Study: Child's Cry Acoustics to Determine Risk for Autism

A new study looks at the acoustics of a child's cry to determine autism risk.

Autism is a poorly understood family of related conditions. People with autism generally lack normal social interaction skills and engage in a variety of unusual and often characteristic behaviors, such as repetitive movements. While there is no specific medical treatment for autism, some success has been shown with early behavioral intervention.

Understanding the importance of early diagnosis, researchers at Women & Infants' Brown Center for the Study of Children at Risk in collaboration with researchers at University of Pittsburgh have been studying the cry acoustics of 6-month-old infants. Their research has recently been published in Autism Research.

"Because we can measure various aspects of babies' cries from the earliest days of life, it may be possible to use this technique to identify risk for neurological problems such as autism long before we can detect behavioral differences," said Stephen J. Sheinkopf, PhD, lead researcher, psychologist at the Brown Center for the Study of Children at Risk, and assistant professor (research) in the Department of Psychiatry and Human Behavior at The Warren Alpert Medical School of Brown University.

The study examined ways in which infants at risk for autism produced cries as compared to the cries of low-risk infants. Recordings of babies' cries were excerpted from vocal and video recordings of six-month-old infants at risk for autism spectrum disorder (ASD) and those with low risk. Infants were considered to be at risk if they had an older sibling with a confirmed ASD diagnosis.

Cries were categorized as either pain related or non-pain related based on observations of the videotapes. At-risk infants produced pain related cries with higher and more variable fundamental frequency (commonly referred to as "pitch") as compared to low-risk infants. A small number of the at-risk infants were later diagnosed with an ASD at 36 months of age. The cries for these babies had among the highest fundamental frequency values and also differed in other acoustic characteristics.

"These findings demonstrate the potential of this approach for babies as young as six months of age," said Dr. Sheinkopf.

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New anticonvulsants are here and more are coming!

The newest Epilepsy Medications  or AEDs

• Clobazam
• Eslicarbazepine acetate*
• Ezogabine (retigabine)*
• Lacosamide
• Perampanel
• Rufinamide
• Vigabatrin

*Not  available in  USA

Youngest Kids in Class May Be More Likely to Get ADHD Diagnosis, Study Claims

A study claims that the youngest children in the class may be incorrectly diagnosed with ADHD and medicated due to a natural lack in maturity.

A new study from Iceland adds to existing evidence that kids are more likely to be diagnosed with attention deficit hyperactivity disorder if they're among the youngest in their grade at school.

The findings suggest -- but don't prove -- that some children are diagnosed with attention deficit hyperactivity disorder (ADHD) when they're just less mature than their peers.

"Educators and health-care providers should take children's ages in relation to their [classmates] into account when evaluating academic performance and other criteria for ADHD diagnosis," said study author Helga Zoega, a postdoctoral fellow at Mount Sinai School of Medicine in New York City. "Parents can use these findings to help inform their decisions about school readiness for children born close to cutoff dates for school entry."

Debate has erupted in recent years about whether ADHD is overdiagnosed in children who are naturally rambunctious and don't need to be medicated.

Earlier this year, a Canadian study found that more boys aged 6 to 12 were diagnosed with ADHD if they were the youngest in their grade levels: the percentages were 7.4 percent among the youngest boys and 5.7 percent among the oldest.

There also was a gap between older and younger girls, although they're much less likely than boys to be diagnosed with ADHD.

The new study tracked nearly 12,000 children born between 1994 and 1996 in Iceland, where there's also been a debate over the diagnosis of the condition and the use of stimulants to treat it, Zoega said. The researchers looked at the children's test scores at ages 9 and 12, and examined whether they were prescribed drugs for ADHD.

Overall, 740 children -- about 6 percent of the total -- were prescribed ADHD drugs at some point from 2003 to 2009.

Children in the youngest third of their classes were 50 percent more likely than those in the oldest third to be prescribed ADHD medications from ages 7 to 14.

The study also found that "being younger relative to one's classmates affects academic performance throughout childhood," Zoega said.

Richard Morrow, a health research analyst at the University of British Columbia who studies ADHD, said the findings are consistent with those from other countries.

"In the education system, it leads to the question, 'What strategies or resources do we need to help ensure the well-being of all children in the classroom, where children vary in age by up to a year?' " he asked. "Parents need to be aware that if behavioral issues arise for their child, this may be related to their child's relative age in the classroom.

"Similarly, doctors need to consider a child's relative age in school or other settings such as athletics before making a diagnosis or writing a prescription," Morrow added. "Lastly, we may need to revisit how the diagnosis is defined to lessen the risk of inappropriate diagnosis."

The findings appear online Nov. 19 and in the December print issue of the journal Pediatrics.

So what can be done?

"Children behave and perform according to their own maturity level within the classroom," Zoega said. "Being younger relative to one's classmates affects academic performance throughout childhood. When evaluating whether a child has ADHD, this should be taken into account to prevent unnecessary diagnoses and prescribing of stimulants."

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Changes to Brain in Post-Concussion Syndrome may Lead to Better Treatment

Those who suffer from Post-Concussion Syndrome, present in some with traumatic brain injury, may get better treatment after brain changes are identified.

Researchers who identified brain changes in people with post-concussion syndrome say their findings may lead to improved detection and treatment of the disorder.

Symptoms of post-concussion syndrome, which occurs in 20 percent to 30 percent of people who suffer mild traumatic brain injury, include headache and memory and concentration problems.

In this study, published online Nov. 21 in the journal Radiology, researchers conducted MRI brain scans of 18 healthy people and 23 people who had symptoms of post-concussion syndrome two months after suffering a mild-traumatic brain injury.

The MRI scans were done when the participants' brains were in a resting state, such as when the mind wanders or while daydreaming. It is believed that the resting state involves connections among a number of brain regions and that the default-mode network plays a major role, study author Dr. Yulin Ge, an associate professor in the radiology department at the NYU School of Medicine in New York City, said in a journal news release.

Previous research has shown that the default-mode network is altered in people with brain disorders such as Alzheimer's disease, autism and schizophrenia.

This study found that communications and information integration in the brains of the people with post-concussion syndrome were disrupted among key default-mode network structures, and that the brain had to tap into different areas to compensate for this impaired function.

Through their ongoing research, Ge and colleagues hope to identify a biological feature, or biomarker, that can be used to monitor post-concussion syndrome progression and recovery, and to assess the effects of treatment.

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Study: Continued Use of ADHD Drugs May Reduce Criminal Behavior

According to research from Sweden, people who routinely take their ADHD medication are less likely to be arrested.

For teens and adults who don't grow out of attention deficit hyperactivity disorder, staying on ADHD medications may help them stay out of trouble.

Males with ADHD who stayed on medications for the disorder reduced their risk of criminal behavior by 32 percent, while women who did so reduced their rates of criminal behavior by 42 percent, according to a large Swedish study.

"It seems as though ADHD medications decrease the risk for criminality while under treatment," said the study's lead author, Paul Lichtenstein, professor of genetic epidemiology at the Karolinska Institute, in Stockholm.

Results of the study are published in the Nov. 22 issue of the New England Journal of Medicine.

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, said past research has found that adults with ADHD have a "host of increased risks later in life, like driving accidents, losing jobs, divorce and arrests." Adesman said those at greatest risk of criminal behavior are those with hyperactivity.

Adesman added that it's important for parents to know that not all children with ADHD will engage in criminal behavior, and that some children will outgrow ADHD. Still, "collectively, people with ADHD are at risk for a range of poor outcomes," he said.

For the current study, the researchers gathered information on more than 25,000 people living in Sweden with a diagnosis of ADHD. They also collected information on what types of medications were given as treatment, and any criminal convictions that occurred between 2006 and 2009.

Researchers then compared non-medication periods to medication periods and the rates of criminal behavior for each person.

The risk of criminal activity dropped by more than a third for men and women combined during medication periods, according to the study.

Lichtenstein said the researchers didn't study whether medications were more effective in reducing criminal behavior for a particular age group. They also didn't look at whether one type of medication was better at decreasing the risk of criminal activity, but he said those that influence the core symptoms of ADHD -- such as impulsivity, restlessness and irritability -- are likely to be better at reducing criminal behavior.

Lichtenstein said ADHD medications should be seriously considered for adolescents and young adults with ADHD who are at risk for criminal behavior.

"All medications have potential adverse side effects, and the clinician should weigh risks and benefits for each patient," he added. "Now, they should include the potential decreased risk of criminality in that evaluation."

For his part, Adesman said that based on the findings of this study, it looks as though treatment with ADHD medication can make a difference in the risk of criminal behavior. But, he said, it's important to realize that the population in this study isn't the same as the population in the United States, so the findings might be different if the study were done here.

Adesman said it is also important not to "presume that children diagnosed with ADHD today have the same risks of criminality as people diagnosed 20 years ago, given the greater awareness, education resources and support that is available today."

However, he added, "I suspect that symptomatic people probably do better with medications."

Although the study found an association between staying on ADHD medication and reduced criminal behavior, it did not prove a cause-and-effect relationship.

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Survey shows kids in the US are getting enough sleep

A survey shows that children in the United States do get enough sleep, despite concerns of the contrary.

"Our estimates are in line with the amount of sleep recommended for children by the [U.S.] Centers for Disease Control and Prevention, which suggests that children in the U.S. are getting an appropriate amount of sleep on average," said study author Jessica Williams, a doctoral candidate at the Fielding School of Public Health at the University of California, Los Angeles. 

The finding stems from an in-depth look at current sleep norms among infants and children, as reflected by data collected in 1997—with follow-ups in 2002 and 2007—by a large National Science Foundation survey that set out to assess behavioral and mental health development from birth through age 18. 

Williams and her colleagues report their findings in the Nov. 26 online issue of the Archives of Pediatrics & Adolescent Medicine. 

The authors noted that the CDC recommends that children between the ages of 1 and 3 years get roughly 12 to 14 hours of sleep per day, while those between ages 3 and 5 years should get 11 to 13 hours per day. By the time kids reach the ages of 5 to 10 years, 10 to 11 hours of sleep are deemed sufficient. By adolescence, 8.5 to 9.5 hours of sleep is considered enough. 

In the survey, childhood activities, including sleep time, were detailed in family diaries logged by survey participants, which initially included about 2,800 children, later dropping to about 1,400 children by the final follow-up. 

The investigators determined that infants were sleeping an average of 13-plus hours per day, a figure that slowly but continuously fell as they aged through adolescence. By the time teens were between 14 and 18 years old, the average amount of sleep hovered at about nine hours per day, with all the figures holding up regardless of race or ethnicity. 

Daytime sleep was much higher among infants, with a fall-off by the time children reached school age. The team further observed that older children tended to sleep more during the weekend than during the week.

The researchers concluded that American children do seem to be getting the recommended amount of age-appropriate sleep, contrary to what they suggested was mostly unsubstantiated anecdotal evidence that recent generations of infants, preteens and teens have been struggling with mounting sleep deprivation. 

That said, Williams cautioned that while her analysis shed some light on the normal patterns of sleep among American children—and how closely they matched current recommendations—it did not render any verdict as to whether or not such patterns are, in fact, healthy. 

But Williams nonetheless suggested that the norms observed in the study might "be used by clinicians and parents to determine when a child falls far from the median as a signal that that child's sleep patterns may need further assessment." 

For her part, Shelby Freedman Harris, director of the behavioral sleep medicine program and of the Sleep-Wake Disorders Center at Montefiore Medical Center in New York City, said that "this study stands out because it suggests something very different than previous reports of sleep averages in kids." 

She noted: "Many papers have found that kids are getting less sleep on average than this paper did. Others suggest different sleep averages based on racial/socioeconomic differences, and these researchers didn't. The averages that each age group [were] getting in this study was on par with the current sleep-need guidelines in the sleep field." 

However, added Freedman Harris, who is also an assistant professor of neurology and psychiatry at the Albert Einstein College of Medicine, "What is not surprising though, but consistent with pediatric sleep knowledge, is the gradual decrease of sleep-need as kids get older. Sleep helps kids' bodies grow at a rapid rate. It helps their brains develop. As they get older and drop naps, their total sleep times gradually decrease. In adolescence, it is thought that teens' melatonin levels drop off and delay, leading to later bed [times]." 

Melatonin is a hormone that helps regulate the body's sleep-wake cycles. 

Freedman Harris also stressed that the amounts of sleep found in the study aren't necessarily the ideal for kids' health. "It does help to guide treatment recommendations though, if a child is significantly higher or lower, sleep-wise, than the average," she said.

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Study: Early Autism Intervention Improves Brain Responses to Social Cues

A study shows promising signs that behavioral intervention can positively change brain function in toddlers with autism.

An autism intervention program that emphasizes social interactions and is designed for children as young as 12 months has been found to improve cognitive skills and brain responses to faces, considered a building block for social skills. The researchers say that the study, which was completed at the University of Washington, is the first to demonstrate that an intensive behavioral intervention can change brain function in toddlers with autism spectrum disorders.

"So much of a toddler's learning involves social interaction, and early intervention that promotes attention to people and social cues may pay dividends in promoting the normal development of the brain and behavior," said Geraldine Dawson, lead author and chief science officer for the advocacy group Autism Speaks.

"For the first time, parents and practitioners have evidence that early intervention can result in an improved course of both brain and behavioral development in young children," she said.

Dawson began the study while she was the director of the UW Autism Center. The study was published online Oct. 26 in the Journal of the American Academy of Child & Adolescent Psychiatry.

Forty-eight children, aged 18 to 30 months and diagnosed with autism, either participated in routine community-based interventions or the Early Start Denver Model, which emphasizes interpersonal exchanges and shared participation in activities. The model was developed by Dawson and co-author Sally Rogers, a professor at the UC Davis MIND Institute.

Participants received one of the interventions for about 20 hours each week over a period of two years. For the children randomly assigned to the ESDM group, treatment took place two hours, twice a day, five days a week, by trained interventionists who came to the child's home. The children got an extra boost from their parents, who were trained to use ESDM strategies during routine exchanges with their child.

A previous study found that the ESDM intervention improved IQ, language, and adaptive skills and the researchers wanted to know if the approach also led to brain changes.

After two years of treatment, the brain function of the participants -- now about four to five years old -- was measured with electroencephalography while the youngsters viewed social stimuli, such as faces, and nonsocial stimuli, such as toys.

"Humans are experts at processing faces, but the brains of children with autism have delays in the ability respond to faces," said co-author Sara Webb, a UW research associate professor. If the brain can quickly identify a face, she said, then it can build on this to also quickly decide whether the face is of a man or a woman, happy or sad, and familiar or not.

Children in both intervention groups showed similar brain responses to faces as did children in a control group who did not have autism, suggesting that "the high level of intervention in both groups allowed the children with autism to catch up to the children in the control group," Webb said. "That's fantastic news."

Looking at a higher level of brain processing, the researchers studied whether the treatments changed brain measures of attention and cognitive engagement when seeing faces compared with a nonsocial stimulus. Eleven of 15 -- or 73 percent -- of children in the ESDM group showed greater attention to faces than to toys. In contrast, the EEGs of only five of the 14 recipients of the community intervention, or 36 percent, showed similar activation.

"The ESDM intervention resulted in greater attention and cognition brain activity to social stimuli, and these brain function patterns are more similar to the typical developing group of children," Webb said.

She stressed not only the importance of receiving intensive early intervention for autism, but that the intervention should focus on enhancing social attention, reciprocal interactions and engagement with a social partner.

Other study authors at UW are Emily Jones, Kaitlin Venema, Rachel Lowy, Susan Faja, Dana Kamara, Michale Murias, Jessica Greenson, Jamie Winter and Milani Smith, as well as Kristen Merkle of Vanderbilt University.

The study was funded by a grant from the National Institute of Mental Health and an Autism Speaks postdoctoral fellowship awarded to Jones.

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Surgery and Epilepsy in Children

This article discusses epilepsy in children and when medications can be discontinued following surgery. Also there is a discussion of when surgery should be considered as a treatment. JR

Around one in every hundred people worldwide is affected by epilepsy, with 40 per cent of them developing the condition before the age of 15. If patients with epileptic fits do not respond to antiepileptic drugs, epilepsy surgery can be used to remove the part of the brain that is responsible for the fits so that the patient can be free of them. Afterwards, the prompt discontinuation of medication is of significant therapeutic interest. 

Until now, it was not known when the most favourable time was for this without running an increased risk of further fits. Now, an international team of researchers, with collaboration from the MedUni Vienna, has discovered that discontinuing medication even immediately after the operation represents a promising approach.

At the MedUni Vienna and the Vienna General Hospital, the Epilepsy Centre in the Children's Department, which is run by Martha Feucht and Gudrun Gröppel, was involved in the "Time to Stop" study group. The study has now been published in the highly respected journal Lancet Neurology. The study included 766 children and young adults with epilepsy. The result: "If the epilepsy surgery was one hundred per cent successful, patients no longer need to take antiepileptic drugs. 

Early and rapid discontinuation of the medication after the operation does not influence the subsequent outcome of the recovery," says Feucht. "On the contrary, early discontinuation 'unmasks' any inadequate surgical results and therefore leads to new diagnostic procedures more quickly." Most centres have so far waited at least two years before even discussing any attempt to discontinue medication. "This means a major improvement in the quality of life of children affected by the condition, and better chances of post-operative development that is as free from problems as possible," explains the MedUni scientist.  "Epilepsy surgery procedures are already being carried out on small children aged just a few months. The younger the patients are, the more important these findings are for them." 

Two types of epilepsy suitable for surgical intervention

There are generally two types of epilepsy that are amenable to surgical intervention: symptomatic and cryptogenic epilepsy. The condition is referred to as being symptomatic if there is a known cause (e.g. a tumour or following birth trauma), while the term cryptogenic means "hidden". In this case, the cause is unclear. There is also a condition known as genetic epilepsy, which is primarily hereditary and which can be treated very effectively with medication.
 
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Why the Holidays can Trigger Migraines

This article discusses why migraines can result from extra stress resulting from the holidays.

People who suffer from migraine headaches face additional triggers during the holiday season.

"During the holidays, people's sleep/wake cycles are often skewed," said Dr. Karen Lauze, a neurologist at Portsmouth Regional Hospital. "They do not get enough sleep. Traveling through different time zones and the stress of travel can trigger a headache."

And there is the convergence of family members.

"If there are family conflicts," Lauze said, "it can make a difference, although both good and bad stress can trigger a migraine. Excitement, as much as bad stress can be a factor. Then you add in a lot of bright lights, flashing camera bulbs and noises and all your triggers are thrown into play."

Food can also be a trigger, Lauze said, along with red wine, spirits, certain cheeses, chocolate and nuts, as well as foods containing MSG.

"Butternut squash contains a great deal of MSG," she said. "Skipping lunch, altering the timing of food is another. Weather, a change in barometric pressure is a big trigger. Even flying, while the cabin is theoretically pressurized, changes your system. If there is only one trigger, the person may be OK. Add two or more and a migraine is likely."

People who are aware of their susceptibility can take steps to try to prevent migraines. Lauze said they can take increased levels of their prescribed medication, under the advice of their doctor. They can also try to assure they get enough sleep and avoid foods they know are triggers.

"If you are traveling to see family and can afford it, it might be better to pay the extra money for a hotel room," Lauze said. That way, you can retreat to the quiet when family wants to stay up all night. Plan ahead. Maybe use biofeedback meditation and relaxation techniques. We do offer that training here at the hospital."

It takes time to relieve painful symptoms of a migraine. Lauze said medications like Aleve or Imitrex can help. Caffeine has been known to help some people although she cautions that too much can increase anxiety, and make the pain worse.

There are medications that can be prescribed to decrease the frequency of attacks. Healthy lifestyle changes can also reduce the number and severity of migraines. Avoiding the activities, foods or situations that have triggered migraines in the past is one of the best prevention tools. Don't smoke. Estrogen-based medications, such as birth control pills or hormone replacement therapy, may need to be reduced or replaced with other methods.

Lauze said she considers biofeedback techniques and other alternative therapies such as acupuncture and chiropractors as long-term solutions. But, she said they can be used to lessen the severity and frequency of migraine headaches.

Craig Shannon, a Portsmouth based chiropractor, said he treats many patients who suffer from migraines.

"We can't cure migraines but we can lower the triggers," Shannon said. "By adjusting the cervical area (neck) we can remove pinched nerve areas to allow for freer blood circulation and that does help a lot. Think of a garden hose. Step on it and it is blocked. Take your foot off and the water flows again. We see fast results in our patients and I think it's neat to see them come here after trying a lot of other things and finding relief."

Dr. Christopher Santini, a chiropractor in York, Maine, agrees. He said he works to improve proper motion and posture. He also looks at his patient's lifestyle.

"We do nutritional counseling because certain foods or the chemicals in them are factors," Santini said. "If we can figure out when they get the headaches and what they were doing at its onset, we can often help them avoid a future migraine once their body is in proper alignment."

Carie Bernard, a licensed acupuncturist who works with Santini, said she approaches the pain itself.

"Where there is pain, there is an imbalance," Bernard said. "There is a loss of energy and things are not flowing as they should. I do a complete intake. I observe the whole person, take their pulse and look at their tongue. It is not a one size fits all medicine. I need to find out where their blockage is and treat it. Ten people may present in ten different ways."

Portsmouth acupuncturist Bridget Lewis Holzer said once you figure out the trigger, fine needles are used on the proper points to treat the condition. Magnets are used effectively on young children. She said location of the points for the needles varies with the triggers that are responsible.

Adam Learner of Family Acupuncture and Wellness of Portsmouth said acupuncture can provide both immediate relief and can be used as a long term therapy for prevention.

"If it's a chronic problem, they might come weekly at first," Learner said.

"Eventually, they might come once a month, for maintenance of their condition. It varies with the individual. Acupuncture is on of the best treatments for migraine headaches. We treat a fair number of patients here and finding the underlying cause is the key to successful treatment."

Learner added wheat and dairy products to the list of food triggers. He said he puts his patients on a "challenge diet" in order to ferret out their triggers.

The bottom line is that, with care, holiday stress does not have to be the source of a migraine headache, Lauze said.

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Five "Natural" Cures for Migraines

A few points about herbals and supplements as a critique. 

"Natural" does not mean inert. Fever few and butterburr can have side effects and the long term effects are not known. One active component of feverfew "parthenolide" can induce cell death in in-vitro cancer models...whoa.....I suggest great caution in using these in children and young people.

Dont forget riboflavin! B2 is water soluble.

Reliability of these preparations can vary almost 40 fold. 

But who can argue with exercise, good posture, trigger elimination and good sleep? JR


This article discusses five natural treatments that may help cure your migraines.

A debilitating headache or migraine will not only put a damper on your day, it will stop you in your tracks and have you running for a dark room and cool head cloth. If you find yourself regularly reaching for pain relievers, you may want to implement these natural headache treatments and migraine remedies for taking the edge off.

Identify your triggers: In my clinical practice I have seen patients eliminate their migraines just by discovering their food allergies. In fact, I had one patient discover that the grapefruit she had enjoyed each morning with her breakfast for over 20 years was the instigator behind her pounding headaches. To determine the true culprit behind your distress I recommend doing a two week elimination diet. This includes the removal of all of the most common food allergies (all grains that contain gluten, dairy, citrus, peanuts, caffeine, sugar and soy). After the 14-day removal period you should slowly reintroduce the foods one at a time. By doing so, any physical or mental symptoms related to the food can be isolated. Don’t just be on the lookout for headaches. Common symptoms of a food allergy include: gas, bloating, constipation, headaches/migraines, fatigue immediately after eating the food, fatigue on waking the next day, or a gradual decline in energy, irritability, anxiety, headaches, water retention (can’t get your rings off) and dark circles under the eyes.

Straighten up your posture: Tight muscles in the neck and traps can be a one way ticket to head pain, especially when it’s linked to weak back and neck muscles, and poor posture. Acupuncture (http://nccam.nih.gov/health/acupuncture/acupuncture-for-pain.htm), chiropractic, massage and osteopathic manual therapy have all been shown to alleviate tight muscles and reduce pain sensors. In one study chronic tension headache sufferers received structured massage therapy treatment directed toward neck and shoulder muscles. Researchers found that the treatment was effective in reducing both the number and duration of headaches. For best results, ask your practitioner for some homework to do in between treatments. This may include corrective exercises, ergonomic adjustments (particularly at work) and even relaxation techniques to relieve tension in the muscles of the neck and upper back.

Bump up your magnesium: I have written about the benefits of magnesium before and luckily, it is also a powerful defense against headaches. Magnesium can affect the regulation of blood flow to the brain, which can be compromised during a migraine attack. In one study, the treatment group, receiving 600mg of magnesium for a 12 week period, experienced a 41.6% reduction in headaches as compared to only 15.8% reduction in migraine headaches in the placebo group. Additional research suggests that magnesium supplements may shorten the duration of a migraine and reduce the amount of medication needed. As an added bonus, magnesium is a natural muscle relaxer, so you may find that supplementation reduces other muscle aches and pains. I recommendtaking magnesium glycinate or citrate, taken to bowel tolerance each night (approximately 200mg – 600mg). If you get loose stools you can reduce the dose.

Check out some herbals: Out of all the herbal medicines, feverfew has the most promise for its ability to decrease the frequency and/or intensity of their migraine attack. In one study, 72 volunteers were randomly allocated to receive either one capsule of dried feverfew leaves a day or matching placebo for four months and then transferred to the other treatment for a further four months. Treatment with feverfew was associated with a reduction in the mean number and severity of attacks in each two-month period. Feverfew seems to work its magic by inhibiting the production of inflammatory substances and re-establishing proper blood vessel tone. Another herbal preparation, butterbur, has been shown to relax the blood vessels of the brain which can prevent headaches. As with all herbal medications, they require consistent usage for optimal benefits. I recommend working with a naturopath or herbalist to determine the dosage that is best for you.

Cool Your headaches with Coq10: Coenzyme Q10 (also known as CoQ10) plays a critical role in the function of your cells. The supplement has also been found to reduce migraine attacks in humans, according to a double-blind placebo-controlled study. Researchers studied 42 subjects who suffered an average of 4.4 migraine attacks per month. Approximately 48 percent of the CoQ10 group experienced a 50% response rate during the three-month study. In addition, the patients treated with CoQ10 experienced fewer migraine attacks per month, 2 after treatment compared to 4.4 before treatment, while the placebo group experienced no reduction in migraine frequency. CoQ10-treated subjects also had more headache-free days than the placebo group and fewer days with nausea. Supplementation with CoQ10 may not only improve your energy but also your heart health, blood sugar balance, nervous system and help to manage high cholesterol and high blood pressure in individuals with diabetes. Take 100mg up to two times daily.

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Study: Autism Risk for Developing Children Exposed to Air Pollution

This study discusses a possible link between exposure to air pollution during pregnancy or while an infant and the development of autism in the child. Is this another epigenetic factor? JR

Research conducted by University of Southern California (USC) and Children's Hospital Los Angeles scientists demonstrates that polluted air -- whether regional pollution or coming from local traffic sources -- is associated with autism.

The study titled "Traffic Related Air Pollution, Particulate Matter, and Autism," shows that exposure to traffic-related air pollution during pregnancy and the first year of life is associated with a more than two-fold risk of autism. In addition, exposure to regional pollution consisting of nitrogen dioxide (NO₂) and small particles -- particulate matter less than 2.5 and 10 microns in diameter (PM2.5 and PM10) -- is also associated with autism even if the mother did not live near a busy road. The study is published in theArchives of General Psychiatry, a sister publication of the Journal of the American Medical Association.

"This work has broad potential public health implications," said the study's principal investigator, Heather Volk, Ph.D., assistant professor of preventive medicine at the Keck School of Medicine of USC and investigator in the Division of Research on Children, Youth and Families at Keck School-affiliated Children's Hospital Los Angeles. "We've known for a long time that air pollution is bad for our lungs, and especially for children. We're now beginning to understand how air pollution may affect the brain."

The research is the first to look at the amount of near-roadway traffic pollution individuals were exposed to and combine that with measures of regional air quality. The study builds on previous research by Volk and colleagues that examined how close subjects lived to a freeway, said Volk, who also has appointments at the Keck School's Zilkha Neurogenetic Institute and Department of Pediatrics.

"We took into account how far away people lived from roads, meteorology such as which way the wind was blowing, how busy the road was, and other factors to study traffic-related pollution," she said. "We also examined data from air quality monitors, which measure pollution over a larger region that could come from traffic, industry, rail yards, or many other sources."

In the 2012 study, Volk and colleagues from USC and the University of California, Davis examined data on 279 autism cases and 245 control subjects enrolled in the California-based Childhood Autism Risks from Genetics and the Environment (CHARGE) study. Mothers' addresses from birth certificates and addresses reported from a residential history were used to estimate exposure during each trimester of pregnancy and the first year of life. The researchers used air pollution levels derived from the Environmental Protection Agency's Air Quality System to determine exposure to NO2, PM2.5, and PM10. They also applied dispersion models to estimate the amount of traffic the mothers and children were exposed to.

Particularly interesting was the effect of mothers' and children's exposure to particles, both PM10 and PM2.5. PM10 includes both coarse and fine particles, while PM2.5 includes only the smaller (fine) particles, which are most likely to have deleterious effects on the human body.

"From studies conducted in the lab, we know that we can breathe in tiny particles and they can produce inflammation," said Volk. "Particles have varied composition, and there are many chemicals that can bind to them. The components of these particles could be hazardous to the brain."

Other researchers who participated in the study include Irva Hertz-Picciotto, University of California, Davis; Rob McConnell from USC; and Fred Lurmann and Bryan Penfold from Sonoma Technology, Inc.

The research was funded by the National Institute of Environmental Health Sciences (grant 1 R21 ES019002-01).

Volk and colleagues are now at work on a study of how genes related to autism may be affected by environmental exposures to try to identify if there are factors that make people are genetically more vulnerable to particular pollutants.

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Cholinergic Autonomic Dysfunction in Veterans With Gulf War Illness

Robert W. Haley, MD; Elizabeth Charuvastra†, RN; William E. Shell, MD; David M. Buhner, MD; W. Wesley Marshall, MD; Melanie M. Biggs, PhD; Steve C. Hopkins, BS; Gil I. Wolfe, MD; Steven Vernino, MD, PhD

Arch Neurol. 2012;():1-10. doi:10.1001/jamaneurol.2013.596.

Published online November 2012

Background  The authors of prior small studies raised the hypothesis that symptoms in veterans of the 1991 Gulf War, such as chronic diarrhea, dizziness, fatigue, and sexual dysfunction, are due to cholinergic autonomic dysfunction.

Objective  To perform a confirmatory test of this prestated hypothesis in a larger, representative sample of Gulf War veterans.

Design  Nested case-control study.

Setting  Clinical and Translational Research Center, University of Texas Southwestern Medical Center, Dallas.

Participants  Representative samples of Gulf War veterans meeting a validated case definition of Gulf War illness with 3 variants (called syndromes 1-3) and a control group, all selected randomly from the US Military Health Survey.

Main Outcome Measures  Validated domain scales from the Autonomic Symptom Profile questionnaire, the Composite Autonomic Severity Score, and high-frequency heart rate variability from a 24-hour electrocardiogram.

Results  The Autonomic Symptom Profile scales were significantly elevated in all 3 syndrome groups (P < .001), primarily due to elevation of the orthostatic intolerance, secretomotor, upper gastrointestinal dysmotility, sleep dysfunction, urinary, and autonomic diarrhea symptom domains. The Composite Autonomic Severity Score was also higher in the 3 syndrome groups (P = .045), especially in syndrome 2, primarily due to a significant reduction in sudomotor function as measured by the Quantitative Sudomotor Axon Reflex Test, most significantly in the foot; the score was intermediate in the ankle and upper leg and was nonsignificant in the arm, indicating a peripheral nerve length–related deficit. The normal increase in high-frequency heart rate variability at night was absent or blunted in all 3 syndrome groups (P < .001).

Conclusion  Autonomic symptoms are associated with objective, predominantly cholinergic autonomic deficits in the population of Gulf War veterans.

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Experts claim too much technology use can give you 'semi-somnia'

This article discusses a newly identified sleep disorder called 'semi-somnia' caused by too much stress and technology use.

A growing number of people are now suffering from a newly identified sleep disorder called 'semi-somnia' triggered by stress and technology use, sleep experts say. Rather than totally sleepless nights, sufferers of semi-somnia experience short bouts of sleep disruption - perhaps on particularly busy or stressful days, experts claim. An Indian-origin expert has even coined a phrase 'fizzy sleep' to explain sleep difficulties faced by sufferers. "It's not a scientific term, but clients say that's what their head feels like. They are asleep but it's not restful. It's a jangly, information-filled sleep where the brain is still highly active," said Dr Nerina Ramlakhan, a sleep coach at London's Capio Nightingale hospital, and author of the book Tired But Wired. The condition is being called insomnia's irritating little sister, but despite not sharing the full agonising symptoms of acute sleeplessness - which has been linked to weakened immune systems, depression, high blood pressure and even heart disease - semi-somnia is far from harmless, the 'Daily Mail' reported. Victims may wake every night for 30 minutes, or find it impossible to sleep for an hour because their minds are racing. Experts are of the opinion that semi-somnia started plaguing people now because of excessive use of technology. "We've spent five years researching this with 30,000 sufferers and technology is probably the main cause," said Jean Gomes, chairman of The Energy Project - a consultancy to help people counteract tiredness issues. "You may have had a stressful day, but your mind could process problems overnight and you'd wake the next day refreshed. Now the ways we relax - shopping online, tweeting while watching television and checking Facebook- mean our brains are in a permanent state of arousal. When bedtime comes around, this can cause big problems," Gomes said. For people to sleep, three main things happen: the decline in light triggers the production of the sleep-inducing hormone melatonin, our temperature starts to fall and our mind and body relax, allowing our nervous system to switch off. Using technology interferes with each of those steps, experts believe. Sleep is when the mind processes the information we've taken in throughout the day, but the huge amount of material people now consume online can simply be too much to deal with. "The part of the brain that deals with information processing is relatively small - and it can't cope with the sheer amount of input it's getting now," said Ramlakhan. "Take information "minibreaks" every 90 minutes through the day to give your mind some space. Drink lots of water. Your bladder will then force you to take a time out - and don't take your phone to the bathroom with you," she suggested. Read more here

Study: Link found between flu during pregnancy and infant autism

A study from Denmark examines a link between having the flu or prolonged fever during pregnancy and the chance of the infant having autism.

An epidemiologic study from Denmark has raised the possibility that influenza and fever during pregnancy increase the risk of autism in infants, but the findings are far from conclusive.

The researchers studied the records of more than 96,000 children and interviewed their mothers about infections during pregnancy. About 1% of those children had autism spectrum disorder (ASD) or infantile autism. The researchers found signs that flu during pregnancy doubled the risk of infantile autism and that prolonged fever during pregnancy tripled it.

But because they assessed so many pregnancy-related variables, they said those findings could have shown up merely by chance, and much more research is needed. Their report was published online yesterday by Pediatrics.

Clue from animal studies
Evidence from animal studies suggests that activation of the immune system during pregnancy can cause problems with brain development in fetuses, the report says. Hence the research team set out to assess whether common infections, febrile episodes, or use of antibiotics during pregnancy were associated with a risk of ASD or autism in babies.

Using the Danish national birth cohort and the Danish Psychiatric Central Register, the team examined data on 96,736 children born from 1997 to 2003. In telephone interviews they questioned the children's mothers about infections, febrile episodes, and antibiotic use during pregnancy and the early postpartum period. The questions covered 11 types of infections and symptoms and five classes of antibiotics.

The team found that 976 (1%) of the children had ASD, including 342 (0.4%) with infantile autism.

The researchers found no significant associations between overall ASD and specific types of infections. But when they looked at infantile autism only, they found that flu during pregnancy was associated with a 2.3-fold increase in risk (adjusted hazard ratio, 2.3; 95% confidence interval [CI], 1.0 to 5.3).

Similarly, febrile episodes in general were not associated with any increase in risk of ASD or autism. But febrile episodes longer than 7 days were associated with a 1.6-fold increase in the risk of ASD (95% CI, 1.0 to 2.5) and a 3.2-fold jump in the risk of infantile autism (95% CI, 1.8 to 5.6).

The analysis also linked the use of various antibiotics during pregnancy with a small increase in risk of ASD or infantile autism. The use of sulfonamides or penicillin raised the risk by about 50%, and the use of macrolides increased the risk of infantile autism 2.2-fold (95% CI, 1.1 to 4.4).

A major qualifier
But the researchers take pains to explain that these hints of associations could be pure chance findings rather than evidence of a real connection.

"A great limitation of this study is that we made 106 adjusted comparisons; thus, the few statistically significant associations observed could be chance findings," they state. "The study is explorative, and we thus made no adjustments for multiple testing."

In fact, they add, "None of the statistically significant findings would have survived any correction for multiple comparisons."

Their overall conclusion is that there was little evidence that self-reported common infections during pregnancy are risk factors for ASD in children. On the other hand, the findings alone do not rule out a possible association. "We emphasize the need for further research on this important topic," the report concludes.

Andrew T. Pavia, MD, chief of the Division of Pediatric Infectious Diseases at the University of Utah, agreed with the authors' caveats about their findings.

"This is an interesting study, but at best exploratory," Pavia commented by e-mail. "In addition to being exploratory, the major limitation is statistical. As the authors point out, the associations they found were just marginally statistically significant in the way they approached the analysis, meaning there would be about a 5% chance of finding an association by chance alone when there was in fact no association."

Pavia said the problem of multiple comparisons makes the findings "relatively unreliable," although the topic deserves more research.

"In essence the problem of multiple comparisons is that if you look at 20 random variables (cystitis, penicillin, herpes outbreaks, etc) then on average you will find one association by chance alone with a 'statistically significant' P value of 0.05," he said. "The authors looked at 106 variables, which suggested that on average they would find 5 significant associations that were due to chance alone. They found about that [many]."

He added that the relatively wide confidence intervals noted in the findings, with lower limits as low as 1.0, support the possibility that they could have occurred by chance.

Pavia also commented, "This type of epidemiological study may eventually point us in the right direction, but no single study can be taken alone. This is analogous to some of the studies of heart disease and diet, where depending on the study and the methods, a given food may or may not appear to be associated with disease. Epidemiologists understand this, but when the public hears about each study with a weak effect, it becomes pretty chaotic."

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Brain Compensates After Traumatic Injury, Evidence Shows

ScienceDaily (Nov. 26, 2012) — Researchers at Albert Einstein College of Medicine of Yeshiva University and Montefiore Medical Center have found that a special magnetic resonance imaging (MRI) technique may be able to predict which patients who have experienced concussions will improve. The results, which were presented November 26 at the annual meeting of the Radiological Society of North America (RSNA), suggest that, in some patients, the brain may change to compensate for the damage caused by the injury.

"This finding could lead to strategies for preventing and repairing the damage that accompanies traumatic brain injury," said Michael Lipton, M.D., Ph.D., who led the study and is associate director of the Gruss Magnetic Resonance Research Center at Einstein and medical director of MRI services at Montefiore, the University Hospital and academic medical center for Einstein.
Each year, 1.7 million people in the U.S., sustain traumatic brain injuries (TBI), according to the Centers for Disease Control and Prevention. Concussions and other mild TBIs (or mTBIs) account for at least 75 percent of these injuries. Following a concussion, some patients experience a brief loss of consciousness. Other symptoms include headache, dizziness, memory loss, attention deficit, depression and anxiety. Some of these conditions may persist for months or even years in as many as 30 percent of patients.

The Einstein study involved 17 patients brought to the emergency department at Montefiore and Jacobi Medical Centers and diagnosed with mTBI. Within two weeks of their injuries, the patients underwent diffusion tensor imaging (DTI), which "sees" the movement of water molecules within and along axons, the nerve fibers that constitute the brain's white matter. DTI allows researchers to measure the uniformity of water movement (called fractional anisotropy or FA) throughout the brain. Areas of low FA indicate axonal injury while areas of abnormally high FA indicate changes in the brain.

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Epilepsy Care for Adults Needs Improvement

This article discusses epilepsy care in adults and how the standard of care needs to be improved.

Only about half the U.S. adults with active epilepsy see a specialist for their condition, the CDC reported Friday.

In 2010 about 1% of those 18 or older reported a diagnosis of epilepsy coupled with recent seizures or with medication to control attacks – so-called "active" epilepsy, agency researchers reported in the Nov. 16 issue ofMorbidity and Mortality Weekly Report.

Another 0.8% had been diagnosed with the condition but reported they had not had a seizure in the previous year and were not taking medication – defined as "inactive" epilepsy.

But in both groups, the proportion that reported recent consultation with a specialist was low – 53.4% and 6.9%, respectively.

Combined, just 33.4% of those with any history of epilepsy had visited a neurologist or epilepsy specialist in the previous year, the CDC analysis showed.

The findings are based on data from the 2010 National Health Interview Survey, an annual cross-sectional survey of the civilian, non-institutionalized U.S. population. Statistical software applied to the survey respondents generates population estimates, the agency noted.

Based on the 27,139 adults surveyed, the researchers estimated that there are 4.1 million adults in the U.S. who have been diagnosed with the condition, including 2.3 million with active and 1.7 million with inactive disease.

While they appeared to make limited use of specialty care, they were more likely to visit a generalist physician than the non-epileptic population, the agency found.

Specifically, 86.4% of adults with active epilepsy and 76.6% of those with any form of the condition had visited a generalist in the previous 12 months, compared with 66.1% of those without epilepsy.

The agency also found that the prevalence of the condition did not vary by age, sex, or education, but those with a history of epilepsy were more likely to be white or black or to live in families at the lowest income level.

For example, among those living in families with annual incomes of $34,999 or less, 3.1% reported a history of epilepsy and 1.9% had active disease.

The agency cautioned that the estimates are based on self-reported data and could be subject to reporting bias. In addition, reported cases are not classified by seizure type, severity, or etiology and some other forms of seizure might have been misclassified, inflating the prevalence estimates.

The findings form a baseline, the agency noted, from which a Healthy People 2020 objective can be developed.

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