Neurology for Children, Teens, Young Adults & Sleep Medicine for All Ages - Dr. Joshua Rotenberg

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

2012-02-01T05:07:00.000-08:00

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

2012-01-29T21:06:00.000-08:00

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.

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

2012-01-29T20:56:00.000-08:00

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.

Hockey helmet adds anti-concussion liner

2012-01-29T20:34:00.001-08:00

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.

Study links sleep apnea and sudden deafness

2012-01-29T20:11:00.000-08:00

Sudden hearing loss might be tied to an underlying sleep disorder that interrupts breathing, suggests a new study from Taiwan.

Consulting a large health insurance database, researchers found that people who'd suffered sudden deafness were more likely to have a previous diagnosis of sleep apnea than a comparison group without hearing loss.

The absolute difference was small: 1.7 percent of those with hearing loss had sleep apnea, compared to 1.2 percent without hearing trouble.

"If there is sudden hearing loss, I would investigate the presence of apnea as well, given that it's easy to diagnose and it's easy to treat," said Dr. Seva Polotsky, a sleep apnea researcher from Johns Hopkins University School of Medicine in Baltimore who wasn't involved in the new study.

"Obviously we don't know from this paper whether treating apnea will reduce hearing loss," or the chance of having hearing problems in the first place.

For now, he said, "There are more questions than answers."

Polotsky added, it's possible that sleep apnea, which is known to increase the buildup of plaque in blood vessels, could affect vessels in areas of the brain that control hearing, or vessels that feed the nerves responsible for hearing.

But he said more research will be needed to find out what could be behind this link -- or whether something besides the apnea, itself, might explain an increased risk of deafness.

There are about 4,000 new cases of sudden deafness each year in the United States, according to the National Institutes of Health, and there are many possible causes, including infections and head injuries.

Typically the deafness only occurs in one ear, and most people regain their hearing over a period of weeks, sometimes aided by steroid treatment. But occasionally the hearing loss becomes more serious.

Looking at health records of one million Taiwanese, researchers led by Dr. Jau-Jiuan Sheu, of Taipei Medical University Hospital, found almost 3,200 had been diagnosed with sudden deafness between 2000 and 2008. For each of those people, they picked out another five of the same age and sex without hearing loss to serve as a comparison.

Out of those 19,000 people in total, 240 had been diagnosed with sleep apnea before the episode of sudden deafness occurred.

When researchers took into account health and lifestyle factors that may be related to both sleep problems and hearing loss -- such as obesity and heart disease -- they found that men with sudden deafness were 48 percent more likely to have a previous sleep apnea diagnosis than men without hearing loss.

The association for women was less clear, the researchers reported in the Archives of Otolaryngology-Head & Neck Surgery.

Sleep apnea is characterized by closing off of the airways during sleep, leading to repeated drops in oxygen levels in the blood and frequent short wake-ups, along with snoring. It's often treated with a mask and breathing device, called continuous positive airway pressure, or CPAP, but one of the most effective treatments is weight loss.

The new study doesn't prove that sleep apnea causes sudden hearing loss. The researchers couldn't account for people's smoking and drinking, for example, which may affect the risk of both conditions.

Cancer Sequencing Initiative Discovers Mutations Tied to Aggressive Childhood Brain Tumors

2012-01-29T20:06:00.000-08:00

St. Jude Children's Research Hospital - Washington University Pediatric Cancer Genome Project provides first evidence linking cancer to mutations in genes involved in DNA organization

Researchers studying a rare, lethal childhood tumor of the brainstem discovered that nearly 80 percent of the tumors have mutations in genes not previously tied to cancer. Early evidence suggests the alterations play a unique role in other aggressive pediatric brain tumors as well.

The findings from the St. Jude Children's Research Hospital - Washington University Pediatric Cancer Genome Project (PCGP) offer important insight into a poorly understood tumor that kills more than 90 percent of patients within two years. The tumor, diffuse intrinsic pontine glioma (DIPG), is found almost exclusively in children and accounts for 10 to 15 percent of pediatric tumors of the brain and central nervous system.

"We are hopeful that identifying these mutations will lead us to new selective therapeutic targets, which are particularly important since this tumor cannot be treated surgically and still lacks effective therapies," said Suzanne Baker, Ph.D., co-leader of the St. Jude Neurobiology and Brain Tumor Program and a member of the St. Jude Department of Developmental Neurobiology. She is a corresponding author of the study published in the January 29 online edition of the scientific journal Nature Genetics.

DIPG is an extremely invasive tumor that occurs in the brainstem, which is at the base of the skull and controls such vital functions as breathing and heart rate. DIPG cannot be cured by surgery and is accurately diagnosed by non-invasive imaging. As a result, DIPG is rarely biopsied in the U.S. and little is known about it.

Cancer occurs when normal gene activity is disrupted, allowing for the unchecked cell growth and spread that makes cancer so lethal. In this study, investigators found 78 percent of the DIPG tumors had alterations in one of two genes that carry instructions for making proteins that play similar roles in packaging DNA inside cells. Both belong to the histone H3 family of proteins. DNA must be wrapped around histones so that it is compact enough to fit into the nucleus. The packaging of DNA by histones influences which genes are switched on or off, as well as the repair of mutations in DNA and the stability of DNA. Disruption of any of these processes can contribute to cancer.

Researchers said that the mutations seem unique to aggressive childhood brain tumors.

"It is amazing to see that this particular tumor type appears to be characterized by a molecular 'smoking gun' and that these mutations are unique to fast-growing pediatric cancers in the brain," said Richard K. Wilson, Ph.D., director of The Genome Institute at Washington University School of Medicine in St. Louis and one of the study's corresponding authors. "This is exactly the type of result one hopes to find when studying the genomes of cancer patients."

The results are the latest from the PCGP, an ambitious three-year effort to sequence the complete normal and cancer genomes of 600 children with some of the most poorly understood and aggressive pediatric cancers. The human genome includes the complete set of instructions needed to assemble and sustain human life. The goal is to identify differences that explain why cancer develops, spreads and kills. Researchers believe the findings will provide the foundation for new tools to diagnose, treat or prevent the disease.

For this study, researchers sequenced the complete normal and cancer genomes of seven patients with DIPG. "The mutations were found at such high frequency in the cancer genomes of those seven patients that we immediately checked for the same alterations in a larger group of DIPGs," Baker said. When researchers sequenced all 16 of the related genes that make closely related variants of histone H3 proteins in an additional 43 DIPGs, they found many of the tumors contained the same mistakes in only two of these genes.

Of the 50 DIPG tumors included in this study, 60 percent had a single alteration in the makeup of the H3F3A gene. When the mutated gene was translated into a protein, the point mutation led to the substitution of methionine for lysine as the 27th amino acid in this variant of histone H3 protein. Another 18 percent of the DIPG patients carried the same mistake in a different gene, HIST1H3B.

Researchers are now working to understand how mutations in H3F3A and HIST1H3B impact cell function and contribute to cancer. Earlier research provides some clues. The lysine that is mutated is normally targeted by enzymes that attach other molecules to histone H3, influencing how it interacts with other proteins that regulate gene expression, Baker said. Mutations in the enzymes that target histone H3 have been identified in other cancers, but this is the first report showing a specific alteration of histones in cancer.

Brain-Derived Neurotrophic Factor: Finding May Have Implications for Rett Syndrome, Other Neurological Disorders

2012-01-29T06:21:00.000-08:00

Brain-Derived Neurotrophic Factor: Finding May Have Implications for Rett Syndrome, Other Neurological Disorders

ScienceDaily (Jan. 27, 2012) — Researchers at Oregon Health & Science University have discovered that a molecule critical to the development and plasticity of nerve cells -- brain-derived neurotrophic factor (BDNF) -- is severely lacking in brainstem neurons in mutations leading to Rett syndrome, a neurological developmental disorder. The finding has implications for the treatment of neurological disorders, including Rett syndrome that affects one in 10,000 baby girls.

The new discovery is published online in Neuroscience and is expected in the print issue of Neuroscience in March.

Using a mouse model of Rett syndrome, the OHSU team found that mutant neurons in the brainstem fail miserably at making BDNF. When normal neurons are faced with a respiratory challenge, such as low oxygen, they dramatically increase the production of BDNF, whereas mutant neurons do not.

According to the National Institutes of Health, Rett syndrome is estimated to affect one in every 10,000 to 15,000 live births and almost exclusively girls because it is caused by an X-linked gene mutation. In addition to severe problems with motor function, other symptoms of Rett syndrome may include breathing difficulties while awake.

"The new finding, coupled with our previously published data that show BDNF is involved in normal maturation of neuronal pathways controlling cardiorespiratory function, could play a significant role in the development of a treatment for Rett syndrome," said Agnieszka Balkowiec, M.D., Ph.D., principal investigator and associate professor of integrative biosciences in the OHSU School of Dentistry; and adjunct assistant professor of physiology and pharmacology in the OHSU School of Medicine. To conduct this research, Balkowiec partnered with John M. Bissonnette, M.D., professor of obstetrics and gynecology, and cell and developmental biology in the OHSU School of Medicine.

Additional study authors include: Anke Vermehren-Schmaedick, Ph.D., OHSU Department of Biomedical Engineering; Victoria K. Jenkins, B.A., who is currently pursuing her doctorate at Boston University; and Sharon J. Knopp, a research assistant in Bissonnette's lab.

The study was supported by grants from the National Heart, Lung, and Blood Institute of the National Institutes of Health; March of Dimes; and International Rett Syndrome Foundation.

enceDaily: Your source for the latest research news and science breakthroughs -- updated daily

Trisomy 18 - What Is Trisomy 18?

2012-01-28T22:41:00.000-08:00

With Rick and Karen Santorum's daughter hospitalized, I have had questions about trisomy 18. I hope Bella returns to health and gets home soon. JR

What Is Trisomy 18?

Trisomy 18, also known as Edwards syndrome, is a condition which is caused by a chromosomal defect. It occurs in about 1 out of every 3000 live births. The numbers increase significantly when early pregnancy losses are factored in that occur in the 2nd and 3rd trimesters of pregnancy.

Unlike Down syndrome, which also is caused by a chromosomal defect, the developmental issues caused by Trisomy 18 are associated with medical complications that are more potentially life-threatening in the early months and years of life. 50% of babies who are carried to term will be stillborn, with baby boys having higher stillbirth rate than baby girls.

At birth, intensive care admissions in Neonatal units are most common for infants with Trisomy 18. Again, baby boys will experience higher mortality rates in this neonatal period than baby girls, although those with higher birth weights do better across all categories.

Some children will be able to be discharged from the hospital with home nursing support for their families. And although less than 10 percent survive to their first birthdays, some children with Trisomy 18 can enjoy many years of life with their families, reaching milestones and being involved with their community. A small number of adults (usually girls) with Trisomy 18 have and are living into their twenties and thirties, although with significant developmental delays that do not allow them to live independently without assisted caregiving.

NIH/NINDS

Foundation Website

Seizures in Children - Causes, Tests, Treatments, What next?

2012-01-28T22:32:00.000-08:00

Seizures in Children - Causes, Tests, Treatments, What next?

Dont wait. Read this and seek care!

Seizures in Children Overview

A seizure occurs when the brain functions abnormally, resulting in a change in movement, attention, or level of awareness. Different types of seizures may occur in different parts of the brain and may be localized (affect only a part of the body) or widespread (affect the whole body). Seizures may occur for many reasons, especially in children. Seizures in newborns may be very different than seizures in toddlers, school-aged children, and adolescents. Seizures, especially in a child who has never had one, can be frightening to the parent or caregiver.

Around 3% of all children have a seizure when younger than 15 years, half of which are febrile seizures (seizure brought on by a fever). One of every 100 childrenhas epilepsy-recurring seizures.
A febrile seizure occurs when a child contracts an illness such as an earinfection, cold, or chickenpox accompanied by fever.Febrile seizuresare the most common type of seizure seen in children. Two to five percent of children have a febrile seizure at some point during their childhood. Why some children have seizures with fevers is notknown, but several risk factors have been identified.
- Children with relatives, especially brothers and sisters, who have had febrile seizures are more likely to have a similar episode.
- Children who are developmentally delayed or who have spent more than 28 days in a neonatal intensive care unit are also more likely to have a febrile seizure.
- One of 4 children who have a febrile seizure will have another, usually within a year.
- Children who have had a febrile seizure in the past are also more likely tohave a second episode.
Neonatal seizures occur within 28 days of birth. Mostoccur soon after the child is born. They may be due to a large variety of conditions. It may be difficult to determine if a newborn is actually seizing, because they often do not have convulsions. Instead, their eyes appear to be looking in different directions. They may have lip smacking or periods of no breathing.
Partial seizures involve only a part of the brain and therefore only a part of the body.
- Simple partial (Jacksonian) seizures have a motor (movement) component that is located in one portion of the body. Children with these seizures remain awake and alert. Movement abnormalities can "march" to other parts of the body as the seizure progresses.
- Complex partial seizures are similar, except that the child is not aware of what is going on. Frequently, children with this type of seizurerepeat an activity, such as clapping, throughout the seizure. Theyhave no memory of this activity. After the seizure ends, the childis oftendisoriented in a state known as the postictal period.
Generalized seizures involve a much larger portion of the brain. They are grouped into 2 types: convulsive (muscle jerking) and nonconvulsive with several subgroups.
- Convulsive seizures are noted by uncontrollable muscle jerking lasting for a few minutes-usually less than 5-followed by a period of drowsiness that is called the postictal period. The child should return to his or her normal self except for fatigue within around 15 minutes. Often the child may have incontinence (lose urine or stool), and it is normal for the child not to remember the seizure. Sometimes the jerking can cause injury, which may range from a small bite on the tongue to a broken bone.
- Tonic seizures result in continuous muscle contraction and rigidity, while tonic-clonic seizures involve alternating tonic activity with rhythmic jerking of muscle groups.
- Infantile spasms commonly occur in children younger than 18 months. They are often associated with mental retardation and consist of sudden spasms of muscle groups, causing the child to assume a flexed stature. They are frequent upon awakening.
- Absence seizures, also known as petit mal seizures, are short episodes during which the child stares or eye blinks, with no apparent awareness of their surroundings. These episodes usually do not last longer then a few seconds and start and stop abruptly; however, the childdoes not remember the event at all. These are sometimes discovered after the child's teacher reports daydreaming, if the child loses his or her place while reading or misses instructions for assignments.
Status epilepticus is either a seizure lasting longer than 30 minutes or repeated seizures without a return to normal in between them. It is most common in children younger than 2 years, and most of these childrenhave generalized tonic-clonic seizures. Status epilepticus is very serious. With any suspicion of a long seizure, you should call 911.
Epilepsy refers to a pattern of chronic seizures of any type over a long period. Thirty percent of children diagnosed with epilepsycontinue to have repeated seizures into adulthood, while othersimprove over time.

Full article here

‘Big Hits, Broken Dreams’ Examines Concussion Hazards in Youth Football

2012-01-28T22:08:00.000-08:00

‘Big Hits, Broken Dreams’ Examines Concussion Hazards in Youth Football

‘Dr. Sanjay Gupta Reports’ documentary debuts Sunday, January 29, 8:00pm ET

Football is a cornerstone of family life in Greenville, NC, and four-time statewide football champion JH Rose High School is one reason why. But the costs for all of that football glory can be very high. The hard hits can mean concussion injuries and the community has borne terrible consequences.

In summer 2008, JH Rose junior and star running back, Jaquan Waller, died as a result of repeated concussion injuries. Weeks earlier, neighboring RJ Reynolds High School sophomore Matthew Gfeller had died from concussion injury. In 2010, JH Rose head coach Todd Lipe had to permanently sideline the varsity quarterback, AJ Flores, after he sustained his fourth football-related concussion. In 2011, JH Rose starting linebacker Gray Dixon was one of nearly a dozen players to sit out part of the season with a serious concussion.

In a new, one-hour documentary, CNN chief medical correspondent and practicing neurosurgeon Dr. Sanjay Gupta had exclusive access to follow the JH Rose team for their full 2011 season, exploring concussion in high school football – what happens to the brain under concussive brain injury, and what parents, coaches, and athletes need to be aware of to try to protect themselves. Big Hits, Broken Dreams debuts Sunday, January 29 at 8:00p.m. ET.

In September 2008, Jaquan Waller hit a middle linebacker head-on during an intense practice. When he came off the playing field, Waller described headaches and balance issues, but the team trainer who later checked him, sent him home with no special instructions for further medical follow up. Dressed for practice the following day, team mate and friend Zach Rogers describes Waller as seeming “normal.”

But during that Friday’s game, some 48 hours after his first concussion, Waller sustained what has been described by others as a relatively low intensity hit, after which it was quickly apparent that something was very wrong with him. Waller seemed confused, began foaming at the mouth, and soon collapsed. Emergency medical services arrived approximately ten minutes after he was sidelined. Within the hour, Waller was declared dead.

The second guessing at JH Rose following Waller’s death has been painful. “You wouldn’t know how many times I thought about doing something different,” reflects Coach Lipe to Dr. Gupta in the documentary.

Superintendent Beverly Reep, PhD, acknowledges that having a certified athletic trainer on the field for practices and games, and having Waller medically evaluated following his first concussion, may have changed Waller’s outcome.

In 2008, the concussion protocol at JH Rose was not unique. Every season, according the Sports Concussion Institute in Los Angeles, one in ten high school football players gets a concussion. Yet, despite this troubling statistic, the Center for Injury Research & Policy at the Research Institute at Nationwide Children’s Hospital reports that less than half of American high schools have a certified athletic trainer on the field during games and practices. And many high school trainers are not actually athletic trainers, they may be skilled in first aid, but not certified to recognize possible head trauma. This is coupled with the fact that young players often want to return to play quickly – and some will even not tell the truth in order to keep playing.

Brock Niceler, MD, a Greenville family and sports medicine physician says that because their brains are still developing, “adolescents take longer to heal from their concussions, than their college or pro counterparts.”

“Everybody just thought that he just got his ‘bell rung,’” said Rogers of his friend, Waller in the documentary. “Nothing out of normal. It’s just how you play. You play hurt when you have to.”

Kevin Guskiewicz, PhD, one of the nation’s leading concussion researchers, feels that part of the problem is the terminology. Like Dr. Gupta, he prefers to refer to concussion as “brain injury” – since that is what it is – and he hopes the strong terminology will encourage players, families, and coaches to take the injury more seriously. And, Dr. Guskiewicz’s research demonstrates that even subconcussive blows to the head, particularly when repeated, can cause sustained cognitive impairment.

Coach Lipe and Dr. Reep have supervised the implementation of new procedures and protocols to improve the safety of the game since Waller’s death. Now, certified athletic trainers are present at practices and games and are considered essential. Athletes do not have the last word when it is time to assess whether they can play football. Cognitive baseline tests for each player are repeated at intervals during the season and following concussions, to determine if players are healthy enough to return to the game.

Preview here

Does a child have unexplained CP? Genetic Abnormalities May Cause Cerebral Palsy, Study Suggests

2012-01-28T21:09:00.000-08:00

Genetic Abnormalities May Cause Cerebral Palsy, Study Suggests

ScienceDaily (Jan. 26, 2012) — For years it was thought that a difficult birth and other perinatal factors were the leading causes of cerebral palsy (CP), a group of disorders that can involve brain and nervous system functions such as movement, learning, hearing, seeing and thinking. Now, researchers at Geisinger Health System find that the majority of cerebral palsy causes may in fact be caused by genetic abnormalities.

Published in the The Lancet Neurology, Geisinger researchers find that CP -- the most common physical disability of childhood -- is probably caused by multiple genetic factors, similar to other neurodevelopmental disorders such as autism and intellectual disability. The paper suggests physicians should consider performing genetic testing when children present with CP and CP-like conditions.

"There is a widespread misconception that most cases of CP are caused by difficult delivery leading to birth asphyxia," said Andres Moreno De Luca, M.D., research scientist at the Genomic Medicine Institute, Geisinger Health System, and lead author of the paper. "What we're finding is a growing body of evidence that suggests mutations in multiple genes are responsible for CP. In fact, we suspect these genetic abnormalities may also be the cause of some difficult births to begin with."

Despite substantial improvements in obstetric and neonatal care, the paper finds the worldwide prevalence of cerebral palsy has remained stable at 2 to 3 per 1,000 livebirths for more than 40 years. Inadequate oxygen supply to fetuses, known as birth asphyxia, remains the most studied factor associated with CP, though electronic fetal monitoring and other technologies have been developed to detect fetal distress.

"What we're finding is even though more preventative efforts have been put in place, like fetal monitoring, the incidence of CP has not decreased," said David Ledbetter, Ph.D., chief scientific officer, Geisinger Health System. "We've seen a five-fold increase in the rate of caesarean sections, which are done in part to avoid potentially difficult delivery, and again, the CP rates remain steady. These findings lead us to believe genetics play a much bigger role than previously thought."

The paper also reports that even though most cases of CP are not caused by birth asphyxia and those that are can rarely be prevented by obstetric intervention, between 1999 and 2003 an estimated 76 percent of obstetricians in the U.S. faced medical malpractice litigation, most often for alleged birth mismanagement resulting in CP.

"We now know of six genes that can cause CP when disrupted, and we estimate that many other developmental brain genes probably contribute to the genetic heterogeneity of this disorder," said Dr. Moreno De Luca. "Many capable obstetricians face legal action even though research is telling us genetics is the likely cause of most cases of CP."

As the paradigm shift continues and more researchers, clinicians, and the general population start to consider the cerebral palsies as a group of neurogenetic disorders, the paper states we will probably witness an increase in research efforts, a change in the diagnostic approach, and eventually novel therapies for treating CP.

Link here

Living With Epilepsy Conference - Drs. Rotenberg and Jones to Speak

2012-01-28T20:32:00.000-08:00

What: “Living With Epilepsy” Conference

Who: The Epilepsy Warriors Foundation

When: Saturday, March 31, 2012

Why: The Goal of this Conference is to Educate those dealing, living and working with Epilepsy on what Epilepsy is, how it is managed, the Dangers of SUDEP and not talking about it, the daily struggle of trying to manage epilepsy and also manage a family as well . The Main Goal is to provide Research Funding and Attention to the phenomenal research that is being done within the Houston Medical District both at University of Texas and Baylor Medical College and what we need to do to keep it moving forward towards a CURE

Where: Memorial City - The Westin Hotel, Houston, Texas

Announcement:
http://epilepsywarriors.org/events/

Adolescents With Autism Spend Free Time Using Solitary, Screen-Based Media

2012-01-26T20:41:00.000-08:00

Children with autism spectrum disorders (ASD) tend to be fascinated by screen-based technology. A new study by a University of Missouri researcher found that adolescents with autism spend the majority of their free time using non-social media, including television and video-games.

"Even though parents and clinicians have often observed that children with ASD tend to be preoccupied with screen-based media, ours is the first large-scale study to explore this issue," said Micah Mazurek, assistant professor in the School of Health Professions and the Thompson Center for Autism and Neurodevelopmental Disorders. "We found that 64 percent of adolescents with ASD spent most of their free time watching TV and playing video and computer games. These rates were much higher than among those with other types of disabilities. On the other hand, adolescents with ASD were less likely to spend time using email and social media."

The majority of youths with ASD (64.2 percent) spend most of their free time using solitary, or non-social, screen-based media (television and video games) while only 13.2 percent spend time on socially interactive media (email, internet chatting).

This is the first study to examine the prevalence of screen-based media use within a large nationally representative sample of youths with ASD. Data were compiled from the National Longitudinal Transition Study 2, a group of more than 1,000 adolescents enrolled in special education. The study includes youths with ASD, learning and intellectual disabilities, and speech and language impairments.

The findings affirm that solitary screen-based media use represents a primary and preferred activity for a large percentage of youths with ASD, Mazurek said. Previously, researchers found that excessive use of these media in typically developing children is detrimental to outcomes, with regard to academic performance, social engagement, behavioral regulation, attention and health.

"This is an important issue for adolescents with ASD and their families. Studies have shown that excessive use of TV and video games can have negative long-term effects for typically developing children," Mazurek said. "In future studies, we need to learn more about both positive and negative aspects of media use in children with ASD. We need to look for ways to capitalize on strengths and interests in screen-based technology."

Mutations in 2 Genes Linked to Rare Autism-Related Disorder

2012-01-26T20:10:00.000-08:00

Newly discovered mutations in two adjacent genes cause a rare genetic brain condition called Joubert syndrome, according to a new study.

People with Joubert syndrome have malformation or underdevelopment of the cerebellum and brainstem, resulting in a range of physical and mental disabilities such as poor muscle control and mental retardation.

As many as four in 10 people with Joubert syndrome meet the criteria for an autism diagnosis and other neurocognitive disorders, according to background information in a news release about the research.

In the study, a team led by University of California, San Diego School of Medicine researchers found that mutations in two adjacent genes -- TMEM216 and TMEM138 -- cause Joubert syndrome.

"It is extraordinarily rare for two adjacent genes to cause the same human disease," team leader Dr. Joseph Gleeson, a professor ofneurosciences and pediatrics, said in the university news release. "The mystery that emerged from this was whether these two adjacent, non-duplicated genes causing indistinguishable disease have functional connections at the gene or protein level."

The researchers conducted evolutionary analysis and concluded that the two genes became joined end-to-end about 260 million years ago. The connected genes then evolved simultaneously and became regulated by the same transcription factors, the authors reported in the study published online Jan. 26 in Science Express.

Co-Existing Conditions May Explain Why Autism Diagnosis Can Change

2012-01-25T04:16:00.000-08:00

Co-Existing Conditions May Explain Why Autism Diagnosis Can Change

Children with autism spectrum disorder (ASD) are more likely to have a co-occurring neurodevelopmental or psychiatric condition, such as a learning disability or depression. Differentiating between these diagnoses can be challenging, and some children originally diagnosed with ASD no longer meet the criteria for an ASD diagnosis as they grow older.

In the study, "Co-occurring Conditions and Change in Diagnosis in Autism Spectrum Disorders," in the February 2012 Pediatrics (published online Jan. 23), researchers at the Johns Hopkins Bloomberg School of Public Health examined the relationship between co-occurring conditions and changes in diagnosis of ASD. Using data from the National Survey of Children's Health 2007, study authors found the type of co-occurring conditions was dependent on the age of the child.

Young children (aged 3-5 years) with a current ASD diagnosis were more likely to have a moderate or severe learning disability or developmental delay compared to children with a past but not current ASD diagnosis. In children ages 6-11, those with a current ASD diagnosis were more likely to have had a past speech problem or current moderate or severe anxiety compared to children with a past but not current ASD diagnosis. Among adolescents (aged 12-17), those with a current ASD diagnosis were more likely to have moderate or severe speech problems or mild seizures or epilepsy compared to children with a past but not current ASD diagnosis. Both children and adolescents with a current ASD diagnosis were less likely to have had past hearing problems than those with a past but not current ASD diagnosis. In all age groups, children with a current ASD diagnosis were more likely to have two or more co-occurring conditions compared to children with a past but not current ASD diagnosis.

The study results suggest some co-occurring conditions may, in part, lead to a change in an ASD diagnosis, though the mechanisms underlying this change remain unclear.

The American Academy of Pediatrics is an organization of 60,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults.

The Price of Your Soul: How the Brain Decides Whether to 'Sell Out'

2012-01-25T04:14:00.000-08:00

The Price of Your Soul: How the Brain Decides Whether to 'Sell Out'

At the end of the experiment, participants were given the option of auctioning their personal statements: Disavowing their previous choices for actual money. The participants could earn as much as $100 per statement by simply agreeing to sign a document stating the opposite of what they believed. They could choose to opt out of the auction for statements they valued highly. (Credit: Image courtesy of Emory University)

ScienceDaily (Jan. 22, 2012) — A neuro-imaging study shows that personal values that people refuse to disavow, even when offered cash to do so, are processed differently in the brain than those values that are willingly sold.

"Our experiment found that the realm of the sacred -- whether it's a strong religious belief, a national identity or a code of ethics -- is a distinct cognitive process," says Gregory Berns, director of the Center for Neuropolicy at Emory University and lead author of the study. The results were published in Philosophical Transactions of the Royal Society.
Sacred values prompt greater activation of an area of the brain associated with rules-based, right-or-wrong thought processes, the study showed, as opposed to the regions linked to processing of costs-versus-benefits.
Berns headed a team that included economists and information scientists from Emory University, a psychologist from the New School for Social Research and anthropologists from the Institute Jean Nicod in Paris, France. The research was funded by the U.S. Office of Naval Research, the Air Force Office of Scientific Research and the National Science Foundation.
"We've come up with a method to start answering scientific questions about how people make decisions involving sacred values, and that has major implications if you want to better understand what influences human behavior across countries and cultures," Berns says. "We are seeing how fundamental cultural values are represented in the brain."
The researchers used functional magnetic resonance imaging (fMRI) to record the brain responses of 32 U.S. adults during key phases of an experiment. In the first phase, participants were shown statements ranging from the mundane, such as "You are a tea drinker," to hot-button issues such "You support gay marriage" and "You are Pro-Life." Each of the 62 statements had a contradictory pair, such as "You are Pro-Choice," and the participants had to choose one of each pair.
At the end of the experiment, participants were given the option of auctioning their personal statements: Disavowing their previous choices for actual money. The participants could earn as much as $100 per statement by simply agreeing to sign a document stating the opposite of what they believed. They could choose to opt out of the auction for statements they valued highly.
"We used the auction as a measure of integrity for specific statements," Berns explains. "If a person refused to take money to change a statement, then we considered that value to be personally sacred to them. But if they took money, then we considered that they had low integrity for that statement and that it wasn't sacred."
The brain imaging data showed a strong correlation between sacred values and activation of the neural systems associated with evaluating rights and wrongs (the left temporoparietal junction) and semantic rule retrieval (the left ventrolateral prefrontal cortex), but not with systems associated with reward.
"Most public policy is based on offering people incentives and disincentives," Berns says. "Our findings indicate that it's unreasonable to think that a policy based on costs-and-benefits analysis will influence people's behavior when it comes to their sacred personal values, because they are processed in an entirely different brain system than incentives."
Research participants who reported more active affiliations with organizations, such as churches, sports teams, musical groups and environmental clubs, had stronger brain activity in the same brain regions that correlated to sacred values. "Organized groups may instill values more strongly through the use of rules and social norms," Berns says.
The experiment also found activation in the amygdala, a brain region associated with emotional reactions, but only in cases where participants refused to take cash to state the opposite of what they believe. "Those statements represent the most repugnant items to the individual," Berns says, "and would be expected to provoke the most arousal, which is consistent with the idea that when sacred values are violated, that induces moral outrage."

Article here

Study links autism, intestinal bacteria levels

2012-01-24T17:38:00.000-08:00

Editors note: I am interested in systemic comorbidities in autism. For many years, parents have reported GI symptoms in children with autism. Perhaps we are getting some reputable data on this topic? But for those living with autism I ask you to proceed with caution! There is a difference between association and causation. For instance, do children with Down syndrome get more ear infections? Yes. Does that mean that ear infections cause Down Syndrome? Obviously not. JR

Study links autism, intestinal bacteria levels

Researchers at Columbia may be making strides toward understanding the neurological disorder of autism–starting with, of all places, the intestine, according to a recent study.

Dr. Brent Williams, an associate research scientist from the Mailman School of Public Health, headed the study, which examined gastrointestinal disturbances in children with autism. Researchers discovered that children diagnosed with autism that suffer from gastrointestinal disturbances have heightened levels of Sutterella, a type of intestinal bacteria.

After examining intestinal biopsies from his patients, Williams found that Sutterella bacteria existed in more than half of the children who had been diagnosed with autism. In comparison, Sutterella was not found in any normally developing children that also had gastrointestinal, or GI, disturbances.

“There have been reports relating to the prevalence of GI disturbances in children with autism, and those reports have been somewhat inconsistent,” Williams said. “One of the questions that is important to look at is whether the molecular underpinnings of the GI symptoms differ between children with autism and typically developing children.”

Although the correlation between autism and gastrointestinal dysfunction has been explored before, “the link between gastrointestinal and central nervous system dysfunction remains unclear,” according to Mady Hornig, researcher and associate professor of epidemiology.

“Gastrointestinal complaints are a prominent cause of concern and distress among children with autism and their caregivers,” Hornig explained. “Our approach allows us to rigorously investigate whether specific clinical and molecular patterns in the gastrointestinal tract are associated with neuropsychiatric disease.”

Williams and Hornig both said that they plan to work on future studies that delve more deeply into the relationship between GI disturbances and autism.

“We are exploring larger prospective studies where we could control for many factors that could be playing a role in the specific changes,” Williams said. “There is much work to be done toward understanding the role Sutterella plays in autism.”

Hornig added that to test the strength of the correlation, she hopes to expand the research to sample from a larger pool of patients.

“If we saw a close correlation, we would have a better time in accessing a larger population because not everyone will have serious GI disorders to bring to colonoscopy,” she said. “We could study larger populations in a more rapid fashion.”

Children with ADHD benefit from healthy lifestyle options as first-line treatment

2012-01-24T17:31:00.000-08:00

Every year between 3 and 10% of school-age children in this country are diagnosed with attention deficit hyperactivity disorder (ADHD). Increasingly, families are using natural or complementary therapies to improve their child's attention or behavior, and often seek advice from an integrative pediatrician, according to a new study by researchers at Wake Forest Baptist Medical Center.

"Many parents are reluctant to put their children on medication for ADHD, and instead want to first try healthy lifestyle options to help promote optimal focus and attention," said Kathi Kemper, MD, professor of public health sciences and pediatrics at Wake Forest Baptist, and lead author of the study.

Published in the January issue of the journal Focus on Alternative and Complementary Therapies, the research is the first to study what parents who seek natural remedies for their child's ADHD are actually using or interested in learning about from an integrative pediatrician. The growing field of integrative pediatrics covers not only complementary therapies, but also focuses on health promotion, disease prevention, lifestyle coaching and coordinated team care.

In the study, the researchers reviewed intake forms, physician reports and laboratory studies for 75 new patients seen in an integrative pediatric clinic over a year and a half. Most of the patients (87%) were referred by their primary care physicians and the rest were referred by specialists. Among the patients, 31% of the families had concerns about ADHD, but only 13% of the children were taking medicine for the condition.

Emerging trend

The data suggest that these children often suffer from several chronic health conditions, receive care from multiple, diverse specialists as well as primary care clinicians, and take a variety of medications and supplements while avoiding ADHD medications. "Although it was a small study from one practice, we believe that it reflects an emerging trend among pediatricians and primary care providers," Kemper said.

The Wake Forest Baptist researchers showed that most families with ADHD children were interested in information about diet, exercise, stress management and sleep. Physician recommendations focused on health promotion information, dietary supplements, such as multivitamins/minerals and omega-3 fatty acids, and referrals to specialists.

"For example, if your child has trouble concentrating in his mid-morning math class, be sure he eats a really good breakfast, or try having him go to bed an hour earlier to see if that helps," Kemper said. "If your child can't sit still to do homework when he gets home from school, have him go outside to shoot some hoops and then try doing homework. I recommend using low-risk, healthy lifestyle approaches first before resorting to medication."

For parents interested in finding an integrative pediatrician, Kemper recommends the American Academy of Pediatrics' website under the Section on Complementary and Integrative Medicine for a list of board-certified integrative pediatricians.

Autism Redefined: New Diagnostic Criteria More Restrictive

2012-01-22T13:02:00.000-08:00

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 preliminary data presented by Yale School of Medicine researchers at a meeting of the Icelandic Medical Association.

The proposed changes to the diagnostic definition would 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 (CSC) director Fred Volkmar, M.D., who conducted the study with CSC colleagues Brian Reichow and James McPartland.

Volkmar and his team found that in a group of individuals without intellectual disabilities who were evaluated during the 1994 DSM-IV field trial, it was estimated that approximately half might not qualify for a diagnosis of autism under the proposed new definition.

Volkmar stressed that these preliminary findings relate only to the most cognitively able and may have less impact on diagnosis of more cognitively disabled people. "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."

Volkmar first presented the preliminary research results in September at Yale and in October at the Institute On Autism American Academy of Child Adolescent Psychiatry Meeting In Toronto. Volkmar and colleagues will publish full study results in the April print edition of the Journal of the American Academy of Child and Adolescent Psychiatry. The study may be available online as early as late February or early March.

Another Clue in the Mystery of Autism

2012-01-22T12:14:00.000-08:00

Although the genetic basis of autism is now well established, a growing body of research also suggests that environmental factors may play a role in this serious developmental disorder affecting nearly one in 100 children. Using a unique study design, a new study suggests that low birth weight is an important environmental factor contributing to the risk of autism spectrum disorder (ASD).

"Our study of discordant twins -- twin pairs in which only one twin was affected by ASD -- found birth weight to be a very strong predictor of autism spectrum disorder," said Northwestern University researcher Molly Losh. Losh, who teaches and conducts research in Northwestern's School of Communication, is lead author of the study that will be published in the journalPsychological Medicine and is now available online.

Prior twin studies have shown that when one identical twin had ASD, the other twin was much more likely to have ASD than not. "Because identical twins share virtually 100 percent of their genes, this is strong evidence for the role of genetics in autism," said Losh. "Yet it is not 100 percent the case that ASD affects both identical twins in a twin pair."

"That only one twin is affected by ASD in some identical twin pairs suggests that environmental factors may play a role either independently or in interaction with autism risk genes," she added. "And because autism is a developmental disorder impacting brain development early on, it suggests that prenatal and perinatal environmental factors may be of particular importance."

The researchers found that lower birth weight more than tripled the risk for autism spectrum disorder in identical twin pairs in which one twin had ASD and the other did not.

To control for shared genetic and environmental factors, the researchers used a co-twin control study design in which the ASD-affected twin served as the case and the unaffected twin served as the control. They found the risk for autism spectrum disorder rose 13 percent for every 100 gram- (3.5 ounce-) decrease in birth weight.

"There's been a great deal of misinformation about the causes of autism -- from the 1950s misconception that the distant maternal behavior of what were dubbed "refrigerator mothers" was at fault to the ill-informed myth that vaccines can cause autism," said Losh.

Losh and her colleagues' findings add to a growing body of knowledge about the complex causes of autism and suggest that birth weight could be one of the environmental features that interacts with underlying genetic predisposition to autism.

Losh, who directs Northwestern's Neurodevelopmental Disabilities Laboratory, warned that the findings from twin studies might not extend to singletons, as the prenatal and perinatal conditions for twins and singletons differ in important ways.

The researchers studied a population-based sample of 3,725 same-sex twin pairs that were part of the Swedish Twin Registry's Child and Adolescent Twin Study that was directed by Paul Lichtenstein of Sweden's Karolinska Institute. The discordant twins they studied were pairs in which one twin was more than 400 grams (about 14 ounces) or at least 15 percent heavier at birth than the other.

Sleep Might Help Deepen Traumatic Memories

2012-01-22T12:11:00.000-08:00

Your emotional response to a disturbing image or traumatic event is weaker if you remain awake afterward, while sleep reinforces unpleasant emotional memories, according to new research.

The experiments involving 68 female and 38 male volunteers aged 18 to 30 also found that people who saw an unsettling image or traumatic event and then went to sleep are as upset as they originally were if they see the picture again or experience a flashback, but not those who stayed awake.

"We found that if you see something disturbing, let's say an accident scene, and then you have a flashback or you're asked to look at a picture of the same scene later, your emotional response is greatly reduced, that is, you'll find the scene far less upsetting, if you stayed awake after the original event than if you slept," Rebecca Spencer, a neuroscientist at the University of Massachusetts Amherst, said in a university news release.

"It's interesting to note that it is common to be sleep-deprived after witnessing a traumatic scene, almost as if your brain doesn't want to sleep on it," she added.

The study results may make sense from an evolutionary standpoint because this type of response would help our ancient ancestors survive by preserving negative emotions and memories of life-threatening situations, thus helping them avoid similar situations in the future, the researchers explained.

Spencer also said the "findings have significance for people with post-traumatic stress disorder, for example, or those asked to give eyewitness testimony in court cases."

The study appears in the current issue of the Journal of Neuroscience.

Lack of Sleep Makes Your Brain Hungry

2012-01-22T11:37:00.000-08:00

New research from Uppsala University shows that a specific brain region that contributes to a person's appetite sensation is more activated in response to food images after one night of sleep loss than after one night of normal sleep. Poor sleep habits can therefore affect people's risk of becoming overweight in the long run.

The findings are published in The Journal of Clinical Endocrinology & Metabolism.

Researchers Christian Benedict and Helgi Schiöth, of the Department of Neuroscience at Uppsala University, showed in an earlier article, published in American Journal of Clinical Nutrition, that a single night of total sleep loss in young normal weight men curbed the energy expenditure the next morning. This research also showed that subjects had increased levels of hunger, which indicates that an acute lack of sleep may affect human's food perception.

In a new study, Christian Benedict, together with Samantha Brooks, Helgi Schiöth and Elna-Marie Larsson from Uppsala University and researchers from other European universities, have now systematically examined which regions in the brain, involved in appetite sensation, are influenced by acute sleep loss. By means of magnetic imaging (fMRI) the researchers studied the brains of 12 normal-weight males while they viewed images of foods. The researchers compared the results after a night with normal sleep with those obtained after one night without sleep.

Christian Benedict explains: "After a night of total sleep loss, these males showed a high level of activation in an area of the brain that is involved in a desire to eat. Bearing in mind that insufficient sleep is a growing problem in modern society, our results may explain why poor sleep habits can affect people's risk to gain weight in the long run. It may therefore be important to sleep about eight hours every night to maintain a stable and healthy body weight."

Medical Receptionist Position

2012-01-18T15:50:00.000-08:00

Medical Receptionist Position
We are welcoming Dr. Sarat Susarla, pediatric pulmonary and sleep, in February!

Immediate openings at a busy pediatric specialty practice for both FT Medical Assistant AND a FT front office/receptionist to join our dynamic team.

We are looking for two individuals who are energetic, compassionate, team players. A quick-learner is a must in a medical specialty. The MA will be responsible for performing administrative duties and basic clinical tasks. Duties include but are not limited to providing over-all support for Physicians and office operations, rooming patients, taking vitals, answering phones, taking messages, assist with scheduling of tests and treatments, etc. a successful candidate must have knowledge of EMR and have signifcant relevant experience.

Enjoy working where you make a difference every day! Please send a cover letter& resumes to houstonresume@txmss.com

Medical Assistant Opportunity

2012-01-18T15:48:00.000-08:00

Medical Assistant Opportunity

We are welcoming Dr. Sarat Susarla, pediatric pulmonary and sleep, in February!

Immediate openings at a busy pediatric specialty practice for both FT Medical Assistant AND a FT front office/receptionist to join our dynamic team.

We are looking for two individuals who are energetic, compassionate, team players. A quick-learner is a must in a medical specialty. The MA will be responsible for performing administrative duties and basic clinical tasks. Duties include but are not limited to providing over-all support for Physicians and office operations, rooming patients, taking vitals, answering phones, taking messages, assist with scheduling of tests and treatments, etc. a successful candidate must have knowledge of EMR and have signifcant relevant experience.

Enjoy working where you make a difference every day! Please send a cover letter& resumes to mailto:houstonresume@txmss.com

Women suffer from sleep apnea, raised heart risks, too

2012-01-18T15:41:00.000-08:00

Just as it does in men, obstructive sleep apnea can raise the risk for women of dying from heart attacks and having other cardiovascular problems, a new Spanish study indicates.

However, treating severe apnea at night with a system called CPAP -- continuous positive airway pressure -- can also help reduce the risk of heart attack deaths in women with apnea, just it can in men, the researchers report.

Sleep apnea -- characterized by repeated interruptions of breathing during sleep -- affects many more men than women, but up to 3 percent of middle-aged women have the disorder. One common symptom is snoring. Most patients have daytime sleepiness because of the sleep disorder. However, little research has focused on women until now.

"Women with untreated severe obstructive sleep apnea have a three-and-a-half-fold increase in the risk of dying from cardiovascular disease compared to women without (it)," said researcher Dr. Francisco Campos-Rodriguez, director of the sleep-disordered breathing unit at Valme University Hospital in Seville.

However, he found that treatment with CPAP in the women with severe apnea reduced that risk. The study is observational, so the researchers cannot say whether the apnea caused the increased rates of death or whether it was the CPAP that reduced that risk.

The study is published in the Jan. 17 issue of the Annals of Internal Medicine.

Researchers discover source of infant epilepsy

2012-01-18T15:38:00.000-08:00

ADELAIDE researchers have unlocked a 20-year mystery about a type of epilepsy in infants. It is caused by a single mutation in one gene.

The discovery will allow for better screening, diagnosis and prediction of the risk of seizures for sufferers of benign familial infantile epilepsy, the researchers say.

University of South Australia research fellow Dr Susan Heron said yesterday the rare condition occurred in about 60 Australian families.

She said the mutation was pinned to the chromosome responsible more than 15 years ago but the particular gene had been hard to identify.

"It was difficult to find because it wasn't a gene that you would think about linking to epilepsy," Dr Heron said. "The gene that we found is not a type of gene that's been known to be involved with epilepsy before."

The mutation causing the disorder adds one more code to a 12-code sequence on chromosome 16, which affects a gene known as PRRT2.

Of 23 families previously diagnosed with benign familial infantile epilepsy, DNA analysis found the mutation present in 19 families.

Dr Heron said children with the condition typically suffered seizures from the age of six months to two years.

Later in life, the genetic mutation can cause a movement disorder, characterised by sudden, startling, involuntary jerks when the children start moving.

"The children grow out of epilepsy but they can develop a movement disorder," Dr Heron said.

She said families would now be able to have their children screened for the mutation, with a definite diagnosis made.

"If we can confirm what they have, we can better target treatment," she said.

The UniSA researchers made the discovery in conjunction with a team at the University of Melbourne.

The work was published on Friday in the American Journal of Human Genetics.

Professor Ingrid Scheffer, from the Melbourne team began looking at the disorder some 20 years ago.

She said it was already known the gene made a protein called proline rich transmembrane protein 2.

"That means we can home in on what's happening biochemically and start to develop targeted treatments for the condition," she said.

The Sleep Apnea Business Is Booming, And Insurers Aren't Happy

2012-01-17T21:00:00.000-08:00

The Sleep Apnea Business Is Booming, And Insurers Aren't Happy

Snoring was once considered a simple annoyance for bed partners, but there is a growing awareness in the medical community that the grunts and snorts of noisy sleepers can also be a sign of sleep apnea.

It's a condition shown to increase the risk of several serious illnesses, including heart disease, stroke and dementia. Critics, however, worry that overnight tests to diagnose apnea, particularly those done in sleep labs, may be over-prescribed, at great cost to the health care system.

Testing can be a lucrative business, and labs have popped up in free-standing clinics and hospitals across the country. Over the past decade, the number of accredited sleep labs that test for the disorder has quadrupled, according to the American Academy of Sleep Medicine.

At the same time, insurer spending on the procedure has skyrocketed. Medicare payments for sleep testing increased from $62 million in 2001 to $235 million in 2009, according to the Office of the Inspector General.

Sleep apnea occurs when the muscles in the back of the throat relax. That causes an airway obstruction that can stop a person's breathing for several seconds — even minutes. It causes restless sleep and, sometimes, dangerously-low blood oxygen levels. The disorder can be diagnosed by monitoring a snorer's sleep patterns, either in an overnight visit to a sleep lab or at home using a portable testing device. It's then often treated with a CPAP machine that helps keep a snorer's airway open during sleep.

Sleep apnea has likely become more common because the population has grown older and more obese — two major risk factors for the disorder. The National Institutes of Health estimates that more than 12 million Americans suffer from the apnea. Many are never diagnosed.

"The medical community is sort of dropping the ball," Dr. David Gross, medical director of the sleep lab at the National Rehabilitation Hospital in Washington, D.C., says. "It's just sad when you walk through the hospital and you see these patients with heart failure — the person might be 35 years old, he's 350 pounds — but no one's thinking that he has sleep apnea, which he statistically does." Gross says more than three-quarters of the patients who come to his lab are diagnosed with apnea.

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Jenny Gold/Kaiser Health News

Dr. David Gross, medical director of the sleep lab at the National Rehabilitation Hospital in Washington, D.C., says more than three-quarters of the patients who come to his lab are diagnosed with apnea.

But the testing isn't cheap: Each night at a hospital sleep lab can cost $1,900 and is usually mostly covered by a patient's health insurance. Some patients end up spending two nights at the lab — one to test for apnea and the second to try the CPAP machine.

Dr. Fred Holt, an expert on fraud and abuse and a medical director of Blue Cross Blue Shield in North Carolina, says some patients aren't having basic exams done first and are therefore being prescribed expensive tests they don't need. Not everyone who snores has a chronic disorder, he says. In other cases, Holt says, the labs prescribe CPAP machines right away without first suggesting other strategies that could reduce apnea, such as losing weight or sleeping on your side.

"We are spending more and more money on sleep testing and treatment," he says, "and like anything else in health care, there are unscrupulous people out there who are more than happy to do testing and treatment that might be of questionable value. This might be because of naiveté on the part of the physician, or unfortunately, it could be done for the sake of improving the cash flow of the business."

It's no secret that the sleep business can be lucrative for physicians. A website for Aviisha, a sleep testing company, has a special page for physicians showing a picture of a doctor with a stack of money in his lab coat pocket. And in February, the American Academy of Sleep Medicine is offering a seminar on the "business of sleep medicine for physicians" at a golf resort in Arizona.

While many sleep centers offer comprehensive care for sleep disorders, others are largely focused on overnight sleep testing, according to Dr. Nancy Collop, president of the academy. "A lot of people have gotten into the sleep business specifically to do that procedure," she says. The goal of the academy's accreditation process, she says, is to make sure sleep labs are offering more, because "many patients may not even need a sleep study."

Helen Darling, president of the National Business Group on Health, which represents large employers offering health insurance to their workers, says the tests are driving up the cost of premiums. "This is a good example of something where we have technology, we have financial incentives to use more of it then we've historically done. You have enough problems, including a growing obesity epidemic, and you sort of put together the so-called perfect storm for driving up overuse and health care costs."

Doctors should focus instead on common-sense approaches to sleep apnea, she says, like losing weight, before turning to expensive testing and medical devices.

Another option is a home sleep test, which costs less than a fifth as much as a lab test, and is considered effective for most patients. Medicare began paying for home sleep tests in 2008, but the tests have had only modest growth.

"I believe lab tests, as opposed to the home tests, are being wildly overprescribed," says Michael Backus, senior vice president of American Imaging Management, a subsidiary of WellPoint.

Right now, 99 percent of the sleep tests given to WellPoint patients are done in the lab, he says, but "it should be 70 percent at home and 30 percent in the lab." Backus adds that the majority of patients who are diagnosed with apnea and then given CPAP machines stop using them within the first year.

Some insurers, including WellPoint, are changing the way they pay for sleep testing to curb the costs. Many now require a special pre-authorization. They also ask the doctor whether a patient qualifies for a home sleep test instead of one at the lab. Those changes are now widespread among Massachusetts insurers and are having an effect on the sleep industry in the state.

Dr. Lawrence Epstein, the chief medical officer of Sleep HealthCenters in Massachusetts, says the labs have already experienced a 20 percent drop in the number of patients coming in for testing. While the past decade was focused on industry growth, he says it's "now going to be about consolidation and provision of better quality, more efficient care."

Sleep HealthCenters has shut down three of its 15 sleep labs, and more closures may be on the way. Epstein says the company is focusing more on "sleep wellness," including treating and managing sleep disorders, and less on testing. The key, he says, is to become more efficient without decreasing access to care for patients who need it.

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Study Could Lead to a Treatment for Angelman Syndrome

2012-01-15T17:00:00.000-08:00

Study Could Lead to a Treatment for Angelman Syndrome

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Angelman syndrome is a severe neurodevelopmental disorder caused by mutation or deletion of the maternally inherited copy of Ube3a (blackened region of the chromosomes). The paternally inherited copy of Ube3a is intact but epigenetically silenced in neurons (grey neuron, green chromosomal region). A high-content screen with mouse primary cortical neurons identified several topoisomerase I and II inhibitors (white flurries covering pink neuron) that unsilence the paternal copy of Ube3a. This study highlights a role for topoisomerase enzymes in epigenetic gene regulation and suggests a novel approach for restoring Ube3a function in patients with Angelman syndrome. (Credit: Illustration by Janet Iwasa)

ScienceDaily (Dec. 21, 2011) — Results of a new study from the University of North Carolina at Chapel Hill may help pave the way to a treatment for a neurogenetic disorder often misdiagnosed as cerebral palsy or autism.

Known as Angelman syndrome, or AS, its most characteristic feature is the absence or near absence of speech throughout the person's life. Occurring in one in 15,000 live births, other AS characteristics include intellectual and developmental delay, severe intellectual disability, seizures, sleep disturbance, motor and balance disorders. Individuals with the syndrome typically have a happy, excitable demeanor with frequent smiling, laughter, and hand flapping.

No effective therapies exist for AS, which arises from mutations or deletions of the gene Ube3a on chromosome 15. The Ube3a protein produced by the gene is a key component of a molecular pathway that is very important to all cells, especially brain neurons by helping them pass electrical or chemical signals to other neurons via the synapse.
Angelman syndrome is linked to mutations or deletions in the Ube3a gene inherited from the mother; thus, the maternal allele. In most tissues of the body, both the maternal and paternal alleles are expressed. But in rodents and humans, the paternal Ube3a allele is intact but silent, or dormant.
What apparently accounts for the dormancy of that allele is a strand of ribonucleic acid known as antisense RNA, which in terms of gene expression keeps paternal Ube3a silenced, or off. Once referred to as the genome's "dark matter," antisense RNA makes no functioning gene product, but works to repress expression of another gene by binding to its RNA.

"We wanted to determine if there could be a way to "awaken" the dormant allele and restore Ube3a expression in neurons," said neuroscientist Benjamin D. Philpot, PhD, associate professor of cell and molecular physiology, one of three senior investigators in the study and a member of the UNC Neuroscience Center.

In a report of the research published online Dec. 21, 2011 in the journal Nature, the interdisciplinary team of UNC scientists say they have found a way to "awaken" the paternal allele of Ube3a, which could lead to a potential treatment strategy for AS.

"We have taken advantage of a tool that allows us to distinguish between active and inactive alleles," Philpot said. "That tool is a modified mouse that's engineered so that the Ube3a gene has a fluorescent 'reporter' gene attached to it, which tells you when the gene is on or when it's off. When the gene is on, neurons will fluoresce in yellow, but won't when the gene is off."

Other 'tools' available on the UNC campus come from study senior author Bryan L. Roth, MD, PhD, Michael Hooker Distinguished Professor of Pharmacology and Translational Proteomics and director of the National Institute of Mental Health Psychoactive Drug Screening Program. These include highly automated robotics of the sort normally found in major pharmaceutical companies: fluid handling robotics and automated high-content imaging that combine the molecular tools of modern cell biology with automated high resolution microscopy and robotic handling (seehttp://pdspdb.unc.edu/download/robotLab2011.php).

Using a library of FDA-approved drugs obtained from the National Institute of Health (the NIH Clinical Collection) the UNC team discovered that irinotecan, a topoisomerase (TOPO-EYE-SOM-ERASE) inhibitor known to be active in the central nervous system -- robustly 'awakened' Ube3a. Subsequently, the team identified the FDA approved medication topotecan and several other topoisomerase inhibitors as drugs which can 'awaken' Ube3a.

"When we gave topotecan to these neurons they would now glow, indicating that the paternal allele was now on," Philpot said. Topotecan apparently awakened the dormant Ube3a allele by down-regulating, or reducing, antisense RNA in the paternal copy of Ube3a, the researchers determined.
When topotecan was given to the genetically engineered mice, "it unsilenced the paternal Ube3a allele in several regions of the nervous system, including neurons in several areas of the brain and in the spinal cord," the authors state. These findings also held true for irinotecan.

Importantly, the protein from the unsilenced paternal Ube3a was functional and was expressed by the gene in amounts comparable to that of normal maternal Ube3a in 'control' animals.

The study's third senior co-author, neuroscientist Mark J, Zylka, PhD, assistant professor of cell and molecular physiology and a UNC Neuroscience Center member says the study is "the first example of a drug that regulates antisense RNA and, as a result, regulates [protein] levels of a coding gene."
According to Philpot, the increased scientific interest in Ube3a is because certain DNA copies, or duplications, in maternal chromosome 15 are associated with classic forms of autism. "If you have too little Ube3a you have Angelman syndrome. If the maternal allele is duplicated, it might be a contributing factor to autism."

Zylka and Philpot caution against using topoisomerase inhibitors now to treat Angelman syndrome, given the limits of current knowledge.

"We'd like to stress that these compounds are not ready to be used clinically for Angelman syndrome," Zylka said. "We don't know what the off-target effects might be on a gene or genes with similar DNA sequences. We need to figure out optimal concentrations and dosing before we move to clinical trials. And we need to determine which drug is best."

For people to use these drugs now for Angelman syndrome, without further preclinical studies, might be a health risk, Philpot adds, "one that could jeopardize successfully bringing these compounds to clinical trials."

Along with Philpot, Zylka and Roth, coauthors from UNC were Hsien-Sung Huang, John A. Allen, Angela M. Mabb, Ian F. King, Jayalakshmi Miriyala, Bonnie Taylor-Blake, Noah Sciaky, J. Walter Dutton Jr, Hyeong-Min Lee, Xin Chen, Jian Jin, and Arlene S. Bridges.
The research was supported in part by funds from the Angelman Syndrome Foundation, the Simons Foundation, the National Institute of Mental Health, the National Eye Institute, the National Institute of Neurological Disorders and Stroke, the NIMH Psychoactive Drug Screening Program, and NC TraCS Institute funded by the NIH Clinical and Translational Science Awards (CTSA).
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The above story is reprinted from materials provided by University of North Carolina School of Medicine, via Newswise.
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Journal Reference:

Hsien-Sung Huang, John A. Allen, Angela M. Mabb, Ian F. King, Jayalakshmi Miriyala, Bonnie Taylor-Blake, Noah Sciaky, J. Walter Dutton, Hyeong-Min Lee, Xin Chen, Jian Jin, Arlene S. Bridges, Mark J. Zylka, Bryan L. Roth, Benjamin D. Philpot. Topoisomerase inhibitors unsilence the dormant allele of Ube3a in neurons. Nature, 2011; DOI: 10.1038/nature10726

People Mimic Each Other, but Only When They Have the Same Goal, Study Suggests

2012-01-15T08:19:00.001-08:00

People Mimic Each Other, but Only When They Have the Same Goal, Study Suggests

ScienceDaily (Jan. 11, 2012) — It's easy to pick up on the movements that other people make -- scratching your head, crossing your legs. But a new study published in Psychological Science, a journal of the Association for Psychological Science, finds that people only feel the urge to mimic each other when they have the same goal.

It's common for people to pick up on each other's movements. "This is the notion that when you're having a conversation with somebody and you don't care where your hands are, and the other person scratches their head, you scratch your head," says Sasha Ondobaka of the Donders Institute for Brain, Cognition and Behaviour at Radboud University Nijmegen in the Netherlands. He cowrote the paper with Floris P. de Lange, Michael Wiemers, and Harold Bekkering of Radboud and Roger D. Newman-Norlund of the University of South Carolina. This kind of mimicry is well-established, but Ondobaka and his colleagues suspected that what people mimic depends on their goals.
"If you and I both want to drink coffee, it would be good for me to synchronize my movement with yours," Ondobaka says. "But if you're going for a walk and I need coffee, it wouldn't make sense to be coupled on this movement level."
Ondobaka and his colleagues devised an experiment to see how much of a pull people feel to mimic when they have the same or different goals from someone else. Each participant sat across from an experimenter. They played a sort of card game on a touch screen embedded in the table between. First, two cards appeared in front of the experimenter, who chose either the higher or the lower card. Then two cards appeared in front of the participant. This happened 16 times in a row. For some 16-game series, the participant was told to do the same as the experimenter -- to choose the higher (or lower) card. For others, they were told to do the opposite. Participants were told to move as quickly and as accurately as possible.
When the participant was supposed to make the same choice as the experimenter, they moved faster when they were also reaching in the same direction as the experimenter. But when they were told to do the opposite of the experimenter -- when they had different goals -- they didn't go any faster when making the same movement as the other person. This means having different goals got in the way of the urge to mimic, Ondobaka says.
The researchers think that people only copy each other's movements when they're trying to accomplish the same thing. The rest of the time, actions are more related to your internal goals. "We're not walking around like chameleons copying everything," Ondobaka says. If you're on a busy street with dozens of people in view, you're not copying everything everybody does -- just the ones that have the same goal as you. "If a colleague or a friend is going with you, you will cross the street together."

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The above story is reprinted from materials provided by Association for Psychological Science.
Note: Materials may be edited for content and length. For further information, please contact the source cited above.

Journal Reference:

S. Ondobaka, F. P. de Lange, R. D. Newman-Norlund, M. Wiemers, H. Bekkering. Interplay Between Action and Movement Intentions During Social Interaction. Psychological Science, 2011; 23 (1): 30 DOI: 10.1177/0956797611424163

Could Heading in Soccer Lead to Brain Injury? No Clear Link to Chronic Traumatic Encephalopathy, So Far

2012-01-15T08:15:00.000-08:00

Could Heading in Soccer Lead to Brain Injury? No Clear Link to Chronic Traumatic Encephalopathy, So Far

As yet there's not clear evidence to link heading to short- or long-term brain injury, according to experts. However, while research is ongoing, they stress the need for proper heading technique at all levels of organized soccer. (Credit: © Sylvie Bouchard / Fotolia)

ScienceDaily (Jan. 9, 2012) — Could heading the ball in soccer lead to degenerative brain disease, like that seen in athletes in other sports?

That's the question addressed by a review in the January issue of Neurosurgery, official journal of the Congress of Neurological Surgeons.
As yet there's not clear evidence to link heading to short- or long-term brain injury, according to Dr Alejandro M. Spiotta of the Cleveland Clinic and colleagues. However, while research is ongoing, they stress the need for proper heading technique at all levels of organized soccer.
New Review of Evidence on Heading and Brain Injury Risk in Soccer
Soccer (called football outside the United States) is the only sport in which players use their unprotected heads to intentionally deflect, stop, or redirect the ball. Headed balls travel at high velocity both before and after impact, raising concerns about possible traumatic injury.
In 2002, English footballer Jeffrey Astle, known as a "formidable header," died with degenerative brain disease. The damage was consistent with chronic traumatic encephalopathy (CTE): a progressive neurodegenerative disease caused by repeated brain injury, seen in American football players and other athletes. Those reports have prompted concerns about similar risks in soccer players.
Although concussions are common in soccer, they more often result from the head striking another player or the goalpost, rather than heading the ball. But there's still concern about long-term injury related to repetitive trauma from heading.
Detailed biomechanical studies have been performed, showing that heading is a complex task in which significant energy is absorbed by the head. Emphasizing the importance of proper heading technique, studies have shown that anticipation and "pre-tensing" of the neck muscles play a key role in absorbing and redirecting the impact of a headed ball.
Pending Further Research, Emphasis on Proper Heading Technique
Older studies reported symptoms related to heading ("footballers' migraine"), but more recent research has not confirmed those effects. One factor may be the introduction of newer soccer balls that don't absorb moisture -- unlike the leather balls used in Jeffrey Astle's day.
Soft headgear has been suggested to protect against soccer-related head injuries, although studies have questioned the protective benefits. There are even concerns that wearing headgear might even lead to increased injury risk, if players develop a false sense of security.
For now, the data on heading and brain injury "leave us somewhat in the grey zone," according to Dr Spiotta and colleagues. While it's reassuring that there's no clear link to CTE, the potential for long-term brain injury remains. "Even if the cognitive impairment were to be mild, it would still present a major medical and public health concern because of the massive volume of soccer players worldwide," the researchers write. "Any possible detrimental effect…may only become clinically evident decades in the future."
Dr Spiotta and coauthors emphasize the need for further research -- including autopsy studies of players in the "light ball" era -- to see if there is any similarity to the patterns of brain injury seen in CTE. Meanwhile, "Proper heading technique should continue to be stressed at all levels of play." The authors also highlight the importance of using an age-appropriate ball size for younger soccer players, as they develop the neck strength and posture control needed for proper heading technique.
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The above story is reprinted from materials provided by Wolters Kluwer Health: Lippincott Williams & Wilkins, via Newswise.
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Journal Reference:

Alejandro M. Spiotta, Adam J. Bartsch, Edward C. Benzel. Heading in Soccer. Neurosurgery, 2012; 70 (1): 1 DOI: 10.1227/NEU.0b013e31823021b2

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Diet Counts: Iron Intake in Teen Years Can Impact Brain in Later Life

2012-01-14T11:02:00.000-08:00

Editorial note: Be careful...only use iron with your doctor's guidance! Iron overdose can be fatal.

Iron is a popular topic in health news. Doctors prescribe it for medical reasons, and it's available over the counter as a dietary supplement. And while it's known that too little iron can result in cognitive problems, it's also known that too much promotes neurodegenerative diseases.

Now, researchers at UCLA have found that in addition to causing cognitive problems, a lack of iron early in life can affect the brain's physical structure as well.

UCLA neurology professor Paul Thompson and his colleagues measured levels of transferrin, a protein that transports iron throughout the body and brain, in adolescents and discovered that these transferrin levels were related to detectable differences in both the brain's macro-structure and micro-structure when the adolescents reached young adulthood.

The researchers also identified a common set of genes that influences both transferrin levels and brain structure. The discovery may shed light on the neural mechanisms by which iron affects cognition, neurodevelopment and neurodegeneration, they said.

Their findings appear in the current online edition of the journalProceedings of the National Academy of Sciences.

Iron and the proteins that transport it are critically important for brain function. Iron deficiency is the most common nutritional deficiency worldwide, causing poor cognitive achievement in school-aged children. Yet later in life, iron overload is associated with damage to the brain, and abnormally high iron concentrations have been found in the brains of patients with Alzheimer's, Parkinson's and Huntington diseases.

Since both a deficiency and an excess of iron can negatively impact brain function, the body's regulation of iron transport to the brain is crucial. When iron levels are low, the liver produces more transferrin for increased iron transport. The researchers wanted to know whether brain structure in healthy adults was also dependent on transferrin levels.

"We found that healthy brain wiring in adults depended on having good iron levels in your teenage years," said Thompson, a member of UCLA's Laboratory of Neuro Imaging. "This connection was a lot stronger than we expected, especially as we were looking at people who were young and healthy -- none of them would be considered iron-deficient.

First lady announces new program to help people with traumatic brain injuries

2012-01-14T10:54:00.000-08:00

A local doctor was among those asked to be with Michelle Obama today in Richmond, Virginia, as she announced a new program to help the troops coming home from the wars in the Middle East.

Dr. Paul Harch joined the first lady to talk about how medical schools can do research and train new doctors to better care for veterans needs, especially with brain injury.

The White House is recognizing the importance of brain research, such as the research being done here in New Orleans, as beneficial to the health of the men and women who fought in Iraq and Afghanistan.

"The mental health challenges many of our troops face once they return home," Michelle Obama said from the podium in Richmond Wednesday afternoon.

For 20 years now, Medical Watch has been following the research of two LSU Health Sciences Center doctors, emergency medicine specialist Dr. Paul Harch, director of the LSUHSC New Orleans Hyperbaric Medicine and Wound Care Department, and Dr. Keith Van Meter, the chief of the section of emergency medicine.

They have worked on projects to help patients with brain injury healing through hyperbaric oxygen treatments. They have treated near drowning victims, such as a California man who spent nearly a half hour at the bottom of the Mississippi River and has no brain damage, and many others with strokes, traumatic brain injury, and those with some mental disabilities and brain defects from birth.

A few years ago, the doctors began studies on veterans coming home from the Middle East, those who had post traumatic stress disorder from war and those whose brains were injured from explosions.

They testified in front of the Congressional House Armed Services Committee and reported to the Department of Defense on their oxygen treatment studies for injured soldiers.

Young marine Jake Mathers was in the pilot study when he came home with brain damage from a suicide bomber explosion and PTSD.

"You forget where you put your cell phone. Like 10 times a day you can't find your car keys. You can't really do anything productive without screwing it up a couple of times," he said before the treatments in February 2009.

After the oxygen treatments (HBOT), his health changed.

"My sleep is better. I'm sleeping longer. I'm not dreaming about mean and angry things constantly. My memory, I don't even have a memory problem anymore. I don't have headaches at all any more," said Mathers back in 2009 after HBOT treatments.

Study: Digital addiction may damage your brain

2012-01-14T10:51:00.000-08:00

We throw around words like “crackberry” to describe how dependent we are on high-tech devices.

But now, a study finds that Internet addiction may actually damage the brain—the same as too much alcohol or drugs.

For the study, published in the Jan. 11 issue of PLoS One, researchers studied 17 men and women who were diagnosed with Internet addiction disorder (IAD) and compared scans of their brains to scans of 16 healthy people who weren’t addicted to the web. Study participants were between the ages of 14 and 21 and lived in China.

The researchers found more patterns of “abnormal white matter” on brain scans of Internet addicts, compared with scans of non-addicts. White matter areas in the brain contain nerve fibers that transmit signals to other parts of the brain.

These changes showed evidence of disrupting pathways related to emotions, decision-making, and self control.

Physician and best-selling author Dr. Deepak Chopra called the study “very valid” on “CBS This Morning.”

“Addictive behavior means that you’re compulsively repeating that behavior at the cost of everything in your life. You can’t sleep. You miss out on relationships, social interactions, health, well-being. Any addictive behavior will cause the same damage in the brain at the receptors as a drug will do. The study is very valid. Once there’s damage, then that perpetuates the behavior. It becomes a vicious cycle. The behavior damages the brain. The brain then reinforces the behavior. And soon, it spins out of control.”

But how do you know you have a problem—and is there hope to rewire your brain if you do?

How Stem Cell Implants Help Heal Traumatic Brain Injury

2012-01-14T10:49:00.000-08:00

For years, researchers seeking new therapies for traumatic brain injury have been tantalized by the results of animal experiments with stem cells. In numerous studies, stem cell implantation has substantially improved brain function in experimental animals with brain trauma. But just how these improvements occur has remained a mystery.

Now, an important part of this puzzle has been pieced together by researchers at the University of Texas Medical Branch at Galveston. In experiments with both laboratory rats and an apparatus that enabled them to simulate the impact of trauma on human neurons, they identified key molecular mechanisms by which implanted human neural stem cells -- stem cells that are in the process of developing into neurons but have not yet taken their final form -- aid recovery from traumatic axonal injury.

A significant component of traumatic brain injury, traumatic axonal injury involves damage to axons and dendrites, the filaments that extend out from the bodies of the neurons. The damage continues after the initial trauma, since the axons and dendrites respond to injury by withdrawing back to the bodies of the neurons.

"Axons and dendrites are the basis of neuron-to-neuron communication, and when they are lost, neuron function is lost," said UTMB professor Ping Wu, lead author of a paper on the research appearing in the Journal of Neurotrauma. "In this study, we found that our stem cell transplantation both prevents further axonal injury and promotes axonal regrowth, through a number of previously unknown molecular mechanisms."

Study: One in 10 infants at risk for sleep disorders

2012-01-12T21:05:00.000-08:00

One in 10 infants and toddlers have problems sleeping at night and may be at greater risk of developing a sleep disorder as they get older, a new study suggests.

The new research is a rare look at a problem that many parents and even pediatricians sometimes fail to notice. The study, which looked at children ages 6 months to 3 years, found that sleep problems were common in this age group. But parents did not always perceive red flags like loud and frequent snoring — which can be a risk factor for obstructive sleep apnea, a potentially serious breathing disorder — as problems that warranted mentioning to their pediatricians.

The findings also challenged a widespread notion that children who have sleep troubles early on tend to outgrow them. In the study, children who had one or more sleep problems at any point in early childhood were three to five times as likely to have a sleep problem later on.

“The data indicate that sleep problems in children are not an isolated phenomenon,” said Dr. Kelly Byars, an associate professor at the Cincinnati Children’s Hospital Medical Center and an author of the study, which was published in the journal Pediatrics. “If you have it early and it’s not remedied, then it’s likely to continue over time.”

The warning signs of a disorder can vary widely. But some indicators of a potential problem in children are loud snoring several nights a week, frequent bouts of getting up in the middle of the night, nightmares or night terrors, and routinely taking longer than 20 minutes to fall asleep.

Although serious sleep issues are more often thought of as a problem of adulthood, the National Sleep Foundation estimates that up to 69 percent of children younger than 11 have a sleep-related problem of some kind. Many parents, though, do not know what to look for or how to distinguish a true sleep disorder from the normal challenges of putting an infant or child to bed.

Pediatricians, too, may also overlook a child’s nighttime troubles. One report found that roughly half of all pediatricians do not ask about or screen for sleep disturbances when talking to parents about the health of a toddler or infant.

Melatonin found to ease sleep woes in children with autism

2012-01-12T21:03:00.000-08:00

A new Vanderbilt study shows that the over-the-counter supplement melatonin is promising in helping children with autism spectrum disorders (ASD), and their families, sleep better.

The study, published in the Journal of Autism and Developmental Disorders, contributes to the growing literature on supplemental melatonin for insomnia in ASD, according to lead author Beth Malow, M.D., M.S., professor of Neurology and Pediatrics, Burry Chair in Cognitive Childhood Development and Vanderbilt Kennedy Center investigator.

Malow said the study was designed to allow researchers to identify doses at which children responded to melatonin and also how long it took to observe a response.

Sleep difficulties, particularly insomnia, occur in 50 percent to 80 percent of children with ASD and are often accompanied by child and family distress.

“We are excited about the potential melatonin has for treating insomnia, which can be overwhelming to children with autism as well as their families,” Malow said.

“The next step is to perform large-scale, controlled trials to prove that melatonin is effective in this population.”

Malow and colleagues recruited children ages 3-9 years with a clinical diagnosis of an ASD whose parents reported sleep onset delay of 30 minutes or longer on three or more nights per week.

Supplemental melatonin, given 30 minutes before bedtime, improved sleep latency in most children at 1 mg or 3 mg dosages.

Sleep latency, or the amount of time it takes a child to fall asleep, was measured by using an actigraph, which is a wrist-watch-like sensor worn by participants to monitor human rest/activity cycles.

Melatonin was effective in the first week of treatment, maintained effectiveness over several months, was well-tolerated and safe, and showed improvement in sleep, behavior and parenting stress, Malow said.

Neurological conditions increase flu risk

2012-01-12T15:35:00.000-08:00

Doctors should be alert to the possibility of influenza among children and young adults with neurological and neurodevelopmental conditions, U.S. officials say.

A study published in the Centers for Disease Control and Prevention Morbidity and Mortality Weekly Report

describes the findings of a joint investigation between the CDC and the Ohio Department of Health into an outbreak of influenza in a residential facility for children and young adults with neurological and neurodevelopmental conditions.

"Among 130 residents of the facility, 58 percent developed respiratory illness in February 2011; 13 became severely ill and seven of those patients died," the report said. "All 13 severely ill residents had multiple neurological and neurodevelopmental conditions, and their underlying medical conditions might have hindered early diagnosis and treatment and contributed to the severity of illness."

Because those with neurological and neurodevelopmental disorders are at high risk for complications from influenza, vaccination should be part of a larger program of influenza prevention that includes antiviral drugs that are given early in the course of illness -- ideally within 48 hours of symptom onset, the report said.

A Nap a Day Keeps Tantrums Away

2012-01-12T15:31:00.000-08:00

Skipping a nap - even for one day - has a significant effect on toddlers' ability to express enthusiasm and deal with frustration according to a recent study.

While it may seem obvious that a nap-deprived child would be cranky, the skipped naps could contribute to long-term problems in emotional and cognitive development, warn researchers in the first known study to investigate how sleep deprivation affects young children's emotional states.

Monique LeBourgeois, an assistant professor at the University of Colorado Boulder, led the study, in which children's emotional reactions and facial expressions were assessed while they assembled puzzles and looked at photos on two different days, one with a nap and one without. They showed more anxiety and less interest on the day without a nap.

"Many young children today are not getting enough sleep, and for toddlers, daytime naps are one way of making sure their 'sleep tanks' are set to full each day," LeBourgeois said.

"This study shows insufficient sleep in the form of missing a nap taxes the way toddlers express different feelings, and, over time, may shape their developing emotional brains and put them at risk for lifelong, mood-related problems," she added.

The researchers analyzed the emotional expressions of healthy toddlers after the children had first followed a strict sleeping schedule that included 12.5 hours in bed for five straight days before the study.

Then, the children were asked to solve puzzles and were shown positive, negative or neutral images for their reactions on two different days: one day an hour after having skipped their normal 90-minute nap and then on a different day following their normal nap.

With less sleep, the toddlers had more negative expressions when shown neutral pictures and less positive expressions in response to the positive images.

Then they were videotaped while they worked on a solvable puzzle that had all its pieces and an unsolvable one with an incorrect piece that replaced a missing piece.

The researchers assessed the children's positive reactions when they correctly assembled the complete puzzle and their frustration when they could not finish the mismatched puzzle.

The toddlers had a 34 percent decrease in positive emotional responses on the day they finished the complete puzzles without a nap compared to the day when they had their regular nap.

As they tried to put together the insolvable puzzles, they showed a 31 percent increase in negative emotional responses when they were sleep-deprived compared to their well-rested attempts.

"Without a nap, children are not going to get an adequate amount of sleep for their developmental age," William Kohler, MD, director of the Florida Sleep Institute and director of Pediatric Sleep Services at Florida Hospital Tampa, told dailyRx. "It's yet another study showing us that quality sleep is essential for optimal cognitive development."

3-D Modeling Software Benefits Kids With Autism

2012-01-11T21:23:00.000-08:00

These days, we hear a lot about the disorder of autism, but researchers at the University of Utah have created a program that helps kids with autism focus on building their skills and utilizing an aptitude for visual-spatial thinking, computers and other electronic media.

One of the program participants is 12-year-old Christopher Charles, who was diagnosed with what's now known as high-functioning autism when he was 18 months old. His parents started him in therapies early on, but hadn't found something that seemed to hold Christopher's interest or accommodate his behaviors.

Chris has participated for the past year and a half in workshops at the University of Utah to teach 3D modeling software by Google called SketchUp. Cheryl Wright, associate professor of family and consumer studies, coordinated the workshops in partnership with Google's Project Spectrum, an initiative to teach job skills to kids with autism. Steve Gross, a certified SketchUp instructor and designer for Universal Creative theme parks, leads the workshops.

Wright and her team soon found far greater benefits to these workshops than acquiring a skill set for potential employment, however. The sessions facilitated social engagement among the students and their peers, parents, siblings and even grandparents.

They have published a study about these findings in the December issue of Family & Consumer Sciences Research Journal. The study focuses on the effects of the workshops on individual students involved as well as on multiple generations within their families -- an uncommon opportunity in the research on social interactions of people with autism spectrum disorders (ASD).

After just weeks in the workshops, Christopher Charles' parents noticed a big difference. "Christopher spends hours on his design projects," says his father Nik. "There are few activities that have been able to hold Christopher's attention like SketchUp." In fact, Christopher once noted that he wouldn't miss the SketchUp sessions "even if aliens invaded the Earth."

Each session was two hours long and included hands-on training in the use of the design program as well as time for students to share their design projects. At the end of six weeks, the participants, all boys, presented their designs to classmates at their schools and at community events.

"One of the most compelling parts of this program came from when the boys presented their findings to their classmates," says Wright, who notes that children with autism sometimes struggle in a regular school setting, where their disability is highlighted more than their talents.

"Their talents are often invisible. In our program, we provided a platform for their talents to shine," she says. Many of the parents of participants were pleased that the workshops had developed self-confidence in their children, and noted that this made the parents more confident about what their children will be able to accomplish in the future.

Parents enrolled their children in the workshops with a bit of skepticism. Like Christopher's parents, they had experienced prior failures and had found few activities their sons enjoyed. The parents soon noticed that these workshops were different than other extracurricular activities, and seemed to be more aligned with their son's interests.

In turn, the success of the workshops led to greater self-confidence in parents, who began to rethink what they expected of their parenting ability and began to feel more effective.

They also noticed their sons' sincere concern about friends in the workshops -- something that hadn't happened in other social interactions. The parents and grandparents who noticed these changes began to feel optimistic that the boys would be able to develop genuine relationships with children and adults in the future.

"Many of the boys were in inclusive, regular educational settings so when they presented to their peers, it was the first time some of their classmates had seen the boys in control of a situation and teaching something the other kids didn't know," Wright says.

Healthy Diet May Help ADHD Children, Study Suggests

2012-01-11T21:04:00.000-08:00

A steady diet of healthy foods may benefit children with attention deficit hyperactivity disorder (ADHD), according to a new study.

An article published in the journal Pediatrics Monday compared the effectiveness of several dietary methods intended to replace medicinal treatments that have proven "unsatisfactory or unacceptable" for treating children with ADHD.

After analyzing 70 studies, researchers J. Gordon Millichap and Michelle M. Yee suggested a balanced diet heavy in fiber, folate and omega-3 fatty acids is most effective in decreasing effects of hyperactivity. Such a diet may include foods like fish, vegetables and whole grains, according to CBS News.

This particular study compared the effects of an "ADHD-associated 'Western-style'" diet, which tends to include a high amount of fat and refined sugar, to an "ADHD-free" assortment of healthier foods heavy in nutrients.

The review also examined several other diets, including the elimination diet, which avoids common food allergens like milk, nuts and eggs, and the Feingold diet, which avoids artificial coloring, artificial flavorings and some preservatives, USA Today reported. Researchers point out that these types of diets are often difficult to follow.

While scientists readily recognize the importance of a healthy diet, many still suggest changes in eating habits aren't always enough to improve behavior in children with ADHD, NPR reports. Instead, they suggest the nutritional changes should complement medicinal treatment.

Genes of Early-Onset Epileptic Encephalopathies: From Genotype to Phenotype

2012-01-11T21:02:00.000-08:00

Genes of Early-Onset Epileptic Encephalopathies: From Genotype to Phenotype

A review the genes more frequently associated with early-onset epileptic encephalopathies:

Early-onset epileptic encephalopathies are severe disorders in which cognitive, sensory, and motor development is impaired by recurrent clinical seizures or prominent interictal epileptiform discharges during the neonatal or early infantile periods. They include Ohtahara syndrome, early myoclonic epileptic encephalopathy, West syndrome, Dravet syndrome, and other diseases, e.g., X-linked myoclonic seizures, spasticity and intellectual disability syndrome, idiopathic infantile epileptic-dyskinetic encephalopathy, epilepsy and mental retardation limited to females, and severe infantile multifocal epilepsy. We summarize recent updates on the genes and related clinical syndromes involved in the pathogenesis of early-onset epileptic encephalopathies: Aristaless-related homeobox (ARX), cyclin-dependent kinase-like 5 (CDKL5), syntaxin-binding protein 1 (STXBP1), solute carrier family 25 member 22 (SLC25A22), nonerythrocytic α-spectrin-1 (SPTAN1), phospholipase Cβ1 (PLCβ1), membrane-associated guanylate kinase inverted-2 (MAGI2), polynucleotide kinase 3′-phosphatase (PNKP), sodium channel neuronal type 1α subunit (SCN1A), protocadherin 19 (PCDH19), and pyridoxamine 5-prime-phosphate oxidase (PNPO).

Summary

Genetic knowledge about early epileptic encephalopathies has revolutionized the diagnostic approach to these disorders, and an increasing number of gene mutations have been related to their pathogenesis.

In the future, a more detailed classification of epileptic encephalopathic genotypes will improve the accuracy of risk assessment and genetic counseling. M

oreover, all these developments could yield unexpected therapeutic applications such as gene therapy or antiepileptic drugs “tailored” to the specific patient through specific genetic markers or targets.

Full article HERE

Disruption of Biological Clocks Can Lead to Neurodegeneration, Early Death, Study Suggests

2012-01-11T20:51:00.000-08:00

New research at Oregon State University provides evidence for the first time that disruption of circadian rhythms -- the biological "clocks" found in many animals -- can clearly cause accelerated neurodegeneration, loss of motor function and premature death.

The study was published inNeurobiology of Disease and done by researchers at OSU and Oregon Health and Science University. Prior to this, it wasn't clear which came first -- whether the disruption of biological clock mechanisms was the cause or the result of neurodegeneration.

"In these experiments, we showed through both environmental and genetic approaches that disrupting the biological clock accelerated these health problems," said Kuntol Rakshit, an OSU graduate fellow.

"There's a great deal of interest right now in studies on circadian rhythms, as we learn more about the range of problems that can result when they are disrupted," Rakshit said. "Ultimately we hope that this research will be taken from the laboratory to the bedside."

These studies were done with fruit flies, but the OSU scientists said previous research has indicated there are close parallels between them and humans. Some of the genes regulating circadian rhythms in flies are so important that they have been preserved through millions of years of separate evolution and still do the same thing in humans.

The biological clock, in humans and many other animals, is a complex genetic mechanism tuned to the 24-hour day and regular cycles of light, dark and sleep. It influences a wide range of biological processes, from fertility to hormone production, feeding patterns, DNA repair, sleep, stress reactions, even the effectiveness of medications. In humans, researchers have found strong correlations between disrupted clock mechanisms, aging, and neurologic diseases such as Alzheimer's and Huntington's disease.

The fruit flies used in this research carried two mutations, one that disrupts circadian rhythms and another that causes flies to develop brain pathologies during aging. These double mutants had a 32-50 percent shorter lifespan, lost much of their motor function, and developed significant "vacuoles" or holes in their brains far sooner than flies with a functional clock.

The decline and loss of clock function may be just the beginning of a damaging, circular process, said Jadwiga Giebultowicz, an OSU professor of zoology, member of the OSU Center for Healthy Aging Research and project leader.

"When the biological clock begins to fail, rhythms that regulate cell function and health get disrupted, and we now know that this predisposes the brain to neurodegeneration," Giebultowicz said. "But that neurodegeneration, in turn, may cause more damage to the clock function.

"A healthy biological clock helps protect against this damage," she said. "When the clock fails, the damage processes speed up."

Aging is closely associated with this process, Giebultowicz said, but it's not clear exactly how. Molecular clock oscillations decline during aging. Finding ways to restore them might form a possible therapy for biological clock damage and help to prevent disease, and work in that area will be part of future research.

Autism center changes name, location, leaders

2012-01-11T11:43:00.000-08:00

Autism center changes name, location, leaders
The Thoughtful House Center for Children — an Austin facility geared to education, research and treatment of children with autism and other developmental disorders — has a new name, address and faces.

It is now the Johnson Center for Child Health and Development, named for Betty Wold Johnson, a prominent donor and member of the family who founded the health care company Johnson & Johnson. On Monday, the center will be move from its longtime Bee Cave Road location to 1700 Rio Grande St., Suite 200.

Thoughtful House was led by Andrew Wakefield until he resigned last year. The medical board in the United Kingdom took away his medical license for his role in a controversial 1998 study that suggested a possible link between autism, vaccines and bowel disease.

Wakefield said last year that he didn't want to be a distraction from the work of Thoughtful House, which he said was getting away from a focus on gastrointestinal issues and autism.

Anissa Ryland, executive director of the Johnson Center, said the organization does not collaborate with Wakefield or a doctor who worked with Wakefield at the center, Dr. Arthur Krigsman.

Another physician who worked with Wakefield and Krigsman, Dr. Brian Jepson, also has left the center.

http://www.statesman.com/news/local/central-texas-digest-autism-center-gets-new-name-1459998.html

Target Is ‘Down’ With Down Syndrome: 5 Things Target Said By Saying Nothing At All

2012-01-07T18:18:00.000-08:00

Target Is ‘Down’ With Down Syndrome: 5 Things

Target Said By Saying Nothing At All

January 2, 2012

If you were browsing through this week’s Target ad you may have passed right over the adorable little boy in the bright orange shirt smiling at you on page 9! And if so, I’m glad!

The reason I’m glad? Well, that stylish young man in the orange shirt is Ryan. Ryan just so happened to have been born with Down syndrome, and I’m glad that Target included a model with down syndrome in their typical ad!

This wasn’t a “Special Clothing For Special People” catalog. There wasn’t a call out somewhere on the page proudly proclaiming that “Target’s proud to feature a model with Down syndrome in this week’s ad!” And they didn’t even ask him to model a shirt with the phrase, “We Aren’t All Angels” printed on the front.

In other words, they didn’t make a big deal out of it. I like that....

read more HERE

Diabetes during pregnancy may raise ADHD risk

2012-01-04T20:51:00.000-08:00

Young children are far more likely to experience attention and hyperactivity problems if their mother develops diabetes during pregnancy and they are born into a poor or lower-middle-class household, a new study suggests.

The study, published this week in the Archives of Pediatrics and Adolescent Medicine, found that children whose mothers received a diabetes diagnosis during pregnancy (known as gestational diabetes) were twice as likely as their peers to meet the criteria for attention deficit hyperactivity disorder (ADHD) at age six.

Living in a family with below-average socioeconomic status likewise doubled the risk of ADHD in six-year-olds. But children with both risk factors -- those who were exposed to gestational diabetes and grew up in a less-than-affluent household -- had a 14-fold increased risk of ADHD compared to children with neither risk factor.

The findings don't prove that gestational diabetes directly causes ADHD, but the researchers say they send a message to mothers and doctors that gestational diabetes may pose hidden dangers to a child well after birth, especially if the child grows up in a challenging environment.

"Mothers should be aware that gestational diabetes can affect her fetus," says Yoko Nomura, Ph.D., the lead author of the study and an assistant clinical professor of psychiatry at the Mount Sinai School of Medicine, in New York City.

Gestational diabetes, which affects roughly 5% of expectant mothers in the United States, generally develops during the second or third trimester of pregnancy -- the same window of time in which a fetus undergoes a critical burst of brain development.

Women with gestational diabetes have abnormally high blood sugar (glucose). If the fetus is bombarded with excess blood sugar, energy normally used for nervous-system development could potentially be diverted to absorb that excess, Nomura says. As a result, the central nervous system may not develop properly.

Growing up in poverty would likely aggravate any underlying nervous-system deficits, Nomura says.

"When babies are born into higher socioeconomic status households, they have better access to medical care [and] remedial activities, intellectual stimulus is higher, they have better foods," she says.

In addition, low-income women may not control their gestational diabetes as well as more prosperous mothers-to-be, says Luigi Garibaldi, M.D., clinical director of pediatric endocrinology at the Children's Hospital of Pittsburgh.

"Having diabetes during pregnancy by itself may not be so bad, but if you don't take care of it, there may be consequences on the brain development of the child," says Garibaldi, who was not involved in the study.

Schizophrenia Diagnosis Associated With Progressive Brain Changes Among Adolescents

2012-01-04T20:49:00.000-08:00

Adolescents diagnosed with schizophrenia and other psychoses appear to show greater decreases in gray matter volume and increases in cerebrospinal fluid in the frontal lobe compared to healthy adolescents without a diagnosis of psychosis, according to a report in the January issue of Archives of General Psychiatry, one of the JAMA/Archives journals.

"Progressive loss of brain gray matter (GM) has been reported in childhood-onset schizophrenia; however, it is uncertain whether these changes are shared by pediatric patients with different psychoses," the authors write as background information in the study.

Celso Arango, M.D., Ph.D., of the Hospital General Universitario Gregorio Marañón, Madrid, Spain, and colleagues, examined the progression of brain changes in first-episode early-onset psychosis and the relationship to diagnosis and prognosis at two-year follow-up among patients at six child and adolescent psychiatric units in Spain. The authors performed magnetic resonance imaging (MRI) of the brain for 61 patients (25 diagnosed with schizophrenia, 16 with bipolar disorder and 20 with other psychoses) and 70 healthy control participants. MRI scans were conducted at study baseline and after two years of follow-up.

Compared with control patients, those diagnosed with schizophrenia showed greater gray matter volume loss in the frontal lobe during the two-year follow-up. Patients with schizophrenia also showed cerebrospinal fluid increase in the left frontal lobe. Additionally, changes for total brain gray matter and left parietal gray matter were significantly different in patients with schizophrenia compared with patients in the control group.

Among patients with schizophrenia, progressive brain volume changes in certain areas were related to markers of poorer prognosis, such as more weeks of hospitalization during follow-up and less improvement in negative symptoms. Greater left frontal gray matter volume loss was related to more weeks of hospitalization whereas severity of negative symptoms correlated with cerebrospinal fluid increase in patients with schizophrenia.

The authors did not find any significant changes in patients with bipolar disorder compared to control patients, and longitudinal brain changes in the control group were consistent with the expected pattern described for healthy adolescents.

"In conclusion, we found progression of gray matter volume loss after a two-year follow-up in patients who ended up with a diagnosis of schizophrenia but not bipolar disease compared with healthy controls," the authors write. "Some of these pathophysiologic processes seem to be markers of poorer prognosis. To develop therapeutic strategies to counteract these pathologic progressive brain changes, future studies should focus on their neurobiological underpinnings."

School-age children need more sleep at night

2012-01-04T20:02:00.000-08:00

Many parents don’t realize their child might not be getting enough sleep every night.

Most people feel eight hours a night is plenty of sleep for a school-aged child.

However, children between 5 and 12 years old need about 9 to 12 hours of sleep every night.

Sleep is important for children because it has an effect on their mental and physical well-being, and the hormone that stimulates growth is released while a child sleeps.

Symptoms of sleep deprivation in children include:

• Moodiness and irritability;

• Tendency to explode or have tantrums;

• Over-activity or hyperactive behavior; and

• Reluctance to get out of bed or overly groggy in the morning.

Some suggestions for making sure your child sleeps enough are:

• Don’t let your child’s activities interfere with sleep. Many children participate in activities such as sports or other hobbies.

Though these activities are beneficial for them, if they have too much going on in their lives, they might miss out on valuable sleep.

• Try to keep your child calm before bedtime. Regular exercise is good for children, but exercise too close to bedtime can keep children awake.

• Give your child a warm bath. If your children are too wound up to go to sleep, try having them take a warm bath before bedtime. Soaking for even 15 minutes can relax them.

• Don’t let your child have caffeine for at least six hours before bedtime. Caffeine, a stimulant in sodas and chocolate, can keep your child awake at night. If they want a drink before bedtime, give them milk or water.

• Don’t allow your child to watch television or play on the computer before bed. Instead, read to your child before bedtime. Reading is a great way to help children get to sleep.

• No texting 30 minutes before bedtime or during the night.

• Make sure their room is comfortable and sleep-friendly. It should be quiet, not too hot or too cold, and dark. If necessary, use a small night light.

• Set a consistent sleep schedule and be firm about bedtime. The body functions best when it’s on a regular timetable so it’s best for a child to wake up and go to bed at the same time every day — weekends included.

• Make sure your child knows it’s important to get a good night’s sleep.

Children who have sleep problems, such as daytime drowsiness, loud snoring or breathing pauses during sleep, might have a sleep disorder. If your child has these symptoms, talk to your pediatrician.

Here’s another thing to keep in mind: The earlier your children go to bed, the more time you have to relax and catch up on your own sleep.

Nap-Deprived Tots May Be Missing out On More Than Sleep

2012-01-04T19:58:00.000-08:00

A new study led by the University of Colorado Boulder could be a wake-up call for parents of toddlers: Daytime naps for your kids may be more important than you think.

The study shows toddlers between 2 and a half and 3 years old who miss only a single daily nap show more anxiety, less joy and interest and a poorer understanding of how to solve problems, said CU-Boulder Assistant Professor Monique LeBourgeois, who led the study. The results indicate insufficient sleep alters the facial expressions of toddlers -- exciting events are responded to less positively and frustrating events are responded to more negatively, she said.

"Many young children today are not getting enough sleep, and for toddlers, daytime naps are one way of making sure their 'sleep tanks' are set to full each day," she said. "This study shows insufficient sleep in the form of missing a nap taxes the way toddlers express different feelings, and, over time, may shape their developing emotional brains and put them at risk for lifelong, mood-related problems."

LeBourgeois and her colleagues assessed the emotional expressions of healthy, nap-deprived toddlers one hour after their normal nap time, and tested them again on another day following their normal nap. The study, believed to be the first to look at the experimental effects of missing sleep on the emotional responses of young children, indicates the loss of a nap -- in this case in just 90 minutes -- may make toddlers unable to take full advantage of exciting and interesting experiences and to adapt to new frustrations, she said.

"Just like good nutrition, adequate sleep is a basic need that gives children the best chance of getting what is most important from the people and things they experience each day," said LeBourgeois of the integrative physiology department.

In the study, the toddlers' faces were videotaped while they performed "kid-friendly" picture puzzles, including those of farm animals, sea creatures and insects. One puzzle each child worked had all of the correct pieces, which gave him or her the opportunity to experience and express positive emotion, she said. A second puzzle had a "wrong" piece and therefore was frustrating to the toddlers in the study because it was unsolvable.

Facial expressions of the toddlers were coded on a second-by-second basis for emotions like joy, interest, excitement, sadness, anger, anxiety, disgust, shame and confusion.

The study showed nap-deprived toddlers completing the solvable puzzles had a 34 percent decrease in positive emotional responses compared to the same children completing similar puzzles after their usual midday naps. The study also showed a 31 percent increase in negative emotional responses of nap-deprived toddlers when they attempted to complete unsolvable puzzles when compared with puzzle-solving attempts after they had napped.

In addition, the study found a 39 percent decrease in the expression of "confusion" when nap-deprived toddlers attempted to put together unsolvable puzzles. "Confusion is not bad -- it's a complex emotion showing a child knows something does not add up," said LeBourgeois. "When well-slept toddlers experience confusion, they are more likely to elicit help from others, which is a positive, adaptive response indicating they are cognitively engaged with their world."

A paper on the subject recently appeared online and will be published in an upcoming issue of the Journal of Sleep Research. Co-authors included Rebecca Berger and Ronald Seifer of Bradley Hospital in East Providence, R.I., Alison Miller of the University of Michigan School of Public Health and Stephanie Cares of Boston College. The study was funded by the National Institute of Mental Health. The study participants were from Providence, R.I.

"The non-adaptive emotional effects we saw in toddlers who missed a single nap make us wonder how young kids who consistently don't get enough sleep deal with their complicated social worlds," said LeBourgeois, who undertook the study with colleagues while at Brown University.

The toddlers were kept on a strict sleep schedule of at least 12 and a half hours of nighttime and daytime sleep for at least five days before the emotion-testing sessions. Having children follow a set sleep schedule before testing is important because it synchronizes their circadian cycles and makes sure the participants are well-slept prior to the nap and no-nap emotional assessments.

"A sleepy child in a classroom or daycare environment may not be able to engage with others and benefit from positive interactions," she said. "Their coping skills decrease and they may be more prone to tantrums or frustration, which would affect how other children and adults interact with them. This study shows that missing even a single nap causes them to be less positive, more negative and have decreased cognitive engagement."

Similar interactions in the home setting could affect parent-child relationships and a child's quality of life, LeBourgeois said.

The toddlers in the study all wore devices on their wrists that measured their sleep patterns. The parents also kept daily diaries documenting their toddlers' sleep.

"The goal of our study was to understand how losing sleep affects the way young kids respond emotionally to their world," said LeBourgeois. "This is important because toddlerhood is a sensitive period for developing strategies to cope with emotions and a time children naturally lose some sleep as they begin giving up their daytime naps."

Le Bourgeois and her colleagues are now recruiting 40 families with 2-year-olds from the Boulder area for a toddler-sleep study that involves how sleep restriction may affect not only emotion, but also higher levels of cognition known as executive function, which includes working memory and inhibitory control. "These are the building blocks for lifelong learning," she said.

Sleepy At 3? Don’t Reach Out For Sugar-Based Foods!

2012-01-04T19:53:00.000-08:00

It’s three o’clock in the afternoon and you have a few more hours of work to wind up at the office before you head for home. Yet you think you can barely go on any longer.

You are drowsy and desperate for a nap. You reach for the donut you bought while you were out walking after lunch.

Sound familiar? Studies now suggest that is exactly the thing you should not be doing. Apparently it is protein, and not sugar, that keeps us up and alert.

Scientists at the University of Cambridge have found that protein activates the cells that are responsible for keeping us awake and help us burn more calories. These cells called orexin cells or hypocretins are basically a type of excitatory neuropeptide hormones.

Orexin cells or hypocretins are responsible for stimulating food intake, wakefulness and energy expenditure. Reduced activity of these special orexin cells causes narcolepsy as well as conditions of weight gain. (1)

The findings of the study were published in the scientific journal Neuron (November issue) has deeper implications in terms of understanding sleep disorders and obesity. It was found that orexin is affected by different nutrients to different degrees. Nutrients found in proteins such as egg whites stimulated orexin neurons more than other nutrients found in any other food.

We have always known that sleep patterns and health are intertwined with body weight, but now orexin cells which are affected by the type of food we eat also plug into the wakefulness and body weight issues.

Scientists were able to highlight the orexin cells which are usually hard to find and then introduced different nutrients to them and waited to see the resultant excitability of these cells. They found that amino acids stimulate orexin cells considerably.

It was particularly interesting because the same group of scientists had earlier observed that glucose blocks the orexin cells and thus the level of wakefulness reduces drastically. This had helped them explain post-meal drowsiness.

The researchers then studied the interactions between sugars and protein and discovered that proteins were stopping the glucose from blocking orexin cells, or in other words, nullifying the glucose effect. (2) This goes to show why it is smarter to eat an egg or other protein-based snack mid-afternoon rather than going for that donut to combat sleepiness.

According to the lead researcher, Dr Denis Burdakov of the Department of Pharmacology and Institute of Metabolic Science, “To combatobesity and insomnia in today's society, we need more information on how diet affects sleep and appetite cells. For now, research suggests that if you have a choice between jam on toast, or egg whites on toast, go for the latter! Even though the two may contain the same number of calories, having a bit of protein will tell the body to burn more calories out of those consumed.” (2)

Autism May Be Linked to Abnormal Immune System Characteristics and Novel Protein Fragment

2012-01-04T19:47:00.000-08:00

Immune system abnormalities that mimic those seen with autism spectrum disorders have been linked to the amyloid precursor protein (APP), reports a research team from the University of South Florida's Department of Psychiatry and the Silver Child Development Center.

The study, conducted with mouse models of autism, suggests that elevated levels of an APP fragment circulating in the blood could explain the aberrations in immune cell populations and function -- both observed in some autism patients. The findings were recently published online in the Journal of the Federation of American Societies for Experimental Biology.

The USF researchers concluded that the protein fragment might be both a biomarker for autism and a new research target for understanding the physiology of the disorder.

"Autism affects one in 110 children in the United States today," said research team leader Jun Tan, MD, PhD, professor of psychiatry and the Robert A. Silver Chair, Rashid Laboratory for Developmental Neurobiology at USF's Silver Child Development Center. "While there are reports of abnormal T-cell numbers and function in some persons affected with autism, no specific cause has been identified. The disorder is diagnosed by behavioral observation and to date no associated biomarkers have been identified."

"Not only are there no associated biomarkers, but the prognosis for autism is poor and the costs associated with care are climbing," said Francisco Fernandez, MD, department chair and head of the Silver Center. "The work of Dr. Tan and his team is a start that may lead to earlier diagnosis and more effective treatments."