Do doctors have an obligation to protect athletes from concussions?

This article discusses if doctors have an ethical obligation to teach and protect athletes from concussions.

The American Academy of Neurology (AAN), the largest professional association of neurologists and a leading authority on sports concussion, is releasing a new position paper that states doctors have an ethical obligation to educate and protect athletes from sports concussion and clear them to play only when the athlete is medically ready, standing firm against objections from players, parents or coaches. The statement is published in the July 9, 2014, online issue of Neurology®, the medical journal of the AAN, and is being released ahead of The Sports Concussion Conference, July 11-13, 2014, in Chicago, where the AAN will share the latest scientific advances in diagnosing and treating sports concussion.

The AAN position statement calls for doctors to safeguard the future mental and physical health of athletes as a top priority, especially regarding return-to-play decision-making. Physicians also must educate patients and their families about the dangers of concussion in all relevant sports, according to the statement.

The Academy has spent several years analyzing all of the available research and ethical issues to develop this official position paper, which corresponds with the AAN's guideline on sports concussion.

"With nearly four million sports-related concussions in the US each year, it is imperative doctors are educated and protect these athletes who may have sustained a concussion," said lead author Matthew P. Kirschen, MD, PhD, a neurologist with The Children's Hospital of Philadelphia and a member of the American Academy of Neurology. "Concussions can have devastating effects such as short-term impairments in athletes' cognitive and athletic performance. Repeat concussions have been linked to long-term impairments in brain function, such as problems with learning, memory and behavior."

The statement also:

• Supports wider use of baseline cognitive testing

• Recommends that concussion evaluation and management training be added to neurology residency programs

• Suggests the development of a national concussion registry with mandatory reporting, which may help to document more rigorously the incidence and recurrence of concussion at all levels of play

Ethically, the statement concludes that physicians caring for athletes during and after a sports-related concussion should have adequate training and experience in the recognition and evaluation of both the existence and severity of potential brain injury.

"These strategies could help identify the threshold at which the number and severity of head injuries leads to irreversible brain injury. They may also help to clarify how concussion risk varies with factors like age, gender, puberty stage and ethnicity so athletes and parents can make informed decisions about playing contact sports," said Kirschen.

Read more here

All About Obama's BRAIN Initiative

This article discusses the new BRAIN Initiative, , and how the initiative's bureaucracy is structured at the NIH.

Today at the White House, President Barack Obama unveiled the "BRAIN" Initiative -- a bold new research effort to revolutionize our understanding of the human mind and uncover new ways to treat, prevent, and cure brain disorders like Alzheimer's, schizophrenia, autism, epilepsy, and traumatic brain injury.

The NIH Brain Research through Advancing Innovative Neurotechnologies (BRAIN) Initiative is part of a new Presidential focus aimed at revolutionizing our understanding of the human brain. By accelerating the development and application of innovative technologies, researchers will be able to produce a revolutionary new dynamic picture of the brain that, for the first time, shows how individual cells and complex neural circuits interact in both time and space. Long desired by researchers seeking new ways to treat, cure, and even prevent brain disorders, this picture will fill major gaps in our current knowledge and provide unprecedented opportunities for exploring exactly how the brain enables the human body to record, process, utilize, store, and retrieve vast quantities of information, all at the speed of thought.

Why is the NIH BRAIN Initiative needed?

With nearly 100 billion neurons and 100 trillion connections, the human brain remains one of the greatest mysteries in science and one of the greatest challenges in medicine. Neurological and psychiatric disorders, such as Alzheimer's disease, Parkinson's disease, autism, epilepsy, schizophrenia, depression, and traumatic brain injury, exact a tremendous toll on individuals, families, and society. Despite the many advances in neuroscience in recent years, the underlying causes of most of neurological and psychiatric conditions remain largely unknown, due to the vast complexity of the human brain. If we are ever to develop effective ways of helping people suffering from these devastating conditions, researchers will first need a more complete arsenal of tools and information for understanding how the brain functions both in health and disease.

Why is now the right time for the NIH BRAIN Initiative?

In the last decade alone, scientists have made a number of landmark discoveries that now create the opportunity to unlock the mysteries of the brain. We have witnessed the sequencing of the human genome, the development of new tools for mapping neuronal connections, the increasing resolution of imaging technologies, and the explosion of nanoscience. These discoveries have yielded unprecedented opportunities for integration across scientific fields. For instance, by combining advanced genetic and optical techniques, scientists can now use pulses of light in animal models to determine how specific cell activities within the brain affect behavior. What's more, through the integration of neuroscience and physics, researchers can now use high-resolution imaging technologies to observe how the brain is structurally and functionally connected in living humans.

While these technological innovations have contributed substantially to our expanding knowledge of the brain, significant breakthroughs in how we treat neurological and psychiatric disease will require a new generation of tools to enable researchers to record signals from brain cells in much greater numbers and at even faster speeds. This cannot currently be achieved, but great promise for developing such technologies lies at the intersections of nanoscience, imaging, engineering, informatics, and other rapidly emerging fields of science.

How will the NIH BRAIN Initiative work?

Given the ambitious scope of this pioneering endeavor, it is vital that planning for the NIH BRAIN Initiative be informed by a wide range of expertise and experience. Therefore, NIH is establishing a high level working group of the Advisory Committee to the NIH Director (ACD) to help shape this new initiative. This working group, co-chaired by Dr. Cornelia "Cori" Bargmann (The Rockefeller University) and Dr. William Newsome (Stanford University), is being asked to articulate the scientific goals of the BRAIN initiative and develop a multi-year scientific plan for achieving these goals, including timetables, milestones, and cost estimates.

As part of this planning process, input will be sought broadly from the scientific community, patient advocates, and the general public. The working group will be asked to produce an interim report by fall 2013 that will contain specific recommendations on high priority investments for Fiscal Year (FY) 2014. The final report will be delivered to the NIH Director in June 2014.

How will the NIH BRAIN Initiative be supported?

In total, NIH intends to allocate $40 million in FY14. Given the cross-cutting nature of this project, the NIH Blueprint for Neuroscience Research -- an initiative spanning 14 NIH Institutes and Centers -- will be the leading NIH contributor to its implementation in FY14. Of course, a goal this audacious will require ideas from the best scientists and engineers across many diverse disciplines and sectors. Therefore, NIH is working in close collaboration with other government agencies, including the Defense Advanced Research Projects Agency (DARPA) and the National Science Foundation (NSF). Strong interest has also been expressed by several private foundations, including the Howard Hughes Medical Institute, the Allen Institute for Brain Science, and The Kavli Foundation, and the Salk Institute for Biological Studies. Private industries have also expressed a high level of interest in participation in this groundbreaking initiative.

Read more here

High-Tech Gadgets Can Help Diagnose and Study Autism

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

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

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

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

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

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

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

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

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

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

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

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

Read more here

White-matter abnormalities on term MRI predict cognitive problems in very preterm infants

• Editor's Note:  Here is another reason that before going home, many NICU babies have an MRI and a neurologist's input to help predict outcome.  
• In this study, abnormal white matter predicted mildly low verbal IQ (odds ratio, 6.2), performance IQ (6.0), and full-scale IQ (6.3), and the need for special assistance at school (5.9). 
• 
  

Qualitative Brain MRI at Term and Cognitive 

Outcomes at 9 Years After Very Preterm Birth

1. Sachiko Iwata, MD^a,^b, 
2. Tomohiko Nakamura, MD, PhD^b, 
3. Eriko Hizume, DOT^c,
4. Hideki Kihara, DPT, PhD^c, 
5. Sachio Takashima, MD, PhD^d, 
6. Toyojiro Matsuishi, MD, PhD^a, and 
7. Osuke Iwata, MD^a,^b

+Author Affiliations

1. ^aCentre for Developmental & Cognitive Neuroscience, Department of Paediatrics and Child Health, Kurume University School of Medicine, Kurume, Fukuoka, Japan;
2. Divisions of ^bNeonatology, and
3. ^cRehabilitation, Nagano Children’s Hospital, Nagano, Japan; and
4. ^dYanagawa Institute for Developmental Disabilities, International University of Health and Welfare, Fukuoka, Japan

ABSTRACT

OBJECTIVE: A prospective study was performed to assess the relationship between the appearance of cerebral MRI at term and the cognitive functioning at 9 years old in very preterm born infants.

METHODS: Seventy-six very preterm born infants (birth weight <1500 g or gestational age ≤32 weeks) obtained cerebral MRI at term-equivalent period, which was assessed by using established composite scores for the white and gray matter; cognitive outcomes at 9 years old were assessed in 60 subjects by using Wechsler Intelligence Scale for Children, Third Edition.

RESULTS: Mildly low scores on the different IQ indices (<85) were observed in 23.3% (verbal IQ), 41.7% (performance IQ), and 30.0% (full-scale IQ) of the cohort, whereas moderately low scores (<70) were noted in 3.3% (verbal IQ), 11.7% (performance IQ), and 11.7% (full-scale IQ); cerebral palsy was diagnosed in 10.0%, whereas special assistance at school was required in 56.7%. Abnormal white matter appearances predicted mildly low verbal, performance, and full-scale IQs; moderately low performance and full-scale IQs; cerebral palsy; and the requirement for special assistance at school. Abnormal white matter appearances predicted mild cognitive impairment even after the adjustment for known clinical risk factors. In contrast, abnormal gray matter appearances did not predict any of the outcome measures.

CONCLUSIONS: In a cohort of very preterm born infants, abnormal white matter appearance on term MRI showed consistent associations with cognitive impairments at 9 years old, further supporting the benefit of obtaining term MRI for very preterm born infants.

Just What's Inside Those Breasts?

Just What's Inside Those Breasts?

May 16, 2012

When writer Florence Williams was nursing her
second child, she read a research study about
toxins found in human breast milk. She decided
to test her own breast milk and shipped a
sample to a lab in Germany. What came back surprised her.

Trace amounts of pesticides, dioxin and a jet
fuel ingredient — as well as high to average
levels of flame retardants — were all found in
her breast milk. How could something like this
happen?

"It turns out that our breasts are almost like
sponges, the way they can soak up some of these chemicals, especially the ones that are fat­
loving — the ones [that] tend to accumulate in fat tissue," Williams tells Fresh Air's Terry Gross.
"Unfortunately, the breast is also masterful at converting these molecules into food in the way of
breast milk."

Learning that breasts soak up lots of chemicals made Williams wonder just what else was going on
with breasts. A lot, as it turns out. In her new book, Breasts: A Natural and Unnatural History,
Williams offers her take on — among other things — why breasts are getting bigger and
developing earlier, why tumors seem to gravitate toward the breast, and how toxins from the
environment may be affecting hormones and breast development.

She says many of those toxins, including the flame retardants found in her breast milk, may come
from ordinary household items like couches and electronics, which often contain flame retardants.
Some animal studies have shown that certain types of flame retardants interact with hormone...

Listen here

Long-term Treatment Outcomes of Children&Adolescents who have Cerebral Palsy with Secondary Osteoporosis.

Editor's Note:  I start screening my most severe patients and teenagers for osteoporosis when treating cerebral palsy. JR

Curr Med Res Opin. 2012 May;28(5):737-47. Epub 2012 Apr 18.

Long-term outcomes of children and adolescents who had cerebral palsy with secondary osteoporosis.

Iwasaki T, Nonoda Y, Ishii M.

Source

Kitasato University School of Medicine , Sagamihara , Japan.

Abstract

Abstract Objective: To investigate the long-term efficacy and index of treatment with vitamin D alone or with a bisphosphonate in children and adolescents who have cerebral palsy (CP) with secondary osteoporosis. Research design and methods: Thirty patients diagnosed with CP and secondary osteoporosis were analyzed for 5 years, and the efficacy of treatment was compared. Treatment was divided into three groups: The monotherapy group, consisting of patients taking only alfacalcidol (0.03 µg/kg/day); the polytherapy group, consisting of those taking alfacalcidol and risedronate (0.05 mg/kg/day); and the control group, consisting of patients who discontinued taking their medications for reasons unrelated to these therapies. Bone mineral density (BMD), bone-specific alkaline phosphate (BAP), and N-telopeptides of type I collagen (NTX/Cr) were measured on each patient just before and at discontinuation of treatment, after 6 months, and again at 1 and 3 years, respectively. The changes in BMD (ΔBMD), BAP (ΔBAP), and NTX/Cr (ΔNTX/Cr) were evaluated at these intervals, because the normal value of each parameter varies over time during childhood. Results: ΔBMD significantly increased in the polytherapy group at ≥1 year (p = 0.006), and the difference in BMD between the polytherapy and the control groups at ≥1 year was also significant (p = 0.005). ΔBAP was increased in the monotherapy and polytherapy groups at ≥1 year (p = 0.021 and p = 0.033). ΔNTX/Cr decreased in the polytherapy group at ≥1 year, which was consistent with the polytherapy group of the period from 1 month to 1 year (p = 0.033). The relation between ΔBMD to ΔBAP was a positive correlation in the second period in the monotherapy group (r = 0.46). And the relations between ΔBMD to ΔNTX/Cr were not recognized negative correlations in the monotherapy and polytherapy groups. Thus, ΔBMD reflected ossification of secondary osteoporosis in patients with CP, and ΔBAP and ΔNTX/Cr was significantly related to the increase and decrease of ΔBMD. There were no effects of other factors except sexual maturity. Limitations of this study include that each index of examination was the evaluation according to rate of change. Therefore, the results of this study were limited to longitudinal evaluations. Conclusion: Evaluation according to ΔBMD and both methods of monotherapy and polytherapy were useful for CP patient taking antiepileptic drugs (AEDs) and regardless of sex. Especially, polytherapy for longer than 1 year led to improvement in BMD in children who had CP with secondary osteoporosis. BAP and NTX/Cr were useful for the index of the progression osteoporosis with or without these therapies.

Read More: http://informahealthcare.com/doi/abs/10.1185/03007995.2011.645562

Impact of New Autism Diagnostic Criteria

Getting an autism diagnosis could be more difficult in 2013 when a revised diagnostic definition goes into effect. The proposed changes may affect the proportion of individuals who qualify for a diagnosis of autism spectrum disorder, according to a study by Yale Child Study Center researchers published in the April issue of the Journal of the American Academy of Child & Adolescent Psychiatry.

The proposed changes to the diagnostic definition will be published in the fifth edition of the American Psychiatric Association's (APA) "Diagnostic and Statistical Manual of Mental Disorders (DSM-5)."

"Given the potential implications of these findings for service eligibility, our findings offer important information for consideration by the task force finalizing DSM-5 diagnostic criteria," said Yale Child Study Center director Dr. Fred Volkmar, who conducted the study with colleagues Brian Reichow and James McPartland.

Volkmar and his team performed an analysis of symptoms observed in 933 individuals evaluated for autism in the field trial for DSM-4. They found that about 25 percent of those diagnosed with classic autism and 75 percent of those with Asperger's Syndrome or pervasive developmental disorder, not otherwise specified, would not meet the new criteria for autism. The study also suggests that higher-functioning individuals may be less likely to meet the new criteria than individuals with intellectual disabilities.

Volkmar cautioned that these findings reflect analyses of a single data set and that more information will be provided by upcoming field trials overseen by the APA. He stressed that it is critical to examine the impact of proposed criteria in both clinical and research settings.

"Use of such labels, particularly in the United States, can have important implications for service," he said. "Major changes in diagnosis also pose issues for comparing results across research studies."

Read more here

Dos and Don'ts of Seizure First Aid - Houston Pediatric Epilepsy Care

Dos and Don'ts of Seizure First Aid

Would you know what to do if you witnessed someone having a seizure? These dos and don'ts could help you save a person's life.

By Alice Martin 

Medically reviewed by Lindsey Marcellin, MD, MPH

A seizure can be terrifying to witness, especially if you aren’t prepared to help. Doctors say that it’s a good idea for everyone to know how to react with the right first aid, particularly if a family member, friend, or co-worker has epilepsy.

How to Recognize a Seizure

When 10-year-old Will Bibbo had his first seizure a year ago, his mother, Margaret, was understandably frightened. “It was the middle of the night, and he started making gurgling sounds, like he was choking," she recalls. "He was foaming at the mouth, and his body was rigid.” Not knowing what else to do, the Atlanta mother called 911.

“With the most intense seizures, a person will make choking sounds, go stiff, lose consciousness, and jerk their arms and legs," says Joshua Rotenberg, MD, a pediatric neurologist at Memorial Hermann Memorial City Medical Center in Houston. "It can be very dramatic and very hard to miss.”

The most important thing you can do if you witness someone having a seizure, he says, is to stay calm. About 80 percent of seizures are over in three minutes — which makes it all the more important to act quickly and effectively. These basic dos and don’ts can help.

Epilepsy First Aid: Dos

• Keep a cool head under pressure. Focus on your goal — to keep the person safe until the seizure stops.
• Move things out of the way. Remove the individual’s eyeglasses, tie, or scarf, if you can. Also look out for any hard or sharp objects nearby that might cause injury. If the person is seated, try to gently pull him onto a flat surface so he does not fall.
• Place something soft and flat under the head. A pillow, a folded jacket, or a sweater offers protection.
• Try to turn the person on her side. This clears the airways by allowing saliva to flow out of the mouth.
• Time the seizure. Note the time when the seizure begins. An epileptic seizure will generally last only two to three minutes.
• Check for medical identification. Someone with epilepsy should be wearing a medical bracelet or card containing emergency contact information, what medications he takes, and any drug allergies.
• Call 911 — if you don’t know the person; if it is the person’s first seizure; if the person is pregnant, has diabetes, or is injured; or if the seizure lasts longer than five minutes.
• Control the crowd. If you are in a public place, clear a path for emergency medical workers and tell onlookers to move along.

Epilepsy First Aid: Don’ts

• Restrain the person. You could injure the person or get injured yourself.
• Offer food or drink. Even a sip of water could cause choking.
• Put anything in the person’s mouth. It is not true that people having an epileptic seizure can swallow their tongue. Attempting to put an object in the individual’s mouth could be dangerous to you and to him.
• Perform CPR. Don’t attempt cardio pulmonary respiration or artificial respiration unless the person is not breathing when the seizure has stopped.

Epilepsy First Aid: After the Seizure

Most people, like Margaret’s son Will, don’t remember their seizures — but that doesn’t make the experience any less distressing. “A seizure can be traumatic and embarrassing,” Rotenberg says. “People may wake up to find that they have lost control of their urine or vomited. It’s important to respect them.”

The person may also be confused and combative or try to run away, but more likely, he or she will be very tired and want to sleep. Stay as long as you can and offer reassurance.

Epilepsy First Aid: Practice Makes Perfect

If a loved one has epilepsy, it’s a good idea to come up with a “seizure action plan.” Every family member should know — and practice — what to do.

Bibbo’s twin sister has witnessed his seizures and heard his choking sounds in the night. But now she knows how to stay calm and help her brother. “It’s still a shock every time Will has a seizure,” says his mother, “but it gets easier because we are prepared.”

article here

Gene Mutation in Autism Found to Cause Hyperconnectivity in Brain's Hearing Center

ScienceDaily (Jan. 31, 2012) — New research from Cold Spring Harbor Laboratory (CSHL) might help explain how a gene mutation found in some autistic individuals leads to difficulties in processing auditory cues and paying spatial attention to sound.

The study has found that when a suspected autism gene called PTEN is deleted from auditory cortical neurons -- the main workhorses of the brain's sound-processing center -- the signals that these neurons receive from local as well as long-distance sources are strengthened beyond normal levels. These effects, the study shows, can be blocked by a drug currently in use as an immunosuppressant.

"It's long been hypothesized that autism spectrum disorders (ASDs) arise from a partial disruption of long-range connections in the brain during development," explains Professor Tony Zador, who led the study. "Our finding that PTEN-deficient neurons receive stronger inputs suggests that one way this disruption can be caused is by signal enhancement." His team's work appears in the Journal of Neuroscience on February 1.

Although ASDs could arise from mutations in any of dozens of candidate genes, a core triad of symptoms defines all cases: impaired language, impaired social interaction, and restricted and repetitive behaviors. "The challenge therefore has been to understand how this diverse set of candidate genes and the pathways they control converge to cause the common signature of ASDs," Zador says.

The auditory cortex, which plays a critical role in auditory attention and perception, forms functional connections with other sensory cortices and critical brain areas. The neural network within the auditory cortex has therefore been a target of studies aimed at understanding how alterations in neural circuits contribute to dysfunction in ASDs.

Zador's team focused for several reasons on the role of one suspected autism candidate gene, PTEN, on circuit alterations within the auditory cortex. Well known for its role as an anti-cancer gene that powers down cell growth, proliferation and survival, this gene has also been linked to ASDs by a slew of studies in humans and mice. PTEN mutations have been found in autistic individuals with extreme macroencephaly -- an increase in brain volume. PTEN loss in mice has been found to boost cell size and the number of neuronal connections in the brain.

To decipher the role of PTEN on functional connectivity in the auditory cortex, Zador's group selectively disrupted the function of the PTEN gene in adult mice, only in a subset of neurons of the auditory cortex, while leaving the gene intact in neighboring neurons. The scientists then assessed the effect of the loss of PTEN on connectivity within the auditory cortex using techniques that involve stimulation by laser or flashes of blue light to trigger neuronal activity either locally or in other brain areas that send neuronal projections into the auditory cortex.
The rapid and robust increase in the strength of both long-range and local inputs observed following PTEN loss could possibly be explained by an increase that the scientists observed in the length and density of dendritic spines -- the tiny, knob-like structures jutting out of a neuron that act like signal-receiving antennae.

These effects could be blocked, however, by chemically negating the effect of PTEN loss. One of the pathways regulated by the PTEN protein involves shutting down an intracellular enzyme called mTORC1, which promotes cell growth, among other things. Zador's group found that treating the PTEN-deficient mice for 10 days with the mTORC1-inhibitor rapamycin prevented an increase in dendritic spine number and signal strength.....

more here

Brain Receptor in Eyes May Link Epilepsy, Cataracts and Antidepressants

Researchers from the University of Medicine and Dentistry of New Jersey (UMDNJ) and Columbia University have discovered that the most common receptor for the major neurotransmitter in the brain is also present in the lens of the eye, a finding that may help explain links between cataracts, epilepsy and use of a number of widely prescribed antiepileptic and antidepressant drugs. The research appears online in Biochemical and Biophysical Research Communications.

"Recent studies identified associations between increased cataracts and epilepsy, and showed increased cataract prevalence with use of antiepileptic drugs as well as some common antidepressants," explained corresponding author Peter Frederikse, PhD, of the UMDNJ-New Jersey Medical School. "One common theme linking these observations is that our research showed the most prevalent receptor for the major neurotransmitter in the brain is also present in the lens."

The research team, which included Norman Kleiman, PhD, of the Mailman School of Public Health at Columbia University, with Mohammed Farooq of the New Jersey Medical School and Rajesh Kaswala, DDS, and Chinnaswamy Kasinathan, PhD, from the New Jersey Dental School, found these glutamate receptor proteins, and specifically a pivotal GluA2 subunit, are expressed in the lens and appear to be regulated in a surprisingly similar manner to the way they are in the brain. In the nervous system, glutamate and GluA receptor proteins underlie memory formation and mood regulation along with being an important factor in epilepsy, considered a primary disorder of the brain. Consistent with this, these receptor proteins are also targets for a number of antiepileptic drugs and antidepressant medications.

"The presence of these glutamate receptors in the lens suggests they contribute to links between brain disease and cataract, as well as providing unintended secondary 'targets' of current drugs," Frederikse said. "Our goal now is to use this information to parse out the potential effects of antiepileptics and antidepressants on these 'off-target' sites in the lens, and to determine the role glutamate receptors have in lens biology and pathology."

This research was supported by a grant from the National Eye Institute of the National Institutes of Health.

Read more: http://www.sciencedaily.com/releases/2012/01/120126223607

In the Brain, Signs of Autism as Early as 6 Months Old

Measuring brain activity in infants as young as six months may help to predict the future development of autism symptoms.

Research conducted at the Centre for Brain and Cognitive Development, Birkbeck, University of London, and published in the January edition of Current Biology,shows that in their first year of life, babies who will go on to develop autism already show different brain responses when someone looks at them or away.

"The study is only a first step toward earlier diagnosis, but our findings demonstrate for the first time that direct measures of brain functioning during the first year of life associate with a later diagnosis of autism -- well before the emergence of behavioural symptoms," said Professor Mark Johnson, MRC scientist and head of the Centre for Brain and Cognitive Development at Birkbeck.

The behaviours characteristic of autism emerge over the first few years of life and firm diagnoses are currently made in children only after the age of two. Professor Johnson's team looked to six- to ten-month-old babies at greater risk of developing autism because they had an older brother or sister with the condition. They placed passive sensors on the scalp to register brain activity while the babies viewed faces that switched from looking at them to looking away from them or vice versa.

The human brain shows characteristic patterns of activity in response to eye contact with another person, and that response is a critical foundation for face-to-face social interactions. Older children diagnosed with autism show unusual patterns of eye contact and of brain responses to social interactions that involve eye contact.

The new studies reveal that the brains of infants who will go on to develop autism already process social information in a different way. "At this age, no behavioural markers of autism are yet evident, and so measurements of brain function may be a more sensitive indicator of risk," Professor Johnson said.

However, in the study some babies who showed these differences in brain function were not later diagnosed and vice versa. The method will need refining, most likely in combination with other factors, if it is to form the basis of a predictor accurate enough for clinical use in the general population.

Read more: http://www.sciencedaily.com/releases/2012/01/120126123703

Hockey helmet adds anti-concussion liner

A sports equipment maker is trying to reduce head injuries with a new type of helmet.

Bauer Hockey unveiled its Re-akt helmet in Ottawa on Friday, calling it the first designed specifically to manage multiple hits, including rotational-force impacts from turning the head, which can cause significant head injuries such as concussion.

"There are several scientific studies that have shown a significant correlation between rotational force impacts and head injuries, and it is important to look at solutions to help protect players from these impacts," Dr. Mark Lovell, the retired founding director of the University of Pittsburgh Medical Center's sports medicine concussion program, said in a company news release.

The helmet features a special liner that is meant to protect the head from excessive rotational acceleration when the helmet is hit. The liner is made with a light, pliable material that dissipates extreme forces on impact, Bauer said.

Claude Giroux of the Philadelphia Flyers was one of the first players to wear the new helmet leading up to this weekend's all-star game in Ottawa.

"No helmet is going to completely prevent concussions, but helmets like this one are providing an added level of protection, which is important in today's game," said Giroux, who missed four games due to a concussion earlier this season.

"It comes down to player accountability," Steven Stamkos of the Tampa Bay Lightning told reporters. "We can wear all the new equipment that you want but you have to be aware of situations on the ice."

When the Public Health Agency of Canada launched its "Active and Safe" educational program to reduce concussions and other brain injuries among children and youth last week, safety experts stressed that helmets can't protect against all injuries.

Read more: http://www.cbc.ca/news/health/story/2012/01/27/helmet-concussions.html