Friday, August 31, 2007

Awakenings at Columbia

From The New York Times:

Oliver Sacks Joins Columbia Faculty
September 1, 2007

Attracted by his breadth of interests, ranging from schizophrenia to music, Columbia University has appointed Oliver Sacks, the neurologist and writer, as its first Columbia artist, a newly created designation.

Beginning next week, Dr. Sacks, who has been a clinical professor of neurology at Albert Einstein College of Medicine in the Bronx for the past 42 years, is leaving to become a professor of clinical neurology and clinical psychiatry at the Columbia University College of Physicians and Surgeons, a post he will occupy in addition to the new artist position.

The new appointment will allow Dr. Sacks, the author of 10 books and a frequent contributor to The New Yorker, to range freely across Columbia’s departments, teaching, giving public lectures, conducting seminars, seeing patients and collaborating with other faculty members. Many of the details of his appointment have yet to be worked out, but among other things, he will be teaching in the university’s creative writing department as well as at the medical school.

[ ... Read the full article ... ]

Thursday, August 30, 2007

New Position-Openings Board Provided by the Neurotechnology Industry Organization (NIO)

Zack Lynch has posted a message on his Brain Waves blog about his NIO's new job-postings page. Please read the posting for an introduction and take a look at the cool new board:

Brain Waves posting

Neurotech Job Board

The Social Behavior of Spiders?

From the Associated Press, a report of curious cooperative behavior ... or merely a fluke:

Spiders Create Giant Web
August 30, 2007
Filed at 7:02 a.m. ET

WILLS POINT, Texas (AP) -- Entomologists are debating the origin and rarity of a sprawling spider web that blankets several trees, shrubs and the ground along a 200-yard stretch of trail in a North Texas park.

Officials at Lake Tawakoni State Park say the massive mosquito trap is a big attraction for some visitors, while others won't go anywhere near it.

''At first, it was so white it looked like fairyland,'' said Donna Garde, superintendent of the park about 45 miles east of Dallas. ''Now it's filled with so many mosquitoes that it's turned a little brown. There are times you can literally hear the screech of millions of mosquitoes caught in those webs.''

Spider experts say the web may have been constructed by social cobweb spiders, which work together, or could be the result of a mass dispersal in which the arachnids spin webs to spread out from one another.

[ ... Read the full report ... ]

Wednesday, August 29, 2007

Neuropsychology Abstract of the Day: Mild Cognitive Impairment (MCI) and Neuropsychological Testing

Belleville S, Chertkow H, & Gauthier S. Working memory and control of attention in persons with Alzheimer's disease and mild cognitive impairment. Neuropsychology. 2007 Jul; 21(4): 458-469.

Research CenterInstitut Universitaire de Geriatrie de Montreal, Montreal, PQ, Canada

The goal of the present study was to assess 3 attentional control processes--divided attention, manipulation capacities, and inhibition--in persons with mild cognitive impairment (MCI) and with mild Alzheimer's disease (AD). Manipulation capacities were tested by comparing immediate serial recall with alphabetical-order recall of words. Divided attention was tested with the Brown-Peterson procedure, in which participants divide their attention between simple addition tasks and consonant trigrams over delays. Inhibition was tested with the Hayling procedure, in which participants complete sentences with words irrelevant to their context. Persons with AD showed severe impairment on the 3 attentional control components. Persons with MCI exhibited impaired performance on the Brown-Peterson procedure but normal performance on the other 2 tasks. With AD and MCI participants, there was a negative correlation between general cognitive deficits and impairment on attentional control tasks, indicating that attentional control deficits increase in the MCI/AD continuum. When separating MCI with and without significant subsequent decline, those with subsequent decline showed impaired performance on both the Brown-Peterson procedure and manipulation task. These data suggest that control of attention tasks can track AD at a preclinical stage and that impairment increases gradually during the preclinical phase of AD.
PMID: 17605579 [PubMed - indexed for MEDLINE]

Tuesday, August 28, 2007

The Best of the Brain

While travelling on neuropsych business over the past week, I've been totally enjoying the new collaboration between Dana Press and Dr. Floyd Bloom - an edited book of feature articles from Scientific American.

The book contains 21 articles of the many that have appeared in the magazine from 1999 onward.

My favorite is the last one, "The Quest for a Smart Pill," by Stephen Hall. I may be mistaken, but I believe Hall has also written on this topic for the journal, Science. It deals with memory- and other cognitive-function- enhancing drugs currently under development by a number of biotech companies and some of the ethical issues involved in this domain.

Good reads on the neurobiology of psychiatric disorders and computer-brain interfaces also are included. Articles by Antonio Damasio, Eric Kandel, and Fred Gage are representative of some of the neuroscientific leaders found in the book. Science journalist Carl Zimmer is represented, as well.

List price of $25.00, The Best of the Brain from Scientific American, edited by Floyd Bloom (Dana Press, 2007).

Sunday, August 26, 2007

Omneuron and fMRI

From today's New York Times:

Mind Over Matter, With a Machine’s Help
Published: August 26, 2007


Omneuron is one of a number of new companies that are commercializing a brain-scanning technology called real-time functional magnetic resonance imaging, or fMRI. Using large scanners to measure blood flow to different parts of the brain, the technology makes the brain’s activity visible by revealing which of its parts are busiest when we perform different tasks.

While fMRI dates back to the early 1990s, hitherto it has been used mainly by doctors in hospitals to make diagnoses. The commercialization of brain scanning is a recent development, spurred by the refinement of the technology. Omneuron, which Dr. deCharms founded in 2001 and whose research has been funded by the National Institutes of Health, uses fMRI to teach people how to play with their own heads. Other entrepreneurs are working on ways to deploy fMRI as a lie detector, a tool for conducting marketing research or an instrument to make brain surgeries safer and more precise.

Here’s how Omneuron uses fMRI to treat chronic pain: A patient slides into the coffin-like scanner and watches a computer-generated flame projected on the screen of virtual-reality goggles; the flame’s intensity reflects the neural activity of regions of the brain involved in the perception of pain. Using a variety of mental techniques — for instance, imagining that a painful area is being flooded with soothing chemicals — most people can, with a little concentration, make the flame wax or wane. As the flame wanes, the patient feels better. Superficially similar to an older technology, electroencephalogram biofeedback, which measures electrical feedback across multiple areas of the brain, fMRI feedback measures the blood flow in precise areas of the brain.

“We believe that people will use real-time fMRI feedback to hone cognitive strategies that will increase activation of brain regions,” Dr. deCharms said. With practice and repetition, he said, this could lead to “long-term changes in the brain.”


[ ... Read the full article ... ]

Thursday, August 23, 2007

Neuropsychology Abstract of the Day: ADHD Drivers

Reimer B, D'Ambrosio LA, Coughlin JF, Fried R, & Biederman J. Task-induced fatigue and collisions in adult drivers with attention deficit hyperactivity disorder. Traffic Inj Prev. 2007 Sep; 8(3): 290-299.

AgeLab, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA.

Objective. This study compares collision involvement between adult drivers with attention deficit hyperactivity disorder (ADHD) and control participants in a simulation experiment designed to enhance the effects of fatigue. Because the effects of ADHD include difficulties in maintaining attention, drivers with ADHD were hypothesized to be more susceptible to the effects of fatigue while driving. Methods. Data are drawn from a validated driving simulation study, portions of which were focused on enhancing the effects of fatigue. The simulator data are supplemented with written questionnaire data. Drivers with ADHD were compared with controls. Results. The self-report data indicated that drivers with ADHD were more likely to report having been involved in an accident within the previous five years. Simulation data showed that time of day of participation in the experiment were significantly related to likelihood of collision, and that these effects were further exacerbated by ADHD status. Participants with ADHD were more likely than controls to be involved in a crash in the simulator regardless of time of day, but the effects were particularly pronounced in the morning, and the rate of increase in accident involvement from the late afternoon into the evening was greater among participants with ADHD. No differences in self-reported sleep patterns or caffeine use were found between participants with ADHD and controls. Conclusions. The results suggest that drivers with ADHD became fatigued more quickly than controls. Such drivers thus face greater risk of involvement in accidents on highways or open roadways where the visual and task monotony of the environment contribute to greater driver fatigue.

PMID: 17710720 [PubMed - in process]

Risperdal (risperidone) and Pediatric Schizophrenia and Bipolar DIsorder

An FDA press release from yesterday:

FDA Approves Risperdal for Two Psychiatric Conditions in Children and Adolescents

The U.S. Food and Drug Administration today approved Risperdal (risperidone) for the treatment of schizophrenia in adolescents, ages 13 to 17, and for the short-term treatment of manic or mixed episodes of bipolar I disorder in children and adolescents ages 10 to 17. This is the first FDA approval of an atypical antipsychotic drug to treat either disorder in these age groups.

Until now, there has been no FDA-approved drug for the treatment of schizophrenia for pediatric use and only lithium is approved for the treatment of bipolar disorder in adolescents ages 12 and up.

“The pediatric studies of Risperdal provided an opportunity to assess the effectiveness, proper dose, and safety of using this product in the pediatric population,” said Dianne Murphy, M.D., director of FDA’s Office of Pediatric Therapeutics. “These data have permitted the identification of the effective pediatric dose ranges and have provided an evidence-based approach for treating these disorders in pediatric patients.”

The FDA first approved Risperdal in 1993 for the treatment of schizophrenia in adults. The drug later was approved for the short-term treatment of acute manic or mixed episodes associated with bipolar I disorder in adults and the treatment of irritability associated with autistic disorder in children and adolescents 5 to 16 years old.

Evidence to support this approval was collected through studies the FDA requested as part of its pediatric drug development initiatives.

The efficacy of Risperdal in the treatment of schizophrenia in adolescents was demonstrated in two short-term (6 to 8 weeks), double-blind, controlled trials. All patients were experiencing an acute episode of schizophrenia at the time of enrollment. Treated patients generally had fewer symptoms, including a decrease in hallucinations, delusional thinking, and other symptoms of their illness.

The efficacy of Risperdal in the treatment of manic or mixed episodes in children or adolescents with bipolar I disorder was demonstrated in a three-week, randomized, double-blind, placebo-controlled, multicenter trial in patients who were experiencing a manic or mixed episode. Treated patients generally had fewer symptoms, including a decrease in their elevated mood and hyperactivity, and other symptoms of their illness.

Drowsiness, fatigue, increase in appetite, anxiety, nausea, dizziness, dry mouth, tremor, and rash were among the most common side effects reported.

Schizophrenia is a serious and disabling psychiatric disorder. Symptoms may include hallucinations, delusions, and disorganized thinking. Bipolar disorder, also known as manic-depressive illness, is a serious psychiatric disorder that causes wide shifts in a person's mood, energy, and ability to function.

Risperdal is manufactured by Janssen, L.P. of Titusville, N.J.

For more information:

FDA Office of Pediatric Therapeutics

National Institute of Mental Health—Schizophrenia

National Institute of Mental Health—Bipolar Disorder

Tuesday, August 21, 2007

Wednesday, August 15, 2007

HIV Dementia

From the BBC's website:

HIV's double hit on brain cells
HIV can trigger learning and memory deficits by launching a double attack on the brain, research shows.

It was already known that a protein on the surface of the virus could kill off mature brain cells.

But the latest study shows it also prevents the production of replacements by crippling cells with the potential to step in and take their place.

The University of California at San Diego study appears in the journal Cell Stem Cell.

The researchers hope their work, which was carried out on mice, will aid efforts to find new ways to combat HIV-associated dementia.

Researcher Dr Marcus Kaul said: "It's a double hit to the brain.

"The HIV protein both causes brain injury and prevents its repair."

The success of antiretroviral therapies in keeping "viral load" down has helped to reduce the severity of HIV-associated dementia in recent years.

However, the condition is becoming more common as people with HIV are living longer.

Part of the problem is that anti-HIV drugs find it tough to enter the brain.

Disrupted chemistry

The researchers had already shown that a protein called gp120, which is found on HIV's outer coating, can kill off brain cells by disrupting their internal chemistry.

In the latest study, they showed that gp120 also slows production of new brain cells in the hippocampus, a brain region central to learning and memory.

Under normal circumstances, these newborn cells become integrated into existing brain circuits and are thought to contribute to certain forms of learning and memory.

It appears the same chemical disruption that kills cells is also responsible for blocking production of replacements.

Dr Kaul said: "This indicates that we might eventually treat this form of dementia by either ramping up brain repair or protecting the repair mechanism."

Keith Alcorn, senior editor of the HIV information service NAM, said: "The discovery that HIV affects stem cell proliferation in the brain is bound to add to concerns that people with HIV doing well on antiretroviral therapy may nevertheless face a higher risk of dementia in years to come.

"Antiretroviral drugs have lowered viral load so that HIV will not kill cells directly, but we don't know the consequences for brain functioning of a long-term low level of infection.

"It may be that low level infection is enough to interfere with the regeneration pathways in the way shown in this experiment."

Vanessa Griffiths, clinical director at the HIV charity Terrence Higgins Trust said: "This is fascinating research, but at an extremely early stage.

"It may well produce benefits for people with HIV, but that is still some years away."

[ ... Read the full article ... ]

Tuesday, August 14, 2007

Dementia and the Sniff Magnitude Test

From today's New York Times:

Sniff Test May Signal Disorders’ Early Stages
Published: August 14, 2007


The Sniff Magnitude Test, developed with the aid of a $1.3 million grant from the National Institutes of Health, consists of a nasal tube called a cannula attached to a plastic container about the size and shape of a coffee thermos. Chemical vapors inside the canister are released through the tube, exposing subjects to a series of smells, some more objectionable than others.

“People describe some of the smells as skunky or sewerlike,” said Jason Bailie, a University of Cincinnati graduate student working on the test. “There’s also one that smells like banana.”

As patients take whiffs of each new fragrance, sensors in the thermos unit measure the negative pressure the inhalations produce. The size and intensity of these sniffs turn out to be important gauges of olfactory ability. After detecting a strong or disagreeable odor, people with a normal sense of smell take very small sniffs to avoid smelling it. Subjects with an impaired sense of smell, on the other hand, continue taking deep whiffs, because the scent does not register in their brains.


The Cincinnati team’s efforts have piqued the interest of other researchers, including Dr. Doty and Alan Hirsch of the Smell and Taste Research and Treatment Foundation, who is using the Sniff test in his clinical practice. “They’ve chosen some very good odors that stimulate the olfactory system effectively,” Dr. Doty said. “This is a very novel approach — it just needs to be tested more broadly.”

Still, Dr. Doty added, the Sniff Magnitude Test may not be the ideal way to assess every patient with cognitive deficits. “Very early in life, we make a connection between an odor and its source,” he said. “We give it a name. If the connection between the name of an odor and the odor itself is what’s breaking down in an Alzheimer’s patient, this test might not be as helpful,” because it does not tell evaluators how a patient identifies and categorizes smells. The Sniff Magnitude Test is likely to raise red flags only if an impending cognitive disorder directly affects a patient’s olfactory abilities.


[ ... Read the full article ... ]

Monday, August 13, 2007

Light-Switch Technology: Channelrhodopsin-2

From tomorrow's New York Times:

The Beam of Light That Flips a Switch That Turns on the Brain
Published: August 14, 2007


One of the newest, fastest strategies co-opts a photosensitive protein called channelrhodopsin-2 from pond scum to allow precise laser control of the altered cells on a millisecond timescale. That speed mimics the natural electrical chatterings of the brain, said Dr. Karl Deisseroth, an assistant professor of bioengineering at Stanford.

“We can start to sort of speak the language of the brain using optical excitation,” Dr. Deisseroth said. The brain’s functions “arise from the orchestrated participation of all the different cell types, like in a symphony,” he said.

Laser stimulation can serve as a musical conductor, manipulating the various kinds of neurons in the brain to reveal which important roles they play.

This light-switch technology promises to accelerate scientists’ efforts in mapping which clusters of the brain’s 100 billion neurons warble to each other when a person, for example, recalls a memory or learns a skill. That quest is one of the greatest challenges facing neuroscience.

The channelrhodopsin switch is “really going to blow the lid off the whole analysis of brain function,” said George Augustine, a neurobiologist at Duke University in Durham, N.C.

[ ... Read the full article ... ]

Thursday, August 09, 2007

Virtual Skulls: Research Applications

From the Canadian Broadcasting Corporation's website, a report from the Australian Broadcasting Corporation:

Virtual skull could lead to better crash helmets
Last Updated: Thursday, August 9, 2007 | 8:57 AM ET
Australian Broadcasting Corporation

A sophisticated new computer-generated virtual skull could help researchers study evolution and design better crash helmets, says an Australian scientist.

The virtual chimp skull was designed by Dr. Stephen Wroe of the University of New South Wales and colleagues from the University of Newcastle.

"It's the most sophisticated model of a chimp skull ever made," said Wroe, a paleontologist with an interest in skull mechanics.

[ ... Read the full article ... ]

Tuesday, August 07, 2007

Neuropsychology Abstract of the Day: Assessing Non-motor Symptoms in Parkinson's Disease

Chaudhuri KR, Martinez-Martin P, Brown RG, Sethi K, Stocchi F, Odin P, Ondo W, Abe K, Macphee G, Macmahon D, Barone P, Rabey M, Forbes A, Breen K, Tluk S, Naidu Y, Olanow W, Williams AJ, Thomas S, Rye D, Tsuboi Y, Hand A, & Schapira AH. The metric properties of a novel non-motor symptoms scale for Parkinson's disease: Results from an international pilot study. Movement Disorders. 2007 Aug 2; [Epub ahead of print].

National Parkinson Foundation Centre of Excellence, Kings College Hospital, London, United Kingdom.

Non-motor symptoms (NMS) in Parkinson's disease (PD) are common, significantly reduce quality of life and at present there is no validated clinical tool to assess the progress or potential response to treatment of NMS. A new 30-item scale for the assessment of NMS in PD (NMSS) was developed. NMSS contains nine dimensions: cardiovascular, sleep/fatigue, mood/cognition, perceptual problems, attention/memory, gastrointestinal, urinary, sexual function, and miscellany. The metric attributes of this instrument were analyzed. Data from 242 patients mean age 67.2 +/- 11 years, duration of disease 6.4 +/- 6 years, and 57.3% male across all stages of PD were collected from the centers in Europe, USA, and Japan. The mean NMSS score was 56.5 +/- 40.7, (range: 0-243) and only one declared no NMS. The scale provided 99.2% complete data for the analysis with the total score being free of floor and ceiling effect. Satisfactory scaling assumptions (multitrait scaling success rate >95% for all domains except miscellany) and internal consistency were reported for most of the domains (mean alpha, 0.61). Factor analysis supported the a prori nine domain structure (63% of the variance) while a small test-retest study showed satisfactory reproducibility (ICC > 0.80) for all domains except cardiovascular (ICC = 0.45). In terms of validity, the scale showed modest association with indicators of motor symptom severity and disease progression but a high correlation with other measures of NMS (NMSQuest) and health-related quality of life measure (PDQ-8) (both, rS = 0.70). In conclusion, NMSS can be used to assess the frequency and severity of NMS in PD patients across all stages in conjunction with the recently validated non-motor questionnaire. (c) 2007 Movement Disorder Society.

PMID: 17674410 [PubMed - as supplied by publisher]

Monday, August 06, 2007

Neuropsychopharmacology Text Available Online

A big thank you to Zack Lynch of Brain Waves for posting about the availability online of a comprehensive neuropsychopharmacology textbook.

Here is the link to Brain Waves, which links to the text: link.

The text is a publication by and is available on the website of the American College of Neuropsychopharmacology (ACNP), a professional society. Additionally, the ACNP is noted for the exceptional quality of its conferences.

Sunday, August 05, 2007

Losing Betsy: A Journey Through Dementia

The latest installment in a compelling feature series in The Seattle Times:

Losing Betsy — A move nobody wanted
By Marsha King
The Seattle Times
05 August 2007


"I've always said I want to keep her as long as I can," Jeff said several weeks ago. "But I'm kind of reaching the end of my ability to do this stuff."

Sooner than expected, that day arrived.

Seven years ago, when she was 46, Betsy got a shocking diagnosis — early onset dementia — probably Alzheimer's disease. Since then, she's gone from forgetting how to fold laundry to forgetting who she is.

On the morning of July 13, Jeff moved his wife to a state-licensed adult family home in Renton.

Now 53, Betsy would be the youngest resident by 24 years.


[ ... Read the full article ... ] Includes links to earlier reports in the series.

Friday, August 03, 2007

Neuropsychology Abstract of the Day: Agitation in Alzheimer's Disease (AD)

Mahlberg R, Walther S, Eichmann U, Tracik F, & Kunz D. Effects of rivastigmine on actigraphically monitored motor activity in severe agitation related to Alzheimer's disease: A placebo-controlled pilot study. Archives of Gerontology and Geriatrics. 2007 Jul-Aug; 45(1): 19-26.

Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charité-Universitätsmedizin Berlin, Turmstr. 21, D-10559 Berlin, Germany.

Acetylcholinesterase inhibitors (AChEIs) are effective in the treatment of cognitive symptoms in Alzheimer's disease (AD). Because the behavioral and psychological symptoms of dementia (BPSD) have also been attributed to central cholinergic deficits, we examined whether the AChEI rivastigmine can reduce motor activity as measured in a rater-independent manner by wrist actigraphy in agitated AD patients. A total of 20 consecutive AD inpatients (13 females, 7 males, 80.4+/-9.1 years, S.D.) were included from our geriatric psychiatry unit, all of whom were exhibiting agitated behavior not attributable to delirium. Patients were assigned randomly and in a single-blinded fashion to rivastigmine 3mg or placebo for 14 days. Motor activity levels were monitored using an actigraph worn continuously on the wrist of the non-dominant hand. At the beginning and end of the study, patients were assessed using the Neuropsychiatric Inventory (NPI) and Nurses' Observation Scale for Geriatric Patients (NOSGER). Patients in the rivastigmine group exhibited less agitation than placebo recipients on the NPI-agitation subscale, but not on NOSGER. Actigraphic measurements showed a tendency towards reduced motor activity in the rivastigmine group. Because rivastigmine usually exerts its main effects after a longer period of time, the short-term effects seen in our study justify further controlled clinical trials examining the use of rivastigmine in BPSD by means of actigraphy.

PMID: 16963137 [PubMed - indexed for MEDLINE]

MEDIA: Obsessive-Compulsive Disorder (OCD) and Time Magazine

From the current issue of Time:

When Worry Hijacks The Brain
Thursday, Aug. 02, 2007

[ ... To read the article, click here ... ]

Wednesday, August 01, 2007

Deep Brain Stimulation

A curious case report discussed in today's New York Times:

Man Regains Speech After Brain Stimulation
Published: August 1, 2007

A 38-year-old man who spent more than five years in a mute, barely conscious state as a result of a severe head injury is now communicating regularly with family members and recovering his ability to move after having his brain stimulated with pulses of electric current, neuroscientists are reporting.


The new report, which appears in the journal Nature, provides the first rigorous evidence that any procedure can initiate and sustain recovery in such a severely disabled person, years after the injury occurred. An estimated 100,000 to 300,000 Americans subsist in states of partial consciousness, and most are written off as beyond help.

Doctors said it was not clear how many such patients would benefit from the treatment, in which two wire electrodes are implanted deep in the brain. The procedure also raises sticky ethical questions about operating on patients who cannot give their consent, they said.

“We really see this as a first step, but it should open doors that have not been open before for patients like this,” said Joseph T. Giacino, associate director of neuropsychology at the JFK Johnson Rehabilitation Institute and the New Jersey Neuroscience Institute, in Edison. Dr. Giacino performed the study with doctors from the Weill Cornell Medical College and the Cleveland Clinic Foundation.

[ ... Read the full report ... ]