "map shock."
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Anthony H. Risser | |

What's New in ...... Confabulation?

Sticking with the confabulation theme, here are some of the most recent publications on the topic:

Schnider A, Bonvallat J, Emond H, & Leemann B. Reality confusion in spontaneous confabulation. Neurology. 2005 Oct 11; 65(7): 1117-1119. PMID: 16217071 [PubMed - in process]

Fujii T, Suzuki M, Suzuki K, Ohtake H, Tsukiura T, & Miura R. Normal memory and no confabulation after extensive damage to the orbitofrontal cortex. Journal of Neurology, Neurosurgery, and Psychiatry. 2005 Sep; 76(9): 1309-1310. PMID: 16107380 [PubMed - indexed for MEDLINE]

Moulin CJ, Conway MA, Thompson RG, James N, & Jones RW. Disordered memory awareness: recollective confabulation in two cases of persistent deja vecu. Neuropsychologia. 2005; 43(9): 1362-1378. PMID: 15949520 [PubMed - indexed for MEDLINE]

Hecht-Nielsen R. Cogent confabulation. Neural Networks. 2005 Mar; 18(2): 111-115. Epub 2005 Jan 18. PMID: 15795109 [PubMed - indexed for MEDLINE]

Nys GM, van Zandvoort MJ, Roks G, Kappelle LJ, de Kort PL, & de Haan EH. The role of executive functioning in spontaneous confabulation. Cognitive and Behavioral Neurology. 2004 Dec; 17(4) :213-218. PMID: 15622017 [PubMed - indexed for MEDLINE]

Nedjam Z, Devouche E, & Dalla Barba G. Confabulation, but not executive dysfunction discriminate AD from frontotemporal dementia. European Journal of Neurology. 2004 Nov; 11(11): 728-733. PMID: 15525293 [PubMed - indexed for MEDLINE]

Turnbull OH, Berry H, & Evans CE. A positive emotional bias in confabulatory false beliefs about place. Brain and Cognition. 2004 Aug; 55(3): 490-494. PMID: 15223194 [PubMed - indexed for MEDLINE]

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Anthony H. Risser | |

Confabulation

Mind Hacks continues its good work of updating readers about its favorite radio show, Australia's All in the Mind.

This week, it blogs that the show was about the fascinating topic of confabulation. Their report includes links to the audiostream and the podcast for the show.
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Anthony H. Risser | |

Saturday, October 15, 2005

In the Weeklies: Katrina and Hypoxic-Ischemic Encephalopathy (HIE)

The new, 13 October 2005 issue of The New England Journal of Medicine includes a series of free full-content-downloard perspective pieces on the health-care experience of Hurricane Katrina. It also includes a research article and an editorial commentary on a treatment for hypoxic-ischemic encephalopathy (HIE) in neonates. The research article is S. Shankaran et al. Whole-body hypothermia for neonates with hypoxic–ischemic encephalopathy [Abstract].
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Anthony H. Risser | |

Tuesday, October 11, 2005

Webcast by Dr. Daniel Weinberger about COMT, Prefrontal Lobe, and Executive Function

According to an NIH press release, Dr. Daniel Weinberger will be speaking tomorrow on a live webcast on the topic, Complex Genetics in the Human Brain: Lessons from COMT, tomorrow from 3:00-4:00 p.m. ET at http://videocast.nih.gov.

The talk may be viewed live or at a later time. The NIH page streams via RealPlayer.

According to the press release:
"Weinberger will explain why such psychiatric genetics has proven to be a daunting challenge, using as an example the gene that codes for catecho-O-methyltransferase (COMT), the enzyme that breaks down the chemical messenger dopamine. A tiny variation in its sequence results in different versions of the gene. One leads to more efficient functioning of the prefrontal cortex, the other to less efficient prefrontal functioning and slightly increased risk for schizophrenia."
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Anthony H. Risser | |

Upcoming Event: Washington, D.C., 20 October 2005

A press release from the NIH:

Tuesday, October 11, 2005
CONTACT: Margo Warren 301-496-5751

Science Reporters Briefing: New Advances in Parkinson’s Research and Treatment

What:
The National Institute of Neurological Disorders and Stroke (NINDS) in partnership with the Parkinson’s community is bringing together a panel of leading physicians, scientists, and caregivers to provide an overview of the newest advances in Parkinson’s disease. Researchers will discuss genetic aspects of the disease, new approaches to therapeutics, and environmental and other factors that may impact onset of Parkinson’s. Panelists will discuss their work and respond to questions from the audience.

Why:
After Alzheimer’s disease, Parkinson’s is the most common neurodegenerative disorder. There are an estimated 6.3 million people worldwide suffering from Parkinson's disease. Because of the aging world population, and given that the number of older Americans will more than double to 70 million by 2030, now is the time to begin gaining a better understanding of diseases, such as Parkinson’s, that have a significant impact on older adults.

Who:
Experts in Parkinson’s disease will make brief remarks. A session for questions and answers will follow each speaker.

- Story Landis, Ph.D., Director, NINDS
- J. Timothy Greenamyre, M.D., Ph.D., University of Pittsburgh Medical Center, Environmental Influences and Parkinson’s Disease (PD)
- Robert L. Nussbaum, M.D., National Human Genome Research Institute, Genetics of PD
- Peter T. Lansbury, Jr., Ph.D., Brigham and Women’s Hospital, Drug Discovery for PD
- Clive Svendsen, M.D., University of Wisconsin-Madison, Future Therapeutic Approaches
- Monique Giroux, M.D., The Cleveland Clinic Foundation, Caring for Patients with PD Across the Clinical Spectrum
- Morton Kondracke, Author of Saving Milly, Caregiver’s Perspective

When:
Thursday, October 20, 2005, 10:00 a.m. ET

Where:
The Dana Center 900 15th St, NW, Washington, DC

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Anthony H. Risser | |

Upcoming Event: Boston, 04 November 2005

On the 4th of November, the opening of the McGovern Institute for Brain Research at the Massachusetts Institute of Technology takes place. A day-long celebration is scheduled.

According to the website:
"The McGovern Institute is conducting interdisciplinary research that combines and extends the results of recent breakthroughs in three major, interrelated areas: systems and computational neuroscience, imaging and cognitive neuroscience, and genetic and cellular neuroscience. Fundamental studies in genetics and cell biology, live measurement of brain physiology in humans and other animals performing cognitive tasks, and modeling of brain function using advanced tools in biocomputation and cognitive sciences -- such research will lay a foundation for a comprehensive description of the brain, including how it learns and communicates. "
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Anthony H. Risser | |

Pandemic-Flu (H5N1, Avian Influenza, "Bird Flu") Educational References

Here is an update of the references I posted last week during Pandemic Flu Awareness Week:

Background and historical references:

Barry, John M. (2004). The great influenza. NY: Viking. [comment: A very readable account of what happened and why in the 1918 pandemic, with an emphasis on the political expediences and cronyism of the day and media complacency - along with accounts of the public-health leaders who needed to fight not only the virus, but politicians and newspaper editors in order to eke out ways of dealing with the virus. Also, a good description of how this type of influenza differs from the typical, yearly bouts of influenza that most all of us are aware of.]

Department of Health and Human Services (2004). Pandemic Influenza Preparedness and Response Plan [Executive Summary - Draft August 2004].

Garrett, L. (2005). The next pandemic? Foreign Affairs, July/August issue. Link

National Intelligence Estimate (2000). The Global Infectious Disease Threat and Its Implications for the United States. (NIE 99-17D, January 2000). Link

Osterholm, M.T. (2005a). Preparing for the next pandemic. The New England Journal of Medicine, 352, 1839-1842. Link

Osterholm, M.T. (2005b). Preparing for the next pandemic. Foreign Affairs, July/August issue. Link

Public Broadcasting Service (PBS) Influenza 1918 (American Experience). Link [comment: Includes a transcript of the broadcast.]

Snacken, R., Kendal, A.P., Haaheim, L.R., & Wood, J.M. (1999). The next influenza pandemic: Lessons from Hong Kong, 1997. Emerging Infectious Diseases, 5(2). Link


Medical/clinical/public health references:

Australian Government Department of Health and Aging - Avian Influenza (also called Bird Flu): Link

CDC - Avian Influenza (Bird Flu): Link

CDC - Antiviral Agents for Influenza: Background Information for Clinicians (December 2003): Link

CIDRAP - Avian Influenza: Link

Department of Health and Human Services - Medical Surge Capacity and Capability Handbook (2004): Link

Department of Health and Human Services - Pandemic influenza: Link

Department of Health and Human Services - Pandemic Influenza Tabletop Exercise Package: Link

Food and Agricultural Organization of the UN (FAO) - Animal Health: Avian Influenza: Link

Gani R, Hughes H, Fleming D, Griffin T, Medlock J, Leach S. (2005). Potential impact of antiviral drug use during influenza pandemic. Emerging Infectious Diseases, 11, 1355-1361. Link

NIH NIAID DMID (National Institutes of Health - National Institute of Allergy and Infectious Diseases - Division of Microbiology and Infectious Diseases): Link

NIH NIAID DMID - Influenza page: Link

NIH NIAID DMID - Development of a Clinical Trial Plan for Pandemic Influenza Vaccines (22-23 September 2005): Link

The Writing Committee of the World Health Organization (WHO) Consultation on Human Influenza A/H5.
Avian Influenza A (H5N1) infection in humans. The New England Journal of Medicine. 2005; 353: 1374-1385.
Link

WHO - Avian Influenza: Assessing the pandemic risk (January 2005): Link

WHO - Avian Influenza Fact Sheet: Link

WHO - Responding to the avian influenza pandemic threat: Recommended strategic actions (02 September 2005): Link

WHO Global Influenza Preparedness Plan (2005). Link


Surveillance and tracking websites:

Avian Influenza Outbreak Maps: Link

European Union Documented Human Case Map [jpg updated on a regular basis]: Link

ProMED-mail: Link

World Health Organization (WHO): Link


Individual websites:

FluWiki: Link

H5N1 Blog: News and resources about Avian Flu: Link

A webpage from my own website: Infectious Disease Link [comment: I have not updated the page in over a year, but contains some educational and backgrounder general resources.]

At the more "worst-case scenario" end of the spectrum is The Coming Influenza Pandemic, a .pdf document written by a Georgia physician that you can download from the webpage cited below. Some of the self-care, home-care comments might be useful. Some of the contents seem alarmist, unless taken with a "worst case" grain of salt -
Link

Flu Pandemic Preparedness Snowball by Peter M. Sandman (10 October 2005): Link

Pandemic Influenza Risk Communication: The Teachable Moment by Peter M. Sandman and Jody Lanard (04 July 2005): Link
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Anthony H. Risser | |
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