Study: Poor sleep could make high blood pressure harder to treat

What do we know already?

In this study, researchers looked at whether poor sleep might be partially to blame. Previous studies have shown that people who have poor-quality sleep are more likely to get high blood pressure. Could poor sleep also play a role in making some people’s blood pressure harder to treat?About 1 in 3 adults in the UK has high blood pressure, which increases their risk of heart attacks, strokes, and other serious health problems. Most people can lower their blood pressure by making lifestyle changes - such as exercising more and eating less salt - and taking medications. But some people’s blood pressure remains high despite treatment.

To explore this, the researchers looked at 234 people with high blood pressure who were being treated at a clinic in Pisa, Italy. Some of the participants (around 15 in every 100) still had high blood pressure despite taking multiple drugs. Doctors call this treatment-resistant high blood pressure. Everyone in the study filled in a detailed questionnaire about their sleep habits and sleep quality. The researchers also looked at the participants’ health and other factors that might affect their sleep quality and blood pressure.

What does the new study say?

Poor sleep was more common in people with treatment-resistant high blood pressure than in those with blood pressure that improved with treatment.

After factoring in people’s ages, use of sleeping tablets, and several other things that might have affected the study’s findings, the researchers estimated that people with poor-quality sleep were twice as likely to have treatment-resistant high blood pressure.

However, the link between the two weakened when the researchers factored in whether people had signs of depression. Depression may affect both sleep quality and blood pressure. We need more studies to explore this.

How reliable is the research?

This study can’t show cause and effect, so it can’t prove that poor sleep increased people’s risk of having treatment-resistant high blood pressure. It can show only that there may be a link.

Also, this study hasn’t been published in a medical journal, but was presented at a medical conference. That means we haven’t been able to look in detail at its methods and results.

What does this mean for me?

It’s too soon to say whether poor-quality sleep plays a role in treatment-resistant high blood pressure. However, we do know that a good night’s sleep is important in other ways. Besides helping you to be more alert and focused throughout the day, studies suggest good sleep may also be important in preventing disease, avoiding weight gain, and staying healthy long term. If you’re having difficulty sleeping or don’t feel rested when you wake, speak with your doctor.

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Perry struggled with sleep disorder during Presidential campaign

New information shows that Rick Perry was diagnosed with sleep apnea during his Presidential campaign.

New behind-the-scenes details are emerging about Rick Perry's presidential campaign, one that started strong but shriveled after a series of surprising gaffes and misstatements.

A spokesperson with Perry's office confirmed an account in a new book that the Texas governor discovered he had "mild sleep apnea" during his White House bid.

Perry, who entered the race late in August 2011, drew criticism for not taking his presidential run seriously because of his mistakes on the campaign trail. The most memorable moment, perhaps, came in a Michigan debate in November, when Perry failed to remember the third federal agency he had proposed eliminating. He named two, but could not come up with the third, even after appearing to consult notes.

"I would do away with the Education, the, uh, Commerce, and, let's see. I can't," Perry said, after struggling to come up with the name for 53 seconds. "The third one I can't. Sorry. Oops."

Some attributed the mental lapse, as well as a candid and comedic New Hampshire speech days earlier, to painkillers after Perry underwent back surgery in the summer of 2011. Perry's team maintained the governor discontinued use of the medicine prior to the start of his campaign.

A Perry spokesperson said the governor, however, found out he had a sleep condition.

"The Governor's July 2011 back surgery and his late entry into the presidential race presented obstacles during his campaign. Gov. Perry was diagnosed with mild sleep apnea during the campaign and was treated with a breathing machine for a few weeks," the spokeswoman said in a statement Sunday.

"Once the governor's back recovered sufficiently to return to his regular exercise routine, the apnea issue was resolved and no further treatment was necessary."

Perry's sleep problems were first reported in a new book, "Oops," by Texas Tribune reporter Jay Root.

"After conducting overnight tests on Perry, they produced a rather startling diagnosis: He had sleep apnea, and it had gone undetected for years, probably decades," Root writes, according to an excerpt of the book posted on the Texas Tribune website.

The ailment, Root continues, affects one in 10 men worldwide and "causes loud snoring and temporary lapses in breathing that disrupt normal sleep." Doctors prescribed a breathing machine to help alleviate symptoms, and Perry, an exercise junkie, soon got back to normal once he was able to work out again.

"The way he told it later, all that rigorous physical activity over the year had kept his sleep apnea in check," Root writes. "Then back surgery he underwent in July 2011 sidelined him, kept him out of the gym, and he went from light sleeper to insomniac."

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High-Tech Gadgets Can Help Diagnose and Study Autism

New technology claims that it can help diagnose autism in children, and also help study autism.

Researchers in Georgia Tech's Center for Behavior Imaging have developed two new technological tools that automatically measure relevant behaviors of children, and promise to have significant impact on the understanding of behavioral disorders such as autism.

One of the tools -- a system that uses special gaze-tracking glasses and facial-analysis software to identify when a child makes eye contact with the glasses-wearer -- was created by combining two existing technologies to develop a novel capability of automatic detection of eye contact. The other is a wearable system that uses accelerometers to monitor and categorize problem behaviors in children with behavioral disorders.

Both technologies already are being deployed in the Center for Behavior Imaging's (CBI) ongoing work to apply computational methods to screening, measurement and understanding of autism and other behavioral disorders.

Children at risk for autism often display distinct behavioral markers from a very young age. One such marker is a reluctance to make frequent or prolonged eye contact with other people. Discovering an automated way to detect this and other telltale behavioral markers would be a significant step toward scaling autism screening up to much larger populations than are currently reached. This is one goal of the five-year, $10 million "Expeditions" project, funded in fall 2010 by the National Science Foundation under principal investigator and CBI Director Jim Rehg, also a professor in Georgia Tech's School of Interactive Computing.

The eye-contact tracking system begins with a commercially available pair of glasses that can record the focal point of their wearer's gaze. Researchers took video of a child captured by a front-facing camera on the glasses, worn by an adult who was interacting with the child. The video was then processed using facial recognition software available from a second manufacturer. Combine the glasses' hard-wired ability to detect wearer gaze with the facial-recognition software's ability to detect the child's gaze direction, and the result is a system able to detect eye contact in a test interaction with a 22-month-old with 80 percent accuracy. The study was conducted in Georgia Tech's Child Study Lab (CSL), a child-friendly experimental facility richly equipped with cameras, microphones and other sensors.

"Eye gaze has been a tricky thing to measure in laboratory settings, and typically it's very labor-intensive, involving hours and hours of looking at frames of video to pinpoint moments of eye contact," Rehg said. "The exciting thing about our method is that it can produce these measures automatically and could be used in the future to measure eye contact outside the laboratory setting. We call these results preliminary because they were obtained from a single subject, but all humans' eyes work pretty much the same way, so we're confident the successful results will be replicated with future subjects."

The other new system, developed in collaboration with the Marcus Autism Center in Atlanta and Dr. Thomas Ploetz of Newcastle University in the United Kingdom, is a package of sensors, worn via straps on the wrists and ankles, that uses accelerometers to detect movement by the wearer. Algorithms developed by the team analyze the sensor data to automatically detect episodes of problem behavior and classify them as aggressive, self-injurious or disruptive (e.g., throwing objects).

Researchers first developed the algorithms by putting the sensors on four Marcus clinic staff members who together performed some 1,200 different behavior instances, and the system detected "problem" behaviors with 95 percent accuracy and classified all behaviors with 80 percent accuracy. They then used the sensors with a child diagnosed along the autism spectrum, and the system detected the child's problem-behavior episodes with 81 percent accuracy and classified them with 70 percent accuracy.

"These results are very promising in leading the way toward more accurate and reliable measurement of problem behavior, which is important in determining whether treatments targeting these behaviors are working," said CSL Director Agata Rozga, a research scientist in the School of Interactive Computing and co-investigator on the Expeditions award. "Our ultimate goal with this wearable sensing system is to be able to gather data on the child's behavior beyond the clinic, in settings where the child spends most of their time, such as their home or school. In this way, parents, teachers and others who care for the child can be potentially alerted to times and situations when problem behaviors occur so that they can address them immediately."

"What these tools show is that computational methods and technologies have great promise and potential impact on the lives of many children and their parents and caregivers," said Gregory Abowd, Regents' Professor in the School of Interactive Computing and a prominent researcher in technology and autism. "These technologies we are developing, and others developed and explored elsewhere, aim to bring more effective early-childhood screening to millions of children nationwide, as well as enhance care for those children already diagnosed on the autism spectrum."

Both technologies were presented in early September at the 14th ACM International Conference on Ubiquitous Computing (Ubicomp 2012). Among the other devices under study at CSL are a camera/software system that can track children's facial expressions and customized speech analysis software to detect vocalization patterns.

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The value of a disabled child

What is the life of a physically disabled child worth? It’s a cruel, but important question for the devoted people who work in pediatric rehabilitation as well as Treasury officials who want to cut costs and medical ethicists who think about what is morally right.

The annual financial cost of taking care of an Israeli child with cerebral palsy, muscular dystrophy or other disabilities is around $50,000. The US Environmental Protection Agency calculated that the “statistical value” of a coal miner, calculated by how much the government would invest in preventing him from dying in a work accident, is $6.1 million. Governments are willing to spend $129,000 a year to keep a kidney-failure patient alive using dialysis to clean their blood.

Related:

• Kids taught how to conquer world on wheelchairs
• Children play their way to improved concentration

According to Dr. Eliezer Be’eri, deputy director-general of Jerusalem’s Alyn Hospital, “taking care of a child in our pediatric rehabilitation hospital is worthwhile for society. But I can’t look at people as numbers. It’s easy to lose our humanity. Money is not the only thing to be considered. Our humanity is at risk. What are all our resources worth if we are not humane?”

“A brain-damaged child will not contribute to society, but I must take care of him because he’s a human being. I have to do it not because society might one day benefit from him. Even though economic benefits are important, expenses mustn’t determine if it’s ‘worthwhile’ to treat such a child. We look at their humanity, not their usefulness. It strengthens our own humanity.”

Be’eri was one of the speakers at Alyn’s First Conference on Pediatric Rehabilitation, which was held recently at Jerusalem’s Crowne Plaza Hotel and special workshop sessions at the hospital in the capital’s Kiryat Hayovel neighborhood.

The multidisciplinary medical institution, the only one of its kind in Israel and one of the few in the world, is directed by Dr. Maurit Beeri (no relation to Eliezer) and treats hundreds of children and teenagers as inpatients and outpatients. It has both regular rehabilitation and respiratory rehabilitation departments and a medical-educational rehab department for children as young as six months old. A rehabilitative day care center is available for infants and toddlers up to the age of three years, while kindergartens and a school serve children up to age...

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Male DNA Found in Women’s Brains, Likely from Prior Pregnancy With a Male Fetus, Less in Women with Altzheimer's

Male DNA Commonly Found in Women’s Brains, Likely from Prior Pregnancy With a Male Fetus  

ScienceDaily (Sep. 26, 2012) — Male DNA is commonly found in the brains of women, most likely derived from prior pregnancy with a male fetus, according to first-of-its-kind research conducted at Fred Hutchinson Cancer Research Center. While the medical implications of male DNA and male cells in the brain are unknown, studies of other kinds of microchimerism -- the harboring of genetic material and cells that were exchanged between fetus and mother during pregnancy -- have linked the phenomenon to autoimmune diseases and cancer, sometimes for better and other times for worse.

The study findings are published Sept. 26 in PLOS ONE. Lead author William F. N. Chan, Ph.D., in the Department of Biochemistry at the University of Alberta, conducted the research while working in the Hutchinson Center laboratory of J. Lee Nelson, M.D., a member of the Center's Clinical Research Division and a leading international authority on microchimerism. Nelson is senior author on the paper.

Chan said the study is the first description of male microchimerism in the female human brain. The findings support the likelihood that fetal cells frequently cross the human blood-brain barrier and that microchimerism in the brain is relatively common. Until this study, it was not known whether these cells could cross the barrier in humans. For this research, scientists examined brain autopsy specimens from 59 women who had died between the ages of 32 and 101. Male microchimerism was detected in 63 percent of subjects, was distributed in multiple brain regions and was potentially persistent throughout the human lifespan; the oldest female in whom male fetal DNA was detected in the brain was 94.

Twenty six of the women had no neurological disease and 33 had Alzheimer's disease. The brains of women with Alzheimer's had a somewhat lower prevalence of male microchimerism, which appeared in lower concentrations in regions of the brain most affected by the disease. However, the authors noted that the small number of subjects and largely unknown pregnancy history of the women means a link between Alzheimer's disease and level of male cells of fetal origin cannot be established.

The study also does not provide an association between male microchimerism in the female brain and relative health versus disease. "Currently, the biological significance of harboring male DNA and male cells in the human brain requires further investigation," Chan said.

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Pregnant Mother's Sleep Apnea Can Hurt Health of Child

This article discusses how a pregnant mother's sleep apnea affects both her and her child.

Women who suffer from sleep apnoea during pregnancy are more likely to have babies who suffer from early health problems, researchers say.

They found babies of mothers with the breathing disorder had a greater risk of needing neonatal intensive care than unaffected mothers.Scientists from Case Western Reserve University in Cleveland studied obese pregnant women both with and without obstructive sleep apnoea.

They found OSA was also associated with higher rates of pre-eclampsia in the overweight women.The pregnancy complication causes high blood pressure and for protein to leak into the urine. If untreated it can develop into eclampsia, which is a type of life-threatening seizure.

Lead author Dr Judette Louis, from the University of South Florida, said: ‘Our findings show that obstructive sleep apnea can contribute to poor outcomes for both obese mothers and their babies. ‘Its role as a risk factor for adverse pregnancy outcomes independent of obesity should be examined more closely.’

Sleep apnoea occurs when muscles and soft tissues in the throat collapse sufficiently during sleep to block the airway for 10 seconds or more. A sufferer can have as many as 100 episodes during the night, with each one jerking them out of deep sleep causing fatigue.

Some experts believe pregnancy can increase the chances of developing sleep apnoea, especially in the third trimester due to weight gain. Nasal membranes can also swell as blood vessels expand over the nine months.

Those who are overweight before they fall pregnant are more likely to develop the condition. A fifth of women in the U.S are obese when they conceive, but the number is not known in the UK.

Dr Louis and former colleagues from Case Western Reserve, analysed data for 175 obese pregnant women who had been tested for OSA at home using a portable device.Around 15 per cent of the participants had sleep apnoea. These women were heavier on average and more likely to have high blood pressure.

Around 42 per cent of women with sleep apnoea had pre-eclampsia compared to 17 per cent of those without the condition. Meanwhile nearly half (46 per cent ) of babies born to women with sleep apnoea needed intensive care treatment compared to 17 per cent of the other overweight mothers. Many of these admissions were due to respiratory distress.

Finally 65 per cent of the women with sleep apnoea required a caesaeran section compared to a third of those without the condition. Premature birth rates were similar between the groups.

Approximately one in five women are obese when they become pregnant in the U.S, according to research from the federal Centers for Disease Control and Prevention. Such statistics are not gathered in the UK.

While numerous studies have examined complications associated with obesity in pregnancy - including high blood pressure and gestational diabetes - sleep apnoea has been underdiagnosed and understudied.

The study authors suggest the best way to decrease obesity-related conditions that lead to poor pregnancy outcomes, including sleep apnoea, would be to treat obesity before a woman becomes pregnant, but acknowledge that ‘losing weight is often difficult.’Dr Louis said the study also points to the need for better ways to screen and treat this common form of sleep-disordered breathing during pregnancy.

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Study Claims Sleep Problems In Young Children Linked To Greater Need For Special Education

A study shows that children with sleeping problems are more likely to require special education.

Kids who snore may be more likely to have behavioral problems, but that may not be all. A new study, published in Pediatricsthis month, found that children with sleep problems through the age of 5 were more likely to require special education by age 8.

Karen Bonuck, a professor of family and social medicine at Yeshiva University's Albert Einstein School of Medicine, led the study that gathered data from 11,049 children with sleep-disordered breathing -- a general term covering snoring and sleep apnea -- and 11,467 children with behavioral sleep problems. Bonuck found that children with one of these disorders were 30 percent more likely to need special education, while children with behavioral sleep problems, such as bedtime refusal or delayed sleep onset, were an additional 7 percent more likely to require speciality courses.

"What we found was that absolutely both behavioral and respiratory problems did increase the likelihood of special education," Bonuck told CBS News' HealthPop. "The take home from this is we need to be looking at these breathing and behavioral sleep problems at very young ages in these children."

The research follows from an earlier study led by Bonuck, published in Pediatrics in March, that linked sleep disorders in young children to the development of behavioral problems such as hyperactivity and aggressiveness.

"This is the strongest evidence to date that snoring, mouth breathing, and apnea can have serious behavioral and social-emotional consequences for children," Bonuck said in a statement.

Though Bonuck's new study does not prove cause and effect, sleep problems in young children may lead to a host of other issues outside the behavioral realm, including special education needs.

"We've got a generation of children potentially at risk from long-term developmental deficits that might occur from these sleep problems," Bonuck told HealthDay. "Parents need to be vigilant."

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Helmet sensor sends a mobile alert when athletes are at risk for concussion

A sensor in helmets can send an alert to parents and coaches when a player has possibly had a concussion.

When it announced it was donating $30 million to the NIH’s Neurology Institute earlier this month, the NFL made a big statement about its concern for the impact hard hits could have on players’ brain health.

The NFL is far from alone in its push to address head injuries in football and other sports. A movement over the past several years has spawned new research, collaborations and products, including one that’s getting traction helping high school and college sports teams monitor the hits their players sustain.

Impakt Protective Inc. is a Canadian company using sensors to help parents, coaches and athletic trainers identify hard hits that could potentially cause concussions. The company’s Shockbox sensor, powered by a rechargeable battery, is installed with an adhesive into a football or hockey player’s helmet. It measures linear and rotational acceleration and sends data about the forces being applied to players in real-time to a smartphone, laptop or tablet using Bluetooth technology. A mobile alert is triggered any time a player takes a hit above 50 G.

High school football players sustain about 100,000 diagnosed concussions per year, according to the Centers for Disease Control. Concussions occur when impact causes the brain to move violently and suddenly, resulting in a range of ambiguous symptoms including headache, dizziness, nausea or blurred vision. Kids who have concussions are more prone to catastrophic and long-term injuries, said Jonathan French, a neuropsychologist at University of Pittsburgh Medical Center Sports Medicine Concussion Clinic.

One thing worth noting is that the technology’s founders know its own shortcomings. “Concussions in sports has always been a problem and will always continue to be a problem,” Crossman said. “The need is that no one knows when they should start intervention.”

The problem with these kinds of sensors, according to French, who wasn’t familiar with Shockbox, is that there’s no universal threshold for head injury. “The second issue is that once sensor goes off, there’s still the need for a good sideline clinician who can do a thorough evaluation,” he said.

Shockbox doesn’t claim to be a concussion sensor; rather, it’s a tool to help coaches and parents avoid missed head injuries. “It’s kind of like CPR – everyone knows how to do it, but when someone needs it, everyone just looks around because they don’t know when they’re supposed to do it.”

And while some research has indicated that other factors aside from impact are at play in head injuries, Crossman said 50 G seemed like a logical place to start. “There’s a range that starts somewhere around 70-80 G and goes up to 100-110 G – that’s the area where there are most concussions,” he said. “We look at 50 G because in college level sports, 86 percent of hits are below 50 g. We’re looking for the exception cases.”

Shockbox, which is available in retail stores for use in football, hockey and snow sports, has gotten some traction. “We’ve only fully launched it about two to three months ago, and we sold out of our first manufacturing run.” It’s also the supplier of the East Coast Athletic Conference hockey league.

But it’s got some competition. Riddell, which makes the official helmet of the NFL, has a sensor-embedded helmet that allows for sideline monitoring on on-the-field impact, and the NFL is alsoreportedly testing BAE Systems’ helmet sensors developed for the Army.

Starting next spring, the Shockbox sensors will be part of similar smart helmets for football and hockey. But Crossman said the company will continue to focus primarily on youth and college sports, as high school teams often have one athletic trainer covering multiple schools, or maybe student trainers, and have more of a need for this technology.

Crossman wants people to know that Impakt isn’t smoke and mirrors, and that it underpins a lot of its work with research. But he also wants to make sure people understand the purpose of his product. “Brain-Pad just got slapped by the FTC for making false concussion claims – we’re very wary of that,” he said. “We are not a concussion censor. We just want to help them identify when a hit is too hard.”

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Perinatal Outcomes Associated With Obstructive Sleep Apnea in Obese Pregnant Women

In obese women, sleep apnea increases risk of NICU admission from 17% to 46%, cesarean  33 to 65% and preeclampsia 17 to 42%! JR

Perinatal Outcomes Associated With Obstructive Sleep Apnea in Obese Pregnant Women

Louis, Judette MD, MPH; Auckley, Dennis MD; Miladinovic, Branko PhD; Shepherd, Anna BSN; Mencin, Patricia BBA; Kumar, Deepak MD; Mercer, Brian MD; Redline, Susan MD, MPH

Published Ahead-of-Print

Abstract

OBJECTIVE: To investigate the associations between obstructive sleep apnea (OSA) and maternal and neonatal morbidities in a cohort of obese gravid women.

METHODS: Participants were enrolled in a prospective observational study designed to screen for OSA and describe the possible risk factors for and outcomes of OSA among obese (body mass index [BMI, calculated as weight (kg)/[height (m)]2] 30 or higher) pregnant women. Women underwent an overnight sleep study using a portable home monitor. Studies were manually scored by a central masked sleep reading center using American Academy ofSleep Medicine diagnostic criteria. An apnea hypopnea index of 5 or more was considered diagnostic of OSA. Perinatal outcomes were compared between women with and without OSA.

RESULTS: Among 175 women, OSA prevalence was 15.4% (13 mild, nine moderate, five severe). Compared with no OSA (apnea hypopnea index less than 5), the OSA group had a higher BMI (46.8+/-12.2 compared with 38.1+/-7.5; P=.002) and more chronic hypertension (55.6 compared with 32.4%, P=.02). Maternal complications included maternal death (n=1, amniotic fluid embolus [no OSA group]) and cardiac arrest (n=1, intraoperative at cesarean delivery [OSA group]). One previable birth and two stillbirths occurred in the no OSA group. Among live births, OSA was associated with more frequent cesarean delivery (65.4 compared with 32.8%; P=.003), preeclampsia (42.3 compared with 16.9; P=.005), and neonatal intensive care unit admission (46.1 compared with 17.8; P=.002). After controlling for BMI, maternal age, and diabetes, OSA (odds ratio [OR] 3.55, 95% confidence interval [CI] 1.1-11.3), previous preeclampsia (OR 2.79, 95% CI 1.09-7.19), and hypertension (OR 4.25, 95% CI 1.67-10.77) were associated with development of preeclampsia.

CONCLUSION: Obstructive sleep apnea among obese pregnant women is associated with more frequent preeclampsia, neonatal intensive care unit admissions, and cesarean delivery.

LEVEL OF EVIDENCE: II

Abstract here

Monitoring Brain Activity While Studying Can Help Predict Test Performance

A new study shows that using an EEG while a person is studying information can predict their performance on a test.

Research at Sandia National Laboratories has shown that it's possible to predict how well people will remember information by monitoring their brain activity while they study.

A team under Laura Matzen of Sandia's cognitive systems group was the first to demonstrate predictions based on the results of monitoring test volunteers with electroencephalography (EEG) sensors.

For example, "if you had someone learning new material and you were recording the EEG, you might be able to tell them, 'You're going to forget this, you should study this again,' or tell them, 'OK, you got it and go on to the next thing,'" Matzen said.

The team monitored test subjects' brain activity while they studied word lists, then used the EEG to predict who would remember the most information. Because researchers knew the average percentage of correct answers under various conditions, they had a baseline of what brain activity looked like for good and poor memory performance. The computer model predicted five of 23 people tested would perform best. The model was correct: They remembered 72 percent of the words on average, compared to 45 percent for everyone else.

The study is part of Matzen's long-term goal to understand the Difference Related to Subsequent Memory, or Dm Effect, an index of brain activity encoding that distinguishes subsequently remembered from subsequently forgotten items. The measurable difference gives cognitive neuroscientists a way to test hypotheses about how information is encoded in memory.

She's interested in what causes the effect and what can change it, and hopes her research eventually leads to improvements in how students learn. She'd like to discover how training helps people performing at different levels and whether particular training works better for certain groups.

The study, funded under Sandia's Laboratory Directed Research and Development program (LDRD), had two parts: predicting how well someone will remember what's studied and predicting who will benefit most from memory training.

Matzen presented the results of the first part of the study in April at the Cognitive Neuroscience Society conference in Chicago. She presented preliminary findings on the second part this summer to the Cognitive Science and Technology External Advisory Board, made up of representatives of universities, industry and laboratories who advise the investment area team managing the LDRD portfolio.

The second part tested different types of memory training to see how they changed participants' memory performance and brain activity. One of Matzen's goals is to find out whether recording a person's brain activity while they use their natural approach to studying can predict what kind of training would work best for that person.

She's still analyzing those findings, but said preliminary results are encouraging. The computer model from the earlier study was used to predict who would perform best on the memory tasks, and the high performers did even better after memory training.

"That's promising because one of the things we want to do is see if we can use the brain activity to predict how people react to the training, whether it will be effective for them," Matzen said.

A next step would be "to use more real-world memory working tasks, such as what military personnel would have to learn as new recruits, and see if the same patterns apply to more complex types of learning," she said.

About 90 volunteers spent nine to 16 hours over five weeks in testing for the memory training techniques study. Their first session developed a baseline for how well they remembered words or images. Most then underwent memory training for three weeks and were retested.

A control group received no training. A second group practiced mental imagery strategy, thinking up vivid images to remember words and pictures. The final group went through "working memory" training to increase how much information they could handle at a time. Matzen said that averages about seven items, such as digits in a phone number.

Each volunteer, shut into a sound-proof booth, watched a screen that flashed words or images for one second, interrupted with periodic quizzes on how well the person remembered what was shown.

"It's designed to be really difficult because we want lots of room to improve after memory training," Matzen said. The test was divided into five sections, each about 20 minutes long followed by a break to keep volunteers alert.

Each section tested a different type of memory. The first, middle and last sections consisted of single nouns. During quizzes, volunteers hit buttons for yes or no, indicating whether they'd seen the word before. The other two sections combined adjectives and nouns or pairs of unrelated drawings, with volunteers again tested on what they remembered. The image section tested associative memory -- memory for two unrelated things. Matzen said that's the most difficult because it links arbitrary relationships.

When performance was compared before and after training, the control group did not change, but the mental imagery group's performance improved on three of the five tasks.

"Imagery is a really powerful strategy for grouping things and making them more memorable," Matzen said.

The working memory group did worse on four of the five tasks after training.

Volunteers trained on working memory -- remembering information for brief periods -- improved on the task they'd trained on, but training did not carry over to other tasks, Matzen said.

She believes it boils down to strategy: The imagery training group learned a strategy, while working memory training simply tried to push the limits of memory capacity.

While the imagery group did better overall, they made more mistakes than the other groups when tested on "lures" that were similar, but not the same, as items they had memorized.

"They study things like 'strong adhesive' and 'secret password,' and then I might test them on 'strong password,' which they didn't see, but they saw both parts of it," Matzen said. "The people who have done the imagery training make many more mistakes on the recombinations that keep the same concept. If something kind of fits with their mental image they'll say yes to it even if it's not quite what they saw before."

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Study: Noisy Neighborhoods Could Impact Sleep

A new study shows why living in a noisy city or in a busy neighborhood could impact sleep.

If street noise is keeping you up at night, you are certainly not alone, according to a new study.

A new study examines how traffic and street noise affects the annoyance levels and ability to sleep of residents of a major Georgia county.

Researchers at the Centers for Disease Control and Prevention looked at the noise and sleep habits of residents of Georgia's Fulton County (which includes much of Atlanta, as well as other cities including Sandy Springs, Alpharettea, Roswell and College Park).

They found that 9.5 percent of people experienced noise during the daytime that left them feeing highly annoyed. They also found that street noise was putting 2.3 percent of people at a high risk of sleep problems.

Residents of Atlanta, Sandy Springs and Alpharetta constituted most of the people who reported being highly annoyed by street noise, and residents from those cities, plus the city of Roswell, comprised most of the people reporting sleep disturbances, the researchers found.

"This research demonstrated that the overall road traffic noise of a highly urbanized area (i.e., Fulton County [greater Atlanta] GA) can be substantial, which might be indicative of poor environmental quality in this urban community," the researchers wrote in the American Journal of Preventive Medicien study.

Plus, the researchers found that more than half of people who experienced annoyance and sleep problems also happened to live within the "corridor" of the Interstate Highway 285, which runs in the county.

Because Atlanta wasn't even one of the top metro areas to cite traffic noise as an issue in a recent Census Bureau survey, the researchers said that this means residents of other metro areas that have even more traffic noise than Atlanta could be even more at risk of annoyance and sleep disturbances.

"The two psychosocial effects of road traffıc noise (i.e., annoyance and sleep disturbance) have been associated with negative health outcomes and may lead to the development of certain chronic diseases," the researchers wrote in the study.

A recent study also linked traffic noise with the risk of heart attack. That finding, published in the journal PLoS ONE earlier this year, showed tat with every additional 10 decibels of noise from traffic, it ups the risk of heart attack by 12 percent.

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Sleep apnea can also impact children

This article discusses how sleep apnea can impact children and when a child should be evaluated by a professional for sleep apnea.

When we think of a sleeping child, the picture that often comes to mind is of a cherubic face relaxed into a smile, with an air of complete peace about her. This, unfortunately, is not the case for many children (and their parents) whose nights are interrupted by a sleep disorder.

It is generally accepted that from time to time in a child’s life there will be periods when a restful night’s sleep is not a given. For a child with a sleep disorder, those nights can become the norm rather than an occasional occurrence. One type of sleep disorder, obstructive sleep apnea syndrome, is more common in children than one might think and can lead to a whole host of issues during the day for a child who is affected by this condition.

There has been plenty of information made available about obstructive sleep apnea in adults over the last 20 years or so, but rarely have we heard about children being affected with the disorder. About 2 percent of children have sleep apnea, which may not seem like a lot, but to put it into context, of the approximately 16,000 children (birth to age 18) in Livingston County, 320 could possibly have this disorder.

Children who are most at risk for this disorder are those with Down syndrome, cerebral palsy, skull and face abnormalities or those who are overweight.

In a report published in the August 2012 issue of Pediatrics, the American Academy of Pediatricians (AAP) recommends that any child who snores on a regular basis be evaluated for sleep apnea. Symptoms of this sleep disorder can include:

• Frequent snoring
• Problems breathing during the night
• Sleepiness during the day
• Difficulty paying attention
• Behavior problems

In order to make a diagnosis of sleep apnea, usually an overnight sleep study called a polysomnogram will be performed. Sensors are attached to the sleeping child to monitor breathing, oxygen levels and brain waves. This information can help the doctors determine whether sleep apnea is present.

If left untreated, complications that can arise from sleep apnea include cardiovascular problems, poor growth and developmental delays. Treatment often begins with the removal of the child’s tonsils and adenoids, as they are commonly enlarged in these children. This is an effective treatment and will often be all that is required for the child to be symptom free.

A second line of treatment is for the child to use a CPAP machine at night. This is a mask that delivers steady air pressure through the nose, keeping the airways open and allowing for more regular breathing. For children who are overweight, weight loss can improve the symptoms but a CPAP may be necessary until the excess weight is lost.

Getting proper sleep is imperative for a child to grow and develop as best they can. Any sleep disorder that interrupts or decreases the quality of their sleep is a problem worth tackling right away. Quiet nights and happy, thriving kids are things every parent hopes for as they navigate the joys and worries of raising children.

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Gestational Diabetes and Poverty Linked to Increased Chance of ADHD

While gestational diabetes and poverty are shown to have an increased chance of a child having ADHD, breastfeeding shows the opposite effect.

Gestational diabetes and a lower socioeconomic status are the latest environmental factors to be associated with an increased risk of attention-deficit/hyperactivity disorder (ADHD), according to new research.

The German study found that children born to mothers who developed high blood sugar during pregnancy (gestational diabetes) were almost twice as likely to have ADHD as children born to mothers without gestational diabetes. The study also found more than double the risk of ADHD for children born into a family with a low socioeconomic status compared to those in the highest socioeconomic class. Children in the middle class had almost a 60 percent higher rate of ADHD compared to the upper-class children.

"This study found interesting associations that have public health implications," said Dr. Andrew Adesman, chief of developmental and behavioral pediatrics at the Steven and Alexandra Cohen Children's Medical Center of New York, in New Hyde Park, N.Y. Adesman wasn't involved in the current research.

"The U.S. is experiencing an increasing epidemic of obesity, which is a risk factor for gestational diabetes. We need to be mindful of the broader implications of these unfortunate trends. They won't just have an impact on the mother's health, but can also affect the offspring," Adesman said.

The good news from this study is they found that breast-feeding appeared to be protective. Children who were breast-fed were almost 20 percent less likely to develop ADHD, according to the study.

Results of the study were published online as a research letter in the Sept. 10 issue of the Archives of Pediatrics & Adolescent Medicine.

In the United States, more than 5 million children between 3 and 17 years of age have been diagnosed with ADHD, a neurobiological condition that often persists into adulthood. ADHD is characterized by difficulty focusing on tasks and controlling behavior, unusual restlessness and impulsiveness.

The authors of the new study noted they had seen a U.S. study suggesting that gestational diabetes and socioeconomic status might be linked to ADHD. So, they reviewed health information from a national German database and focused on more than 13,000 children and teens from 3 years to 17 years old.

Of that group, nearly 5 percent had an ADHD diagnosis.

In addition to the gestational diabetes and socioeconomic status findings, the researchers found a number of factors associated with the development of ADHD. Boys were more than four times as likely to develop the condition as girls were, according to the study.

Maternal smoking was associated with a nearly 50 percent increased risk of ADHD in the child. Perinatal health problems (such as birth defects, preterm birth and low birthweight) increased the risk of a child developing ADHD by 69 percent, according to the study. Researchers also found that having the allergic skin condition eczema was associated with a 62 percent increased risk of ADHD.

"During pregnancy and for the first few years after birth, the brain is undergoing active development, and is vulnerable to a range of influences," Adesman said.

Dr. Mary Rosser, an assistant professor of obstetrics, gynecology and women's health at Montefiore Medical Center, in New York City, said the study covers new ground.

"We've known for a while that perinatal factors have been cited as potential causes for many childhood problems," Rosser said. "Smoking during pregnancy has always been one of the factors that has been linked to ADHD in kids. This study is one of the first I've seen that's looking at gestational diabetes and ADHD."

Noting that "an unfavorable uterine environment can cause developmental issues," Rosser recommended that women see an obstetrician before getting pregnant, and that they continue prenatal care throughout their pregnancies. This can help prevent or treat some of the issues, such as gestational diabetes, that may contribute to ADHD in the child.

In addition, she recommended that women breast-feed their babies. Breast-feeding may be protective for ADHD, and it's known to be beneficial for the baby's overall health, she said.

The study did not prove that gestational diabetes and a lower socioeconomic status cause ADHD, it merely found an association.

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Scientists Discover Biological Mechanism That Triggers Epileptic Seizures

Scientists have found a biological mechanism that is capable of causing seizures. This is an important discovery for both therapies and future research.

Scientists have discovered the first direct evidence that a biological mechanism long suspected in epilepsy is capable of triggering the brain seizures -- opening the door for studies to seek improved treatments or even preventative therapies.

Researchers at Cincinnati Children's Hospital Medical Center report Sept. 19 in Neuron that molecular disruptions in small neurons called granule cells -- located in the dentate gyrus region of the brain -- caused brain seizures in mice similar to those seen in human temporal lobe epilepsy. The dentate gyrus is in the hippocampus of the temporal lobe, and temporal lobe epilepsy is one of the most common forms of the disorder.

"Epilepsy is one of those rare disorders where we have no real preventative therapies, and current treatments after diagnosis can have significant side effects," said Steven Danzer, PhD, principal investigator on the study and a neuroscientist in the Department of Anesthesia at Cincinnati Children's. "Establishing which cells and mechanisms are responsible for the seizures allows us to begin working on ways to control or eliminate the problem therapeutically, and in a more precise manner."

Epilepsy can develop from a wide range of causes, including birth defects in children that disrupt normal brain development. It can also surface in children and adults who suffer serious brain injuries. These individuals can have high risk of developing some form of epilepsy, depending on the location and severity of their injury, Danzer said.

Technical advances in genetically altering laboratory mice to mimic human disease made it possible for the scientists to generate animals with a specific molecular disruption in dentate gyrus granule cells (DGCs). DGCs are one of only two populations of neural cells that continue to form in significant numbers in the mature brain -- the other being olfactory neurons. This is beneficial considering the hippocampus is responsible for learning and memory, and the dentate gyrus acts as a gate for excitatory signals in the brain that can lead to seizures if not properly regulated.

The presence of abnormal DGCs in epilepsy has been observed for decades, although evidence linking them to seizures was lacking until the current study. Danzer and his colleagues were able to delete a gene called PTEN from mouse DGCs that formed after birth. This caused hyper-activation of a molecular pathway called mTOR (mammalian target of rapamycin), which regulates cell growth and is also linked to tumor formation and cancer when hyper-activated under certain circumstances.

In tests by Danzer and his colleagues, hyper-activation of mTOR caused mice to develop abnormal neural connections among their DGCs -- similar to that observed in human temporal lobe epilepsy -- and the animals experienced seizures. Abnormal neural connections and seizures occurred even in mice that had the PTEN gene deleted in less than 10 percent of their total DGC population, strengthening the link between biological disruption of DGCs and seizures.

When researchers treated epileptic mice with a drug that blocks the mTOR pathway -- rapamycin -- the seizures stopped, solidifying the link to the PTEN-mTOR pathway. Rapamycin has been tested successfully at Cincinnati Children's in the treatment of a disease called tuberous sclerosis, in which benign but still dangerous tumors can form around critical organs. Interestingly, people with tuberous sclerosis are also at risk for developing epilepsy, Danzer said. Newer mTOR inhibitors are also being tested at Cincinnati Children's for the treatment of epilepsy.

Danzer is following up the current study by trying to eliminate abnormal DGCs from the brains of mice that already have epilepsy and to see if this will stop the seizures. Researchers are attempting this by treating mice systemically with diphtheria toxin.

Although diphtheria toxin is not normally toxic to mouse cells, in their experiments the researchers will add a molecule to abnormal mouse DGCs that binds with the toxin. In theory, this should allow the toxin to kill off abnormal DGCs. If treatment stops the seizures, it would further verify the connection between abnormal DGCs and the onset of epilepsy, Danzer said. This would also allow researchers to begin laboratory testing of prospective therapeutic strategies for treatment and prevention.

Mutations involving PTEN and the mTOR pathway have also been identified in other neurological conditions, such as autism and schizophrenia. Danzer said findings in the current study will likely attract the interest of researchers studying these diseases and others involving abnormal granule neurons generated after birth.

"The profound impact of disrupting this pathway in just a small number of granule cells suggests the dentate may be a critical target for mTOR pathway mutations in other neurological diseases," Danzer said. "We believe neuroscientists will be surprised by the huge neurological impact of granule cell disruption and interested in the demonstration of a potentially novel disease mechanism."

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Study Shows Children With Autism Experience Interrelated Health Issues

Children who have autism are more likely to also have anxiety, gastrointestinal issues, and sensory problems, all of which can effect their daily lives.

One in 88 children has been diagnosed with an autism spectrum disorder (ASD) in the United States, according to the Centers for Disease Control and Prevention. A new study by a University of Missouri researcher found that many children with ASD also experience anxiety, chronic gastrointestinal (GI) problems and atypical sensory responses, which are heightened reactions to light, sound or particular textures. These problems appear to be highly related and can have significant effects on children's daily lives, including their functioning at home and in school.

Micah Mazurek, an assistant professor of health psychology and a clinical child psychologist, found in her study of 2,973 children and adolescents with ASD that nearly one-fourth also had chronic GI problems, such as constipation, abdominal pain, bloating, diarrhea or nausea. The results also showed that children with chronic GI problems were more likely to experience anxiety and sensory problems.

"These problems can have a very real impact on daily life. Children with anxiety may be distressed or reluctant to engage in new activities, and those with sensory problems may have trouble paying attention or participating in over-stimulating enviornments," Mazurek said. "These children may also suffer uncomfortable GI problems that they may not be able to communicate about to adults."

Clinicians should be aware that anxiety, GI problems and sensory sensitivity often co-occur in individuals with ASD. Effectively managing these concurrent issues may improve children's quality of life and their responses to treatment, Mazurek said.

"Parents need to be aware that these problems may underlie some of their children's difficulties, so if they notice any symptoms, they should talk to their doctors or therapists about treatment options," Mazurek said. "Practitioners who work with children with ASD need to be mindful that there is a pretty high rate of these problems, so if children are treated for one issue, it may helpful to screen for these additional symptoms."

This is the first study to examine the relationships among anxiety, GI problems and sensory over-responsivity in a large, nationally representative sample of children and adolescents with ASD. Participants in the study were enrolled in the Autism Treatment Network, a network of 17 autism centers throughout North America that are focused on best practices for medical treatment of children with ASD.

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