BrainBlog

BrainBlog

Monday, December 21, 2009

Patient H.M.: A Follow-up Interview

Building a Search Engine of the Brain, Slice by Slice
By BENEDICT CAREY
The New York Times
Published: December 22, 2009

"The dissection of the brain of H. M., an amnesiac, has opened the door to a much more ambitious project."

Read the full article

Monday, December 07, 2009

Friday, December 04, 2009

Patient H.M.: The Man Who Couldn't Remember

The Man Who Couldn't Remember
PBS NOVA
February 2009
transcript

Patient H.M.: The End of the Week, The End of the Sectioning

The web feed for the continued brain slicing of Patient H.M. suggests that, to the music of Stan Getz, "Primary visual cortex has surfaced. The end is in sight!"

:-)

If you have not yet watched some of the web stream, give it a look at this time! http://thebrainobservatory.ucsd.edu/hm_live.php

Thank you Brain Observatory for providing this live feed of an historic couple of days in neuroscience and neuropsychology!

Here is the transcript of an interview that NPR completed with the director of The Brain Observatory at this time last year, December 2008: transcript

Thursday, December 03, 2009

Patient H.M.: Watch and Tweet!

The Twitter tag for the Patient H.M. brain slicing has sprouted up as #HM . Join the tweets and discuss!

Patient H.M. Update

From the Brain Observatory website at the end of last night's work:

"We have reached the corpus callosum. The team is resting for the night. The brain will be safe surrounded by our chillers until tomorrow morning. The cutting will resume again at 8AM PST.

"Tomorrow will be a big day - We will try to cover the medial temporal lobes and the area surrounding the hippocampus."

The Brain Observatory

Today at 0800 PST, 1100 EST, 1600 GMT.

===

Today's New York Times article by Benedict Carey about the brain sectioning:
Dissection Begins on Famous Brain
Read here

Wednesday, December 02, 2009

Patient H.M.

The sectioning of Patent H.M.'s brain begins today and will be streamed online live at the following location:

http://thebrainobservatory.ucsd.edu/hm_live.php

===

H.M. recollected
Famous amnesic launches a bold, new brain project at UCSD
BY SCOTT LAFEE,
SAN DIEGO UNION-TRIBUNE
MONDAY, NOVEMBER 30, 2009 AT 12:04 A.M.

Read the article

Friday, November 27, 2009

Psychosurgery, Redux

Surgery for Mental Ills Offers Hope and Risk
By BENEDICT CAREY
The New York Times
Published: November 27, 2009

"Hundreds have undergone brain surgery for problems like depression, anxiety, even obesity."

Read the article

Monday, November 23, 2009

fMRI Neuroimaging of Neural Control Over Speech

Inside the mind of an actor (literally)
How does an actor engage with the part they are playing? Fiona Shaw undergoes a brain scan while reciting TS Eliot to help shed some light on the mystery
Stuart Jeffries
The Guardian
Tuesday 24 November 2009

[snip]

The experiment is the latest in which Scott has explored the different ways our brains control our voices. "In the past, I've worked with impressionists to see what happens in their brains when they impersonate people's voices. The literature in psychology on faces is huge, but there's a lot less work on voices – partly because when we talk about speech, we go straight to focusing on language itself.

"Fiona is going to perform some lines from a text she's familiar with [Shaw performed Eliot's epic poem 13 years ago in a production directed by Deborah Warner, and will reprise that performance at Wilton's music hall in London next month]. She's conveying different people by the way they speak, and we're interested in finding out which parts of her brain are involved here."

The results will be displayed in new exhibition on identity at the Wellcome Trust. "Voices simultaneously convey a lot of different things about us," says Scott. "If you speak to someone on the phone you can tell if they're a man or a woman, roughly how old they are, roughly where they come from in the country, if they're ill, if they're in a bad mood – that's all there. But also voices change a great deal so I sound different speaking to you than if I'd just been arrested.

[snip]

Read the full article

Friday, November 13, 2009

BBC The Forum: Antony Gormley, Viktor Mayer-Schoenberger, & Beau Lotto

Broadcast on The BBC World Service. Available on podcast here.

Body, memory, perception. Gormley, Mayer-Schoenberger, Lotto 14 Nov 09
Thu, 12 Nov 09
Duration: 49 mins

"We like nothing better than talking about ourselves so this week’s Forum with Bridget Kendall casts a spotlight on the human brain and human form. One of Britain’s best known sculptors Antony Gormley looks at why we need to peel back our skin in order to understand our own humanity. He also conducts an experiment inviting all BBC listeners to close their eyes and connect with deep space beyond. Information technology professor Viktor Mayer-Schoenberger offers a vista of a future nightmare world where humans may be in danger of losing the capacity to forget as digital memories become so efficient at keeping our data for ever. And we peer inside our brains with neuroscientist Beau Lotto who reveals the illusion of perception and shows - with a little help from bees - why we see the way we do."

Tuesday, November 10, 2009

Piggy Smarts!

New in the world of pig cognition research, interesting results:

Pigs Prove to Be Smart, if Not Vain
By NATALIE ANGIER
The New York Times
Published: November 10, 2009

"Recent discoveries from the nascent study of pig cognition offered evidence that pigs were quick learners, slow to forget and similar to humans in many ways."

Read the article

Autism, Asperger's, and the DSM by Simon Baron-Cohen

The Short Life of a Diagnosis
By SIMON BARON-COHEN, Op-Ed Contributor
The New Yotk Times
Published: November 10, 2009

"Asperger syndrome and autism should be thoroughly tested before being lumped together in the Diagnostic and Statistical Manual of Mental Disorders."

Read the Op-Ed piece

Monday, November 09, 2009

Sleep, Dreams, and Cognitive Function

A Dream Interpretation: Tuneups for the Brain
By BENEDICT CAREY
The New York Times
Published: November 10, 2009

"A new theory suggests that dreams are a warm-up for the day ahead."

Read the article

Business World: Pfizer/Wyeth Research Consolidation

An Associated Press report this evening outlines changes at a number of Wyeth and Pfizer research facilities:

Read article

Media: Michael Rutter Interview on BBC Radio 4

Listen to an interview with Dr. Michael Rutter on BBC Radio 4's All In The Mind programme:

Click here for a link to the podcast.

Tuesday, November 03, 2009

Narrative: Brain Abscess

My brain abscess and me
I had no idea I had a potentially fatal infection. Now, after my life-saving surgery, I will never take my health for granted again
Tim Lusher
The Guardian
Tuesday 3 November 2009

Read Tim's narrative report here.

[snip]

"Finally, on Tuesday morning, someone realises something is horribly wrong. My GP sees immediately that my gait is clumsy, my focus wild, my speech slurring. She sends me straight to A&E at the Royal London hospital and phones ahead to order a brain scan. There, I collapse gratefully into the care of doctors and nurses."

[snip]

Gordon Bell's Digital Memory

Brain food: the problem with digital memory
Digital memory means we can store more than ever before. But isn't it important, sometimes, to forget?
Aditya Chakrabortty
The Guardian
Tuesday 3 November 2009

Read the article

Monday, November 02, 2009

Upcoming Event: Mobile Healthcare Conference (London, 01-02 Dec 2009)

The Mobile Healthcare Industry Summit takes place this 1st and 2nd of December at the Thistle Marble Arch Hotel in London, England.

According to the conference website, topics include:

- Using Mobile Healthcare Partnership to Transform a Health System From Responsive Into Preventative
- Using Mobile Healthcare to Improve Precision in the Diagnosis and Cure of Patient Illness
- Freeing the Patient and the System with Intelligent Biometric Diagnostics
- Defining the Data Management of Digital Healthcare
- What Are The Technical Platforms For Mobile Healthcare Success? - SMS, Devices, Intelligent M2M
- Globalising Mobile Healthcare: Regional Case Studies and Uniting the Service – South Korea, North America, Japan

Visit the conference website for detailed information.

Alzheimer's Disease Awareness

November Is National Alzheimer's Disease Awareness Month.

Friday, October 30, 2009

MEDIA: We've Got Charlie Rose on the Brain!

Charlie Rose began his series of episodes about neuroscience with his show last evening, the 29th of October. Go to his website to watch the full episode from the 29th and to check in for the additional episodes: Charlie Rose homepage

From the website:

"Charlie Rose Brain Series Episode One. Tonight’s introductory topic-- The Great Mysteries of the Human Brain: consciousness, free will, perception, cognition, emotion and memory with a roundtable of brain researchers. Co-Host Eric Kandel from Columbia University and Howard Hughes Medical Institute; Cornelia Bargmann from Rockefeller University, Tony Movshon from New York University, John Searle from University of California Berkeley and Gerald Fischbach of the Simons Foundation."

Wednesday, October 28, 2009

Nature's NeuroPod: New Edition Available

The October 2009 issue of Nature's NeuroPod podcast is available for listening and download. It can be found at NeuroPod homepage.

This edition includes reports about gaming mice and the relation between sleep problems and memory function.

From the homepage:

"About NeuroPod

"NeuroPod is the neuroscience podcast from Nature, produced in association with the Dana Foundation. Each month, join us as we delve into the latest research on the brain, from its molecular makings to the mysteries of the mind. We'll also be bringing you the latest news from neuroscience conferences around the globe, along with special reports on hot areas in neuroscience.

"For complete access to the original papers featured in NeuroPod, subscribe to Nature, Nature Neuroscience, and Nature Reviews Neuroscience."

Tuesday, October 27, 2009

Extremes of Memory

Like a Skyline Is Etched in His Head
By JIM DWYER
The New York Times
Published: October 28, 2009

"Stephen Wiltshire, working only from the memory of a helicopter flight over New York, has been rendering the city’s 305 square miles along an arc of paper that is 19 feet long."

Read the full article

View the slideshow, "Portrait of the Artist," which shows parts of his amazing work

A Perspective on the Future of Neuroscience

From stevenroseonline.net:

Prospects and Perils of the New Brain Sciences: A twenty year timescale
Royal Society Science Policy Lab
20th October 2009
by Steven P R Rose

Read the full paper

Dopamine

A Molecule of Motivation, Dopamine Excels at Its Task
By NATALIE ANGIER
The New York Times
Published: October 27, 2009

"A view has emerged to counter the image that a neurotransmitter is the little Bacchus of our brain."

Read the article

Monday, October 19, 2009

Sunday, October 18, 2009

Cardiff Neuroscience

The Cardiff Neuroscience Centre
Webpage

Read about neuroscience research activities in and around Cardiff and their collaboration with Bristol via this virtual centre.

Thursday, October 15, 2009

"Does the Brain Like E-Books?"

From The New York Times:

OPINION
Room for Debate: Does the Brain Like E-Books?
By By The Editors
Published: October 14, 2009

"How the reading experience differs between paper and screen."

Read the entry and the debate

Wednesday, October 14, 2009

The Fourth Plinth One & Other Project Ends: Chiari Malformations

The One & Other Antony Gormley project ended today in Trafalgar Square, London.

Among the many media reports and summaries of the project, Laura Hickman who represented Chiari Malformation awareness efforts during her hour on the Fourth Plinth has received additional attention.

The Times (UK) cites her hour as being on of the best of the 2400 individual hours in the project and says this about her:

"Laura Hickman: held up placards carrying the words of 30 sufferers of rare brain condition Chiari Malformation. Has since persuaded the NHS to recognise the condition, started work for Chicago's Chiari Centre Foundation, and plans to open a UK branch of the charity."

Excellent work!

Here is a link to the full report: Best of the Trafalgar Square plinthers (14th October, 2009).

Tuesday, October 13, 2009

iPhone Neuroscience App (Dana Foundation Blog)

Follow the link to the Dana Foundation Blog for a posting about a pretty-decent looking intro neuroanatomy app for your iPhone:

Brain browser comes to iPhone (5th October, 2009).

Upcoming Online Event: Malcolm Gladwell (14th October, 1430 hrs ET)

From The New Yorker:

Author Malcolm Gladwell has a live chat about brain injuries and sports tomorrow at 1430 hrs ET.

The chat can be found at the link found below. If you wish to submit a question for the essayist and author, go to that link and you can submit a question in advance of the event.

Questions for Gladwell/Live Chat

Parkinson's Disease: DATATOP

A news release from the NIH:

Investment in Parkinson's Disease Data Bank Yields Potential Therapy

12th October, 2009

[snip]

Individuals with Parkinson's disease who have higher levels of a metabolite called urate in their blood and in cerebrospinal fluid (CSF) have a slower rate of disease progression, according to a study funded by the National Institutes of Health. A clinical trial is under way to examine the safety and potential benefits of supplemental urate elevation for recently diagnosed Parkinson's patients who have low urate levels.

Investigators demonstrated the link with urate by mining a repository of clinical data and tissue samples collected from Parkinson's patients more than 20 years ago as part of a pioneering study called DATATOP, funded by NIH's National Institute of Neurological Disorders and Stroke (NINDS). The new study appears in Archives of Neurology. It was funded primarily by NINDS, with additional support from the Department of Defense and private organizations.

"This study speaks to the value of saving data and biospecimens from large clinical studies, and making them available to the research community to pursue new, unanticipated ideas," said Michael Schwarzschild, M.D., Ph.D., an associate professor of neurology at Massachusetts General Hospital in Boston, who lead the study together with Alberto Ascherio, M.D., Dr.PH, a professor of epidemiology and nutrition at the Harvard School of Public Health.

[snip]

Sunday, October 11, 2009

Fourth Plinth: Cara and "Shift Multiple Sclerosis" Virtual Community for Young People with MS

In the final several days of Antony Gormley's One & Other project on the Fourth Plinth at Trafalgar Square, London, Cara is going to ascend the plinth in support of Multiple Sclerosis awareness.

Her plinth hour is 1900 hrs BST, Monday the 12th of October.

She writes in her bio:

"I thought that this project was an unusual and unique opportunity and so put my name forward. During the hour on the plinth, I am going to try to bring awareness to www.shift.ms - an online community for young people with Multiple Sclerosis. When I was diagnosed with MS, I found the website to be a source of support and reassurance during a weird and shocking time.

So, if anyone who is affected by MS, or anyone who'd like to know more about it, you are welcome to become part of the shift.ms community!"

Bests wishes, Cara!

Cara's plinth hour can be viewed live at http://www.oneandother.co.uk/. If you miss it live, a refeed of the hour is available on the One&Other website within a couple of hours of the plinter's descent.

Give Cara a note of support at Cara's One&Other homepage

From the "Shift.ms" homepage:

"Shift.ms is a community for young people affected by Multiple Sclerosis. Users can share, support and interact with each other throughout the site. Register now to create a profile, plot yourself on the map and start adding your voice to the community."

Monday, October 05, 2009

Multitasking: Cons

If you only do one thing this week … avoid multitasking
Often considered the pinnacle of efficiency, multitasking can actually be a negative practice, according to latest research. So stop what else you're doing and concentrate, says Giles Morris

Giles Morris
guardian.co.uk
Monday 5 October 2009 11.33 BST

Read the full article

The 2009 Nobel Prize For Medicine

Read details about this year's awardees at The Nobel Prize website

Awarded to Elizabeth H. Blackburn, Carol W. Greider and Jack W. Szostak "for the discovery of how chromosomes are protected by telomeres and the enzyme telomerase."

Friday, October 02, 2009

Fourth Plinth: Epilepsy Action on the One & Other Plinth

Di Flatt, manager of the fundraising team at Epilepsy Action, has her hour on the Fourth Plinth in Trafalgar Square at 1700 hrs, Saturday. She is one of the 2400 taking part in Antony Gormley's One & Other project.

You can read about Di and view a refeed of her plinth hour at DiFlatt.

You can watch her live at One&Other.

Read all about the 60th anniversary of Epilepsy Action.

Fourth Plinth: Alzheimer's Research Trust's Memories Matter

Thomas G., a member of the Alzheimer's Research Trust, was on the fourth plinth in Trafalgar Square this afternoon to promote Memories Matter. He was one of the 2400 plinthers of Antony Gormley's One & Other project.

Watch Tom and listen to his message at Thomas_G.

Take a look at the Trust's Memories Matter website.

Monday, September 28, 2009

Great Ormond Street Hospital for Children

Neuropsychology at the Great Ormond Street Hospital for Children and the UCL Institute of Child Health
View the website here

From the homepage:

"The Paediatric Neuropsychology Service consists of the Clinical Neuropsychology Department at Great Ormond Street Hospital and the Developmental Cognitive Neuroscience Unit based at the Institute of Child Health (ICH). The academic and clinical staff in the Service work collaboratively to offer a comprehensive neuropsychology service for children, adolescents and their families."

MRI Imagery: Inside Bill Moorier's Head

"Inside Bill Moorier's Head"
website link

Saturday, September 26, 2009

Living With A Child With Disabilities: A Narrative from The Plinth

Early Saturday morning, Gav C, the father of a now-deceased young boy named Tom, spent his hour for the One and Other Antony Gormley project from the Fourth Plinth in Trafalgar Square describing life with his son. It is a narrative extraordinary in its directness.

I recommend its viewing for any student training to work with young children with disabilities. You will learn something from it.

To view it: Gav C. on the Fourth Plinth

Cognition in the Time of Twitter

From The Times (UK)

Speed of digital era may be harming our ability to think
The age-old rhythms of life are under assault as the distinction between work and leisure is eroded by new technology. Is it damaging our very humanity?
Eva Hoffman
September 26, 2009

Read the article

Thursday, September 24, 2009

One and Other Fourth Plinth: "Be Safe, Not Scrambled"

Barbara, a rehabilitation professional, went on Antony Gormley's One and Other Fourth Plinth project in Trafalgar Square yesterday morning.

She promoted helmet use for sports and recreational activities and did so in a very nice kiddie-friendly manner.

Her hour can be viewed at: oneandother.co.uk/participants/BarbaraJean

Upcoming Event: Genesis Conference 2009 (London, 10th-11th December)

The Genesis 2009 Conference will take place on the 10th and 11th of December at the Queen Elizabeth II Conference Centre (London).

From the website:

"Welcome to Genesis 2009 – “Back in focus!”
The challenges of the economic downturn stimulated us to build innovative new partnerships at Genesis last year. The resultant exciting mix of business and science is something many have only dreamed of. This will be retained for 2009 with a streamlined approach for delegates to maximise the return on your investment in participating."

For details, please see the conference website

Obit: Dr. Leon Eisenberg

Dr. Leon Eisenberg, Pioneer in Autism Studies, Dies at 87
By BENEDICT CAREY
Published: September 24, 2009

"Dr. Eisenberg conducted some of the first rigorous studies of autism, attention deficit disorder and learning delays."

[snip]

“Leon took a very courageous stand and denounced the way psychiatry treated children, this whole system in which we had a few rich kids and their parents getting psychoanalysis five days a week and still not being cured,” said C. Keith Conners, a professor emeritus in the department of psychiatry and behavioral sciences at Duke University. “No one even knew what a cure looked like. He had this conviction that nothing was being done for the bulk of children who needed help, and that we had very little scientific data to guide us.”

[snip]

Read the full article

Wednesday, September 23, 2009

Alzheimer's Disease: Britain's Future

Terry Pratchett: Britain facing tsunami of Alzheimer's disease
Sir Terry Pratchett has warned of a "worldwide tsunami of Alzheimer's" facing Britain as figures show the Government spends less on researching the disease than the cost of building one mile of motorway.

By Rebecca Smith, Medical Editor
The Telegraph
Published: 7:30AM BST 22 Sep 2009

Read the article

Clinical Trials: Upcoming Conference

Early next year:

Third Annual Patient Recruitment in Clinical Trials conference, to be held 08th-09th March, 2010 in Philadelphia, PA.

From the conference webpage:

"Patient recruitment and retention are critical to drug development programs. Patient recruitment if not adequately planned for can extend your development timeline by a number of years. Retention of patients throughout the life of a clinical trial is essential in order have complete data sets for your analysis and subsequent filings. In order to optimize both you have to have a plan. This conference is intended to cover the topics one should consider when drafting and strategically implementing a patient recruitment and retention plan for a clinical development program."

Please see conference webpage for details.

Parkinson's Disease: Narrative From A Spouse

From The Times (UK):

Case study: ‘It’s hard to recognise the man I married’
Judith Magill’s retirement dreams were dashed when her husband, Patrick, had Parkinson's disease diagnosed aged 57
21 September 2009

[snip]

"People die with Parkinson’s disease, not of it,” said the specialist to my husband, Patrick, when he got the diagnosis at the age of 57. He was upbeat, though leaving us in no doubt that the condition would worsen. Parkinson’s would nibble away at Patrick’s physical and, if we were unlucky, his mental reactions. It would fundamentally change our lives after just two years of marriage.

[snip]

Read the full piece

Tuesday, September 22, 2009

Brain Well-Being

From The Guardian

How to boost your brain power
Gardening, friendship, dancing, pregnancy and the odd glass of wine could improve your mental prowess
Stephen Pincock
The Guardian
Tuesday 22 September 2009

Read the article

Monday, September 21, 2009

World Alzheimer's Day

Today is World Alzheimer's Day.

Read something today to increase your knowledge about the disease and dementia.

Here's a general-readership resource:

Alzheimer's Disease: Unraveling the Mystery

... and a report from the Alzheimer's Association:

Summary of 2009 World Alzheimer Report

Parkinson's: Wii-hab and Symptom Improvement

From The Times (UK):

The latest Parkinson’s treatment: Wii-hab
Parkinson’s disease symptoms could be controlled by a game that can be bought on every high street, says a recent study

Simon Crompton
21 September 2009

[snip]

This summer, the Medical College of Georgia in the United States announced the striking results of its research into the effects of “Wii-hab” on people with Parkinson’s disease. In an eight-week study, 18 people were asked to play Wii Sports, including virtual versions of boxing and ten-pin bowling, for an hour a day, three times a week for four weeks. By the end of that time all the participants showed significant improvements in rigidity, movement, fine motor skills and energy levels. Importantly, their depression levels also decreased; depression affects around half of people with Parkinson’s disease.

[snip}

Read the full article

Sunday, September 20, 2009

Cognitive Pharmacological Enhancement

From The Observer:

Can a daily pill really boost your brain power?
In America, university students are taking illegally obtained prescription drugs to make them more intelligent. But would you pop a smart pill to improve your performance? Margaret Talbot investigates the brave new world of neuro enhancement
Margaret Talbot
The Observer
Sunday 20 September 2009

Read the article

Thursday, September 17, 2009

Surrealism: Count on Kafka!

From The Guardian:

Reading Kafka 'enhances cognitive mechanisms', claims study
Subjects who had just read Kafka's The Country Doctor were better at recognising patterns in grammar test, psychologists found
Alison Flood
guardian.co.uk
Thursday 17 September 2009 14.59 BST

[snip]

Research from psychologists at the University of California in Santa Barbara and the University of British Columbia claims to show that exposure to surrealism enhances the cognitive mechanisms which oversee implicit learning functions. The psychologists showed a group of subjects Kafka's story The Country Doctor, a disturbing and surreal tale in which a doctor travels by "unearthly horses" to an ill patient, only to climb into bed naked with him and then escape through the window "naked, exposed to the frost of this most unhappy of ages".

A second group were shown the same story, but rewritten so the plot made more sense. Both groups were then asked to complete an artificial grammar learning task which saw them exposed to hidden patterns in letter strings, and then asked to copy the strings and mark those which followed a similar pattern.

"People who read the nonsensical story checked off more letter strings - clearly they were motivated to find structure," said Travis Proulx, a postdoctoral researcher at UCSB and co-author of the research, which appears in an article published in the September issue of the journal Psychological Science. "But what's more important is that they were actually more accurate than those who read the more normal version of the story. They really did learn the pattern better than the other participants did.

[snip]

Read the full article

Business World: Biotechnology & Venture Capital

From The New York Times:

Biotech Tries to Shrug Off Setbacks
By JAMES FLANIGAN
Published: September 17, 2009

"While some investors are pulling back, life sciences companies continue to innovate, and hope the capital to expand will come."

Read the piece

Wednesday, September 16, 2009

Computerized Cognitive Testing in Clinical Trials

A United BioSource Corporation press release from 10th September, 2009:

United BioSource Corporation (UBC) today announced the acquisition of Cognitive Drug Research, Ltd. (CDR), the leader in computerized cognitive testing for clinical trials. The CDR System is the most widely used computerized cognitive testing system in the world: it is used in more than 1000 trials encompassing approximately 50 different disease areas, validated in over 60 languages, and cited in more than 700 publications and abstracts. Additionally, CDR maintains the industry’s largest healthy subject, patient, and drug databases of cognitive effects, providing the standard for establishing the clinical relevance of compounds.

Read the full press release

FDA: Updated Info on Tysabri (Natalizumab)

From the FDA:

Information on Natalizumab (marketed as Tysabri)
Updated Information: [9/2009]

The FDA continues to receive reports of progressive multifocal leukoencephalopathy (PML) in patients receiving Tysabri. Tysabri was approved by the FDA for the treatment of relapsing forms of multiple sclerosis (MS) in November 2004 and for moderately to severely active Crohn’s disease in January 2008. From July 2006, (when Tysabri marketing resumed) to September 8, 2009, 13 reported cases of Tysabri-related PML were confirmed worldwide in patients being treated for MS with Tysabri monotherapy. Of these, four cases were patients in the United States (U.S.). There have been no postmarketing reports of PML in patients treated with Tysabri for Crohn’s disease. Less than 2% of Tysabri use in the U.S. has been in patients with Crohn's disease.

The risk for developing PML appears to increase with the number of Tysabri infusions received. The number of monthly infusions of Tysabri in the 13 patients who developed PML ranged from 12 to 35 infusions. The average number of infusions received before the diagnosis of PML was 25. There is minimal experience in patients who have received more than 35 infusions of Tysabri.

The overall rate of developing PML with Tysabri therapy in patients who have received at least one infusion remains below one per 1,000 patients. Based on available data from the U.S. and outside of the U.S., the current rate of PML in patients who have received at least 24 infusions ranges from 0.4 to 1.3 per 1,000 patients.

At this time, the FDA is not requiring changes regarding PML to the Tysabri prescribing information or to the Tysabri risk management plan, called the TOUCH Prescribing Program. All patients receiving Tysabri therapy in the U.S. must be enrolled in the TOUCH Prescribing Program. Under this program, every patient who receives Tysabri is closely monitored for the occurrence of PML and other serious opportunistic infections.

Read the Update

Neuropsychology Abstract of the Day: Aphasia Assessment

van der Meulen I, van de Sandt-Koenderman WM, Duivenvoorden HJ, & Ribbers GM (2009). Measuring verbal and non-verbal communication in aphasia: Reliability, validity, and sensitivity to change of the Scenario Test.
International Joutnal of Language and Communication Disorders


Background: This study explores the psychometric qualities of the Scenario Test, a new test to assess daily-life communication in severe aphasia. The test is innovative in that it: (1) examines the effectiveness of verbal and non-verbal communication; and (2) assesses patients' communication in an interactive setting, with a supportive communication partner. Aims: To determine the reliability, validity, and sensitivity to change of the Scenario Test and discuss its clinical value. Methods & Procedures: The Scenario Test was administered to 122 persons with aphasia after stroke and to 25 non-aphasic controls. Analyses were performed for the entire group of persons with aphasia, as well as for a subgroup of persons unable to communicate verbally (n = 43). Reliability (internal consistency, test-retest reliability, inter-judge, and intra-judge reliability) and validity (internal validity, convergent validity, known-groups validity) and sensitivity to change were examined using standard psychometric methods. Outcomes & Results: The Scenario Test showed high levels of reliability. Internal consistency (Cronbach's alpha = 0.96; item-rest correlations = 0.58-0.82) and test-retest reliability (ICC = 0.98) were high. Agreement between judges in total scores was good, as indicated by the high inter- and intra-judge reliability (ICC = 0.86-1.00). Agreement in scores on the individual items was also good (square-weighted kappa values 0.61-0.92). The test demonstrated good levels of validity. A principal component analysis for categorical data identified two dimensions, interpreted as general communication and communicative creativity. Correlations with three other instruments measuring communication in aphasia, that is, Spontaneous Speech interview from the Aachen Aphasia Test (AAT), Amsterdam-Nijmegen Everyday Language Test (ANELT), and Communicative Effectiveness Index (CETI), were moderate to strong (0.50-0.85) suggesting good convergent validity. Group differences were observed between persons with aphasia and non-aphasic controls, as well as between persons with aphasia unable to use speech to convey information and those able to communicate verbally; this indicates good known-groups validity. The test was sensitive to changes in performance, measured over a period of 6 months. Conclusions & Implications: The data support the reliability and validity of the Scenario Test as an instrument for examining daily-life communication in aphasia. The test focuses on multimodal communication; its psychometric qualities enable future studies on the effect of Alternative and Augmentative Communication (AAC) training in aphasia.

PMID: 19724959 [PubMed - as supplied by publisher]

Ataxia Awareness on One & Other Fourth Plinth

This Monday, Bev Ashby, an artist, will take the plinth for her hour in the One & Hour Fourth Plinth event in Trafalgar Square. She will create a sculpture representing ataxia to promote ataxia awareness.

Read article

Follow at One&Other for live media stream.

Tuesday, September 15, 2009

Contemporary Healthcare in U.S.: Assistive Devices

For Speech-Impaired, Insurance Fights Remedy
By ASHLEE VANCE
The New York Times
Published: September 15, 2009

"Despite their usefulness and lower cost, devices like iPhones and netbook PCs that can help the speech-impaired are not covered by Medicare or insurers."

Read the article

Sunday, September 13, 2009

David Axelrod Speaks About Epilepsy in Upstate New York

From The Utica Observer-Dispatch:

Obama adviser speaks about epilepsy locally
Axelrod also touts healthcare reform
By ELIZABETH COOPER
Observer-Dispatch
Posted Sep 12, 2009 @ 09:01 PM
Last update Sep 12, 2009 @ 10:59 PM

WHITESBORO —Amid the national debate on health care, a top White House adviser related his personal story about troubles his family encountered in getting care for a daughter with epilepsy.

David Axelrod, a close adviser to President Barack Obama, was the keynote speaker at a fundraiser for Citizens United for Research in Epilepsy, known as CURE, at Hart's Hill Inn Saturday evening.

Axelrod's wife, Susan Landau, is one of the founders of CURE, and she has come to the Mohawk Valley in the past for CURE fundraisers, though Saturday was Axelrod's first visit. More than 700 people attended Saturday's fundraiser, which raised $207,000.

Before the event, he took questions from reporters about his personal story, and said it had been “the cause of our lives to see to it that other families don't have to experience the sadness our family has.”

He also said Obama's health care objectives would help families cope with the cost of serious illnesses like his daughter Lauren's.

“Half the bankruptcies in this country flow from medical issues,” he said. “I think many people in this country live in fear of becoming seriously ill, not just because of what it means for their health, but because of what it does for their finances.”

Read the full article

===
The CURE website: click here

Friday, September 11, 2009

Merck's Cladribine and Multiple Sclerosis

From FierceBiotech:

Merck KGaA pulls ahead in hot oral MS drug race
By John Carroll
September 11, 2009 — 8:22am ET

Researchers for Merck KGaA say that new analysis of the late-stage data for their oral drug cladribine highlight the drug's potential as a new therapy for multiple sclerosis. Patients taking a short course of the therapy were more likely to go two years without seeing the disease flare up, and that could prove crucial for the developer as it prepares to make its case that cladribine should be neurologists' preferred choice among a slate of experimental oral MS therapies.

Read the full article

Patient Advocacy

After a Diagnosis, Someone to Help Point the Way
By LESLEY ALDERMAN
The New York Times
Published: September 12, 2009

"Patient advocates can help research treatment options, sort out insurance claims and open doors to specialists."

Read the full article

Thursday, September 10, 2009

Upcoming Event:Alzheimer's Drug Discovery (Jersey City, NJ, 14-15 September)

The 10th international conference on Alzheimer's disease drug discovery takes place next week on the 14th and 15th in Jersey City, NJ.

From the conference website:

"The 10th International Conference on Alzheimer's Disease Drug Discovery is presented by the Alzheimer's Drug Discovery Foundation (ADDF), the only public charity solely dedicated to rapidly accelerating the discovery and development of drugs to prevent, treat and cure Alzheimer's disease and cognitive aging.

This conference brings together academic and industry scientists to accelerate the development of novel drug discovery programs for Alzheimer’s disease and related dementias."

Visit the conference website

Dr. Brenda Milner

From the CBC:

McGill neuroscientist wins $1M research prize
Last Updated: Tuesday, September 8, 2009 | 5:26 PM ET

[snip]

McGill University Prof. Brenda Milner has won the International Balzan Prize for 2009. The prize is one million Swiss francs, or about $1 million Cdn, for her groundbreaking research into cognitive neuroscience and how we remember.

[snip]

Read the full article

Dr. Milner was interviewed on the 9th of September on As It Happens. You can download the podcast at this link (tune in to the last 10 minutes). She speaks about several aspects of her work, including Patient H.M., and the Balzan Prize.

Chronic Wasting Disease

Study Spells Out Spread of Brain Illness in Animals
By SANDRA BLAKESLEE
The New York Times
Published: September 10, 2009

The infectious agent that leads to chronic wasting disease is spread in the feces of infected animals long before they become ill, new research indicates.


Read the full article

Monday, September 07, 2009

Alzheimer's Disease: Advances in Genetic Understanding

A report from The Guardian about ongoing genetics research in Alzheimer's disease:

Alzheimer's research links three genes to disease
Findings hailed as 'huge step' towards earlier testing and better treatment for Alzheimer's
Ian Sample, science correspondent
guardian.co.uk
Sunday 6 September 2009 18.05 BST

Read the article

Tuesday, September 01, 2009

Popular Neuroscience: Books for a Long Train Ride

Looking for reading material for a longish train trip I am about to take, I decided to hit to bookshelves of my Square's Barnes & Noble to see what popular neuroscience titles might be a good diversion (as well as potential supplementary 'lighter' references, should I re-teach an introductory course to neuroscience sometime over the next year).

I chose three.

The first is by Elkhonon Goldberg, a revision of an earlier work, which is titled "The New Executive Brain: Frontal Lobes in a Complex World" and is available in paperback by Oxford University Press. I first met the author when I was a graduate student, so I am looking forward to reading up on what he's been up to.

The second is about glial cells and is entitled, "The Root of Thought: Unlocking Glia" by Andrew Koob. Five years ago, if someone said there would be a popular offering about glia, I would have thought 'Yeah, right...' Though I do enjoy adding discussion about glia to my teaching, I never thought I'd see such a book, published by FT Press, on the shelves. I posted an entry about glial cells on the blog in August.

The final book is about empathy and "mirror neurons." Social cognition has become a popular topic over the past decade and I am looking forward to reading what Marco Iacoboni has written about this in his book, published by Picador.

Acadia's Pimavanserin and Parkinson Disease Psychosis

FierceBiotech reported today about a failed Phase III trial of Acadia's Pimavanserin in a study of Parkinson's Disease Psychosis (sometimes abbreviated as "PDP"):

ACADIA Pharmaceuticals Announces Results from Phase III Trial of Pimavanserin in Parkinson's Disease Psychosis
Pimavanserin Misses Primary Endpoint of Antipsychotic Efficacy; Meets Key Secondary Endpoint of Motoric Tolerability

[snip]

SAN DIEGO -- Sep. 1, 2009-- ACADIA Pharmaceuticals Inc. (Nasdaq: ACAD) today announced top-line results from the first pivotal Phase III trial with pimavanserin in patients with Parkinson's disease psychosis, or PDP. The study did not meet its primary endpoint of antipsychotic efficacy as measured using the Scale for the Assessment of Positive Symptoms, or SAPS. Pimavanserin met the key secondary endpoint of motoric tolerability as measured using the Unified Parkinson's Disease Rating Scale, or UPDRS. Pimavanserin was safe and well tolerated, with the frequency of adverse events generally similar in the pimavanserin and placebo arms.

[snip]

Read the full article

NOTE: Pimavanserin is a 5-HT2A receptor inverse agonist.

Neuropsychology Journal

I received the September 2009 issue of the Journal of the International Neuropsychological Society yesterday. If you (or your library) have access to it) it is chock-full of excellent articles, including an overview to the anterior temporal lobes and semantic memory, a paper about the Brixton Spatial Anticipation Test, several papers relevant to problems and deficits in executive functioning in different pathologies, and a look at the phenomenon of "closing-in" behavior in patients with Alzheimer's disease

Multiple Sclerosis

An article in The Times (U.K.):

Blood test could predict severity of multiple sclerosis
Mark Henderson, Science Editor
August 31, 2009

[snip]

Patients whose MS is thought likely to progress quickly could be started swiftly on therapies that can reduce the frequency and severity of attacks, while those at lower risk could be spared medication they do not need immediately. More accurate ways of assessing prognosis could also help to prepare patients for what they should expect in the future, removing the uncertainty that can be a distressing feature of the disease.

[snip]

Read the full article

Dr. Rachel Farrell, of the Institute of Neurology at University College London, is the principal investigator.

Monday, August 31, 2009

Business World: R&D Spending

A report from BusinessWeek from 27 August 2009:

Drug, Biotech Research Spending Hangs Tough
Overall U.S. corporate R&D spending is down 4% since the end of 2007, but some companies have chosen to buck the trend
By Emily Thornton and Frederick Jespersen

[snip]

Corporate America's research spending shrank 4% overall, or $1.9 billion, from the fourth quarter of 2007 through the second quarter of this year, according to data compiled by Capital IQ on 961 U.S. companies. But many health-care companies have boosted their research outlays.

BusinessWeek sought out 25 companies that most aggressively increased their research budgets during the first six months of 2009. Thirteen members of the group, which collectively boosted its spending by $2 billion, were pharmaceutical and biotech companies. Only eight were high-tech outfits, such as Apple (AAPL) and Microsoft (MSFT).

[snip]

Read the full article

Sunday, August 30, 2009

Clinical Trials: Pradaxa (dabigatran etexilate) and Stroke Prevention

From today's Guardian:

Major drug trial highlights a new approach in stroke prevention
The success of Pradaxa in a 44-country trial indicates a possible end to the use of the rat poison warfarin as a primary treatment to prevent stroke
Press Association
guardian.co.uk
Sunday 30 August 2009 23.27 BST

Read the full article

Boehringer Ingelheim's (BI) corporate website information about their clinical trial programmes: click here

Saturday, August 29, 2009

Clinical Trials: Social Networking for Recruitment and Feedback

Pharmafocus reported earlier in the week about a plan by Pfizer to roll out some social networking options for patients considering clinical-trial participation:

Pfizer to develop online community to find new trials patients
Monday , August 24, 2009
Read the report.

The report indicates that Pfizer has teamed with Private Access in this product.

I know I have been involved in co-hosting online communities for Alzheimer's disease and in oncology and such online communities can be very exciting for patients, caregivers, and scientists.

Friday, August 28, 2009

U.S. Hospital Websites

Tara Calishain and her diverse service specialty called Research Buzz provides a link to a new Google Custom Search Engine specific to hospital websites in the U.S., 2800 of them at current count.

For specifics, please see her website/blog entry: click here

Memory and Quantum Entanglement

From The Guardian's ScienceBlog, 27 August 2009:

Is quantum mechanics messing with your memory?
For all we know we may live in a world in which windows un-break and cold cups of coffee spontaneously heat up, we just don't remember. The explanation is quantum entanglement.

Read the piece here

Thursday, August 27, 2009

Upcoming Event: Alzheimer Disease (Las Vegas, 29-30 Oct 2009)

2nd Conference on Clinical Trials on Alzheimer’s Disease (CTAD)

From the conference website:

"Dear Colleague,

"It is a great pleasure for us to invite you to attend the 2nd conference Clinical Trials on Alzheimer’s Disease (CTAD), which will take place in Las Vegas on October 29-30, 2009.

"This conference is co-organized by the Montpellier and Toulouse European Alzheimer’s Disease Consortium (EADC) Centers and the Cleveland Clinic : Lou Ruvo Center for Brain Health.

"The aims of the meeting are to bring together the current leaders in clinical trials in Alzheimer’s Disease to discuss new results, drugs in development, and future methodological issues (disease modifying, outcomes, biomarkers, health economics)."


Full details available at the conference website: http://www.ctad.fr/01-presentation/presentation.asp

Upcoming Event: Minneapolis, 13 Nov 2009

Center for Bioethics Fall Seminar Series
Time: 12:15 to 1:30 pm
Location: 1-451 Moos Tower, University of Minnesota campus (unless noted otherwise)
Minneapolis, MN
ITV to University of Minnesota, Duluth, Room 160 Life Science

November 13

“Family Stories: Decision Making in Advanced Dementia”
Presented by
Barbara Elliott, PhD
Professor, Department of Family Medicine, Medical School, Duluth; Director,
Clinical Research, Department of Family Medicine; Adjunct Professor,
Department of Behavioral Sciences, University of Minnesota, Duluth

Seminars are free and open to the public. Refreshments will be provided.
For more information email visit www.bioethics.umn.edu

Upcoming Event: Newcastle University, 07 September 2009

An upcoming presentation at the Newcastle University Institute of Neuroscience:

IoN Seminar: The evolution of brain systems for vocal learning

Erich Jarvis (Duke University)
Venue: Room 218, Henry Wellcome Building
Date: 7th September 2009
Time: 13:00 - 14:00

The title "The evolution of brain systems for vocal learning" is a provisional title, to be confirmed.

Host: Tom Smulders

Medical Students and Empathy

Hojat, Mohammadreza; Vergare, Michael J.; Maxwell, Kaye; Brainard, George; Herrine, Steven K.; Isenberg, Gerald A.; Veloski, Jon; Gonnella, Joseph S. The Devil is in the Third Year: A Longitudinal Study of Erosion of Empathy in Medical School Academic Medicine, September 2009 - Volume 84 - Issue 9 - pp 1182-1191.
doi: 10.1097/ACM.0b013e3181b17e55

The full text of this research paper is available at: Click here

This issue of Academic Medicine includes additional commentary and research papers on the topic of empathy, available as courtesy full-text downloads.

Ataxia

From The Guardian:

First person: My condition means people always assume I'm drunk
Jayne Wallace
The Guardian
Thursday 27 August 2009

Read the article

Wednesday, August 26, 2009

Obit: Sen. Edward M. Kennedy





The New York Times: Edward Kennedy, Senate Stalwart, Dies

The Independent: Legacy of the only Kennedy brother to grow old

The White House: Statement by the President

The Office of the Vice President: Statement by the Vice President (includes YouTube link.)

(Photo: The White House)

The Placebo Problem and Clinical Trials



The September 2009 issue of Wired has a nifty little article on the impact of placebo effects on pharmaceutical clinical trials and pharma company decision making: "Real. Fake. Both Can Cure Depression." by Steve Silberman.

===
Addendum on 28th August: As you will see from the comments, this piece is available on Wired magazine's website. You can access it here
===

Alzheimer Disease: Famous Faces Testing and fMRI

Neuropsychologist Stephen Rao is in the news, with a recent publication in the journal Neurology looking at fMRI of individuals who had frisk factors for Alzheimer's disease and normal contols as they identify famous faces.

Here is a report from Time magazine's website:

What Britney Spears Can Reveal About Alzheimer's
By ALICE PARK
Wednesday, Aug. 26, 2009

Read article

Drug Development in Neurodegenerative Diseases

Available at BMC Neurology

Proceedings of the 2009 Drug Discovery for Neurodegeneration Conference
Proceedings from Drug Discovery for Neurodegeneration Conference
Washington, DC, USA. 2–3 February 2009
Edited by Diana W Shineman and Howard M Fillit

BMC Neurology
Contents of Volume 9 Suppl 1

Click here for open access to contents of this issue

Monday, August 24, 2009

Galanin and Multiple Sclerosis

From The Guardian:

'Dramatic' breakthrough in MS research
Scientists find a substance called galanin is resistant to a multiple sclerosis-like disease in both mice and human brain tissue
The Guardian
24 August 2009

Read the article

About a research finding from a neuroscience team at the University of Bristol.

Glia

An article written by Carl Zimmer for the September issue of Discover magazine:

read the article

The Dark Matter of the Human Brain
Meet the forgotten 90 percent of your brain: glial cells, which outnumber your neurons ten to one. And no one really knows what they do.

===

Neuropsychology and neuroscience students" One of Carl's books, Soul Made Flesh, is an excellent story about Thomas Willis and his times. Must-read history about neuropsychology, alongside that of the later times of Broca, Wernicke, and Hughlings Jackson.

Telemedicine in the US and Home Health Care: Cleveland Clinic

Cleveland Clinic considering telemedicine services for ICUs, home health care
MedCity News
August 20, 2009
by Chris Seper

Read the article

Friday, August 21, 2009

FDA: Lundbeck's Sabril (Vigabatrin) and Infantile Spasms

From a press release by the FDA:

Sabril Approved by FDA to Treat Spasms in Infants and Epileptic Seizures

Sabril (vigabatrin) Oral Solution has been approved by the U.S. Food and Drug Administration to treat infantile spasms in children ages 1 month to 2 years. Sabril is the first drug in the United States approved to treat the disorder, characterized by a severe type of seizure that usually appears in the first year of life, typically between ages 4 months and 8 months. The disorder can be debilitating because of the frequency of difficult-to-control daily seizures.

Sabril (vigabatrin) Tablets have been approved for adult use in combination with other medications to treat complex partial seizures that have not responded adequately to previous drug therapies.

“Seizures can cause impaired nervous system function and reduced quality of life,” said Russell Katz, M.D., director of the Division of Neurology Products at the FDA’s Center for Drug Evaluation and Research. “Infantile spasms in children this young are very serious and this approval provides these patients and their parents a treatment option.”

Read the full press release

===

Lundbeck's corporate press release

Tuesday, August 18, 2009

Business World: Novartis, Multiple Sclerosis, FTY720, & Betaseron

From The Wall Street Journal's Health Blog:

AUGUST 17, 2009, 11:12 AM ET
Novartis’s Big Plans for Multiple Sclerosis
By Jeanne Whalen

[snippet]

The FDA gave Novartis the green light today to start selling a copy of Betaseron, the multiple sclerosis drug long sold by Bayer.

Why would Novartis want to sell somebody else’s years-old drug? Largely to gain experience in the MS marketplace as Novartis plots a future launch of the MS drug FTY720.

“It’s a way to build a strong commercial organization and a strong medical organization ahead of FTY,” Novartis pharmaceuticals chief Joe Jimemez told the Health Blog recently.

[snippet]

Read the full blog entry

==========

Note: Here is a reference to FTY720:

Horga A, & Montalban X. (2008). FTY720 (fingolimod) for relapsing multiple sclerosis. Expert Rev Neurother., 8(5) 699-714.

Clinical Neuroinmunology Unit, Multiple Sclerosis Center of Catalonia (CEM-Cat), Vall d'Hebron University Hospital, Barcelona, Spain.

FTY720 (fingolimod) is a structural analogue of sphingosine, an endogenous lysophospholipid, which targets sphingosine-1-phosphate receptors after biotransformation to FTY720-phosphate. The immunomodulatory properties of this agent are mainly related to its ability to entrap lymphocytes in secondary lymphoid organs, reducing their availability for cell-mediated immune responses. Emerging evidence suggests that FTY720 also exerts direct actions on glial and precursor cells of the CNS which may be relevant for the process of tissue repair after injury. The therapeutic effects of the drug observed in animal models of human multiple sclerosis have provided the experimental basis for its clinical application. A recent Phase II study has demonstrated that oral FTY720 is effective in reducing disease activity in relapsing multiple sclerosis with a favorable adverse-effect profile. These results are awaiting confirmation in the three ongoing Phase III clinical trials evaluating FTY720 for relapsing-remitting multiple sclerosis.

PMID: 18457527 [PubMed - indexed for MEDLINE

Monday, August 17, 2009

The CNS and Stress

From The New York Times:

Brain Is a Co-Conspirator in a Vicious Stress Loop
By NATALIE ANGIER
Published: August 18, 2009

"Chronic stress changes the brain, but relaxation can change it back."

Read the full article

Identification of Possible or Probable Memory Impairment

Settling in in my coffeehouse for a reading of an interesting new publication by Dr. Brian Brooks and his colleagues on the topic of "Minimizing Misdiagnosis: Psychometric Criteria for Possible or Probable Memory Impairment." The authors seek to develop new psychometric criteria for identification of memory problems in older individuals. This has both clinical and research implications; my primary interest at this time is the accuracy of such identification for including or excluding individuals in clinical trials that test potential drug treatments for Alzheimer's and related dementias.

Medical Data Mining Issues

From The New York Times:

And You Thought a Prescription Was Private
By MILT FREUDENHEIM
Published: August 9, 2009

"Prescriptions and the information on them are bought and sold in a murky marketplace, often without the patients’ knowledge or permission."

Read the article

Sunday, August 16, 2009

Brainstrust in the U.K.

From the Brainstrust.org.uk website: link here

Lizzie Hudson to appear on the 4th plinth for brainstrust!

"Fantastic news just in that Lizzie Hudson from Ipswich has won the chance to appear on the 4th plinth in Trafalgar Square for an hour. Better still, she's devoting her time on the plinth to braintrust and our battle against brain cancer.

Lizzie's appearance is part of sculptor Anthony Gormley's 'One & Other' project, wherein he is asking the people of the UK to occupy the empty Fourth Plinth in Trafalgar Square in London, a space normally reserved for statues of Kings and Generals. Gormley's idea is that successful applicants then become an image of themselves, and a representation of the whole of humanity.

Every hour, 24 hours a day, for 100 days without a break, a different person will make the Plinth their own, including lucky Lizzie!

Lizzie, 26, states "I wanted to do something useful with my time, and so have decided to raise money for this much deserving charity". And she'll certainly be putting her time on the plinth to good use! She's hoping make the longest paper chain she can, racing to make it reach the ground before her hour is up.

So, if you're in London, why not come along and meet us, and Lizzie! We'll be at Trafalgar square cheering Lizzie on from 5pm on the 16th August. If you can't make it, you'll be able to watch a video, streaming live, of Lizzie on the plinth at oneandother.co.uk

You can show your support for Lizzie and her feat of derring-do (we're scared if heights!) by clicking here and visiting her JustGiving page.

Go Lizzie!"

===

Note: If you type in the website's URL make sure you add that "s" there, elsewise you get directed elsewheres.

Saturday, August 15, 2009

Parkinson's Disease Awareness in the U.K.


From the website of the Parkinson's Disease Society:

PDS fundraiser to stand on the Fourth Plinth in London

Tim Andrews, from Milford in Surrey, is taking part in the Antony Gormley project 'One & Other' on Saturday 15 August 2009, taking his place on the Fourth Plinth in Trafalgar Square, London from 6pm to 7pm.

Tim is taking part in the project as part of a new found determination to live life to the full since he was diagnosed with Parkinson's disease in 2005, at the age of 54.

Despite being afraid of heights, Tim intends to stand on the Fourth Plinth for the full hour.

Tim will play tracks from the new album, The Liberty of Norton Folgate by one of his favourite bands, Madness, who have given their permission for it to be played. Tim has chosen the album because the lyrics recount various stories about the city of his birth, London, which he adores.

Tim hopes that many will come along, show their support and perhaps dance with him. Tim says:

"Being diagnosed with Parkinson's has enabled me to view life and death from a completely different perspective and I feel liberated as a consequence. Standing on the Fourth Plinth represents this feeling.

"If I can raise awareness of Parkinson's at the same time, that's even better."

Friday, August 14, 2009

FDA: Saphris (Asenapine) Approval, Schizophrenia and Bipolar

From the FDA:

FDA Approves Saphris to Treat Schizophrenia and Bipolar Disorder

The U.S. Food and Drug Administration has approved Saphris tablets (asenapine) to treat adults with schizophrenia, a chronic, severe and disabling brain disorder, and to treat bipolar I disorder in adults, a serious psychiatric disorder that causes shifts in a person's mood, energy, and ability to function.

“Mental illnesses like schizophrenia and bipolar disorder can be devastating to patients and families, requiring lifelong treatment and therapy,” said Thomas Laughren, M.D., director of the Division of Psychiatry Products in the FDA’s Center for Drug Evaluation and Research. “Effective medicines can help people with mental illness live more independent lives.”

Read the full FDA press release

S-P corporate press release

Thursday, August 13, 2009

Chiari Malformation Awareness in the U.K.




On Saturday, the 15th, from 1100 to 1200 hrs, plinther Laura Hickman of the One&Other art project in Trafalgar Square will be promoting Chiari Malformation awareness.

The Chiari Center Foundation

Chiari Malformation information page here and here

[credits: Photo courtesy Laura Hickman}

Imitation and Social Bonding

From a National Institutes of Health (NIH) press release:

Imitation Promotes Social Bonding in Primates
Capuchin Monkeys Predisposed Toward Individuals Who Imitate Them


Imitation, the old saying goes, is the sincerest form of flattery. It also appears to be an ancient interpersonal mechanism that promotes social bonding and, presumably, sets the stage for relative strangers to coalesce into groups of friends, according to a study by a team of scientists at the National Institutes of Health and two Italian research institutions.

The study authors found that capuchin monkeys preferred the company of researchers who imitated them to that of researchers who did not imitate them. The monkeys not only spent more time with their imitators, but also preferred to engage in a simple task with them even when provided with the option of performing the same task with a non-imitator.

Read the full press release

C-SPAN-3 Airing Alzheimer's Disease Session of Senate Subcommittee (from earlier in year)

C-SPAN-3 is currently airing an earlier session by the subcommittee on aging on the topic of Alzheimer's Disease. All C-SPAN channels can be streamed online.

Information about the program can be found here.

Neuropsychology/Neuro New Books

I have a fun task to complete later today: Recommend to a client five new neuroscience books that have been published in 2009 to be purchased to "freshen up" their company library shelves.

NeuroYouTube

The blog Brain Ethics posted a blog entry last month with links to several YouTube videos of historical figures in neuroscience and psychology: Read Brain Ethics post here

Neuropsychology Abstract of the Day: Multiple Sclerosis, Fatigue, and Cognition

Morrow S, Weinstock-Guttman B, Munschauer F, Hojnacki D, & Benedict R. (2009). Subjective fatigue is not associated with cognitive impairment in multiple sclerosis: cross-sectional and longitudinal analysis. Multiple Sclerosis, 15(8),:998-1005.

School of Medicine, The Jacobs Neurological Institute, State University of New York at Buffalo, Buffalo, New York, USA.

Background Studies in multiple sclerosis (MS) report conflicting conclusions regarding fatigue and cognition, which may partly be due to the use of small sample sizes and frequent reliance on a cross-sectional approach. Objective The ability to distinguish between these two disabling symptoms is necessary in order to properly assess and treat MS patients. Methods In a retrospective analysis, we assessed the correlation between fatigue and neuropsychological (NP) testing using a cross-sectional (n = 465) and longitudinal approach (n = 69). Cognition was measured using a comprehensive battery called the Minimal Assessment of Cognitive Function in MS (MACFIMS), and fatigue was measured with the Fatigue Severity Scale (FSS). FSS scores were categorized as normal (< /=4.0), borderline fatigue (4 < FSS < 5.0), and fatigued ( >/=5.0). Repeat assessments (n = 69) were categorized as improved or worsened by a change in FSS of either 0.5 or 1.0. Results MS patients had significantly higher FSS scores than normal controls (P < 0.001). No correlation was found between FSS and NP scores in either cross-sectional or longitudinal analyses. Fatigue was moderately correlated with depression, assessed using the Beck Depression Inventory Fast Screen (BDIFS) (r = 0.44, P < 0.001). Longitudinally, there was a medium correlation between change in FSS and BDIFS (r = 0.34, P = 0.001), but no significant differences on NP scores using either definition of change. Conclusion We conclude that self-reported fatigue, while correlated with self-reported depression, is not significantly related to cognitive capacity in MS.

PMID: 19667024 [PubMed - in process]

Wednesday, August 12, 2009

Missing Meningitis in a Flaky/Dodgy Swine Flu System: Another Case

Yet another case from the UK:

Woman dies of meningitis after swine flu diagnosis
• Woman prescribed Tamiflu and paracetamol dies in hospital
• Son urges doctors to heed symptoms of other illnesses


Karen McVeigh
guardian.co.uk
Wednesday 12 August 2009 17.02 BST

A man whose mother died of meningitis days after being misdiagnosed with swine flu has called on doctors to pay more heed to other illnesses when treating patients.

Jasvir Kaur Gill, 48, a mother of three from Leicester, began suffering from a sore throat and vomiting during the evening of Saturday 1 August.

She was told to take Tamiflu after a telephone diagnosis, but 12 hours later she suffered a heart attack and was taken to hospital.

She died without regaining consciousness, four days later.

An inquest, which opened today, heard how her death was caused by meningococcal septicaemia, or blood poisoning caused by meningitis.

After the hearing, her son Sukhvinder Gill, 25, said: "We said to the doctors in the hospital, everything these days seems to be about swine flu.

"You've got a sore throat, they tell you to take Tamiflu; you've got a headache, they tell you to take Tamiflu.

"Everyone seems to be swine flu, swine flu, swine flu. What she had were also symptoms of meningitis, but they didn't think of that."

Gill, an estate agent, said the family were "just trying to get by" but were full of questions over his mother's death.

He said he hoped her funeral on Friday would allow the family to start moving on.

"I don't feel angry yet. At the moment I just miss my mum. The cause of death is not a problem, it's just wondering if it could have been caught earlier.

"The doctor said it might not have made a difference, but we don't know that. If she had 12 more hours, they could have put antibiotics in her, which might have helped."

At the inquest, Gill told Leicester city coroner, Catherine Mason, that his mother started complaining of a sore throat but then vomited repeatedly throughout the night and at 5am, prompting her husband to call NHS Direct.

Gill said that, following conversations with both his father and mother, they were told to pick up some Tamiflu.

Read the full article

Neuropsychology Abstract of the Day: Cognitive Rehab in Ugandan Childhood Malaria Survivors

Bangirana P, Giordani B, John CC, Page C, Opoka RO, & Boivin MJ (2009). Immediate Neuropsychological and Behavioral Benefits of Computerized Cognitive Rehabilitation in Ugandan Pediatric Cerebral Malaria Survivors. Journal of Development and Behavioral Pediatrics. Aug 7.

OBJECTIVE:: Our earlier studies on Ugandan children surviving cerebral malaria showed cognitive deficits mainly in attention and memory. We now present the first study in sub-Saharan Africa to investigate the feasibility and potential benefits of computerized cognitive rehabilitation training on neuropsychological and behavioral functioning of children surviving cerebral malaria. METHODS:: A randomized trial in which 65 children admitted 45 months earlier with cerebral malaria were recruited at Mulago Hospital, Kampala, Uganda. For 8 weeks, 32 of the children received weekly training sessions using Captain's Log cognitive training software and the other 33 were assigned to a nontreatment condition. Pre- and postintervention assessments were completed using CogState, a computerized neuropsychological battery, measuring visuomotor processing speed, working memory, learning, attention and psychomotor speed and the Child Behavior Checklist measuring internalizing problems, externalizing problems, and total problems. RESULTS:: Preintervention scores were similar between both groups. Treatment effects were observed on visuospatial processing speed [group effect (standard error) 0.14 (0.03); p < .001], on a working memory and learning task [0.08 (0.02); p < .001], psychomotor speed [0.14 (0.07); p = .04], and on internalizing problems [-3.80 (1.56); p = .02] after controlling for age, sex, school grade, quality of the home environment, and weight for age z scores. Similar treatment effects were observed when no adjustments for the above covariates were made. CONCLUSIONS:: Computerized cognitive training long after the cerebral malaria episode has immediate benefit on some neuropsychological and behavioral functions in African children. The long-term benefit of this intervention needs to be investigated.

PMID: 19668094 [PubMed - as supplied by publisher]

Eunice Kennedy Shriver: NIH Statement

From a National Institutes of Health (NIH) press release:

Statement of Duane Alexander, M.D., Director
Eunice Kennedy Shriver National Institute of Child Health and Human Development
National Institutes of Health
On the Contributions of Eunice Kennedy Shriver
in Advancing Research in Child Health, Human Development, and Intellectual Disability


The entire world owes a debt to Eunice Kennedy Shriver for her foresight in calling for an institute at the National Institutes of Health to study the myriad aspects of human development, both as it unfolds without problems and when medical and environmental factors prevent it from doing so.

In 1961, Mrs. Shriver persuaded her brother, then-President Kennedy, to include in his first health message to Congress the proposal for an NIH institute focusing on child health and human development research. After the bill that would establish the new institute was introduced, Mrs. Shriver testified in support of that bill and worked to persuade members of Congress to approve it. The institute that now bears her name, by act of Congress, is a tribute to her vision and commitment.

Research that the Eunice Kennedy Shriver National Institute of Child Health and Human Development has sponsored has led to the near-elimination in the developed world of once common causes of intellectual disability. For example, as recently as the 1980s, Haemophilus influenzae Type B (Hib) meningitis was the leading cause of acquired mental retardation in the United States. A vaccine against the disease, developed in the NICHD's laboratories, has been so effective that today the disease is nearly eliminated. Children with the metabolic disorder phenylketonuria, or PKU, develop severe intellectual disability soon after birth. In the 1960s, a blood test for PKU was developed and children with the disorder were identified at birth. NICHD research documented that a diet low in the amino acid phenylanine spared them from brain damage and allowed normal functioning. Another newborn blood test developed through NICHD research for a disorder caused by failure to produce sufficient amounts of thyroid hormone allowed diagnosis and treatment before any brain damage could occur. Other NICHD research documented the benefits and feasibility of mainstreaming children and adults with intellectual and physical disabilities into schools and communities, a practice that is now routine.

She was also instrumental in creating in 1961 what eventually became the President's Committee for People with Intellectual Disabilities (ACF/HHS), and served on that Committee from 1966-1968 and from 1977-1980.

We owe these and numerous other advances in health, especially for those with disabilities, to Mrs. Shriver's determined efforts. She will be greatly missed.

The NICHD sponsors research on development, before and after birth; maternal, child, and family health; reproductive biology and population issues; and medical rehabilitation. For more information, visit the Institute's Web site at http://www.nichd.nih.gov/.

The National Institutes of Health (NIH) — The Nation's Medical Research Agency — includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. It is the primary federal agency for conducting and supporting basic, clinical and translational medical research, and it investigates the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov.

FDA: Datscan: A Radiopharmaceutical and Parkinson Disease

Following up on a posting earlier this week:


From a General Electrics press release

11 August 2009
FDA ADVISORY COMMITTEE RECOMMENDS DaTSCAN™ (Ioflupane I 123 Injection)

PRINCETON, NJ--GE Healthcare announced today that the Peripheral and Central Nervous System Drugs advisory committee of the U.S. Food and Drug Administration (FDA) has voted to recommend DaTSCAN (Ioflupane I 123 Injection) to the FDA. The panel determined DaTSCAN has a favorable risk to benefit profile, voting 11 to two with one abstention.

The proposed indication for DaTSCAN is for the visualization of the dopamine transporter (DaT) distribution within the striata by single photon emission computed tomography (SPECT) imaging in patients presenting with symptoms or signs suggestive of dopaminergic neurodegeneration.

In May 2009, the FDA accepted the New Drug Application and granted DaTSCAN priority review, a designation identified for areas of unmet medical need. If approved, DaTSCAN will be the first radiopharmaceutical agent available to detect DaT distribution within the brain.

“We are pleased that the committee has recognized the potential benefit of DaTSCAN,” said Don Black, MD, head of R&D for GE Healthcare Medical Diagnostics. “Making DaTSCAN available in the U.S. would be an important milestone for GE Healthcare and improved patient care.”

The Prescription Drug User Fee Act (PDUFA) date for DaTSCAN is September 9, 2009.

Sports Safety and Traumatic Brain Injury: S100 Batting Helmet

Batting Helmet is Safer, but Players Hate the Look
By DAVID WALDSTEIN
The New York Times
Published: August 13, 2009

"Some major league players don’t want to sacrifice comfort and style for the added protection of Rawlings’ new helmet."

Read article

[Note: The helmet is called the Rawlings S100 and the company's website has promotional material about it's features.}

Tuesday, August 11, 2009

In The Wide World: Two Kennedy Centers

The Eunice Kennedy Shriver National Institute of Child Health and Human Development
Bethesda, MD
http://www.nichd.nih.gov/


The Rose F. Kennedy University Center for Excellence in Developmental Disabilities
Bronx, NY
http://www.aecom.yu.edu/cerc/kennedy.htm

Obit: Eunice Kennedy Shriver

Eunice Kennedy Shriver, 88; member of Kennedy clan, founder of Special Olympics
By Bryan Marquard
Boston Globe Staff / August 11, 2009

"Eunice Kennedy Shriver, who planted the seeds for the Special Olympics when she launched Camp Shriver on the lawn of her Maryland home, and then with force of will and the clout of her family name spread her vision of lifting the developmentally disabled "into the sunlight of useful living," died this morning at Cape Cod Hospital in Hyannis."

Read full article

Monday, August 10, 2009

FDA: Datscan: A Radiopharmaceutical and Parkinson Disease

The Wall Street Journal's HealthBlog discusses this radiopharmaceutical and the FDA meeting to be held tomorrow about it [read post here]

Neuropsychology Abstract of the Day: Developmental Deprivation and the Cerebellum

Bauer PM, Hanson JL, Pierson RK, Davidson RJ, & Pollak SD. (2009). Cerebellar Volume and Cognitive Functioning in Children Who Experienced Early Deprivation. Biological Psychiatry. 2009 Aug 4. [Epub ahead of print]

University of Wisconsin-Madison, Madison, Wisconsin.

BACKGROUND: The cerebellum is a brain region recognized primarily in the coordination of movement and related accessory motor functions. In addition, emerging evidence implicates the cerebellum in cognitive processes and suggests that this brain region might be subject to experience-dependent changes in structure. Therefore, the aim of this study was to evaluate the role of early environmental deprivation in the maturation of the cerebellum and aspects of cognitive development. METHODS: Structural magnetic resonance imaging volumes of 12 cerebellar sub-regions from 31 previously neglected and 30 typically developing children were compared with subjects' corresponding neuropsychological test scores. RESULTS: Neglected children had smaller volume of the superior-posterior cerebellar lobes. Moreover, superior-posterior lobe volume was found to mediate neuropsychological test performance differences between groups, with larger volumes yielding better outcomes on tests of memory and planning. CONCLUSIONS: These data support the importance of experience-dependent changes in cerebellar structure and highlight the role of the cerebellum in higher cognitive functions.

PMID: 19660739 [PubMed - as supplied by publisher

Capgras Syndrome and Traumatic Brain Injury

An interesting feature article from the front page of yesterday's New York Times:

After Injury, Fighting to Regain a Sense of Self
By BENEDICT CAREY
The New York Times
Published: August 9, 2009

"Scientists are investigating delusions caused by brain trauma for clues to one of the most confounding problems in brain science: identity."

Read the full article

Friday, August 07, 2009

Missing Possible Meningitis in a Flaky/Dodgy Swine Flu System

From The Guardian:

Girl, two, dies after swine flu misdiagnosis
Child with possible meningitis was 'failed by system' say parents
Jo Adetunji
guardian.co.uk
Saturday 8 August 2009 01.08 BST

[snippet]

The parents of a two-year-old girl thought to have died from meningitis after they were told she was suffering from swine flu said yesterday that she had been "failed by the system".

Georgia Keeling, from Norwich, died after being rushed to hospital on Tuesday. Her parents, Paul Sewell, 21, and Tasha Keeling, 22, said they contacted health services, including NHS Direct, the swine flu helpline and the emergency services, five times after their daughter first developed a temperature on Saturday.

The couple said that by Tuesday she had also developed a rash, bruising and had been sick, but their concerns that she might have meningitis were ignored.

They said that on two occasions they were told Georgia did not need to be admitted to hospital and after one 999 call, a paramedic arrived with Tamiflu and paracetamol. It was only after another 999 call an hour later, when her eyes had glazed over, that she was taken to hospital. Georgia suffered a heart attack and attempts to resuscitate her failed.

Speaking to a local paper, Sewell said: "I don't feel like the paramedics did their job properly. She wasn't given a chance, they had diagnosed her before even looking at her and came out ready to give her Tamiflu. She was failed by the system big time. I just want to know how come they didn't take her into hospital straight away."

[snippet]

The child's death comes just a few weeks after a warning from The Meningitis Trust against mistaking the symptoms of meningitis for swine flu. Several, including fever, muscle pain and headaches, are common to both conditions and several health charities have expressed concern that doctors and health professionals could miss them.

Read the full article

Read The Meningitis Trust press release (20 July 2009)

And, with this is mind also today, read this headline from The Mail: "Swine flu hotline run by 16-year-olds: NHS pays GCSE pupils to give advice and hand out drugs" Read article

Attention and Concentration

Dr. Ed Vogel of the University of Oregon on Distraction and The Brain, a short YouTube video:

Neuropsychology Abstract of the Day: Cricket Learning and Memory

A very interesting paper about classical conditioning. Enjoy. If you are a student, you might also see this referred to as Pavlovian conditioning ...


Makoto Mizunami, Sae Unoki, Yasuhiro Mori, Daisuke Hirashima, Ai Hatano, & Yukihisa Matsumoto. (2009). Roles of octopaminergic and dopaminergic neurons in appetitive and aversive memory recall in an insect. BMC Biology, 7:46 [doi:10.1186/1741-7007-7-46]

Published: 4 August 2009
Abstract, with link to full BioMedCentral paper

Abstract (provisional)

Background
In insect classical conditioning, octopamine (the invertebrate counterpart of noradrenaline) or dopamine has been suggested to mediate reinforcing properties of appetitive or aversive unconditioned stimulus, respectively. However, the roles of octopaminergic and dopaminergic neurons in memory recall have remained unclear.

Results
We studied the roles of octopaminergic and dopaminergic neurons in appetitive and aversive memory recall in olfactory and visual conditioning in crickets. We found that pharmacological blockade of octopamine and dopamine receptors impaired aversive memory recall and appetitive memory recall, respectively, thereby suggesting that activation of octopaminergic and dopaminergic neurons and the resulting release of octopamine and dopamine are needed for appetitive and aversive memory recall, respectively. On the basis of this finding, we propose a new model in which it is assumed that two types of synaptic connections are formed by conditioning and are activated during memory recall, one type being connections from neurons representing conditioned stimulus to neurons inducing conditioned response and the other being connections from neurons representing conditioned stimulus to octopaminergic or dopaminergic neurons representing appetitive or aversive unconditioned stimulus, respectively. The former is called 'stimulus-response connection' and the latter is called 'stimulus-stimulus connection' by theorists studying classical conditioning in higher vertebrates. Our model predicts that pharmacological blockade of octopamine or dopamine receptors during the first stage of second-order conditioning does not impair second-order conditioning, because it impairs the formation of the stimulus-response connection but not the stimulus-stimulus connection. The results of our study with a cross-modal second-order conditioning were in full accordance with this prediction.

Conclusion
We suggest that insect classical conditioning involves the formation of two kinds of memory traces, which match to stimulus-stimulus connection and stimulus-response connection. This is the first study to suggest that classical conditioning in insects involves, as does classical conditioning in higher vertebrates, the formation of stimulus-stimulus connection and its activation for memory recall, which are often called cognitive processes.

In the Wide World: BASIC in Manchester, UK

BASIC: Brain and Spinal Injury Centre
visit website

With a shout out to Andy_G, who is on the plinth in Trafalgar Square right now wearing a BASIC shirt and is a part of the One & Other art event.

From the website:

"BASIC is a specialist resource for people and their families in crisis followinga traumatic brain injury or neurological diagnosis. This includes people recovering from severe head injury, brain haemorrhage, brain tumour and otherbrain-related conditions such as stroke and brain cancer."

Thursday, August 06, 2009

BBC Radio 4 Looks at DSM Decision-Making Transparency

BBC Radio 4
Rewriting the Psychiatrists' Bible
Matthew Hill
04 August 2009

Listen to the report (40 mins.) about the Diagnostic and Statistical Manual (DSM) of the American Psychiatric Association (APA) as decisions are being reached about its forthcoming revision. Visit the show's webpage

Online availability ends on the 11th of August.

Tuesday, August 04, 2009

Obit: Dr. Mark Rosenzweig

Mark Rosenzweig, pioneer in brain plasticity, learning and hearing, has died at 86
UCBerkeley News
By Yasmin Anwar, Media Relations | 03 August 2009
Read the full report

BERKELEY — Mark R. Rosenzweig, a professor emeritus of psychology at the University of California, Berkeley, whose early studies paved the way for today's recognition of the brain's ability to grow and repair itself, died July 20 at his home in Berkeley from kidney failure. He was 86.

A prolific researcher, writer and French-speaking internationalist, Rosenzweig collaborated with some of the greatest minds in neuropsychology at Harvard University, UC Berkeley and the Louis Pasteur University in Strasbourg, France.

At UC Berkeley, Rosenzweig collaborated with biochemist Ed Bennett, psychologist David Krech and neuroanatomist Marian Diamond on studies that provided early evidence of brain plasticity - the now-well established notion that neural pathways change throughout our lives as we grow and learn. In addition, his earlier research into auditory perception also laid the groundwork for modern, noninvasive hearing tests.

"Rosenzweig's investigations were rigorous, groundbreaking and continue to be cited in all current accounts of brain development and plasticity, though they were conducted half a century ago," said Stephen Hinshaw, chair of UC Berkeley's Department of Psychology. "If anyone deserves the term 'pioneer,' he does."

Through extensive studies of laboratory rats at UC Berkeley in the 1950s and '60s, Rosenzweig and his colleagues were able to show that "environmental therapy" can stimulate brain growth at a cellular level not only in children, but also in adults. For example, he found that rats living in an "enriched environment" with stimulating interactive tasks performed better at learning activities than those in passive, impoverished conditions.

Neuropsychology Abstract of the Day: Alzheimer's, MCI, & CSF Markers

Mattsson N, Zetterberg H, Hansson O, Andreasen N, Parnetti L, Jonsson M, Herukka SK, van der Flier WM, Blankenstein MA, Ewers M, Rich K, Kaiser E, Verbeek M, Tsolaki M, Mulugeta E, Rosén E, Aarsland D, Visser PJ, Schröder J, Marcusson J, de Leon M, Hampel H, Scheltens P, Pirttilä T, Wallin A, Jönhagen ME, Minthon L, Winblad B, & Blennow K. (2009). CSF biomarkers and incipient Alzheimer disease in patients with mild cognitive impairment. JAMA, 302(4), 385-393.

Institute of Neuroscience and Physiology, Department of Neurochemistry and Psychiatry, The Sahlgrenska Academy at University of Gothenburg, Mölndal, Sweden.

CONTEXT: Small single-center studies have shown that cerebrospinal fluid (CSF) biomarkers may be useful to identify incipient Alzheimer disease (AD) in patients with mild cognitive impairment (MCI), but large-scale multicenter studies have not been conducted. OBJECTIVE: To determine the diagnostic accuracy of CSF beta-amyloid(1-42) (Abeta42), total tau protein (T-tau), and tau phosphorylated at position threonine 181 (P-tau) for predicting incipient AD in patients with MCI. DESIGN, SETTING, AND PARTICIPANTS: The study had 2 parts: a cross-sectional study involving patients with AD and controls to identify cut points, followed by a prospective cohort study involving patients with MCI, conducted 1990-2007. A total of 750 individuals with MCI, 529 with AD, and 304 controls were recruited by 12 centers in Europe and the United States. Individuals with MCI were followed up for at least 2 years or until symptoms had progressed to clinical dementia. MAIN OUTCOME MEASURES: Sensitivity, specificity, positive and negative likelihood ratios (LRs) of CSF Abeta42, T-tau, and P-tau for identifying incipient AD. RESULTS: During follow-up, 271 participants with MCI were diagnosed with AD and 59 with other dementias. The Abeta42 assay in particular had considerable intersite variability. Patients who developed AD had lower median Abeta42 (356; range, 96-1075 ng/L) and higher P-tau (81; range, 15-183 ng/L) and T-tau (582; range, 83-2174 ng/L) levels than MCI patients who did not develop AD during follow-up (579; range, 121-1420 ng/L for Abeta42; 53; range, 15-163 ng/L for P-tau; and 294; range, 31-2483 ng/L for T-tau, P < .001). The area under the receiver operating characteristic curve was 0.78 (95% confidence interval [CI], 0.75-0.82) for Abeta42, 0.76 (95% CI, 0.72-0.80) for P-tau, and 0.79 (95% CI, 0.76-0.83) for T-tau. Cut-offs with sensitivity set to 85% were defined in the AD and control groups and tested in the MCI group, where the combination of Abeta42/P-tau ratio and T-tau identified incipient AD with a sensitivity of 83% (95% CI, 78%-88%), specificity 72% (95% CI, 68%-76%), positive LR, 3.0 (95% CI, 2.5-3.4), and negative LR, 0.24 (95% CI, 0.21-0.28). The positive predictive value was 62% and the negative predictive value was 88%. CONCLUSIONS: This multicenter study found that CSF Abeta42, T-tau, and P-tau identify incipient AD with good accuracy, but less accurately than reported from single-center studies. Intersite assay variability highlights a need for standardization of analytical techniques and clinical procedures.

PMID: 19622817 [PubMed - indexed for MEDLINE]