Sunday, April 18, 2021

Neuromodulation for appetite control in Prader Willi

More literature how TDCS can modify food craving in Prader Willi. 

Call our office for an appointment to see if your child is a candidate. 


Prader–Willi syndrome (PWS) is a neurodevelopmental genetic disorder characterized by multiple system involvement with hypotonia, poor suck with feeding difficulties, growth and other hormone deficiencies, intellectual disability, and behavioral problems with childhood onset of hyperphagia resulting in obesity, if not externally controlled. Transcranial direct current stimulation (tDCS) has been increasingly shown to modulate cognitive and behavioral processes in children and adults, including food-intake behaviors in patients with PWS. This study further reports the positive effects of brief tDCS sessions on Go/NoGo task performance involving food and non-food stimuli images, alterations in N2 brain amplitude, and genetic subgroup differences (maternal disomy 15, UPD; 15q11-q13 deletion, DEL) before and after tDCS as assessed by event-related potentials (ERPs) in 10 adults with PWS. The results indicate a group effect on baseline NoGo N2 amplitude in PWS patients with DEL vs UPD (p =0.046) and a decrease in NoGo N2 amplitude following tDCS (p = 0.031). Our tDCS approach also demonstrated a trend towards decreased response time. Collectively, these results replicate and expand prior work highlighting neurophysiological differences in patients with PWS according to genetic subtype and demonstrate the feasibility in examining neuromodulatory effects of tDCS on information processing in this patient population to stimulate additional research and treatment.

Transcranial stimulation may reduce appetite in Prader Willi

Sunday, February 07, 2021

Concussion Mild Brain Injury in Children Lasts Longer than a Few Weeks


Hate to spoil the Super Bowl ...

But, so many kids suffer from brain injury that is unrecognized. It’s true in Houston Texas and elsewhere. 


Post Here

Friday, February 05, 2021

Autism and Maternal Antibodies

 This is an interesting article about association without a clinical application at this time. 


Risk assessment analysis for maternal autoantibody-related autism (MAR-ASD): a subtype of autism


The incidence of autism spectrum disorder (ASD) has been rising, however ASD-risk biomarkers remain lacking. We previously identified the presence of maternal autoantibodies to fetal brain proteins specific to ASD, now termed maternal autoantibody-related (MAR) ASD. 

The current study aimed to create and validate a serological assay to identify ASD-specific maternal autoantibody patterns of reactivity against eight previously identified proteins (CRMP1, CRMP2, GDA, NSE, LDHA, LDHB, STIP1, and YBOX) that are highly expressed in developing brain, and determine the relationship of these reactivity patterns with ASD outcome severity. We used plasma from mothers of children diagnosed with ASD (n = 450) and from typically developing children (TD, n = 342) to develop an ELISA test for each of the protein antigens. 

We then determined patterns of reactivity a highly significant association with ASD, and discovered several patterns that were ASD-specific (18% in the training set and 10% in the validation set vs. 0% TD). 

The three main patterns associated with MAR ASD are

  • CRMP1 + GDA (ASD% = 4.2 vs. TD% = 0, OR 31.04, p = <0.0001), 
  • CRMP1 + CRMP2 (ASD% = 3.6 vs. TD% = 0, OR 26.08, p = 0.0005) 
  • NSE + STIP1 (ASD% = 3.1 vs. TD% = 0, OR 22.82, p = 0.0001). 

Additionally, we found that maternal autoantibody reactivity to CRMP1 significantly increases the odds of a child having a higher Autism Diagnostic Observation Schedule (ADOS) severity score (OR 2.3; 95% CI: 1.358–3.987, p = 0.0021). 

This is the first report that uses machine learning subgroup discovery to identify with 100% accuracy MAR ASD-specific patterns as potential biomarkers of risk for a subset of up to 18% of ASD cases in this study population.

Monday, November 23, 2020

Cannabis Epilepsy Trivia

Cannabis Trivia  

CBD has been in the news as a treatment for many conditions epilepsy. It was widely used for millennia by Indian "Arabian" and Persian medical traditions.

Q: When was cannabis first described in WESTERN medical literature as a TETANUS treatment?

A: 1839

Saturday, September 19, 2020

Medication Use ADD ADHD and Risk of Motor Vehicle Crashes

 Is there a relationship between medication use and a LOWER risk of accidents? 


Short term? Yes.

Long-term? Yes.

Men? Yes.

Women? Yes. 

Please take your medicines. 

Association Between Medication Use for Attention-Deficit/Hyperactivity Disorder and Risk of Motor Vehicle Crashes


Is the use of attention-deficit/hyperactivity disorder medication associated with a reduced risk of motor vehicle crashes in patients with the disorder?


In a national cohort study of 2 319 450 patients with attention-deficit/hyperactivity disorder, the use of medication for the disorder was associated with a significant reduction in the risk of motor vehicle crashes in male and female patients.


Attention-deficit/hyperactivity disorder medication use may lower the risk of motor vehicle crashes, a prevalent and preventable cause of mortality and morbidity among patients with the disorder.

ADHD & Accidents Crashes Violations Suspensions in Motor Vehicles - New Data

 Do teens with ADHD have more accidents? More Moving Violations?

Yes. For Years,

Traffic Crashes, Violations, and Suspensions Among Young Drivers With ADHD

Accidents and Moving Violations in ADHD (purple) vs Control (orange)Allison E. Curry, PhD, MPH,corresponding authora,b Benjamin E. Yerys, PhD,c,d Kristina B. Metzger, PhD, MPH,a Meghan E. Carey, MS,a and Thomas J. Power, PhDb,d


Methods: We identified patients of New Jersey primary care locations of the Children's Hospital of Philadelphia who were born in 1987-1997, were New Jersey residents, had their last primary care visit at age ≥12 years, and acquired a driver's license (N = 14 936). Electronic health records were linked to New Jersey's licensing, crash, and violation databases. ADHD diagnosis was based on International Classification of Diseases, Ninth Revision, Clinical Modification diagnostic codes. We calculated monthly per-driver rates of crashes (at fault, alcohol related, nighttime, and with peers), violations, and suspensions. Adjusted rate ratios were estimated by using repeated-measures Poisson regression.

Objectives: To compare monthly rates of specific types of crashes, violations, and license suspensions over the first years of licensure for drivers with and without attention-deficit/hyperactivity disorder (ADHD).

Results: Crash rates were higher for drivers with ADHD regardless of licensing age and, in particular, during the first month of licensure (adjusted rate ratio: 1.62 [95% confidence interval: 1.18-2.23]). They also experienced higher rates of specific crash types: their 4-year rate of alcohol-related crashes was 2.1 times that of drivers without ADHD. Finally, drivers with ADHD had higher rates of moving violations (for speeding, seat belt nonuse, and electronic equipment use) and suspensions. In the first year of driving, the rate of alcohol and/or drug violations was 3.6 times higher for adolescents with ADHD.

Conclusions: Adolescents with ADHD are at particularly high crash risk in their initial months of licensure, and engagement in preventable risky driving behaviors may contribute to this elevated risk. Comprehensive preventive approaches that extend beyond current recommendations are critically needed.