Neuroscience

Articles and news from the latest research reports.

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My mistake or yours? How the brain decides
Humans and other animals learn by making mistakes. They can also learn from observing the mistakes of others. The brain processes self-generated errors in a region called the medial frontal cortex (MFC) but little is known about how it processes the observed errors of others. A Japanese research team led by Masaki Isoda and Atsushi Iriki of the RIKEN Brain Science Institute has now demonstrated that the MFC is also involved in processing observed errors.
The team studied the brains of monkeys while the animals performed the same task. Two monkeys sat opposite each other and took turns to choose between a yellow and green button, one of which resulted in a liquid reward for both. Each monkey’s turn consisted of two choices.
After blocks of between 5 and 17 choices, the button that resulted in reward was switched unpredictably, usually causing an error on the next choice. The choices made by each monkey immediately after such errors, or errors that were random, showed that they used both their own errors and their partner’s to guide their subsequent choices. While the monkeys performed this task, the researchers recorded activity of single neurons in their brains.
In this way they were able to determine which behavioural aspect was most closely associated with each neuron’s activity, explains Isoda. “We found that many neurons in the medial frontal cortex were not activated when the monkey made an error itself, but they became active when their partner made an error.” This brain activity shows that it is the MFC which processes observations of another’s error, and the corresponding behavior shows that observing and processing such errors guides subsequent actions.
“Such error identification and subsequent error correction are of crucial importance for developing and maintaining successful social communities,” says Isoda. “Humans are tuned into other people’s mistakes not only for competitive success, but also for cooperative group living. If non-invasive techniques become available in humans, then we should be able to identify medial frontal neurons that behave similarly.”
Having identified the MFC as being involved, Isoda now wants to delve deeper into the process. “The next steps will be to clarify whether the inactivation of medial frontal cortex neurons reduces the ability to identify others’ errors, and to determine whether other brain regions are also involved in the processing of others’ errors.”

My mistake or yours? How the brain decides

Humans and other animals learn by making mistakes. They can also learn from observing the mistakes of others. The brain processes self-generated errors in a region called the medial frontal cortex (MFC) but little is known about how it processes the observed errors of others. A Japanese research team led by Masaki Isoda and Atsushi Iriki of the RIKEN Brain Science Institute has now demonstrated that the MFC is also involved in processing observed errors.

The team studied the brains of monkeys while the animals performed the same task. Two monkeys sat opposite each other and took turns to choose between a yellow and green button, one of which resulted in a liquid reward for both. Each monkey’s turn consisted of two choices.

After blocks of between 5 and 17 choices, the button that resulted in reward was switched unpredictably, usually causing an error on the next choice. The choices made by each monkey immediately after such errors, or errors that were random, showed that they used both their own errors and their partner’s to guide their subsequent choices. While the monkeys performed this task, the researchers recorded activity of single neurons in their brains.

In this way they were able to determine which behavioural aspect was most closely associated with each neuron’s activity, explains Isoda. “We found that many neurons in the medial frontal cortex were not activated when the monkey made an error itself, but they became active when their partner made an error.” This brain activity shows that it is the MFC which processes observations of another’s error, and the corresponding behavior shows that observing and processing such errors guides subsequent actions.

“Such error identification and subsequent error correction are of crucial importance for developing and maintaining successful social communities,” says Isoda. “Humans are tuned into other people’s mistakes not only for competitive success, but also for cooperative group living. If non-invasive techniques become available in humans, then we should be able to identify medial frontal neurons that behave similarly.”

Having identified the MFC as being involved, Isoda now wants to delve deeper into the process. “The next steps will be to clarify whether the inactivation of medial frontal cortex neurons reduces the ability to identify others’ errors, and to determine whether other brain regions are also involved in the processing of others’ errors.”

Filed under brain brain activity neuron error correction primates frontal cortex neuroscience science

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Banded mongooses structure monosyllabic sounds in a similar way to humans
Animals are more eloquent than previously assumed. Even the monosyllabic call of the banded mongoose is structured and thus comparable with the vowel and consonant system of human speech. Behavioral biologists from the University of Zurich have thus become the first to demonstrate that animals communicate with even smaller sound units than syllables.
When humans speak, they structure individual syllables with the aid of vowels and consonants. Due to their anatomy, animals can only produce a limited number of distinguishable sounds and calls. Complex animal sound expressions such as whale and bird songs are formed because smaller sound units – so-called “syllables” or “phonocodes” – are repeatedly combined into new arrangements. However, it was previously assumed that monosyllabic sound expressions such as contact or alarm calls do not have any combinational structures. Behavioral biologist Marta Manser and her doctoral student David Jansen from the University of Zurich have now proved that the monosyllabic calls of banded mongooses are structured and contain different information. They thus demonstrate for the first time that animals also have a sound expression structure that bears a certain similarity to the vowel and consonant system of human speech.
David A.W.A.M. Jansen, Michael A. Cant, and Marta B. Manser. Segmental concatenation of individual signatures and context cues in banded mongoose (Mungos mungo) close calls. BMC Biology

Banded mongooses structure monosyllabic sounds in a similar way to humans

Animals are more eloquent than previously assumed. Even the monosyllabic call of the banded mongoose is structured and thus comparable with the vowel and consonant system of human speech. Behavioral biologists from the University of Zurich have thus become the first to demonstrate that animals communicate with even smaller sound units than syllables.

When humans speak, they structure individual syllables with the aid of vowels and consonants. Due to their anatomy, animals can only produce a limited number of distinguishable sounds and calls. Complex animal sound expressions such as whale and bird songs are formed because smaller sound units – so-called “syllables” or “phonocodes” – are repeatedly combined into new arrangements. However, it was previously assumed that monosyllabic sound expressions such as contact or alarm calls do not have any combinational structures. Behavioral biologist Marta Manser and her doctoral student David Jansen from the University of Zurich have now proved that the monosyllabic calls of banded mongooses are structured and contain different information. They thus demonstrate for the first time that animals also have a sound expression structure that bears a certain similarity to the vowel and consonant system of human speech.

David A.W.A.M. Jansen, Michael A. Cant, and Marta B. Manser. Segmental concatenation of individual signatures and context cues in banded mongoose (Mungos mungo) close calls. BMC Biology

Filed under banded mongoose language speech animal communication science

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Epigenetic processes orchestrate neuronal migration

Neurobiologists at the Friedrich Miescher Institute for Biomedical Research (FMI) are the first to show that directional migration of neurons during brain development is controlled through epigenetic processes. In an elaborate study bridging epigenetics and neurobiology, the scientists found that the migratory pattern is orchestrated through epigenetic regulation of genes within neurons and spatial signals in the environment. Their study has been published in Science.

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As the foundation for our mind is laid, 100 billion cells are formed and appropriately connected in the brain. Despite the huge number of cells, no aspect of this process is left entirely to chance. Neurons divide, take on defined identities, migrate to the correct nodes in the network and send out their connecting axons along predefined paths to make contact with specific target neurons. The blueprint for these arrangements is encoded in the genome. However, how coordinated transcription of genes is finely tuned to achieve the precision of these processes is not yet clear.

A study by the research group of Filippo Rijli, group leader at the FMI and Professor of Neurobiology at the University of Basel, shows now for the first time that long-distance neuronal migration in the developing brain is regulated through transcriptional programs that are epigenetically controlled.

In their study published in Science, the neurobiologists have looked at a part of the brain called the brain stem and, in particular, at the neuronal ensembles forming the so-called precerebellar pontine nuclei. These nuclei are particularly important for the relay of information from the sensory and motor cortex to the cerebellum. During development, neurons, which will gather to form the pontine nuclei, migrate a long way from a distant progenitor compartment to their final positions, where they form connections that are vital for coordinated movement. The migratory path of these cells is defined by the relative position of the neuron in the progenitor compartment and is controlled by its specific combinatorial expression of Hox genes. Hox genes encode transcription factors and play an important role in many developmental processes that rely on a body plan and confer cellular identity.

It has been known that neurons in the precerebellar pontine nuclei start to migrate in the wrong direction as soon as their Hox identity has been disrupted. The Rijli team has now shown that epigenetic processes control the maintenance of appropriate Hox expression during migration. The key player in this scenario is a major contributor to mammalian epigenetic control, the histone methyl-transferase Ezh2. Ezh2 methylates histones and silences specific stretches of DNA, thus maintaining certain Hox genes repressed, while allowing expression of others.

Ezh2 also regulates the appropriate response to environmental clues that direct neuronal migration. The cells in the brain stem bathe in a sea of attractants and repellants. They respond to these stimuli depending on their identity and adapt their migratory paths. Rijli and colleagues found that Ezh2 controls transcription of both environmental Netrin, a neuronal attractant molecule and of its repellant receptor Unc5b in migrating neurons, such that the appropriate balance between attraction and repulsion is maintained throughout migration to keep neurons on track.

“Being able to link epigenetic regulation with a complex process such as long-distance directional neuronal migration during brain development is extremely exciting,” comments Rijli. “All the more we were delighted to see that the migratory pattern is not only epigenetically maintained through an intrinsic program established in the progenitor, but is also coordinated with an Ezh2-dependent silencing program that regulates the spatial distribution of extrinsic signals in the migratory environment. The knowledge gained from our studies contributes as well to our understanding of certain neurological syndromes that are caused by faulty neuronal migration and are currently incurable.”

(Source: fmi.ch)

Filed under epigenetics brain development neuronal migration neuron genome neuroscience science

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ucsdhealthsciences:


Confocal micrograph of a primary human fibroblast cell grown in culture stained blue for actin, a highly abundant protein that makes up the cytoskeleton of cells. Energy-producing mitochondria are shown in green. Image courtesy of Matthew Daniels, University of Oxford and Wellcome Images.
Regulating Single Protein Prompts Fibroblasts to Become Neurons Repression of a single protein in ordinary fibroblasts is sufficient to directly convert the cells – abundantly found in connective tissues – into functional neurons. The findings, which could have far-reaching implications for the development of new treatments for neurodegenerative diseases like Huntington’s, Parkinson’s and Alzheimer’s, will be published online in advance of the January 17 issue of the journal Cell. In recent years, scientists have dramatically advanced the ability to induce pluripotent stem cells to become almost any type of cell, a major step in many diverse therapeutic efforts.  The new study focuses upon the surprising and singular role of PTB, an RNA-binding protein long known for its role in the regulation of alternative RNA splicing. In in vitro experiments, scientists at University of California, San Diego School of Medicine and Wuhan University in China describe the protein’s notable regulatory role in a feedback loop that also involves microRNA – a class of small molecules that modulate the expression of up to 60 percent of genes in humans. Approximately 800 miRNAs have been identified and characterized to various degrees.One of these miRNAs, known as miR-124, specifically modulates levels of PTB during brain development. The researchers found that when diverse cell types were depleted of PTB, they became neuronal-like cells or even functional neurons – an unexpected effect. The protein, they determined, functions in a complicated loop that involves a group of transcription factors dubbed REST that silences the expression of neuronal genes in non-neuronal cells. According to principal investigator Xiang-Dong Fu, PhD, professor of cellular and molecular medicine at UC San Diego, it’s not known which neuronal signal or signals turn on the loop, which in principle can happen at any point in the circle. But the ability to artificially manipulate PTB levels in cells, inducing them to become neurons, offers tantalizing possibilities for scientists seeking new treatments for an array of neurodegenerative diseases. It is estimated that over a lifetime, one in four Americans will suffer from a neurodegenerative disease, from Alzheimer’s and Parkinson’s to multiple sclerosis and amyotrophic lateral sclerosis (Lou Gehrig’s disease).“All of these diseases are currently incurable. Existing therapies focus on simply trying to preserve neurons or slow the rate of degeneration,” said Fu. “People are working with the idea of replacing lost neurons using embryonic stem cells, but there are a lot of challenges, including issues like the use of foreign DNA and the fact that it’s a very complex process with low efficiency.”
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Confocal micrograph of a primary human fibroblast cell grown in culture stained blue for actin, a highly abundant protein that makes up the cytoskeleton of cells. Energy-producing mitochondria are shown in green. Image courtesy of Matthew Daniels, University of Oxford and Wellcome Images.

Regulating Single Protein Prompts Fibroblasts to Become Neurons

Repression of a single protein in ordinary fibroblasts is sufficient to directly convert the cells – abundantly found in connective tissues – into functional neurons. The findings, which could have far-reaching implications for the development of new treatments for neurodegenerative diseases like Huntington’s, Parkinson’s and Alzheimer’s, will be published online in advance of the January 17 issue of the journal Cell.

In recent years, scientists have dramatically advanced the ability to induce pluripotent stem cells to become almost any type of cell, a major step in many diverse therapeutic efforts.  The new study focuses upon the surprising and singular role of PTB, an RNA-binding protein long known for its role in the regulation of alternative RNA splicing.

In in vitro experiments, scientists at University of California, San Diego School of Medicine and Wuhan University in China describe the protein’s notable regulatory role in a feedback loop that also involves microRNA – a class of small molecules that modulate the expression of up to 60 percent of genes in humans. Approximately 800 miRNAs have been identified and characterized to various degrees.

One of these miRNAs, known as miR-124, specifically modulates levels of PTB during brain development. The researchers found that when diverse cell types were depleted of PTB, they became neuronal-like cells or even functional neurons – an unexpected effect. The protein, they determined, functions in a complicated loop that involves a group of transcription factors dubbed REST that silences the expression of neuronal genes in non-neuronal cells.

According to principal investigator Xiang-Dong Fu, PhD, professor of cellular and molecular medicine at UC San Diego, it’s not known which neuronal signal or signals turn on the loop, which in principle can happen at any point in the circle. But the ability to artificially manipulate PTB levels in cells, inducing them to become neurons, offers tantalizing possibilities for scientists seeking new treatments for an array of neurodegenerative diseases.

It is estimated that over a lifetime, one in four Americans will suffer from a neurodegenerative disease, from Alzheimer’s and Parkinson’s to multiple sclerosis and amyotrophic lateral sclerosis (Lou Gehrig’s disease).

“All of these diseases are currently incurable. Existing therapies focus on simply trying to preserve neurons or slow the rate of degeneration,” said Fu. “People are working with the idea of replacing lost neurons using embryonic stem cells, but there are a lot of challenges, including issues like the use of foreign DNA and the fact that it’s a very complex process with low efficiency.”

More here

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The pilot and autopilot within our mind-brain connection
Have you ever driven to work so deep in thought that you arrive safely yet can’t recall the drive itself? And if so, what part of “you” was detecting cars and pedestrians, making appropriate stops and turns? Although when you get to work you can’t remember the driving experience, you are likely to have exquisite memory about having planned your day.
How does one understand this common experience? This is the question posed by Professor of Biology, John Lisman and his former undergraduate student, Eliezer J. Sternberg, now in medical school, in a recent paper in the Journal of Cognitive Neuroscience. Lisman explains that once a task such as driving has become a habit, you can perform another task at the same time, such as planning your day. But looking closer at these two behaviors, driving and planning, one can see interesting differences. The Habit system that is driving you to work is non-flexible: if the new parking regulations at work require you to go left instead or right, the likelihood that you’ll go right is very high. On the other hand, if you heard yesterday that your boss has scheduled a group meeting for noon, the likehood that you’ll plan your day accordingly is high. In other words, your non-habit system is flexible.
What interests Lisman and Sternberg is the relationship of the habit/non-habit systems to concepts of conscious vs unconscious. These concepts were popularized by Freud, who posited a duality of the human mind. Behavior can be influenced by both the conscious system and unconscious system. Freud compared the mind to an iceberg——with the small conscious system above water and the larger unconscious system below. Modern cognitive neuroscience now accepts this duality.
The mind can be described as having an unconscious and conscious part. And the brain can be described as having both habit and non-habit systems. Lisman and Sternberg argue that these two views can be merged: there is a habit system of which we are unconscious and a non-habit system of which we are conscious.
This simple equation turns out to have enormous implications for research on the mind-brain connection. Experiments on consciousness are done in humans because you can ask them to report their awareness, something you can’t do with animals. On the other hand, there are many invasive procedures for studying what’s happening in the brain of animals. So how can you study consciousness in rats?
Lisman and Sternberg provide a simple answer — ask whether rats have habit and non-habits. Scientific literature demonstrates that rats indeed have both habits and non-habits. For instance, when a rat comes to a choice point on a maze (and the reward site is to left), rats display very different behavior depending on how much experience they’ve had with that maze. With relatively little experience, rats pause at the choice point and look both ways before making a decision; in contrast, a highly experienced rats zooms left without stopping. Experiments have shown that different parts of the brain are involved in these two phases. Lisman and Sternberg make two conclusions: first, that rats, like us, have conscious and unconscious parts of the brain and second, that from experiments on rats we can learn to identify the parts of the brain that mediate conscious vs unconscious processes.
In their paper, Lisman and Sternberg also discuss potential objections to their hypothesis, and suggest further tests.
(Photo: GETTY)

The pilot and autopilot within our mind-brain connection

Have you ever driven to work so deep in thought that you arrive safely yet can’t recall the drive itself? And if so, what part of “you” was detecting cars and pedestrians, making appropriate stops and turns? Although when you get to work you can’t remember the driving experience, you are likely to have exquisite memory about having planned your day.

How does one understand this common experience? This is the question posed by Professor of Biology, John Lisman and his former undergraduate student, Eliezer J. Sternberg, now in medical school, in a recent paper in the Journal of Cognitive Neuroscience. Lisman explains that once a task such as driving has become a habit, you can perform another task at the same time, such as planning your day. But looking closer at these two behaviors, driving and planning, one can see interesting differences. The Habit system that is driving you to work is non-flexible: if the new parking regulations at work require you to go left instead or right, the likelihood that you’ll go right is very high. On the other hand, if you heard yesterday that your boss has scheduled a group meeting for noon, the likehood that you’ll plan your day accordingly is high. In other words, your non-habit system is flexible.

What interests Lisman and Sternberg is the relationship of the habit/non-habit systems to concepts of conscious vs unconscious. These concepts were popularized by Freud, who posited a duality of the human mind. Behavior can be influenced by both the conscious system and unconscious system. Freud compared the mind to an iceberg——with the small conscious system above water and the larger unconscious system below. Modern cognitive neuroscience now accepts this duality.

The mind can be described as having an unconscious and conscious part. And the brain can be described as having both habit and non-habit systems. Lisman and Sternberg argue that these two views can be merged: there is a habit system of which we are unconscious and a non-habit system of which we are conscious.

This simple equation turns out to have enormous implications for research on the mind-brain connection. Experiments on consciousness are done in humans because you can ask them to report their awareness, something you can’t do with animals. On the other hand, there are many invasive procedures for studying what’s happening in the brain of animals. So how can you study consciousness in rats?

Lisman and Sternberg provide a simple answer — ask whether rats have habit and non-habits. Scientific literature demonstrates that rats indeed have both habits and non-habits. For instance, when a rat comes to a choice point on a maze (and the reward site is to left), rats display very different behavior depending on how much experience they’ve had with that maze. With relatively little experience, rats pause at the choice point and look both ways before making a decision; in contrast, a highly experienced rats zooms left without stopping. Experiments have shown that different parts of the brain are involved in these two phases. Lisman and Sternberg make two conclusions: first, that rats, like us, have conscious and unconscious parts of the brain and second, that from experiments on rats we can learn to identify the parts of the brain that mediate conscious vs unconscious processes.

In their paper, Lisman and Sternberg also discuss potential objections to their hypothesis, and suggest further tests.

(Photo: GETTY)

Filed under habit system conscious system unconscious system brain memory experience neuroscience science

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Depressed Stroke Survivors May Face Triple the Risk of Death

People who are depressed after a stroke may have a tripled risk of dying early and four times the risk of death from stroke than people who have not experienced a stroke or depression, according to a study released today that will be presented at the American Academy of Neurology’s 65th Annual Meeting in San Diego, March 16 to 23, 2013. “Up to one in three people who have a stroke develop depression,” said study author Amytis Towfighi, MD, with the Keck School of Medicine of the University of Southern California and Rancho Los Amigos National Rehabilitation Center in Los Angeles, and a member of the American Academy of Neurology. “This is something family members can help watch for that could potentially save their loved one.”

Towfighi noted that similar associations have been found regarding depression and heart attack, but less is known about the association between stroke, depression and death.

The research included 10,550 people between the ages of 25 and 74 followed for 21 years. Of those, 73 had a stroke but did not develop depression, 48 had stroke and depression, 8,138 did not have a stroke or depression and 2,291 did not have a stroke but had depression.

After considering factors such as age, gender, race, education, income level and marital status, the risk of dying from any cause was three times higher in individuals who had stroke and depression compared to those who had not had a stroke and were not depressed. The risk of dying from stroke was four times higher among those who had a stroke and were depressed compared to people who had not had a stroke and were not depressed.

“Our research highlights the importance of screening for and treating depression in people who have experienced a stroke,” said Towfighi. “Given how common depression is after stroke, and the potential consequences of having depression, looking for signs and symptoms and addressing them may be key.”

Filed under stroke depression American Academy of Neurology neuroscience science

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Are Crows Mind Readers … Or Just Stressed Out?
Are crows mind readers? Recent studies have suggested that the birds hide food because they think others will steal it — a complex intuition that has been seen in only a select few creatures. Some critics have suggested that the birds might simply be stressed out, but new research reveals that crows may be gifted after all.
Cracks first began forming in the crow mind-reading hypothesis last year. One member of a research team from the University of Groningen in the Netherlands spent 7 months in bird cognition expert Nicola Clayton’s University of Cambridge lab in the United Kingdom studying Western scrub jays, a member of the crow family that is often used for these studies. The Groningen team then developed a computer model in which "virtual jays" cached food under various conditions. In PLOS ONE, they argued that the model showed the jays’ might be moving their food—or recaching it—not because they were reading the minds of their competitors, but simply because of the stress of having another bird present (especially a more dominant one) and of losing food to thieves. The result contradicted previous work by Clayton’s group suggesting that crows might have a humanlike awareness of other creatures’ mental states—a cognitive ability known as theory of mind that has been claimed in dogs, chimps, and even rats.
In the new study, Clayton and her Cambridge graduate student James Thom decided to test the stress hypothesis. First, they replicated earlier work on scrub jays by letting the birds hide peanuts in trays of ground corn cobs—either unobserved or with another bird watching—and later giving them a chance to rebury them. As in previous studies, the jays recached a much higher proportion of the peanuts if another bird could see them: nearly twice as much as in private, the team reports online today in PLOS ONE.

Are Crows Mind Readers … Or Just Stressed Out?

Are crows mind readers? Recent studies have suggested that the birds hide food because they think others will steal it — a complex intuition that has been seen in only a select few creatures. Some critics have suggested that the birds might simply be stressed out, but new research reveals that crows may be gifted after all.

Cracks first began forming in the crow mind-reading hypothesis last year. One member of a research team from the University of Groningen in the Netherlands spent 7 months in bird cognition expert Nicola Clayton’s University of Cambridge lab in the United Kingdom studying Western scrub jays, a member of the crow family that is often used for these studies. The Groningen team then developed a computer model in which "virtual jays" cached food under various conditions. In PLOS ONE, they argued that the model showed the jays’ might be moving their food—or recaching it—not because they were reading the minds of their competitors, but simply because of the stress of having another bird present (especially a more dominant one) and of losing food to thieves. The result contradicted previous work by Clayton’s group suggesting that crows might have a humanlike awareness of other creatures’ mental states—a cognitive ability known as theory of mind that has been claimed in dogs, chimps, and even rats.

In the new study, Clayton and her Cambridge graduate student James Thom decided to test the stress hypothesis. First, they replicated earlier work on scrub jays by letting the birds hide peanuts in trays of ground corn cobs—either unobserved or with another bird watching—and later giving them a chance to rebury them. As in previous studies, the jays recached a much higher proportion of the peanuts if another bird could see them: nearly twice as much as in private, the team reports online today in PLOS ONE.

Filed under cognition crows mind-reading hypothesis stress re-caching animal behavior science

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Neurologists Describe the Most Feared and Devastating Strokes

Among the most feared and devastating strokes are ones caused by blockages in the brain’s critical basilar artery system. When not fatal, basilar artery strokes can cause devastating deficits, including head-to-toe paralysis called “locked-in syndrome.”

However, a minority of patients can have good outcomes, especially with new MRI technologies and time-sensitive treatments. These treatments include the clot-busting drug tissue plasminogen activator (tPA), and various new-generation neurothrombectomy devices, according to a review article in MedLink Neurology by three Loyola University Medical Center neurologists.

About 85 percent of strokes are ischemic, meaning they are caused by blockages in blood vessels. (The remaining strokes are caused by bleeding in the brain.) About 4 percent of all ischemic strokes are caused by blockages in the basilar artery system. The basilar artery supplies oxygen-rich blood to some of the most critical parts of the brain.

The first clinical description of a basilar artery stroke was reported in 1868, according to the MedLink article, which was written by Loyola neurologists Sarkis Morales Vidal, MD, (first author); Murray Flaster, MD, PhD; and Jose Biller, MD; and edited by Steven R. Levine, MD, of the SUNY Health Science Center.

A character in Alexandre Dumas’ novel, “The Count of Monte Cristo,” described as a “corpse with living eyes,” had what appears to be locked-in syndrome. More recently, the book and movie “The Diving Bell and the Butterfly” describe a French journalist with locked-in syndrome. The journalist was mentally intact, but able to move only his left eyelid. He composed a moving memoir by picking out one letter at a time as the alphabet was slowly recited.

The MedLink article reports that an estimated 80 percent of locked-in patients live for at least five years, and some patients have survived for more than 20 years. One survey of long-term survivors found that 86 percent reported their attention level was good, 77 percent were able to read and 66 percent could communicate with eye movements and blinking. Forty-eight percent reported their mood was good.

The review article cites a study of basilar artery stroke patients that found that a month after the stroke, one-third of patients were dead and one-third needed help for activities of daily living such as bathing, dressing and eating.

Most basilar artery strokes are caused by atherosclerosis (hardening of the arteries). The second-leading cause is clots.

Leading risk factors for basilar artery strokes are high blood pressure, diabetes, smoking, high cholesterol, coronary artery disease and peripheral vascular disease. Affected individuals tend to be over age 50. Basilar artery strokes are more common in men than in women.

Dr. Morales is an assistant professor, Dr. Flaster is an associate professor and Dr. Biller is a professor and chair in the Department of Neurology of Loyola University Chicago Stritch School of Medicine.

(Source: loyolamedicine.org)

Filed under basilar artery locked-in syndrome stroke neuroscience science

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Declining Access to Electroconvulsive Therapy: A Clinical Choice or an Economic One?

Horrific images from One Flew Over the Cuckoo’s Nest notwithstanding, modern electroconvulsive therapy (ECT) remains one of the safest and most effective antidepressant treatments, particularly for patients who do not tolerate antidepressant medications or depression symptoms that have failed to respond to antidepressant medications.

Since its introduction in the 1930s, ECT has evolved into a more refined, but more expensive and extensively regulated clinical procedure. Each treatment involves the assembly of a multidisciplinary clinical team and the use of a highly specialized device to deliver brief pulses of low dose electric currents to the brain. ECT is performed while the patient is under general anesthesia and, depending upon each individual’s response, is usually administered 2-3 times a week for 6-12 sessions.

A new study in Biological Psychiatry suggests that reductions in ECT treatment have an economic basis. From 1993 - 2009, there was a progressive decline in the number of hospitals offering ECT treatment, resulting in an approximately 43% drop in the number of psychiatric inpatients receiving ECT.

Using diagnostic and discharge codes from survey data compiled annually from US hospitals, researchers calculated the annual number of inpatient stays involving ECT and the annual number of hospitals performing the procedure.

Lead author Dr. Brady Case, from Bradley Hospital and Brown University, said, “Our findings document a clear decline in the capacity of US general hospitals - which provide the majority of inpatient mental health care in this country - to deliver an important treatment for some of their most seriously ill patients. Most Americans admitted to general hospitals for severe recurrent major depression are now being treated in facilities which do not conduct ECT.”

This is the consequence of an approximately 15 year trend in which psychiatric units appear to be discontinuing use of the procedure. The percentage of hospitals with psychiatric units which conduct ECT dropped from about 55% in 1993 to 35% in 2009, which has led to large reductions in the number of inpatients receiving ECT.

Analyses of treatment for inpatients with severe, recurrent depression indicate the changes have equally affected inpatients with indications like psychotic depression and with relative medical contraindications, suggesting declines have been clinically indiscriminate. By contrast, non-clinical patient factors like residence in a poor neighborhood and lack of private insurance have remained important predictors of whether patients’ treating hospitals conduct ECT, raising the concern of systemic barriers to ECT for the disadvantaged.

Where hospitals have continued to conduct the procedure, use has remained stable, indicating divergence in the care of patients treated in the large academic facilities most likely to conduct ECT and those treated elsewhere.

"Psychiatry has taken a step backward. The suffering and disability associated with antidepressant-resistant depression constitute a profound burden on the patient, their family, and society. ECT remains the gold standard treatment for treatment-resistant depression," commented Dr. John Krystal, Editor of Biological Psychiatry. "We must insure that patients with the greatest need for definitive treatment have access to this type of care. ECT may be one of the oldest treatments for depression, but its role in treatment has been given new life in light of a generation of research that has outlined molecular signatures of ECT’s antidepressant efficacy."

(Source: alphagalileo.org)

Filed under electroconvulsive therapy ECT depression antidepressant treatment science

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Dopamine regulates the motivation to act
The widespread belief that dopamine regulates pleasure could go down in history with the latest research results on the role of this neurotransmitter. Researchers have proved that it regulates motivation, causing individuals to initiate and persevere to obtain something either positive or negative.
The neuroscience journal Neuron publishes an article by researchers at the Universitat Jaume I of Castellón that reviews the prevailing theory on dopamine and poses a major paradigm shift with applications in diseases related to lack of motivation and mental fatigue and depression, Parkinson’s, multiple sclerosis, fibromyalgia, etc. and diseases where there is excessive motivation and persistence as in the case of addictions.
"It was believed that dopamine regulated pleasure and reward and that we release it when we obtain something that satisfies us, but in fact the latest scientific evidence shows that this neurotransmitter acts before that, it actually encourages us to act. In other words, dopamine is released in order to achieve something good or to avoid something evil", explains Mercè Correa.
Studies had shown that dopamine is released by pleasurable sensations but also by stress, pain or loss. These research results however had been skewed to only highlight the positive influence, according to Correa. The new article is a review of the paradigm based on the data from several investigations, including those conducted over the past two decades by the Castellón group in collaboration with the John Salamone of the University of Connecticut (USA), on the role of dopamine in the motivated behaviour in animals.
The level of dopamine depends on individuals, so some people are more persistent than others to achieve a goal. “Dopamine leads to maintain the level of activity to achieve what is intended. This in principle is positive, however, it will always depend on the stimuli that are sought: whether the goal is to be a good student or to abuse of drugs” says Correa. High levels of dopamine could also explain the behaviour of the so-called sensation seekers as they are more motivated to act.
Application for depression and addiction
To know the neurobiological parameters that make people be motivated by something is important to many areas such as work, education or health. Dopamine is now seen as a core neurotransmitter to address symptoms such as the lack of energy that occurs in diseases such as depression. “Depressed people do not feel like doing anything and that’s because of low dopamine levels,” explains Correa. Lack of energy and motivation is also related to other syndromes with mental fatigue such as Parkinson’s, multiple sclerosis or fibromyalgia, among others.
In the opposite case, dopamine may be involved in addictive behaviour problems, leading to an attitude of compulsive perseverance. In this sense, Correa indicates that dopamine antagonists which have been applied so far in addiction problems probably have not worked because of inadequate treatments based on a misunderstanding of the function of dopamine.

Dopamine regulates the motivation to act

The widespread belief that dopamine regulates pleasure could go down in history with the latest research results on the role of this neurotransmitter. Researchers have proved that it regulates motivation, causing individuals to initiate and persevere to obtain something either positive or negative.

The neuroscience journal Neuron publishes an article by researchers at the Universitat Jaume I of Castellón that reviews the prevailing theory on dopamine and poses a major paradigm shift with applications in diseases related to lack of motivation and mental fatigue and depression, Parkinson’s, multiple sclerosis, fibromyalgia, etc. and diseases where there is excessive motivation and persistence as in the case of addictions.

"It was believed that dopamine regulated pleasure and reward and that we release it when we obtain something that satisfies us, but in fact the latest scientific evidence shows that this neurotransmitter acts before that, it actually encourages us to act. In other words, dopamine is released in order to achieve something good or to avoid something evil", explains Mercè Correa.

Studies had shown that dopamine is released by pleasurable sensations but also by stress, pain or loss. These research results however had been skewed to only highlight the positive influence, according to Correa. The new article is a review of the paradigm based on the data from several investigations, including those conducted over the past two decades by the Castellón group in collaboration with the John Salamone of the University of Connecticut (USA), on the role of dopamine in the motivated behaviour in animals.

The level of dopamine depends on individuals, so some people are more persistent than others to achieve a goal. “Dopamine leads to maintain the level of activity to achieve what is intended. This in principle is positive, however, it will always depend on the stimuli that are sought: whether the goal is to be a good student or to abuse of drugs” says Correa. High levels of dopamine could also explain the behaviour of the so-called sensation seekers as they are more motivated to act.

Application for depression and addiction

To know the neurobiological parameters that make people be motivated by something is important to many areas such as work, education or health. Dopamine is now seen as a core neurotransmitter to address symptoms such as the lack of energy that occurs in diseases such as depression. “Depressed people do not feel like doing anything and that’s because of low dopamine levels,” explains Correa. Lack of energy and motivation is also related to other syndromes with mental fatigue such as Parkinson’s, multiple sclerosis or fibromyalgia, among others.

In the opposite case, dopamine may be involved in addictive behaviour problems, leading to an attitude of compulsive perseverance. In this sense, Correa indicates that dopamine antagonists which have been applied so far in addiction problems probably have not worked because of inadequate treatments based on a misunderstanding of the function of dopamine.

Filed under dopamine motivation depression addiction neurotransmitters neuroscience science

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