Adolescent brain sensitivity

A few studies indicate that an adolescent's brain may be especially sensitive to new memories, drug use, and social stress.

Adolescence, like infancy, has been said to include distinct sensitive periods during which brain plasticity is heightened; but in a review of the neuroscience literature published on September 23 in Trends in Cognitive Sciences, University College London (UCL) researchers saw little evidence for this claim. However, a small number of studies do support that memory formation, social stress, and drug use are processed differently in the adolescent brain compared to other periods of life.

"Conclusively proving that adolescent sensitive periods exist will require studies comparing children, adolescents, and adults and will need to take into account individual differences in adolescent development," says Delia Fuhrmann, a PhD student in UCL's Institute of Cognitive Neuroscience Developmental Group. "Adolescents are much more likely than children to choose their own environments and choose what they want to experience."

Humans retain some plasticity--changes in brain and behavior in response to environmental demands, experiences, and physiological changes--throughout life. However, during sensitive periods plasticity is heightened and the brain "expects" to be exposed to a particular stimulus. For example, the brains of infants are primed to process visual input and language.

The ability to form memories seems to be augmented during adolescence, one example for how it may be a sensitive period. Memory tests in different cultures show a "reminiscence bump"; at 35 or later, we are more likely to recall autobiographic memories from ages 10 to 30 years than memories prior or subsequent. The recall of music, books, films, and public events from adolescence is also superior compared with that from other periods.

Further, they point out that simple aspects of working memory or ongoing information processing may reach maturity in childhood, while more complex, self-organized working memory abilities continue to improve during early adolescence and recruit frontal brain regions that are still developing. "Working memory can be trained in adolescents, but we don't know how these training effects differ from other age groups," Fuhrmann says. "Such data would be useful for planning curricula because it would tell us what to teach when."

Many mental illnesses have their onset in adolescence and early adulthood, possibly triggered by stress exposure. The UCL team explored studies indicating that both social stress and social exclusion have a disproportionate impact during adolescence. They also argue that adolescence may be a vulnerable period for recovery from these negative experiences.

"Adolescents are slower to forget frightening or negative memories," says Fuhrmann. "This might mean that some treatments for anxiety disorders, which are based on controlled exposure to whatever a patient is afraid of, might be less effective in adolescents and alternative treatments might be needed."

Finally, studies showed that adolescence is also a time of heightened engagement in risky health behaviors, such experimenting with alcohol and other drugs. Young adolescents seem to be particularly susceptible to peer influence on risk perception and risk taking compared with other age groups. Research in rodents also supports that adolescent brains might have an increased sensitivity to marijuana.

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Study shows younger children recover quicker from concussions than adolescents

A study shows that younger children recover quicker from concussions than adolescents do.

Children aged 10 years and younger appear to recover faster from concussion than those older than 10, study findings indicate.

The difference may be related to symptom severity, mechanism of injury, or a lower incidence of premorbid conditions, according to Rejean M. Guerriero, DO, of Boston Children's Hospital and Harvard Medical School, who reported the findings during a session at the American Academy of Neurology 2015 Annual Meeting.

It's well understood that young adults have slower neurocognitive recovery compared to adults, however there's little data on children in the 5- to 10-year range. Using a Standardized Clinical Assessment and Management Plan, Guerriero and colleagues collected data on 466 patients who presented at a pediatric neurology clinic with concussion, including 93 patients 10 years or younger and 373 patients aged 10 to 21. Data included demographics, clinical presentation, premorbid conditions, diagnostic testing, and treatments.

Overall, premorbid conditions were more common among older patients than younger patients, especially headache (14.37 versus 12.77 years, P<0.001) and psychiatric comorbidities (22.9% anxiety, 8.9% depression, 15.6% attention problems vs. 9.8%, 0%, 7.3%, respectively), while learning disabilities and ADHD/ADD were equally as common among both older and younger populations, particularly in a pediatric neurology practice.

Children 10 years and under had significantly lower scores on the post-concussion symptom scale across all domains — headache, vestibular, cognitive, and sleep — than older children, except for emotional symptoms. Younger children also recovered more quickly from concussion (mean 61 days for ≤10 vs. 74 days for >10, P=0.01). Guerriero noted that while the data from the study can be applied to all children, the younger children in this unique population (neurology practice vs. primary care/clinic/ED) took longer than typical to recover from concussion: 14 – 30 days for standard recovery vs. 60 days in the study.

“It's hard to know whether (comorbidities) affect susceptibility,” Guerriero said, referencing the younger population's seeming ability to recover from concussion faster. “It's certainly well known that learning disabilities, migraine headaches, and behavioral issues are all risk factors for prolonged neurocognitive symptoms, but at this point it seems less likely that those characteristics put patients at greater risk for concussion.”

The researchers also suggested that the similar emotional symptom scores in both younger and older children may reflect the post-concussion symptom scale's inability to detect subtle emotional symptoms in younger children.

“Younger kids may be more resilient or they may not know better, so they  bounce back (from injury) and think, ‘What do I have to be anxious about? It's fine and I feel better,'  where as older kids, who may watch the news or have other exposures, think ‘Jeez, am I going to have chronic brain problems now?'”

While children 10 and under may be more resilient in terms of knowledge of injury and brain health baseline, Guerriero stressed that physicians need to be more conscious of subtle changes in behavior that may not be self-reported by younger children or their parents.

“There are other scales specifically geared toward identifying emotional issues in younger children that highlight trouble with transitions and irritability, which physicians can use in younger patients that may be more sensitive than aspects of the post-concussive symptom score.”

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Kids with ADHD may be more likely to drink and smoke

A study shows that kids who have ADHD may be more likely to drink and smoke as teenagers.

Teens are more likely to start smoking or drinking with each additional symptom they have of attention-deficit hyperactivity disorder (ADHD) or conduct disorder, new research suggests.

"Our findings underscore the need to counsel families about the risk of substance use as [these] children approach adolescence," said study author Dr. William Brinkman, research director at Cincinnati Pediatric Research Group, which is part of Cincinnati Children's Hospital. "This need is heightened among children with ADHD and/or conduct disorder diagnoses or symptoms."

Brinkman's team analyzed data on more than 2,500 teens, aged 12 to 15, in a national survey conducted with their parents between 2000 and 2004.

First, the researchers identified the teens with an ADHD and/or conduct disorder diagnosis, as well as those with the symptoms of either disorder, regardless of whether there was a diagnosis. Conduct disorder is characterized by aggressive, destructive or deceitful behavior. Children with ADHD tend to be hyperactive, impulsive and/or inattentive.

Then Brinkman's team compared use of tobacco and alcohol among the teens, to look for a link between symptoms of ADHD or conduct disorder and substance use.

Brinkman said that 45 percent of the children in the study had at least one ADHD symptom, and nearly 15 percent had at least one conduct disorder symptom.

For each additional ADHD symptom related to inattention -- but not hyperactivity or impulsivity -- the risk that a teen would use tobacco or alcohol increased by 8 percent to 10 percent. Similarly, each additional conduct disorder symptom was linked to a 31 percent increase in the likelihood of using tobacco, according to the study.

A very small percentage of teens in the study -- about 1.5 percent -- were diagnosed with both ADHD and conduct disorder. These teens were more than three times more likely to use tobacco or alcohol, even after accounting for differences in age, race/ethnicity, sex, household income and having a household member who smoked.

The findings were published recently in the journal Drug and Alcohol Dependence.

Brinkman said more research may provide clues as to why the link exists between these disorders and substance use.

"Because nicotine can improve attention and arousal, some have speculated that the association between inattention symptoms and higher rates of tobacco use suggests a form of self-medication for ADHD," Brinkman said. "Certainly higher rates of risk taking and novelty seeking has been documented among children with a diagnosis of ADHD, as well as those with ADHD symptoms [but too few for a diagnosis]."

Social pressures may be involved as well, suggested Dr. Glen Elliott, chief psychiatrist and medical director of Children's Health Council in Palo Alto, Calif.

"It is important to emphasize that not all teens with ADHD follow this path, just a higher percentage than those without ADHD," Elliott said. "We believe it is a combination of impulsive decision-making and perhaps the social strain that ADHD can place on the individual, who may feel unable to connect with peers in socially acceptable ways and therefore more vulnerable to trying other methods such as doing things peers dare them to do or that they view as 'cool' or 'adult.' "

Elliott said the study provides new insights into the interplay between ADHD and conduct disorder. But it sheds little light on whether treating ADHD, either earlier in childhood or during adolescence, might change the risk of starting to smoke or drink, he said.

"We believe medication can make a difference, but the evidence is not nearly as compelling as we wish it were -- partly because teens often go through a phase of refusing to take medications just when it might do them the most good," Elliott said. "Just as with parents of any teenager, there is no guaranteed way to prevent a son or daughter from experimenting if they are determined to do so."

The best tools parents have, Elliott said, are setting consistent and clear expectations for their children, closely monitoring them, praising them for good choices and administering appropriate, meaningful consequences for poor choices -- while also showing children early on what behavior is acceptable.

"Adolescence is hard," Elliott said. "And having ADHD can make it harder. So parents need to be vigilant, caring, consistent and involved."

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FDA approves migraine prevention medication for adolescents

The FDA has approved Topamax for migraine prevention in adolescents aged 12 to 17 years old. This is the first approved medication for this purpose in this age group.

Today, the U.S. Food and Drug Administration approved Topamax (topiramate) for prevention (prophylaxis) of migraine headaches in adolescents ages 12 to 17. This is the first FDA approval of a drug for migraine prevention in this age group. The medication is taken on a daily basis to reduce the frequency of migraine headaches.

Topamax was first approved by the FDA in 1996 to prevent seizures. It was approved for migraine prevention in adults in 2004.

“Migraine headaches can impact school performance, social interactions, and family life,” said Eric Bastings, M.D., deputy director of the Division of Neurology Products in the FDA’s Center for Drug Evaluation and Research. “Adding dosing and safety information for the adolescent age group to the drug’s prescribing information will help to inform health care professionals and patients in making treatment choices.”

About 12 percent of the U.S. population experiences migraine headaches. Migraine headaches are characterized by episodes of throbbing and pulsating pain in the head, and may occur several times per month. Other common symptoms include increased sensitivity to light, noise, and odors, as well as nausea and vomiting. Many patients experience their first migraine attack before reaching adulthood, and migraine can be just as disabling in teens as it is in adults.

The safety and effectiveness of Topamax in preventing migraine headaches in adolescents ages 12 to 17 was established in a clinical trial that enrolled 103 participants. Those treated with Topamax experienced a decrease in the frequency of migraine of approximately 72 percent compared to 44 percent in participants that took an inactive drug (placebo). 

The most common adverse reactions with the approved dose of Topamax (100 milligrams) were paresthesia (a burning or prickling sensation felt in the hands, arms, legs, or feet), upper respiratory infection, anorexia (loss of appetite), and abdominal pain.

Topamax must be dispensed with a Medication Guide that describes important safety information about the drug. Topamax and all anti-epileptic drugs may increase the risk of suicidal thoughts and behavior, and patients should be advised of the need to be alert for the emergence of, or worsening of, the signs and symptoms of depression, or unusual changes in mood or behavior.

Topamax increases the risk of the development of cleft lip and/or cleft palate (oral clefts) in infants born to women who take the drug during pregnancy. The benefits and risks of Topamax should be carefully weighed before using it in women of childbearing age.  If the decision is made to use the medication by a woman of childbearing age, effective birth control should be used.

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ADHD medication use leads to BMI rebound

A study of ADHD stimulant medication shows that its use is associated with BMI rebound later in adolescence.

A new study from researchers at Johns Hopkins Bloomberg School of Public Health found that children treated with stimulants for attention deficit hyperactivity disorder (ADHD) experienced slower body mass index (BMI) growth than their undiagnosed or untreated peers, followed by a rapid rebound of BMI that exceeded that of children with no history of ADHD or stimulant use and that could continue to obesity.

The study, thought to be the most comprehensive analysis of ADHD and stimulant use in children to date, found that the earlier the medication began, and the longer the medication was taken, the slower the BMI growth in earlier childhood but the more rapid the BMI rebound in late adolescence, typically after discontinuation of medication. Researchers concluded that stimulant use, and not a diagnosis of ADHD, was associated with higher BMI and obesity. The study was published in Pediatrics.

"Our findings should motivate greater attention to the possibility that longer-term stimulant use plays a role in the development of obesity in children," said Brian S. Schwartz, MD, MS, Professor of Environmental Health Sciences, Epidemiology, and Medicine at the Bloomberg School of Public Health and lead author of the study. "Given the dramatic rise in ADHD diagnosis and stimulant treatment for it in recent decades, this is an interesting avenue of research regarding the childhood obesity epidemic, because the rises in each of these roughly parallel one another."

Previous research has found substantial evidence that stimulant use to treat ADHD is associated with growth deficits, and some evidence of growth delays. However, the reported associations of ADHD with obesity in both childhood and adulthood was paradoxical and somewhat unexplained. The results of this study suggest it is likely due to the strong influence that stimulants have on BMI growth, with delays in early childhood and a strong rebound in late adolescence. The study also found longitudinal evidence that unmedicated ADHD is associated with higher BMIs, but these effects were small.

ADHD is one of the most common pediatric disorders, with a 9% prevalence among children in the U.S., and ADHD medication is the second most prescribed treatment among children. Over the past 30 years, treatment for ADHD with stimulants has increased rapidly. From 2007 to 2010, 4.2.% of children under age 18 had been prescribed stimulants in the past 30 days, more than five times the amount prescribed to the same-aged children between 1988 and 1984.

The study analyzed the electronic health records of 163,820 children, ages 3 to 18, in the Geisinger Health System, a Pennsylvania-based integrated health services organization. The research geographic area included 37 counties in central and northeastern Pennsylvania. There were an equal number of boys and girls. Nearly 7% -- 11,080, or 6.8% -- had an order for stimulants. (13,789, or 8.4%, received a diagnosis of ADHD. A total of 15,473 were prescribed stimulants, some for other reasons.) There were 201,854 orders for the ADHD medications used in the analysis. The median age at first stimulant use was 8.5 years. Median use was 183 days, with 50% of children taking stimulants for less than 6 months and 50% of children for more than 6 months.

The researchers compared the BMI trajectories of those who had never had a diagnosis or prescription (the "controls") with three groups: 1.) those with a diagnosis but no stimulant prescription; 2.) those with orders for stimulants without an ADHD diagnosis and 3.) those with both an ADHD diagnosis and stimulant orders.

Those in group 3 had slower rates of BMI growth in early childhood, with more rapid rates during adolescence that eventually exceeded those of the controls. Those with a diagnosis of ADHD but no stimulant orders had more rapid BMI growth after age 10 versus the controls, but the effects were small.

"Stimulant use was strongly implicated," said Dr. Schwartz. "The earlier stimulants were started and the longer they were used, the stronger was their influence on the degree of both the delayed BMI growth in early childhood and the rebound BMI growth in late adolescence. This is an important unintended consequence of stimulant use in childhood."

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Study: Later school start times are beneficial for adolescents

A study shows that later school start times result in improved sleep quality and a better overall mood in adolescents.

Julie Boergers, Ph.D., a psychologist and sleep expert from the Bradley Hasbro Children's Research Center, recently led a study linking later school start times to improved sleep and mood in teens. The article, titled "Later School Start Time is Associated with Improved Sleep and Daytime Functioning in Adolescents," appears in the current issue of the Journal of Developmental & Behavioral Pediatrics.

"Sleep deprivation is epidemic amongadolescents, with potentially serious impacts on mental and physical health, safety and learning. Early high school start times contribute to this problem," said Boergers. "Most teenagers undergo a biological shift to a later sleep-wake cycle, which can make early school start times particularly challenging. In this study, we looked at whether a relatively modest, temporary delay in school start time would change students' sleep patterns, sleepiness, mood and caffeine use."

Boergers' team administered the School Sleep Habits Survey to boarding students attending an independent high school both before and after their school start time was experimentally delayed from 8 to 8:25 a.m. during the winter term.

The delay in school start time was associated with a significant (29 minute) increase in sleep duration on school nights, with the percentage of students receiving eight or more hours of sleep on a school night jumping from 18 to 44 percent. The research found that younger students and those sleeping less at the start of the study were most likely to benefit from the schedule change. And once the earlier start time was reinstituted during the spring term, teens reverted back to their original sleep levels.

Daytime sleepiness, depressed mood and caffeine use were all significantly reduced after the delay in school start time. The later school start time had no effect on the number of hours students spent doing homework, playing sports or engaging in extracurricular activities.

Boergers, who is also co-director of the Pediatric Sleep Disorders Clinic at Hasbro Children's Hospital, said that these findings have important implications for public policy. "The results of this study add to a growing body of research demonstrating important health benefits of later school start times for adolescents," she said. "If we more closely align school schedules with adolescents' circadian rhythms and sleepneeds, we will have students who are more alert, happier, better prepared to learn, and aren't dependent on caffeine and energy drinks just to stay awake in class."

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Sleep Tips for Children and Teens

This article discusses good sleep habits for children and teenagers.

When it comes to good sleep habits, the old saying "early to bed, early to rise, make a person healthy,wealthy and wise," has never been truer.

 

May is designated as Better Sleep Month, a good time to review some good sleep habits for kids and teens. Mohsin Maqbool, M.D., Director of the Pediatric Neurology Sleep Center and Laboratory on staff at the DMC Children’s Hospital of Michigan offers the following tips.

 

• The amount of sleep needed for optimal brain development in children varies with age. Newborns sleep up to 20 hours per day. The sleep requirement decreases in toddlers down to 12 to 14 hours of nightly sleep with naps during the day.
• A child’s bedroom should be cool, quiet and comfortable. Children who stare at clocks should have their clocks turned away from them. Bedtime should follow a predictable sequence of events, such as brushing teeth and reading a story.
• Avoid spending lots of non-sleep time in bed — spending hours lying on a bed doing other activities before bedtime keeps our brains from associating the bed with sleep time.
• Going to bed in a timely manner, assuring sufficient sleep duration, is the key to getting up on time in the morning, refreshed.
• Keep consistent bedtimes and wake times every day of the week. Late weekend nights or sleeping-in can throw off a sleep schedule for days.
• Adolescents can benefit from a daytime nap. A short nap (20 to 30 minutes) in the afternoon has shown to improve physical efficiency and cognitive performance. The key here is that the nap should not be longer than 45 minutes or else grogginess kicks in.
• Avoid high stimulation activities just before bed, such as watching television, playing videogames, communication with friends, or exercise. It is especially important to avoid these acitivites during a nighttime awakening. It is best not to have videogames, televisions, computers or phones in the child’s bedroom.
• Avoid caffeine (sodas, chocolate, tea, coffee) in the afternoons/evenings. Even if caffeine doesn’t prevent falling asleep it can still lead to shallow sleep or frequent awakenings. Caffeine should be avoided within 4 to 6 hours of bedtime.
• If a child is awake in bed tossing and turning, it is better for them to get out of bed to do a low stimulation activity, (i.e., reading) then return to bed later. This keeps the bed from becoming associated with sleeplessness. If the child is still awake after 20 to 30 minutes, spend another 20 minutes out of bed before lying down again.

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Teen Sleep Issues - Back to School Considerations

The big game is coming - that is, the first day of school! I recommend that parents start shifting bedtimes now so there are no surprises as we get back to school. JR

This article discusses effects of sleep deprivation on teens and adolescents. This is very important to address with school starting back up.

Is your adolescent yawning during the day and struggling to fall asleep at night? 

Is your child persistently late for school or falling asleep in class? 

The problem could easily be not enough sleep. 

Is your adolescent impulsive, hyperactive, irritable, unfocused and performing poorly in school? Again, not enough sleep?

At least nine hours of “quality” sleep or more is optimal for children ages 13-18, according to Sarah Morsbach Honaker, Ph.D., a pediatric behavior sleep medicine specialist at the University of Louisville School of Medicine who spoke Thursday at the American Psychological Association Convention in Orlando. 

That number goes up the younger the child.

Sleep deprivation is a common adolescent diagnosis because teens stay up late then oversleep, which exacerbates the problem because they literally have less time in the light. “They delay the Circadian Sleep Rhythm because they don’t get light exposure until they wake up,” Dr. Honaker explained.

Pediatric sleep apnea is also problematic where poor quality of sleep interrupts the REM phase and disrupts how the child functions when awake, often mimicking ADHD characteristics, she adds.

Interventions like going to bed early enough on weeknights to get nine hours of sleep are challenging, when biologically teens aren’t tired until 10 or 11 p.m. and high school schedules have them up and out sometimes before the sun comes up.

 Or, convincing your child to shut down electronics an hour before bedtime and creating a calming environment with music, reading, or puzzles. Even a little before bed conversation with family members has been shown to help.
 Imagine that. “The blue light from electronic screens sends strong signals to the brain suppressing melatonin and inhibiting sleep,” she says. “Instead of TV, games or Internet surfing, experiment with other before bed activities to promote readiness for a good night’s sleep.”

If you notice your child operates well with a summer schedule and falls apart during the school year then seeing a sleep professional in advance could be helpful to realign the Circadian rhythm. “The first line of treatment is behavioral intervention,” Dr. Honaker says. “Light therapy, sleep scheduling, and melatonin pills are others. 

Sleep medications are not approved by the FDA for use by children and adolescents.”

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Doctors claim sleeplessness eroding public health

Emergency room doctors helped implement seatbelt use, lung specialists led the charge to reduce cigarette smoking. Now, a group of sleep specialists meeting in Montreal is agitating for a sleep policy.

That's right. A good night sleep is so important for physical and mental well-being that its lack poses a grave risk to public health, experts say.

If science has yet to unravel the mystery of why we need to sleep, the toll of inadequate slumber is well-documented in studies linking bad sleep to obesity, cancer, cardiovascular diseases and metabolic disorders. Lack of sleep weakens the immune system.

Look at the numbers: 25 per cent of adults don't get enough sleep or have chronic insomnia, said psychologist Reut Gruber, director of the attention, behaviour and sleep lab at the Douglas Mental Health University Institute in Montreal.

But the worst group for sleeplessness is adolescents: up to 80 per cent of Canadian students come to school extremely sleep-deprived, while the portrait of school age children "isn't pretty . . . 43 per cent are going to bed at a very, very late time."

Robust evidence on sleep deprivation and health consequences led most medical schools in North America, including Montreal's McGill University, to abolish 24-hour shifts for medical residents. Not only do sleepless nights impede students' ability to learn, they can lead to medical errors that put patients at risk.

Fatigue is cumulative, and crashing on weekends to play catch-up doesn't work, said Gruber, who is bringing together about 40 sleep scientists from across Canada and the United States to discuss how to translate sleep medicine research, specifically pediatric sleep, into educational and public policies and lifestyle changes.

Some people suffer from sleep apnea or other medical problems that interfere with slumber, but for many, the chief culprit is the mistaken belief that sleep is a waste of time.

"Sleep feels like it's something we can give up when we have other competing priorities," said Gruber, who is chair of the pediatric interest group, Canadian Sleep Society. "Our choices are going to affect many things that are important to us."

In fact, sleep should be a high health priority, along with eating well and exercising, she said.

Children, for example, need at least nine hours of sleep, Gruber said. Among other functions, sleep allows the brain to do its "executive actions", consolidating learning and memory, something that is imperative for academic performance, she said.

Working guidelines on good sleep hygiene would mean, for example, that sports and cultural activities would not be scheduled late on school nights.

"I'm very excited to hear presentations from the (Quebec) institute of public health on this topic. It's a great step forward," Gruber said. "My request to each presenter was to identify barriers to integrating pediatric sleep into public health and the education systems.

"We have the knowledge. We have the evidence. Why can't we integrate it and overcome the barriers?"

Five common myths about sleep.

- Sleep is a time when your body and brain shut down for rest and relaxation.

False. Our bodies and brains actually do a lot of work while we sleep, which helps us to refuel and to stay healthy and happy. Sleep also plays an important role in memory and learning; as we sleep, we consolidate all the information we learned during the day.

- Sleep is less important than some of our other important basic needs, such as eating.

False. Even cutting our sleep by one hour one night has a serious impact on our health, mood, and behaviour the following day. Furthermore, a single night of partial sleep deprivation is enough to impair our immune functioning, which heightens our risk for acquiring a virus or illness.

- Adolescents need less sleep than younger children.

False. While it is true that adolescents tend to get less sleep than younger children and may have a harder time falling asleep, getting an adequate amount of sleep is still just as important for their development and well-being as it is for younger people.

- Sleeping in on weekends compensates for lack of sleep throughout the week.

False. Having a consistent bedtime and wake time throughout the week is important to ensure we maintain healthy sleep habits. Waking up early throughout the week and then sleeping in on the weekends creates an irregular sleeping schedule and confuses our bodies. If we do not get enough sleep one night, a better way to compensate for this is a short nap in the afternoon.

- Alcohol and other sedatives help us to sleep.

False. While alcohol may help us to fall asleep easily and quickly, it actually disrupts our sleep and prevents us from achieving a deep, restful sleep. Sleeping pills can be problematic. If we use them regularly and then stop, it becomes difficult to fall asleep without their use, thus starting a vicious cycle of dependence.

Read more: http://www.montrealgazette.com/health/Sleeplessness+eroding+public+health+docs/6562402/story.html#ixzz1uOMCgZWb

Three Things You Should Know About Concussions

Concussions have become a hot topic of discussion with the recent head traumas seen throughout the NFL in the 2011 season. It is estimated that approximately 400,000 concussions related to sports are reported on the high school level each year. These concussions are reported in four female sports and five mail sports. It is believed, however, that this figure should be much higher. Concussions can significantly impact the athlete, especially the child and teen athlete. There are three facts that every child and teen athlete need to know to help protect themselves.

Helmets are Not Foolproof

Helmets are extremely important because they lessen a blow's impact and help to prevent skull fractures. However, people have sustained concussions when wearing a helmet because they do not prevent the brain from sliding and hitting the skull. Because of this, athletes and their coaches need to educate about how to tackle so that it lessens the chance of injuring the other athlete.

Physical Rest is Not Enough to Recover

Child and teen athletes certainly need physical rest after sustaining a concussion, but this is just not enough. This is even true for professional athletes. Concussions can take a long time to recover from, even months in some cases. Just look at Cleveland Browns' quarterback Colt McCoy. When recovering, athletes should refrain from all risky activities to prevent the chance of a second concussion occurring when they are still recovering from the first. Also, athletes need to rest mentally. If the athlete is having difficulty doing mental activities, such as reading or concentrating, more mental rest is necessary. This is a brain injury, so both physical and mental rest are equally important in leading to a total recovery.

Not all Concussions Cause Unconsciousness

It is a common misconception that all concussions cause the person to pass out. However, about 90 percent of the time, the person does maintain consciousness. This is why it is so critical for all head injuries to be evaluated by a medical doctor immediately after sustaining the injury. Athletes should also follow the motto: when in doubt, sit it out. It is always better to be on the safe side when it comes to concussions and head injuries.

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As Minds Get Quicker, Teenagers Get Smarter

Adolescents become smarter because they become mentally quicker. That is the conclusion of a new study by a group of psychologists at University of Texas at San Antonio. "Our findings make intuitive sense," says lead author Thomas Coyle, who conducted the study with David Pillow, Anissa Snyder, and Peter Kochunov. But this is the first time psychologists have been able to confirm this important connection. The study appears in the forthcoming issue of Psychological Science, a journal published by the Association for Psychological Science.

"Our research was based on two well-known findings, Coyle continues. "The first is that performance on intelligence tests increases during adolescence. The second is that processing speed" -- the brain taking in and using new stimuli or information -- "as measured by tests of mental speed also increases during adolescence."

To find the relationship between these two phenomena, the UTSA psychologists analyzed the results of 12 diverse intelligence and mental speed tests administered to 6,969 adolescents (ages 13 to 17) in the 1997 National Longitudinal Survey of Youth. Intelligence was measured by performance on cognitive tests of diverse abilities, such as vocabulary knowledge, math facts, and mechanical comprehension. Mental speed showed up in timed tests of computing and coding -- matching digits and words and other arithmetic tasks.

In both of these categories, the researchers could see that the older teenagers did better and worked faster than the younger ones. Then, running the data in numerous ways, they discovered that the measured increase of intelligence could be accounted for almost entirely by the increase in mental speed.

This is what they expected to find, says Coyle. After all, "performance on intelligence tests reflects, in part, the speed of acquiring knowledge, learning things, and solving problems." Those cognitive processes, he says, are related to how fast the brain is working -- and all that improves during the teenage years.

Read more: http://www.sciencedaily.com/releases/2011/09/110927124645.htm?utm_source=feedburner&utm_medium=email&utm_campaign=Feed%3A+sciencedaily%2Fmind_brain+%28ScienceDaily%3A+Mind+%26+Brain+News%29

When is development complete? Some Brain Wiring Continues to Develop Well Into Our 20s

The human brain doesn't stop developing at adolescence, but continues well into our 20s, demonstrates recent research from the Faculty of Medicine & Dentistry at the University of Alberta.

It has been a long-held belief in medical communities that the human brain stopped developing in adolescence. But now there is evidence that this is in fact not the case, thanks to medical research conducted in the Department of Biomedical Engineering by researcher Christian Beaulieu, an Alberta Innovates -- Health Solutions scientist, and by his PhD student at the time, Catherine Lebel. Lebel recently moved to the United States to work at UCLA, where she is a post-doctoral fellow working with an expert in brain-imaging research.

"This is the first long-range study, using a type of imaging that looks at brain wiring, to show that in the white matter there are still structural changes happening during young adulthood," says Lebel. "The white matter is the wiring of the brain; it connects different regions to facilitate cognitive abilities. So the connections are strengthening as we age in young adulthood."

Read more: http://www.sciencedaily.com/releases/2011/09/110922134617.htm?utm_source=feedburner&utm_medium=email&utm_campaign=Feed%3A+sciencedaily%2Fmind_brain+%28ScienceDaily%3A+Mind+%26+Brain+News%29

Dr. Rotenberg admitted to membership in the American Headache Society

In December 2010, Dr Rotenberg was welcomed as a member of the American Headache Society. he is now one of the few pediatric neurology members of this society.

The American Headache Society® (AHS) is a professional society of health care providers dedicated to the study and treatment of headache and face pain. Founded in 1959, AHS brings together physicians and other health providers from various fields and specialties to share concepts and developments about headache and related conditions.Learn More

Search here for headache specialists. http://www.achenet.org/